Report of 25 July '13

Hello from Geek Heaven -

"Big Bang Theory" is on, we are on computers doing our own e-businesses.  I don't watch much TV and find there are whole new shows on, though this one might not be new.

Work has been frenetic and good, overall.  There was a memorable patient last week: he said he had Stage IV colon cancer, and was admitted for pain control.  So our sympathies flowed over and we flooded him with narcotic pain meds while we sought background info.  As it turns out, he's had some kind of cancer, but definitely not stage IV colon cancer.  He was robust and healthy, and stronger than some of the other folks we admit, and he was aged 33.  Psychiatry saw this patient and diagnosed him with a personality disorder, with a substance abuse problem.  This is why it is good to seek background info before accepting patients' stories.  All the background info stated "This patient does not have stage IV colon cancer as he states, but he is adamant that he does."

A 19 year old male came in with a near-fatal heroin overdose, accidental.  When I saw him - younger than my sons and more confused, evidently - there was a strong desire to smack him one; however, that would not have been appropriate therapy and, as my sons pointed out, unprofessional and grounds for a lawsuit.  So I stabilised him medically and the next day, suggested inpatient rehab for this young man, as the usage of heroin had almost been fatal.  His parents had waited to talk to me and we had a good conversation; I felt fortunate that the young patient had a loving relationship with his mother and step-father.   

This is my week off and I have liked it.  I had to go in for a few hours on Monday as the other team was short-handed; the rest of the time, I have spent at St. V, learning of illnesses and cures and other cool medical stuff.  Navin and I have also seen 4 movies, Naren being otherwise occupied.  I also got to talk to my father and that was nice: a lot of laughter and concern and general bonhomie.  Scott comes home today for the weekend and that will be nice. 

The Banyan is doing well and the folks in Chennai just celebrated our 20th anniversary.  What magnificent work the staff do there.  How glad I am that Vandana and Vaishnavi founded this lovely organisation. 

Unw -

R    

Report of 13 July '13

Hello from St. Louis!

Scott and I are here on a little weekend getaway to celebrate our 25th wedding anniversary.  Big trips came earlier (Rio) and neither of us has seen St. Louis, so here we are.

The city is beautiful in parts, and decrepit in parts.  As Scott and I sat outside a funky little restaurant enjoying an artsy meal, 2 guys came up and 1 wanted to know more about the restaurant.  My antennae always go up at any interaction and we left the place shortly thereafter.  The boys and I had been at a restaurant in Greenwood earlier this week, enjoying a meal outdoors, and a car pulled up at the traffic light, a young man perhaps 12 or 13 stuck his head out and yelled, "Hey, hope your dinner sucks!".  I felt for our sons - that this comment might have been directed at us because of our skin color.  But prejudice is alive and unwell in India, too, and no single area is devoid of stupidity.

Racial harmony distinguished Brazil for me.  It has other ills, of course, but not racial discontent.  All coexist peacefully, and the men and I never felt like we did not belong.

Work has been fine, very busy.  The patient admitted with confusion - and the son dosing her Tylenol-ish med - has been discharged.  The Healeys (eminent geriatricians at St. Vincent) drilled it into us that if confusion persisted during hospitalisation, there was likely an element of dementia in the person.  And I said that to this family.  They were fairly accepting.  I also had to seriously whittle down the med list - a favorite Healey dictum - of an older lady admitted with a stomach bleed.  After the med list was shortened, the lady went from her baseline belligerence to being somewhat less nasty - and that was the best possible outcome we could hope for.  I kept the son updated and he was in agreement with plans.

This was my first full week off in a while, though I chose to work on Monday as the other team was short-handed.  I studied a little bit, attended wonderful medical lectures at St. V, and the boys and I saw practically every new movie in town - "Despicable Me 2," which was lovely, "The Lone Ranger," which was so-so, and "Identity Thief," at the $1.75 cinema.  I am starting to become a big Melissa McCarthy fan and all of us thoroughly enjoyed "The Heat."  Usually, the boys and I grab a bite to eat at a restaurant after movies, and I have been privileged to be part of the chats - full of candor and opinion and humor.

The Banyan hums along, and I am kept updated on the goings-on there.  Next week, the B will celebrate 20 years of existence, founded by a 21 year old and a 22 year old, who chose to handle a mentally ill woman on the road rather than do as most of us would have done - turn our backs.  It is a *great* place to work.

Unw -

R