sorry everybody

Thanks for telling me about my comment issue, Irene!

For some reason my settings were for registered users only - oops!

This issue has now been resolved, so comment to your heart's content!

Also, Irene - I didn't get any of your emails - I wonder if you are sending them to my old Seattle U address?? Thanks for the population info! I also read that it's worse in Punjab where the ratio is 650/1000 in some areas - brides are bought and brought in from other areas.

Checked into a 5-star hotel today and I'm feeling really culture shocked about it - and I feel guilty and ashamed to be priviledged enough to stay there - the money it costs each night would go a long way here. I read that the average unskilled worker in Bombay makes only 80 rupees per day - that's less than 2 dollars!

I'm showing the new student around today - he's super cool and nice - from the Bay Area - Filippino descent. We drank some beer and rum with our caretakers and played some games and walked around and danced to music and had a generally festive night last night - sort of like my going-away party from the guesthouse. It was hard to leave today because I got really attached to the cook and the caretakers after living with them for 30 days...They are like my Indian family now. If they saw the hotel I'm in now, they would freak out, especially about all the money I'm spending to stay there. We're just there for 2 nights, so I'll consider this the splurge of the trip and rough it for the next two weeks...

The bed at the guesthouse was like sleeping on a board, so I haven't had a good night's rest in a month - I'm curious to see how well I sleep tonight in the cloud-like bed! I weighed myself in my room and I lost 6 pounds! I got really sick of the cooking at the guesthouse, so I ate very lightly. My last meal there today was hard to choke down - I ate a small amount really slowly. Asha, the cook, said she wants to come to America with me and be my cook there - ha ha - she would have to take some cooking classes first...

Josh is due to arrive in about 6 hours now! It will be so weird to see him after so long apart! Going home is going to be really weird too I'm sure. The return-to-the-US culture shock is always harder for me than the foreign-country culture shock.

Well, I guess that's all for now - thank you for reading and comments should be fixed now - anyone can comment - sorry about that mix-up!

namaste

comments

contrary to popular belief, anyone can post a comment - you don't need to sign on to blogger or become a blogger member or register with blogger - just choose "other" or "anonymous" and you can type in your name so I know who you are - so, please leave me a comment! :)

transition period

Today is my first day without clinic and I'm feeling rather directionless today. Last night, the four remaining students all went out for a nice Indian dinner - the food was phenomenally amazing! And cheap - only about 5-6 dollars per dish. The atmosphere was really nice and ever single thing I tasted was the BEST I had ever had, even down to the rice pudding dessert. I wish this restaurant could be teleported to Seattle, so I could eat there all the time. Seattle doesn't even know Inidan food like this...sigh. I am taking Josh there when he gets here and I want to order some of the same things I already had - yum.

After dinner, we went to this gorgeous place called Seijo and the Soul Dish - the interior looked like a beautiful Japanese garden - really classy place. We sat in the restaurant and each had a cocktail. In the attached bar, they were having an independent short film festival and a lot of artsy people were gathered there watching - it was really cool to see some artsy fartsy types here in India. Then we went to Zenzi and had some bottled water, but the bartender fell hopelessly in love with my roommate, so he gave us all free drinks. There was a live band there from New York - the members were all originally from India, but had almost perfect American accents. They were decent, but wouldn't impress many Seattlites - too generic. Then a DJ played Jungle and we danced for a little while which was really fun.

Now, there's just me and 2 other students left and they are both leaving tonight around 9 or 10pm, then I'll be alone at the guesthouse, unless a new student shows up for next month's programs, until Sunday afternoon when I relocate to a hotel.

I had a suit tailored for my medical school interviews - it's made from the finest lamb's wool from Scotland - it is herrringbone tweed and mostly grey with some blue hints in the weave. I had two dress shirts made as well - a white one and a light blue one. I had the fitting done 2 days ago and the suit will be ready to pick up on Monday - it's so nice. The whole thing cost $275 - the biggest expense was the lamb's wool. In Seattle, for the same suit, I would pay closer to $1000.

Um, what else is of interest?
cultural differences maybe...

Let's see - in India, male-to-male affection is commonplace - men hold hands while walking together or walk with their arms around each other's shoulders. Men dance together. The 2 men looking after us sleep on a tiny sofa together a lot of the time and they spoon sometimes - entirely nonsexual - just affection. Men massage each other's shoulders, etc etc etc. But men and women do not touch each other. Men don't touch women and women don't touch men. I have only witnessed upper class young couples holding hands in public.

Burping is not considered rude, in fact it is a non-event - burps come when they come and no one takes notice - life goes on as if nothing happened - perhaps it is accepted here as the natural occurence that it is.

Um...

As you would guess, since there are over a billion people here, it is crowded, so it is normal and necessary to push and shove your way onto public transit, etc. People scatter onto the train like rats intent on finding a seat if possible. And it is commonplace to have a few people cut in line, but you can call them out on it and you have a 50/50 chance they will go to the back of the line. Sometimes when you're standing in line, the person or people behind you will press their body into you as if that will make their turn come faster or to insure they aren't overlooked. People and cars and bikes and dogs and autorickshaws and cows and elephants and many other things all move together in the streets in a chaotic, yet highly efficient manner. To cross the road, you take it one lane at a time, so while waiting, you have a car zooming behind you while one flies by in front of you. It takes a lot of awareness to be a pedestrian here. People are good at it and drivers are good at not hitting people.

What else?

People tend to marry earlier - by the time they are 25 or so. Marriages are arranged about 50% of the time amongst almost all religions here (as far as I know) - if the marriage is not arranged, it is called a "love marriage." A young man who had lived in the US for 2 years asked me if my parents had a love marriage - ha ha ha - I said "yes" and he said, "wow, that's really cool man."

And there's the caste system, which is basically a very well-defined "class" system. In Panvel, while eating lunch with 2 young Indian women, they asked if I was in the Brahman caste since I am a vegetarian. I said "no" - it's a personal choice. They said, "well, what caste are you in?" I told them that America doesn't have a caste system, but my family is lower to middle income.

We were invited to dinner at the program director's house and our caretaker came with us. I had assumed he would have dinner with us, but he ate in the kitchen with the servant standing up. His personality totally changed there - he was very quiet and subservient. At one point, he was tired of standing, so he sighed and sunk down into a chair, the host walked in at that moment and looked at him like he had lost his mind and had him get up. He leaned against the wall until we left. The surprising thing to me is both the host and our caretaker are muslim, so I thought they had nothing to do with the caste system - so it's more like a class system I guess. It's more complex than I may ever understand. I felt really bad for our caretaker and felt guilty being able to be a guest while he was treated in that manner. However, I don't think he minds it that much, it's normal here. He treats the woman who sweeps and mops our floor that way and he really respects the wealthy and hopes to be wealthy himself someday.

Being late is normal here - up to an hour is fine. Up to 30 minutes or so goes unnoticed. Traffic is horrible here and people aren't especially rushed here (unless they're behind the wheel) like they are in the States.

A woman is blamed and shamed for giving birth to a female - sons are highly valued, but daughters are a burden due to the dowry you must pay to give her away to another family with marriage. Sonography and abortion is abused here for female feticide.

more cultural differences - hmm... there are so many, but nothing else is sticking out in my mind at the moment

We went to a movie called Golmaal a few weeks ago at an old movie theater - it was packed - our seats were assigned. During the movie, a fist fight broke out in front. The guys were making these really strange noises to intimidate each other that I've never heard before. The movie was really funny and well-made - the plot was easy to follow without understanding Hindi. I liked the movie so much, I bought it on DVD with English subtitles and watched it at the guesthouse. The song is really popular here now too. All of the music in intertwined with movies - the actors lip sinc to the songs from their movies on music videos and they are all sex idols. The peple actually singing are often unattractive and kept behind the scenes. There's one guy though that sings his own songs and I bought 2 of his CDs - I'm forgetting his name right now.

I'm looking forward to Josh's arrival - I have a busy 2 weeks planned loosely -- Aurangabad, Rajastan, Punjab, Daramsala, Delhi and Agra.

The day before yesterday I saw a very interesting and puzzling surgery involving an oversized scrotum filled with urine(?). And I saw an appendectomy. Than patient stopped breathing after a coughing fit while they were stitching her up. That was a little scary. Surgery is a LOT different here - I do not reccomend Bombay for your next surgical procedure. I can tell you more when I see you if you're interested.

I'm going to spend the next 2 days working on secondaries since the program is finished and I'm alone until Josh gets here and I don't really have any other sight-seeing to do or any other shopping to do here.

Other interesting medical cases:
a young boy with a zipper stuck to his foreskin
lots of malaria
leprosy
fungal infections
TB
spinal TB (Pott's disease)
typhoid fever
HIV/AIDS
rectal fistulas
most Indians are anemic - hemoglobin of 10 is good here
a patient had her appendix and her gall bladder in plastic jars under her bed and we got to look at them
brain lesions caused by TB
lots of gastritis
premature babies
pediatric pnemonia with the right lung completely filled with fluid
hepatitis
calcified uretary injunction
scabies
measles
swollen groin lymphs
Hirayama disease (suspected)

surgeries:
-removal of benign cyst (the size of a gumball) from behind the ear, patient was two-years-old
-some cervical surgery involving insertion of cylindrical instruments (I couldn't figure out what was going on)
- scrotum the size of a papaya, when doctor gut through all the skin layers, a large quantity of urine (?) poured out, he then turned a testicle inside out and sutured it up that way (?)
-3 fractured femur repairs
- cleft lip and palate repair
- suturing patient post-c-section
- appendectomy

medical cultural differences:
- gloves are not worn unless blood or feces are explicitly invloved
- masks are not worn around patients with contagious respiratory diseases - considered rude to patient and thought to scare the patient
- shoes are not worn in clinic or in surgery
- eye protection is not worn in surgery
- medical care even at a private clinic is really affordable - doctors make up for their low prices be seeing an amazingly large quantity of patients for at least 12 hours a day. The slum clinic doctor saw a new patient every 3.3 minutes
- patients visit the doctor for things we would take care of on our own in the states - like cleaning a wound and putting a bandade on it, over-the-counter meds like tylenol, pepto, laxitives, pregnancy tests, etc.
- Doctors have big egos and can be very arrogant - I guess those types of doctors are in the States as well...
- hands are not washed between patients, exam tables are not sterilized, etc.

The Ganesh festival starts on Sunday - it lasts like 10 days and it's the biggest festival in Mumbai, so that should be interesting for Josh and I to see. I'll try to get pictures.

We just discovered 2 days ago that the milk we've been having in our chai everyday is not pasteurized - hmmm...we all had intestinal cramping last week for a few days (even our caretaker), so we're wondering if that's the reason why. They pulled the bag of milk out of the fridge and said, "It's fresh," then made cow-milking gestures to us. Our faces all went pale - ha ha! I guess there's like 3 diseases you can contract from unpastuerized milk...

Not much else to say now - please comment with questions if you have any and with information and opinions on this blog.

I miss everyone so much! I'll be home soon - 2 more weeks! :)

long time, no write

hello again -

sorry I haven't written anything in so long - I was going to write something after posting all of those pictures, but I had bronchitis and was too tired by that time.

We were sent to Panvel instead of Virar for the rural rotation - I had a cold the whole time I was there, but managed to make clinic every day with the help of cold medicine. We lived in a leper colony - Shantivan - in the middle of nowhere. Tons of mosquitoes, mosquito net was absolutely necessary. Toilet was not so nice. Shower consisted of cold water coming out of a faucet in the wall about waist-high and a bucket. Food wasn't so good and it was served on these giant Thali platters with huge portions and the staff got upset if ou didn't finish it all - I tried to communicate that they should give me less, but no one knew English.

Shantivan had male and female outpatient clinics - we went around to each female patient's cot, talked to them, examined their lesions and hands and feet. At one point, I sat alone with a woman in the corner who was missing all of her fingers and all of her toes and about half of her feet. She proceeded to rub her deformed hands all over my head and back and arms, while I grinned and put my arm around her despite feeling slightly uneasy. I know A LOT about leprosy now so if anyone is interested to learn more, I can fill you in when I get back. This patient would not have lost her toes and fingers if she had been compliant with her treatment - She should have taken the medication and done certain exercises and massages and worn special shoes, but instead she ignored all of that advice and worked in the field all day barefoot and came in and out of the outpatient department when the ulcers on her feet became unbearable.

Another female leprosy patient there was from the highest class and had been a very rich and important woman before her diagnosis with leprosy - her family dumped her off at the leper colony and never contacted her again. She didn't do the exercises and massages for her hands, so they are badly deformed - "claw-hand" - she can't even use them. She was very sweet and seemed a little sad and lonely. Everyone in the clinic appreciated the attention we gave them.

After the outpatient clinic, the doctor (?) took us to the old folk's homes which are on the leper colony, but have nothing to do with leprosy - they are more for community outreach. First, we had chai in the home where the residents are still independent, which was relaxing and we had some nice conversation, then we went next door where the dependents lived. There were many more of them and they were all sitting ou together for entertainment time. One of the women sang a beautiful Indian song, then us four girls stepped up to the mic and sang "Amazing Grace" - ha ha ha - they really got a kick out of it. There was one patient in the home who was not old, he was around 30 or so. He is the thinnest person I have ever seen - no fat, no muscle, just skin over bones. He laid curled up in the bed only able to move his skinny arms. He had been in a terrible accident at the age of 18. Before he was injured he was a talented artist - 2 of his pencil drawings were hung by the office - one was a portrait of Gandhi and the other was of a freedom fighter named Bharat something - both were amazingly well-done and detailed and realistic. The caregivers mentioned that this patient has limitless optimism. He was very sweet.

Shantivan is a working farm and factory which employs lepers exclusively - they raise Swiss cows for the dairy and Indian cows, grow rice and veggies, and hand-weave high-quality cotton rugs. They also have students come there for educational purposes on a regular basis. And they run a natural health clinic.

After visiting the old folk's homes, we went to prayer. The man who we're not sure whether he is a doctor or not sat at the front, legs crossed, eyes closed. We sat to the side in front. And the people who live on Shantivan sat segregated by sex. First, we listened to the news on the radio, then a few men took turns singing songs and mantras. The kids smiled at us a lot and little frogs hopped around on the floor. One of the children sang a song entirely in English for us and it was very good and cute.

The next morning was Independence Day in India, so everyone gathered in their best clothes at 7:30am around the flag pole, again seperated by sex. A few men (community leaders?) led the salute to the flag and one man led the singing of the national athem, another gave a heartfelt speech. One of the men marched back and forth in a very serious way in front of everyone and all of us students had to hold back laughter or even a smile at the risk of seriously offending everyone. You had to be there. Then a few men passed around dates and candy to everyone and that was it - Independence Day celebrations were over. It's also interesting to note that Independence Day is a "dry" day in India. And the clinics and hospitals were running as usual on this day even though the doctors seemed to take every other holiday off.

The next day was Krishna's birthday - much more racious. All the young men in each community wear orange and form human pyramids to reach something pinata-like way high up that's filled with something - milk? money? candy? Not sure really. The young men play loud music and all dance together and generally have a really fun, energetidc time together. The women stand across the street huddled together and watch or they stay home. We watched one community where the thing was on top of a really high pole and one older man climbed it alone to reach the thing. The younger guys tried a few times and failed to do the pyramid thing and we watched one boy fall from really high all the way to the ground and jump up smiling - I thought he was giong to die, but he is lucky he didn't land on his head. Turns out in the news the next day that 60 people were injured and 3 people died in the festivites, which is normal on this holiday each year.

Another holiday which a lot of doctors took off was a day when all the sisters tie a bracelet on their brothers and their brothers give them a small gift or amount of money. I can explain the history of this if you're interested in person.

So much more to write about, but getting tired of hanging out in the internet cafe now, so more tomorrow - today was my last day at the hospital, the other students leave tonight and tomorrow night, then Josh gets here Sunday night - I can't wait to see him! I've really missed him.

tata!

all of the pictures

snaps