Report of 28 Jan 2014

Hello all!  Hello to the folks at Standard Chartered who check my blog!

It's different that a blog can be accessed on work time and using work resources.  Many of my readers can only check the blog at home, and I am much more used to that.

We are well, and hope the same with you.  Work continues to be fun.  Our clinic in Kovalam had a police officer come by one day, seeking care.  He was a fearsome guy, big belly and big moustache.  When he sat down, however, he was just another patient.  I had wondered about his symptoms and checked a test for diabetes, and there it was - he is floridly diabetic.  He came back for a follow-up yesterday, and we talked about his illness, the need to control his diet, the imperativeness (imperativity?) of exercise.  He then said his father was diabetic, and I told him to bring his father, too.

Our community workers had intervened masterfully in the case of an impoverished family whose son was dodging school, and he had started attending school regularly.  I really appreciate school as a way to haul one's a-- out of poverty and insist on it, as much as I can.  [Our health care workers, who have had to give up school primarily for monetary reasons, get trained on the job, and several are first-rate clinicians.  They have since learned spoken English, and some Hindi, and are coming along nicely.]  The mother and son came to see me at about 11 AM, and I asked why the son was there, instead of at school; the mother answered that the son had woken up late and had announced that he was not going to school.  The mother had let him not go.  Her daughter had danced at the previous day's Republic Day function at the school, pronounced herself with leg pain, and had not gone to school, either.  I was livid.  I summoned the community workers, and all of us tried to figure out the deal.  The parent's laissez-faire attitude was not fine for me, neither was the kids' dodging.  I said I would not see the mother (my patient) and told them to leave.  Argh!  When my colleagues go the extra mile for every family, I like to see the effort replicated in the family.

Today was my day in Mogappair.  Classes resumed for the health care workers, and today we spoke of dengue.  The interaction is always good in class: the young ladies respond avidly, ask questions interestedly, and want to learn.  They are also sharp.  This makes them every teacher's dream.  Class always rejuvenates me.  I ask them who they are, and they answer "Health care workers;" I then ask who I am and they say "Doctor."  I then say I am a health care worker, also, and we share a great bond.

Navin left last week, and the house is quiet.  Naren left 2-1/2 weeks ago.  Both boys have reached safely, Allah be praised.  Honestly, since I know the issues with air travel, I tend to worry until the boys reach.  Scott and I went to Madurai over the weekend; 26 January is the anniversary of the demise of my brother, Manu, and my father and I annually go to the cemetery.  Scott came along this year, which was good.  It is a tough time.  This year, I asked Manu why we were at gravesite instead of watching our children gab and laugh and eat, why his lovely wife and children were alone, why why why.  And then bawled.  All of it was therapeutic.

My sister, Anu, and brother-in-law, Benji, were also in Madurai and it was good to see them.  It is fun to share a laugh with these folks.

We caught up on a couple of movies - The Wolf of Wall Street and American Hustle.  I thought the acting was first-rate, of course, but did not enjoy either flick.  The depravity, the almost-nudity, the weirdness.  

Hope all of you are having some non-weird days.

Unw -

R

Report of 19 Jan 2014

Hello from quiet Chennai!


My family is asleep - the ones who are here, that is.  It is quiet, our temperamental modem is cooperating for now, and you'd be surprised what you'd consider joys once you've lived on the other side, e.g., with a modem that simply won't turn on.


Life is fine.  All doctors should be patients once in a while.  I contracted food poisoning 2 days ago and that changed plans for the weekend.  I lay on our sofa and ate bland food.  Navin, who is still here and leaves on the 24th, went off to see friends; Scott sorted through piles of old documents; you know what I did.  Illness gives a fine appreciation for good health - see first paragraph.


Work is good.  Last week, at our busy Kovalam clinic, we saw quite a few patients.  One of them is one of my favorite people.  He is older, has some high blood pressure, is non-complaining.  We had had a heck of a time getting his blood pressure under control, he admitted some home stressors, and the psychiatrist started him on an antidepressant: voila - BP under control and sleeping better!  Wow.  I told him last week that he had meds enough for 2 weeks and he said, "What?  Does that mean I don't come next week?"  I told him he could come if he wanted, that the clinic would be open, and he was reassured: for several of our patients, the clinic forms a social outlet and a place where folks listen to them, treat them kindly, etc.  As all visits and meds are free, I don't dissuade anyone from coming.  Often, the words they hear at the Banyan are kinder than the ones they hear at home.


So, there was another patient - new to me, and just after having delivered her 2nd child.  I forget her complaint, but in the course of the history, she showed me a leg wound.  She said she had fallen, and I asked about domestic violence.  She looked at her sister-in-law (her older brother's wife) and denied violence.  I looked at our able assistant, Keerthana, and told her and the patient that I thought otherwise.  The sister-in-law then stated this patient had been brought back from her husband's place as he had beaten her and kicked her even when pregnant.  She'd had a son this time and I told her that her husband might ask her to come back, given she'd had a boy baby, and for her to choose carefully.  That's all I can say, truly, in addition to pointing out that she'd been beaten to within an inch of her life.


I did not go to Adaikalam this week as it was Pongal, our harvest festival, and many of the health care workers were going to be away.  Since part of my duties involve teaching, and since half of my student populace was going to be absent, I worked from home.  It was good to catch up on professional reading, and prepare training material. 


Naren is well in NYC, Navin is preparing to wind up matters and head stateside, and Scott is enjoying his job.  All good, and I hope the same with you.


Unw -


R

Report of 5 January 2014

Hello all!

A husband is wandering around defrosting meat and doing household-y things, 2 sons are asleep and the family is complete.  It's very nice.

We are well and hope the same with you.  We catch the boys in passing, as they fly out the door to play soccer or see their friends.  The reason for whisking them off to Sri Lanka was to be able to see them, away from distractions; the cell phone was still overactive, but we could see the whites of these boys' eyes.  And Sri Lanka, with its genteel and gentle people, was wonderful.

As we sat outside a restaurant in Colombo, drinking milkshakes and eating decadent pastry (we eat like pigs when on holiday), we noticed a man lie down outside.  The staff hastened out; the place was on the beach and a nice locale, thus someone passing out ostensibly could disrupt the scenery.  I walked out, offered my services and checked the old man out.  He had a hernia, he said, and he had not eaten all day as it hurt him to eat; as I got a quick, cursory history, I realized the man must be evaluated by a surgeon and suggested it.  He declined, the staff were nonplussed and then the man decided he must be on his way.  The manager of the restaurant asked me later if the man was faking and I said I did not think so.  Good health is a wonderful thing to have, is it not.  As I sit here in my 50's, realizing that rushing to the restroom is now de rigueur, I think of all the illnesses that could hit with old age (or middle age, as I now am in!) and find myself fortunate.

Scott and I went to the funeral of a neighbor's father.  Our sons don't like funerals and we did not force them to come, though they know this neighbor well and we consider her a friend.  She was holding up well, being strong for her mother, younger sister, husband and sons.  I marveled at her composure, and she wept as we hugged.  I remember when my mother died that I was grateful for old friends in Madurai coming to her memorial service. 

I have been off work this week, travelling and then returning to Chennai.  It has felt weird and I don't quite know what day and date it is.  The students who worked with us in December have left; the Banyan is richer for their having been here.  I spoke to my father on New Year's Day and wished him; he had had a good holiday in the Andamans with my sister and family, and I was pleased.

Sons, husband, food that we can afford, a shelter that does not leak - all fine blessings.  Hope you have many such blessings this year, as well as robust good health.

Unw -

R  

Report of 1 Jan 2014

Happy New Year!

May this year bring you good health and happiness.  As I age, I find this business of good health to be a grand thing to wish for.

We are well, and hope the same with you.  I am sitting here getting shocked by this computer (there is some faulty wiring, which is causing me to get regular zaps, prevented by a pillow case against the keyboard), Scott is updating his diary and the boys are out gallivanting with friends.  This is a fun time for them, getting together with those they consider soulmates, from an era when sassing the teacher and playing sports were de rigueur.  They now must discuss college, and finances, and life in general, without the detour of sassing the teacher.

One year, when Naren and Navin were in the business of teaching underprivileged students, one of them returned home and said over dinner of his student, "She looks around, does not pay attention, does not try to grasp concepts.  Whom am I teaching for?"  And then the epiphany struck almost immedately: our son was similar in his behavior in math class.  It was very funny, and we reminded both boys that their teachers were likely experiencing the exact doubts, too.

Work was fine.  The students finished their physical exams and examined a staff member or 2.  We saw the patient who had been chained by her ankle and had fought it, subsequently causing a big wound on her ankle.  We treated the wound after she got to the B, using an IV antibiotic suggested by our lead health care worker (very sharp!), and doing careful cleaning and dressing changes.  The wound has since healed - halleluia.  I wonder how I would react if I were chained as my caregivers did not understand mental illness - probably similarly, fighting the chain and causing a wound.

Many of the health care workers and other staff spoke of how much they had enjoyed Family Day, and I was pleased.  The work is demanding: if we can give them a few treats on 1 day of the year, I am very willing.  Thanks to all of you who donated, and who share a keen interest in the Banyan.

Christmas was in Chennai, with my extended family and the med students.  It was fun, and vats of food were eaten.  We saw off the various relatives and friends, and then went with our sons to Sri Lanka.  We loved our time there: the people are gentle and genteel, the place is clean, there were vast Buddhist influences everywhere, and the food was delicious.  We spaced our holiday out, doing manageable things daily instead of running around madly doing touristy things.  As a result, we got to listen to our sons and revel in their senses of humor; enjoyed each other's presence; slept lots (one day, I got up at 8.45 AM, which is not common); and generally relaxed.  It was a fine trip.  We returned today, slept a bit, saw some beloved friends whose blessings we must receive on New Year's Day and were privileged to have both boys home for the 2 meals for which we were awake.

Lots of good times, plenty of blessings.  We hope you have your own, today and all through 2014!

Unw -

R