Report of 31 Aug 2010

Hello from the U.S. -



Life has been frenetic - with work, shopping, packing, throwing, etc. But it's all good. The patients, in particular, have offered a variety of cases.



Mr. X, the cancer patient, has died. It happened a lot quicker than I anticipated, and I wanted to go to the funeral, but there were no details as of the end of last week. I liked his spirit, especially being feisty enough to pull a shotgun at people. One of my beloved cousins has a daughter who was diagnosed with leukemia when she was 3 (some years ago), and the family went from Coorg to Bangalore for treatment; when I talked (from the U.S.) to my cousin there, he gave me an update, and then said remorsefully about his daughter, T, "She does not behave, she gets angry when the nurses and doctors come in to draw blood, and hits and kicks and bites." I was delighted, and said so: this is exactly the spirit we want our cancer patients to have, instead of rolling over and letting the diagnosis take over. Thankfully, knock on wood, T's cancer is in remission. And her spirit sails on.



There was another patient, a young student from a prestigious engineering school, who brought 2 pages of typed asthma symptoms. Her mother came with her, extolled the virtues of her singing, tennis playing, very bright daughter, and they offered an exhaustive account of these symptoms. It was annoying; more so because I did not feel well, had had some surprising news from home, and was not up to listening to some treatise. The mother also stated that the daughter had enough credits to be at a higher level than she was; I understood none of this, as I did not go to undergraduate college in the U.S., except that the info was said to draw some ooh's and aah's, which were provided (right along with the thought of "Why the **** do I need to know this?"). Lung and ENT evaluations were already set up and I suggested a psychiatry eval for the patient's anxiety; thanfully, the pair did not balk at it.



Some fine times last week: I got together with Cindy Belloli and a bunch of her female friends for dinner. It was a great time, with some luscious finger foods, and all of us ate and talked and laughed. Faith discussions at the Nortons' place wound up, and we were privileged to have Traci join us. I have enjoyed these discussions, and have asked all the questions I wanted to. As I looked around, I noticed that all the Mormons gathered were extremely nice-looking: all this clean living sure manifests on the outside, doesn't it. Theresa Jefferson and I had lunch on Thursday as she took a break at work, and that was as lovely as always; Theresa's perspective, sense of humor, love of life and family are all inspirational and fun. We talked endlessly, or as much as we could fit in 45 minutes. Kris, Gabe, Isabella and Rosalia made time in their busy schedule to have me over for pizza, and I revelled in their company. I love, *love* these folks and enjoyed my time there. On Saturday, Colleen and I met up with several St. V colleagues for a Beatles concert; it took us 2 hours to go about 7 miles to the venue, but the show was outstanding and Sister Rosie, who just turned 80, and I danced to "Twist and Shout." Deb Rasper, the St. V Mercy CEO, again put on a terrific time - with a potluck meal and tix to this event. Carolyn Scanlan and I met for dinner on Sunday, and it was wonderful to catch up with this friend and share her sense of humor and ebullient spirit. I have always been impressed by her ministering skills, and she is the reason I started going to church for a time. Colleen and I managed to talk for a bit, and it was lovely to sit in their beautiful backyard and gab; she also helped me shop, which I always appreciate. Sid and I met for a wrap-up session yesterday and it was nice to talk and listen to his remarkable perspective. I got to talk to Hema, who operates Friends of the Banyan for us in the U.S., and it is like talking to a sister - loads of affection, and good humor, and the best of wishes. Yesterday, there was a gorgeous Debbie-Weaver-made cake at Alexandria, which I had 2 pieces of, and plenty of farewell hugs. I chatted with Dr. Love this morning, and he was kind to address my umpteen medical and faith questions. Today, I have had a wonderful lunch with Elwood colleagues, and got loaded down with beautiful gifts to take home. Lots of memories.



Boot Camp wrapped up last week, and stayed clean. It was an exemplary workout, and I enjoyed it immensely. I appreciated even more that it stayed clean.



Naren and Navin have been up to some merriment at home, and their father has been stretched a bit to handle both. It really is time for me to go, isn't it - to handle things as a couple, and as parents, to hug and love and talk and laugh. I was 100 times worse as a teenager, so will try to discuss these young folks' shenanigans with that perspective - but don't bet on it. :)



Unw -



R

Report of 23 Aug 2010

Hello from Indiana -

Hope the week has been good.

I got some spectacular news last week. Ms. X, the patient I have mentioned before as being very kind to the young Indian neighbor, had come in with her husband, also a patient, some weeks ago. Mr. X had coughed up blood, and had a lung mass seen on CT, and I feared the worst, i.e., cancer. So I sent them to a lung doctor, who looked at Mr. X's lungs through a special instrument, and determined that he did not have cancer. Hooray! Ms. X told me she had called and left a message for me as soon as she heard the lung doctor's news: "I knew you would be worried." I found this extraordinarily sweet, and though I did not get the message, I appreciated her gesture, and more so, I appreciated enormously the news about Mr. X.

Good things do happen to good people.

Ms. X also brought me 2 jars of apple butter and 1 jar of tomatoes, all of which she had canned herself. So wonderfully kind and generous.

Some fine times last week. My salsa class wound up. A few people from the Y and I got together for Mexican food. Natalie, Chris, Cara and I do Boot Camp together, and Amy and all of us spin together. It was a nice evening, spent gabbing and eating, and these are fine folks to do this with. A diner from another table stopped at ours as he was leaving, and asked Chris (who generously treated all of us to dinner) how he could be sitting with 4 women; Chris answered, "I used to be one," (not true) and it was funny. On Friday, my colleague, Beth Prusinski, had all of us over for lunch and it was fabulous. It was nice to spend some time gabbing over great food with colleagues, and Beth's Mom was there, too, which made for a fun time; I love meeting parents. We sat in Beth's beautiful house and had a great view of their yard as we ate. Friday evening was spent talking with my hostess, Mary Beth Simon, and sharing her unique sense of humor and unflappable perspective; that was nice. I spent part of Saturday at the farm with in-laws, and was fortunate to see Scott's Mom, aunt, uncle, an aunt visiting from Oregon, and both my sisters-in-law, Diane and Karen, and Karen's partner; Scott's grandparents stopped by briefly. The in-laws are a fun bunch, I love them dearly, and I had a very nice afternoon. I then joined the St. V Elwood hospital (Mercy) crowd for an open air concert at Conner Prairie, to hear Duke Ellington's band. Mercy's CEO is Deb Rasper, and she does a great job as many female CEO's are wont to do. I enjoyed talking with Deb and her husband, and partook of some sinful dessert. On Sunday, I had lunch with Mary Remster and her son, Donnie; Mary and I volunteered at Special Olympics many moons ago and have stayed in touch since, to my great delight. The food and company were spectacular. As they were at dinner with the Sparzos; it was nice to eat scrumptious food, talk and spend a pleasant evening on their porch.

Boot Camp ended up becoming a bit weird with innuendos about the milk jugs we run with, a student sticking out her rear end toward the (male) instructor and the man patting it. I found all of it singularly inappropriate, and after the workout, said so to him. He said that he and several students had known each other socially for years; he did say that it was difficult to remember the line between social and Boot Camp. I noticed that he tried to stay clear of the innuendo today, and appreciated that. Several students revel in the raunchy, and it gets uncomfortable. The cosmos does align itself; this is the part of the U.S. that I don't quite like - the tremendous obsession with all things sexual - and the message is very clear, broadcast to me every Boot Camp morning, that it is time to go.

I spoke to most of the men in my immediate circle - my Dad and 2 Weiss men, and that was nice. The other one did not pick up the cell phone and might have been asleep.

The Tabers' warm, cozy, hospitable home is my current location, and the warm, hospitable Tabers are as comfortable to be with as ever.

I saw "The Switch" over the weekend and it was surprisingly good.

Unw -

R

Report of 17 Aug 2010

Hello to all -

Hope everyone is well and enjoying the gift of good health.

Work has been fun. I am off crutches and am thankfully well enough to see the tons of patients that come in. The day flies by, and soon I am driving back "home" after 5 PM, listening to Lady Gaga or Dire Straits. One of the patients who came yesterday was reeling under a migraine. I could not give her the usual migraine meds as she has a heart condition, and I was hard-pressed for other choices. I did suggest that the patient see her dentist, too, because my able dentist, Dr. Scott Prusinski, said sometimes tooth problems can cause a headache, and I wanted to rule out all other pathology in my patient. She did not feel good at all, and did not answer my questions directly or to the point; this got a tad frustrating after a while, and I pulled my stool closer to the patient and said, "I am not sure if I am not making my questions comprehensible, or whether it's my accent, or something else, but I am not getting clear answers to my questions, so let me try again as it is my responsibility to get the information I need." I had to go after the answers, and thought I was getting on the patient's nerves, because she was in so much pain she actually was in tears at points of the interview and I felt awful. At the end of the visit, though, she did very sweetly thank me for being thorough, and her husband said my accent was not an issue. Very kind, I thought, on both their parts. Our capable medical assistant checked on the patient this morning, and she is a bit better; apparently her husband remarked on her looking better, too. Halleluia.

I work with some magnificent folks, I assure you.

After such genuine patients, it was easy to tell the young woman who had a chest piercing (screwed in, has to be surgically removed if she wants it out), and had been released from rehab for alcohol and sedative addiction, that I could not give her Vicodin. We had a clear note from the rehab facility not to give her narcotics, and I said so, and the lady got irate, and said, "Who are they to tell you what to do? God?!" I suggested she take it up with the facility, walked her out, did not charge her for the visit, and went on to my next patient.

We saw a patient last week, walked up from the ER by the ER doc; Mr. X has lung cancer which has spread to the liver. I talked at length to Mr. X, and set up Hospice for him, figuring he'd need some attention at home and could avoid going to the ER. There was a note for me yesterday, saying Hospice had gone to Mr. X's home, and he had come out with a loaded shotgun, threatening to fire it and saying he wanted to work some more. I laughed; I'll check with Mr. X when I see him next what his understanding of Hospice is.

Naren's foot is swollen, I changed his antibiotics over the phone and he has been ferried to class by Scott, thank goodness. Navin was cramming for a test, and I said, "Good plan, yeah, to study for a test?," and he chuckled. I love hearing this sound from the men. My nephew, Sudhir (Manu's son), is visiting in Chennai, and I truly like the fact that this nice young man feels at home in our house and that he and our sons have a blast hanging out together. Scott is managing everyone well, and it is time to go home and join the party. Nothing like hearing that a child is ill to bring out the Mother persona and micromanaging tendencies.

Some fine times last week - I spoke to Sudha Swaminathan, a dear friend from Madurai days now living and working in Connecticut, and liked that; it's nice to chat of home and now. I joined Mandy and John Sparzo, and some of their friends, to listen to a band. I danced at the venue, and revelled in that; dancing is truly a life force for me. I saw "Eat, Pray, Love" and it was horrible; Javier Bardem managed to salvage a bit of the movie, and not just by his looks, either. Colleen Taber, Sonia and Anna Inger, and I went to the Indiana State Fair, and enjoyed each other's company immensely; I joined my salsa instructors, Dean and Audrey, for a demo at a "Dance for Health" stage. It was great fun, as my partner (Audrey's husband, Brent) was a very competent leader and I find it easy to follow steps when the lead is so good. On Sunday, I had breakfast with Tamela Horkay, Ruth Ranalletta, Boni Hypes, Beth Hartauer and one of their friends, Monica; it was a rejuvenating time with good female friends and tasty food, and we ate and laughed a lot. I attended the Indians baseball game, tix given by St. V, and had a great time - I enjoy live sports. I did not sit at my assigned seat, as it was too hot, but stood in the shade and ended up talking to a very personable young woman sitting nearby; she is undergoing treatment for uterine cancer, and we talked of it, her good doctor, Rob Manges (also a friend of mine), our sons, and husbands, and life, and all of it was lovely. I admired this lady's courage, and love of sports. That night, I met Louise Hass for dinner. Louise is an extraordinarily intelligent lady, and is widely travelled; her sense of humor, solid perspective, love of life and witty conversation serve to make each meeting memorable. She has lost her son, I have lost my mother and brother, and we talk of life, love and loss; all very therapeutic. Sid Norton continues to host discussions on faith at his house, and Sister Esplin and Sister Humpherys join Sid in being very patient as I muck around in my confused state. The discussions are very illuminating, and I enjoy them, as I enjoy the company; Sid's wife Traci is a beautiful lady, inside and out, and has done a spectacular job of raising their kids.

I hope you have your share of good times, great food and wonderful company.

Unw -

R

Report of 9 Aug '10

Hello all -

This kind of stinks. I am sitting here nursing a sprained ankle. I so love the Boot Camp workout that when I twisted my ankle today, running in the dark, I was resentful. Chee chee chee. Anyway, I imagine it could be worse: the instructor told me that one of the participants, in the past, had clonged her head on the gym wall. I am glad that did not happen. It did mean I could not work out today, and I have been hobbling around the patients, trying to dexterously examine on one leg, overall looking ridiculous. The patients have been mighty understanding, though.

Work has been good. Cosmically aligning to finish out the course. This morning, as I swung in on crutches and finished up with the first patient, the second one wanted to leave. It was 8.50, his appt was at 8.30, and unfortunately he had been put in the room at 8.06. So 45 minutes later, the doctor was not in the room. I stand in the way of no one who wants to leave. I do feel bad, however, when I disappoint the patients, and abhor being late. But this patient wanted to see his regular provider, and that was fine with me, because I think those who cannot be fit in their regular provider's schedule must settle for 2nd best - i.e., me. :)

The patient who was refused Valium complained about me to my boss. All feedback is welcome and she really was spot on with her assessment that I appeared close-minded to the possibility of Valium; indeed, I was, and am. There are better meds, especially for an itchy rash. Other patients have come, and hugged, and chatted, and I especially like that. The young farmer with the frequent falls has some disc abnormalities on his MRI, and has been referred to a neurosurgeon. I hope for some relief for this patient, and will see him again in a couple of weeks.

Some fine times last week. My friend, Olivia, flew me out to Kansas, and her parents came in from western Kansas as well. It felt like I was with family and was great; we cooked Indian food together, and it helped immensely that our sous chef exemplaire, Olivia, had done the cutting ahead of time. Some delightful friends of Olivia's came for dinner and barely survived the heat of the food, but the intrepid Fondobles loved it. It was a fun evening, and I played dominoes for the first time. Olivia, her mother and I also saw "Charlie St. Cloud," getting a nice eyeful of Mr. Efron ("Zac Efron, really, Amma?" said my perplexed son) and caring a hoot for the story line. (Same way when we saw the dreadful "Catwoman" - "she (Halle Berry) doesn't have to act," said Scott.) It was a therapeutic weekend, and I returned rejuvenated. Olivia's gentle presence and powerful sense of humor will do that every time.

I spoke to all the men in my immediate life - my Dad and the 3 Weiss men. All are well, Naren reiterated that he'd be home the weekend I arrived, Navin said, "Really?!" when I said there were 4 weeks to go, Scott's messages continue to use complimentary adjectives, and my Dad said, "When are you here?" You can tell where the focus is. I have enjoyed my time here and appreciate all the folks who have made my summer oh-so wonderful.

Unw -

R

Report of 2 Aug '10

Hello from Indiana -

Trust all are well. A new month is on us. And soon, a new year will be.

Several people asked very kindly why I got teary last week. Here's the story: I spend a fair amount of time explaining the ills of controlled substances to folks. If they persist in wanting them, it makes for a very frustrating encounter, with acrimony, which I detest. So, if I want to avoid this, I have to prostitute some of my beliefs which I do not do - and the impasse persists.

Busy schedules last week, but those are nice. I had a patient with a prominent lymph node in her armpit, and a family history of breast cancer. I sent her to a surgeon, and he removed the node and sent it for a biopsy (normal, thank goodness); follow-up with him was postponed as he had a death in the family. In the meantime, her armpit became swollen, and she could push it and squirt fluid out through a gap in the incision. She actually demonstrated this in the office. I was somewhat concerned about infection, or blockage of the lymphatic ducts, which drain fluid that collects the waste products from cells; I started an antibiotic and suggested she apply heat to the area. She returned this week, completely healed; there is a small lump at the incision, but she is otherwise free of the squirtings and swelling. At one time, general surgery was a consideration for my career choice - for joys such as this healing - but I headed elsewhere. This patient has also beaten a cocaine addiction and is back in school, and I commend her for both choices every time I see her. She is a lovely person, determined to succeed, and I wish her the best.

As I documented a physical exam last week, I noticed the left halves of the letters start to blur. I took off my glasses and shook my head, and the letters - on my note and on the posters on the wall - were still blurry. I checked to see if I'd just left a brightly-lit room for one less bright, and I hadn't; my left field of vision then looked like clear jello with multicolored wavy lines. This was a wee bit freaky - was I having a stroke? - and I asked my remarkable colleague, Nurse Practitioner Karen to examine me. Nurse Practitioner Beth would have done as stellar a job, but she had just left. Karen found nothing wrong in the neuro and eye exam, but thought the suddenness of the symptoms merited an ER evaluation. The ER doc was perfectly willing to see me, but he only had an ophthalmoscope to look in my eyes, which Karen had already done. So Karen sent me to the optometrist (I am really grateful to Karen for following through), who ably ran a battery of tests, and diagnosed me with ophthalmic migraine. Huh? The visuals were my aura - which indicate that a headache is about to hit - and then the headache hit. The optom and her husband suffer from the same condition (!) and she quickly produced a migraine pill and a Sprite to keep down the puke. I got home a tad exhausted, and paused to mull over the effects of aging, and illness, and illnesses that hit when one is not aged. The first thought through my head as I sat in the chair with the optom ruling out a retinal detachment - S.c.o.t.t. I didn't want to go through it alone, but all was okay.

Some fine times last week - I got together with Sid, his family, and 2 visiting lady missionaries to discuss Mormonism, faith and such. It was a nice discussion. I had not realised that was the purpose of the evening - thinking it was just a get-together to meet the missionaries, see Sid's family, eat some dessert - and so, got mildly disconcerted when the organised education started. It was actually great, though: I enjoy hearing about various faiths. I got to ask a lot of questions and we will meet again. One of my best colleagues from a previous job is Wiccan, and I have asked her a lot of questions also. I spent the weekend at the farm with some of my favorite people - Scott's mom, sister, aunt, uncle and nephew. We went out to eat, hung out, talked and laughed. My sister-in-law, Diane, and I visited her grandparents at the nursing home, and that was nice. I wish more people would visit their older relatives: it so recharges the latter.

Salsa continues well, with our instructor Dean's assistant, Audrey, having to lead like a male. She does very well, it can't be easy learning to lead. That class is fun, and I like it. Boot camp is fabulous and we do much running and twisting and crunching - it is a charge.

Inception, shminception. The best movie I've seen so far this year - "Winter's Bone." This year's "The Hurt Locker" for its realism. It was excellent, and the young woman who played the lead did magnificently. The supporting entourage also served to make the whole package fabulous, and I enjoyed the flick immensely.

I got to talk to my Dad, Scott and Navin, and that was nice. Naren has wanted to come home from the dorm for a couple of days when I return, and I was quite honored by that request.

Unw -

R