Report of 27 March 2014

Good evening!

The lights of the villages around can be seen.  Mosquitoes are a little fewer now that it is hot in Chennai and we can leave the balcony door open.

Work is wonderful.  The other day, I was treating a young colleague who was fatigued.  I asked if her periods were regular and she said she hadn't had one this month; I then enquired about the possibility of pregnancy, at which point our able senior nurse turned to me and whispered, "Doctor, she's a widow."  I was thunderstruck: the patient was oh-so young, and widowed.  Ergo, in our culture, not likely to be pregnant.  I apologized for my gaffe and the lady was very gracious.  In the midst of her solo state, and feeling unwell, and exhausted, still finding the wherewithal to be gracious - nice, eh.

Kovalam is also fine.  We have some young post-graduates from our helpful hospital, SMF, assisting us in our clinic there.  It was great: the docs were bright and quick and enthusiastic.  Several patients still wanted me to look over their management, and that was fine.

Scott and I were in Mysore yesterday, to see 2 of my aunts, and a cousin and her son.  One of my aunts has dementia, and that's sad to see, but she exhibited quite a bit of her old spunk.  My other aunt is her caregiver and this is commendable.  We had a great visit and went out for lunch.  My cousin (actually cousin-in-law) takes care of her special-needs son almost single-handedly these days as my cousin is out of town; the young son is a hoot, laughing joyfully at stories of our sons.  He is about their age.  It was a lovely visit.

Nice to see relatives.  Grand to enjoy their company.

No movies in a long time.  I have not had the mood.  Official word has come about MH 370 and the heart has stopped hurting, sometimes it resumes.

Unw -

R 

Report of 21 March 2014

Good morning from our room with a beautiful view -

Clouds are gathering and we are hopeful of rain.  The city faces a water shortage.

How the chest can hurt, eh.  It happens when I am driving, or seeing patients, or now.  We know little about the flight MH 370 and my thoughts turn there often.  Our friend's husband and daughter are holding up; the situation must be as wrenching for them.  If not more. 

My only cousin on my Dad's side passed away on Sunday.  He was 59, no age to die.  I went to Coimbatore after the funeral and saw his wife.  She is a lovely person; grieving with her and talking of our common relative was therapeutic.

Work has been good.  There is a patient, one of our residential clients at Kovalam, who gives massages, apparently.  It's an Indian-style massage, with pressing of the limbs and back.  She had pressed my arms one day and then asked for money.  While I do not really need a massage at work, I had let her massage and then given her Rs. 10.  She bounded in again on Monday and - viscerally feeling the need for human contact - I took a break and got a massage.  It was nice; press, press, press; feel the grief ooze out; revel in work, life.  I gave her the usual Rs. 10 and she left after tying it in one corner of her dupatta (shawl).  Several minutes later, she came back in; we were flooded with patients by this time and I thought to decline her repeat massage, but she opened her hands - full of sweets - and gave me one.  I nearly wept: this lady had no money other than the Rs. 10 I'd given her and what did she think to do with it - buy sweets that she would then share. 

Life is mysterious, but overall nice.

The boys are well and busy with their respective activities.  I spend much more conscious time with Scott now: we used to hang out and I'd be zoned out, or reading, or looking at others.  Now I talk more to him, listen, share time.  All very precious.

Unw -

R

Report of 11 March 2014

Hello -

I imagine there is a limit to the amount of pain the heart can handle, eh.  We heard last week that a beloved friend, Chandrika, boarded the missing MAS flight.  Her family waits for news and so do we.  In between, we bawl and reminisce.  And continue to wonder what happened.  I know this, though: we will never read a news report about a missing flight the same way again.

We visited Chandrika's family on Sunday and they are holding up.  Both parts of the couple are powerfully intelligent and fun folks; Chandrika worked for an international non-profit in support of fishworkers.  The family and we chatted, and shared, and laughed.  "It is good to laugh," said her husband.

The Banyan has been fine.  I had hoped work would help dispel some of this heaviness, but it has not, yet.  The patients in Kovalam have been grateful and are healing, and bring back more patients.  Our young assistant, Keerthana, is remarkable in her clinical skills and work ethic, and I am truly privileged in where I am.

Adaikalam has been good.  Last week's teaching session was on the thyroid.  The health care workers were interactive, curious and delightful - as usual.  Though poverty and other unforeseen sadnesses have limited study, the young ladies are coming along very nicely in the medical arena.

We Skyped with both boys last week and that was fabulous.  It was time to reconnect with the family.

I have to stop.

Unw -

R

    

Report of 4 Mar 2014

Good morning from Chennai!

Hope all are well.  We are fine and have experienced the joys of public transport in the city: our car has been in the repair shop.  I'd oriiginally thought our new flat was in the boonies, but the boonies are also well-connected.  We have joyously taken the bus and autorickshaws everywhere.  In peak hours, driving in Chennai is a challenge and I have loved not having to.

Work has been wonderful.  Mind-blowingly busy in Kovalam.  Yesterday saw an unceasing flow of patients; many - especially older patients - come to socialise at the B, as interaction is minimal in their homes.  Child-in-law tension, etc.  One of the much older patients asked us (in a chat a couple of weeks ago) if we had eaten; she then hastened home to bring us 2 chappatis (similar to wheat tortillas) and a tasty chutney.  I had an upset stomach that day and was not eating much, but absolutely could not say no to this expression of unbridled affection.  So, Keerthana, our young assistant, and I ate; we asked the patient to join us and she had a teeny piece.  It was a very companionable moment.  Those who have little tend to share.

Yesterday, an older patient - new to us - came in having clonged her head on something.  The bleeding did not stop, Keerthana checked her blood pressure and saw it was over 200/120.  Yikes.  This lady likely had undiagnosed high blood pressure, or had given up her meds.  We told the family she needed to be seen at the hospital, and the family said - rather blithely - "Just give her a few meds for her BP, and we'll take her home."  My sons know this expression of mine well: my eyes harden, the tone of voice steels and my temper comes flying to the fore.  I said again that the lady needed to be seen in the Emergency Room and asked that the relatives not mess around.  Our able community workers came in to the room to try and make the family understand.

Older patients are often treated like chattel.  Bugs me.  What happened to our famed respect for the elders?

We saw a couple of movies and unexpectedly enjoyed "Dallas Buyers Club."  Aids is a sexy topic and I had thought Mr. McConaughey would win his Oscar.  The best scene for me in the film was when the 2 gentlemen - a gay couple, I think - offered MM the use of the house and offered to help.  So lovely, so powerfully emblematic of the U.S. mindset.  I get few such offers here, when folks find out what we do.  Life in India is so challenging, and poverty so omnipresent, that the mindset gets overwhelmed by other things.

I hear from our sons and they are well.  It is wonderful to be in touch with family.  I am especially happy that our sons make us proud daily - with their choices, their intellect, their treatment of others.

Unw -

R