Renu's Week

Sunday, January 30, 2005

Report of 30 Jan '05

Hello from sunny Chennai -

I am convinced that the non-stop sunlight contributes to the sunny dispositions here as well. Remind me of this in May, when 110 deg and no airconditioning might cause a change in my disposition. :)

We were delighted to get a package from Ruth at St. Vincent, and she sent some professional journals, some non-p mags given to her by Louise, and some American candy which the boys fell on w/ total glee. What joy! Packages here are a big treat, and historically for me as well, as mailing packages is very rare here. When I first got to the U.S., American friends would mail me tiny things - artificial flowers, little packs of candy - as they knew I liked getting packages. This is not to be construed as any kind of hint, it is a statement of great appreciation for kindnesses shown to us from far away.

The Banyan is doing well. Their annual fundraiser is next Saturday, and they are still short several hundred thousand rupees. I have tried to solicit, but the charity rupee or dollar is hard to come by. Not very much fazes the 2 young women who started the orgn, and their work will go on. They also work to rehabilitate the mentally ill women who CAN be rehab'd, and last week, one such lady was sent to work at a donor's house. She returned to the Banyan when I was at work, w/ her face completely puffed out and eyes itching. Methinks there were some plants or some clothing at the work site which caused an allergic reaction, so I asked that she be placed in the "sick room" (our ward) and started IV steroids. I received a call the next day that she was much better, the same day that I received total silence from several people I had approached for funding or a job for May. I tell you, perspective is everything: I was delighted that the patient was better, glad the news came then, and somewhat resigned to the silences from overseas. If I had a penny for every time I heard "No, we can't fund you" or total silence w/ the same msg, I would be a very rich woman. My riches now are coming from my patients' health, which is not at all a bad thing.

When I was in Madurai, I attended a clinical meeting at the hospital where my father works. I welcome such formal learning opportunities, especially as I don't get them working with the poverty-stricken. One of the cases was that of an abdominal aneurysm, which is an enlargement and subsequent weakening of the wall of a blood vessel, usually an artery. The senior surgeon stated that the diagnosis was confirmed by a Cat scan, they made the decision to operate and then they got an MRI, a very expensive test. At the end of the presentation, which my father was chairing, there was an opportunity for questions and I asked why the MRI had been ordered, if the decision had already been made to operate; the surgeon replied that it was for his teaching files and that the patient could afford it. I was furious; it is drilled into us during training that we must only order a test if the results of it are going to change our management, and here was one of my esteemed colleagues ordering it for his personal benefit, because the patient could afford it. Why I must expect ethics from my professional compadres is beyond me, given the diversity of personalities, but it would be a special treat, wouldn't it.

The tutoring is waxing and waning. Today, we will go around trying to resurrect the effort. At least one child should be lifted out of poverty or kept out of prostitution - this is my goal.

The boys had their annual Sports Festival and I was the team doctor on all 3 days. It was fun. Naren and his teammate Nikhila won the table tennis gold and Navin and his team won a basketball event. Neither son did the running events, but perhaps next year - I had to cajole Naren for this, esp as his legs are now as long as his mother. I had a lot of side business, talking to a parent separated from her husband and one who lost his wife 2 years ago. (We've had both parents' children over for sleepovers and they have been fun.) I was also approached by a lady who just moved here from the U.S.; her son hates it here and she wants advice on how to help him cope. Beyond urging her to involve him in activities for the underprivileged, I have no idea what to say. Her son will feed off the top, and our sons knew it was not a democracy in our house, that we were moving regardless and that they could either like it or like it. No, there's no typo there.

Scott and I spent yesterday totally blowing off necessary errands (boys' haircuts, photographs, grocery shopping) and taking in a movie and a lovely meal (2 sandwiches and 2 chocolate mousses surely made in paradise - total cost 285 bucks). The movie - National Treasure - was completely implausible and ludicrous, but Million Dollar Baby, Ray, and The Aviator are not here yet. That bugs me, that I have to wait several months for American movies to show up here. Scott and I used to have our picks in hand on Oscar day, but this year, I did not even know which movies were nominated or what they were about. I was delighted to see that Mr. Foxx secured the nomination for Collateral and for Ray. He is surely my pick this year. (I did think, tho', that Ms. Berry's win was racially motivated, but what the heck.)

Someone asked me if things were stressful - no money, no registration, indifference from the U.S. towards one trained there working here, etc. Au contraire - I have a fun, funny husband; 2 children who are developing undercurrents of compassion just by living here; an American education which I always thank God for; patients that are healing; relatives that we are within a train ride of; and friends who sustain us w/ notes and Sour Brite Crawlers. Things could be much, much worse.

"I've reached the age where competence is a turn-on." - Billy Joel

Best to you all. May you have Sour Brite Crawlers of your own.

Sunday, January 23, 2005

Report of 23 Jan '05

Hello all -

It is sunny out, the 3 Weiss men are reading here, we just ingested some excellent British chocolate (kind courtesy Doug) and are here in a mellow, high-sugar state of mind.

The week has been eventful. I learned that 2 of my patients at the Banyan died over the weekend. One was the lady who yelled non-stop for food. The other was a patient who was suspected of having TB, but when I saw her lack of weight gain and completely emaciated state, I was convinced something else was up. On digging through some back records (from waaaay back), I saw that an xray had looked like cancer but this had not been followed up on, I guess as treatment options were limited. This lady's face had bone right under the skin (the rest of us have at least some fat or other tissue below) and looked like a skull w/ skin pulled taut over it. Ostensibly, she had been in some pain right before death. The redeeming feature here is that both women died in surroundings of kindness and compassion, and were well taken care of (thanks to the phenomenal Banyan staff) right until and at the end. What more can one ask for, in one's passing.

Please check out www.thebanyan.org if you are so inclined and email them as well. They do absolutely wonderful work, are fairly chronically short of funds but are not inclined to whine about it (unlike some of us .... :) ).

My cousin, his wife and their 13 yo son (named Ashwin), severely afflicted w/ cerebral palsy, were here to get the child evaluated by a local orthopedic surgeon to examine options to help him walk. I accompanied them to the appointment as it sometimes helps to have a physician relative on hand, and was particularly urged to do so by my scientist aunt. Continued physical therapy, not surgery, has been recommended for the child for now. It has been 15 years since I saw my cousin, we were decades younger then, and are now family folks. He has become very wealthy, knock on wood, by working in Papua New Guinea, and while the rest of the family oohs and aahs at all his possessions (2-3 apartments, an SUV), I'm glad for him that he has the resources to care for his son. The couple's marriage has become severely strained and I spoke to both parties separately, and urged counselling, which helped Scott and me in the melancholy months following my brother Manu's demise, which was followed by several deaths in the family. Beyond that, I feel I can only be here to assist as necessary and simply cannot singlehandedly save the marriage (might it even be worth saving is a question only they can answer). Dr. Vohra, a pulmonologist of Indian descent at St. Vincent, told me before I moved to India to do something about only those things which I COULD do something about and not try to take on more than I could handle. This was priceless advice, which I still value. It is a strange feeling to watch a dear cousin's marriage disintegrate, but I can only provide a listening ear and help if asked.

And entertainment for their son!! Our boys outdid themselves in keeping their disabled cousin amused. We had the visiting family, my brother and Tina, and Coorgi neighbors over for a meal and it was fun. Ashwin spent the entire evening in N and N's room, and the evening was punctuated w/ guffaws from that quarter and periodic squeals from all 3. I was very happy that our sons did not feel any difference between themselves and their cousin, and picked up on his style of communication very quickly. In San Antonio, we had some wonderful neighbors who had a daughter w/ CP and I imagine that's where N and N learned of this condition. Anyway, all 3 boys had a blast.

I spent Friday in Madurai w/ my parents. 26 Jan is the anniversary of Manu's demise and my father and I went to the cemetery, my mother feeling too tired to go. My father's gait faltered at the entrance and he busily looked elsewhere. I imagine it must be hugely difficult to think of one's firstborn child as having died. Anyway, we cleaned off the grave and the tombstone (the back of which had graffiti by local children), put a rose garland on it and I prayed, sort of. Anu asked my parents to excuse her for not going to Madurai then as she states she has a visceral response at the cemetery, and Vinu and Tina will go on the 26th. It was difficult to think of my robust, handsome, dance-loving brother as deceased, but I suppose our task now is to take care of his family. Please pardon me if you find my mention of my brother onerous; it has been 6 years since his demise, but he was a sibling and all our siblingy bickerings notwithstanding, we were a fairly closeknit lot.

The tutoring putters on. We will have a meeting w/ those who are used to doing such work and figure out what we can do to ensure steady attendance. We must educate at least 1 child and pull him/her out of poverty. The founder of the Little Theatre, which stages plays to raise money for poor kids' scholarships, mentioned one of her beneficiaries as having graduated and having secured a good job. I was mightily thrilled to hear that.

Have a good week. We're sorry that the Colts are out of the running in the Super Bowl, but Go Eagles! We haven't had TV since we moved here (it exists here, as does cable, but we find that the boys read more in its absence and so are choosing to do without - I do miss watching sports, tho'), so I have no idea what the teams look like, but I hear the Pats look invincible. Is this so?

"A man in love is incomplete until he has married. Then he's finished." - Zsa Zsa Gabor
"When I eventually met Mr. Right, I had no idea that his first name was Always." - Rita Rudner

Monday, January 17, 2005

Report of 17 Jan '05

Hello folks -

I am exhausted, but do need to get this report out. We were in Hyderabad for a short vacation this past weekend. The kids had a long weekend, we found some cheap flights and off we went. We stayed w/ some friends who were at Purdue when Scott was and that was lovely. These are the sort of friends to whom you announce (not ask) that you are raiding their freezer for ice cream, who have you cut the veges for lunch, who spoil your children tho' they don't have any, etc. There were also plenty of good sights in Hyderabad, again reflecting our wonderful heritage (now ruined by people using the roads as restrooms, which irritates the daylights out of me), and the boys had a good history lesson. We had a good, but tiring, holiday.

On day 2 of the 3-day holiday, Scott threw up several times and had a severely upset stomach. Sight-seeing was kept to a minimum and we honored his delicate health. Day 3 was spent w/ the boys in front of the TV and Scott hooked up to IV fluids at a friendly clinic. The Typhoid test was negative, but I am treating him for it anyway, esp because these episodes of upset stomach have been ongoing since he joined his new job. He now looks emaciated and this is a matter of great concern to all of us. Lactose intolerance (lack of the ability to digest milk products) remains in my mind, tho' there is not an obvious connection to his drinking milk.

Anyway, in addn to having several pts at my house (Scott and variously, both boys), the work at the Banyan goes on in a very nice fashion. There is, regretfully, a lot of typhoid there. One of the pts I suspected of having it did have it - she'd come in looking wan and lethargic, w/ fever and an upset stomach. I'd told Leela to call me w/ the results of blood tests (there is no lab at the Banyan and the pt had to go elsewhere) and she was so busy she forgot. The doc at the hospital which did the blood tests did prescribe the appropriate meds and I was happy the results of the tests were followed up on. As Leela apologised to me, I said the lack of contact w/ me was no problem as long as the patient had been appropriately tended.

Someone else looked after the tutoring for us this past week. Scott saw a report that said 87% of Indian children do not finish 10th grade. Of course not, they go to work. What a terrible state of affairs. Education so broadens the mind and prevents ignoramus things like mistaking the road for a restroom (tell a pattern here?), domestic violence and prejudice, but regretfully, some families here simply cannot afford this luxury when they feel they have potential earners in their children. Scott says this is where our tutoring's significance particularly comes in and I thought that was a sweet thing to say.

As we age, we are aware that our contemporaries now are rising in their respective professions. Our friend in Hyderabad now runs his own lab at a prestigious Govt-run institution, and is salaam'd as he walks about, commands clout at the local grocery store, etc. What a kick! We are proud of all our friends' successes, and are privileged that we knew you when.

The regn saga continues, we have started snail-mailing, and I expect nothing to come out of this. I will not bribe, tho' it will produce results, as many of you know.

"Camping: nature's way of promoting the motel industry." - Dave Barry

Best and all that,

Sunday, January 09, 2005

Report of 9 Jan '05

Hello from Chennai!

The air is comfortable, we had pomagranates w/ our b'fast and soon we will have some inadvertently overspiced noodles for lunch. Our cook is still on maternity leave and the boys have to contend w/ my cooking (which I like to do). Come April and May, tho', when sitting on the balcony is like sitting by a furnace, cooking by a hot stove will take a back seat to simply eating cold mangoes for b'fast, lunch and dinner.

The Banyan is also involved in Tsunami efforts and has had a bunch of donations. We were there this past week and Doug handed over a generous check from his family, friends and himself, for the Banyan's work. Shortly thereafter, he was greeted by a bouquet of roses and as I turned from admiring them, I found I was being given my own (all volunteers were). They were lovely and graced my table for a while. The patients are also healing nicely - a gaping bed sore is now acquiring new skin and healing ("granulating") and we have attempted to help the process along by improving the pt's nutritional intake and having her stay off the bed as much as possible. This is where our outstanding nurse comes in: Leela suggested an appetite stimulant and I concurred. Not having used it at all in the U.S. (the problem is the other extreme there - obesity), I appreciated the suggestion hugely and the pt's intake did improve. It is absolutely wonderful to have good medical assistance. We have to use non-pricey means here - and several work.

By the way, if you want to give to relief efforts here and want to guard against fake orgns (which are springing up everywhere), consider Udavum Karangal at udavum@vsnl.com. They do great work and are now involved in long-term rehab: rebuilding houses, etc. I contacted them to see if they needed medical help (outlining the lack of registration clearly) and they said they did not, but would keep me in mind for later. Scott's best friend, a wonderfully irreverent sort, told me of the need to include tourists in Tsunami news reports: it sustains Western interests more. I guess so; playing the media is an art form in itself.

We had some children come to be tutored and there were far more tutors than tutees: the ratio being 3:1. When I asked some tutors to please leave, they begged to stay and teach. So we had to triple up, and I suppose that was ok for 1 day, b'cos some teaching WAS indeed going on. At times when the poor students looked intimidated at the sheer numbers of teachers, I had to step in and ask the teachers to be less enthusiastic. There is a very poor family that comes regularly; their regularity merited their being given an umbrella each, which Doug had also brought. Now when it rains, the children have a way of getting to tutoring.

My registration saga is slowly getting on my nerves. Today, my English friend from school days, Clare, phoned; she lives in Bangalore and we were commiserating about bureaucracy. We have even started emailing and phoning the Ministry for some results. One of the senior employees there asked why I had moved from the U.S. and I said it was to take care of the poor. It sounded absolutely lunatic. The powers that be obviously think a totally deranged individual has landed in Chennai to care for the unfortunate poor.

N and N did not pass the entrance test to one of Bangalore's schools (apparently some kind of Gifted program) and Scott is investigating other options. It looks like we will be in Chennai for the time being. The boys attend a school (Abacus) similar to one I attended - small, not academically intense, but definitely catering to all-around devt. Several of us who graduated 27 years ago still keep in touch and it was here and in undergrad college that lasting friendships were made. The boys should have the benefit of such a school, but I told them that academic responsibilities were definitely to be kept in mind. Incidentally, I will start teaching Sex Ed at Abacus this month - I consider this as big a community responsibility as caring for the poor.

Have a good week!

"When the question: 'How old Cary Grant?' was wired to the star's agent, Grant had him reply: 'Old Cary Grant fine. How you?'" - From TELEGRAM! by Linda Ronsenkrantz

Sunday, January 02, 2005

Report of 2 Jan '05 - long

Hello all!

Happy New Year! Hope this year brings you health (#1 in my book) and happiness.

Let me take a deep breath and launch into this report. First of all, thank you very much for all the kind messages that flew here after the tsunami. Yes, Chennai was directly in its path and hard-hit. We had no idea at first how hard, because we were in Madurai celebrating Xmas w/ my parents and all the initial reports mentioned the earthquake. We left for Bangalore on the 26th and then learned of the devastation and massive loss of life. We returned to Chennai on the 31st and found our apartment complex standing and unharmed, which we had not been worried about, but felt the need to assure you of.

When we first house-hunted, the real estate agent showed us some beautiful apartments near the beach. I am a big beach/sea fan and was mildly lured by said flats, but good sense prevailed and we did not rent one of these. Thank goodness.

A cousin's beach house in Kanyakumari (the southern-most point in India) was washed off - my sister and family reached there for a short holiday 3 hours after the tsunami and found this event, along w/ the fact that my cousin's hospital was overrun w/ pts, whom my sister and brother-in-law helped treat. Another cousin's relatives (in-laws) had gone on a pilgrimage to a seaside Christian shrine which has since become secular, and several were killed, leaving one survivor. She mentioned that the bodies (3 of 8) were unrecognizable; the unrecovered family members are missing and presumed dead.

Several of you thought I would have plunged into relief efforts and I was flattered by that thought. Many relief agencies are generating various drives w/ varying results. As we just returned to town, I will investigate some of the more reliable agencies and find out if they need help. I imagine the need for medical help will be ongoing and will renew the push for my registration. Medical school also taught us disaster management, and I will be ticked if these skills languish. Actually, I was once part of a scenario in Emergency Medicine where a simulation of large crowd injuries happened and I remember helping the paramedics dive in while they yelled instructions. Some of that has stuck, and I think will be put to good use. Let's see.

So we are grateful for survival. Regretfully, the reality is that if we are too stupid to control our population, nature tends to even things out. You live in an evenly populated place where the resources are adequate, even abundant, and such disasters can be averted as there are pricey early warning systems in place. I live in an overpopulated country where the resources are so scarce and poverty so prevalent that several families must live on the beach and then be subject to such tragedies. This is why I push for small families and birth control, wanting to ensure that every child can be fed before its parents even think of conceiving it. Harsh it must sound to you, eh? The newspaper had an excellent article by a non-Indian, talking of imperialism still existing in light of the media focusing on the foreign tourists affected in Thailand, etc., and slight mention being made of the hordes of brown people dying. There is a non-Asian child whose mother is missing and pictures of said child make the paper almost daily; certainly, there is pathos in this story, but there is also a vat of pathos in the Asian fisherman holding his dead daughter and crying. Tragedy is tragedy; the fact that there are white victims makes it no more devastating than if there were brown victims alone.

The week before Xmas, I could not send my report out as we were very busy packing and ensuring that everyone's travel schedules and Xmas presents were remembered. We have a young English med student friend, Doug, staying w/ us and he has weathered the chaos well. We also had several local activities to coordinate before we left and a fair amount of necessary socialization to pack in, thus some prioritization needed to be done. With my working gratis, I take off when the kids are off; I still feel fairly guilty that my work schedule is thus, but then think that if my pay schedule is thus (i.e., non-existent), I can call the shots w/ my time to some degree.

Doug and I visited the Banyan and then he went onto some other hospitals. The patients at the Banyan were thrilled to see a white guy loping through and we were happy to provide the entertainment. Of note at the Banyan was my patient w/ a broken hip wanting to go home. The staff is plentifully aware that the pt's family does not want her at home, but compassion prevents all from divulging this. So we say that she must stay w/ us and come across as the villainesses of this piece, but it's better this way.

We also had some children show up for tutoring in spite of recovering from illness. Everyone was happy they came and went out of their way to tutor. As I sat w/ one little child to work on math, she let out a cough that wracked her already frail and thin body. I am not a pediatrician, but the grandmother said she was better and we finished the tutoring, passed out sweets and as a Xmas present to all, gave the boxes of crayons that several of you donated. Thank you for making Xmas meaningful to little kids far away! I daresay that this would have been the only present some of these children got.

Doug, Naren, Navin and I went to Madurai and onto Nagercoil (where my Dad is from) and Kerala. We were happy to see relatives we scarcely see, and these folks are so neat we rediscovered them all over again. We returned to Madurai for Xmas and then Scott and the hordes landed. My parents have 4 children and all are married, w/ my younger brother yet to breed. Thusly, you can imagine 16 of us (Doug bravely in the thick of it) crammed around the table, yelling for the biryani to be passed and picking on my younger brother's eating habits and his mysterious (only to him) weight gain. We opened presents on Xmas morning - as I have said, Xmas is very low key and non-commercial here, which I love. We took a family photograph w/ a professional photographer amid much moaning and complaining, but are happy to have this photo as a record of Xmas 2004.

The Weisses then went onto Bangalore, Doug onto Mysore and Coorg (where my Mom is from) from there. We visited Scott's workplace and it is lovely! Truly a harbor of high intellect and great achievements. Scott's boss and boss's boss (a vice president) joined us for tea, which I consider a mark of their regard for him, and we had a nice visit. We also saw Bangalore's sights, including a marvellous botanical garden where Navin was mugged by a monkey (which grabbed his doggie bag and took one of the 2 packages of food in it - mine, the spicy noodle dish which it did not appear to care for), and checked out some schools. This move vs. non-move will be a big decision for us, considering Chennai's educational system is vastly superior to Bangalore's. I told Scott I'd move to B'lore in a flash if the kids were in college.

We are back, life will resume and the kids have been told about independently taking care of their studies. Naren's grades came up and he acted in a school play, doing pretty darn well. He also privately admitted a romantic attraction for a classmate, and I was honored at the confidence. Navin has also brought home decent grades and appears to be turning his organizational skills around. Both boys are sitting w/ Scott and attempting to rework difficult issues from last term, w/ the need to know the basics reinforced to Naren and school habits reinforced to Navin.

This was longer than usual. There was much to unload about. Have yourself a very happy New Year!

"We make a living by what we get. We make a life by what we give." (Author unknown to me)