Renu's Week

Sunday, November 15, 2009

Report of 16 Nov '09

Hello from the Banyan -

I missed blogging last week. University College, London (UCL) and the Banyan Academy of Leadership in Mental Health (BALM) ran a course on Medical Anthropology, and I was deputed. I enjoy courses and conferences. This one was well-run; when it dove into anthropological and "high funda" terms, I was lost. Dichotomy, paradigm, etc. - these terms, concepts and what they were used to elucidate were totally befuddling. There was a session on Faith Healing which was excellent; the B brought patients treated by a faith healer, and a faith healer, and it was cool to listen to them.

It is my belief that I am of lesser intellect than someone who can confidently discuss esoteric concepts. Folks talked of menopause in Japan, that it was different from menopause in the U.S.; they discussed Indian scenarios and others; some got passionate about the role of medicine. Through all of this, I sat, contributing only when someone said she did not believe mental illness was stigmatised.

At the B, Ms. M had an event. She was being escorted back to her bed when she collapsed. I went to help her up with another patient's help, and she collapsed again. She then lost control of her bowels and bladder, and was unresponsive to me. As I felt her pulse, she started to gurgle, and spit up, and the moment of crisis was past. Another patient there tried to summon help, and was unsuccessful; the glucometer that is supposed to be present in the sick room was not; there was no powdered sugar on hand to put in Ms. M's mouth; all these are issues I am going to have to discuss when we get together with the team next. When the patient trying to assist me was yelling for help, I could hear the staff nearby in the dining room chiding her, asking her to contact the staff member in the sick room; there was none. You see, we cannot discount matters when a mentally ill person cries for help - the reason may or may not be genuine, but we must always err on the side of caution.

Well, Ms. M got better soon after some sugar was put in her mouth. She was back to her usual sprightly self, but we sent her to the hospital anyway to get evaluated. As I was squatting next to her, holding her very light head in my hand and near a smelly mess, I evaluated my role in the situation, being placed between Ms. M's life and death. This has freaked me out as a med student and intern, but has since become fairly routine. It is good to check our own pulse first, as they suggest in "The House of God," and try to stay calm through a crisis. Fortunately for me, Ms. M started gurgling and puking, and those were good signs. I did feel pretty privileged, though, to be treating someone who had NO ONE else, no husband/sibs/friends/parents, to turn to; is there Godliness about - I imagine so.

Our cook's husband, Mr. P, was unwell and they had tried to call me when I was at the conference. My phone was on "silent" and I did not hear it; the next day I heard that P had had fever and an upset stomach. I guessed he had eaten out, and he had; his wife lovingly packs a lunch, which he eats. He must have had a snack or 2 outside, and this was affirmed. In the monsoon season, contamination is rife, and eating out is fraught with more risks than usual. I sent the young man some antacids, Tylenol, and stern instructions about what to eat and what to avoid, and he appears to be better.

The rains are here. The slum folks have moved on to the railway station platform for a modicum of shelter. They do not speak Tamil, and I do not know where they have come from. It is not uncommon to see folks from other states here: we are a relatively peaceful place, with abundant religious tolerance, and a long history of hospitality. There is no dorm space in Naren's college, because young people have come from many miles away to study here; there are either no good colleges in their states, or violence precludes normal activity. Scott said the other day, after yet another bomb blast in Pakistan, that we think nothing of sending our sons by public transport, or out to gad about on their own. Blessings exist in many forms.

There were some fine times in the last couple of weeks. Scott and I went to hear a band cover the music of "The Eagles," and they were good. Navin joined us (Naren being off to follow up on climate change and Bhopal's 20th anniversary) to see a fantastic performance on dances of India - there are so many, and all so beautiful - by our legendary Kalakshetra, to raise money for marginalised kids. The boys and we saw some movies together. Yesterday, the men took turns to prepare the meals for the day and do household chores; this was the first time in my married life that I was completely free of household responsibilities and it was quite nice. Naren volunteered at a medical camp for underprivileged children, and discovered that it was being run by a friend of his, Archana. Navin is to volunteer for something similar in a couple of weeks. The great thing about such ventures is that a group of young people gets together, runs it, has jolly good fun hanging out together, and by the way discovers the fantastic joy in doing for someone much less privileged than themselves. Archana apparently sponsored lunch for all the impoverished kids at the camp, and Naren said there were so many other ways she could have spent her cash: iPod, a new outfit, CD's. I like the way these kids are choosing some of their friends, and their activities.

The big dilemma for me now is that one of Navin's friends strikes me as being not right for him. I have said it, Scott has requested me not to, and I am trying very hard not to harp on it. It will be a lesson for me in "Keep your mouth shut 101," which I have legendarily flunked.

Happy Thanksgiving to all in the U.S., and to all elsewhere, Happy November!

Unw -



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