Report of 28 Jan '07

Hello from the B -

My stomach is rumbling and I look forward to eating at our cafe soon. The residents run it and the food is tasty; I often hope for Western food, but might be in the minority.

We are well. The lady w/ the butt gash, Ms. M, is finally to head back to Kolkata this week. The rehab team plans and executes this: a social worker preps ahead of time that the families are where they say they'd be, tickets are booked (a must in this overpopulated country) and then the residents are taken. I had my Bengali friend, Gopa, explain this to Ms. M over the phone, and Ms. M was delighted. After the call, she took my hands in both of hers and said something fervently. It was not necessary to know the language to know that she was praying, so I sat there and looked on. It was wonderful. I knew she was praying for anyone associated with me, and me, and the depth of the affection was evident though I could only catch the occasional "Allah" (Ms. M is Muslim). We finished the prayer and Ms. M stated that she was now "kush" - in Hindi, this means "happy." I'm glad she is kush.

I am at our other center now and one of the patients here, Ms. B, is to be sent home as well. Her little baby is now with her, having been brought from the orphanage for the trip. The language of the mother is universal, isn't it; as I was examining her, her baby (in another resident's arms) was crying and Ms. B looked around to see what was happening. Finally, the child was handed to her, he put his thumb in his mouth and simmered down, while Ms. B rocked him and spoke gently to him in a language that I did not fully understand but recognised as Mother-ese.

Lots of fun interactions last week. My brother, Vinu, and I saw our childhood friend Farshid in Mysore. Farshid is an avid environmentalist, pursuing his Ph.D. in Ecology, and blogs at notes-from-the-field.blogspot.com. More than that, tho', Farsh is a genial, easygoing, salve for the soul - we laugh a lot when we are together. His parents were in Chennai for a friend's son's wedding, and we also got together. It was great to touch base w/ old friends, and laugh and love. We also got to see a play on the Bible, which our neighbor was acting in. Greg Brown, now an intern making his 2nd trip to India after his 1st one last year as a student from my med school, also visited us and that was great; obviously his first trip did not scare him off. His professor, who is of Indian descent, also came w/ him, and wasn't as happy w/ things in South India. The 3 Weiss men and I went out for b'fast - bonding over sausages and eggs was great.

Tutoring was looked after by the boys as we headed to the play. Navin leaves on a school trip this week - 4 days to Kerala. Naren hits the home stretch as he crams in the last month before exams start on 1 May. We are very blessed to have our neighbor, Usha, who is a child education specialist, and she has given Naren lots of pointers on studying, and adolescence, and emotions. She has also sat Scott and me down over lunch to talk about what we ought to do at this time, and we hugely appreciated every word.

I'd better wind up. Oh, nearly forgot - I will be in the U.S. from 9 April to 1 May attending a conference and then speaking around the country. I look forward to it.

Unw -

Renu

Report of 21 Jan '07

Hello from the B -

Oh, go Colts! I so miss watching sports. Scott would tell me intricacies of the game (football, baseball, basketball) I might otherwise miss, and I'd enjoy every bit of it. We got invited to Superbowl parties and never went, because I wanted to watch all of the game and not chit-chat. It was that way w/ all the sports, esp basketball.

It was a wonderful weekend. I went to Coorg for my cousin Pravin's wedding. His mother, Gangai, was widowed when she was expecting him; not only did she single-handedly raise the boy to be a fine young man, she made it a point to attend all our weddings. And stayed genial through all her interactions w/ everyone, even though widowhood in India is particularly humiliating (cannot play the main role at family functions as the widow is considered unlucky, need a man around to get things done by service people, etc.). Ergo, the crowd at the wedding was thunderous. I stayed w/ my cousin, Sheila. Her father, Bollu, and my mother are sibs and have not spoken in 50 years due to opposition over her marriage; he doesn't speak to any of her kids, either. Well, I had breakfast at my uncle Bollu's place. It was epoch-making that he would tolerate my presence there. In fact, we had a most genial conversation, he was hospitable (but not gushy) and I return full of good memories. I got to hang out w/ plenty of other cousins, too (our parents don't get along, but we do, which makes me very happy) - and it was massively therapeutic. Sheila said she told her parents, aunts and uncles that the cousins don't get a chance to fight because the parents do such a good job of it. It was a lovely, lovely time and I returned to find that Scott had had a fender bender here, replete w/ yellings between the drivers, but I refuse to let that cloud the historical moment.

Last week, I got the devastating news that the patient we'd rescued from the street (whom I'd mentioned in the blog) died. She developed respiratory distress, then her BP dropped and she could not be resuscitated. I am kicking myself a bit here: as is customary, I waited for her to get cleaned up before I examined her; I thought her whispering was due to her mental illness (she could have been having breathing difficulty then); I missed some clues to her condition. Dang it. I think she might have had HIV, and a serious resp illness that might have gone along w/ it.

Sometimes I wonder what I do here. Whether I too am starting to treat the impoverished patients as unimportant. I tell you, I was so looking forward to the lady recovering and telling me more about how she'd become as literate as she was: we get nice surprises in our work daily. And, obviously, some not-so-nice ones, also.

Tutoring was looked after by someone else as the boys and we had a long awaited family night at the movies. Actually, I was supposed to zip to Mumbai for the day to attend a press conf and zip back, and I would have missed the movie, so I was trying to figure out how to juggle everything. As it turned out, the flight was too expensive and the B could not afford it; Allah be praised. I love hanging out w/ the 3 Weiss men and we saw "Happy Feet," which was hilarious and excellent, and went to eat at a very expensive burger joint (85 bucks for my tuna salad sandwich). I invest a bit of money and a lot of time in our family events, and like the returns; all of us had a blast.

Hope you are having fun times of your own.

Unw -

Renu

Report of 14 Jan '07

Hello from the B, where good equipment reigns -

I need to clip through this, as we are about to celebrate the birthday of our founder, Vandana. She turns 36 today, and the B has existed for 14 years. So, do the math, she was 22 when, along w/ Vaishnavi, she started this organisation in a little rented house, taking in mentally ill women who would otherwise have been brutalised on the streets, and facing massive ostracism for that very step. The Banyan has since grown by leaps and bounds, and this model is starting to be replicated around the country. Mental illness ain't my thing, physical illness is - as are V and V. They are simply exceptional and noteworthy individuals, and never act like it.

We had a patient rescued from the street, whom I saw yesterday. She was in a corner of the sick room, crouched and shutting herself off from the world. She was gaunt, completely emaciated, somewhat dirty, not approachable. The health care worker (hcw), Uma, stated that she had a wracking cough, and I needed to get more info about it; I crouched down next to the patient and touched her shoulder. I expected to get no response, or a slap, but the pt turned around and I asked her what her name was. She whispered something, I didn't get it, and then she asked for a pen and paper. After being handed those, she wrote in very clear Tamil her name and complete address. Then she ended w/ some English. Praise be. So she is literate, and capable of communicating in some form. I started treatment for the cough, though all of us suspect tuberculosis. I look forward to this lady healing, and becoming the person that she can completely be. What a fine profession to be in, what a good life.

I've mentioned JJ before - the patient whom we discovered had nursing skills and whom we are putting to work at the B. JJ went to visit her relatives in Trichy over the weekend. She had relapsed last summer, back into some sort of psychotic stupor, and had not worked at being a medical assistant. After I returned from the U.S., I wanted to use the skills of this extremely intelligent woman, and requested that she work w/ me; I suggested that some of the psych meds be reduced as she seemed pretty sedated. She is back to her old form now, wonderfully skilled in the sick room, and I am delighted. JJ brought me back a box of sweets from her Trichy trip and I was completely heart-warmed: she does not have much money to start with, and chose to remember me. My whole family shared in my appreciation of this thought. Such are the moments then, that make up my life.

It was the harvest festival in Tamil Nadu, indeed all of India, last 4 days, and no one showed up for tutoring. The markets are full of sugarcane and we have been gorging. On Pongal Day (harvest day), sweet rice is made w/ jaggery (brown sugar) and ghee (clarified butter). Neighbors shared some with us, and that was lovely. The boys were off school for 4 days, but Naren continued to write exams in that period. Navin came with me to the Banyan yesterday and was my model for a first aid class that I taught.

Hope all of you are well, and are enjoying the New Year.

Unw -

R

Report of 7 Jan '07

Hello from Chennai -

How easy it has become to write '07, instead of the perennial struggle to remember the new year and not keep writing the old year in error. This year is clipping along w/ some speed.

The week was fine. The B had a mini-reunion of patients who have been successfully reintegrated w/ their families or in society. It was great! These patients continue their follow-up w/ the B's psychiatrists, and receive a small sum of money to come in for their reviews (as they/family members would otherwise lose a lot of income in taking a day off to make the trip). The B's able social workers ran the show, and talked of starting support groups and income-generating ventures. Then it was party time w/ games and food. One of the games was for 1 team to sing a song until the host terminated it, and for the other team to start a song w/ the letter of the last word of said song; this is called "Anthakshari" here and is hugely popular. The average Indian is bashful, so there was not a lot of zeal initially; I did notice that one father urged his daughter to sing when it was their team's turn. He then sat w/ a gentle but definitely proud smile on his face when the young woman sang. It was a lovely moment, worth remembering, esp in this country where daughters are still viewed as burdens and where the father-daughter bond is not always one strengthened by affection. Thank goodness for the good fortune of being born in a family where my parents could afford me and where my father thought his daughters came directly gift-wrapped from God.

One of our patients, Ms. N, returned. She had been at a temple here in August, and had met with an accident. Her replies to the police had not been coherent, so they'd shipped her off to the B. After able treatment, she was lucid and recovering, and provided us an address. The B wrote to this add, and Ms. N's son and daughter came to take her home, the relief in having located their mother very palpable. Well, Ms. N "relapsed," as they say here: she talks of her deceased husband as though he exists, refers to me as her daughter and tells her son imaginary things. The son is quite upset, and we told him that we'd have to keep Ms. N for a bit. She speaks Telugu, I don't, the son speaks both Telugu and Tamil, and when I asked him to translate for his mother, he was most reluctant; on some urging, it came out that Ms. N had just said Rajiv Gandhi's mother (both RG and his mother, Indira Gandhi, were our Prime Ministers) was related to her husband (likely not). I watched the son's anguish, and told him these behaviors were common characteristics of mental illness, so not to panic.

Tutoring was fine. 2 little girls came, and learned math from Naren and Navin, finishing up their session w/ doing the only 2 jigsaw puzzles that we have. We had a big treat this time: our friend in the U.S., Anastasia Settle (whom I'd just met last summer), had sent M&M's and we passed some out. Chocolate is a big treat and we were thrilled to get this package. We also got a huge package 2 days ago from Scott Semester, also a friend I met last summer; this package contained chocolate, movies, a book, a CD and a snowball each for Naren and Navin (obviously not in the original form). This package was also received w/ lots of joy. We were tremendously touched that newly-acquired friends would pamper us thus. We also got some antihistamines from Dr. Katasha Butler, whom I'd met while working at Citizens in 2005; these are a great joy for me, as I have drippy (i.e., nose-running, allergy-prone) family and friends.

Ok, let me wind up. Have a great week!

Unw -

R

Report of 2 Jan '07

Happy 2007!

Hope the year is happy and healthy for all of you. The concept of wishing someone good health is high in my book, more so as I age. When I pack for a trip, the Ibuprofen must also go along.

There were tons of blessings last year. Even the teenager mouthing off daily was not a curse: adolescence is probably as trying on him w/ the world's stupidest parents in the house, and worse, having sired him. The 3 Weiss men and I took turns over dinner last night talking about what had made us happy last year, and what we hope for this year; it's a big treat to hear everyone's thoughts. We are happy that Scott is based in Chennai for the time being. I particularly appreciate it as we try to divide and conquer teenage hormones; whoever said teenage boys don't have pubertal mood swings never raised a teenage boy.

The B has embarked into a resident-run cafe and massages by the residents. I had a massage the other day (head, hand and foot; the concept of full-body massage is still a tad reserved for the elite here) and it was excellent. It was nice to help a Banyan resident earn a living. We have a patient whose relatives are extremely well-off, some of whom have settled in the U.S. We received a cursory enquiry from a sister in Florida, and Vandana asked who would reply; after some discussion, I showed Vandana my draft of a letter where we collectively urged the sister to enlighten herself (from our web site among other sources) about mental illness, its treatability and the effects that family support has on one reeling from it. We sent it off and the sister replied, assuring us she would donate to the B - missing the point fairly completely.

Our lawyer resident, Ms. U, has started going to court and assisting in cases. Magnificent! Her mentor lawyer, who had been taking advantage of Ms. U, continued to do so and the B stepped in and severed relations w/ this woman. We are fairly protective of our own: we do want them to succeed and want to ensure that all those who would exploit them stop it forthwith, bringing to bear the powerful resources of our organisation. Sometimes, as I sigh over a non-verbal patient who can't tell me where her belly hurts or answer any of the other questions that would clue me in right away to the cause of her pain, I think that if we can rehabilitate one woman and make her productive, that makes the night's sleep well-earned. Who would take care of these folks if we did not? The street?

We wound up tutoring for the year w/ a party, Doug's umbrellas and crayons donated by many of you as gifts. We also passed out goody bags full of junk food - chips, chocolate, candy and cashews (very expensive). Our students can ill-afford this stuff, and I sanctioned the junk, knowing full well it would bring lots of joy. 3 of our students are Christian, and I asked how they'd celebrate Xmas; they said they got new clothes and went to church. One said she had a part of a Nativity set which they displayed at home. I asked if special goodies ("palagaaram") were made at home and they said No. No one can afford that part. I was saddened momentarily, but the spirit of *their* Xmas prevailed: new clothes and church were more than enough for these kids, by the looks of it, and I was grateful for their simplicity and rejoicing in small things.

The veg market is going through some changes which were occupying the vendors, so our rounds through there were quick. We were happy to get together for lunch w/ our friends, Meenakshi and Mitch, and their kids Maya and Evan. It is great fun to eat and talk and laugh w/ kindred spirits (somewhat more so when their situation is the same as ours - woman Indian, man American, raising 2 kids, comparing and contrasting life here and there), and we had a whale of a time. M&M's senses of humor make their company a special treat.

I will take unpaid leave from my job in Feb and March as Naren has study holidays and then giant exams. Much though Naren and Navin do the typical teen actions such as backtalk and fight daily, exam time for 10th and 12th graders in this country is a colossal event and many parents take leave from their jobs for tutoring and other prep (let's not forget food for teenage males). While we were tempted to let Naren face the consequences of his actions of not studying, better sense prevailed and we sit w/ him while he studies. Scott is a very patient tutor and looks over and corrects Naren's work, I read my journals which I enjoy. As all decided, no one wants to have me tutor anyone; my lack of patience w/ those that came from my uterus is legendary.

"Teenagers express a burning desire to be different by dressing exactly alike." - Unknown

Unw -

Renu