Renu's Week

Sunday, October 29, 2006

Report of 29 Oct '06

Ahhh, sunshine -

Esp coming after 3 days of relentless and massive rain, some of which came through our windows (this is a poorly-constructed flat, says Scott), our damp laundry is loving the sun on our balcony. We have just finished lunch - idlis (steamed rice cakes), egg curry and veges, and homemade chocolate ice cream. I think I have some gall calling it chocolate ice cream - it's milk w/ sugar and drinking chocolate, stuck in the freezer until it hardens; all loved it, tho'.

I've battled some lingering depression this week, it even felt physically heavy on my chest. I tried to put my finger on it and couldn't. Some of my orders at the B have been ignored, somewhat persistently and spectacularly, and I must figure out how the situation should change, esp as it hurts our patients. Scott and I hung out yesterday at a bookstore (such wonderful places) and I could feel the cloud lift. I so miss public libraries. We also went out to dinner, and I realised what a long time it had been since the ol' spouse and I were on a date. Teenage affairs tend to consume us.

Our patient w/ the huge gash on her bottom speaks!!! As it turns out, she speaks Bengali, and we have a social worker who speaks it a bit, so we are communicating. It is awesome. We have an idea what she wants now, and though the health care worker (hcw) states that Ms. M cries to herself w/ some deep, personal grief, establishing a communication connection is simply tremendous. I showed her wound to my plastic surgeon father, and he explained that taping it up w/ surgical tape was sufficient for now, that the tissue would adhere and heal. Very lovely. Ms. M also speaks a bit of Hindi, and w/ my smattering of it, we chat. She is to go to the Goverment's mental health facility, but I don't want to send her until her wound heals, as I am unsure of the type of medical treatment she'd get there. It is absolutely wonderful to bring a patient, destitute or otherwise, to a semblance of good health.

My father, Sam, and I had a bit of an argument about the state of affairs at the B, w/ him saying that there really ought to be sterile surgical instruments and the works. I laughed outright and explained our budget, and the man started shouting. As Scott and I discussed, perhaps Sam's discomfiture at the B's populace was manifested in his yelling, and Scott said he still meant well, that good care ought to be provided to our folks. I found it odd that someone should start yelling in his discomfort, but it takes all kinds of people to make up the world, doesn't it. The B ain't for everyone, and it sure ain't for folks who yell when they start coming there, esp if they are not mentally ill patients of the B.

Tutoring was non-existent this week as our students couldn't cross flooded streets to get to us. The poor things also live in leaky homes, so tend to start coming down w/ respiratory infections, etc., in this weather. Our friend, Doug Watts, gave us a bunch of sturdy umbrellas for the students, and we handed 'em over, but they are not being used. Methinks the moms are terrified the kids will break 'em and have sequestered them somewhere for safekeeping.

The boys have exams next week and are cramming. I do like the Indian system of rigor in education. Naren learned the coagulation cascade (blood clotting mechanism) in 8th grade, and I learned it in 1st year of med school. Navin was in a debate at school on corruption in sports, and I like the boys' participating in such activities also. Earlier, both boys were on either side of the issue, "The U.N. is irrelevant today." We were reading the Matrimonials yesterday for grins, and Naren was irate about the emphasis on "fair" brides (this is a very color-conscious society); Scott said that when it was time to advertise Naren's candidature as a groom, we'd state, "Young man seeking unfair bride."

"Parents learn a lot from their children about coping with life." - Muriel Spark

Unw -


Sunday, October 22, 2006

Report of 22 Oct '06

Hello from breezy Chennai -

This keyboard tended to hang, so I thought the blog was doomed, but here I am. I do so miss good technology.

Life is fine. We have just had a week of family visiting. My parents' 50th anniversary was on 18 Oct, and we had a party for them and their friends. My widowed sister-in-law came from Bangalore, my sister came from Vellore, and my brother and I organised the show here. My mother is disabled w/ a non-functional left knee and tends to shun the outdoors as she is embarrassed to be seen w/ a walker. But she came here w/ my father and we were all together in various permutations and combinations, and it was a blast. The hosting was that much easier due to my husband's good nature and easy presence, plus his great love for his in-laws; such a peach, that man.

Belated Happy Diwali - the festival of lights! All of us celebrated it yesterday, i.e., the entire Bose family. It was a fun time w/ non-stop eating, and it looks like a good time was had by all. My sons want to host the whole family again soon; it is awfully nice to get along w/ one's fam. I gave my parents an enlargement of a professional photograph taken of the 6 of us - Sam, Saroja, Manu, Anu, Renu and Vinu. Certainly, it'd have been nice to throw in pics of the children-in-law and grandkids, but that required massive coordinating and I figured I'd do that another time. This enlargement was from a precious picture - the last professional one taken before Manu died. My parents wept when they opened the gift in private.

The B is fine. Our patient who was rehab'd enough to accompany me on rounds and use her medical assistant training, JJ, had psychiatrically relapsed when I was away. She had had to be restrained and sedated, and stopped going on doctors' rounds. I was very sorry when I saw this, as her clinical skills are thunderously good. Shortly after my return, I noticed that she was tailing me - offering a magazine or the newspaper - and asked the therapists if she might work w/ me on rounds. They agreed, and JJ comes on rounds. Flashes of her original brilliance show, as do the effects of her psych meds (she is pretty groggy sometimes), and we are continuing to work w/ her. Working on rounds had done JJ, and the patients, a world of good. It was only when I saw her at work much earlier, and saw her robust sense of self and self-esteem, that I realised the importance of successful psych rehab and income-earning for a woman. JJ was a delight, and she is showing signs of her old self, and I am hopeful.

Ms. K's son, the child w/ cancer in his eyes, is undergoing treatment. Stand by for more. We have to be realistic here, though it breaks our hearts to do so.

My father, Sam, lectured to the healthcare workers at the B on wound care. Our head nurse, Leela, found the talk excellent and very useful. Sam found the B depressing, esp the mass of women being herded, and couldn't wait to leave. Scott suggested I cut the man some slack, as the sight of a psychiatric facility does depress; perhaps our success stories aren't as glaringly evident as the work that's ongoing. Anyhoo, I found the talk arrogant and elitist: Sam works at a purely for-profit institution (even though he ain't purely for-profit), and is used to that mindset. His treatment for bedsores: vacuum-assisted closure; my treatment: turn the patient regularly. Sam had also forgotten some of his Tamil, and so the talk got even more uppity as it was partly in English. Quite a hoot, overall. Scott felt I was being a bit harsh.

We tutored last week and gave the students this week off for Diwali. After last week's studies, the kids played Uno and had a whale of a time. I really like the tutors and the "outcastes" sitting together at a game. The veg market is also fine, w/ all my patients holding up, knock on wood. My mother noticed that the veges served at meals in our house were fresh and lovely; I mentioned that it was nice to have patients in high places, like veg-vending.

"When choosing places at the table, important persons don't care and those who care aren't important." - English proverb

Unw -


Sunday, October 15, 2006

Report of 15 Oct '06

Hello from sultry Chennai -

This has been an unpleasant week. I think I've been in a bad mood through much of it, and it is only just lifting because my oh-so tolerant spouse is on the couch here also doing some work.

Our patient w/ HIV, Ms. K, whom I've spoken of in talks, has a son in an orphanage here. The teacher noticed that the child was not picking up toys on his right and they sent him to the eye doctor. Nothing amiss was found, and a couple of months later, his gait started to waver. He was re-sent to the ophthalmologist (eye doctor) and found to have cancer in his right eye, which has spread to his left. He will lost the right eye for sure, likely the left, and the doctor does not think he will tolerate chemotherapy and radiation. I am really furious and distressed: I don't know if substandard care was given because the child is from an orphanage and not the product of wealthy parents, or what the heck happened, but we are going to have a blind child at the end of this whole exercise. We have asked for the test reports, but the docs are balking at giving them to us.

Neighbors of ours, Mr. M and his family, have started a customised suit-making and exporting business, and their grandfather, also a neighbor and sometime patient of mine, stated that the business was very successful and that Mr. M (now 33) could retire in 3 years. Before I could stop it, the ugly face of envy loomed. I thought to myself that being financially settled would be a great thing, and that I could perhaps buy N and N pizza on a more regular basis than once in 6 months. When Scott and I discussed this, he mentioned that M's clientele was not the poor but the wealthy in the U.S. and the U.K.; that if I'd practiced in the U.S., I could also have retired after 5-8 years of work; that if I had more money, I'd be giving it away, anyway (the spectre of Hospice remains just that - a distant dream).

And then, I showed up at the B, and we got a patient rescued from the street. She smelled foul, and didn't say anything, and the health care workers (hcw's) got ready to give her a bath and take her to the Institute of Mental Health (IMH). I was then called to see her, and this was why: she had a huge gash across her right buttock and the skin and flesh were hanging off it. The possible causes of this saddened me greatly, and I again could not really stop to mull over man's depravity to man (are we the only species that does this?). We made plans to send her to the hospital first, as she needed surgery for this huge wound. I didn't want to send her stinking, though, and as I supervised arrangements for her bath and haircut, I was struck by how trusting she was, though nonverbal. She looked at me w/ placid eyes, declined my offer of food and sat unfightingly through a sponge bath and haircut. She could answer no questions about how the tear had happened, and so we put a huge gauze dressing on it, wrote a note to the duty doctor and sent her on. We can only imagine the circumstances under which certain patients come to us - emaciated, dirty, reeking, w/ either broken bones or HIV - but they must sense that we mean them no harm as we bathe them and arrange for a meal. This is a powerfully humbling trust.

This, then, is what my purpose on earth is, eh. Some people are put on earth to make money, some to take it; some are here to care for others and some to make us wonder why we ought to bother caring; some play certain games very well and get what they want in life, and some will always struggle for their next meal; some will have staggeringly wonderful spouses and some will get the tar beaten out of them by the same person that put the ring on their finger or the thali round their neck; some will have mouthy teenagers and some will pray for the day their teenager says, "Amma;" some will keep their morals and values intact and yet be successful (see - Scott's company's founder is called the "Corporate Gandhi"), and some will perforce prostitute themselves in more ways than one to reach a goal; some might lose a child and still retain faith in a higher power, and some will lose a sibling and say "What God?"; some will go gently insane and some will find their way to the Banyan so that we might treat their mental and physical illnesses and send them home to a family where the children wait for their Amma, that she might make some curd rice or some biryani, and give the kids a smile as they return from school.

I welcome all messages. Find fault w/ my thinking if you want. As I wallowed in this rage and forced myself to suppress the envy, this thought also occurred to me - there are many, many people in this world far worse off than I.

"My early choice in life was either to be a piano player in a whorehouse or a politician. And to tell the truth, there's hardly any difference." - Harry S. Truman

Unw -


Sunday, October 08, 2006

Report of 8 Oct '06

Hello from humid Chennai -

Both boys are at homework, Scott has left for Bangalore, and I am wilting w/ this 90% humidity. I don't enjoy high heat, she says as she chooses to live in India. In fact, I loved fall and winter in the U.S. Esp when it was crisp and got colder, walking or playing outside was such a joy. There is a dear former classmate from Poland on this mailing list and he loves Houston weather; he states he's had enough winter to last him a lifetime, just as I'd had enough summer by the time I got to the U.S.

The Banyan is fun and getting busier. My days of 3 days a week, part-time, are long gone. Now it's trying to fix problems and anticipate issues, and try to deal w/ our patients enough to make 'em healthy. In my outpatient side this week, one of the residents spoke of having leg pain; she was abandoned a while ago by her husband, her son is being raised by her brother and she tried to leave her household stuff w/ her uncle as she looked for a place to live, and he beat the tar out of her. She showed me a smashed finger. She had me by the heartstrings, let me tell you, and as she told me that she wanted to raise her son herself w/o being a burden to anyone, she tightened her grip on said strings. The B is sending her outside to work as a cleaning lady, her mental illness is under control, and I prescribed some meds for her leg ache, and told her I wanted to see her next week to ensure that she was better. I like the B's approach of trying to make our ladies independent, self-reliant, and magnificent.

Our resident who has since become a lawyer was waiting one day to be photographed for a billboard which will feature our successfully-employed residents w/ the caption "She might have been your lawyer; she might be your favorite beautician; she probably cleans your house; she was once at the Banyan." I asked her to try on her robes and she did, and appropriately preened, and I admired her, and am happy that she is now successfully rehabilitated. The social workers are a tad miffed that she doesn't acknowledge the B's role in her rehab, attributing it to the lawyer she's clerking with; said lawyer is standing for a political office and is milking our resident's prior history for all she's worth ("I gave poor Ms. U her first job, see how great I am"). I'm not miffed: I think if it is in U's nature to appreciate us, so be it. If it is not in her nature, who on earth are we to demand it. Appreciation must come from within, it can't be cast from without. For the record, U has been pretty appreciative of the medical help; even had she not been, it is enough for me that she is healthy, and well on the way to a successful, independent life.

The tutoring service goes on well and after last week's session, all the kids had a raucous session of "Pick up sticks." It is nice to see tutors and students sit together in this caste-ridden society and play a popular game. Naren and Navin are quite the leaders in ensuring that all are treated equally, and for this, and for their American upbringing, I am grateful.

The boys have been delightful this week, arguing and helping and mouthing off and loving. All part of the teenage package. I told them again that I was 100 times worse as a teenager. We had a bunch of people over for dinner last night, including some new friends from the U.S., Meenakshi and Mitch, and their kids, Maya and Evan. N and N babysat w/ gusto after helping to prepare the meal and clean up; as usual, they received compliments from the guests and this made them very happy.

This is a good life, knock on wood. I am happy to be in it.

Unw -


Sunday, October 01, 2006

Report of 1 Oct '06

Hello from Chennai -

Well, I lost this blog once when my computer's power conked (it happens frequently now, though the computer is plugged in), so let me hasten. Happy Saraswathi Pooja (worship of the goddess of learning) and Happy Ayudha Pooja; the latter is where we worship instruments (like stethoscopes) and books. The books are then set aside and unopened until the following am, thus students don't study today and the poor overworked things welcome this holiday big time. Tomorrow's Gandhi's b'day and also a holiday to honor a great man.

The Banyan is fine. Very busy, and now I'm expected to do Medical Director kind of things like discipline other doctors. Yikes. Not yet, I told Vandana, let me concentrate on setting right some systems first. Our patient, Ms. V, who had been so debilitated earlier is now better: her ear infection has been treated, a different physiotherapist has worked w/ her and now she's up, walking and dancing! Oh, halleluia - it was such a welcome sight to see her rear end swaying in perfect rhythm to the filmi music and then she bopped her head and made little clicking sounds and was totally in her groove. Sometimes, patients will heal due to non-medical interventions (physical therapy, Bollywood music!) quite nicely.

I met the brother and sister-in-law of the burns patient, Ms. U. They are indeed loving, kind and concerned, and a priceless lesson to us not to jump to conclusions about events that might seem otherwise than actual. Ms. U is now a giant paint in the neck - obsessive, demanding, childish; we have a great appreciation of how much her family, whom she lived with, had to endure. As soon as she has healed, she goes to an old age home, which all feel is the best place for her. She weighs 26 kgs, 57 lbs and is about my height (5'3"); I am concerned about tuberculosis in this lady and we are going to start treatment for it though the tests have come back negative.

We were phenomenally privileged to have my sister Anu and her family visit us yesterday and today. Anu is an eminent researcher w/ all kinds of collaborations w/ Johns Hopkins and UK medical personnel, and is usually very busy; we were glad she had time to unwind. I like her husband and kids a lot, too, so we had a whale of a time. It is wonderful to get along w/ one's family. We watched the excellent movies "Collateral" and "Hitch." My brilliant scientist aunt, Indira, asked us to go visit today, and we did, and had a wonderful time, sitting out on her porch after a glass of mango juice, speaking of all things family-ish and not-so-familyish. We are very privileged in our relatives (well, these ones at any rate).

Naren and Navin are typical teenagers, but at least they talk to us. I would very much welcome emails to Naren ( that are confidence-boosting; along w/ this lack of confidence is a perverse denial that his preparation for the exams was inadequate. Well, the boy will figure it out, we hope. Navin, too, has been shoddy w/ exam prep. Talk of dating is on the wane; now Naren wants to invite some young woman and her entire family over so that we can meet them and get to know them - ostensibly he and the lady are just friends. Again, I am happy that he thought to go this route instead of the one adopted by quite a few of his friends: to slink around w/the romantic interest, cut class and go to movies, and lie to the parents. I was very happy to get advice from Ann Bagley, a friend and also the mother of a friend, who has raised 2 fine young men, one of whom I love very dearly; we are extremely blessed in our friends.

Unw -