Report of 08 April 2012

Good evening!

It is hot. Thankfully, there's a bit of a breeze.

I will head elsewhere soon and am wrapping up events for a bit. Kovalam was great yesterday: my gypsy patient returned. She had come again when I was not there, and we had missed each other. She came yesterday, resplendent in a sari, though I like her swirly skirt and midriff-baring blouse also. She had felt tired, and on checking her blood work, I found that her sodium was low. This is sometimes called the "Tea and Toast" syndrome in the U.S., where older folks drink tea and eat sparingly, causing their sodium to drop. So I asked her, and knew the answer before she spoke: she cannot afford food. I asked our community workers if the lady and her niece could eat with us, and they said sure. I mentioned this to my patient, asked that she not bring hordes of her compatriots and regretted it the minute I said it: she replied - with considerable dignity - that she would not, as she knows we can't feed everyone. She kissed my hand as she left, though I had done nothing to cure her aches and pains. Some physiotherapy equipment would go a long way. If we can dream it, we can do it.

One of our patients is being treated for mental illness at Adaikalam and her 8-year-old son is at Kovalam. He's a beautiful little boy and wears the traditional Muslim clothes of white long shirt and loose pants, as well as the topi (cap) on his head. Last week, he was busy dusting everything with a colorful feather duster, and it was a very cute sight. School's out for him (many schools have summer vacation in April and May, the hottest months), and we must find a new school; in the meantime, he hangs out at Kovalam with his grandmother and aunts, much adored by everyone and knowing it. It is wonderful. Bryan Benedict, one of the finest ER docs around Indy, and his stunningly beautiful pathologist wife, Cindy, had given me a box of chocolate turtles and I'd hoarded 'em; I ate a few and then decided the box must go to folks who've never had such chocolate, so off to Kovalam it went. The little boy had a couple of pieces rapturously, as did every single colleague - also rapturously. It was great!

Adaikalam is fine. One of our residents has fallen and sustained a fracture. Our patients have osteoporosis (brittle bones) and we have a gym instructor who is trying to teach gait stability. A fall equals a broken bone and I appreciate his efforts to thwart this. The resident with the fracture is in the sick room, ably looked after by another patient, Ms. S. Ms. S was picked up from the streets, barely clad, is HIV positive and has a husband and children in Mumbai (Bombay). She is now treated for her mental illness, dresses decently and wears kumkum on her forehead and sindoor in her hair's parting - the latter indicating that she is married. She looks lovely, and has also shown that she has quite a flair for languages: she is starting to speak Tamil, which is quite difficult. She asked today, in Tamil, if I had eaten and I answered, asking her if the uppuma (a savory dish made from cream of wheat) was tasty; matter-of-factly, she answered, "Illai (No)," and it was so funny, I burst out laughing. She's a treat, that one, and has taken to needling the sick room patients; though they protest, it is a nice break from routine.

We had an appreciation meeting today. Several friends donated cake and goodies, we said something specifically nice about each staff member and all had cake and fruit. I looked at everyone eating happily, and thought to myself how little it takes to keep our staff happy: a kind word, cake and a vegetable puff (a savory pastry), some juice and fruit. Leela was complimented by the Senior Coordinator of Adaikalam, Preetha, as invaluable in teaching Preetha the ropes as a new employee; this was particularly fabulous, because Leela had interviewed for the position of Senior Coordinator, also, and clearly bears no ill will towards the person who did get the position. This is a great place to work.

We heard that our friend, Andrea Schichan, is engaged! Andrea visited us from Germany, conducted an excellent training session for the hcw's on First Aid; we visited her in Germany, and there is a lot of love between us. We were also thrilled to bits to get a donation of $2000 from Dr. Ram Yeleti, a very nice cardiologist at Community South, where I worked last year; this gift is a fine glimmer of good news, from a fine, compassionate person. Jasmine Hamilton, an extraordinarily competent nurse, also at Community South, has collected for and shipped us a big box with raisins, other dried fruit, and toothpaste and toothbrushes, after a campaign she called "Raisin the Bar." This is fabulous, because our residents do not get much fruit at all; Jasmine has truly gone over and above the call of duty, in her usual magnanimous, unobtrusive fashion.

Naren and I spent a fun weekend eating out and getting some shopping/banking/doctor visits done. My high school classmate, Mohan, was in town and I had not seen him for about 30 years. We met in our other classmate D. Ramesh's clinic, and it was as though no time had lapsed, really, a very fun visit. Scott, Naren, Navin and I skyped. The boys are full of admiration for each other's achievements, and that is a treat to see. Lots of smiles, happy faces. Naren wrote an article online on El Haked, the rapper trying to bring about change in Morocco. Navin won "Big Assassin on Campus." Though the significance of some of this is lost on me, it is nice to see the boys flush with achievement and I, too, applauded them.

"Remember that as a teenager you are at the last stage in your life when you will be happy to hear that the phone is for you." - Fran Lebowitz, Social Studies, 1981

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Report of 01 April 2012

Good morning!

It is Good Friday, also my nephew Sudhir's 23rd birthday. My bedspread is hanging on the balcony; I woke up soaked in sweat this morning and my nightie and the bedclothes were sopping wet. Only the 2nd or 3rd time in my life this has happened, and weird. I am grogging myself with Tylenol (paracetamol) this morning, not knowing what on earth I am treating.

Busy. I suppose that's a good state of being. I cannot recall the last time I got to read a professional journal - I try to read for an hour every day and absolutely love it. But the B has been so busy - with admin stuff. Our neighbor, Usha, and I talked, and we spoke of how one tends to do more admin work as one moves up in the ranks. We are faced with a severe fund shortage, and our health care workers are understaffed, thus that cadre is stretched. Poor things. I love my twice-weekly sessions with them: we talk about all manner of things and laugh and sometimes share candy.

Kovalam has been fine. One of our impoverished patients left her house at 5 AM, took several buses and got to us a little after 9. 4 hours' travel to see a doctor. She had some swelling in both feet, and appears to have some blood pressure issues, and I told her I needed to check her kidneys. She spoke with pronounciation similar to my father's home town, Nagercoil, and I asked about that; she was from Tirunelveli, near NGL. I said, "Aha, you see, I thought I detected the 'vandhittu' and such that folks there favor," and she laughed out loud. After the visit, and my explanation, the lady said that no doctor had spoken thus to her, and I was honored; I said, "I am simply a big mouth, that's all, and don't forget the Nagercoil-Tirunelveli connection," and both of us shook hands and laughed. I tell Scott often that I merely possess Wal-mart greeter skills, and no particular skill at doctoring.

It is nice to laugh, isn't it, breaks the day. When Scott's father died, there was a lot of reminiscing and laughter the night before the funeral - sort of like a wake - and while I was culturally alien to laughter at such an occasion, it was soothing to relive memories with the family. The in-laws are fine people, I tell you.

A young, unmarried woman admitted at Kovalam for psychiatric issues came to see me and spoke of abdominal pain and other pains radiating across systems (i.e., heart, lungs, stomach); such multiple complaints can be due to psychiatric issues, plus the patient wanted to go home and had been discharged by the psychiatrist, so the social worker agreed to look her over. The following day, when I was sitting at a movie called "3," I got multiple phone calls from Kovalam. On calling back, I was told that a pregnancy test had been done on the patient - and was positive. Well, well. Such news is no longer the exclusive preserve of foreign countries. I did not even consider the possibility of pregnancy, as the patient was unmarried. Time to learn something, doctor.

Adaikalam has been grand. A lot of leptospirosis around. Our corporation commissioner visited us and promised to help with clearing garbage promptly, and addressing the open sewer nearby. Wilfred is a great guy and our fathers were college roommates and fast friends. Thus, he extended a personal favor almost, and we appreciated it. Our patient, Ms. E, the cheerful one, has lepto and her smile has dimmed a little; yesterday, however, she was feeling better and gave me her megawatt smile again, making my day much brighter. I introduced her to Wilfred on his visit, and she asked him, "Have you eaten?" It unfailingly staggers me that even the impoverished can ask someone if they have eaten, completely prepared to offer the guest her/his own meal.

Our health care workers and I had a session on what would make their jobs easier and it was magnificent. All of us sat in a circle on the floor and we went around the room. These folks are so bright and so motivated to help/learn/share/care that it is humbling. I wish the staff shortage would be eased, so that some can be sent for cross-training: to suture, or drive, or learn nursing. Maybe someday; if we can dream it, we can do it.

I had a lovely weekend. My father came into town on our invite, and we invited a couple of friends over for dinner. Sam is from Uganda and a volunteer at the B, a very cheerful sort and much adored by all. Mike is from France, we met in Pondicherry at a conference, and he is a great guy. We had a fun time, and the following morning, all of us (sans Mike, who was catching a flight back to France) went out for one of my favorite meals - breakfast with sausage and eggs and fruit. Yummy. Our car's battery died shortly thereafter, stranding us until the mechanic got there (no jumper cables here, I might invest in one in the U.S.), but I refused to let anything dampen my mood.

Some neighbors got together on the rooftop last night to say bye to a neighbor leaving town, and I joined them also. It was a fun evening, in the cool breeze and with some great people; music played and people danced. I do not need much coaxing at all to dance, thus I too got up and let the music take over. Fun, fun. Katy Perry played at an event here, and my friend Pushkala had 2 passes, and invited me. I do not know KP's music at all, but it was a great show and KP's genuineness and warmth were patently obvious. Suddenly, I am a quasi fan.

Scott, Navin and I skyped yesterday and it was grand fun. Navin's hair is almost as long as mine and just as unruly. It was cool to see him smile as I yelled "Hairy!" and of course, it is always, always a treat to hear Scott chuckle.

"Let us endeavor so to live that when we come to die even the undertaker will be sorry." - Mark Twain

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