Renu's Week

Tuesday, February 26, 2008

Report of 27 Feb '08

And the 2nd month is about to end too.
Hello from the B -

Hope life is good with all of you. We are well.

The 2nd part of the B's fundraiser is this Saturday. Ravi and Anoushka Shankar are to play. We continue to reel under unimaginable financial strain, and Scott and his colleague are implementing a program called LEAN at the B. It aims to eliminate waste in all areas, and is timely - esp with the multiple projects of the B. I am not a huge fan of expansion, and think we should handle just 1 or 2 areas well. But I am not a visionary individual, and must take my hat off to Vandana and Vaishnavi for plonking on.

One of our patients, Ms. M, is very ill and wasting away in front of my eyes. She eats perhaps a spoonful of tender coconut, having forsaken all solid food long ago due to nausea and vomiting after eating, and is losing her verve and zeal. The classic signs of starvation are setting in, including weight loss on the sides of the forehead, called temporal wasting. All investigations so far have been normal. She is worrying me greatly. We had another patient like this some years ago, and she was found to have TB of the stomach ("Koch's abdomen"). The lesion was cut out, and then the patient couldn't stop eating - hooray! No such lesion has been found in Ms. M, and we have sent her to the hospital. Considering there is a great temptation at just a few places (certainly not all) to give our patients substandard care, I sent a note with the patient, signing my name and following it with the initials, "AB." (I don't ever like preening thus, but it is sometimes necessary.) "AB" means "American Board," and means I am board-certified in the United States. It also equates to the fact that my training is somewhat solid, and I add it when I feel the person at the other end must know that someone remotely competent is looking over the patients' care at the Banyan. It has sometimes produced good results, and Naren and I had a philosophical discussion on this once: he said that Gandhi said the means are as important as the end, and Subhash Chandra Bose said the means are irrelevant as long as they achieve the end.

The day Ms. M was going to the hospital, I squatted down next to her wheelchair and asked how she was. She answered as cheerfully as she possibly could, holding my hand, and then asked how my husband was. I bloody near melted: there's this lady oh, so ill, and she finds the reserves and wherewithal to ask about my esposo. Very moving, humbling, and energising.

We addressed the health care workers' stealing with them, and I find that the young ladies still greet me in the morning, and are cheerful and efficient. All of us make mistakes, don't we - no need to focus greatly on them, time to forgive and move on.

I spent Saturday in Madurai, as it was my alma mater Lady Doak College's Alumnae Day of the Diamond Jubilee Celebrations. (Did you know "alumni" referred to both genders and "alumnae" to women only? I didn't, until y'day.) It was lovely to be there, I have some absolutely fantastic memories of undergraduate days, and I saw some beloved professors. I stated during "Alumni Recollections" what I do - in English and Tamil - and had to leave before the session ended. As I walked out, a young woman came running up and stated that she had been told spirits had possessed her, the family was despairing of her condition and she wondered if there was help. I've put her in touch with the B's remarkable social workers. Then I went home and hung out with my parents, and with a beloved friend, Leela Kurien. That was a rejuvenating afternoon - full of good food, great conversation and laugh-out-loud humor.

Naren and Navin got good reports at school and Scott and I were euphoric! This is the first time ever. One of Naren's English essays is magnificent and he writes so effortlessly. Navin spent yesterday cooking with the class girls in preparation for the snack bar today, and was the only boy to do so. When Scott worked at Abacus, the 9th grade was divided into 2 sections to run the snack bar on consecutive days; the first group's food caused serious stomach upsets in about 50% of the customers (students and teachers and staff) and ergo, the second group's catchy marketing slogan for their endeavor was "Eat our food, you won't get sick." Ingenious!

Hope all are well.

Unw -


Tuesday, February 19, 2008

Report of 20 Feb '08

Hi from the B -
It has been a hectic 2 weeks. The Banyan Academy of Leadership in Mental Health (BALM) and University College, London, ran a course on Mental Health at the Margins here in Kovalam, and I was sponsored by Vandana to go. Mental illness is not my thing, but one can always learn from any conference, so I went, and did learn. Some of the anthropological discussions were way beyond the scope of my limited medical mind, but the discussions were good and the participants were great! One young man, an engineer, spoke of being cured of his cancer by Jesus Christ. (This was in a session on faith healing, esp as applicable in the mental health field.)

A distressing piece of news is that one of our patients unexpectedly died in the hospital. We asked for a post-mortem, and the private hospital declined. We met the Medical Superintendent, to no avail. Requests for p-m have to be routed through the police, and the language used therein is fraught with suspicion, as though the blame is initially and relentlessly cast on the hospital/doctors. That was not my intent, the mission was to find out the cause of death (especially if preventable) so as to apply the info in caring for the other 400+ women I help take care of; even the dead have powerful lessons for us medical people. But I was deprived of a treasure trove of info, and am still disappointed and hurting.

My sister-in-law, Susan, was here for a day. Her son, Sudhir, had got into a "spot of bother" (skipping class and such) at college, Scott and I had gone to check it out, and then Susan came. She went to visit her son by herself, as we had an appointment with Naren's teachers. It was apparently a productive visit, and Sudhir has settled down. I feel like I have 3 sons, and must also ensure that Sudhir is ok, as education is a vital ingredient for success, I think. It was nice to have Susan here; she does ably by herself, poor young widow that she is. We were pleasantly surprised by the visit of my sister, Anu, and her family the same evening, and a wonderful family reunion was had - replete with non-stop eating and gabbing and laughing. I will always appreciate being able to get together with my sibs, sibs-in-law and parents; so many people don't.

We met with Naren's teachers and heard yet again about the "Lots of potential but unmotivated" saga. Naren has found a friend at his new school who is exactly like the kid at his old school who guided all Naren's actions (sassing the teacher, not studying) and we now have a motivation plan in place. We also have such a plan for Navin, who apparently does not require anyone else's help to be unmotivated. The boys walk a fine line between academic success and failure, and it requires all my energies to ensure they stay on the "S" side. We let them have an afternoon by themselves last Saturday, and Scott and I went out for lunch and to a most beloved activity: hanging out at the bookstore. It was fabulous; Scott is such great, intelligent company that the afternoon rejuvenated me nicely.

I'd better wind up, I have patients to see.

Unw -


Tuesday, February 05, 2008

Report of 6 Feb '08

Hello from the B -

Well, I just returned from a meeting. The health care workers (hcw's) were found to be stealing toiletries intended for the residents, and this is concerning. There is always a motive for theft, isn't there, and we're wondering about the finances of the young ladies. However, those that stole are very senior personnel (earning good salaries), and this has stabbed the hearts of my colleague and senior coordinator, Vanitha, and me. I swear by these hcw's, who do a very good job with the residents; stealing, though, introduces some blackness into hearts and minds, which cannot happen. And stealing from our residents - sheesh. Perhaps the hcw's feel that their demanding work with residents entitles them to more than usual recompense? Vanitha has already had meetings with the hcw's, and we will meet again tomorrow with them, and with our Human Resources Manager. Perhaps we will then get to the reason for this occurrence. Perhaps not.

The B's patients are well. Two of them in the sick room, Ms. M and Ms.C, are older ladies; when Ms. M complained to me of intense nausea, Ms. C turned to her and asked, "Are you pregnant?," and then turned to me with a most impish smile. It was hilarious and I burst out laughing. Isn't it wonderful that a sense of humor can linger through the most trying of circumstances, and stay on to see the owner through much else. I am always grateful for the presence of the 3 Weiss men and their senses of humor in my life; the last Mother's Day photo has me holding Naren's card in my hand, throwing my head back and laughing. Laughter is such a fine thing.

Tutoring is limping along. The parents and guardians of the young students are not taking our sons' service seriously, and that might or might not change.

We were at the Banyan's fundraiser last weekend. Basant Utsav ("Spring Celebration") featured Aditi Mangaldas and Kishori Amonkar this year. Aditi is a dancer trained in Kathak who has introduced some great fusion moves in her dance, and the performance was magnificent. I sat in awe of her courage in breaking away from traditional boundaries and incorporating moves from ballet, salsa, flamenco. Kishori is a singer and a prima donna ("Turn off cell phones, don't take photographs, don't move during my performance, don't fidget"), the latter trait not being my cup of tea, and we moved to the grounds of the venue during her performance. The 3 Weiss men enjoyed the evening, esp hanging out with the wonderful hearts that are associated with the Banyan. They didn't care for the prima donna-ness either, and we left after dinner.

We had Navin's classmates over to celebrate his election, and the young folks were absolutely delightful. Esp the girls - what a treat! We also had some neighbors over for the same reason, to bless both our boys, and the evening was so lovely - with good, good people and great camaraderie. My little niece, Ahana, cried when it was time for her to leave.

I'd better wind up. Hope all are well.

Unw -