Renu's Week

Tuesday, October 23, 2012

Report of 24 Oct 2012

Good morning from a very soggy Chennai!

The monsoon is here.  It makes for incessant rains, roads that get ruined, and huts that leak.  One year, Vaishnavi, one of the founders of the Banyan, went around in the rains looking for folks that would have been marooned; sure enough, she found someone, Ms. X, and this person was sent to the Banyan.  Ms. X had a touch of jaundice and I got a phone call; I was not going to work that day as the roads were simply not navigable - Adaikalam is situated in a very low-lying area and one monsoon, boats had to be brought to ferry folks to and fro - and promised to look in on her when I could get to work.

This is the joy of working for the B: the founders do for others in a manner as natural as breathing.

Our patients have been fine.  There is a much older lady, Ms. K, at Adaikalam who is becoming emaciated; she does not eat solid food and takes sips of fluid at a time.  She is actively dying, and might have cancer; I am not going to go searching for this disease as my management will not differ.  I have told the health care workers (hcw's) of the prognosis and asked that they not get upset.  This is also a joy of the B: the hcw's consider the patients their own, part of the extended Banyan family.  They address the paatis (grandmothers, older ladies) in the singular and it denotes great affection.  Thus, the prospect of losing someone like that is very, very difficult.  I mentioned to them how grateful I was that Ms. K was with us, instead of dying on the street - alone, unkempt, neglected.  The hcw's shower love and affection and dignity on our patients and - especially in death - that is invaluable for me.  Ms. K unfailingly asks about others still and likely has a family that she adored.  I am very fortunate that I can still see mine.

Kovalam is fine.  One of our patients is hard of hearing and had to place her face right next to mine to hear me; she then coughed fully in my face.  Dear dear.  "Turn your head and cough," is intended to protect the physician.  I came home from work with a headache and proceeded to run a fever.  No matter - this patient seemed pleased with the care and went to touch my feet (a gesture offered to much older/revered folks or Gods - neither of which I am); as I said to her that I was simply doing my work and not deserving of any feet-touching, the health care worker with me got very teary.  A subsequent patient said, "Even in private (private practice where doctors can charge a hefty fee), I am not treated this way."  Hmmm.  I asked my father once why it made such a difference to patients that I talked/listened to them and he explained that it was also very revelationary to them when we touched them; coming from the "Untouchable" caste, it gives them great status when we touch them.  Uh huh.  I can't diagnose without touching; that's all.  Wal-mart greeter skills, that's all.  Still, it is nice to work in a place where we impart such dignity and respect all in the course of a day's work. 

The patients start lining up at 7.30 AM (unheard of here) and I finish at about 2.30 PM.  The other day, I started to get hungry in the middle of this; when that happens, I get snippy.  I managed to curb snippiness and crabbiness and get through the work.  Little Ms. A sure helped.  I was examining a patient who held a 1-year-old in her hand; said baby thought I was going to harm her mother, or inject her (a mortal fear of all little ones here), and screamed and cried.  Ms. A wandered in, looking at the other little one quizzically: I've never heard A cry.  After the patient left and A sat comfortably in my room, reaching for the thermometer and the BP cuff and every other thing on my desk, I asked her who had been crying.  She answered, "The baby," as though she herself were 25 years old.  It was hilarious and I asked it again: "Paapa (baby)," she said.  There were blank papers on my desk that we use to write lab tests for our patients, etc., and I handed A a pen; she scrawled merrily on the papers and, while aware of the waste which we can ill-afford, I was delighted that A was gainfully and intellectually occupied.  A little while later, I saw her mother carrying her as she neared sleep or was sleeping; A is everyone's baby, but marvellously, in the manner of babies everywhere, she knows who her mother is and goes to her, and the mother, while reeling under a mental illness and healing, knows enough to pick up her child and take her for a nap.  Isn't parenthood wonderful.

It is, indeed.  We managed to Skype with Navin and that was fun.  There was a smile or 2 as I narrated incidents at the B, and it was nice to see our long-distance son happy.  There was also a fair amount of chatter and that is a grand privilege for me, that the boys would choose to talk to us.  Yesterday was a holiday and Naren stayed home; we talked of his plans and goals.  He said to us, "The only way I survived college was because both of you said, 'We have raised you, you are now free to make of college what you will.'"  That was lovely. 

Cary Laxer, the chair of the department of computer science at Rose-Hulman, was in India on business and spent 2 days with us afterwards.  That was grand fun.  As with all powerfully intelligent people, Cary had excellent insight and opinions and observations and those were cool to hear.  We did touristy things and then Cary came to the Banyan.  He does a lot of work with "Big Brothers, Big Sisters" in Terre Haute, Indiana, and we found commonality in our causes.  Cary was very respectful of Indian culture and that made him easy to be around.  We have had guests who continue to diss Indian culture and we tend to avoid the topic when we are around them.  Dissing another culture has always seemed a bit narrow-minded to me, and smacks of insecurity.

Scott and I saw, "Killing them softly," and it is not a movie to be seen in India, where a fair amount of heckling, etc., goes on.  We also went to listen to a band that did covers of Pink Floyd and Deep Purple; the evening was smartly called "Pink and Purple."  I love covers and Deep Purple is one of my favorite bands, thus I enjoyed the music.  It was deafening, however, and Scott and I left at intermission.  It is cool to have Scott's company; India is that much better when I have his wry sense of humor around.

I talked to my Dad and he is well.  It was good for me that I was there when he was ill; I got to treat him and see for myself that he was better.  Such a relief.

Unw -



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