Report of 6 May 2021

Good afternoon!   The sun is shining on the sea, the view is clear and crisp, and we have partaken of a cold mango.  The best mangoes come out in the summer, and make up for the intense heat. We are home safely.  United left on time, and service was good.  The plane was almost empty.  Scott had filled out all the paperwork necessary to get us on the plane.  I had to render medical assistance on the flight.  The patient - my husband.  As I got up from a night's sleep, he stated that he did not feel well, had felt a pop in his left leg, got nauseated and could not bear weight on the leg.  The orthopedic exam is a challenge at the best of times - stabilize, pull, push (What do I pull?  What do I push?  Where's Google?) - and in an airplane seat, well, well.  But I managed; the knee joint seemed stable and when I mooshed, there was pain in his muscles.  I diagnosed a severe muscle spasm from all the heavy lifting + the lengthy drives.  Scott took Tylenol, I got out the ibuprofen - as we age, we travel with medication within reach - and hoped for the best.  I asked the flight attendant for a banana, wanting to replete Scott's electrolytes, and she gave me her personal fruit as the airline did not stock fruit.  Super kind and I did not want to take it, but she had 2.  Another flight attendant suggested tonic water, Scott had that and seemed mildly better.  I asked if I could look at the plane's stash of meds, and the flight attendants had to see my medical licence before they opened the kit.  They also consulted with a medical advisory service.  I looked at the meds, found some lidocaine solution and got excited about the cream; it turned out to be an oral solution and we did not want that yet.  3 of us - 2 flight attendants including the purser (chief attendant) and I - looked at the list of meds and then the kit with glasses on; it was quite a sight, as all us aging folks pored over the meds.  I decided we did not need any meds, and thanked the staff.  The purser (chief attendant) asked if we wanted a wheelchair in Mumbai airport and I said yes.   We got through the formalities in Mumbai with my husband in a wheelchair - quite novel.  Then we went to a transit hotel 2 floors below.  Very convenient and much more comfortable than 14 hours in an airport chair.  Scott - an avid yoga proponent - stretched and did some asanas, and we slept.  The next day, more ibuprofen, he could bear weight on the leg and we came to Chennai.  There was some excitement at the domestic flight with potentially overweight bags, but they saw that our baggage allowance was higher than the 50 pounds normally allowed, and did not charge us.   I went an-exercising this morning; the frangipani are blooming - pretty pink and more pink, the brilliantly red/orange gulmohur (flame of the forest) is not yet blossoming, and the sun came out fairly quickly.  I was in shorts - not de rigueur for me as I do not want to rock the boat in the homeland and stay with more conservative clothing.  However, as I age, I think the heck with it - got to be comfortable when exercising.  I did not take into account the intense heat or that my body had just got used to 50 degree temps in Muncie, and came down with some heat exhaustion.  Pukey, tired, etc.  So I am on our sofa, drinking vats of water.  A lovely sea breeze has emerged, we have all the doors open, and the ambient temperature has decreased.   We saw both our children before we left.  Nat came to Muncie and helped us clear out of our apartment, taking food that I was absolutely loath to throw.  We saw Naren in Newark; he also took food that we removed from our suitcases to try and make them wieldy; we handed over nuts and chocolate.  In addition to the unique joy that only children can bring, I was super grateful to not have to throw food and was happy the children helped. There are some very fine minds in India and many are hard at work to address the pandemic.  The owner of the clinic/small hospital that I sometimes see patients at has worked overtime, addressing desperate people calling for beds and doing all he can to accommodate every request.  Patients who get the diagnosis of COVID think they must be hospitalised: I have just fielded a message from my sister-in-law about a common friend who got the diagnosis, plus a CT scan by a specialist that shows some inflammation and "she must be hospitalised."  I have explained that if she does not have trouble breathing, she can be safely isolated at home and CT scans must not be used in diagnosis.  The situation here is chaotic.  Profiteering, private citizens hoarding oxygen cylinders, Remdesivir being hawked at high rates, the poor CEO of a vaccine company being hounded out of the country, vaccines not administered without a fee, ignorance of patients demanding oxygen.  This last part is the hardest - no amount of educating can convince well-breathing individuals not to get O2 when they view it as life-saving.  If patients are not given what they want, threats often ensue.  We are hopeful of some sense in this mess as we head in to the umpteenth lockdown today.  I look forward to contributing my mite as a physician.    Still a fine profession to be in - whether I am treating COVID or a severe muscle strain.   I will tell you this; as much as all of us brace for a time when the spouse might not be with us, nothing really prepares us.  In a different situation, a colleague's husband apparently stated that his entire world darkened; it was that way with Scott and his inability to bear weight on his leg.  After the initial THUD THUD of my pulse (What the heck happens now?  Is it his ACL?  How could that have happened?  An ortho exam???), I had to calm down ("Check your own pulse, doctor"), stay calm on the outside (and inside) and work through the steps - get the history, ask tons of questions, do a thorough exam.  And then, halleluia, wait for the meds and stretches to take effect.  I was lucky with this instance.  The sun is out today.   Along with the knowledge that there are, indeed, good people everywhere - flight attendants who will sacrifice their personal banana, a wheelchair attendant who had to pull one wheelchair and push another, a hotel employee who asked 2 travellers if breakfast was okay, children who will take all the food their parent clears out of the fridge/suitcase knowing how viscerally their mother hates to throw food, an assistant who has cleaned the house in Chennai and stocked the fridge with delicious food and some treats.  Folks such as yourselves, whom I consider privileged to know.   Stay safe and well. R ReplyForward