Report of 25 Sept '07

Hello from the B -

One of my young patients has died, and I am awaiting the results of the post-mortem. This is not easy - we have to report to the police station, where they must do a lot of paperwork (lest suspicion fall on us that we induced death), then beg the local hospitals for a post-mortem (some are more willng than others) and wait, wait, wait. When our HIV positive patient's son was hospitalised, his father accused everyone of stealing his eye - it had been removed due to cancer. As organ-selling for money is rife here, his accusation was not without basis, but it does mean we have to cover our you-know-whats. Even those who take care of the destitute face a fair amount of obstacles, you'd think folks would attempt to *ease* said obstacles. But you know, nothing worthwhile ever came easily.

So I stopped by the empty bed this morning, and before I knew it, I had started crying. The young lady, RR, spoke a language none of us understood, she was sick and getting better, and we hoped for the best. She had been incontinent, and when I sent her urine for tests, we discovered an infection. Let's hear it for medical training that teaches us infn can lead to incontinence, even in a young person. So we had treated the infection and she had become better, not incontinent any more, and was getting up and about, and then abruptly took a turn for the worse. I must be grateful for the fact that her last days were w/ us and not on the street, w/ no one to look after her, and indeed, plenty of people to abuse her. Somehow, though, that is not sufficient consolation today.

Tutoring is sluggish, as the kids are not coming - ill, rains, exams, etc. I hope to get them back in soon.

The 3 Weiss men are well, and helped host a big gathering of neighbors last weekend. The boys are truly growing up w/ extended family - neighbors help take care of them most willingly, esp when we are away. The soiree was an appreciation for such wonderful folks, and all of us cooked. Naren makes a sumptuous dessert which has become a regular feature at our meals, and Navin helped make the salad, so we ate well.

Our love to you all. Enjoy each other, and express appreciation often.

Unw -

R

Report of 19 Sept '07

Hello from the B -

Now that I am paid more here, I find it necessary to go on rounds everyday and try and earn my keep. It has become a tremendous challenge to keep the place clean, and daily rounds are sapping my time. Various excuses are given for not doing certain things, and I am clueless as to how to achieve hygiene. When Manu was hospitalised, the neurosurgeon in charge of him, Dr. Praharaj, and I used to have wonderful conversations. He was a magnificent doctor, and we once discussed an error that had happened in Manu's care: he said that Indians only work on fear, that the employee at the lowest level is scared of the one above her/him, who is similarly scared of her/his boss and so on. So the work gets done only because folks fear the wrath of Khan. Too bad. I enjoyed the atmosphere in the U.S., where folks, esp those in the health professions, worked diligently for the sole purpose of getting the job done well. So we are here, trying our best to keep out preventable illnesses.

The pregnant patient, Ms. N, who complained of abdominal pain has had a baby girl!! Baby girls are not hugely welcome in India, for the weight of dowry that they come with, but not in our family - I consider this a big treat, and saw the infant yesterday. She is truly pretty, w/ perfect skin and a head full of jet black hair. (Indian babies are rather distinctive that way - plenty of hair gives them a complete look. When Naren was born w/ peach fuzz on his head, my mother-in-law appreciated all the "hair" on his head; I said, "Hair?!! This fuzz?" and she said, "Honey, compared to what my kids had at birth, this is hair.") Ms. N is balking at breastfeeding the baby, giving hazaar (1000) excuses, and I am beside myself; I've roped in all our nurses to talk to her, as the surest sign of infecting the little girl prematurely is to bottlefeed her. Note we've already discussed hygiene issues above.

One of our patients who was rehabilitated (reunited w/ her family after successful treatment) is back. She was found on the street w/ matted hair and required serious medical attention as she had an empyema (pus in the space between the 2 coverings of her lungs). She has been successfully surgically treated, and started on anti-TB meds, and is doing well. I feel bad for this lady, given that the husband now has essentially abandoned her (he was contacted, and has not come to see her). When I was sick over the weekend w/ a cold, cough and fever (clearly not as severe as an empyema needing surgery), and got really whiny, needing companionship, the 3 Weiss men rallied to stay around. How sad for this lady that she has no family, or perhaps we are her family now.

I was in Madurai last week and got to see my parents, which was lovely. They continue to be an inspiration to me.

Better wind up and return to work.

Unw -

R

Report of 12 Sept '07

Well, here we are - having just celebrated Vaishnavi's b'day. She turned 36 today, and founded the Banyan 14 years ago. She is quiet, unassuming and very funny, and shuns publicity; she is also a big dog lover (as is Vandana) and brought ice cream for the dogs at the B to celebrate her b'day. I watched her traipse around, having established a nationally known service orgn, having accomplished much more than people twice her age, and wandering about as though she'd done none of this. One of the residents prayed w/ her and blessed her, and Vaishnavi seemed very grateful.

I got to see Scott over the weekend (it had been 2 weeks since the last sighting) and suddenly, all was ok w/ the world. The apathy, dispiritedness and doubt vanished, and I am enjoying life (and work) again. One of the women at the B is pregnant, I am yet to ascertain what happened w/ her husband and in-laws that she is here, and she told me today that her belly hurt. The staff said she mentions this often, but I cannot blow off a mentally ill person's complaint on that ground alone. So I asked that she be sent to the hospital, she has gone and been admitted, on the presumption that she has contractions. I feel for this lady, that she is away from loved ones at this Hormonal Harini stage. She is well tended at the B, and I suppose I must feel grateful that she is not on the street. When I was preggers and craved a muffin at 10 PM after my chemistry class, my husband stated he craved 1 too and simply waltzed out and got 2. Life is so good when one's spouse is nice.

We are on a massive kick to clean up the B as there is more than expected illness - lepto, dengue, gastroenteritis. Preventable illnesses must not happen, esp when we are in charge of caring for the destitute, and I go on rounds every morning in an effort to improve hygiene. My father, when in Government service, ran one of the few clean wards in an otherwise apathetic hospital (Govt. hospitals are like County hospitals, and not known for sterling care), and I asked him what to do. He stated that all his staff had consequences, like losing their day off, if the ward was not clean; I am trying it here and today's results were very good. They need to be sustained, as do my rounds. I've told the social workers that this can only work if they are energized also.

Tutoring did not happen, as a couple of the kids were ill. We will get to this w/ gusto soon, as we find there are benefits for all here: tutors and students. Naren was even bringing in classmates from his new school to assist, and we were grateful.

Enjoy your week! We'll chat next week -

R

Report of 3 Sept '07

Hello from wet Chennai -

A monsoon of sorts is here. One's expected in June and one in Oct, and this one's freaky. I don't mind it as it cools the place down, however it plays havoc w/ the traffic and roads get damaged w/ ease. My civil engineer husband stated that if roads are well-laid at the start, w/ the sand compressed properly and then tar poured, they'd last; in India, the whole process is so rife w/ corruption that bulk of the money is pocketed, tar is poured cursorily, and when the rains come, the sand settles and the tarred surface develops potholes easily. The approach to Abacus, Navin's school, is a nightmare at this time and for that reason alone, we pay a lot of money for school transportation.

The Banyan is well. The staff, Vandana and I had words because my orders continue to be ignored - or rather, acted on in the staff's own time. Non-medical personnel have little idea of the imperative nature of the medical profession, and I must come across as arrogant when I bleat that my orders have been ignored. I liked the environment at St. V where I trained in Indianapolis, where orders were carried out, or the staff were answerable to someone. The focus of everyone here is mental health, not physical health, whereas mine is the converse. Vandana would like me to take a much more active role in whipping the place in shape, and has given me as much of a raise as the B can afford, but I detest admin duties - and am rapidly realising that I don't particularly like many healthy people. Given me tons of sick ones any day - and most especially if they are destitute/impoverished. I am no longer a "people person," preferring to do my work and bolting. Thus, stories of interpersonal conflicts, delays in carrying out my orders, ineffectual and unassertive staff - these are not my cup of tea at all. Perhaps an amicable solution will be arrived at, as Vandana and Vaishnavi want to phase out their involvement in the B, and have put a new team of coordinators in place - which does not include me, thank Heavens. When Vandana sits in a meeting, things clip along and action is taken - but she wants to head off and do other things, and perhaps someone will learn her style.

We have had sundry viruses at the B and home, and I came down w/ one a few days ago. I am seriously suspecting dengue, having had 2-3 attacks before, and w/ stagnant water everywhere we look. Scott was not here this weekend, having a team-building workshop in Mysore, and the boys trod lightly around me. We spent a fairly quiet weekend, w/ the exception of going out to eat at a spectacular b'fast yesterday. It is an expensive entity, and one we rely on to set our moods right - sausage and eggs, muesli, fruit, yogurt; mmmm - little can go wrong when one's bellies are full w/ this stuff.

Tutoring is taking a hit w/ this weather. We've given umbrellas to the kids, but methinks the parents forbid the kids to use 'em on fear of breakage. Naren and Navin are pretty eager to continue involvement, and perhaps we'll get the students to join us.

I'd better wind up. Hope life is good w/ all of you. Pls keep those emails coming, and all suggestions about how to keep the workplace clean are welcome; it's an ongoing challenge for us at the B, and I welcome input.

Unw -

R