Report of 12 June '05

Hello from the libraire on a wet Sunday (perfect place to be) -

Hope all are well, and enjoying the summer. As a colleage at St. V grimaced at the heat (about 90 deg), he told me it must be cooler than India; yes, it is - about 15 deg cooler.

Work is good. I have extremely nice coworkers and that makes a heck of a difference. When I am busy, I have no time to mope. And I was pretty busy this week. Several patients were nice, too - such as the lady who came in for follow-up after her hand tumor was removed. She continues to have some pain, but asked for the lowest dose of the pain med. She was widowed last year, then proceeded to lose her entire in-law family, has a 20 yo son ready to leave for Iraq leaving his wife and 4 yo and 2 yo behind, and is attempting to make a go of her nursing career. As I questioned her on her smoking (3 cigs/day) and told her she ought to quit, I said out loud that w/ her life, the cigarettes were probably helpful. She seemed very grateful for that comment. The letters "R" and "N" are among the most respected in the alphabet for me, and I told her whenever she decided to seek work a bit of a distance away from her home, I'd write a letter for her. At this, she burst into tears. I am not sure how much a letter from *me* ("Lunatic doctor serving the poor free in India endorses this candidate") is going to help, but perhaps she appreciated the gesture.

The gay patient came back. She returns weekly, prompting a tirade about Medicaid abuse from my competent medical assistant. This time, she thought she had been poisoned, as she had got sick after a fast-food sandwich she had them re-do. Oh my. Her son has gonorrhea, as it turns out, and I told him during his visit that he needed to be extremely honest w/ his doctor on his practices - 3 of us had looked at the rash all over his body and couldn't agree on what it was. As I looked at his test result later, I cussed using strong profanity and the nurse manager, a very competent and compassionate lady, seemed surprised. I told her that I cannot do what I do for a living w/o cussing. Scott does not like this habit, but is gracious about it, even telling the kids, "Hey, when you're 42, you can say what you want, but not now."

My car's battery died and kind Jim Hillman jumped it for me. It went into the shop for extensive repairs, all of which I cheerfully allow as I love this automobile. This necessitated Colleen driving me places and when I picked up the car, she and I got pizza and sat outside, eating and gabbing. It was great. I am also truly impressed w/ the repair shop - Firestone on Rangeline - and w/ its female manager.

I was privileged to eat dinner this week w/ Louise Hass, the former St. V librarian. The restaurant we ate at was very expensive, but had great food. We sat outside in the balmy breeze and talked endlessly. Both of us have lost close family members and spoke of the experience. This unloading to one who is aware, down to the atom, of bereavement is very therapeutic and I felt the vice of grief easing its grip on me. We talked of several other things also and it was a memorable evening - a lovely breeze, great company, good food.

Saturday was spent w/ Scott's mother, aunt and uncle down at their farms. It was a nice day to be down there, and we talked, ate and laughed - all the while sitting outside enjoying the beautiful weather. It was fabulous and rejuvenating! Driving through rural Indiana had been a bit creepy, w/ my dark skin, etc., and as I tried to make light of the experience, my in-laws told me not to ignore my instinct. Scott and boys are w/ my parents in Mdu this weekend, and though the 3 Weiss men appear to have forgotten 1/2 the things I sent for my parents - carefully labelled and packed, everyone likes gifts from overseas - they must have had a good time. How spectacular it is to get along w/ each other's family.

Today, I saw "Sisterhood of the Traveling pants" which was good. We leave soon to eat dinner w/ the Janis and I look forward to it.

As much as I bemoan the presence of jerks in the world (Louise told me of an attorney who had been unpleasant during the trial, but also of several nice folks), I think we would never know what nice people are if we didn't also have the jerks around.

Best to all of you -

Report of 5 June '05

Hello from the public lib -

Man, I could live here.

Trust all are well and had a good week. Mine involved taking the 1st 3 days off (Mon was a holiday, anyway) and taking the boys to Chicago to board their flight. They did very well, getting ready on time and helping load the car. We got their beloved breakfast sandwiches - you know, the low-cal, healthy, sprouts and tofu kind from McDonald's - and hit the road. I thought about stopping en route to fill up gas, which had always meant a soft-drink break for these 2, but they had raided the Tabers' fridge for their drinks and were ok. We had signed them up for the Unaccompanied Minor service, and their bags were even tagged "Priority." A dear friend asked privately (she had not wanted to ask in front of the boys) if I had been nervous about their flight; I had not, but did not want to let that plane out of my sight. I was allowed to wait at the gate (hooray!) and could leave when it was airborne. The flight was delayed at Frankfurt, but the boys said later they'd enjoyed the experience, had met another nice UM en route who sat w/ them, and Naren found the extra charge for the UM service very worthwhile b'cos they got to avoid the lines at Immigration. One of their bags did not make it, but got there the following day.

Work is fine - nice when it's busy and the day goes by quickly. I still get time for a breather now and then, thank heavens, and am pretty grateful that my remuneration does not depend on the number of patients I see, as it does w/ other private practitioners. The types of cases I see now turn my reports into not-quite-family-fare (many of you have said you share it w/ your kids), but must represent the current circumstances. Such as the attractive young woman who came stating that she was back w/ her abusive husband, that he had been intimate w/ sex workers, that she was worried about contracting a disease. Before I could stop myself, I had said it - "Why are you with this man?" Indian directness does not always bode well, does it now, but ol' Dr. Phil appears to be making a career out of directness. Anyway, I tested the young woman for STD's and HIV, and results are awaited. She said she would be interested in counselling to break herself free of her husband and we set that up.

The number of patients who bound in joyously for a Pap smear continues to increase. This is not by any stretch my favorite procedure to perform, but perform I do. At one point during residency, I waited outside an exam room door waiting for the pt to disrobe and get ready, and took a deep, sighing breath; the nurse assisting me said, "Dr. Weiss, the pt will be fine." I said, "I'm not sighing for her - I'm sighing for me." Bit selfish, but what to do.

My patient who had had the astronomically high blood sugar and been tested for diabetes returned for follow-up, reeking of cigarette smoke. I told her about the need to stop said habit. We then set her up for check-ups by the eye doctor and the foot doctor, both on our premises - which is so heavenly. I met the foot doctor the other day and we had a long chat about kids, movies, basketball. He's a great guy and a firm believer in giving back to the community.

I forgot to tell you last week that I spoke at St. Vincent Hospital, my residency alma mater. While in training, speaking at noon conf was a dreaded chore - we had to present our take on recent journal articles or other topics. This time around, it was a pretty joyous time for me to speak of my work. I was privileged to have in the audience both the program director and the associate director - Drs. Lubitz and Love; the CEO and nurse coordinator from my current job - Dr. Ruth Stevens and Jan Dallas; some staff members; Louise Hass, St. V's former librarian; Sandy, Karen and Tom from St. V physician recruitment - Sandy and Tom had tried very hard to find me a locum and their efforts were so appreciated; Kurt Broderick, a St. V pharmacist and great friend who has donated $, crayons and markers for the tutoring kids. Naren and Navin were there as well, waiting w/ bated breath to see if I would make them speak of their work tutoring the kids and organising the Halloween carnival for the underprivileged kids - I did not, earning their gratitude.

We got together at the home of Cindy Ching, former residency classmate, w/ her and her family, and another r.c., Olivia, and Olivia's friend, Paula. It was lovely to see everyone again. Some of my former r.c.'s state that they always feel bad to complain about their working conditions, esp when they read of mine in India. I feel that working here is pretty darn stressful in its own right and private practitioners do have challenges - patients demanding disability or Vicodin when they don't need either, pts coming in w/ multiple problems on a 15-minute visit ("electricity running through my body" was a memorable one for me), the umpteenth STD case, needing to see pts at a brisk pace and figuring out how to enter the proper numeric codes for all their problems - thus entitling the docs to vent now and then. Venting is therapeutic, was the best advice I got during a very harried intern year from our pastoral counsellor.

Yesterday, I saw "Cinderella Man." It was magnificent, w/ strong performances from all. I had not seen Paul Giamatti before, except in "Sideways," where he did very well, but which was not the most ideal movie to watch w/ my 14 yo - I've been called prudish before, but I truly have not generally seen the need for graphic depiction of sex. (After entering medicine, I don't like slow-paced flicks also, thus did not like "Lost in Translation," either, and found "The English Patient" particularly tedious and boring - probably the only one in the United States who thought so.) P. G. looked like he gave a Best Supporting Actor-worthy performance here; I was impressed w/ how he pitched a business proposition to bring down-and-out boxer James Braddock back to the ring. I discovered long ago that improved health for poor Indians does not qualify as any kind of investment lure :-) Russell Crowe was, of course, excellent and so was Ms. Zellweger. I could truly believe they were married to each other and making a go of tough times. I also saw "Crash," which was an excellent ensemble piece, much like "Traffic." On my return "home," I found the Tabers watching "The Motorcycle Diaries" and piled on. It is absolutely fabulous to satisfy my movie fix here.

At least from my patients, I get the impression this is a somewhat spiritually bereft society, w/ tremendous pressures to look attractive, have a huge rock on the finger, to be thin, have plenty of romantic interests (or a great car), blah blah blah. One of my Indian Christian friends here says she must rely a lot on church to keep her kids grounded in values. Perhaps that explains the value of religion here. And the trail of folks who come to India, seeking spiritual solace, even amidst the dreadfully poor. Doug, our English med student friend, even wants to practice in India. The U.S. remains for me a great place to have studied and made friends in. And as Scott said jokingly, when we were discussing "Ray" and the poor choices Ray Charles made, not everyone can marry as well as I did. Yes, this is also true. Great American husband, wonderful American education, sincere friends here and in India - couldn't really ask for more.

Have a great week -