Report of 26 Oct '09

Hello from the Banyan -

It has been about 6 hours of addressing emails, and several other issues. Somewhat exhausting, but necessary as this is the first chance I've got this week.

fotb.usa@gmail.com - that's the email address for our tax-exempt entity, in case anyone in the U.S.A. wants to donate, and avail a tax break. It was accomplished by a remarkable friend of the Banyan named Hema Venkatramanan, who is a wonderful, caring, giving human being. Hema can ably answer all your queries. I understand a similar entity is planned for, in the U.K.

The monsoon is on us. It started yesterday, and we are grateful that the windows in Adaikalam are getting fixed so that our poor ladies can stay dry.

It is also, apparently, the time of year when the teenagers decide to unleash massive doses of selfishness. I probably should be a gentle mother, pointing out the error of their ways. Instead, everyone got a dose of wrath this morning, and thunderous consequences. As I told a friend, if we did not routinely have such turbulence, we might never appreciate the peace. And you know, I was 100 times worse when I was their age.

The lady who's had the stroke has a huge bedsore. Last week, I asked to examine it and found it infected and very, very smelly (malodorous). I started an antibiotic, and asked that she be turned every hour instead of every 2 hours. I looked at the wound again yesterday, and it is better! HOOOOO! Our triumphs are small, but they are mighty.

I took the train this morning and had to cross a huge open-air slum by foot to get here. The kids in the slum had put stones across a giant puddle so that all could cross without getting too wet. I was touched by their thought: in the midst of their staggering poverty, they spared a thought for people who essentially would not give them a second glance. How many of us would be similarly kind?

I got a package of journals and candy from some former colleagues in the U.S. I was very happy to see the journals and the family was elated at the candy. Food of a different kind, for each of us; where would be without diversity.

Unw -

R

Report of 19 Oct '09

Hello from the Banyan -

I trust everyone had a good week. On Saturday, the whole country celebrated Deepavali, or Diwali. It is a triumph of good over evil, in Hindu mythology, and celebrated with lighting lamps, new clothes for all (a major investment for some) and sweets. Once I had a patient who was critically ill, who refused to spend the money for a CT scan as she had to buy new clothes for her daughter and son-in-law. I had a discussion with the latter folks, and they bemoaned their mother's priorities also, but no one could do anything about the decision.

In our house, Naren and Navin make the sweets. The recipe is simple and tasty, the best kind. All the neighbors know who the chefs are in our house that day, and the boys love the accolades. We make the sweets the night before, or some days before, and get up early on Diwali, have hair washes, put on new clothes and go down to set off fireworks, which the boys have since outgrown. After breakfast, the boys distribute the sweets to neighbors and we sit in the house, receiving the platters of sweets and savories that come from neighbors. Some folks have friends and relatives over for a meal; for us, Diwali is family time and we plop in front of the TV, eat junk ad infinitum, and watch movies until someone says stop (usually I).

The Banyan had a musical group come on Thursday to perform for the residents and filmi songs were played. The residents had a nice break in the daily routine, listening to the peppy music. I was moved: here were a bunch of women, destitute, combating mental illness and family weirdness, overcoming ostracism and trying to make a life for themselves, listening to music and getting a little therapy for their souls. Rhythm is in our bloodstream; many of us cannot listen to music without feet tapping or head bobbing. One of the health care workers told some of the patients to dance and dance they did - with rhythm and joy - and it was a cool sight. As the cast of "Slumdog Millionaire" told questioning reporters at the Academy Awards, everyone dances in India.

A. R. Rahman, who won 2 Oscars for the music of "SM," had a concert here last week and it would have been nice to go as we are firm fans. However, as we age, the thought of giant crowds and battling traffic simply does not constitute a good time for us.

One of the patients, Ms. M, is a fairly permanent inhabitant of the sick room. Her gait is unsteady and she will fall if she heads off to the dorm; I have requested our able physical therapist to work with her. Ms. M has been abandoned by her lawyer husband, whom the Banyan has sued and won monthly support from. This check goes directly to Ms. M, and she spends it as she wishes. Often her list of expenses includes a cup of coffee for me, which I have to decline as I don't drink it. I am *always* touched by the thought, however. Ms. M also asks unfailingly about my children and my husband, and last week, stated that her son had bought her a new pair of spectacles. She does not have children - considered a huge personal misfortune and a slight on the woman, not the man, in India - but all of us played along with her delusion, not wanting to give her the impression that she was an unlucky sort, and giving her some perceived commonality with other mothers on the staff and me. We aim to please.

All are well here, and we hope the same with you. The teenagers tend to launch into some exhausting battles with us, but you know, it is markedly better that they verbalize their anger and duke it out with us than find some other ways of coping. We do not have a functional TV in our house, and the boys read a fair amount, consequently; as such, their arguments are often well-thought-out and well-informed. They are, like their father, cool young men and I am quite, quite privileged to have these folks in my life.

Unw -

R

Report of 14 Oct '09

Hello from the Banyan -

Always good for the doc to know what it feels like to be a patient. I have a stomach ache today and have been short-tempered and irritable. It does not hurt to be this way at the Banyan; as Scott's friend, Craig, and I discussed, it's always good to have a bit of an edge if you want to get anything done. Niceness does not go very far at all.

The B has been good, but with "creative chaos," as our new CEO calls it. Everything is done at the last minute, with massive pandemonium and late nights, but it gets done. I can't usually work this way in the medical world, and thus there is a lot of adjusting to do. But there is grand good humor all around, and we can live.

I am thunderstruck to find that Ms. SA, whose recovery from a stroke was so magnificently achieved by our physical therapist, has had another stroke. Her blood thinner had been inadvertently left off her list of meds, and she had not received it for a lengthy period; I am trying to find out why. And now, the second stroke. It is a massive stroke, and the patient can respond to her name, but that's all. I look at her, and I consider her present condition a personal failure; yes, I was not here when the error occurred, but that's irrelevant as it is my team that takes care of this patient's affairs, especially medical. And I am in charge of said team.

On a good note, one of the sweepers at the B had told me a couple of years ago that her adult, married son was not to be seen or heard from. She had asked his in-laws and replies had been vague. She is a widow, with an only child, and wanted to find her son. Having 2 of my own, I could completely relate, and thus spoke with Vandana (one of the founders of the B) and the social workers, and a massive effort was planned. The first step involved procuring his photograph, and the lady did not have one. The exercise looked like it would be derailed before it began, but no one wanted to give up. So we kept after the lady to get his photo (maybe from the in-laws), or ask relatives, or inform us his last point of contact, etc. I used to get periodic updates from her over the years as she consulted astrologers (very, very common here), investigated with relatives, etc. Yesterday, I heard from her that he had been found. I was elated! He has remarried, apparently, and the mother states that there is little she can do about that. The first wife has stated she does not want any part of married life; it is not unheard of at all for multiple wives to maintain separate households and lead some kind of lives, though polygamy is eminently illegal in Hindu law. So there we are; I am very happy that this mother has located her son, and it so showed in my eyes that this lady pinched my cheeks and kissed her hands, a gesture used to show affection.

Some fine times last week. A nice volunteer from the U.K. named Karen spent a night with us and that was fun. Karen is married and has a stepson, and we found we could talk about all manner of things; wifehood and motherhood are so universal, aren't they. The men enjoyed meeting Karen as well. For Game Night this week, we played "Outburst Junior," and it was hilarious, as any game with the boys is wont to be. The game involves narrating a list of examples of a particular title, e.g., "Girl Scout Badges," and the boys deliberately distorted sane titles such as those to "Species of Turkey," and "Broccoli-eating Weasels." It was a blast. On Sunday, the boys and I saw a Tamil movie called "Eeram," while Scott was at a meeting of the committee of our apartment complex (the president had asked me to be on the committee and I'd pointed out that Scott was a much better candidate, being rational and intelligent and patient). Then all 4 of us saw "X-Men Origins: Wolverine." I, of course, salivated at Mr. Jackman, and the men enjoyed the movie for reasons of their own. The boys then went off to see a play, and Scott and I (being big Richard Gere fans) saw "Nights on Rodanthe," which was dreadful.

A vat of chocolate pudding was made on Sunday, which is a communal endeavor: someone has to dissolve the gelatin, someone makes the chocolate sauce, yet another the coffee, and then the whole mess is whisked together to make a somewhat foul dish, but one the men enjoy. The joy is in cooking together, and for me, marvelling that the men eat this stuff.

Unw -

R

Report of 5 Oct '09

Hello from the Banyan -

Trust all are well. I got back to work last week, and it has been fabulous. It is wonderful when work rounds out a part of your soul, fills a part of you that was otherwise empty or had been beaten up, when folks who have very little can be made to heal.

As I tried to get caught up at the Banyan, saying hello to the myriad folks, catching up on people's lives and healed mental illnesses, I noticed a young woman sitting in the middle of the chaos in one of our upstairs rooms and studying. One of the psychologists/social workers told me that the young lady had had a relapse, and was back at the B from her family's home. The B is treating her, wants her father to come in for a meeting, and he has refused. The young lady is studying for her pharmacy degree, and I was very impressed that she could find the wherewithal to focus in the middle of a multitude of people wandering back and forth, yelling on occasion, or bustling about as they went from activity to activity. The social worker saw my admiration and asked if I wanted to be introduced; I said yes, and went and met the patient. I told her how happy I was that she was studying, that if any of us could help in any way, not to hesitate to let us know. I am always tremendously impressed when folks overcome staggering odds - in this case, mental illness and an unsupportive family - to pursue education.

One of the sweepers (custodial staff), Ms. K, had lost her son before I left for the U.S. I had condoled with her then, and told her of my own mother's loss of her first-born, and we had comiserated. The bereaved have a unique and tragic bond with each other. She came up to me again this time, and reminded me of that conversation: "I still miss my son," she said, "he should have done the last rites for me, and I had to do his last rites." "That is exactly what my mother said, too," I told her, holding her hands in both of mine, "and this is something all of us must live with." "It has been a year," she said, "and I still think of him." "It has been 11 years," I said, "and my mother too misses her son."

We are pleased to tell you that Lufthansa donated some cash for our upkeep, and we have managed to get some windows repaired at the B. This is crucial, because the monsoon is almost on us, and I find it imperative to keep our women dry and warm. Thanks to those who see fit to help us.

Some fine times last week. 2 Oct was Gandhi Jayanthi, Gandhi's b'day, and a holiday. My widowed sister-in-law, Susan, came to visit us with my niece, Sanjana, for a couple of days. Susan is a lovely person and good fun, thus the visit was nice, and Sanjana enjoyed being with her cousins. On the 2nd, Anu and family, and my younger brother, Vinu, joined us for lunch. It was grand fun, and we overate, talked and laughed. It is customary to poke fun at each other at such times, and this occasion was no different. I feel particularly happy that Scott gets along with in-laws and can tolerate their presence for extended stretches. We also went to the beach as Sanjana wanted to go, and saw a very nice Tamil movie - "Thiru thiru, thuru thuru."

One of the hospitals that treats our patients for free, SMF, held its annual conference over the weekend and it was excellent, as usual. Starting on time is quintessentially rare in India, and SMF is the exception, to my great delight. One of the highlights was a cardiologist from a small town who has trained several local primary care providers from villages around to recognise major heart problems; he presented a nice talk on heart attacks, and 3 of the primary care docs joined him for a case discussion which was the highlight of the conference. They discussed extremely pertinent ways to diagnose serious heart conditions in the absence of fancy imaging equipment and other technology, with purely physical diagnosis; this was invaluable for me, as my patients simply cannot afford expensive tests.

The men and I had Game Night yesterday, playing Taboo. It was a hilarious exercise and a very fun time. I have been privileged to get nice emails from the U.S., and there were several people I met at the gym while working out there who have written. Teri (a personal trainer of considerable skill), Joe, Chris, Natalie and David are exceedingly nice people, with kind hearts and souls and spirits that one recognises as kindred, and I have enjoyed the notes.

Until next week (Unw) -

R