Report of 24 Nov '08

Hello from the B -

In my hand, I hold an invite to a workshop on "Drug promotional practices and cost to consumers," and I look forward to attending. The ethics of pharmaceutical practices have long bothered me; when I was a med student, the senior resident on one of my teams (a new father) was exulting to his colleagues about how he could just tell the drug rep to bring infant formula for free. I liked the perks then - the "free" movies I could take my kids to, the occasional dinner - and came to realise later what was involved in all these freebies. One of the cholesterol agents we willingly prescribed during residency was not the one that had the best safety studies, yet prescribe it we did because the Lipitor person came by much more frequently than the Zocor.

Last week, I visited Kovalam, one of our other projects. Kovalam houses our higher-functioning residents and also has a clinic open to the public. I love it, as I get to interact with patients, and don't have to depend on caregivers for history. One of the patients complained of hip pain and as I probed, she stated that her husband beat her daily. He does not beat her now, for 40 days, because he is headed on a pilgrimage to Sabarimalai and must only do godly things. So she has a bit of a reprieve, but I wanted the social worker to get involved as the 40 days will pass. Quel relief for those of us who don't have such spouses.

The little girls rescued last week are getting their case processed. The brother of one of them has also been "rescued" and is irate at the girls for putting them in this position. He apparently told his sister, "What have you done?" I imagine his easing of his parents' financial woes mattered more to him, but he might have been with a non-abusive employer, too. I have mentioned this case often to our sons, that there are kids begging to go to school, who instead have to get up at 5 AM, wash mountains of clothes by hand and sweep and mop and clean and get beaten.

There is a volunteer at the B from the U.K. and he spent last weekend with us. I remember being exceedingly lonely and homesick when I first got to the U.S., and being very grateful for folks who'd invite me home for the weekend. Two such families - the Premanandans and the Islams - are still on my mailing list, so good and affectionate and fun was our relationship. We simply passed on the favor. It was a fun weekend, showing Joss around, and we got treated to lunch, which was great.

The boys are heading into exam prep mode and have tutoring sessions galore. Soon, I will take time off from the B to sit with them through the prep and exam periods. The best thing that I can do is raise 2 sons and put 2 beings of integrity and dignity on the planet.

Unw -

R

Report of 19 Nov '08

Hello from the Banyan -

Sometimes, it pays to be alive, and in this organisation, and in this profession. There is an opulent house opposite the Banyan Center in Choolaimedu, and I hear a TV star lives there. This morning, 2 little girls were cowering on the Banyan roof, hiding from someone, and we discovered that they worked at said house, that physical abuse (a daily beating) was de rigeur, and the girls really did not want to go back there. The police were called, they came, said they had many other things to do, and said their supervisor had told them the employers could handle the matter with the girls' parents. One of the Banyan employees said complaints about the employers were many, that the police came and usually left without doing anything as the occupants probably bribed them handsomely. This time, the police counted without the piranha tenacity of the Banyan social workers, who called Child Line and an international child aid organisation, and stated that they would absolutely not release the kids to the employers. 1 is an orphan and the other, her cousin, has both parents living. The orphan appears just a tad developmentally slow, probably not having had the means to go to school; the other one is bright, sprightly, stunningly beautiful and articulate, wanting to take care of her cousin. As I write, the girls are being videotaped and interviewed by 1 of the organisations, and their story would be heartbreaking if it were not oh-so common here: "We were left here by our parents saying the summers would be harsh in Andhra (neighboring state), that these folks would take good care of us, that we could return after a year. We get up every day at 5 AM, sweep and mop, put kolam (a decorative design on the floor), and then wash clothes. They give us this many clothes (here, she held out her arms wide) and there are only 3 of them. They beat us if we sit talking to the watchman, and if we play with the kid in the house. The kid beats us, too, with a stick this wide. We want to go home to our relatives." "And then what?" "School." My, here is a 10 year old child wanting to go to school, wanting to escape the drudgery of daily housework (which all of us dread), and in the meantime, we have other kids whining about studies. We are working to rehabilitate the girls, and the social workers deserve accolades for their piranha tendencies.

There is not much one can say after such an experience. We are happy the girls made it to us safely, we find them delightful, and we hope that many more little female people (and of course, male, but those numbers are much less here) escape the harsh confines of dreadful employers; if we find ourselves privileged enough to cross their paths, may we be so blessed.

Hug your children today. Realise that there are many who cannot afford to feed their own, that they must be sent off with some intent (good or bad), that unknown consequences befall the children, and that we are so privileged to see our own, feed 'em, listen to them mouth off, and know they will never be beaten daily by those others who promised to care for them.

Unw -

R

Report of 12 Nov '08

Hello from the Banyan -

I am exhausted. It's a never-ending cycle of doing things for the fam, and arranging events and coordinating tutors and planning holidays and the lack of appreciation is mildly getting to me today. In the scheme of the cosmos, though, this works really well because I usually have a blast during my time in the U.S., completely enjoying work and my various host families and movies and salads and fruit. I told the men this yesterday.

Work, of course, is fabulous. One of Scott's former colleagues, Rajasabai, called me because he saw a destitute, mentally-ill-appearing woman on the road; he stated there seemed to be a fight of sorts, but called later stating the woman did appear to be alone and mentally ill. So the intrepid Banyan team picked her up and she was at Adaikalam last week, in the sick room. She had a huge wound on her left thigh, and was treated at the Government hospital; my colleague, Vijayakumar, stated that the doctors and nurses there got fed up of washing it, and so the Banyan team did all the cleaning. Sigh. This is, unfortunately, par for the course in several Government hospitals here. The wound was dressed, and the patient came to us. In the interim, her family had filed a missing persons report, complete with photo, and that got to the Banyan. The photo was nothing like the lady: the image was of one somewhat plump, light-skinned and very healthy-looking, and our patient was dark and emaciated. The "Helpline" assistant identified the lady by her nose, and when the husband came to enquire, he said the patient was indeed his wife, and started crying. The Banyan team had a long talk with him; it emerged that the lady had had a baby 2 months prior, suffered some sort of post-partum psychosis (unclear whether it was solely post-partum, or was pre-existing), and wandered off 2 weeks ago. The husband was willing to treat her mental and physical illness, and promised to bring her to our outpatient clinic; he then made a financial donation to the Banyan. Vijayakumar called me soon after the release of the patient to the family and gave me this happy news. We then notified Rajasabai. All are pleased.

Among other happy news, and at the risk of polarising my reading audience, I am very pleased that Barack Obama won the U.S. presidential election. I try to stay clear of politics while blogging, but I like this candidate; the choices he made soon after finishing college seemed to indicate a desire to work for the greater good of the populace and that bodes very well for someone in office. I am not too fussed over the Black-White issue, he just seems to be a good guy. That said, McCain's concession speech was one of the classiest I've seen; it was gracious and heart-warming, was reprinted almost in entirety in the newspaper here, and letters to the editor wanted our politicians to learn from it. I wasn't too enthused by Palin; although I am a huge fan of women being in power, this lady didn't seem too together, naming her children after high school subjects ("Track," "Trig") and not having a good handle on the financial crisis, among several other things.

We were privileged to have my Dad zip through Chennai earlier this week. He was en route to a conference to present a surgical technique that his guru, Dr. Balakrishnan, had scrawled on a piece of brown paper and shown him. My Dad has saved the paper, and has managed to scan it for projection, and will speak on this technique. I remember meeting Dr. B when he came to Madurai for a conference; he chose to have dinner with my siblings and me one night instead of attending the dinner at the conference, and I remember having a good time. Not a rivetingly smashing time, but good enough and enjoyable enough that we liked the guy. It's nice when parents' colleagues are fun people.

Scott's boss came for dinner last week as he was in town. He seems very nice, intelligent and visionary. The evening was good fun.

Both boys were grounded last week and had to spend time with us, to no one's great pleasure. We watched "8 Mile" and it was surprisingly good. I hadn't originally wanted to have anything to do with Eminem, but his performance was actually excellent.

We are struggling with Navin's academics; there is nothing wrong with his intellect, but his preparation for exams is so half-baked that exam marks have been dreadful. He sits with his textbooks and reads them, and does precious little writing work - practising questions, writing down formulae, working old tests. This is worrying me tremendously, because the Board exams (starting in 3/09) are very difficult for the unprepared. Navin can quote entire comic strips and song lyrics, so ain't nothing wrong with his memory, either. My biggest challenge, as I told the boys, is not finding enough money to do mammograms for 250+ Banyan residents, but to find out how on earth to motivate Navin to study. Nothing has worked - money, time with friends, time on the Gameboy (or whatever it is), saving up for a computer, donating money to the Cancer Instititute, Nothing. When the boys stated yesterday that they just chose their actions, they didn't really administer the consequences (decided jointly), I reminded them that they could choose a completely different set of outcomes - good grades, no grounding, peace at home, time with friends, independence. It is a measure of their hormones and poor decision-making that they have picked this scenario of dreadful grades and groundings.

Ahhh, parenthood. Parenthood of teenagers. I guess this phase too shall pass. All words of wisdom welcome; I mean this sincerely.

Unw -

R

Report of 3 Nov '08

How time flies.

It is November already. We are facing the end of the year. I am sitting here with a bout of food poisoning; my sister treated us to breakfast yesterday and it was wonderful and I overate merrily - sausages and eggs and chicken and fish. This morning, I got up to exercise and got all my workout gear on and then the body said, "Please go back to bed." It's good for doctors to be sick periodically, you know, it teaches us what patients reel under.

I see from the monthly report for Adaikalam, our transit care facility, that Ms. B's husband, son and niece visited. She's the person I reported on last week, the one kept locked in a room for 20 years. Ms. B refused to see her husband - good for her! She did see the niece and son, and I assume they made her feel good. I enjoy talking to this lady; she conducts conversations willingly and I am delighted to see her spirit blossom.

We are facing many cases of uncontrolled diabetes at the B, and our diet of rice, rice and more rice ain't helping matters. I asked the good medical director of our helper hospital, Sundaram Medical Foundation Hospital, for assistance with the services of a dietitian and Dr. Arjun Ragagopalan sent one of the hospital's dietitians. We are hoping to revamp the diet with our meagre finances in mind and I am looking forward to it; anyone can eat somewhat healthily with any budget.

One of our neighbors, Ms. S, had been sick, and her young adult son, R, came bolting up to our flat to get me. It was a simple upper respiratory infection, easily treatable, but Ms. S looked so terrible with fever and bloodshot eyes and puffy face and unkempt hair that R panicked. The family and I discussed this, and I mentioned how glad I am to be in a position to be able to differentiate between panic-worthy illnesses and others. Ms. S is much better now, with antibiotics and that old standby, paracetamol or acetaminophen.

We had some great interactions last week. My late brother Manu's son, Sudhir, went for a job interview (found out at relatively the last minute) in Scott's suit jacket and tie, and got the job. His jacket button apparently went pinging out as he sat down, and he could hear it skittering across the floor; the General Manager of the hotel (the biggest cheese of all), whom the interview was with, apparently picked it up, said, "This might belong to you," and handed it over. We are pleased at the job offer, and celebrated wildly yesterday. We had my other nephew, Vikram, also spend the night with us on Saturday, and a fine time was had by all as 4 young men aged 19, 18, 17 and 15, sat around the table with Scott and me, and discussed life, movies, food and plenty of other topics. I felt very privileged. We also heard one of the city's prominent psychiatrists discuss teenagers and drug use at Navin's school; a couple of Navin's classmates are partaking and he told me and I told the teachers. It was an outstanding session, and I left with a wealth of info about what to do when the boys come to us with issues like this. I assure you, the fact that they feel they *can* tell us such things is an immeasurable honor.

Unw -

R