Report of 25 Jan 2010

Hello from Chennai -

One's thoughts get addled when a parent is sick, don't they. There has been no focus on anything else. I was in Madurai last week to go to the cemetery. The anniversary of my brother's demise is 26 Jan, and I cannot usually go on that date, especially if it is a weekday. 26 Jan is Republic Day in India, and a national holiday, but travel is usually difficult on that day. So I went on the 22nd, and put a garland of roses on my brother's grave, and remembered the robust, handsome, loving young man who was my brother, whom I got closer to as both of us married and had children, as we went through some similar life experiences, as we sat and snarfed chocolate.

My mother remains confined to bed, though I had her sit in the wheelchair for a couple of hours one morning, and she complained bitterly through it. I explained the new bed sores on her body, and she understood for a bit. My father had pulled an arm muscle, likely in caring for my mother, and remains in some disability. I was only in Madurai for the day, and my father uncharacteristically voiced disappointment; usually he accepts my plans for what they are, and is unfailingly grateful for the effort made to go and see them. I think he is getting exhausted, however. And my mother is ill, "sundowning" with regularity. "Sundowning" is a state where a person's mental status gets altered in the evenings. My mother does not quite know where she is at that time, and speaks irrelevantly. It is a bit difficult to see, because this was a vibrant, classy, sociable and extremely funny woman in her heyday. We are planning to shift her to Vellore next week; Vellore is where my sister and brother-in-law live, and there is an outstanding hospital (Christian Medical College and Hospital) there, where both work. My parents are listed as my sister's dependents, and will get free care at CMC.

There are dogs at the Banyan - both the founders, Vandana and Vaishnavi, are dog fans - and there are 2 around me now hoping for some food.

The Banyan continues well. I was fortunate to have a meeting with Vandana last week. She is 39, founded the Banyan 17 years ago, and is a very visionary, engaging, gregarious, funny, warm, loving human being. We have had raging arguments as well - both of us are intensely opinionated - and she is a fun person to work for. As I often tell her, she did not hire me to keep my mouth shut, and she agrees wholeheartedly. The B's abject lack of money does not bother either of us too much, as the work will go on.

On other updates, the young woman who had been sans a menstrual cycle got evaluated at the center I sent her to, and has started her period, to everyone's great joy. Little Ms. S, the impoverished schoolgirl, now goes to school regularly, says Swapna. Our triumphs might seem small, but they are mighty.

On Saturday, we went to visit a village that Scott's company has sort of adopted. Scott pays for a little boy's school supplies, and we met the child, M, at his school. It was great! Mr. M started out shy and quiet, but warmed up as we went along, and played ball with Naren and Navin. They managed to get a smile out of him, even. Naren quickly walked M to his house to put his gifts away, worried about the bullying by older children; M assured us, though, that the older kids would not yank away his gifts, and we were pleased. Scott's colleagues had taken chocolate, laddus (laddu is a very tasty Indian sweet) and pens for all the school kids, and it was a treat to see the kids line up and glow with absolute joy as they got the goodies. The lead organiser from the company is trying to get more employees involved in this effort; I see now that money exists for all causes, we just need to know where to find it.

Please drop me an email if you can. My head spins with regularity, and I welcome contact from friends near and far.

Unw (Until next week) -

R

Report of 18 Jan 2010

Hello from Chennai -

Sometimes, days of the week tend to blur, don't they. We had a four-day weekend last weekend, and managed to get going on time to work today. Quel surprise. We have mosquitoes in our bedroom in spite of netting at the windows, and I didn't get very much sleep. As I take the train to work on Mondays and Wednesdays, I wasn't too fussed about being too sleepy to drive. I love living in a city with public transport.

Last week was Pongal, the harvest festival. Sweet rice (with jaggery or brown sugar) is made, new clothes are bought, the Gods are worshipped to thank them for the harvest and to request their assistance with the next one, and sugar cane is eaten. I went to work on Pongal, and a patient died at the Banyan. She had been slightly drowsy the previous night, I understand, and then her heart stopped the next morning. I do not know how long that had been before she was found, but I noticed a faint, thready pulse when I checked the young lady, and then it stopped; we started CPR, and worked fairly feverishly to save her. This is a patient who has bantered with me before, and laughed, and joked, and as I looked at her still form, I tried to will some life back into her. That did not work, and then she was rushed to the hospital; I wondered if I had stopped CPR too soon. She could not be resuscitated at the hospital, and I miss her very much. I think of her laugh, and her manner, and I hope I do better for the next patient.

We have no way of getting a post-mortem without casting blame on someone (that's the way the system works in India) and so, I will never know why Ms. AK died. That is very frustrating: there are countless lessons to be learned even from death, and these are denied to us. If there are some causes that can be prevented in young people, or even old, I will not know of them and cannot do the best job I can in the prevention arena.

I am, however, grateful that Ms. AK was with us for a part of the short time she was on Earth, that she was well-tended and cared for, loved and indulged, clothed and safe. A much better option than being on the street and dying surrounded by indifference.

The weekend was spent bonding with the men. Naren's college, MCC, was in a theatre competition, and we saw it. Each college had to present a Shakespeare play in 30 minutes. The entire competition was good and MCC won "Best Play" and "Best Director." Naren and his friends, Karan and Samyuktha (the director), wrote their version of "Julius Caesar," and it was cool. Naren played Antony. The overall trophy was won by Sriram Engineering College, with a very unique play done entirely by miming. They were riveting.

Vandana, one of the founders of the Banyan, took several of us to see "Sherlock Holmes." We loved it. Guy Ritchie is an edgy director.

I'll wind up now and hope for the best for all of you.

Unw -

R

Report of 13 Jan '10

Hello from Chennai -

I feel like I am standing here with my arms outstretched, and several winds are blowing through me. It is a slightly frustrating feeling, and yesterday, I sat the 3 Weiss men down and requested them to carry out their responsibilities themselves, and not get on my nerves too much. The boys very sweetly thanked me for my candor and stated their willingness to try to comply; one said he thought he might not succeed completely in staying off my nerves, and that candor was welcome, too.

My mother is now home, and refusing to get out of bed. She states that getting up causes pain, and who are we really to question that. However, I feel that getting up is mandatory to avoid all manner of complications, but accomplishing this is Herculean. If all of you take one thing away from here, please make it that a daily 30-minute walk now will avoid many disabilities later in life.

The Banyan is great, and it is nice to be here. One of our ladies fell, and her thigh bone, a bone that is usually very strong, is now broken. Our impoverished ladies have brittle bones (osteoporosis) and I have attempted mightily - daily calcium, weight-bearing exercise - to prevent complications, with varying results. I loathe preventable illness, and maybe someday will achieve goals. For now, though, a daily 30-minute walk has to suffice.

Some magnificent interactions last week: my aunts are visiting from Mysore and Coorg, and we have got together with them. Their senses of humor are legendary, and it is a treat to be with them. They took us out to eat yesterday, and all of us pigged out. I also got to talk to Hema, whom many of you have heard from (she runs the Friends of the Banyan group in the U.S.), and that was like salve: Hema is a gentle, fun, easygoing person, totally committed to helping the Banyan, and we had a great chat. I received an email from a former patient in Indianapolis, a gentle person with a wonderful sense of humor and engaging manner: Mr. W stated that he was doing well, and was still managing to stay off alcohol. I was delighted! I attended Navin's sports day, and that was great: I love watching live sports in all forms.

I am very pleased and soothed at receiving emails from friends. Sometimes, a kind word or two can go so far, whether the communicators are closeby or far apart.

Unw -

R

Report of 8 Jan 2010

Hello and Happy New Year!

I haven't written in a while and have sorely missed it. Like communicating with friends.

It has been an exhausting couple of weeks. The Weiss men and I spent Christmas in Madurai with my parents and extended family. My mother had just been released from the hospital after a mild attack of dengue, mild but affected her mental status quite a bit, as illness will in older patients. When she was home, she refused to get out of bed and all activities were done lying down. It took considerable coaxing for her to consider the wheelchair, and one day, when she mildly agreed, Scott and my brother-in-law, Benji, quickly lifted her up and into the chair. That was good, and all of us then sang Christmas carols and prolonged the sitting position. So many things that my eminent professors taught me - about illness in the elderly, the need for constant support, the importance of nourishment and mobility - bore out with my mother. Scott was magnificent in coaxing her out of bed, and endured her illness-induced irritability with grand grace. (My mother is, otherwise, an exquisitely classy person renowned for her hospitality.) It was, of course, wonderful to see my sibs, sibs-in-law, nephews and niece. We ate, talked and laughed, and mulled over what we'd be like in older years.

We returned from Madurai, and the 3 Weiss men and I went to Orissa for a holiday. It is like salve to be with the men, and I like being able to bond thus. Our country has a rich, ancient civilization, and it is a joy to see it and know it; however, many heritage sites are dreadfully maintained and difficult to access. We try, though, as I like being able to see this magnificent history, and I like the men to see it, too. The Sun Temple in Konark is a UNESCO World Heritage Site, and after we went there, I could see why. Hooo! There were explicit sexual positions of all kinds displayed in sculpture form all around the temple, some life-size and some smaller. It then became something of an odd hunt to find out what else we could spot in the small sculptures. Naren and Navin could not believe their eyes, neither could we actually, and all realised the truth that Hinduism really does worship the sexual act. The book "Kama Sutra" originated here. Other than the Sun Temple, the other temples did not permit non-Hindus to enter, and all make an assumption on seeing Scott, the white guy, as being non-Hindu, whereas he is a devout believer. We stayed in a nice hotel, discounted for us through an acquaintance, but did not eat there; instead, we found a sweet little eatery walking distance from the place. The food was extremely tasty and the price so reasonable that we ate there daily, made friends with all the staff, got an autorickshaw organised through them for local sight-seeing and all in all, had a memorable time. The manager, in particular, liked Scott immensely (not hard to do), and said he would come and see us in Chennai, which we welcome. Orissa is a militantly Hindu state, with non-Hindus coming to all manner of harm, and we did not see many non-Indian tourists about. While visiting there was nice, it was lovely to come home to our beautiful, safe Chennai.

On return, we found that my mother had been re-hospitalised, and I went to Madurai. My father had stated that no one need go, but he appeared grateful for my presence. I did not intend to quiz any of the specialists involved in my mother's care, but my father routinely unleashed me on them. This was also a chance to have great conversations with my witty father, and we talked at length. My mother's mental status waxed and waned, concerning me greatly, and it appeared to get better when she ate more, and got out of bed and into a wheelchair. St. V geriatricians, Diane and Patrick Healey, sure taught us well. I did what I could in Madurai, got a bit exhausted, and returned to Chennai. There is now full-time help appointed to take care of my mother, and plans are afoot for both my parents to move to Vellore, where my sister and brother-in-law live, and where medical care is free for my parents, being my sister's dependents.

In Madurai, the sweeper at the hospital finished cleaning my mother's room and asked me why she (herself) was breathless. I did a quick exam, found she was anemic, had a heart murmur, prescribed iron replacement and referred her to a specialist. She then touched my feet in gratitude/respect, which I felt was unnecessary. I chuckled about this to my father, and he said that the young lady was of the "Scheduled Caste" or an outcaste ("Untouchable"), that no one was to touch her and that she likely appreciated the fact that I *touched* her. Really, some things - such as untouchability - in my beloved country are remarkably stupid.

It is lovely to return to the Banyan, and do what I can for those whom others will not care for. I increasingly feel the presence of a Supreme Being, especially as I look at Ms. Ma and she smiles her beautiful, contagious smile and takes my hand.

Please feel free to drop me a line or two. It would be nice to hear from you as I deal with several issues concerning my parents, and myself.

Happy New Year! I wish for you good health and happiness, and am inordinately grateful for the chance to be in touch with you.

Unw -

R