Renu's Week

Friday, September 30, 2011

Report of 30 Sept '11

Hello from Texas!

I finished a lunch of very good Mexican food, and am hanging out at my old med school. If I stayed in one spot on my days off, I would likely be rested; however, being back at school is rejuvenating. I have had splendid, intellectually stimulating discussions with a variety of professors and students, partaken of fabulous food, met up with a very fun classmate - all good.

Work was fun, and being 7 days on did not seem as exhausting the 2nd time around. I still had my fair share of patients, including an older gentleman with myasthenia gravis who had had trouble breathing. His family brought him in to die and he recovered very nicely; I was delighted because the 80+ gentleman was full of wit and charm and all things classy. The family was puzzled and, in some cases, irate as they had been given a bad prognosis; I mentioned that I was actually delighted with the outcome. Even the family pastor asked after a fashion, at our initial meeting, when death would happen and I was a bit surprised at that. So the patient recovered well, we spoke of sending him to a different rehab facility and then he abruptly died. The terminal stages of myasthenia are unpredictable like that, I imagine. I was saddened, however, at the - to me - unexpected demise, but Scott said the patient had had comfort in his last days and that I should focus on that. This is why good spouses are nice to have.

A patient and his wife were on their way back to Des Moines from North Carolina and they stopped in Indy. At that point, the patient's pacer/defibrillator (a device placed in the heart which would shock it if it went out of rhythm) went off multiple times, knocking him to the ground. He was brought to the ICU and placed on a ventilator; when I saw him, he got a little unstable with his blood pressure and heart rhythm and we worked to stabilise him. The ICU team of nurses was magnificent and I was grateful for this excellent support. The patient recovered enough to be responsive, but regretfully, coded (got very critically ill) again in the evening. The cardiologist ran the code and it was futile, which the patient's cardiac nurse wife fully expected. She asked that we terminate the code, and the patient died. I could not leave the patient's bedside for a while, thinking we had not done enough. The wife's class and grace helped the situation immensely, and at the same time, made me feel doubly like a heel that I had not done enough.

So, I finished an exhausting week and boarded the plane for Texas. We were, unexpectedly, a little bit late getting to the airport, which I do not enjoy at all, and Security pulled me aside for a "random" security check. I ordinarily never mind this, but was annoyed this time. Random? I was the only dark-skinned traveller there, and after me, a similarly dark-haired traveller got chosen as well. Unabashed racial profiling, as happens apparently in all Israeli airports, would be refreshing honesty. Also set people up for refreshing lawsuits.

A bunch of us met at the home of Dorothy and Vick Williams (Vick is a former professor of anatomy) to celebrate the 60th b'day of Greg Freeman, former prof of cardiology. Sara Luduena (a former prof's daughter) and her friend Madeleine, med students Neelima, Lisa, Caroline and Andrea, Greg's secretary Elvia, and I met to greet Colleen and Greg Freeman as they walked in. It was a surprise party with Indian food, and Greg appeared to enjoy it. I was grateful to Dorothy and Vick for hosting.

I then went to the home of Linda and David Johnson; Linda is a professor of anatomy and Dave is a pediatrician. It is always therapeutic to be here, the Johnsons' perspective on life and their senses of humor are salve, and we talked for a while, greeting Dave who had returned from the grocery store with Therapia de San Antonio - Blue Bell Homemade Vanilla ice cream. I get spoiled here routinely.

The following day, I spoke to med students at an event hosted by the American Medical Women's Association (Amwa). The talk was about the Banyan, and the intrepid patients' stories spoke for themselves. I got a lot of questions after the talk, and am still fielding them as I sit in the library. One of the questions has provoked some soul-searching: what made you want to do philanthropic work? As Vandana and Vaishnavi have hastened to assure people who think they have sacrificed their lives to do this work, with the info that this is what V and V *want* to do, I too am doing what I *want* to do. Why? That's hard to say - because poverty should not limit access to care; because very good professors in a fine medical system taught me to treat the illness and not base treatment on the size of wallets; because I like the smiles of the impoverished when they realise they mean something to me.

I rounded with Greg Freeman yesterday and saw some cool cardiology cases. Greg is robustly enthusiastic about teaching and I always learn something new when I am here. He is also a funny guy, and we laugh quite a bit in the course of the day. In the evening, my classmate and friend, Katharina Hathaway, made the trip from Austin to have dinner with me and that was a blast. Katharina does a lot of work with refugees, including those from Myanmar and Bhutan - definitely countries from my neck of the woods - and we had a good time talking of it. She has done some going-the-extra-mile work with ensuring access to care for this marginalised populace, and appears to love what she does; I can fairly guarantee that her patient populace is grateful.

Today, I went to pediatric Grand Rounds with Dave Johnson and appreciated the chatter on the way up. I stopped by the office of Alumni Relations and saw Sonia Rogers and David Perryman, fine folks there. We had a good time catching up with their work and family lives; they are efficient, personable and nice people. Today, I have also met separately with Dorothy and Vick Williams, on issues of faith, and have thoroughly enjoyed the extraordinarily intelligent viewpoints from a couple of deep thinkers. I will always be grateful to the Williamses for indulging me.

The 4 med students mentioned above are coming in December 2011 to work with us at the Banyan, and we will meet for dinner tonight at the Johnsons' to discuss that. The planned dessert: brownies and Blue Bell Homemade Vanilla.

Last week, Scott turned 50 and we ate at a very lovely restaurant recommended by a nice colleague. The service was very good, Scott got a free dessert, the food was very well-made, and the evening was memorable. On my request, Scott wore his new suit to dinner and looked very dapper. On our way out, it started raining and that is a very auspicious sign by Indian standards - likely based on the fact that we used to be a predominantly agricultural society, but I'll take the good fortune.

Calling home will have to be done this weekend, and I look forward to it. Both our sons are well, thank goodness, and Scott and I are slowly getting used to the fact that both young men are now out of the house, living their lives.

Unw -



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