Renu's Week

Sunday, October 22, 2017

Report of 22 Oct 2017

Good evening from our balcony!

The sea and sky are merging in color.  The Northeast Monsoon is here and the usual chaos of flooding, etc., is imminent, unfortunately.  Both Banyan facilities are low-lying and I will hope like the Dickens that I can get there.  Otherwise, the staff is mighty diligent about contacting me by phone and we manage.

Life is fine.  Big rain today and the road perpendicular to our apartment complex has several puddles.  I had wanted to swim in our complex's pool and my engineer husband once told me that wasn't a swell idea, to swim when there is rain.

Our patient with a diabetic foot ulcer is back from the hospital after she was operated on.  She is an intelligent person, knowing what is going on with her body, and updated me well.  Sometimes, our patients are sent home to their families and all good intentions abound; then, the issues of the patients not taking their meds, etc., come flying to the fore and the patients come flying back to us.  The medicines are mailed to the patients free of charge - as another blogger said, "The Banyan is for life" - but the meds are not going to do any good at all unless they are placed in the mouth and some water follows, the meds are swallowed.  Noncompliance had happened with our patient and I am happy that the foot is not worse; she came close to losing her toes, but thankfully did not.  She is now on insulin as I simply cannot waffle about with oral medicines. 

Kovalam is fine.  The residents (postgraduate doctors) from a Chennai hospital have stopped coming and I was solo last week; it was fine, really.  We have our share of noncompliance with community-dwelling patients, also, and I had to have the social workers drill some sense into these folks.  For some patients, the clinic visit is social hour; many with blood pressure issues - who only have to be monitored once a year - come very week!  They catch up with the others in the waiting area, fill us in on their family news, share tales; unfailingly, our staff treat all the patients with respect and I imagine the patients like that and want more of it, it being revolutionary to an impoverished, "scheduled caste" populace.  A couple of weeks ago, as we briefly left to have breakfast in our dining hall, one of the patients told me to tell the staff to give her breakfast, just as another patient had asked the previous week for milk.  We do not have the resources to feed all comers, regretfully.  For this reason, I like the breakfast to be ready before the patients start coming, so that eating is completed before those who can afford little come to the clinic

Private practice is also grand.  As I have mentioned before, a new breed of patient is the sexually active unmarried Indian.  One such came, pregnant.  MTP (medical termination of pregnancy) happened and there was a bit of a complication as a pregnancy was detected in the fallopian tube (an "ectopic pregnancy").  I listened to my OB/GYN colleague (and owner of the hospital) explain this condition to the patient and was riveted; it is always nice to listen to other specialists, especially competent ones.  The patient went to surgery and thankfully, is okay.  I always insist on seeing these folks, as I give a huge lesson/lecture on condom use.  [Interestingly, since I am ex-U.S., younger acquaintances seem to think I would condone all manner of sexual practices and freely admit pre-marital liaisons to me; I try not to moralise, but do insist on condom use.]  All of us are relieved the young lady is fine and I gave the number of the Banyan for counselling, as she professed family problems; I never like stories of estranged families and try quite hard to keep the peace.

18 October was Diwali, our festival of lights, the triumph of good over evil.  Scott and I got up early, hair wash, new clothes, prayed to my mother and then ate sweets all day.  We are to also exchange sweets with our neighbors and friends, but did not as we capitalised on our rare mid-week day off to simply eat and read and Skype with the boys.  Speaking of which, we spoke with them today, too; that was lovely - candor and humor and chatter. 

May your days also be filled with candor, humor and chatter.

Unw -



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