Report of 23 October 2015

Hello from our living room as I look at gathering rain clouds here and over the Bay of Bengal:

Rain is very nice when viewed from inside, where one is warm and dry.  One monsoon, 1 of the 2 founders of the Banyan, Vaishnavi, drove around to see which impoverished souls were marooned.  I got a call at our apartment about a person she had rescued, who likely had hepatitis; I could not go to work because of the rains but promised to check the patient when I next went.  Truly, it is an absolute joy to work for principled bosses - and these 2 are younger than I am.

We are safely in Chennai.  The flights were uneventful and I was fed very well - always a pre-requisite for a good flight.  Scott hates flying domestically in the U.S. - the service is apathetic if not downright snarly, the airlines consider a soft drink a meal and delays appear de rigueur.  Not so internationally: food is free on flights, but offerings are getting meager.  Breakfast on the Chicago-London leg was a bowl of fruit and a croissant, when I was hungry enough to eat a full English breakfast.  Or a horse.  I think the flight attendant saw my look of "still hungry" and asked if I would like a bagel.  I declined, and later ate full meals on the next flight.

Work was fine.  I had a patient who was a nun.  It is a tremendous privilege for me to care for people of God and this lady and I talked a bunch.  She had had a fall, but was admitted for low sodium.  I saw that she had brittle bones ("osteoporosis") and the xray did not show a fracture, but I was very suspicious of one and got an MRI - lo and behold, a fracture.  The orthopedic surgeon saw this patient but did not recommend surgery.  On another patient who was an IV drug user, I was told by the Emergency Room doctor that she thought the patient had an infection of a heart valve ("endocarditis"); I was sceptical.  As it turned out, the study of the patient's heart - an echocardiogram - showed that she did have endocarditis.  I had missed it.

Listen to the patient.  Listen to other doctors.  Listen.  Listen.

We spent some fine days in the U.S. before leaving.  We had lunch with colleague Tena Hedges, and that was fun.  We saw a movie or 2 - Tom Hanks's grand "The Bridge of Spies," featuring a fine stage actor well-loved by Naren, Mark Rylance - and attended the beautiful wedding of Melinda Taber.  Melinda's parents, Colleen and Mark, are long-time friends and perennial wonderful hosts, and our sons grew up with the gentle Melinda and her fun brother, Christopher.  We had a blast at the wedding, officiated by another friend, Carolyn Scanlan, and enjoyed seeing old friends Sofiya and Mikhail, and Shilpa and Ravi.  We spent Monday cleaning and throwing, and getting together with colleague Jaswanth and his warm, hospitable wife, Nikhila.  We managed to see the genial Olivia Fondoble before we left, and shopped at Trader Joe.  We stashed our stuff in the garage of other fine friends, Kris Rea and Gabe Soukup, and felt grateful for their friendship, as well as that of others in the U.S.  We were privileged to see my competent and fun colleague, Dhanashri, on the day we left, and we talked endlessly on various topics.  We said bye to gracious neighbor, Becky, and her entire family.  Navin treated us to breakfast at Rose-Hulman on the day of departure, and we talked and laughed.  We spoke to Naren on the phone and that was fun, also.
 
I felt a tremendous sense of gratitude for the presence of our intelligent, candid, opinionated and affectionate sons in our lives, particularly as I help take care of many women who do not have the same joy of contact with their offspring - for a variety of reasons: illness, estrangement, ignorance of whereabouts.

Let me wind up.  Hope all of you are well.

Unw -

R