Renu's Week

Monday, March 18, 2013

Report of 18 March 2013

Good afternoon!
Sun shining, plant on the balcony preening - you know the drill.

Work is good.  Today was my Kovalam day.  Last week, one of the older patients had had BP in the 200's over 100's and complained of blurry vision.  We gave her some medicine to lower her BP and asked that she call someone from home; she said there was no one there, so we made her lie down in a quiet corner and then our able project head, Salih, later went to her house with her.  They told her granddaughter to get her evaluated, and expressed the urgency; which other organisation would do this?  Well, in she marched today, stating she felt okay, and then she said to me, "There you went, giving me 1 tablet and then abandoning me."  I was not in the mood for this, so told her that if one good or kind or appreciative word came out of her mouth, I would faint or drop dead.  Salih then came in, and I asked that he mention the extent of the efforts that everyone made; he tried, but I do not think much of it registered.  It probably registered outside the exam room because we'd had to raise our voices to make ourselves heard - and this is not the patient who is very severely hard of hearing.

Appreciation - now there's a novel, refreshing, human concept.

We did get our share of grateful patients coming in.  After I finished examining one, she put both her hands on my cheeks and then removed her hands and kissed them - a gesture of great affection.  All because I'd laid a stethoscope on her.  My father says that the "untouchable" caste is unfailingly grateful to be touched; shoot, I'd hug many of my patients if I could.  But since that is not de rigueur here, I am okay with the folded hands greeting, or a smile. 

Adaikalam has been good.  One of our patients is 25 kgs, 55 lbs, and she is just a couple of inches shorter than me.  So we are doing some bloodwork - every internist's dream - and will try to figure out what is up with this weight.  The staff mention that she eats very well, so the lack of weight gain must have another cause - I hope. 

Vandana addressed a meeting with all the health care workers, on the issue of patients who hit and bite, and it was magnificent.  Just to be able to listen to her thoughts, and to see her ebullience, and revel in her robust optimism - these are big treats.  The main messages in the meeting were the need to protect oneself and to understand why the patients hit and bite; it was very, very enlightening.  I remain impressed with the hcw's, that they would tolerate physical harm, all in the quest to provide good care for those marginalised patients who know not what they are doing.

Naren turned 22 last week and we spoke on the phone.  He is job-hunting in the midwest.  Navin is well and very busy with school, and Scott is at his assignment in Seattle.  We Skyped yesterday, from 4 different locations, and it was fun.  I continue to enjoy my solo state, except when it is time to see movies; no movie-seeing has happened.  I did go to an event where my alma mater, Lady Doak College, was honored as the best college providing women's education in Tamil Nadu (our state).  That was a blast.  Some of my best experiences and great friends, not to mention careful molding by extraordinarily competent professors, came from Lady Doak. 

I have been invited to participate in a Global Health course from another alma mater, the University of Texas Health Science Center in San Antonio, and would *love* to attend.  Now comes the quest to find some bucks to get there.  Sigh - the lot of those working with the marginalised does not change.  However, it does give us some fine insight into what the poor must go through when they hear "No" at every step :).  My new goal is business class travel on any one leg of a flight: to sleep horizontal - the heck with the fancy food and drink - would be utopian.  I can dream. 

Let me wind up and get to reading that newspaper.  A new Pope, Mr. Chavez's legacy, more corruption in India - lots of things to read about.

Unw -



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