Renu's Week

Sunday, August 19, 2018

Report of 19 Aug 2018

And I am done at Fort Wayne!  The team was lovely, the place was not.  As a colleague here said, now I will find new joy in everything - and that is the reason I was here. 

There is a visceral and spiritual exhaustion, and also a new-found appreciation for all my bosses in India.  I did make some phenomenal friends here and will be in touch with them for the rest of my life.  These are also the reasons I was here, placed here to look at the balance and decide - ultimately - that the good in my life and on earth outweighs the bad.   

A memorable patient was a slender and tiny 89 year old lady, who came with breathing difficulty.  She improved nicely with the nebulizer treatments and - for reasons incomprehensible - the treatments were then stopped.  The next day, she was sitting in bed gasping for breath, bloody near death: no one had notified me prior to that - not the nurse, the respiratory therapist, no one.  This was also mystifying and I became irate; we resumed the treatments and then began what my nurse practitioner colleague calls FBI work - trying to find the source of the error.  The errors were on multiple levels and not easily addressed.  At least 1 person doubted the fact that the patient was near death - and he had not seen her when she was gasping and scarily and agonizingly distressed.  I am very happy to be leaving.

Ultimately, all of health care is about diligence, not brilliance: listen to the patient, watch the patient, check on the patient.  Take the time to do one's job thoroughly. 

Navin's flight schedule cooperated last weekend and he came to Fort Wayne.  We went to the memorial service for Morris Taber; that was therapeutic.  The Tabers are extended family, and it was soothing to grieve together.  We were privileged to be joined at our table by the entire Mark Taber (son of Morris) family, and that was healing.  It was particularly salutary to see Ann (Morris's wife), though under unfortunate circumstances; Ann is a gracious and fine lady, and we were privileged to see her. 

Navin and I also saw "The BlackkKlansman."  It was good, and the fine Denzel's son has some acting chops of his own.  Adam Driver was, as usual, good.

Naren is in India, hanging out with his father, having some fine times on our balcony - which is, truly, a restorative place: views of the sea, and of the green, and a relaxing locale to talk to anyone, including a genial, proud and fun father. 

We are, I am reminded daily, proud of both boys.  Not boys any more, eh - young men.   

The Kerala floods have saddened me.  The destruction of the environment in the name of "development" will have consequences; Mother Nature has a way of periodically reminding us of that.  A school friend's 85 year old mother had to be rescued by total strangers who spent the night with her in her flooded home until help arrived; we are glad she is safe and are grateful for those who would take care of others, known or unknown. 

I had to go to the Immigration department in Cincinnati.  As I told my sister-in-law, I am absolutely not shaken when someone's heart stops or they develop trouble breathing, but the Immigration department - that unfailingly unnerves me.  Thankfully, everyone there was courteous, the issue was addressed professionally and all's well that ends well.  I met my in-laws for dinner after that at Panera, one of my favorite restaurants, and that was a fun-fest.  So much laughter, decompression, debriefing and joy - the in-laws are always a hoot.  A colleague had given me a gift-card for Panera, such a perfect gift, and all of it combined to make the evening fun and joyous - not words ordinarily associated with the Immigration department. 

I have spoken to my father, and all 3 Weiss men.  That was also fun and joyous - words usually associated with them.

Enjoy the good in your life.  Sometimes we have to see the bad to be reminded of what is good.

And the good for me definitely includes all of you.  Thank you, and may your goodness return to you multiplied exponentially.

Unw -

R  

Wednesday, August 08, 2018

Report of 8 Aug 2018

Hello from the Allen County public library in Fort Wayne!

To me, this is one of the joys of the U.S. - the public library system.

We are well.  Work is okay, frenziedly busy.  The team continues to be wonderful and we laugh and talk and eat, all while mostly drowning in work. 

I had an African-American patient who was diagnosed with heart disease.  She also has to have her gallbladder out, which must wait until her heart is tuned up.  Every year, the conference of the American College of Physicians is good enough to have sessions that educate us on the enormous disparity in health outcomes between patients of color and those of non-color.  I told this patient that info, and asked that she be very vocal about her symptoms.  There was an African-American man, as well, with similar issues and I told him the same thing.  He was pleasant and affable and a fine patient, as was the lady; both were appreciative and that helped caring for them easy.  The man reminded me quite a bit of my father.

Speaking of whom, I talked to him last week and that was nice.  His hearing aid does not quite accommodate the cell phone, so I have to yell.  Sometimes he hears the sentence in entirety.  I finish the conversation with "Good to talk to you, Appa," and he unfailingly and sincerely says, "It's a pleasure."

I miss my mother often.  Since one of our sons is now a performer and the other also has a full-time job, I miss what would have been her enjoyment at seeing them.  My mother was an excellent doctor, and actress and singer; she also sewed and made all her daughters' + many of her sons' clothes when we were children.

On my last week off, I was privileged to get together with Louise Hass.  Louise is a panacea for me; we met when she was the librarian at St. Vincent and she is literate, articulate, widely-travelled, funny and engaging.  I cautioned the restaurant staff that we would likely linger after our meal and they were okay with it.  Louise and I chatted, and ate, and laughed; she also brought me a box of my favorite chocolate.  It was a mighty fine, rejuvenating day.

I also saw my friend, Olivia, and that was great.  Olivia has practically outfitted me completely in hand-me-ups and provides all manner of other sustenance, also.  Her dogs are Navin's best friends, and she houses my stuff in storage; so do our other friends, Kris Rea and Gabe Soukup.  All 3 are very good people, and I am privileged to have them as friends.

Naren came to Fort Wayne on my last week off.  We had a whale of a time catching up on movies and taking walks.  Navin has had some bad luck with flights.  As Naren and I sat in a movie theater, Navin forwarded a text that the airline had cancelled his flight.  It's quite blithe of airlines to do this; they might refund the cash, but what of the missed occasion?  Navin could not make it to his cousin Aditya's graduation.  There was a time as recently as last year when airlines would try to accommodate the passenger on the next available flight.  I am not at all certain why the airline industry in the advanced United States operates so miserably.  There is also a certain skewing in the international airline industry towards the convenience and comfort of Middle Eastern, European and American travellers: international flights in these countries leave at humane hours, and in India, usually international flights take off at bizarre hours such at 1.40 AM.  Understandably irritable children, exhausted parents, stressed-out students are the order of the day for international travel from India westward.   

I toodled around Fort Wayne today and walked around part of the older downtown area.  Very pretty, except for a Catholic church that stated it was housed on a former burial ground of the Miami Indians - oh, the sacrilege.  At the airfield, there was a display of World War II aircraft and we could even climb inside the planes.  That was fabulous.  When I am out with the Weiss men climbing hills or walking in parks, I have to try to keep up with them: as I climbed inside one of the planes, it was quite joyous to be walking adroitly about as they were not made for tall people.  I used to think the not-keeping-up-with-the-family was a function of age; it is not, completely, it is also a function of height.

The Banyan is wonderful and we will celebrate its 25th anniversary on 27 August 2018.  We will celebrate at another branch on 28 August 2018; 27 August is the actual anniversary.  Friends such as Carolee Campbell, Emily McNellis, Srikrishna Vasireddy, Sangeeta Mathew, Mohan Arthur and Dr. Arjun have been breathtakingly magnanimous enough to donate money, and we will be able to provide biryani as well as new clothes for the staff + makeovers for the women.  Hooray!  It is an honor to work for the founders, who are visionary and ethical and jolly good fun.  We still need to raise Rs. 28 crores ($4 million) for a corpus from which we can draw interest for our unceasing expenses; I have asked all manner of corporate types and been unsuccessful.  Let us see.  

Well, I am going to head home and eat some watermelon.  Hope you have a good week.

Unw -

R

Monday, July 30, 2018

Report of 30 July 2018

Hoo!  Been a while since I wrote, eh.

The reason - I have been on a busy service in Fort Wayne, Indiana.  The weeks off have been spent recuperating and travelling madly until we put a halt to that a couple of weeks ago.  We drove out East to see our sons - Naren in Brooklyn, NY, and Navin in West Chester, PA - over the summer as they did not have enough time off or funds to get to us. 

What is wrong with the flipping airline industry in the U.S., I say???  Scott would sooner walk than fly here and now I see why - flights cancelled with no easy reschedule, surly service, hefty baggage charges, some sort of humiliating "Basic Economy" fare which appears to preclude airline civility, and endless nonsense.  Easier to fly in India.  While Scott's preference to drive caused some serious butt ache, I have to concur with the driving option.  We did fly to Texas and - of course - the return flight was delayed enough to miss our connection, prompting a drive through the country in a rental car in the wee hours.

So, Fort Wayne it is.  The team is fabulous - easily the best team I have ever worked with.  ("Tall praise," said Naren.)  We are fairly overworked, but no one dodges work and pull together with considerable might.  The patients are grateful, of course, and that makes all of it worthwhile.  An older patient's daughter sent me a very kind note and a picture of her mother, eating donuts and drinking milk, on her porch and I was happy to see it.  It is on my email, for me to look at it and revel in the nice joy that it brings.

We caught up with the boys and that was joyous.  So much candor and laughter and eating and fun.  We did not travel together as much as I had hoped to since both young men are now working, but did see the boyos and that was enough.  We went to San Antonio for a couple of days; that revved up everyone's spiritual heft.  We saw Linda and Dave Johnson, former professors who have known the boys since they were 5 and 3, and our former neighbors, Aurora and Scott Freeman and their whole family.  All of it was an unbridled joy fest and we returned recharged.  We also went to Baltimore, stayed at a nice hotel in Inner Harbor and did some touristy things there.  It was nice to generate some memories together.

We also watched sports; I live in an apartment with a TV, which we do not do in India.  Thus, Wimbledon, FIFA World Cup, other sporty things - all were watched.  Except the NBA finals - what a snooze-fest.  Warriors, Warriors.  If another team can stand up to them, I will start watching again.  That said, if the Spurs were this dominant, you know I would be glued to the tube :).

I am at our local library in Fort Wayne and this is a nice place.  Let me head on and do some reading.  It's back to work tomorrow.  The Banyan celebrates 25 years next month, it is still a beloved place regardless of where in the world I am, and I will return there - Insha Allah - next month. 

Unw -

R     

Saturday, March 31, 2018

Report of 31 March 2018

It's paratyphoid, similar to typhoid.  That's the diagnosis and I am on hefty antibiotics.  This is really honking me off - the fever, chills, malaise.  We went off to Kovalam this morning after I spent a night shivering and being completely unable to get warm enough; it was my young assistant Keerthana's day off, but she sweetly came and started iv fluids on me.  I haven't had them in recent memory, we squirted some IV Acetaminophen/Paracetamol in the fluid and it was a wonder drug.  Several people at Kovalam filtered in to see me and see how I was: I found that very, very kind.  After the IV fluid was finished, Keerthana graciously brought me breakfast - pongal, a rice dish with dhal and some pepper,  It is a safe food and I was relieved to get my appetite back.  I do not at all enjoy being too sick to eat.

Scott and I headed off and ran some errands today.  He is a tad unwell himself, with a booming cough.  We stopped by the Ayurveda store and the gentleman there prescribed 2 powders, to be mixed with honey, for the cough; the result has been almost instantaneous.  Truly, there are so many great systems of medicine in our land, which do the job when allopathy does not. 

We were in Madurai earlier this week.  I leave next week for the U.S. and we wanted to see my Dad before that.  It was a fun trip; we stayed put, ate and drank and were merry, and Scott gave my Dad smartphone lessons.  Scott is very much a part of this family, and rolls nicely with all matters.  I was privileged to see a dear friend, Mrs. Leila Kurien; she is of my parents' generation and we unfailingly have a chuckle when we meet.  This time, it was about Scott stopping by my private practice clinic and sending everyone there into a tizzy; they took selfies with him and - as I told Mrs. Kurien - in my 2 years there, nobody has asked to take a selfie with me.  :)  Let's hear it for the handsome Caucasian.

I did not go to the other Banyan this week; we did have our colossal clinic at Kovalam and that was good.  A young son of one of the patients came to sit with me and learn some medicine; that was fun.  I love it when young people show initiative.  Private practice is also fine.  I had to diagnose a young lady with typhoid and there was no doubt at all on the blood tests.  I had to tell her what I now practice: safe foods, no eating out, plenty of yogurt, etc. 

We Skyped with both boys today and - as I told my sister, Anu - that was panacea. 

May you have many fine times!

Unw -

R   

Sunday, March 25, 2018

Report of 25 March 2018

Hello from our balcony!

The sea is a grey haze, the sky is partly blue, our laundry is drying here, people are splooshing in the pool and the cricket game downstairs is in full swing.  The Australian cricket captain has resigned after colluding to tamper with the ball.  Strange things happen in the world of sport.  My sports authority husband told me what several players echoed, that tampering likely would not have happened without the knowledge of the captain and coach.

I diagnosed myself with pneumonia.  Scott had to position the diaphragm (listening part) of the stethoscope on my back and move it around as I took big breaths; my lungs sounded junky and I put myself on an antibiotic.  This illness is slow to leave: I am still intensely fatigued, no longer beat the alarm when waking up and cannot take the stairs as I normally do.  We took ourselves off to SMF Hospital yesterday and a senior physician examined me; she felt that this is the normal aftermath of a pneumonia and I am now taking calcium and vitamins.  On many days, the bed has been a very attractive alternative to work.

The lady we rescued last week has since tried to run away.  The psychiatrist will review her, social workers will swing into action and try to locate the family.  As this is a family blog, I must use discreet language and let you know that she pinched my backside as I walked by: as I whirled around, she let out a hearty peal of laughter.  Sigh, sigh.  I do not like being touched unwarrantedly by either gender and told her to stop.  The mentally ill and the mentally challenged likely do not fully understand what they do.

Private practice is okay.  In my unwell state, patience is nonexistent.  The other day, relatives of a patient said her husband overseas had asked why she was taking so long to recover.  In India, indirect speech is rife and this question sometimes means the doctor ain't competent.  I felt my eyes blaze and let everybody there have it; I said - not gently - that they could take the patient elsewhere, that her many years of not taking medications as prescribed should have been addressed by her and them, and that I had less-literate patients who did exactly as I told them and recovered beautifully.  One of the relatives apparently asked our front office staff for a feedback form and I told them to ensure that she got at least 10 forms; she could unleash whatever she wanted.  The patient herself appeared to be happy with the care.  I alerted my boss about this episode and he considered it routine, nothing to worry about; I laughed out loud when I read his reply.  Nice.   

We Skyped with 1 boy today, our older son, and that was so good.  He mentioned teaching a class full of elementary students of color, and that they used phrases such as "I'd like to add on to what she said."  This thrilled all of us; it is lovely when little people are on the right track.  We hope to Skype with our younger son on the morrow.

Vandana is in the U.S. getting an award (after zillions of awards, said her co-founder, Vaishnavi) and we are pleased.  The joy of working for ethical folks cannot be understated.

I spoke to my father 2 days ago and he is well.  We hope to see him soon.

Unw -

R

Tuesday, March 20, 2018

Report of 20 March 2018

Hello from our living room!

It ain't a Sunday, I can't see the sea, but had to blog.

Life is fine.  I am supposed to head to the U.S. soon and am not quite ready yet.  The Banyan and private practice have been satisfying: appreciative patients can be so heady. 

I was driving to work today - a long drive - and spotted a red mass on the road.  It seemed like a mortally wounded animal, and I noticed someone on the shoulder of the road, seeming like a gypsy.  As I neared the red mass and passed another vehicle also circumventing it, I noticed that it was a sari, and that the person on the side of the road was standing there in a blouse and "underskirt," the accoutrements for a sari.  It seemed like the lady might have been mentally ill, I got to the B and asked for the rescuing social worker to take the team and rescue this patient.  Sometimes, by the time our team gets there, the patient's location has changed, etc.  Well, this time, they found her - halleluia.  By the time I left the B, they had returned with the patient and I was completely grateful.  The lady limps, and we will slowly find out what happened.  There are also burn marks on her neck and back.  We will find out about those, as well.  She does not speak a language I recognise, but that has never stopped us. 

So, my thought was - here is a lady, who must have been part of a family once, on the road in a strange town, unsure of her next meal or even her safety, mentally ill enough to start doffing clothes, and here is the Banyan, as always, ready and willing to give her whatever she needs to start rebuilding herself.  All for free.  I tell you, it is a powerfully wonderful organisation to work for. 

Private practice is also fine.  We have some young people hospitalised and I have explained their illnesses to them, leading to good interactions.  It is a privilege to be in this profession.

Scott and I attended the wedding reception of a school classmate's son.  Lakshmi, my former classmate, did not know we were coming and it was nice to surprise her.  We had a very good time at the event and drove straight to work the next day.  I do not like going late to our clinic at the seaside village, Kovalam, as the patients start assembling at 7.30 AM.  However, we were driving from 4 hours away and left at a safe 5 AM, reaching the clinic well after 9.  Nobody had budged: all the patients were in the waiting area, squeezed onto the benches there and happy as clams, chatting away until I got there, ate breakfast and then came down to my room.  They are a grateful and happy lot, the patients, and it is very nice to treat them. 

We spoke briefly to my father last week and will speak again this week.  He is a very busy man, which is good.

Naren turned 27 last week and we got to "Hangout" with both boys.  That was tremendously good fun.  Nice chatter and humor and candor.

Hope you have a good week!

Unw -

R   

Sunday, March 11, 2018

Report of 11 March 2018

Good evening from our balcony!

The sea is blue, not crystal clear due to a haze, pretty nonetheless.  The cricket game downstairs is punctuated by conversation, and there are people splooshing about in the pool in our clubhouse next door.  This is nice - to write, and write.  Scott is sitting here reading the paper, having had his evening tea.  I consider that to be a useless meal, preferring to eat dinner at 4.30 or 5 PM, and we have done a preference switch: Indians drink tea and have a snack at 4 or 5 PM, and Americans eat dinner at that time.

I have a virus which set in about 2 days ago.  I was completely wiped out yesterday, but hauled myself to work and saw a couple of patients.  We then went on to a carnival featuring women entrepreneurs.  It was nice; we ate, mostly.  Scott had cheesecake and some baked goodies, I had some savory things and sugarcane juice, a huge favorite.  I felt my throat get better with the beverage and we then went on to our friend D. Ramesh's clinic for an ophthal evaluation. 

It is educational for doctors to fall sick: it is good to know what patients speak of.  I stayed on the sofa today and have gargled with salt water about 5 times, drunk vats of fluid and eaten fruit.  At the end of my reading the newspaper - about a 4-hour exercise - I feel better and am up.  My throat feels better with all that salt; it burned yesterday.

We spent last weekend at my sister Anu's place.  We ate - joined by our med student niece, Sanjana - talked, laughed, walked.  I have a new favorite drink - gin and tonic.  What a nice, mellow beverage.  Scott says it helps when the gin is top class and this was Bombay Sapphire.  I was forgetting words by the end of 2 small drinks, so decided to stop the enjoyment.  Anu was chairing a meeting the next morning and we stopped in to say bye.  It unfailingly gives me a kick in the pants to see a family member occupy a position of power at a meeting or talk or conference :).  Anu was leaving the next day for a Gates Foundation project meeting with the National Institutes of Health in the U.S., and I was pleased that we managed to see her before she left; gracious of her to accommodate us in spite of trans-continental travel.

The Banyan is wonderful.  Women's Day was celebrated with much fanfare and the whole place was festive and joyful and peppy.  A little event was organised on the premises, featuring the superintendent of the local prison - a lady - speaking.  She was great, all enjoyed the talk, and then prizes were given away to deserving residents.  Some residents spoke: it was eye-opening for me that the Banyan gave them hope when they perceived none, that the B has given them self-confidence and dignity and earning potential.  And treated their mental illness.  I knew all this, sort of; it was much more powerful to hear the story from the horse's mouth.  What a great place to work, how privileged I am to be part of an organisation whose very ethos involves imparting hope and joy and succor. 

Private practice is also nice.  We treat a variety of illnesses.  There has been a fair number of people attempting to harm themselves, and the Banyan's array of counselling services is an invaluable resource for such patients.

We were on "Hangout" with both boys today and that was the fun-fest it usually is.  Lots of candor, talk, laughter, love.  We are privileged to have these 2 young men in our lives.

May you have much love and laughter in your own lives.

Unw -

R