Report of 25 Feb '07

Hello from the new blog spot -

It seems like my old posts have moved to this spot, so be it. It is sunny today and beautiful - the clothes are drying on our balcony, Naren is cramming phys, Navin just finished a handwriting exercise (an ongoing battle) and left to get some ice cream at the store, Scott is about to set some work for Naren and lunch is made. A friend is pregnant, and as her husband is half-Coorgi (like me), his aunts followed the Coorgi custom of sending a basket with meal and goodies to the pregnant lady (usually in the 9th month, to give her a break and share treats); the package (called "koopadhi") included Coorgi pork, which was apparently too abundant for the couple, so they sweetly sent us some. It is delicious and will make a great addition to lunch.

The B keeps in touch w/ me by phone and I heard this week of a young woman, Ms. A, getting pukey and unwell. She works in Vandana's house, having been treated of her mental illness enough to earn a living. (Her sister is JJ, my medical assistant and someone very dear to me: when JJ's own illness is under control, she is a brilliant clinician, extremely competent and simply rather "simpatica" - nice.) Ms. A has Hepatitis B, not sure how it was contracted (it's generally through blood products or sex), and we are going to give lessons on safe sex to all our residents, esp those that are in the working world. None of us wants to pass any judgement on their personal lives and choices, all of us definitely want them protected from disease, esp HIV.

The veg market was also fine. The vendors are anxious about Reliance opening its grocery chain. Reliance is a powerhouse business w/ interests in textiles, oil, cell phone connections, and is branching into fresh veges and fruit. Scott and I stumbled on their store in a different neighborhood 2 weeks ago, and found the quality of their produce absolutely superlative, and the prices low. We wonder if they will adopt Wal-mart's strategy of knocking the Mom-and-Pop stores out of business and then raising their prices.

Tutoring was good - short-handed again. Lessons went well, except w/ my student. She had flown through 2-digit additions last week, but was tremendously distracted w/ the same subject this week - unclear to me if it was from hunger, or something else. We don't have the resources to provide nourishment to these little people, or indeed anything else - this little girl's clothes were frayed at the knees and a wee bit too small for her. I remember learning in pediatrics that children's nourishment was vital to their development, and we are (collectively) doing a disservice if she does not get enough to eat. This is on many levels, the main of which is reining in our stupidity in not being able to control our population.

Scott and I got a rare break, and went to see "Blood Diamond." It was exceptionally dreadful. To make a movie tug at the heartstrings and influence behavior, everyone's acting must be sturdy; it was not, here. Jennifer Connelly tried hard to use her anatomy for effect, I guess Leonardo DiCaprio's accent enthralled viewers over there, and Djimon Hounsou looked a tad wooden but tried mightily to salvage the movie. I thought "Happy Feet" did a better job of promoting its cause. We saw "Babel" some time ago, and liked the magnificent performances of the Moroccans and Adriana Barraza. Some neighbors invited us over for their annual dance party last night, and we went and I danced almost all night - it was a blast.

Naren's mighty exams start on 28 February, Wednesday. He has been studying and being tutored in various subjects. We welcome and urge messages to him, including the stark reality that hard work will pay off, at narenweiss@hotmail.com.

"A young man who is not a radical about something is a pretty poor risk for education." - Jacques Barzun

Unw -

R

Report of 18 Feb 2007

Hello from sunny Chennai -

My shift key on the left is stuck, so there will be quite a few letters that are not capitalised. Welcome to the world of intense humidity and mold.

Something alarming happened at the B this week. A young woman named Sumi, in her mid-20's, suddenly died. I asked for a post-mortem, which can only be done in the Government institution here. The nurse and social workers were a bit hesitant to proceed, as apparently the Govt Hospital (GH), no stranger to bribes, could start insinuating that the B caused the pt's death and slander us. I spoke to my Dad, he gave me the name of a contact at GH, then spoke to Vandana, and we decided the p-m was vital. By this time, the social worker, nurse and Human Resources person had decided there would be no p-m and burial of the patient was completed. I was not notified until the evening, and was furious, and yelled at all 3: we would have got golden info about the cause of poor Sumi's death which would have helped in the care of our other patients. No reason for the decision has yet been revealed to me, perhaps next week. I used profanity in my yelling, and accused the 3 parties of some selfish decision-making, both of which upset the folks. I did apologise for the profanity, but let the issue of motive stay.

The veg market was busy and a couple of the vendors had consultations to make of me. It was pretty challenging to do the history and physical in the midst of heaps of okra, yams and cilantro, but nothing new to me. The guy (maybe aged 30-ish) who sells fruit has developed a head tremor and it is concerning me; i know little of such tremors and want him evaluated by a neuro. Let's see if he will go. He is very fond of my gentle husband and always asks about him if I am alone, or goes out of the way to chat to him if he is with me. Scott is revolutionising the way white people are viewed and treated.

Anu, Vinu and I went to Coorg for my Uncle Thammappa's Madha. It is difficult to think of him as gone, but we are glad he did not suffer - as I told my cousins. His dignity in his last days and his unrelenting, unwavering sense of humor are an example for all.

Tutoring was fine and 6 kids came. We were short-staffed again, and i tutored a little girl in 2-digit additions. She does not know her English letters but simply blew along in math. It was wonderful. Perhaps she will study more, and be productive, and raise a family, and not let her husband beat the tar out of her (which is rife among the lower socio-economic class). A couple of young girls in the complex have started their period ("menarche") and their mothers asked that I talk to them of the event, so I did - replete w/ anatomy atlas and discussions of sex. I told them it was fine to giggle or get grossed out. It is very easy to urge abstinence in this culture.

Let me wind up. 2 boxes of journals came from Dr. Love and Louise Hass, and i am loving every mag. Louise sent "Smithsonian" and "Vanity Fair," which all are enjoying.

"My doctor saved my life once. I called him to the house and he never showed up." - Unknown

Unw -

R

Report of 12 Feb '07

Hello folks -

There's something up on the blog site, moving all our accounts to Google. It's painfully slow and, to quote my husband, I have the patience of a boiling tea kettle, so I am going to resort to email today.

My uncle with stomach cancer died last week, less than 2 months after being diagnosed. Many of us from Tamil Nadu could not get to Karnataka for the funeral, because there was agitation in the latter state: a Central Government tribunal had decreed that the water of the Kavery river had to be shared w/ TN, giving us the larger share (prompting some gloating, let me tell you) and Karnataka was furious. So there were riots and disruption of inter-state and intra-state traffic. My cousin Dhanu had sort of asked if I could get to the funeral, which was new to me as I am not used to my presence being wanted, and I simply could not do so safely. So my sibs and I are going this week for the 9th-day pooja, called the "Madha" - I've never been to one, and hear it is more of a celebration of the deceased person's life, like an Irish wake. Scott had seen my kind uncle Thammappa last week, as he was in B'lore, and had taken them a heap of take-out food, which all enjoyed; Scott told me that my uncle had asked about all of us, in the midst of his tremendous agony, and I wept on hearing this. That was my uncle for you, epitome of consideration and affection, and known most of all for standing up to all of Coorg and welcoming my dark-skinned, non-Coorg father into his home.

The B had its share of illnesses w/ one of my favorite pts, Ms. E, suddenly undergoing a change in mental status. We have to tread carefully when this happens, because it could be their psychiatric illness doing it, or the meds, or moodswings, or a physical illness. The health care worker had pointed it out to me and I asked for a Cat scan of Ms. E's brain. Lo and behold, neurocysticercosis - a parasite from undercooked pork. Ms. E used to always greet me cheerfully, with a "Have you eaten?" in Telugu, which I greatly appreciated as she diligently ignored her destitute status and focused on someone else (moving me greatly), and I'd heard none of this for a couple of days. Thank goodness for our astute health care workers. Ms. E is now undergoing some anti-parasite treatment and I have asked for a second opinion.

Tutoring went well and we were a bit short-handed. I tutored a little girl in multiplication, and Kris Rea's beads came in really handy; tiny hands counted out the beads into sets, the concept of groups of numbers entered, and a fun time was had by all. When it came time to draw and paint, the kids did very well and appeared to enjoy it. The session ended w/ candy for all, of course, and gifts of paint boxes to the kids donated by the Cassidy family's daughters' school in Brecksville, Ohio.

I'd better wind up before my computer times out. Best to all of you. Enjoy Valentine's Day and always remember to appreciate those you love.

Unw -

R

Report of 5 Feb '07

So here we are, after a Colts victory!

To those, whether in the U.S. or elsewhere, not familiar w/ American football, let me explain: the culmination of the playing season is the Superbowl. This year, the 2 teams playing in "the final" were the Chicago Bears and the Indianapolis Colts; as we lived in Indy for 3 years and I trained there, we were pretty rabidly cheering the Colts. We got up at 4.45 am, took the neighbors' housekey that they'd given us earlier and let ourselves into their flat as quietly as possible. Turned on their TV, and 3-1/2 hours later, saw the Colts win somewhat comfortably. Yes!! We like their coach, the first African-American to win the Superbowl - thus becoming a trivia question - and their quarterback: both are humble and decent, thus easy to like. It was rather nice to watch our team win without getting an Indiana-sized ulcer.

Some of our patients went back to their hometowns last week. This week, I heard that the patient I'd seen last week w/ the baby, Ms. B, had settled back in w/ the family. Her story was a bit vague, but she'd stated she'd been raped en route to us and the baby was born here. It is not her husband's baby, but ostensibly the in-laws and extended family have accepted Ms. B and the little guy - relieving all of us. It is entirely possible that they do not know (and DNA testing is not an affordable option here), but we'll take all blessings we can get.

Ms. S, the much older lady who'd had the stroke and was so debilitated I didn't think she'd survive, is holding her own and eating by herself. This is a big treat for me and I love watching her eat. The night shift had its share of challenges, w/ a surprise inspection yielding that all the residents were being marched naked to the showers in the mornings - anathema to us. So we had to get to the root of this problem, as the dignity of those who cannot speak for themselves is rather high on our agenda, and that took the better part of a day. I am doing a great many non-medical things, and find that I miss medicine quite a bit.

Tutoring was fun, and a new little girl has joined us. She is very tiny, cute and an enthusiastic learner, thus delighting all of us. The kids got M&M's at the end of their session. Navin returned from a school trip, having had an "okay" time and Naren finished his last mock exam today. My share of patients included Navin, w/a thorn in his big toe, and Scott, into whose eye a bug flew. The thorn came out w/ some effort. The bug was so clearly in Scott's left lower eyelid that it was a treat for me (often, foreign bodies that irritate our patients' eyes can't even be seen) and I removed it after a couple of dabs w/ a tissue (washing the eye had not worked); I was so flushed w/ achievement that I preserved the bug for a bit and stared at it w/ great fascination (sort of trophy-ish).

Let me wind up. I do look forward to heading stateside, and the conference of the American College of Physicians has been an extremely worthwhile annual endeavor.

Unw -

R