Report of 20 Feb '05

Hello from sunny Chennai -

One son is reading here, the other one is playing w/ Legos, Scott regretfully had to take the day train back and I am writing. This is therapeutic for me. I actually started at 7.30-ish this am, welcoming the p and q (peace and quiet), and was all set to write when my younger son came bounding out, chirping, "Good morning," and kissed me. There went the solitude but there also started the family time - can't beat that.

The increased frequency of going to the Banyan is good and I enjoy the fact that transportation is provided. The days are getting hotter, Banyan's transport is non-airconditioned and I have taken to coming home w/ my clothes stuck to my back and the backs of my legs, looking faintly obscene, but I dive into the elevator and hope for the best. The HIV+ young woman's son did come to visit and she sought me out as I stood near the front of the building, her eyes aglow, and told me of the little boy's visit. She said he did not remember her, but that he had a biscuit (cookie) and milk and she spoke to him of it. It was a wonderful exchange. As I continued into the sick room (our ward), the young assistant went to turn off the TV, which had dance sequences from Tamil movies. I told her not to - no need to interrupt patients' entertainment for a darn doctor's visit, plus I like some of the dances too (the boys and I dance everyday at home) - and started w/ the pts. My patient w/ hepatitis, Ms. P, had been on dietary restrictions - no spicy/fried food, plenty of clear fluids, coconut water, etc. - and the assistant, L, asked if she could have pooris, which are round, deep-fried pieces of wheat bread. I am not a big fan of dietary restriction unless absolutely necessary, and Ms. P has been recovering very nicely, so I said she could certainly have the pooris and that they looked good. Ms. P then smiled her oh-so lovely smile and invited me to join them for b'fast. I was warmed completely: such hospitality and consideration in the middle of her illness, her trials and tribulations. I declined, as I had just eaten (after the kids arrived, i.e., after commencing parenthood, I don't miss a meal), but I may join everyone for lunch next week when Naren and his social work club visit our facility later in the afternoon.

Several of my orders had not been followed up on at the B, which is unusual, and I mentioned it to the social workers in person, did not get much results, and then emailed the founders, who are lovely people to work with. One of them replied, apologised, and cc'd the team, asking for answers. I'd thought, at the next visit, that I'd be the most reviled person there, but the social workers apologised and assured me that they'd try and ensure follow-up, even sitting down w/ Leela, the nurse, and me, to improve matters. I was reassured; such response to feedback, instead of finger-pointing or passing the buck or getting defensive, is much more productive.

The tutoring is well underway. One of the little kids seemed intimidated by me, and completely at ease when a peer tutor showed up. Thank heavens for our peer tutors, who truly enjoy this activity. We used to have older students - 8th graders and such - but we cannot locate them and I feel very sorry: they got a lot out of our tutoring sessions and 2 of them wanted to be doctors. We have had newcomers, as I mentioned, and last session, their mother produced an invitation to their ear-piercing ceremony. I was mildly honored by the invite, as I knew it was given w/ one goal in mind - a present. Had it been one of our long-established students, I'd've produced a present quickly, but this was only these kids' 2nd session and as Ann Landers once said, no one can take advantage of you without your permission. So I wished the family and everyone had to settle for that intangible present.

We were w/ some friends for dinner Friday, along w/ my brother and sister-in-law, and had a great time. The meal ran late: we ate at 10.15 PM, which is not totally uncommon here for dinner parties. The boys and I had eaten our regular dinner at 4-ish, so we were not crassly fainting w/ hunger by 10 PM. Our dinner time blows people's minds here, but there are several habits we picked up in the U.S. that we are not giving up - early dinner, OJ w/ b'fast, being candid if certain schedules, e.g., for a neighbor's visit, are inconvenient.

Scott and I saw "The Aviator" which was a bit long and rambly, plus old Leo didn't appear to age thro' the flick at all. Then we rented a DVD for the boys, an older one, Turner and Hooch. It was cool to see a young Tom Hanks, and all of us enjoyed the movie.

We look forward to our U.S. trip and the business of getting my documents ready to apply for locums is underway - yooosh, what a ton of stuff I have to send. There is no locum in the works yet, but blinding optimism is.

"The art of medicine consists in amusing the patient while nature cures the disease." - Voltaire

Until next week -

Renu

Hello from sunny Chennai -

One son is reading here, the other one is playing w/ Legos, Scott regretfully had to take the day train back and I am writing. This is therapeutic for me. I actually started at 7.30-ish this am, welcoming the p and q (peace and quiet), and was all set to write when my younger son came bounding out, chirping, "Good morning," and kissed me. There went the solitude but there also started the family time - can't beat that.

The increased frequency of going to the Banyan is good and I enjoy the fact that transportation is provided. The days are getting hotter, Banyan's transport is non-airconditioned and I have taken to coming home w/ my clothes stuck to my back and the backs of my legs, looking faintly obscene, but I dive into the elevator and hope for the best. The HIV+ young woman's son did come to visit and she sought me out as I stood near the front of the building, her eyes aglow, and told me of the little boy's visit. She said he did not remember her, but that he had a biscuit (cookie) and milk and she spoke to him of it. It was a wonderful exchange. As I continued into the sick room (our ward), the young assistant went to turn off the TV, which had dance sequences from Tamil movies. I told her not to - no need to interrupt patients' entertainment for a darn doctor's visit, plus I like some of the dances too (the boys and I dance everyday at home) - and started w/ the pts. My patient w/ hepatitis, Ms. P, had been on dietary restrictions - no spicy/fried food, plenty of clear fluids, coconut water, etc. - and the assistant, L, asked if she could have pooris, which are round, deep-fried pieces of wheat bread. I am not a big fan of dietary restriction unless absolutely necessary, and Ms. P has been recovering very nicely, so I said she could certainly have the pooris and that they looked good. Ms. P then smiled her oh-so lovely smile and invited me to join them for b'fast. I was warmed completely: such hospitality and consideration in the middle of her illness, her trials and tribulations. I declined, as I had just eaten (after the kids arrived, i.e., after commencing parenthood, I don't miss a meal), but I may join everyone for lunch next week when Naren and his social work club visit our facility later in the afternoon.

Several of my orders had not been followed up on at the B, which is unusual, and I mentioned it to the social workers in person, did not get much results, and then emailed the founders, who are lovely people to work with. One of them replied, apologised, and cc'd the team, asking for answers. I'd thought, at the next visit, that I'd be the most reviled person there, but the social workers apologised and assured me that they'd try and ensure follow-up, even sitting down w/ Leela, the nurse, and me, to improve matters. I was reassured; such response to feedback, instead of finger-pointing or passing the buck or getting defensive, is much more productive.

The tutoring is well underway. One of the little kids seemed intimidated by me, and completely at ease when a peer tutor showed up. Thank heavens for our peer tutors, who truly enjoy this activity. We used to have older students - 8th graders and such - but we cannot locate them and I feel very sorry: they got a lot out of our tutoring sessions and 2 of them wanted to be doctors. We have had newcomers, as I mentioned, and last session, their mother produced an invitation to their ear-piercing ceremony. I was mildly honored by the invite, as I knew it was given w/ one goal in mind - a present. Had it been one of our long-established students, I'd've produced a present quickly, but this was only these kids' 2nd session and as Ann Landers once said, no one can take advantage of you without your permission. So I wished the family and everyone had to settle for that intangible present.

We were w/ some friends for dinner Friday, along w/ my brother and sister-in-law, and had a great time. The meal ran late: we ate at 10.15 PM, which is not totally uncommon here for dinner parties. The boys and I had eaten our regular dinner at 4-ish, so we were not crassly fainting w/ hunger by 10 PM. Our dinner time blows people's minds here, but there are several habits we picked up in the U.S. that we are not giving up - early dinner, OJ w/ b'fast, being candid if certain schedules, e.g., for a neighbor's visit, are inconvenient.

Scott and I saw "The Aviator" which was a bit long and rambly, plus old Leo didn't appear to age thro' the flick at all. Then we rented a DVD for the boys, an older one, Turner and Hooch. It was cool to see a young Tom Hanks, and all of us enjoyed the movie.

We look forward to our U.S. trip and the business of getting my documents ready to apply for locums is underway - yooosh, what a ton of stuff I have to send. There is no locum in the works yet, but blinding optimism is.

"The art of medicine consists in amusing the patient while nature cures the disease." - Voltaire

Until next week -

Report of 13 Feb '05

Hello folks -

I very nearly did not start this report as I got my 151st (or so) No to requests for funding and the mood took a bit of a beating. Then I thought, well I need to snap out of this, so I started writing.

It has been an exhausting weekend. We had to run around getting train tix and plane tix (for our U.S. trip, which all 3 of us are quite excited about); we had used our credit card for the train tix, and the U.S. credit card company always thinks there's fraudulent activity when it sees the card being used in India and cancels it. We have enlightened them ad infinitum that we now live and work here, but no matter. I guess better safe than sorry. Reinstating it is a huge song and dance, and unsuccessful this time. Then Scott and I saw "Alexander." What a dreadful movie. Scott thought it was one of the worst he'd ever seen, which is saying something.

Work at the Banyan is good. The powers there had asked if I could come more often if they sent transport, and I waited to settle the boys in the setting of their father's away job, etc., and then said yes. So this week, a nice, comfy SUV was sent and I went; it was pretty heavenly not having to drive that distance. That day was frenetically busy, and very nice for me as time passed quickly and productively. A couple of staff members also added to the sick list. A young patient there is HIV+ and her child was taken away from her (I think by family) when she was admitted to the Banyan for her mental illness; the Banyan had then arranged for the child to visit and he was expected 2 days later. The young mother's excitement was palpable; she speaks Telugu and only a little Tamil, but she did not need any words to convey to me, a fellow mother, her joy at the prospect of seeing her son. It was a wonderful sight, to watch her beam, and I am supremely glad to be involved w/ such a compassionate organisation. Being a mother also adds a nice dimension to my work.

The tutoring is resurrected! We had 5 poverty-stricken kids last week and it was fabulous. I don't know yet what good we do, but one of the mothers who had been unable to bring her child the last couple of weeks stated that her child had wept, asking to attend our sessions. This child stated during our practicing-spoken-English part that she wanted to be a teacher. The parent also brought a neighbor's kids w/ her and technically, we are not to accept non-complex-servants' kids, but by golly, we cannot turn the little things away. So we are prepared to fight for them, if someone questions us. The teachers, the complex kids, totally love teaching and 'tis a fine, fine sight to watch all the peer learning and teaching. One child to stay out of premature, grinding employment or prostitution - that's all I ask.

So we are putting together this "Speak of this work in the U.S." endeavor, but I am quite realistic about my chances of finding funding, i.e., GRIM. So far, there have been No's to all requests, be they for funding, locums or mini-teaching assignments. I continue to be impressed at the ease w/ which my requests are denied - truly. There is also no glamor, I feel, in an Indian doctor taking care of Indian poor; a foreign doc would probably attract a fair amount of bux for precisely this work but ignorance of resources is also an obstacle for us. However, all it takes is 1 person to believe in this cause. I participated in the Banyan's rural outreach program inauguration, where a film on the founding of the Banyan was screened. The founders spoke of the staggering odds they overcame and their pennilessness: one day, they had Rs. 3.50 (about 8 cents) with them. Does the 8 cents go farther here than there? Absolutely not. They then spoke of all the abuse, revulsion and ostracism their patients had undergone, and that these ladies still not only lived life, but loved it. I thought to myself: who am I to complain? I am not mentally ill, have the 3 Weiss men solidly behind me, I have skills, an education that the lack of registration will never take away from me and I live in my home country. Working gratis is not too bad.

When my brother, Manu, died, I was in counselling w/ a woman who is on this mailing list and I spoke of how isolating grief was and how none of my friends appeared to understand what I was going through. She mentioned that I appeared strong and that my friends probably thought I was just fine. It's the same issue w/ the funding: everyone probably sees my work continuing in spite of zero bucks and thinks I am fine. You know, it would be nice to be paid for my work, so that I could do much more, could take the men out to eat every so often, make concrete plans to honorably start repaying my student loan, take the boys to a movie and not balk at their wanting popcorn and a soft drink, go to American conferences without worrying that a candy bar (50 cents to you, 23 bucks to me) would break my budget. Enough said - therein lies my wish list.

We had lunch w/ some friends from Switzerland who had brought a Swiss tour group along. The group members were, to a person, delightful to talk to, the food was awesome and seeing our friends again was wonderful - what a lovely afternoon. The Swiss folks asked about my work and noticed that people here, even the very poor, seemed very happy. Mais oui - we are a happy people, in poverty or out of. And I am starting to realise more about the former situation than I thought possible; God does work in mysterious ways, doesn't He? No clearer way for me to fully understand my poverty-stricken pts than for me to have a mild dose of it myself.

Ok, time to wind up. Keep those msgs coming!

"Having a family is like having a bowling alley installed in your brain." - Martin Mull

Report of 6 Feb '05

Hello all -

So our doorbell rang at 5.40 AM yesterday and my lovely husband walked in. He normally gets here on Friday nights, but a meeting had run late and he took an overnight bus. His trip was in doubt as all trains were sold out - somewhat commonplace in my overpopulated country - but he got here, and we were all glad. We managed to have about an hour of conversation before he fell asleep and before the boys got up.

My patients at the Banyan are well. One of them has hepatitis, quite probably caused by something she ate. We have to order a special diet for her - no fried or spicy foods, well-cooked dishes and no raw vegetables yet. I am impressed that the Banyan will get it to her. Anytime one of the patients needs something special - bread or some fruit - I ask the nurse about it and she invariably says, "Oh, yes, we can get that." Makes my job much easier. This patient, Ms. P, had been escorted back to her family after her husband and the Banyan had discussions; when they got to her house, the husband refused to "take her back." I feel very bad for her - she has been treated, is much better and would like nothing better than to rejoin her family, but cannot. As I treated her the other day, I went up to the bed and smiled at her, and she smiled back - it was a lovely sight. With my mentally ill patients, I can never be sure that the smile or greeting will be returned. Anyway, we try our best with the patients and they remind me of how fortunate I am not to be mentally ill, that my husband and kids can still stand to be around me, and that we have the resources to plough on.

We are going to start charging for the tutoring service - a nominal amount. I think I've mentioned the clinic started by senior med students in San Antonio and that when it was free, hardly anyone came, but when they started charging (I think $2 per visit), they had plenty of clients.

This week was more than usually fraught w/ No answers - to funding, to a job for May, you name it. It appears to be frightfully easy to blow off email requests. I am looking for a locum (temporary) job for May in the U.S., to keep up w/ Western medicine where most of the advances originate and, incidentally, to make a little $ to continue the work here. The locum agency man states that nothing is available for May and that is echoed elsewhere, also. In the midst of these festivities, the travel agent called yesterday as we were en route to pick up the tickets for our U.S. trip and mentioned that the original fare for our tickets was different as we were travelling on a weekend and that the new fare was 1-1/2 times the quoted amount and that she had just noticed it!! Wooo - I lost it a bit and told her we were not a bottomless pit of money, that I was completely disappointed in these proceedings, and she coaxed me to travel on a weekday; this is a bit difficult to do, with juggling the boys' schedules and those of the relatives who will pick us up. So now our travel plans are in suspense.

The Banyan's fundraiser was yesterday and it was an evening with some of the country's top musicians, singers and dancers. The tickets were extremely expensive, and I had regretfully planned not to attend, but the Banyan gifted us 2 tix ("This is for friends of the Banyan, doctor") and Scott and I went; I was grateful for the Banyan's gesture. It was an evening under the stars, sans mosquitoes or high heat, at a beautiful venue and the performances were magnificent. Scott is the musician among us (saxophone) and appreciated the talents exhibited, pointing out difficult pieces that the flautist was generating w/ ease, etc.; until then, I was simply staring at the handsome musicians :) and idly (but fully) enjoying the music. The dancing and singing by beautiful female artistes were also excellent. Yesterday marked 22 years since Scott and I met (we've known each other over 1/2 our lives now - he is 43, I am 41) and it was a lovely way to spend an evening, w/ my spouse and like-minded people who believe that the work of the Banyan must be supported. Every time my spirits start to flag w/ the reminder of my unfunded, unregistered state, I look at the 2 young women who started the Banyan and am reminded that nothing worthwhile ever came easily, but that it can come and will. Hospice *will* happen - the dying, ostracised and terrified, will have a place where they can be comfortable and their family members *will* be supported. Dream on, Renu.

I plan to speak at several places in the U.S. and have a CD full of wonderful pictures that Doug took. The work here is great and I simply plough on, being very grateful for my education at one of the premier medical systems in the world. Should you be part of a group that would be interested in hearing of this work, pls tell me. My emphasis is in increasing awareness, the money issue is purely secondary. In fact, that appears to be ruling my actions here - when a friend asked me what money I make at the Banyan, I said none and it did not bother me. A dear friend from med school days is helping me navigate the locum waters and he reminded me that he is aware that I don't do this (doctoring) for money, but that I must be paid fairly; he is very correct and I am extremely appreciative of his looking out for me. I know of the advantages of money - last year, as we sat in a relatively plush train compartment and I looked at our sons revelling in it, I thought that an occasional treat such as that must be afforded.

Sex ed classes started at Abacus, the kids' school. The senior (10th grade) boys were ok, their session was short, but one of them did ask what the odds of someone getting pregnant were - I told him one episode of unprotected contact can do it. It is fairly easy for me to encourage abstinence here, culturally, but I am under no illusion that it will be implicitly followed and so I include the advice that if the kids must experiment, they should also ensure condom use. The girls' session was much more fun - lots of giggles, questions and interaction on other issues as well. This is a nice bunch of kids and I told them so, and urged them to keep the issue of helping someone else in mind as they left the protected environment of Abacus.

Well, gotta go before this tome ends up becoming the new "Iliad."

"When people ask if I do my own stunts, I always answer, Not on purpose." - Billy Bob Thornton

Until next week -