Renu's Week

Monday, August 15, 2016

Report of 15 Aug 2016

Hello!

Happy Independence Day to all - 15 August.  Every time I return to the homeland, I feel awe to be able to do that.  So many cannot.  I love living in a free country.

We are well and hope the same with you.  This was my week off and spent watching the Olympics, skewed though coverage was: they even showed the American gymnastics team *waiting* to perform.  Sheesh.  In that time, a portion of the dazzling talent produced by other countries could have been shown.  But no.

This was my week off and a lot of of errands were run, as well as movies watched.  Surprisingly, I have fallen asleep at movies on Tuesdays; I think work is so exhausting that the first day off - Tuesday - provides the first chance of relaxing.  Usually, movies are a favorite pastime and I have never fallen asleep during one, prior to this year.

We saw Navin last weekend, which was fun as always, and then travelled to Columbus, OH, to see college friends Craig, Cathy and Mike.  That was a grand time.  Yesterday, we got together with Shilpa and Ravi Mallur, and their kids, Keerthi, Surya and Akash.  That was also fabulous.  Getting together with good friends and family is panacea.

Work was good.  The portion of young people dabbling in illicit drugs is on the increase, I fear.  We had a young patient admitted with air in his chest; not his lungs, where air belongs, but the chest.  His urine drug screen (UDS) was positive for methamphetamine.  Something had happened to puncture a hole either in his esophagus or trachea and cause air to leak into his chest.  Usually, the management is "Wait and watch."  On seeing the UDS, I offered the young man some counselling by a psychiatrist; he declined, stating that the meth smoking and snorting had been "for fun."  Indeed.  Some fun, that.  My thinking these days is that if an adult patient declines an intervention that could benefit - counselling, for instance - they are certainly entitled to, and can take the consequences that come with that decline (no pun intended).

Why are the movies these days so terrible?  I am hopeful that Naren may make a good one sometime.

Unw -

R  

Thursday, August 11, 2016

Report of 11 Aug 2016

Hello from our living room and in front of the TV -

We don't have a TV in India and don't miss it; I am enjoying all the sporting action from the Olympics while we are stateside.

It would be grand, though, if there were some coverage of other countries: in prime time, we have been inundated with U.S. Gymnastics and Swimming, and I remember doing a double-take when the camera panned to a competitor from elsewhere, only then realising there were other countries competing :).

Life is fine here, work is very busy.  That is one of the characteristics of a tertiary hospital, where challenging cases come from elsewhere.  One of my patients had been in the hospital for 11 days by the time I finished my week on; he has had surgery, and we (Internal Medicine hospitalists) have helped manage his blood pressure and blood sugar.  He and his wife are very gracious and appreciative; it makes the work day that much better when patients and family are nice.

I spoke to my father yesterday and he was well.  We have made plans to meet when Scott and I return to India.  Scott, Naren and Navin are well, and busy with their own individual pursuits.  We saw Scott's mother, aunt and uncle about 2 weeks ago, and Scott's sister, Diane, came up to visit us, all of which was nice.

What is with the movie industry?  There has not been a wealth of good movies this summer and, indeed, I can only remember 2 as being good - "Warcraft," and "Hunt for the Wilderpeople."  I was surprised that Warcraft was entertaining, full of intrigue and plot twists and a good story line.  "Hunt ..." was hilarious - from New Zealand and loaded with humor.

Let me wind up.  Every day brings some joys, does it not.

Unw -

R

Saturday, July 30, 2016

Report of 30 July 2016

Hello from our balcony in Indianapolis!

I had not blogged for a while, for a few reasons - very busy service here and little time on weeks off, plus a relative who uses the blog to keep track of family members' whereabouts which I find a bit creepy.  Anyway, it is what it is and here I am writing.

The conference of the American College of Physicians was the wonderful learn-fest it always is.  I also started work at St. Vincent Hospital in Indy and it has been busy.

This past week, I finally had time to see friends Louise Hass, Patrick and Diane Healey, and Olivia Fondoble.  All 3 interactions were over tasty meals and I had a grand time reconnecting.  Good friends truly are the nice condiments in our lives.  We saw relatives earlier in the summer, and had both boys with us in May.  Today, my sister-in-law, Diane, came to visit and we went to Terre Haute to see Navin, catch a movie and eat, eat, eat.

I have seen movies ad infinitum, that is part of the joy of being here: drive up to a theater, buy a ticket, walk in and see a movie.  India is so overpopulated and movies are so popular that they sell out on most days and pre-booking is required.  It is a treat to see movies anywhere, however, and I have enjoyed it.  The movies this summer are dreadful, with the exception of "Hunt for the Wilderpeople," which was excellent.

A memorable patient this year was the 20 year old man who had smoked a Fentanyl patch with his brother and then become unresponsive.  His 18 year old brother died in this incident.  The 20 year old was admitted, and his brain MRI and echocardiogram showed some damage to his brain and heart.  He also did not know, until 3 days after he was admitted, that his brother had died.  Scott and I went to the viewing and felt completely sorry for the parents; I felt quite some anger at the young people, that an experiment of this magnitude and such catastrophic consequence had to be tried.

I have spoken on weeks off to my father and he is well.  He went for conferences in Mumbai and Chennai, and had a great time.  

Scott is well, Naren is auditioning, Navin is in summer school and I will return for my week "on" in 2 days.  Hope all of you are well.

Unw -

R

Sunday, March 20, 2016

Report of 20 March 2016

Hello.

This has been a tough couple of days.  A beloved patient at the B - a fairly young lady, Ms. X - was hospitalised, took a turn for the worse, and abruptly died.  I saw her in the ICU, wanting to visit and find out what was happening; I was lucky to be one of the few to see her alive in her last days.  SMF Hospital gave their usual excellent care, but Ms. X deteriorated quickly.  I hoped against hope that her young body would fight the low blood pressure and the trouble breathing, but it was not to be.  Ms. X was mildly developmentally delayed; I have no idea of her family, but she was as happy as a clam at the Banyan and a firm favorite of all, with her easy manner and pithy observations on life.  My favorite memory of her - other than her unceasing geniality - is of her offering her guava to the lead health care worker, when fruit is still a rare treat at the B.  I wonder repeatedly if I could have done anything differently, though I was not at all involved in her initial care: that is the Banyan, for you - all of us take responsibility for those who have nothing.  But she has died.  The leader of Adaikalam posted a beautiful tribute, with a picture of Ms. X smiling, and that has comforted me.

Death.  For the young.  What a weird concept.  They ought to live their lives and only die when that is done.

We were en route to Madurai when we got the news.  We changed drivers immediately and I stayed quiet for almost the entire rest-of-the-6-hour journey; this does not happen often.  However, I had sort of seen the demise coming, though hoping for a different outcome; it was still wrenching to hear the news.

Madurai was nice, and soothing.  My father and I spoke of the event; it was nice to go over matters with another medical person.  We visited one older friend, but I did not want to do anything else at all, preferring to stay close to home and lick my wounds in solitude.

We are back from Madurai today; laundry has been done, newspapers have been read.  My father's cook sent some food with us and I don't have to mess with making dinner, etc.

I hope all of you have a good week.

Unw -

Friday, March 11, 2016

Report of 11 March 2016

Hello from our balcony!

It is 6.27 PM, there is still a modicum of daylight, and the sea is visible.  I love the sight of water, especially a sea or lake.

Life has been good.  I have received my permanent registration, or licence to practice medicine in India.  It took 12 years and I have it now.  I am extremely excited about being part of the medical world here.

The Banyan has been wonderful.  I was late getting to our seaside village clinic on Monday as I had to be at the Tamil Nadu Medical Council for a meeting to get my registration.  I had told our Kovalam-living staff to notify all their neighbors that I'd arrive late and to come in the afternoon.  So, the patients were notified and some came in the afternoon.  Many are reeling from arthritis and I have been trying desperately to get a physiotherapist (or physical therapist) to come and treat our patients; let us see what emerges.  Last week, one patient who complained of body aches was getting beaten by a family member, which also happens; at this point, our able community workers take over and counsel the whole family.  The community workers, who live in Kovalam, are remarkable young women who speak eloquently about how to manage various diseases, and this is wonderful.

Scott has a part-time job as a college professor and enjoys it.  The students at his college were on strike earlier in the week protesting the high fees paid to sit again for exams in the courses a student fails.  Violence is quite the name of the game of student protests here; however, Scott said the students told college personnel to take cover, that the students were not targeting the personnel, just the management.  Windows were broken, cars were damaged.  

Women's Day was celebrated with grand gusto at the B.  It is nice to be in the midst of strong women - both patients and staff.

Unw -

R

Thursday, March 03, 2016

Report of 4 March 2016

Hello from Chennai!

The sea and sky are fairly merging today.  There is a haze, I think due to the heat.  It is already pretty darn toasty in Chennai; April and May are the summer months, but we are heading there quickly.  I have a root canal awaiting finish, thus cannot swim today and miss it, though the body woke up exhausted from many pokes and prods and what looked like singed rods placed in the tooth cavity awaiting final touches.  Both dentists were very good, and I am grateful.  I rather like eating, and would like to save my teeth if at all possible.

We were at young Deepika's wedding last Saturday - what fun!  There were lots of people to see and talk to, and the lawn event was very relaxed and nice.  What do people gain from not getting along with family, eh, though of course some self-preservation is mandatory - I like to blithely ignore perceived insults and plough on in the name of geniality.  My Dad flew to Chennai, we picked him up, drove to Vellore, picked up my sister and then on to Bangalore where we stayed near my sister-in-law's place.  The day after the wedding, my nephew, Sudhir, took all of us out to lunch at a nice place with delicious food; my niece, Sanjana, joined us as well, taking a break from her studies.  It was a nice gathering.  Afterwards, my Dad felt Sudhir's heartbeat to see if it could stand the shock of the bill :).

My father came with me to Kovalam on Monday and saw some patients.  They are unfailingly happy to get some second and third opinions, though they are flatteringly comfortable with my care.  It was nice for my Dad to be there - once a doctor, always a doctor.  Scott dropped him at the airport while I continued to see patients.  My aunt, Indira, also visited Kovalam that day to see her friend, who is a resident at the Banyan.  Both ladies appear to have enjoyed the visit and even toodled down the road to get fruit juice of uncertain hygiene; thankfully, neither is worse for wear.

One of our patients at Kovalam came with inability to conceive (a baby).  We are to treat her blood pressure and her thyroid condition, and then the hospital where she was initially seen will address her fertility issues.  She is to get a medication (alpha methyl dopa) which is safe for pregnant women and could not find it at many pharmacies; one pharmacy substituted something that starts with "alfa" and is a vitamin.  Hoo my; we emphasised the importance of the correct medication, I assured the patient we would work together to address her issues and off she went.  Not having children is a huge issue here, and in fact, at many places.  I know I feel fortunate to have Naren and Navin in our lives.

We saw a couple of movies this week.  We are likely the only 2 people on the planet who did not enjoy "The Revenant."  Yeesh - it must have been a slow year for movies that Leo won for this thing.  I could not understand much of the initial dialogue.  We also saw "Carol" and enjoyed the fine, fine performances of 2 actresses who made us completely believe they were an older sophisticate and a younger salesgirl, falling in love.  I'd intended to see a couple of movies today, then root canal intervened.

Hope you have some fine times of your own.

Unw -

R  

Thursday, February 25, 2016

Report of 26 Feb 2016

And February 2016 is almost over.

A lovely breeze on the balcony, sunlight, cottony clouds in a blue sky, the Bay of Bengal a different blue from the sky so we can tell what's sea and what's sky - this is good.

Naren used to sit on the balcony sometimes to write; it does have a nice view.

We are well.  We finished the second edition of "Family Day" at the Banyan - this time at Mogappair, the first time at Kovalam.  We had arranged transport for families to come from afar and it was late, but spirits were not dampened.  Leela, our chief nurse, had gifted me a beautiful orange sari, I wore that to rattle the populace (I don't usually wear saris to work), all were in their Sunday best again and we ate biryani, sang and danced.  The health care workers had been a bashful lot last year, but not this time: there were 3 dances and 1 song from them.  I loved every bit of it!  Scott and I danced again - an inspiration to skinny white guys, said his cousin from afar - and I enjoyed it.  It was a fine carnival-like event ("mela") and we were very happy to indulge the staff and their families for 1 day; they do for the patients the other 364.

We (the B) rescued a patient named Ms. X, who knew she was HIV positive.  She does not have a mental illness and did not want to stay at the B.  She left, went back to her hometown and found that the relatives did not want to have anything to do with her.  From their point of view, she was an 11th grade student who eloped with a man older than her, she was not to be seen for several years and then showed up, wanting a place to stay.  One of our nurses, who speaks the language, tried to coax the relatives over the phone to keep Ms. X for at least 2-3 days and they would have none of it.  So, Ms. X left, and found herself a tailoring job and accommodation in a women's dormitory.  Yes!  As we were lolling about on Family Day, welcoming everyone and goo-goo'ing children, in walked Ms. X; we were delighted to see her and practically hugged her.  She stayed for Family Day, she has stayed a bit longer; she plans to return to her town and has since asked if she can come back to the B if necessary.  The B is like that - congenial, devoted to the client, unfailingly wanting what's best for them.  Vandana and Vaishnavi are inspirational people.

My Dad comes into town today and I look forward to it.  We will go tomorrow to Bangalore for a cousin's daughter's wedding; she is the first of the cousins' children to marry and it will be a nice event.  Her Dad had provided immense succor to my parents when my brother, Manu, was seriously injured and hospitalised.  All of them are nice people, and have already warmly welcomed us.

Scott started a new job as part-time professor at a college of engineering nearby.  I continue joyously with the B.

Hope all of you have joys of your own.

Unw -

R