Mamallapuram

This weekend Codi, Becky, Joel, and I went to explore a city nearby called Mamallapuram and on the way stopped by a silk place, Kanchipuram. The culture here is quite different. I'm slowly adapting to the custom, but I have not yet mastered the skill of eating with your hands. I'll use my hands for Naan but as far as rice goes...still sticking to the utensils. So the city we visited is on the east coast of India, south of Chennai. It was definitely a tourist town. The beach was nice. We mostly spent our time visiting the different temples nearby. The drive was 3 hours and I didn't really see any traffic lights along the way. People use the horn an aweful lot and well there are toll roads just like the U.S. So I think I know why there's trash everywhere! I tried looking for a trashcan to dispose my empty bottle and I couldn't find any! Although in the morning on our way to see sunrise at the beach, I did see a guy sweep the grounds. However, he swept the trash to separate little piles along the walls.....so I guess it just accumulates. At least they try!
Last night, we attended the evening chapel service offered at the CMC hospital. It was packed! People were even standing at the doorways listening in. The sermon was about healing and as a doctor our job is not just to heal our patients but to feel and experience our patients' lives.
So far my stomach has been pretty good, no heartburns, no diarrhea.....hopefully it'll stay this way. The first week flew by and now I'm on CHAD, community health and development. This is a secondary care center for the more rural areas.

Pediatric Surgery

I saw really awesome cases today at the OR. I guess in India the pediatric surgeons do peds urology too. I was able to observe an orchipexy, hypospadia, bifid ureter, TE fistula/diverticula/stricture, TB lymphoma, and rhabdomyosarcoma at the parotids. I got to scrub into the TB lymphoma case....quite different. The gowns are cloth and you do the same thing to scurb in so not too tricky. Well and as a medical student....my job was to retract. However, I did get to feel the golf ball size lymphoma at the ileocecal junction on a 14 yr old girl. It did feel like a golf ball too, so firm! Then I peaked into a C-section, vaginal delivery, and laparoscopic exploration of the uterus for a possible cancerous polyp. They're pretty advanced here in India. They have the tools - fluoroscopy, CT scan, MRI, laparoscopy, X-rays, ventilators, and more. Wow and for vaginal deliveries of course no anesthesia used! Their scrubs are cute too. Long shirts that go down to the knees and huge wide legged pants.

Pimping

I guess pimping isn't much different compared to how we get pimped in the U.S. I felt so bad watching the attending make the student try to answer tricky/impossible/read-my-mind type of questions. Thank goodness I'm done with that...for now that is. Once again I witnessed another procedure without the use of lidocaine! The resident did an LP on a 14 yr old boy with possible manic posturing and they wanted to rule out organic causes. I think the boy was poked 7 times with no localization. Ouch! The idea of possible malingering was definitely ruled out. The patient didn't even flinch or cry with pain. There were tears streaming down his cheeks...brave one. I really feel for these children. They really do go through quite a lot.

On a brighter note, tonight all the UTHSCSA students in India are meeting up for the first time for dinner at the roof top of a hotel.

Peds Wards

Oh wow and ouch are the two words that came into my mind as I stepped into the pediatrics wards. It's so different from our hospital back in the states. The beds are rusty with green sheets and there's some privacy with a curtain. The nurses are all so cute and dressed in white saris with a plastic nurse's type cap on. Very cute. I'm going to have to get a picture of them. The procedure room....let's just say that would never fly by JACHO! They do sterilize the equipments used but everything is cloth and is laid out in the room with the windows open. Today there was a little girl with pleural effusion. First, the resident did a thoracentesis and found empyema and then decided a chest tube was necessary. The way they went about doing these procedures was quite a surprise. First, they do not use anesthesia and will only use localization to numb the skin on a child! The little girl was in so much pain and her eyes were wide-eyed the entire 15 mins with screams in between. Pushing the hemostat with the tube for the chest tube placement into the chest wall while the child was fully awake and had only some localization was quite painful to watch. I can't imagine what can be as painful as feeling a scapel cut into your chest wall and then a metal type probe with a plastic tubing shoved into your chest. OUCH! But brave girl she did it and all that nasty pus is nicely draining out. Oh and the chest tube water/air set up...completely like the original set up back when it was first invented! Very neat!

First day in Peds

So today was my first official day at CMC, Christian Medical College in Vellore. I signed up for pediatrics since I plan on doing this as my future occupation and I wanted to see how different or similar it would be to the way I have been used to practicing/observing in the U.S. To start off, each doctor will see around 60-70 patients a day! There did not seem to be much security around the hospital. The peds wards were locked but the clinic was a "mad house." Those are the exact words my attending used the entire day while I followed him. The etiquette is also quite different. To my surprise, I did see quite a few patients come in with their fathers instead of their mothers. If the dad was not present then the grandmother and mom would be present. The children were cute, as always! Today I saw parvovirus/rubella, status elipticus, gastroenteritis, failure to thrive babies, hypertonic babies, dystonia, and many viral syndromes.
Patients would just wander into the doctors offices and there did not seem to be much organization going on. The physicians would use the PA system to call patients into their rooms and each rooms held two doctors seeing patients at the same time. One bed was used between the two doctors and the sheet on the bed remained the same the entire day. Hands were seldomly washed between patients and equipments were also shared freely between the children....

Arrival to India

It was about a 17 hour flight broken into two to arrive into Chennai, India. The flights were okay, but once we landed into India....things at first seemed so surreal. Am I actually here?! All the way across the world, a 12 hour difference between where I am now and where I was once standing only 24 hours ago....

The hotel by the airport was pretty decent...at least there was running hot water. :) The ride to Vellore...well that's a different story. Codi, my traveling buddy, and I took a taxi ride from Chennai to Vellore. A taxi with A/C because well we heard about not having A/C and having dust blown in your face for 3 hours. Plus it was only $7 dollars more. So, I've concluded that there are no rules when it comes to driving here in India! I'm so greatful to be alive right now. It was almost as if we were playing chicken! Who would steer their car out of the way first....didn't matter the size cuz we would be heading straight towards a huge truck with logs loaded as its cargo or straight into a guy on his moped. It was fun and thrilling, I guess.

After finally arriving into Vellore safe and sound after having to stop every 5 mins to ask for directions, we successfully arrived at a hotel with some rooms available! I was so afraid we would be homeless because the two hotels that were recommended to us were booked until next week.