Report of 1 Jan '06

Happy New Year to all!

Hope the new year brings you health and happiness.

We are well and back after 2 weeks away. It is time to return to the Banyan. There is one patient in particular whom I'd like to see heal. This is the young woman, Ms. S, who had multiple health problems owing to bacteria in her blood ("septicemia"), and was hospitalised w/ the B spending 500,000 bucks on her care. She is much, much better, but continues to complain of pain in her leg and walks w/ a marked limp. She does have an attention-seeking disorder and is given to making up complaints, and throwing things, but I have noticed that she limps even when no one is looking. There is a good orthopedic surgeon working at our local hospital for the overprivileged and I would like him to see her. They treat our folks for free and Dr. Balaji Srinivasan has successfully operated on one of our patients w/ long-standing pain, diagnosing her w/ an infection in her bones ("osteomyelitis"), and surgically treating it. Let's hope he can help S.

The tutoring wound up for 2 weeks. We have many more impoverished kids showing up to be tutored, and I have often wondered what we accomplish there as it seems so rudimentary and unprofessional (none of us is a trained teacher, although the young tutors are working wonders - let's hear it for peer education), but the kids come happily, and ask to learn more, and color and draw, and get candy at the end of the session. We were tremendously privileged to get the school supplies very diligently collected and assembled by Rex Cassidy, husband of my friend Carrie, and little Blythe and Lauren Cassidy. There were pencil boxes identically packed w/ leftover school supplies (markers, scissors, etc.) and we gave these out to the students at our end-of-year party. Let me tell you, the considerate Cassidy work was greatly appreciated by us, and the gifts were eagerly received by the kids, whose supplies are pretty minimal. School scissors are unheard of here, and I imagine several parents as well received these supplies at home w/ glee. We are very grateful to the Cassidys and their school for this donation.

Naren and Navin had end-of-term arts performances, w/ Navin singing Indian music and Naren taking part in South Indian folk dance. I really like the fact that the school has these arts, and indeed, the SI folk dance master teaches the kids arts that are dying - like Silambam, a martial art/dance w/ long sticks. We have insisted that both boys study something local, as opposed to English drama, and they enjoy it. The performances were good. The Indian music troupe only had 4 kids, it being a not-very-popular option among the hip kids, but Navin did sing however bashfully. I used to think everyone had a sense of rhythm, and you only realise the truth when you see someone who does not quite have said rhythm. Naren's group did a dance called "Devarattam," which ostensibly a bunch of gods and goddesses did for Shiva and Parvathi, and it was very good. Naren leapt and twirled in pretty good rhythm, and we enjoyed the show.

We saw the annual Little Theatre performance called "King Arthur and his nights," and it was good, as usual. The money raised goes to scholarships for poor kids, and is a cause dear to us. The play is usually a romp of irreverence, great dialogs, pithy political observations, wonderful humor and lots of dancing. Annually, the cast goes out into the audience at one point in the play and dances w/ 'em, and we usually sit next to the aisle, as we like to dance and show our support. No difference this year, and we had a blast.

We took a 2-week trip - saw my little niece's naming ceremony and were really pleased to see our childhood friend Farshid, who lived in the U.S. for a long time and is now pursuing a Ph.D. in Ecology from Holland w/ field work in Mysore (I must say it's nice when childhood friends are the sort you'd choose as an adult, too, and Farshid is a great soul); visited relatives in Coorg and Mysore; spent Christmas w/ my parents in Madurai; hung out w/ Scott in Bangalore and then went to my sister Anu's for New Year. Her son, Aditya, played the drums in a local band for a New Year's Eve party and we went to hear the music and dance. It was a fun event, w/ many of Anu and Benji's friends, and a great way to ring in 2006. We got home yesterday and got lots of good tidings. Ruth Ranalletta sent us a box of journals and candy which are oh-so welcome here (for different reasons - I love the journals and the kids veritably inhale the candy: Ruth knows us well); Phil Bagley sent us some beads that we can use to teach our kids math, and they are lovely - quite what we desperately need; Carrie Cassidy phoned - so nice to hear friends' voices - and told us the Key Club and Kiwanis wanted to send us some money for the carnival we are to have for poor kids (this will make for a great carnival!); Tori Scott sent a giant parcel of chocolate through our friends, Christine and Ganesh - Tori outdid herself w/ this stash and we have attacked it already, w/ tremendously wam thoughts of the entire generous Scott family in our conversation at every bite. A pediatrician colleague, Sai, whom I'd put in touch w/ Tulir, the orgn that deals w/ child sexual abuse, (and Ability Foundation, the orgn dealing w/ disabled folks) phoned and thanked me for the same, and I was so touched - because Tulir needs her services, and she was thanking *me*. Those who work w/ the destitute are inclined to think this way - who needs the services now - and I am privileged to know some wonderful folks. We were also happy to get back in touch w/ George and Carol Tilley, friends from the boys' infant days, and the Tilleys gave them Curious George books, which they loved. We were also glad to see Matt Newcomb, Scott's former Infosys colleague, now back in the U.S. setting up a business; as Matt apologised for not coming w/ a Xmas present, I told him he'd brought the best possible present - himself. That is indeed how we feel, tremendously happy that we have great friends whom we can see off and on, and whom we hear from regularly. I nearly forgot - I got a very lovely, appreciative note from a former poor patient in Indianapolis who said her diabetes and blood pressure were better due to lifestyle changes she and I had discussed, that she was very happy w/ these results, and that she wanted me to return to Indy soon; Scott said this letter was the kind to put in a frame. I was really touched by this thoughtful letter.

On this euphoric note, as I got ready for bed, I got a call from my widowed sister-in-law, Susan, talking about the umpteenth argument she and her son, Sudhir, had had. Sudhir has not done well in college, and mother and son simply do not get along. I spoke for a few minutes, urging counselling, which Susan is balking at going for since Sudhir will not go, and I tried to emphasise the importance of solo counselling as well. As my day slowly deflated, I realised that if at times we don't taste the bitter, we might never know what is sweet.

The best to you all in 2006! What's the deal w/ this "Happy Holidays" msg in the U.S.? If it's Christ's b'day and Christians celebrate it, what is wrong w/ saying "Merry Christmas?" Yeesh. Some people simply have too much time on their hands.

"The freedom of a society varies in proportion to the volume of its laughter."

Love from the 3 Weiss men and me -

Renu

Report of 11 Dec '05

Hello from a spot of sunshine (it's been cloudy all day) -

We just had a vat of chocolate ice cream and are on sugar overloads. I have a friend visiting: Desmond and I studied together at Temple, a great school in a wonderful city, Philadelphia. We figured out it's been 17 years since we saw each other and I am greyer and Desmond is heavier. C'est tout - otherwise the gabbing is non-stop and today we went to lunch w/ Vinu, which was a blast. In case anyone is wondering where Tina and Ahana are, they are w/ Tina's parents in Mysore. Traditionally, the woman goes to her parents' place for the birth of her first baby, a move intended to give her some rest from the onerous duties at her in-laws' place, where she'd live. Tina chose to have Ahana in Chennai, and they have gone for some TLC and rest to Mysore.

The big news this week was that the Medical Council of India came through w/ their final word that I have to do a screening exam that all foreign medical grads do. India is so overpopulated and medical seats are in such demand that quite a few kids go to whichever country will have 'em and study medicine. They must then pass this exam so that they can practice here, it being ostensibly to ensure that they have the basics down. I was all set to do the exam, then emailed the National Board of Exams and looked at the website that MCI gave me, and both addresses were completely incorrect. That was the straw that broke the camel's back: MCI is a bunch of inept, corrupt, obsolete folks, sitting in Delhi and passing on archaic laws to all who'd have 'em. The medical system in India is a tremendous dichotomy: I've worked w/ brilliant graduates whom I'd trust my mother to and have, and some of them have qualified to work in the United States (some such folks are on this email list); there are also med students who have, right at exam time, come to my parents w/ their parents, a pack of cookies or a jar of pickle, and the visiting parents would implore my parents to pass their child. My parents are the epitome of non-corruption, and I remember my mother clearly telling her student's mother, "If he studies, he will pass. However, I haven't even seen him in class," and she handed the pickle back. There have been several inept candidates who have passed at various med schools in India because they are the vice-chancellor's nephew, an associate examiner's cousin's daughter, a minister's child - you get the picture. Such grads are then unleashed on an unwary, unknowing and unsuspecting public. The exam that is to be passed is some lengthy thing dealing w/ basic sciences (the Henderson-Hasselbach equation, embryology, etc.) which I have been tested rigorously on, and without the benefit of pickle, many years ago. I am tremendously happy with my American education, and consider it as coming from one of the most prestigious medical systems in the world. To equate it to Uzbekistan's, or to consider it inferior to that of this country (India), is an outright insult; let's be realistic about that - as much as I love my country. So I am going to refuse to take the exam and am girding for a fight, especially because the American Board exams (which we pass at the end of our residency training) are recognised post-graduate degrees here. My point is that if the post-graduate degree holds up here, the undergraduate medical degree obtained en route to it must also be valid.

The Banyan is good. We have a patient who had a lymph node removed from her neck and is suspected to have TB, from the biopsy results. Ms. B is from another state, and I read her file. She had been threatened by her in-laws who had thought she didn't bring enough dowry. Her father had urged the Banyan to keep her, and also suggested the B file suit against the in-laws to recover the dowry money. He didn't want it back, but told the Banyan to keep it, which touched me enormously. He also didn't suggest that his daughter be sent back to him, and that was the sad part of it: that there'd be such ostracism heaped on the family if a daughter, fearing for her life, went back to her family. I remember conducting mock interviews in undergraduate college, and the captain of the basketball team, an otherwise fearless sort, telling me she could not shame her parents by returning to them even if she feared harm from her in-laws. You know, I have cause to feel fortunate daily, and this time it was tremendous gratitude for my in-laws, esp my remarkable mother-in-law, who'd rather whack her son than see me harmed, who is a fun person to hang out with, whose sense of humor is legendary, who has passed on her lovely temperament to her son, and who has done things like mow our yard and wipe my toddler sons' butts when she's come to visit. That everyone should have such a mother-in-law, this would be good.

The veg market continues to reel with colds, coughs and discounts on vegetables for me. Our tutoring service is also expanding big-time and we are trying to scrounge up extra tutors. One of the kids was supposed to find out the longest beach in the world, and one of the tutors thought Rio de Janeiro; does anyone know? I asked a couple of little ones how they were, esp as their houses had been water-logged w/ the rains; they answered, and then one asked, "How are you?" My heart came yanking out - such courtesy, such respect, such consideration, even in the midst of their sodden state. We will have a party next week to wind up tutoring for the term. Our long-awaited Halloween carnival, postponed due to rains and other reasons, will be on 8 Jan '06, but won't be called that. Hey, if anyone has access to brightly colored (various size) beads and sticks, pls send them to us as our math kit is very pathetic.

Today, we had a talk by an organisation (most impoverished) dealing very effectively with child sexual abuse. It was a spectacular talk, and focused as much on healing as prevention. www.tulircphcsa.org. If anyone has an extra buck, these folks would welcome it; please, please spread this word. Thank you.

Well, I'll wind up this tome. Trust all of you are well. My computer brought up a picture of "Sexy Singles," focusing on a woman's shorts and panning to her head, on which she had a Santa hat. Let me tell you, there are some things I don't miss (at all) about living in the United States.

"Never believe anything in politics until it has been officially denied." - Otto Von Bismarck

Unw -

Renu

Report of 4 Dec 2005

How time flies -

The end of the year is already on us. Scott is taking an early train back to B'lore, the boys are re-reading some of our favorite comics (Bloom County and the Far Side), and I am emailing.

The week has been good. Actually, any week that one can work is a good week - the money be darned. The rains continue relentlessly, and water-borne illnesses continue to rise. We had a young woman, Ms. A, in the sick room who is routinely in her own world and joins everyone else for meals, etc., but doesn't say very much. When she does, it's in Telugu and we have to yell for Telugu-speaking colleagues to interpret. She ended up with nausea, and the suspicion that the level of her seizure meds was too high (thus causing the side effect of puking) existed; however, I also tested her for leptospirosis and lo and behold, there it was. She is getting treated for it, is improving, can now stomach food, and I am pleased. I cannot make light of any symptom at the Banyan.

We'd had older pts who'd become very ill from diarrhea - really, it can wipe out frail little bodies quickly. One of them, Ms. Ak, had been hospitalised for the same, and is now improving. When I looked over her file, as I do when I have a little time between rounds, I noticed that she'd given birth to a child years ago and had sacrificed the child to appease a God. I was shaken, but cannot stop to dwell too much on these unusual beliefs and shocking courses of action - just as I could not when the impoverished man threw each of his 5 daughters off a bridge into the river and then jumped in himself. That story made page 7 of our paper. I remember the lady in Houston (in our old neighborhood, in fact!) who killed her 5 kids and it making national news. We do not have the luxury of brooding here, life must just go on.

The vegetable market continues well. The tomato lady is to bring her husband's blood test reports ("I want a doctor I trust to look over them," she said, moving me enormously) and I can see what his ailments, in addition to diabetes, are. She said she had no one else in the world - the couple has no children, which is considered a disability here - and said she had to take care of her husband, and then got teary. I patted her arm - I love human touch - and said diabetes was a very treatable condition and not to get so frightened by it. She heaped me w/ a bunch of extra tomatoes, making me the envy of my neighbor as all of us are reeling under high vegetable prices due to rain.

We were very fortunate to run into some former tutoring students who had stopped coming for various reasons. One of them, M, is a ninth grader, again from a desperately poor family, who studies her eyeballs out and wants to become a doctor. It is not for her professional goal that I like her, but that she is keen on educating herself, improving her lot in life and will not take the blows that life has dealt her lying down; I discovered 3 days ago that her father had left them and they had moved in w/ an aunt. I think this situation does not gladden anyone, and I urged her to return to tutoring; she did, bringing her sibs and a neighbor w/ her. M tends to memorise her English lesson w/o understanding a word, and I urged Naren to translate it for her; he flailed w/ the Tamil, and so I helped out. It must be awful to not understand what you are reading, and then get tested on it. These kids had not experienced Maya's markers, w/ the pattern on the end, and had a whale of a time at the end of the session w/ the art work.

We have decided to hold a party during the holidays and Naren can invite all the boys and girls he wants. Actually, he is very sensible in his choice of friends and I look forward to hosting the young 'uns, most of whom I like a lot; this affords him the chance to have girls over as well, and I imagine the young ladies are equally nice. Speaking of parties, Scott and I were invited to one last night given by one of his former employers; it was very high society (I guess) and had film actresses galore in the crowd. As it turns out, 2 of 'em were seated right by us; one of them (Kushbu) had stated publicly that Indian men should not insist on chastity in their brides any more, that everyone experimenting w/ premarital sex should use a condom. Radical Tamilian factions are up in arms, accusing her of demeaning Tamilian women and filing lawsuits aplenty. We told her we supported her viewpoint, and her right to say it. I imagine some in the crowd were awed by the actress brigade; as they were sitting by us (and even otherwise), we tended to view them as human - just as we will always view Richard Gere as David Gere's brother.

We had breakfast w/ my brother, Vinu, today and it was fun. Being able to see my extended fam is something I'll always appreciate. His daughter has been named Ahana ("Dawn") and will have a naming ceremony in 2 weeks, which we'll attend along w/ lots of relatives.

Life and work go on, and I am never sure how to aggressively market my cause to any one, figuring that if anyone is that interested in funding this work, they will so state. However, this we crave - our great wish is to visit the U.S. next year. It was mighty therapeutic and spiritually rejuvenating to hang out there, not to mention enlightening (in attending a great medical conference). If any of you knows of speaking opps, pls let us know. I am getting less and less adept at selling myself (indeed, what am I selling - improved health for impoverished Indians, many miles away, which is not a product or service anyone would jump at) and ramming my work down people's throats. I simply work, plough through the patients, get paid in tomatoes and plenty of goodwill (including blessings for the 3 Weiss men), tutor abysmally poor little kids - it's good work. Folks have wished good wives (no time soon, tho') and lives for Naren and Navin - that is a lovely thing.

"The main difference for the history of the world if I had been shot rather than Kennedy is that Onassis probably wouldn't have married Mrs. Khrushchev." - Nikita Khrushchev

Unw -

Renu

Report of 27 Nov '05

Hello from gloomy Chennai -

It promises to rain again today. We need to be careful what we wish for - when it was hot, we wanted rain and now we have it. Every day. The clothes-have-not-dried, pull-your-saris-up, traffic-is-backing-up kind of rain. Rail tracks and roads to Madurai have been damaged, and we spent an hour today at the train booking office to cancel my Madurai ticket; I'd wanted to go and see my folks.

We just returned from lunch after the booking ofc. It is nice to fill one's belly when one wants to, eh? About 25 years ago, I told my mother how fortunate we were that we could afford the food we like to eat, and she agreed, speaking of how women came to the butcher to buy about quarter pound of meat, that being all they could afford. I have had patients who have not been certain of their next meal, and I remember each of them. Before my registration went into limbo, I took care of several such folks, including one who travelled 4 hours by bus to see me. He had been given a diagnosis of Cystic Fibrosis from a powerhouse medical institution here, I'd disagreed, and treated him for Reactive Airway Disease. He'd improved, and I was deeeelighted. I wonder how he is, and hope he continues to breathe better.

The virus in our house stayed persistently, and it took 2 weeks for us to recover. There are great lessons here: I used to think a cough was a fairly mild symptom, and reconsidered after mine this week, which caused my head to lift right off the pillow, woke me from sleep and caused a headache w/ the effort. Never will I consider a cough a mild annoyance again. Navin got better and then abruptly lost his voice this week. Scott is also recovering. Rest is under-rated in recovery - because I could spend a week in bed and ease back into work, I didn't get as wiped out as Scott did. Scott has been known to drag himself into work even when unwell, and actually was forced to take a day off last week.

The Banyan continues well. Upset stomachs, colds and coughs continue to rule, and the sick room is full. 2 patients had picked a big fight w/ each other, even coming to blows, and when I went in on Thursday, they were asleep. When I heard the preceding events, I ensured they stayed asleep and we continued w/ the rest of the rounds. Many of the patients are on medicines to treat fits ("anticonvulsants") and because their bodies are little, sometimes end up having a rather high level of meds in their bodies which causes sedation. We have to watch for this, and it's a balancing act between side-effects and efficacy. This time, tho', I preferred to let sleeping patients lie. We truly need to pick our battles.

The rains kept the tutoring kids away. I was sorry, but was glad they stayed dry. We were delighted to receive school supplies from Blythe, Lauren, Carrie and Rex Cassidy in Brecksville, Ohio - they had rounded up goodies from end-of-school 2005 and we are happy to get 'em! 3 boxes came to us and several went to an orphanage in Madurai which otherwise must subsist on the kindness of locals. We have not opened the boxes yet, but think the contents'll make good Xmas presents.

Stayed away from my pts at the veg market this week, as I would have flung sickness instead of healing upon them. Good health is such a tremendous gift. We took the boys to see "Harry Potter and the Goblet of Fire" today, and I enjoyed it. All of us did. There were several things good there, including the poignant touch to Neville's character. For those who keep up w/ the series, it is my firm belief that Snape is a good guy and that he only did what Dumbledore told him to do in the 6th book. Let's see if this theory holds up - I am currently the only proponent in my house tho' I am winning Navin over. Naren and Scott maintain that Snape is evil.

We continue to battle teen hormones in our house, w/ Naren cooking up fairly elaborate plans to see his female friends - including those at other schools - and getting belligerent when we state he cannot go to the homes of people we do not know. Amazing how a sweet good-natured kid can rewire as a teenager. Navin is watching this spirited battle, and I think might develop alternate strategies. In the grand scheme of things, we really cannot dictate to our hearts whom they must like, can we.

"Love is the most subtle form of self-interest." - Holbrook Jackson

Unw -

Renu

Report of 20 Nov '05

Hello from Chennai dusk -

My sons are playing soccer downstairs, Scott is en route to Bangalore, and I have a minute.

We did not have to look far for patients this week: Navin had a high fever on Sunday night and Monday morning, and ended up staying away from school for a week. He also had a dreadful cough, and I started him on an antibiotic which worked, but slowly. I had some kind of a virus - cough, upset stomach, malaise, and ended up staying home w/ little energy. Naren stayed healthy, thank Heavens, and almost ran the household. I could not get to the Banyan; the advantage of working gratis is that I can take off when the kids are ill or I am. I generally appreciate this.

Scott called from B'lore on Thursday w/ symptoms similar to Navin's and I prescribed a more powerful antibiotic. The phone rang right after he hung up and I answered and said, "7 days," knowing who it was. Spousal telepathy, and I heard Scott chuckling on the other end. He did make it home on Friday and we spent the weekend glued to the flat, except for a brief beach visit last evening. It was nice to have some quiet time, and we punted on Harry Potter, tho' I am very keen to see the film.

There were certainly other pts. Our cook's son has a squint and I have urged that he be evaluated by my friend, D. Ramesh, an ophthal who'll see my pts for free. God bless D, as we call him. This eval has not happened yet, as the cook's sister-in-law (my cleaning lady) has told the cook a squint is great, good fortune. We have to contend w/ beliefs like this all the time, and the cleaning lady has even treated her son's hepatitis w/ a scalding poultice applied on his arm by a local mendicant, searing the skin and making the boy cry. I used to despair about such practices, now I just say things like, "Well, you know what, do ask the ophthal when you go if the squint is good luck." It is expected that adults will use some sense, but there are of course deep-rooted cultural beliefs to contend with. My recent medical journal had the case of a Hmong girl who died because her seizures were not treated the Western way, but with Hmong spiritual practices.

The veg market had its share of patients, too, all treated over mounds of potatoes and ladies' finger (okra), and w/ the busy-ness of a Sunday morning at the market. The tomato lady's husband recently lost his sister to diabetes and kidney failure, and got his sugar tested - it was 285. So the lady and I discussed diet and exercise, and another customer nearby suggested an herbal med as well. I have heard of this med, and am not a big fan of denigrating other medical systems, so endorsed this as an additional option. The man in question sells cabbage which none of us eats w/ great relish, so I don't stop there. The 2 are devoted to each other, and I love that: she will say, "You know, when I get worn out, he always buys me a soft drink or a snack," and he will say, "I do worry about her, her arm bothers her a lot." Arranged marriages have their way of showing love. The concept of such marriages has blown the minds of our Western guests intermittently; I imagine if I explain the Western way of marriage to the locals here - date partners in succession, see if it works out enough to marry, possibly get intimate along the way - it would completely blow minds here as well.

Well, the saga w/ the American School came to a rather unnecessary head. I think I'd mentioned treating one of AS's opponents who had been slugged by an AS player and ignored by AS staff; when said staff asked me to move aside, I refused until the ice arrived and the boy stood. AS sent a msg to Abacus (my sons' school) that they were debarred due to my actions, until I apologised. I was not at all clear what I was to apologise for, and indeed, was not going to say sorry for treating the child, so sent a note to AS admin asking to meet and talk things over. They sent a note back saying I was barred from entering their school for ever, that they had certain expectations of their guests ("decorum") which I had not met; I wrote that I was happy to be barred and that we had certain expectations of our hosts as well, esp considering the goodness of folks we knew in the U.S., which AS had not met. Several of you responded straight to AS and we greatly appreciate the passion, support and backing; may we humbly request a stop to the name-calling. Thank you very much.

Tutoring continues and we were delighted to have the 2nd-grader back, which had been a huge challenge. It's nice to have the rains let up and have the kids arrive, dry and eager.

I'm off to have dinner w/ the boys, so let me wind up.

"Why shouldn't things be largely absurd, futile, and transitory? They are so, and we are so, and they and we go very well together." - George Santayana

Unw -

Renu

Report of 13 Nov '05

Good morning from my Chennai living room -

The laundry is whirring, stray dogs are making merry outside, the men are asleep but I hear Navin coughing and my 3rd son has already got up once. This is a child named Akhil from a school in Kerala who is at Abacus on an exchange trip and is participating in Navin's 7th grade classes. He is a cute fellow, tiny, full of beans, and easygoing. We are enjoying his presence, and all thoughts of having > 2 children are temporarily satisfied. Probably permanently, also.

The week has been eventful. The city continues to reel under rain and its aftermath, and the Banyan folks have had a rash of upset stomachs. I was reminded by Leela of the need for an antibiotic as I continued my conservative management, and indeed, water-borne illnesses might be very common now. We do not have the luxury of testing everyone for typhoid and I treated 'em for it w/o test confirmation. The patients w/ TB live at a different facility, in Otteri, which has become water-logged, and all of them are now at the main campus in Mogappair. One of them, L, came into the sick room w/ fever and chills, and as she walked in, she saw me, let out a huge smile and said, "HEY!" I have treated her before and she is a little person who will unfailingly offer me her breakfast when I walk in, so warming me with her gesture. (She was found begging at a tea shop when she was brought in, apparently long-abandoned by her family.) I had mixed emotions at her greeting: happy to see her, sorry that her life is such that she's happy to see *me*, and giant gratitude to Vandana and Vaishnavi for starting the Banyan so that folks like L who were on the street now have a home, esp away from rain, and are fed, clothed and unraped.

The vegetable market also had its fair share of patients, including a young lady who appears to miscarry in the 4th month of pregnancy. When she spoke to me once, the head of the market told me to caution her to be more circumspect and respectful, as she had apparently sassed him and is brash and headstrong. I see nothng wrong w/ being headstrong, and talked to this young woman more. She then got very teary (and far from brash) as she spoke about neighbors belittling her for not having procrreated. This is unfortunately very common in India; if a woman hasn't popped a baby 9 months after getting married, everyone considers it their business to comment, and not very kindly, either. I held this girl's hand, told her I'd give her the name of a good Ob/Gyn, and she could get evaluated. The power of the human touch is priceless for me.

All of us, including Akhil, were harboring a virus and the weather was nasty on Friday evening, so I was late ambling down to tutoring, esp b'cos I thought no one would show up. Well, 2 little people did. The tutors had very efficiently opened the tutoring room and got started, which was a big relief for me. The young students said they had got their lessons done and their questions answered. It is time for me, then, to dole out more responsibility to the kids and continue to monitor, but unobtrusively. We are delighted that the kids are doing well. I used to think the kids were too young to be tutored, but we are laying a foundation, I suppose, for lifelong love of learning.

Navin is totally enjoying his guest and both have turned their room into a giant pigsty. Navin is not a clean sort, and I welcome all suggestions to help him keep his things in order. Rewards and consequences have not worked yet. Naren has asked to start dating, and we have refused, stating he is too young at 14. (All inputs welcome to this issue also.) Scott, Naren and I had a long talk yesterday, and we said Naren will shortly turn into Hormonal Harry, with thoughts of only one thing, and that this curiosity could run him into trouble now if he started dating. When he protested vehemently, stating he was not "that way," I told him we trusted him, but that a darkened movie theater and an attractive girl next to him could take his thoughts away from the screen. This discussion will continue. As for Naren's school work, a couple of teachers had some minor complaints, but Naren has buckled down this term and has brought home better grades. He continues to blow off math and science, and Scott will sit with him this weekend.

Well, I have to make a huge breakfast and we are taking the kids to see "Charlie and the Chocolate Factory," so I'd better wind up. The kids had school-related activities y'day, including making up rain days, so Scott and I had a bonus day. We ran errands, including dropping off some American perfume to our travel agent (nice to dole out unexpected things thus), and went to eat some lovely Western food. We lingered over the meal, talked and laughed a lot. We also chatted w/ the chef, who is from New Zealand, and ribbed him for putting on wt. It was a spectacular time, relaxed and w/ awesome food, reminding me of the great benefits of having a nice spouse.

"The trouble with wedlock is that there's not enough wed and too much lock." - Christopher Morley

Unw -

Renu

Report of 6 Nov '05

Cloudy, wet and dark -

A far cry from the sunshine that existed last week. We are historically an agricultural nation and love rain; the Weiss family views it w/ some trepidation bcos our flat leaks.

We returned today from Delhi. It was a very nice trip - very illuminating. Delhi is a beautiful city and as I admired it, our cousin's daughter said it's a pampered place as it is the capital and flush w/ dignitaries, blah blah. We attempted to see the Taj and it was closed the day we trekked over there (a 3-hour drive). This was the most enlightening part of all: we are so unused to attractions closing (it did not happen to us in the U.S., it does not happen in Madurai) that we had not bothered to check ahead of time. Priceless lesson to all. So hear ye - the Taj is closed on Fridays.

However, there is much to see in Delhi. We saw glories that the Mughal emperors left us, and learnt of the lure of India to many plunderers and conquerors. There was a very lovely museum documenting the entire freedom struggle that we could not get through in the time that we were there, and we made plans to return to see it (and the Taj :) ). We met up with cousins there; I have been away from India for 20 years - in that time, cousins have married and procreated, folks have passed away, others have moved. It is to my great delight that the Coorgi cousins in Delhi have married lovely young women and have exceedingly nice kids. My father was at the conference of the Association of Plastic Surgeons of India, in Delhi also, and our stays overlapped one day; we made plans to meet the cousins and families, and my nephew in law school in Delhi, at a somewhat upscale but highly recommended restaurant. It was a spectacular evening, w/ all the kids (7 of 'em)at one table thoroughly enjoying each other, the adults at another and the evening punctuated by lively conversation and brilliant flashes of humor. The food was awesome - tandoor meats and fish, and that added to the grandeur of the evening. My father is not Coorgi (thank goodness, bcos Coorg is not renowned for any intellectual prowess) and had been ostracised by many of my mother's relatives for that very reason and bcos he is dark-skinned (this country is stupidly obsessed w/ skin color); these cousins will have none of that. We are another generation altogether and these folks like my Dad a lot. My mother could not travel and we missed her joie de vie (which Coorgis are renowned for) and her sense of humor also, not to mention her grace and her sense of hospitality.

At a popular market in Delhi, I noticed a crowd gathered around something. When I got closer, I saw that "something" was a woman on the ground, unresponsive. Her relatives were all a-dither and so I bellowed, "I am a doctor, can I help?" The woman came around after several seconds, my Hindi is not good enough to take a history and so I had to ask her daughter to do the deed in English. I never think that what I do is extraordinary, and it emerged quickly that the woman was probably having a heart attack. We packed her off to the ER, and the 3 Weiss men and I continued on our way. My family has this protocol down to a science; they wait away from the action for my signal to bring something or take my bag, etc., and it has become old hat for them to see me respond to emergencies. We used to do more of this in the U.S. as it is just a tad riskier for a woman alone to respond in India - legal issues set in, the party responsible for an accident tries to threaten the doctor to change the findings, etc. But we respond when we can.

On the flight back, the service was so good (as it was on the ongoing) that I filled out a comment card w/ compliments. It was a quick gesture for me, but the crew glowed. (No offence to those in the U.S., but we sort of got used to snarling flight attendants there and total lack of food; it was a change from prior, when service and food used to be good.) An older gentleman was sitting behind us and when he stood up, I noticed that he was shorter than I and I asked if he needed help getting his suitcase down. His neighbor got the bag down, and the man thanked him but also put his hand on my head and blessed me with such sincerity that I was extremely moved; all this for one little gesture, just a few words (and I hadn't even got him the bag). What a lovely world we live in.

Back to the Banyan this week. Back to work, back to helping heal. This is a great job.

"The defect of equality is that we desire it only with our superiors." - Henry Becque

Unw -

Renu

Report of 30 Oct '05

Hello from sunshine land -

We are very happy to see the sun out after 1 continuous day of rain 3 days ago on Thursday. Our flat leaks through the windows and we had to mop and wring out towels every hour. All the joy of sitting inside, dry and cozy, and watching nature's magnificence outside were consequently tempered by the reality of finding nature inside. It gave us a fine appreciation of what the poor might go through when their houses leak. At least we had sturdy towels to do the mopping, and the amount of water did respond to said mopping.

The Banyan is good. One of the staff members, Ms. M, came to me w/ a pounding headache and it was evident from looking at her that she felt terriblly unwell. The only tools at my disposal are the history and physical exam, as my patients simply cannot afford a cat scan or MRI. So I probed; it turned out to be a quasi-sinus headache accompanied by something else. I then asked if she had worries of the heart ("manakkavalai") and she got teary. I held her hand as her friend provided collateral; M's mother is a patient at the Banyan and M works in the kitchen there. She has made a go of her life in spite of her mother's mental illness and those of us who have had to cope w/ our parents' physical illness know the amount of turmoil such illnesses cause and must perforce imagine what *mental* illness can do. M is romantically involved w/ the maintenance man, both are single, and I rather like this young love as it has the potential to provide support to M. I gave M medicine to clear up her sinuses and a powerful pain med, and when I went in the following day, she came up looking fresh and lovely and obviously better. M is a tall, pretty girl and I am very fond of her; it was nice to help her when I could.

A helpline patient came in: the helpline is what anyone can call to report a destitute, mentally ill woman. When I went into the B on Wednesday, one of the senior social workers was waiting for me and gave me the rundown on what the patient seemed to have; you know, it is very nice to be a partner in caring for someone. We went in to see the pt and she was a pathetic sight: a wound on her right foot had not been tended to, there were bones and tendons exposed and maggots in it; her hair was being shaved and maggots were coming out of her scalp; she simply had no reserve to fight any more. To the Banyan employees' great credit, no one was flinching from what they had to do; the young ladies shaved her head, gave her a bath, cleaned her up and she was dispatched posthaste to a local hospital for surgery. At least 2 of the staff members then headed off and vomited. I had not seen maggots before and they were not as disgusting as I expected. I am keen to hear how this patient fared. The B's strength is that everyone merits treatment, warrants compassion, deserves a kind word; what a lovely place to work.

Due to the rains, no one came for tutoring. We have given out the umbrellas that Doug Watts brought, but the kids don't use them. (They are, I think, being hoarded lest they break.) We are really pleased that a couple of the kids are doing well, and will concentrate our efforts on the others also. To educate a child, to pass on the love of learning, to help her/him come out of poverty - this would be a good thing.

The basketball team wound up its season completely winless, of course, and we are having a big party at our house today to celebrate the team's spirit. As Jesse saw, the players show up for every game, knowing w/ 100% certainty that they are going to lose, and play their hearts out. I like this. A lot. We went to see 2 of the best teams - the American school and St. Vincent - play the other day and the match deteriorated into ugliness; one of the AS players (not an American national) punched an SV player in the stomach, the kid collapsed and when I rushed to help, I was asked by the AS staff to stay away as they could handle it. They had not handled it by the time I got there, I examined the patient, suggested treatment and held my ground until the ice got there and the SV player got up. I fail to see any reason for hostility (and said so to the AS players) and I do wish the American school would exemplify some of the wonderful traits of Americans in the U.S. - sportsmanship, friendliness, helpfulness, acceptance. None of the players is American, the coaches are. The player who slugged the kid did come and apologise several times, which I found gracious.

Scott and I hung out at the beach yesterday and it was a blast. I am very glad he is so different from me and can take care of details I overlook - like finances. The kids and I watched "Jerry Maguire;" as I looked at the good news the lead character got, I thought to myself that it's been a while since I heard any nice things about potential funding or my registration and that is currently irrelevant. All my good tidings come from the fact that my patients heal, and that is sufficient for now. We will merrily celebrate Diwali this week, to commemorate Krishna slaying a demon, and wish all of you a Happy Diwali. We will be off to Delhi for a short holiday, in spite of the bomb blasts, and will see the Taj as well.

"There are times when you have to choose between being human and having good taste." - Bertolt Brecht

Unw -

Renu

Report of 23 Oct '05

Hello -

The week has been exhausting. Hope yours was better.

I have a new niece! That is the uplifting part of the 7 days. My younger brother, Vinu, and his wife, Tina, had their first child on 17 Oct. It was an auspicious day for Coorgs, that being the day the river Kavery bubbles up from her source. Kavery is worshipped as a goddess in agricultural Coorg. And along came our little bundle, whom we are inclined to worship also. She is very cute, feisty, and we are looking forward to watching her grow. Vinu msg'd me on my cell phone when Tina's labor pains started, and asked me to go to the hospital if I could, and I was honored. He had told all other medical relatives to stay away and I didn't think I'd be needed, either.

We have a resident visiting from the U.S. Jesse Spear is training at the same hospital that I did in Indianapolis. It was nice to gab about medical issues and familiar folks w/ him. Jesse is gamely trying to cope w/ the culture shock and we are trying to help that process - time will tell if we have succeeded.

The Banyan is great, as always. The folks there embraced Jesse and welcomed him. An older patient, Ms. A, who has been operated on for cataract is recovering nicely. She had a psychiatric relapse and got a bit delusional; our able psychiatrist tended to that immediately. She mentioned being teased by another patient, and I told her I was sorry to hear that, that I looked forward to her smile (it really lights up her face and crinkles her eyes) every time I entered the B and that it made my day; at this, she grabbed my hand and held it to her cheek. It was so lovely. The intangible rewards of working at the B are more than enough for me.

I am attending the Aids conference and many parts of it are illuminating. Thanks to Rabia Mathai for paying my way, and thanks to Dorothy Williams for putting me in touch w/ her.

Tutoring continues. I was shocked to hear that one of the students does not want to come any more b'cos one of the tutors made fun of her. We are going to have a talk soon and remind the tutors of the need to preserve human dignity, regardless of age and economic status.

The basketball team continued to play better, though Abacus has not won a game in 4 years. Jesse has helped coach, and I totally enjoyed the experience of coaching. The boys have generally listened to us, and that appears to have been unusual.

"It is only with the heart that one can see rightly; what is essential is invisible to the eye." - Antoine de Saint-Exupery, The Little Prince

Unw -

Renu

Report of 16 Oct '05

Gads, this week has been tumultous, and I'd been so looking forward to it as there were a bunch of holidays -

The grand thing about working gratis is that I take off when the kids are off. They are currently at the stage where they truly appreciate that. So we hung out on Tues. The monsoon is coming in and it rained buckets on Tues. Fortunately, Naren's best friend's b'day party was postponed from Tues and I was grateful. I like this kid, Anshuman, a lot: when Naren started at this school, he was sick and was in the "sick room" and Anshuman came down every hour to check on him, thus endearing himself to me forever. All of Naren's friends are those I'd pick for him. I don't know too many of Navin's friends, and he states himself that he hangs out w/ those that specialise in irritating others.

Scott came on Tues for a 5-day weekend and that was a blast. We had made plans to spend all of Thursday together, and the kids' school called that am and said it was closed due to rain. We did not want to change our plans, so we gave the kids a suggested schedule including a movie, and left. We had b'fast outside and went to see a Tamil movie. I'd wanted to take the kids to it to buff up their Tamil, but the rating system here is a mite incomprehensible (it was crystal clear in the U.S. and I loved it) and sometimes the flicks are dreadfully inappropriate for 12 yo's. We liked this movie tho' it was violent and came home to spend the rest of the day w/ the boys, playing the hilarious games of Outburst and Taboo. It was nice to get some 1-on-1 time w/ Scott.

I moved my Banyan day to Friday and went in. The young woman, J, who had been separated from her sibs at a young age came to see me as she had belly pain. On getting a history, I asked if she'd ever been beaten; she stated clearly and matter-of-factly that she had been beaten by her husband and that she'd even been throttled with a belt. I could do little but touch the cheerful young woman, and hope like heck that I could do something for her. She now works in the kitchen and lifts heavy weights, so I prescribed an anti-inflammatory and changed her duties, assigning her to the tailoring unit for the next couple of weeks. J has come to see me before, and on the subsequent week, came bolting up to me to tell me that the meds I'd given her had worked (in Tamil, this is worded, "My illness listened to the meds" which I find very quaint and lovely) and I was happy. Whatever little I can do, let me do.

The basketball team continues to flounder, but they are getting technically a bit better. The last 2 scores have been 12:50 and 12:60. At least they dribble, pass and go for the rebound. I like the kids on the team, except for one young Korean boy who is difficult - after Wed's very physical game, he stuck both middle fingers up at the departing opponents who'd yelled something at the Abacus team and didn't stop despite my instructions. I had to report him to the principal as this is against all that I believe in. The regular coach is actually very good and I wish he'd coach more. Hopefully, in time.

As I headed to the Friday game, I got a call from my younger brother, Vinu. His wife, Tina, is expecting, due any day now, and has her parents w/ them. Her father had upper abdominal pain and felt "uneasy." I requested that they rush him to the hospital as it sounded heart attack-ish, and indeed it was. He is in good hands at Sundaram Medical Foundation, where they also see Banyan patients for free (thank you, SMF) and is recovering well. The past couple of days have been spent running to and from SMF, being the medical liaison and trying to comfort the family; one of the St. V staff docs once said serious illness brings out dysfunctionality in families and that looks like it's about to happen w/ Tina's fam but I am trying to head it off. In the meantime, my mother's sibs are in the thick of a horrendous property dispute which she and they would like me to solve, but my energies are limited and so, my sister, Anu, is stepping in. Thank you, Anu; nothing like having sibs that one can rely on. These family disputes are kind of unproductive - no amount of money can justify a fight, in my opinion. I'd rather get along w/ my sibs than not.

Tutoring goes on in my absence, and one of the kids brought her report card to share - she did spectacularly well and I am so pleased. A little bit of help, an ounce of prevention, one child at a time.

We are off to visit my brilliant aunt, who can always help me feel better. See ya next week.

"Before most people start boasting about their family tree, they usually do a good pruning job." - O. A. Battista

Unw -

Renu

Report of 9 Oct '05

Hello from the peace and quiet of my house -

All 3 Weiss men are sleeping, the stray dogs are barking away outside, our laundry is drying on our balcony (dryers are not cost-effective here, why pay for 'em when the abundant sunlight will do the job for free?) and soon the routine of the day will begin - but not before I pour my heart out over email.

The week has been good. Patients continue to heal well at the Banyan. The young woman studying law, UM, returned to me with an upset stomach. It was somewhat transient, but she was leaving for Madurai to write her final law exams and I preferred to treat her with an extended course of antibiotics, so started treatment for amoebiasis and gave her pills to ease her belly pain. I had wanted her to have yogurt (curds) with her lunch and dinner; curds here are legendary for calming bellies. She had asked for 'em, and folks had given her grief, including a comment from a fellow patient serving the meal: "Hey, lawyer!" This was intended to construe arrogance on UM's part, but Leela and I told her she indeed was almost a lawyer, there was nothing but pride in her accomplishment when we heard that comment and that we wished her the very best in her upcoming exams. I like this young woman a lot, and feel very proud of her, and the Banyan for helping her to continue her studies and achieve her dream in spite of her tough life. On reading over her file, I found that her stepmother and she had not got along at all, she had been sent away to college, her father had told her not to return but to make something of herself. She had stood second in her high school in the very rigorous 12th grade board exams, and I was very pleased to see that. Again, I felt very fortunate that I was welcome in my house, had not been aborted due to my gender, and was encouraged to study, play basketball and cricket, climb trees and the wall surrounding our house, go overseas and do whatever the heck I felt like doing.

The sick room is reserved for the sick. There was a patient there, V, who had nothing but psychiatric issues and would cry or whine all day. This was just a tad disruptive. Our able psychiatrist already had her on psychiatric medication, and deemed her attention-seeking. I wanted her shifted out of the sick room to the dorm as she had no medical issues, he concurred and so did the other doctor treating her. The social worker had her own agenda and V continued in the sick room, not needing any treatment by the physicians and continuing to cry and moan all day except when she slept which was a blessed relief. I wanted to talk to the social worker, but she was at a patient's village, and I merely wrote on the chart that 3 doctors had wanted V sent to the dorm and why was she then still in the sick room? V was in the dorm the next time I went there and I was very relieved. I don't often flex my professional muscle, but felt the dire need to do so here.

The son of one of our patients committed suicide. The Banyan social workers took the patient to her village. I was very sorry to hear the news and could only imagine the grief the patient felt - from one mother to another. The Banyan continues to amaze me with its multifarious activities, all of which benefit those who are marginalised by the rest of us in society. I got a chance to see the Banyan in action in the community when Scott, Navin and I were heading to a bookstore after dropping Naren at a party. A young well-dressed man was sitting by the roadside w/ an old woman who was very scantily clad, gaunt and looking ill. I asked Scott to pls turn the car around, we headed over to them and found that the lady was a bit ill and had been wandering around a busy street; she spoke only Telugu. Vimal, the young man, and I then called everyone at the Banyan and there is an onerous new process for picking up folks from the street, but the B managed to get there in an hour. In the interim, we gave the lady water, Scott and Navin were dispatched to buy some cookies (no restaurants nearby for other food) and then we discovered the lady had no teeth. So much for the cookies. As soon as N and S got back with the food, they gave it to the lady, she looked at it and gestured to Navin, wanting the child to have some first. Boy, she darn near melted my heart. I gave him a little bit (as she wouldn't have been happy otherwise), and handed her the rest, and she gave some to Vimal. More heart-melting. She packed the food back in the bag and we determined that she was not hungry. When the B got there, I handed over a note w/ the meds that I wanted her started on (she had a wracking cough) and she got into the vehicle willingly enough. Perhaps she, and others like her who are picked up on the street, knew from the eyes of the pick-up crew that they would not harm her: what a great thing this is, esp for a woman.

Naren and Navin discussed this incident later. To the boys' great credit, when we stop for things like this, neither of them ever says, "Well, can we go now?" They assess the situation and know how it will flow; sometimes they exhibit very adult and considerate behavior, which I am extremely grateful for. Navin told Naren how nice Vimal was; indeed, he was. Scott, V and I discussed working for the destitute. Vimal studies economics at a very good college here, Loyola, and elected not to study social work because he says though working for the destitute is his goal, all decisions there are run by money. Oh yes, they are. When we discussed my lack of funding and the finite resources the world has (at least the world I know), I didn't for one minute feel that that would impede my work. Thank goodness for folks like Vimal and Scott, who are much more pragmatic in money matters.

I am now one of the coaches for Naren's basketball team. I went for the 1st game of this season which ended in a score of 77-11, and could barely stand watching the kids flout every tenet of good play for the 3rd year in a row. When I played in college, we did not have a coach but were schooled by a team-mate, Kalpana, who is one of my best friends and a brilliant player who went on to play for the state (a tremendous accomplishment). We did win the championship under her tutelage and I so, so love the game that I could not sit still for another minute watching the Abacus team do flashy behind the back passes straight into the opponent's hands, fling 3-pointers from half-court without dashing for the rebound and not dribbling when they could. So I marched into school the following day and started putting the kids through the basics. They do have a part-time coach, but Naren said he doesn't do much. Naren said he does get embarrassed when one of his parents is involved in teaching at the school, but knew I would not care and so has resigned himself to being coached. (He and I chuckled about this.) At the 2nd game, the team played far less hastily, did pass, dribble, and defend better. The score was 80-19 and while Abacus's score was 0 for the first several minutes, they did perk up and play using some fundamentals. That was enough for me. There is abundant talent here. In case any of you is expecting some brilliant result a la "Hoosiers," let me assure you that ain't about to happen, at least not this season. This is an overprivileged team (most parents are comfortably off) which has never been coached.

Since I was at the match, a friend looked after tutoring. The kids do come and continue to enjoy it. Scott, Naren, Navin and I went to a traditional dance evening yesterday. We are celebrating "Navarathri," the triumph of good over evil. In Gujarat, this is celebrated with a dance with sticks in the hand - "Dandiya Raas" (or "Kolattam" in Tamil). None of the Weiss men likes to dance as much as I do, but they obliged me a bit. N and N cut the rug at home, but not in public. Scott, who absolutely hates to dance, did the dandiya dance for my sake and we (I?) had great fun. The food was awesome and we pigged out before heading home, but not before Naren had an eyeful of the lovely young teenage girls in beautifully colored, sequined traditional clothes all whirling to the pulse-pounding, rhythmic folk music.

When we were speaking with Vimal and later thinking of things we enjoyed, I found that one of my joys was our "speaking tour" of the U.S. this year. It was such a blast talking of the work here and meeting so many wonderful people who seemed interested in it and who are now on our email list. I would do it again in a flash, so if any of you knows of an opportunity, pls tell me.

Kasha Newcomb, Scott's colleague's Mom from Michigan, landed in Bangalore with a heap of chocolate for us. This was so extremely kind, esp to lug it all the way when she's on holiday, and right when we are running very low on our chocolate stash. She is a great lady w/ a wonderful sense of humor and we are grateful to have made her acquaintance, not just for the chocolate (though of course that helps :) ). Thank you, Kasha!

"There is no love sincerer than the love of food." - Bernard Shaw

"There is only one difference between a long life and a good dinner: that, in the dinner, the sweets come last." - Robert Louis Stevenson

Unw (Until next week) -

Renu

Report of 2 Oct '05

Happy Gandhi Jayanthi (Gandhi's b'day)!

He truly is our most famous export. When I think of all he accomplished, and in some adversity due to his skin color, I remain impressed.

We are well. The custard apple (sugar apple to our Caribbean friends) season is here and it is time to gorge. It is nice to have fresh fruit options that change w/ the seasons.

Work is good. A patient came out of the isolation room to the general sick room, and I asked Leela why she'd been in isolation (reserved for scabies or other contagious conditions); she told me the patient was HIV positive. I then looked over this patient's file; she had been found wandering around a neighborhood and came readily w/ the Banyan's "pick-up" team when they approached her. She was then found to be HIV +. I was saddened: mentally ill women are very prone to rape and this might be how she contracted the disease. None of us speaks her language (India has at least 22 distinct languages, not dialects - they are as different as English and Spanish) and this is where a lot of nonverbal communication sets in: touching, smiling, patting, all of which this patient responds cheerfully to. I don't routinely hug here as it would freak the patients out, but I hug at every available opportunity and enjoy it. (Thankfully, my sons have not outgrown the practice.) I am grateful that this patient is in the safe surroundings of the Banyan, where she is free from rape, and is fed and clothed. We are looking to send her to Udavum Karangal, where they are experienced in the care of HIV + folks.

Tutoring continues; we had 3 students and 11 tutors the other day. I don't dissuade this all the time, as a tutor sometimes gets stuck with imparting a concept such as subtraction and someone else will throw in a helpful suggestion. The little girl who finally passed 1st grade no longer comes, and I have nagged the grandmother into sending her. I know not the circumstances in the family, but we fight an ongoing battle to tutor these kids, esp the female ones. Girls are simply expected to do more in the house, regardless of their academic responsibilities, and this situation stinks to me. If everyone, males included, were to pitch in, the work would get done and allow time for other activities. The kids continue to color, and Maya's "stamp art" markers (with a design on the end of each marker, which is imprinted onto the paper when used) were a huge hit, w/ plenty of pounding going on and magnificent art works produced.

We are sans Scott today and miss him. The kids and I went to the beach yesterday, which is always a fun place to hang out, and played frisbee. We then had burgers at our favorite beachside spot; I'd been craving French Fries, which are 50 bucks a plate here and not as abundantly available as the U.S. We returned and watched Harry Potter and the Sorcerer's Stone, which was hilarious and entertaining. The kids are at school work this am. Naren now gets phone calls from girls in other schools, which is a tad surprising to me. He asked to go to a party of a friend of a friend, and was thunderstruck when I said No; I explained that I know neither the child nor the parents, have no idea of their values and morals and address, and could not in clear conscience permit this. At another party where Naren was not present, ostensibly a pornographic CD was produced; this reached parents' ears and everyone is a tad upset. I told Naren his certainly was the age where curiosity was abundant, but that it had to be channelled properly and porno was not a healthy option. Naren states that his friend Dhruba's mother and I are the strictest in the class, and I am surprised/pleased that Naren continues to maintain a relationship with me: I certainly didn't care for strict relatives when I was growing up.

Well, there is a line for the Internet (my sons), so let me wind up. Woooo - I forgot to mention this: Dorothy Williams, the wife of Vick Williams, an anatomy professor at Uthscsa, put me in touch w/ Catholic Charities' Rabia Mathai and CC is paying for me to attend an International Aids conference in Chennai. I am really pleased to be going! Thank you, Dorothy; thank you, Rabia.

"I pay the schoolmaster, but 'tis the schoolboys that educate my son." - Ralph Waldo Emerson

Until next week -

Renu

Report of 25 Sept '05

Hello from Chennai -

Happy World Heart Day. I trust each of you is taking some steps to protect your heart. The value of a 30-minute brisk walk each day, regardless of age, is unquestioned. In fact, at one of the sessions on diabetes at the 2005 conf of the American College of Physicians, I said a couple of words at the end about the benefits of "lifestyle modification" in my patients. As they cannot afford meds, to treat high blood pressure I suggest salt restriction and a 30-minute daily walk, and it helped bring at least 1 BP down 20 points. Right after this, a U.S.-based physician asked about the feasibility of lifestyle changes, and whether it was realistic to try, and I feel it is. So, feel free to get out there and walk, people.

The Banyan goes along well. After I finish at the sick room, we have patients whom we see at our quasi-outpatient clinic. One of them, UM, came in w/ a serious upset stomach and it sounded like she had amebiasis, which is very common here. As I started investigating how she could have got it - if it's from Banyan food, we have a problem - Leela, the nurse, asked her if a fellow resident known for buying food from outside had given her any. UM said, "Oh, no, her heart is not like that," and we laughed. I was informed that UM is currently studying law (hooray!) and is tutored at an attorney's house, where the family also feeds her; I am happy at this grace and generosity, but felt that UM ought to forsake a meal or 2 which she is glad to do. UM got selected for Criminal Law while in high school, more prestigious here than Civil Law, and Leela informed me that UM's classmates got so jealous that they drugged and raped her. I don't know yet how the mental illness set in, but I was saddened at UM's ordeal. My great good fortune is that friends have generally been happy at any successes I might have had - esp here at the Banyan, which all of you appear to revel in - and one of them, my husband, feels happy and proud regularly, which does bolster the spirit. I am delighted that the Banyan sees fit to ensure that UM gets the education she dreamt of, and again I think what a great place the Banyan is. Vandana and I got to chat a bit this week and it was fabulous; she is a remarkable human being, as is Vaishnavi. Vandana mentioned that a grant of 1.8 million rupees that is rightfully theirs has not come from the Government as they have not bribed anyone, and that they will not. So there is someone else who will not bribe.

We have had a fair procession of sick people come by our flat, too, and treating folks at the vegetable market continues. One day, at the supermarket, a fellow customer stopped, leaned his basket on the checkout counter and said he had to stop and sit down; he was sweating profusely (he was "diaphoretic") and I got pretty worried that he was having a heart attack. He said his legs, ridden w/ arthritis, were bothering him and after quizzing him a bit to rule out said heart attack, we continued on our way. Naren and Navin were pleased that we'd stopped and ensured the man was ok. We stopped similarly at a store in the U.S., too, and one of the ladies that worked there is now on our email ist.

Scott showed up a day early this week - on Thursday night, long after we'd slept (so it took me quite a while to realise that it was him on the phone calling from the train station), and celebrated his b'day with us. It was pretty darn divine to hang out w/ him for an extra weekday and we went out for lunch at an unfortunately obscenely expensive (u.o.e.) restaurant; the food was great, tho', and we resolved to pay the bill in dollars where it did not seem that u.o.e. We lingered over the meal too, so we could eat again if we got hungry and it was lovely; I looked at this intelligent, handsome, witty young man and felt privileged that he would choose to spend a day with me, indeed that he would choose to share his life with me. It was a stellar start to the weekend. We took the kids to a silent film festival hosted by the Ability Foundation to observe Deaf Awareness Week and it was great to be in the midst of differently-abled folks, some of whom were at my talk a couple of weeks ago. I like the kids to regularly see that some folks do without various senses or abilities or money, not just without Nintendo and Game Boy.

As I was hanging out w/ Scott, a friend oversaw tutoring for me and coaching for exam week continued. The students appear to be holding up well. We were tremendously privileged last week to see Jothi and Ketan Sukkawala, their kids Rohen and Ravi, and Jothi's mother. Jothi is a classmate from med school and she and Ketan had spent 2 weeks in Vellore w/ Health Volunteers Overseas, which they enjoyed. It was great to see them and share news of our professional lives, and to enjoy each other's sons. My friend, Maya (from 10 yo days), very generously sent us some markers and activity books for our tutoring kids, which I will be delighted to give out. Her father brought them to Chennai, and he and I had a good time gabbing, too. It is lovely to be in touch w/ old friends and their families, and make new ones. The young folks who were in the crowd at the Brecksville Kiwanis meeting we spoke at in May emailed us and said they wanted to send money or supplies for the work here, which I was totally thrilled at. Really, the compassion of young folks is enormous. So, the Brecksville school kids (Key Club) will send us some $ for our Halloween carnival for the underprivileged and the 7th grade class is collecting some goodies for the same. Carrie and Rex Cassidy, who hosted us in Brecksville, initiated a school supplies drive there with their little daughters Blythe and Lauren, and got many pounds of supplies; they will send some to us and a lot more to an orphanage in Madurai. I like this - that the orphans are sitting around one day, and kaboom, a whole pile of treats shows up announced to them. We are so tremendously fortunate in our friends and correspondents.

Naren and Navin continue with school and are trying to study on their own without us nagging them, under a new system of rewards suggested to us by our friend and my med school biochem professor, Richard Luduena. On Naren's school trip, the girls had a "dare" and 2 girls entered the 10th grade boys' room after curfew, and were caught there, sitting and gabbing. There was a huge meeting to decide if the 4 kids were to be expelled and finally, it has been decided that they will not be, but they are shorn of their titles: House Captain, School Pupil Leader, and House Vice Captains. Naren told us of this incident, and we are grateful the child trusts us enough to confide in us.

We continue to receive kind messages from you all and are grateful. All the chilluns we tutor like the gifts you send.

'There are three things you never want to see on a Christmas present: "One size fits all," "fun for all ages," and "removes unwanted hair." ' - Jim Mullen

Until next week -

Renu

Report of 18 Sept '05

Egad it's hot here.

Hope all are well. We have just survived a fairly epic sleepover (4 kids + our sons) and decided grounding, punishing, etc., probably have run their course w/ our sons. So we'll start anew, and let them have a life in addition to academics (always a tough act in India). The guests' parents joined us for a huge potluck ("pitch-in") last night and it was a fun evening. It is mighty nice when one can socialise w/ one's kids' friends' parents - homogeneity has its place.

Work is good. The Banyan remains a fun place to be. The sick room is getting fuller, and one of the residents who wants to stay on there as it is preferrable to the dorms will soon be evicted (not to the streets, but to said dorms). We have had some older patients (paatis or grandmothers) return after cataract operations and they are to be there until all follow-up is finished. One of them, Ms. M, is a cutie and I watched her the other day as she returned to her bed after a restroom visit. Her neighbor handed her her dark glasses, and I am always struck by the kindness patients here exhibit to each other, regardless of how sick they are themselves. As I watched Ms. M get to the bed unsteadily, I remained very grateful that she was at the Banyan and not made to feel like a burden to her family, w/ caustic words thrown in her direction and not enough food given to her - which is the lot of many older pts in India. M and I talked, we giggled, and she told me she had eaten 3 dosais - crepes made of rice flour - w/ the 3 hesitantly held up on 3 fingers. God bless Vandana and Vaishnavi for starting the Banyan, what a privilege it is to work w/ them. I hope to do it as long as I live. As I thought these deep thoughts, I looked over at M again and saw that she had inadvertently struck a very model-like pose w/ the dark glasses perched upside down on her nose; the medical assistant and I laughed out loud as she went to correct the situation. Humor is in abundance here, and it is a lovely place to work. Check it out - www.thebanyan.org.

The other orgn that I used to work for, Udavum Karangal, has a full-time Resident Medical Officer (RMO) now and does not currently need my services. Next week, I will figure out other options. My mother said the other day that it'd be good to have my registration to work here (still in the works as we speak) so that I could make some money, and I was surprised at the thought of money - hmmmm, I *am* working and the knowledge is kept up, the money is currently secondary. I have to admit it was great to have some in Indianapolis; I saved some to renew my membership in the American College of Physicians and now get their journal. It is very exciting to keep up w/ new advances coming from the West. Next on the agenda: to get to a meeting or 2 per year. I remember my sister Anu getting an invite out of the blue to join other pediatricians at a forum in Austria to discuss injury prevention in children, which is a great interest for her. I've often thought that'd be wonderful, to have someone say, "Dear So-n-so, we have heard of your work and would like you to join us for this meeting, or speak on the subject ...." Someday, perhaps.

Tutoring continues. We have new Security Officers in place at our complex and one of them apparently did not know of our effort, so I could see his whole skeptical demeanor through the window as he escorted 2 young girls towards our tutoring room. I waited for them at the door, and when the girls saw me, they turned triumphantly to him and pointed to me. He nodded, smiled and left. It was great to be a part of the girls' small victory. We worked on exam stuff for the kids, as everyone is in the throes of exams, and managed to get across the concept of addition of 3-digit numbers to a 2nd-grader: it is a fantastic feeling to see the light come on and understanding dawn.

We are going to be in withdrawal soon - the mountains of chocolate I brought have dwindled and we are hoarding every M&M. A lot of candy was given away as gifts, as it is so rare and precious here, and the kids' teachers were particularly appreciative. We saw "Madagascar" today w/ the family and loved it. Scott and I started watching "The Butterfly Effect" but stopped as it was so creepy.

"Children have never been very good at listening to their elders, but they have never failed to imitate them." - James Baldwin

Renu

Report of 11 Sept '05

Hello to one and all!

As I am sitting here w/ a good sense of well-being, a msg flashes up on our computer that an internal registry is corrupted. So be it, we'll deal w/ it later. As of now, a lovely Celtic music CD that my friend Carol let me filch from her is playing, and the ethereal voices and music are soothing us. We finished a whopping Western b'fast - ham and eggs - and the boys are at their books. Scott is sitting w/ Naren as he reworks his physics exam. Regardless of where we live, I think we'll always have a Western b'fast instead of heavy Indian breads and chutneys in the am.

We spent a wonderful week in Bangalore w/ Scott and it was nice to be in the same place as my husband for more than 2 days straight. I wanted to seriously evaluate B'lore, Karnataka, as a place to live, esp given Scott's tremendous sacrifice of giving up an iridescent career at Lockheed Martin to accommodate his wife's move to med school, residency and subsequently here to take care of the impoverished. Naren was on his school trip to Delhi and Agra; Navin and I wandered about, living like Bangaloreans do while Scott was at work. S and I subsequently had long talks and we have decided this: Bangalore is gorgeous and has sensational weather, cool and lovely; it is however, very provincial and pretty unwelcoming of non-Karnatakians though there are many multinational corporations there; schools in B'lore are staggeringly expensive and not all provide the excellent education Abacus does, and besides, there is no guarantee that our sons will get in as school admission is always difficult in our overpopulated country where demand far exceeds supply; the boys will have to study Kannada, the local language of Karnataka, and Naren will have to learn enough to take the rigorous board exam next year, whereas in Chennai, the boys have the option of studying Spanish which they have done for 2 years now; B'lore does not appear to handle traffic very well and jams are routine and expected - in fact, Scott's colleagues have joked that if a patient is in an ambulance en route to the hospital, one might as well write him/her off as the ambulance might not make it to the destination. Thus, we will stay put in Chennai and Scott will continue his weekend commute for now.

Well, I had to take a break to run our anti-virus protection; them msgs were starting to sound dire and needed immediate action, etc.

It was fine to have a week off medicine, but I will be ready to return to the Banyan. The boys have another 1.5 weeks off and have been assigned projects by at least one of the teachers. Naren had a spectacular time up North and came home yesterday; he liked Agra, and the army hosted the school kids as VIPs for a ceremony on the Pakistan border. We returned to a good meal from our cook whose sister is pregnant for a 3rd time in the quest for a boy. This does not warm me, as I crusade for small families where parents might have a better chance of affording the kids' care. It does not appear like the sister has maintained regular prenatal care and the cook said she was very tired; I asked if she was on standard prenatal vitamins and the cook said she was not. I wrote out a prescription for vits w/ iron and folate, though the lady should have been on them from very early on, in fact even before conception as far as the folate goes; we can hope for the best here. The cook appears to like having a doctor as an employer - routine medical issues appear to scare the wits out of folks. I never think I have studied something extraordinary - I think anyone could do what I do - but I value my education very highly, feel pretty blessed to have studied in the U.S., and always, always have occasion to marvel at the intricate workings of the human body.

Someone else managed tutoring for me as we were away. Yesterday's paper had a most lovely picture of 4 young girls who used to be vendors on the beach and who are now being sent to school by a private foundation: all the children are laughing in the picture and look very happy. Most children ARE happy here, though desperately poor, but if they could have a vestige of childhood, I'd be grateful. And an education would haul them out of poverty and prejudice. We have miles to go there before we sleep. We were at the beach yesterday, enjoying the breeze, watching N and N play frisbee, soothed by the image of the water and entertained by colorful kites batting their tails at us, and watched a fair number of child vendors there; at this point, a woman came up and offered to tell our fortune. We declined and she said, "I could tell you about overseas events, too," (thinking the white guy and I obviously lived elsewhere) and I said, "Well, we're inseas now," and she laughed. She then said, "Well, you could get news from overseas, you know," and I said, "Yes, I have the best possible kind, here he is," and she left.

"Love is only a dirty trick played on us to achieve the continuation of the species." - W. Somerset Maugham

Until next week -

Renu

Report of 4 Sept '05

Hello from Chennai!

Boy, time flies, does it not. Here we are in the 9th month already.

Work at the Banyan continues well. Our patients are physically healing and we have able psychiatrists to deal w/ mental issues. One of the pts came into the sick room weeping copiously and loudly the other day; she had been placed on an anti-depressant and had then started hitting everyone, so was taken off the anti-dep. She was calmer on the next visit, so perhaps an alternative had been found. The entire narrative was very funny to me and the nurse and I laughed. Such laughter is not usually malicious, and we do seek to help the pts, but as you can imagine, inadvertent side effects ensue provoking much mirth.

One of our patients in the outpatient area stated to me that her father had died when she was a child, she and sibs were subsequently abandoned by their mother, some of the kids studied but they were separated and she had not seen her sibs in many years. You know, I have cause to feel fortunate daily for many things, and this time it was gratitude that my sibs and I saw each other w/o any family feud or separation interfering. This is a great blessing for me: that we ensure that my widowed sister-in-law has some support; that I tell my sister after some new accolade (most recently, the Fellowship of the Royal College of Pediatrics and Child Health, I think - FRCPCH; all Brits are welcome to correct me) that she is perfectly entitled to buy a peacock blue sari w/ spangles for the occasion even if her husband rolls his eyes at it; that my younger brother emails me and states that his wife states their unborn child is a bit like him already because it gets excited when she eats chocolate. Lots of interactions, most of which serve to boost the spirits - how phenomenally fortunate am I.

A friend took over the tutoring for me this week as I was the school doctor for the 3-day Sports Festival at my sons' school, Abacus. The event was fun, in spite of the heat, and I always feel privileged that my schedule allows me to participate in the kids' school activities. Naren and Navin brought home some medals, and Naren's house, Cassiopeia, won the overall shield (as usual - they are a powerhouse). Navin's house, Perseus, came in last, also as usual. Orion and Andromeda have no reps in our family, so we don't generally show much interest in their standings. We have told the principal, Kamini, that she must institute shields for academics, conduct and the arts as well, not just for overall well-rounded development, but because Perseus has become the punishment kids wish on other kids they don't like - a young friend of theirs said of her less-than-favorite cousin, "Ooh, I hope she joins Perseus."

This week, a friend, Janu, invited me to speak at the Ability Foundation, where she and others help train "cross-disabled" folks (folks w/ any kind of disability) for employment. The entire event was supposed to last an hour. I entered the room, and got so choked up I couldn't speak: awaiting my arrival were blind, deaf and mute college grads. I tried valiantly to put back the tears, and managed to maintain composure. The talk was on health issues, and it was a very interactive audience. My initial puzzlement at their not making eye contact w/ me gave way quickly to the knowledge that they were focusing fully on the signer next to me. Some of them busily signed back, some nodded at comments I made, some pointed to neighbors as some kind of validation of something I said: it was absolutely magnificent. All that interest, all that emoting, all the rapt attention: my word, I was humbled!! We had been at Janu's children's school play (The Sound of Music) the previous day and the chief guest, a very important individual, had made a lengthy speech during which Janu said her mother fell asleep. My audience honored me - an unimportant, underdressed person - differently. At the end of the allotted time, when the questions were by no means finished, I asked to be invited back. One of the young men - a handsome fellow w/ a trendy haircut - stood up and signed the class's collective gratitude and darn near made me weep again. I'll be back there soon and by golly, it will be my privilege.

On the ride back from Ability, I pointed out a disabled man in a wheelchair (very visible here) and Naren requested that I not do that any more as he felt sad to see such folks. We had a talk, and I told him how we react to "differently-abled" folks determines who we are inside, that there was a regime which killed disabled folks (as we know - Hitler's), and that perhaps Naren's sadness would lead to his deciding to build a training facility or home for the disabled. It was a nice chat. The children are developing cores of compassion - whether willingly or not - just due to being w/ impoverished and disabled folks; thank goodness, it could so easily be otherwise.

The boys brought report cards home and the grades are better than zero; that's the extent of good I can say about the grades. To a person, both kids' teachers mentioned their potential and how Naren's is undertapped. Navin has also slacked off in some areas. Naren states he will not sass or interrupt his teachers from now on, as his student in our Friday tutoring group cannot seem to pay attention regardless of what Naren does. Ahhhhhh - this tutoring activity is producing unforeseen benefits. We are starting anew w/ both boys, and emphasising their potential more than their idiocy w/ class pranks now. Naren goes to Delhi w/ 9th and 10th grade kids tonight - a trip we absolutely did not want to keep him back from - and Navin and I go to Bangalore to hang out w/ Scott.

We read a scathing article by an American on the unpreparedness of the U.S. w/ Katrina - feel free to tell me what you think. The article said the poor were the first abandoned. Aiyo - I hope not. It seems like we came through the tsunami ok, underdeveloped and third world though we are.

"It is only the poor who are forbidden to beg." - Anatole France

Until next week -

Renu

Report of 28 Aug 2005

Hello from Chennai -

I just finished some delicious vegetable biryani (pilaf) made by our cook and am awaiting the start of a women's meeting here at our complex. Figured I'd write to you all before then.

Thank you very much for the suggestions sent to deal w/ Naren's rebellion and his underprioritizing academic success. The recurring theme I read was, "Don't back off tho' this stage is tough." Naren's behavior has improved and I noticed him paying rapt attention to the speaker at their school's Independence Day celebs (she was very good) while the rest of his class socialised. It remains to be seen how his grades turn out. I have had long talks w/ Naren and emphasised that academic success is a must anywhere, along w/ being a nice person and getting along w/ others, that the child who was in the honor roll in all his classes in the U.S. really does not have substandard intellect. At least one great friend urged constant communication, and there's not a worry about that w/ Naren: he has told us confidences he has not told his friends yet. He sent us an email just before I left the U.S. telling us how happy he was that we were his parents and that he could talk to us about anything, that not a lot of his friends had that relationship w/ their parents.

The Banyan is great, as always. We have a patient, SV, who had been critically ill w/ multi-organ failure who came back to good health thanks to the docs at Sundaram Medical Foundation; this endeavor cost the Banyan 500,000 bucks. The nephrologist there, Dr. Suresh, trained in the U.S. and is a great favorite of mine. He treats our patients well and is very personable and diligent, and his wife is a lovely lady. We have socialised w/ them, too, and enjoyed it. Anyway, SV is now exhibiting behavioral tendencies like flinging her food across the room and sneaking bananas when she should not; Suresh and I decided the medical issues must be over if the psychiatric issues are flying to the fore. SV has a crush on one of our psychiatrists and I have told the nurse she must see him daily; nothing like a little boost in her spirits to take her mind off misbehaving. The nurse, Leela, enjoys SV's tantrums; I do not, I think because I know the effort it took to bring her back to health, all of which can be jeopardised by overdosing on salt or bananas.

The Banyan's fundraiser, the star glitterati event, was rained out. The sets have incurred massive damage and the event is postponed. Banyan folks are hoping insurance will reimburse for the damage, let's see. After our family's things were stolen in the move and the insurance company denied the claim though all procedures were followed, I have little faith in insurance companies; however, perhaps someone will come through for the Banyan.

Tutoring is fine. A core group comes regularly. This Friday was actually a holiday for many schools as it was Krishna's birthday, but these kids came to be tutored anyway instead of blowing the whole day off. I was humbled. We were short of tutors and I ended up tutoring; my student had to learn an English poem and we went over pronounciation which is a bit of a challenge as Tamil does not have the sounds "F," "Sh," and "Sw." It was fun anyway, and the kids got lollipops at the end courtesy the tellers at our bank in Indianapolis. The poverty of these kids is staggering, as is their desire to learn.

As I was sitting around feeling worthless, a friend's mother came to visit and chatted about her recent health issues; she is a great lady and a friend to all of us, which is a testimony to her goodness that she can get along w/ all ages. As it turns out, she has had a heart attack and no one told her. So I directed treatment. Another great friend of the fam, who is 89 and lives near us, had a touch of heart failure and I treated him along w/ his doctor; he is recovering nicely and this is a boost to my spirits more than any expressed gratitude. My patients at the vegetable market are also in good health and take very good care of me on my visits, even putting new employees in their place as they give me lip. This is a good place to be, and a fine profession to be in.

We read w/ interest that Pat Robertson, the evangelist, has recommended the assassination of Hugo Chavez. Ludicrous that a religious figure in the U.S. would actively advocate assassination.

"We have just enough religion to make us hate, but not enough to make us love one another." - Jonathan Swift

Until next week -

Renu

Report of 21 Aug '05

Hello from Chennai -

We are well, there is a vat of food in the fridge thanks to our cook, so Sunday is left free to email and catch up on other things. Like our sons' academics during this exam week - they have taken to visiting the bathroom rather frequently, as that is about the only valid excuse they have for taking an unscheduled break. Naren, being grounded, could not join us for our Sat movie in the living room, which I felt horrible about; it was a Jackie Chan flick, a great favorite in our house, and when I went to get him from his studies to watch the bloopers w/ us, I found him reading fiction. He was roundly spanked, which I detest also (as I believe he is past the age of efficacy), but he has lost every privilege known to him and I have to resort to other means, esp as Scott has returned to Bangalore and is not here this weekend. My mother asked if Naren is interested in girls; yes, he is - Katie Holmes is a favorite and Naren wants to hear nothing of her engagement to Tom Cruise (there's more than one of us in that boat). There are likely other interests, w/ XX chromosomes, closer to home, but regretfully, Naren's phone and Internet privileges are gone. Navin is rather enjoying this time, I think - nothing like a sib being in deep doo-doo.

Perhaps there is a really valid reason for my going part-time - not just the total lack of funding, but to keep an eye on the kids! We had lunch w/ my aunt and uncle last week, and they mentioned going through this w/ their daughter - my aunt said she'd thought girls were much easier to raise but changed her mind as her daughter hit the teen years w/ a vengeance. They said kids' teenage years meant sacrifice on the part of the parents, in India - a country where academic success predicts professional. While I am distractedly tempted to let Naren go and see if he will use his considerable intellect and common sense well (really, why would he, he's shown no sign up until now), I remember my friend David in the U.S. telling me not to back off. I was discussing the whole issue w/ my parents today (I tell you, lovely to be in the same hemisphere as them) and my father chuckled and told me about my younger brother's teacher shouting at my Dad for the perceived lack of discipline at home. It is similar w/ Scott; while no one has shouted at him, lots of teachers have wondered about home events in the 2 months prior to my return. This appears to make Naren feel bad, but nowhere close to what Scott is feeling.

I resumed at the Banyan last week. The car was sent for me right on time - the Banyan makes few mistakes. (To see what we do - www.thebanyan.org; if you feel you'd like to donate to the Banyan, the cash is always welcome.) Most folks sit in the back seat when a professional driver is driving, kind of a class issue; not for me, I sit up front and gab w/ the driver when I feel like it. (The driver for the other orgn I worked for, Udavum Karangal, has worked in Saudi Arabia and he spoke of watching public beheadings and the element of fear that always ran through him when he lived there; that Saudi citizens appeared to recognise a Hindu when they saw one and rotten eggs and tomatoes would come flying out of nowhere and hit him in the face. It does not appear to be a fun place to live.) Our capable and beautiful medical assistant, Lakshmi, has left to complete her studies. While I sorely miss her, I am delighted at her goal. I was again offered b'fast by one of the patients as soon as I walked in, which unfailingly warms my heart. There have been some patient changes at the Banyan; an older lady who was confined to bed has died, as has the patient who never spoke but who understood us well. We have no resources to find out why the latter died; I always think of how relieved I am that these folks died in comfortable surroundings at the Banyan, w/ folks who took care of them and cherished them. It is a markedly better fate than that which befalls many mentally ill, destitute women here - violence, rape, sometimes a most horrible lonely death.

Hospice - that's the goal. And when I think of whether it can be achieved, I feel it will be, tho' it appears remote now. Scott has been unwavering in that belief - awesome to have a spouse who knows one's innermost desires and supports them.

Tutoring continues. The kids come happily, as do the tutors. This week, the concluding treat was jelly beans, a uniquely American sweet, donated by our friend Olivia. I often wonder why the kids come - after all, we are just extending school here, w/ teaching and ensuring the kids learn. I battled a virus this week and cut short the session by 15 minutes, letting the kids color a little longer instead of doing lessons. Serendipitously, it worked out very well, as the kids enjoyed the longer session w/ the bright markers and tons of crayons donated by our friend Kurt. I may do this again next week.

Would those of you who have adolescent children or have survived the phase please email me w/ your words of wisdom? Thanks. Pls consider that a plea. A friend told me to focus on Naren's strengths and when he and I talked, I wrote down the good things about him that his teachers have said from preschool days and stuck it on his door. "Warm fuzzies work," said the friend - let's see.

"The only people who seem to have nothing to do with the education of the children are the parents." - G. K. Chesterton

Until next week -

Renu

Report of 14 Aug '05

Hello from balmy, breezy Chennai -

Happy Independence Day one day early, to all the Indians on this list! Tomorrow makes 58 years that we have been a sovereign democratic republic and I suppose for being as young as we are, we are doing ok. I look at the corruption, poverty and filth, and think we have more to do daily. The founder of the company Scott works for, Infosys, routinely has VVIP visitors - Putin, other visiting Presidents, Prime Ministers, etc. - all wanting to find out how the man could have been successful in creating that company in a third world country.

We have finished lunch, topped off by cold pomagranates. We had sapota yesterday and there is still sugarcane waiting for us in the fridge. Scott is helping Naren w/ physics and Navin is cleaning a very messy closet. As we discussed Naren's performance w/ his teachers, each one said he was capable of much better. He wants to act (for a living) and I think where would we be w/o Mr. Hanks, Ms. Streep, telling us of injustices and joys; yes, the kid can act, but only after he gets a graduate degree.

The vegetable market is a popular place on Sunday am's and it was packed today. The potato and onion man, whom we merely say Hi to and ask about, quickly weighed and bagged our selection though there were others waiting before us; we used to protest, and then realised this is his form of respect and courtesy, and say nothing now. The brinjal (eggplant) man has a wound on his right big toe; he has scratched it and made it worse, and the skin has thickened. The vicious itch-scratch cycle is not a good one, though of course scratching is momentarily greatly pleasurable. I prescribed a very good cream we have - antifungal, antibiotic and steroid in one - and it is a bit better. The tomato lady sustained a fall last week and hurt her arm; the pain med I suggested for her appears to have helped and of course she gave us 1.5 lbs of lovely tomatoes for the price of 1.

She passed! We have a student in our Friday tutoring group (where the overprivileged tutor the under-p) who is 9 and had been held back in 1st grade. When I left for the U.S. in early April, exam results were not back yet and I did not know if she had advanced. On Friday, 6 kids showed up for tutoring and when one of the tutors asked her which grade she was in, she said, "Second." I was DELIGHTED!! I am not sure if she passed b'cos we helped her out; if she enjoyed math so much she aced the test; if the teacher was tired of having her in 1st grade - don't know, do know that she passed!! Man, that is quite my best gift this year. I am not a big kootchie-kooer of little kids, but if I can keep these young folks out of prostitution or premature employment, and give them some vestige of childhood - an hour of hanging out w/ their peers, learning, coloring, getting a piece of candy at the end - I will be thrilled.

Doug, our English med student friend, asked if I'd got expensive Xmas presents from my patients; he said that was not uncommon among English doctors and that they got fancy perfume, chocolates, etc., from their patients. My best gifts have been that my patients heal, that a pain they thought they had to live with could be removed, that their diabetes can be managed. More than enough for me, esp considering I have a new wardrobe from several American friends. Also, there is no place in my closet for more stuff.

The Banyan has a glittering fundraiser, replete w/ famous movie stars, tomorrow. Scott and I have been given passes for it. I asked to pay, and was declined. We will go and have a good time. Scott returns to Bangalore on Tuesday - boss wants him there - and we are looking into the pros and cons of moving vs. staying. The education system is thunderously better here for the kids, but I am not a big fan of this divide and conquer stuff. Scott said he could not believe we had been apart for 4 months, that it didn't feel like it, that he didn't know what that said about us. Ditto; do know that I loved my time working in the U.S. and would head back there short-term if I had the opp next year.

"If you're lucky enough to do well, it's your responsibility to send the elevator back down." - Kevin Spacey

"Motherhood is not for the faint-hearted. Frogs, skinned knees and the insults of teenage girls are not meant for the wimpy." - Danielle Steele

Until next week, may you have tons of gifts of your own this week -

Renu