Report of 24 July '08

Hello from this wonderful library -

Hope all are well. I got an email message this morning from my older son, Naren. We were in negotiations for me to hire his band for a small fundraiser for the Banyan; I had offered to pay him and they were to set up a date. Naren's email stated that the band had discussed the offer, and that all were reluctant to take money for the show since it was a charity fundraiser. That made my day, let me tell you. We have long stated that we will never leave behind pots of money or huge houses as our legacy, and that our 2 sons will be it; it is extremely affirming to know that they can make the right decision away from us, difficult though it might be, helped considerably by input from *like-minded and wonderful* friends. I adore the boys' friends, and we have parties routinely for them. We have had wonderful conversations with said friends when they have seen fit to speak to us in the midst of a huge gathering of teenagers, and their school, Abacus, appears to have a long tradition of churning out graduates of integrity, wisdom and dignity.

Work has been wonderful. We have had some very busy days with lots of patients, and all providers have pulled together and even seen each other's patients without complaining. It helps matters considerably, I assure you, when coworkers do not complain even under mind-numbingly busy conditions and focus on getting the job done. My coworker, Grace, epitomises this and is true to her name.

One of my patients is HIV+ and is desperately poor and without insurance. He also has Hepatitis C and came to see me as his belly was full of fluid. I had to admit him, and requested that he speak to the hospital's social workers, who would be adept at finding some assistance for him. My coworker stated that his hospital course had been fine, and that he had been discharged; our social worker is hooking him up with a program for HIV+ patients. One of my other patients was in yesterday and we talked about her balking at taking an antidepressant; we discussed the pros and cons of this medicine, and when we said bye, she gave me a hug. She thanked me for listening to her, as did her husband. One can achieve great things when one hears a "Thank you."

I have taken to limiting the people in my exam room to just the patient and not the family member(s) also, unless the patient is much older, in which case collateral history is important. Many people at our clinic treat the doctor's visit as a family outing, and often children and other relatives come along, which tends to complicate the visit considerably. I feel like an enforcer, but the visit goes much, much better when I don't have friends or relatives in the room who suddenly feel compelled to embark on their own medical history to me, or feel the need to toss in all possible details about the patient, whether relevant or not.

The clinic is so great that I am not completely eager to leave, as I might otherwise be at this stage in my sojourn. Returning to my family and the Banyan, though, would be lovely. Also lovely was my get-together with Louise Hass, the former librarian at St. V; we had dinner at a Turkish restaurant and spent the evening gabbing away. Louise is a delightful world traveller, extremely erudite and intelligent, and I had a fine time. I spent time at Kris and Gabe's house watching movies - always a treat. My friend, Jan Dallas, and I had dinner and went to see "Mamma Mia," which both of us enjoyed immensely; Jan's company is good for the spirit. I got together with Carolyn and Will for dinner, also good fun, and have been privileged to meet the mother and sister of one of my hosts, Andy Simon. These ladies are high-spirited and engaging and funny, and I am a big fan of meeting family, so had a great time. Andy's Mom, Mrs. Simon, has donated money to the Banyan out of her own limited budget, and her generosity is extremely touching.

I also saw "The Dark Knight," and might be the lone Emperor's New Clothes person; I found the plot very convoluted and confusing and full of irrelevant details, and the movie entirely too long - 2.5 hours. Mr. Ledger was brilliant, of course, and I have been a huge fan of his for some time, but I have a feeling that this movie would not have been such a hit had the poor young man not died.

Unw -

R

Report of 17 July '08

Hello from this wonderful place, the Carmel library -

I have a day off today and couldn't wait to get here. It is wonderful to have a day off during the week: I caught up with some former colleagues at Citizens Health Center, a great place to work, and shopped briefly at the $1 store (one of my favorite places), and went to the bank. I had a question about our account, and the bank manager said we had a high rate checking account - it pays 0.5%. I smiled only to keep from laughing out loud, and asked the man if that was considered a high rate; he stated yes (savings pays 0.25%).

A delightful patient came to see me this week. She is over 70, lost her husband 11 years ago, and lives alone, no children. Her sister also lives in Kokomo, as do sundry relatives, but this lady said she did not want to bother anyone for her needs as everyone had lives. That was sweet, I thought. She had fallen and hurt her leg, and I sent her for an xray - an ankle bone was broken, and then she went up to the ER for the orthopedic surgeon to see her. What does a person living alone, and getting more frail, do in the event of a fall? Crawl to the phone? Hope someone checks in on her/him? Our geriatricians at St. V used to say anyone with daughters was blessed, and that someone without daughters should suck up to daughters-in-law; I know people with daughters who are not tended to very well. The nurses and medical assistants stated that their new resolve was to keep themselves fit so that they aged well. My patient was trying very hard to be independent, which is a good and noble goal; there are just so many things one can do, however, if one is more frail or debilitated.

A couple of fun interactions last week - I spoke at an event organised by Hendricks Regional Health (a hospital) on the work I do in India. It was at a Marriott Hotel in downtown Indianapolis, we had dinner and then walked over to the baseball field closeby to watch the Indianapolis Indians lose (somewhat miserably) to the Toledo Mudhens. The person who organised this event is John Sparzo, my friend Jeremy Kirk's boss. He is an extremely nice man, with a wonderful wife and very nice kids. In my line of work, there are many people who promise things - money, help, coming to the B to work, etc. - and delivery is not always assured. John has never promised anything, but just delivers - it is fabulous. He emailed me earlier in the year about wanting to do the talk, and I speak so often about the B that I readily acquiesced, he offered to pay me which was lovely, and he had the check at the talk. It is rather heartwarming to be at the receiving end of such spectacular and understated service.

I spent part of the weekend with my in-laws, among my most favorite people in the world, and that was therapeutic, being the laugh and love fest it always is. My sister-in-law, Diane, was there as well and that was a double bonus. We were sorry to hear of the demise of John Ruiz, a close friend of Scott's family, and the gentleman who gave me away at my American wedding; I had wanted to see Mrs. Ruiz, but she was unavailable and so I sent a condolence card. Mr. Ruiz was a loving, warm, gentle person - with always a kind word and generous presents to all who came by or all whom he went to see. I was also happy to see Carolyn's parents, LuBea and Earl Scanlan, a few days ago; they lost their son earlier this year and we talked about what it is like to have a passing in the family, and how we cope. It was, as always, lovely to see them.

I have been working out with a personal trainer, and it is fabulous. She stated to me that 80% of what we look like is due to what we eat, 10% due to genetics and 10% due to exercise - my, 80% !!! So my salad kick is on with a frenzy.

The 3 Weiss men are off to visit my parents this weekend - an event early anticipated by all concerned. I am glad Scott has a good relationship with my parents, and indeed, my entire family.

Unw -

R

Report of 10 July '08

Hello from St. V library -

Also a free place, also wonderful. I just finished doing some work, and had the invaluable assistance of the librarian, and it was all good.

Work has been ok. Some chaos erupted, since we went live with an Electronic Medical Records System. It takes some getting used to, and I like it; it means that we must have some time to get used to it and familiar before we can get up to seeing a patient every 15 minutes. The front office staff didn't appear to quite grasp that, and scheduled a patient every 15 mins, when they were supposed to do 2 per hour. One of my patients left without my seeing them, and I was irate. I stepped up front to "voice my thoughts," and the schedule got better the following day; why does it take some yelling to accomplish matters? The previous day had been the start of my "Be quiet and don't complain" avatar, and you can see how long it lasted.

So I had a patient, who hadn't come in to be seen for his blood pressure in over a year. He's a young man, and I emphasised the need for close follow-up. I also berated him for his marijuana use, telling him my standard line of it causing impotence; in my experience, young people don't care about dropping dead from the drug but are exceedingly distressed about the impotence possibility. He told me God had sent him to see me and I asked if God had also told him to smoke weed; he said no, that's why he was in my exam room, and that he would tell his Mama that his doctor had "got on" him. I told him I'd be honored.

The young lady who had been through some trying times came in, feeling better on the antidepressant and after evaluating her options, and gave me another hug. Nice patients really do make the day light and fluffy and happy, and I felt my spirits rise.

I moved out of Carolyn and Will's warm, friendly house to the equally warm, hospitable environs of Marybeth, Andy, Miranda and Morgan Simon. It is great to be here, and I feel extremely privileged to have wonderful friends in a lot of places.

Ahh, Rafa! Nice job on that Wimbledon title, though the match took all day. I spent the 4th of July with friends Scott Semester, Carolyn, Will and others at a concert and fireworks display. It was great to be with good people. Kris and Gabe's house was also a treat. I got to see Shilpa and Ravi Mallur's new baby, Surya, and ate with all of them, including Shilpa's mother and Ravi's aunt. The day was filled with Indian food and cultural touches, including eating with our fingers, watching Shilpa's Mom massage her new grandson with coconut oil and then bathing him, and looking at Surya's big sister, Keerthi, as she massaged her "baby" (a doll) with coconut oil and then bathed him. It was a languid, wonderful afternoon. We got together with the Tabers for ribs and trimmings, and the conversation at their house was the usual feast for the intellect it always is.

See, privileged to have great friends.

Unw -

R

Report of 3 July '08

Hello from Indiana -

We are well and hope the same with you. This business of being away from the family is starting to get to me. I talked to them last week and there were lots of laughs; Naren had news about how he was not cast in the 11th grade play though there were plenty of other 12th graders cast to help out, as he was too white. We laughed. I think he looks anything but white, he is dark-skinned and dark-haired, but my sister, Anu, thinks his features are Caucasian. Navin has been forced to exercise, and is way less than enthusiastic about it. Also provoking laughter. Scott had instructions to take our friends, Anita and Bryan Sigler visiting from Florida, out to eat but it looked like contact had not been made yet.

Work is fine. I have a patient who is HIV +, and she wept as she mentioned how she'd contracted it from her ex-husband. She has a little daughter, and states she is living for her. I referred this woman to a psychiatrist to help her manage her mental status, and we discussed her body, the blood tests that the Aids specialist was ordering, etc. She returned today and tweaked my hair as she went into the room, and I was delighted - she was feeling better, apparently, and we did indeed have a good visit. Her initial appointment with the psychiatrist went fine.

Tomorrow, we celebrate the 4th of July. I will go to a concert with some friends and watch some fireworks. During the day, I will be at Kris and Gabe's house watching a zillion movies. I am totally enjoying the YMCA; the workouts are great fun.

This truly is a world for the money-ed, isn't it. Thank goodness the destitute exist, so that they may tap into a piece of our hearts, souls and spirits that haven't been tainted by all that money and materialism. What I love about the U.S. is how easily the different layers in society mix: the person next to my family at Wendy's could either be a CEO or a janitor.

Unw -

R