Report of 28 May '06

Phew -

Relief is such a palpable, welcome thing. I just called Scott and he and the boys had at that moment returned home from the airport. Naren and Navin flew from the U.S. to India on their own for the first time w/o airline assistance and we are oh-so happy that all went well. Their route was Chicago-Philadelphia-Frankfurt-Chennai, on 2 different airlines, and they did it "all by ourselves," as Navin said.

Actually, as Scott's cousin Brad and I discussed, it was easier for him also to leave the U.S. and travel overseas. On his return, there were umpteen cumbersome procedures, apparently - all of which made him feel distinctly irritated.

So, now my attention can turn to blogging. Thanks to all who responded w/ comments about Internet adult sites. Apparently, these pop-ups are everywhere, even at seemingly innocuous medical sites. They appeared to prey on certain interested parties, and perhaps I wasn't being fair to Navin when I said he might have been unduly interested. He's a teenager, of course he'd be interested in something he hasn't seen before - especially something intended to seize his hormones.

We had dinner last week w/ the Drs. Healey, eminent geriatricians at St. Vincent, and their family. Diane Healey's mother and Val Bruemmer (another eminent geriatrician at St. V) and family were there as well, and a spectacular time was had by all. N and N had a blast playing w/ Sarah, Erin and Daniel Healey, and Wes and Jenny Bruemmer. It was a fun evening, w/ absolutely delicious food, and it was very interesting to see the family side of former staff physicians.

I've been seeing patients at Citizens' Health Center, and that's been fun. One of them came in for a routine check for blood pressure, and I saw from her chart that I saw her last year prior to her minister husband's sabbatical in Greece. He's also on the Board at Citizens. She's a lovely woman (inside and out), and since there were no patients after her, we sat and gabbed about several things in addition to her health, w/ lots of laughter thrown in. Her blood pressure is doing well, and I will see her again for her next visit. Pleasant patients are such a joy.

The boys and I saw movies rabidly - Ice Age 2, The Benchwarmers, and X-Men 3. We also went out to eat, including at the Mecca of teen appetites, White Castle (yewww). We celebrated a couple of family events last week, including Navin's 13th b'day, and the Tabers (our hosts) had a big party to combine it w/ a teenage friend's high school graduation. It was a fun event, w/ Mark Taber's sense of humor shining through and Colleen Taber's wonderful ability of putting everyone at ease also manifest; Andrea, the Tabers' other houseguest, chopped and diced and mingled merrily too. We were fortunate to see the last game of the Spurs-Mavs series at the home of our friends, the Ingers, who are from Russia and exude grace and hospitality every time they see us. Unfortunately, our beloved Spurs lost, but the Inger home was fun, and we left feeling that we just want the best team to win.

We got together w/ my in-laws at a cousin's son's graduation. I had not seen Andrew, the happy graduate, in many years, and he has turned into a neat kid. Nice to see nice teenagers. The party was the usual happy in-law affair, and we enjoyed ourselves immensely. The boys shopped some more, and had full suitcases when they left. Colleen Taber was nice enough to drive all of us to Chicago, and Andrea, she and I spent a fun day there after we were sure the boys had boarded their plane and it had left.

Unw -

Renu

Report of 21 May '06

Isn't it amazing how a day can change -

I was having a spectacular morning, hanging out w/ extremely intelligent women (my hostess, Colleen, and her other houseguest, Andrea, a nursing student from Germany who is very cool, easygoing, genial, and fun), and my sons (we started preliminary packing for their trip back), and came to the library, and the librarian stepped up to me in strict privacy and told me Navin was looking at porn sites.

Sigh. So we had a talk, and ostensibly, the computer game sites have pop-ups w/ lurid porn. Another patron saw it up on Navin's computer and told the librarian. Navin said he kept trying to get to the games, but that this stuff would not leave. I had the librarian repeat her warning that he would never be permitted into the Internet room again if he persisted, and all of us appreciated the warning. She gave him some names of other game sites that her son has used, and I told Navin he would not permitted to play games again this morning, that he could check his email and must then leave.

Certainly, the pop-ups are an issue, and it's disgusting and evil that the perpetrators would target the sites where apparently innocent games are being played by young folks. However, we have had serious issues w/ Navin lying, and I am aware that his interest in vivid displays of human flesh probably was sustained for more than just the few seconds he insisted had elapsed. All those w/ advice on handling such issues, pls email me.

Ok, back to blog. My car overheated this week and conked out en route to work. A couple of our able colleagues diagnosed the problem as a non-functioning thermostat, repaired it and it was back to running, delighting me no end. The following day, it overheated again. It is now in the shop for extensive and expensive repairs, including a new radiator, and Scott's prediction that this would be the last year I drive the little Accord is coming true. Indianapolis does not have good public transport, and I am dependent on the goodness of folks like Colleen, Andrea, and our friends Maryam and Ali.

I started seeing patients this week and one of them had shingles. It was so classic that I felt like taking a picture. I started her on meds, including something to keep down her pain. One of my other patients came up in a wheelchair, pushed by her 12 yo son while she moaned audibly. This is never a good sign for a doctor, when an apparently healthy-looking woman moans before entering the exam room. So I worked up this lady, 43 yo (just about my age), and diagnosed w/ fibromyalgia, which makes most of us cringe. She mentioned that she also had some nerve problems in her back, had had an MRI, and wanted to get back on her meds. I waited. She reeled off her entire med history (including the fact that the poor 12 yo was her primary caregiver), came to her meds, and I waited some more. There it was - Neurontin, something else, and of course, a little pill ("I think it was Vicodin"). I didn't let her finish, but stated w/ conviction that I would not be prescribing her Vicodin. I told her we needed the records from all her previous doctors (especially to answer the question why she had had so many before me), and then started her exam. Every time I pushed on her back, she wailed and held out her hand to her son, who took it once. We have restarted her meds, except the Vicodin, and she is to return to me in a month. I felt worst for the child.

One of my other patients came in, and she had missed an appointment to go to Pain Management. Speciality clinic appointments are extremely hard to come by and are scheduled months after the initial request. And this lady had missed it. I have no patience w/ such misses; she mentioned her father had died, but neither the death nor the funeral was on the day of the appointment, in fact had been a month prior.

My able pediatrician colleague, Dr. Dima Rifai, brought me some Lebanese goodies, including some authentic Baklava, and they were delicious! Dima's mother-in-law is visiting, and we have exchanged foodie stories before, thus the Baklava. It is nice to be surrounded by generous folks.

We spoke at University High School this week, an appointment made months in advance. It was magnificent. Sarah Healey, the daughter of St. V geriatricians Drs. Diane and Patrick Healey, attends UHS and introduced us. Vicki Townsend, the English teacher, was also present to throw in her comments. Naren and Navin spoke on the work they do as well (well, Naren did, Navin states that he generally comes close to passing out in front of crowds). The students were great and had tons of questions for all of us. At one point, when I mentioned that virginity and chastity were indeed fine things, but had to apply equally to both men and women, there was a thunderous round of applause and I was staggered. It was a fun time, and we are going to be back there on invitation next Tuesday, to speak to one of the classes. Tonight, we join the Healeys for dinner and look forward to it.

Yesterday, we got together for dinner w/ one of my former staff physicians, Maryam Massoumi, and her family. Maryam and Ali are of Irani descent, and made scrumptuous Persian food. We ate a ton, and all of it was so light and delectable that we ate again. Naren and Navin hung out w/ 12 yo Rustom and 11 yo Gulbarg, and had such a whale of a time that Naren has asked to go there one more time before they leave. There was another adult guest there named Atafeh; she is a beautiful young woman (as undoubtedly is Maryam), and so interested in the company around her that it made conversation very easy. We spoke endlessly of India, and Iran, and living in the U.S., our colleagues, our children. All in all, a phenomenally memorable evening: we had to tear ourselves away at 10.30 PM.

We are going to have to do some shopping this week, as there are lists to satisfy from our relatives at home. Scotch tape, pens, shampoo ... The boys and I saw Big Momma's House 2, Madea's Family Reunion (easily one of the best movies I've ever seen), Da Vinci Code, and Over the Hedge. I developed a bed sore sitting through DVC; not having cared for the book very much, I found the movie interminable and boring, w/ the only excitement being a scene from the middle of the movie inadvertently juxtaposed into the beginning and getting lopped off from its proper later place. First day, first showing - kinda prophetic for its run, I think. The manager was on hand w/ refunds.

If anyone has contacts at USAir, pls tell me (that's one part of our journey home). Also if you know of rental car companies that rent by the month. Thanks.

Unw -
Renu

Report of 14 May 2006

Happy Mother's Day from the Carmel library!

There are about 200 folks on my reading list, and all the mothers on there are superlative individuals. Have a great Mother's Day, gang!

Naren and Navin greeted me this am with a handmade card (very lovely) and a pair of sneakers w/ pink streaks across the top - rather pretty. Pretty soon, we'll go see some cerebral entertainment - Mission Impossible III - and then go out to eat.

It didn't take long, did it now. One of the patients I saw last week got her prescription for Xanax (a rather addictive calmative) and called back promptly, stating that her car was broken into and the prescription stolen. We have many folks like this, who will seek controlled substances using many excuses: pills were stolen from the medicine cabinet/purse, scrip was stolen from the car, scrip got inadvertently washed in the pants. Our medical director was good enough to tell me that w/ car break-ins, we need a police report before we proceed w/ any replacement business. This patient could have been telling the truth or not; I told the receptionist that the patient must see her doctor, also at our clinic, and the doctor agreed. The patient apparently wept, etc., I guess she must have thought I would simply call in the prescription, but I have a rather low threshold for nonsense of this sort. I imagine many of my colleagues on this list will have their own stories to tell.

One of Scott's young Indian colleagues, Rajesh, is posted in China and has fallen in love w/ a Chinese young woman. He broke the news to his parents 3 weeks ago after his parents' astrologer predicted doom for him, and the parents want him to break the relationship summarily and head home. He has talked to Scott some about this, and ended up calling me here in the U.S. for advice - we spoke for 45 minutes (I am rather stingy and kept thinking of how much the call was costing him). He is pretty firm that he does not want to break the relationship, and we were comforted; both Scott and I have long been of the belief that nothing is worth breaking off ties w/ one's parents; that family bonds are better off nurtured than severed (especially after kids come along) ; that no decision must be taken in haste (i.e., don't elope) - especially if one is not completely sure of one's romantic partner. So Rajesh and I chatted, and I told him to keep the communication open w/ his family always, to listen to them and work through their objections, and to make it clear that he and the young lady were quite committed to each other. She has not been hassle-free, either: she is an only child (China's policy) and her parents were terrified that Rajesh would take her away to a distant land. She has apparently since convinced them that he's a good guy, and her family is accepting of this liaison.

We used to do a lot of this hand-holding in med school: many inter-racial daters (esp the Asian-White mix) could not believe we were wed w/ the blessings of both sets of parents. Leading us to believe that we truly had some remarkable parents.

I got paid this week and nearly had to be resuscitated (first check in a year, blah blah). My colleagues at this clinic have also been wonderful: one brought me flowers from her garden and they were absolutely lovely; one offered me a home-made lunch; and several have just stopped to chat. It is nice to go to work in a fun place, and Citizens Health Center is a fun place, overall. I spent the weekend w/ my in-laws and that was a blast. Scott's mother and aunt and uncle have 2 adjoining farms and it is where the chilluns spent the last 2 weeks. These are among my favorite people in the world, and the time was spent eating and laughing. It was a soggy weekend, and we watched movies (the fairly wretched Intolerable Cruelty, and The Notebook w/ the amazingly cute Rachel McAdams, a new Naren fave) and developed Texas-sized ulcers watching the Spurs lose to the Mavericks. We also cooked and baked, which were fun things - cooking is very easy here, esp w/ crockpots.

It is nice to have the boys back w/ me. The ride back was spent playing silly games and laughing our eyeballs out. I will switch to part-time this week so that the boys and I can hang out some. Scott is holding his own in Bangalore.

It is nice to be here and get back in touch w/ friends. I've also had the great fortune of attending conferences at St. Vincent Hospital, and that helps me keep afresh on illnesses I don't normally see. The residents there are a gabby bunch (I imagine as we were) and not everyone is interested in the talks: it must be nice to think one is never going to see the illnesses that are spoken of, in the speciality one is going into. I can never have this luxury - much of medicine is still a mystery to me, and I think I must constantly keep learning in order to provide even barebones service to my patients. Some of the resident presentations have been outstanding and I have thoroughly enjoyed 'em.

Unw -

Renu

Report of 7 May '06

Hello from the Carmel public library -

It is great to be here. I started working this week at Citizens Health Center, a clinic in downtown Indianapolis that I worked at last year. I've been doing some administrative things for starters, and when a colleague speculated if it wasn't boring, I told her that I knew women who'd done much worse things for money. There was a scheduling snafu one day, w/ patients scheduled for a doc who wasn't there, and I saw said patients. It was fun - patient care is my thing, research isn't.

One of my patients was a 22 yo Black man, who came to be tested for a sexually transmitted disease (STD), as his girlfriend had tested positive for it. He was having unprotected intercourse, had broken up w/ the girlfriend and continued the habit w/ a subsequent girlfriend. I told him it didn't matter to me if he wanted millions of children, but that this habit could be life-threatening. He was finishing up college, and I told him he was bright, motivated and cute (at which point he straightened up and said, "Thank you"), and that we could not afford to lose him to HIV. He also stated he smoked marijuana and I told him it could make him impotent; many of my young patients seem to care little about getting strokes and heart attacks from drug use, but when I mention the impotence angle, they are quite interested.

What do I know about growing up poor and Black? Nothing. I know little about surviving in the face of daily adversity, the pressure to have relationships w/ the opposite sex, early intimacy, that college might not be an option for all. I am ignorant of this milieu. What I can do is draw on my medical education (and not my cultural cluelessness), and point out the consequences of choices my patients make, like the lack of condom use. Often, my patients listen; as to whether they take my advice, I do not know. Some of them, though, do appear motivated - to me, and to the clinic's social workers and counsellors, many of whom are Black. I like this: Black colleagues establish almost instant rapport.

My good fortune has extended to my being able to attend Grand Rounds and noon conferences at St. Vincent, the hospital where I did my residency. I was also lucky enough to attend a series of meetings at St. Luke's Methodist Church, on medical missions and the church's outreach programs, many of which are international. I met some very committed and wonderful folks, and it continues to puzzle me that people here would be interested in care of the impoverished so far away - in Haiti, Sierra Leone, India. Anyone out there who wants to throw in their opinion is welcome to do so.

I watched "Napoleon Dynamite" last night, a movie that my sons had been urging me to see. It was weird and sweet, an effortlessly flowing movie. I have also enjoyed walking in the verdant surroundings - we don't see very much greenery in urban Chennai. Naren and Navin are spending the weekend w/ the family of their aunt Diane, Scott's sister, a very affectionate young woman who will spoil them and make their time memorable.

Are there some websites better than others for buying domestic U.S. plane tix? Thanks.

Unw -

Renu