Final Days in Dehradun

A lot of stuff happens here—odd encounters, ways of doing things that both baffles and amazes us (as often occurs when one is traveling abroad). On our first auto rickshaw ride to Dr.Vaish’s for instance, we saw a completely naked man walking down the road Bay to Breakers Style. He was acting completely normal and so was everyone around him. It turns out, most of us on the program have “spotted” this local celeb throughout town so I guess this is just his daily uniform.

On this same auto rickshaw ride our driver stopped (more like a running stop) at what can only be described as one of those “water” stations set up during a marathon or charity walk where cups of liquid are handed off to participants as they run by. India-style this consisted of a huge caldron-like pot of bright pink liquid being scooped into plastic cups and handed to drivers and passengers in auto rickshaws and vikram. Let’s just say we passed on the jungle juice.

June 18^th, 2008

Today we got to see a delivery and an abortion. Talk about the “circle of life.” The abortion was actually an evacuation of the fetus in a woman who had a missed abortion (the fetus stopped growing after 22 weeks). Then later in the day we saw a delivery. The delivery was not too much different than what I saw in South Africa. So I wasn’t too shocked by the lack of anesthesia and the violent pushing on the mother’s stomach to get the baby out. I was (and I never thought I would say this) shocked at the lack of basic sanitation techniques including the fact that some people were not wearing shoes, the rest of us were wearing flip flops and only the doctor was wearing gloves. I guess that is pretty much the standard of care here.

After the birth the mother was given some IV pain medications while Dr. Gera finished suturing and then she was not able to see the baby until the sutures were done. When the baby was taken out to see the family no one seemed very happy (and it was a boy—law in India prohibits a couple knowing the sex of the child prior to birth). We told Mrs. Mehta this and she was shocked—she said there is probably some good story behind why they reacted that way.

Because we waited for the delivery, we missed clinic with Dr. Vaish. But in the meantime, some more background on him. He is probably one of the best teachers I have encountered here. He explains everything in a clear and concise manner and has incredible clinical judgment and skills. Not to mention, he loves PA’s! He had a PA work for him for six months and he said she was much better to have around than another MD. Woo hoo.

June 19^th, 2008

Stop the presses. Leigh and I saw the coolest surgery today at Dr. Vaish’s. First at Dr. Gera’s we saw a breast abscess being drained and then another delivery. Then we went to Dr. Vaish’s and saw a premature baby with gastroschisis, which means it was born (they delivered C-Section) with its intestines contained in a sack adjacent to the umbilical cord. The coolest part of the surgery, in which they cut open the baby’s abdomen, was watching the surgeon pull the intestines out of the sack and then like magic they were back where they were supposed to be. I know this seems like it would be straightforward when you think about it anatomically but seeing it in person is a whole other experience. It was one of the craziest, coolest things I have ever seen. There are not words to describe it. The best news is that the baby looked great after surgery and the surgeon says her prognosis is good. She will remain on a ventilator and a special diet but the surgeon said her body should adapt quickly.

After clinic we had a quick late lunch and then went to Dr. Gera’s to get taken to a music/religious gathering of sorts. It was held at a family home close to our home stay. It was really cool. For most of it, since it was in Hindi, I had no clue what they were saying but the music and dancing were beautiful. It was incredible how welcoming everyone was to us. I can’t imagine a group of people being so open to strangers in the U.S.

June 20^th, 2008

Last day in Dehradun. I am very thankful to be here but I still find myself counting down the days until I get home. I am still grappling with this awful cold and the lack of sanitation is still hard for me to take. I understand the system is up against an environment of limited resources but I don’t think it is too much to ask all the people assisting on a surgery to slap on a pair of gloves.

We had our final meeting as a group today at the coffee shop to reflect on our expectations and how they turned out. My expectations were to get as good of an experience out of this trip as I did in South Africa. These were not exactly met. Maybe it’s something about South Africa or has to do with the fact that my program in S.A. was very AIDS/HIV focused (which I have a great interest in), but I felt so much more in need/demand there. Here, limited resources or not, the doctors are able to see an insane number of patients and provide them with great care with an admirable ease. I think the biggest difference between India and South Africa and even India and the U.S. is the respect the people have for their physicians. They trust what they have to say. They typically have a great, positive attitude going into the visit and there is rarely a sense they will question your basic treatment plan. Perhaps this is because they have to pay at the time of service for the lab work they get done so they think twice about running a battery of tests as we often do in the US? I know this definitely has something to do with it, but it is more than that. The people here really try to respect the physician and they seem to have a much healthier relationship as a result.

This weekend I am heading to Amristar with Jen and Val to see the Golden Temple and the Pakistan border. It will be another whirlwind trip but I am sure it will be worth it. I am about to book my plane, etc for the end of my trip, when I will be going to Varanassi with Sarah (who is from Maine). Apparently it is known for its silk and I can get clothes made there very inexpensively. Email me your measurements if you want me to get something for you. Thank you for all the comments. If you want to post a comment just look at the bottom of an entry and click on the comments button.