Report of 20 March 2016

Hello.

This has been a tough couple of days.  A beloved patient at the B - a fairly young lady, Ms. X - was hospitalised, took a turn for the worse, and abruptly died.  I saw her in the ICU, wanting to visit and find out what was happening; I was lucky to be one of the few to see her alive in her last days.  SMF Hospital gave their usual excellent care, but Ms. X deteriorated quickly.  I hoped against hope that her young body would fight the low blood pressure and the trouble breathing, but it was not to be.  Ms. X was mildly developmentally delayed; I have no idea of her family, but she was as happy as a clam at the Banyan and a firm favorite of all, with her easy manner and pithy observations on life.  My favorite memory of her - other than her unceasing geniality - is of her offering her guava to the lead health care worker, when fruit is still a rare treat at the B.  I wonder repeatedly if I could have done anything differently, though I was not at all involved in her initial care: that is the Banyan, for you - all of us take responsibility for those who have nothing.  But she has died.  The leader of Adaikalam posted a beautiful tribute, with a picture of Ms. X smiling, and that has comforted me.

Death.  For the young.  What a weird concept.  They ought to live their lives and only die when that is done.

We were en route to Madurai when we got the news.  We changed drivers immediately and I stayed quiet for almost the entire rest-of-the-6-hour journey; this does not happen often.  However, I had sort of seen the demise coming, though hoping for a different outcome; it was still wrenching to hear the news.

Madurai was nice, and soothing.  My father and I spoke of the event; it was nice to go over matters with another medical person.  We visited one older friend, but I did not want to do anything else at all, preferring to stay close to home and lick my wounds in solitude.

We are back from Madurai today; laundry has been done, newspapers have been read.  My father's cook sent some food with us and I don't have to mess with making dinner, etc.

I hope all of you have a good week.

Unw -

R 

Report of 11 March 2016

Hello from our balcony!

It is 6.27 PM, there is still a modicum of daylight, and the sea is visible.  I love the sight of water, especially a sea or lake.

Life has been good.  I have received my permanent registration, or licence to practice medicine in India.  It took 12 years and I have it now.  I am extremely excited about being part of the medical world here.

The Banyan has been wonderful.  I was late getting to our seaside village clinic on Monday as I had to be at the Tamil Nadu Medical Council for a meeting to get my registration.  I had told our Kovalam-living staff to notify all their neighbors that I'd arrive late and to come in the afternoon.  So, the patients were notified and some came in the afternoon.  Many are reeling from arthritis and I have been trying desperately to get a physiotherapist (or physical therapist) to come and treat our patients; let us see what emerges.  Last week, one patient who complained of body aches was getting beaten by a family member, which also happens; at this point, our able community workers take over and counsel the whole family.  The community workers, who live in Kovalam, are remarkable young women who speak eloquently about how to manage various diseases, and this is wonderful.

Scott has a part-time job as a college professor and enjoys it.  The students at his college were on strike earlier in the week protesting the high fees paid to sit again for exams in the courses a student fails.  Violence is quite the name of the game of student protests here; however, Scott said the students told college personnel to take cover, that the students were not targeting the personnel, just the management.  Windows were broken, cars were damaged.  

Women's Day was celebrated with grand gusto at the B.  It is nice to be in the midst of strong women - both patients and staff.

Unw -

R

Report of 4 March 2016

Hello from Chennai!

The sea and sky are fairly merging today.  There is a haze, I think due to the heat.  It is already pretty darn toasty in Chennai; April and May are the summer months, but we are heading there quickly.  I have a root canal awaiting finish, thus cannot swim today and miss it, though the body woke up exhausted from many pokes and prods and what looked like singed rods placed in the tooth cavity awaiting final touches.  Both dentists were very good, and I am grateful.  I rather like eating, and would like to save my teeth if at all possible.

We were at young Deepika's wedding last Saturday - what fun!  There were lots of people to see and talk to, and the lawn event was very relaxed and nice.  What do people gain from not getting along with family, eh, though of course some self-preservation is mandatory - I like to blithely ignore perceived insults and plough on in the name of geniality.  My Dad flew to Chennai, we picked him up, drove to Vellore, picked up my sister and then on to Bangalore where we stayed near my sister-in-law's place.  The day after the wedding, my nephew, Sudhir, took all of us out to lunch at a nice place with delicious food; my niece, Sanjana, joined us as well, taking a break from her studies.  It was a nice gathering.  Afterwards, my Dad felt Sudhir's heartbeat to see if it could stand the shock of the bill :).

My father came with me to Kovalam on Monday and saw some patients.  They are unfailingly happy to get some second and third opinions, though they are flatteringly comfortable with my care.  It was nice for my Dad to be there - once a doctor, always a doctor.  Scott dropped him at the airport while I continued to see patients.  My aunt, Indira, also visited Kovalam that day to see her friend, who is a resident at the Banyan.  Both ladies appear to have enjoyed the visit and even toodled down the road to get fruit juice of uncertain hygiene; thankfully, neither is worse for wear.

One of our patients at Kovalam came with inability to conceive (a baby).  We are to treat her blood pressure and her thyroid condition, and then the hospital where she was initially seen will address her fertility issues.  She is to get a medication (alpha methyl dopa) which is safe for pregnant women and could not find it at many pharmacies; one pharmacy substituted something that starts with "alfa" and is a vitamin.  Hoo my; we emphasised the importance of the correct medication, I assured the patient we would work together to address her issues and off she went.  Not having children is a huge issue here, and in fact, at many places.  I know I feel fortunate to have Naren and Navin in our lives.

We saw a couple of movies this week.  We are likely the only 2 people on the planet who did not enjoy "The Revenant."  Yeesh - it must have been a slow year for movies that Leo won for this thing.  I could not understand much of the initial dialogue.  We also saw "Carol" and enjoyed the fine, fine performances of 2 actresses who made us completely believe they were an older sophisticate and a younger salesgirl, falling in love.  I'd intended to see a couple of movies today, then root canal intervened.

Hope you have some fine times of your own.

Unw -

R