Happy 25th Birthday to Me

Happy 25th birthday to me! Thank you all for your calls, cards, e-cards (sorry I couldn't open them, the computers are outdated here) and emails! Yesterday I tried to post this blog and the internet went out for "10-30 minutes" which in India time means it may not come back for hours so I lost everything I typed and probably won't be able to look at emails until this weekend or week after next...I will try to keep up with my blog though. Next week I won't have any Internet access FYI...onto my blog:

We started the morning with Dr. Joshi in the ICU on his rounds. The way he distributed medications consisted of taking pills out of plastic boxes sitting, unlocked, at the nurse's station and giving them to the patient. We saw a patient in the ICU who had an MI (heart attack) the day before. I asked Dr. Joshi if they had a cath lab, he responded, "Only in Delhi" (a 10 hour bus ride away).

In spite of Dr. Joshi's heavy patient load, he took the time to go through how he treats the hypertensive patient. He explained the different classes of anti hypertensive medications and when they could be used, the side effects, etc. At the end of the day he let me do an echo! Obviously with his help, but still I got to hold the probe and do it myself.

Dr. Gandhi was in a much more talkative mood today. We spent over an hour with him talking about his childhood, medical school and the evolution of his clinic. He grew up in a one room house with 5 siblings and his parents. He told us how he preferred life on the street to reading and doing his school work and therefore received low marks in school. As the eldest child his father was upset about his poor academic performance so he asked him what he was planning to do with his life if he continued on this path. Dr. Gandhi answered that he would probably wait tables in the morning and evening so that he could nap during the day and make enough money to make ends meet. The next morning he woke up to a vegetable cart outside of his front door. His father asked him if he wanted to sell vegetables instead of going to school. Dr. Gandhi, eager to be allowed to miss school said yes. This infuriated his father and he proceeded to beat him up. When Dr. Gandhi started to run down the street his father threw a pair of scissors at him and punctured his lung. When they arrived at the hospital his father was crying and said he was upset that he was throwing his life away. At this point point he took a step back to evaluate why his father was acting this way and decided to give school a try. He improved so much in school that his teachers thought he was cheating! He then decided to go to medical school. The school he applied to had 1.5 million applicants and 110 seats. He started the clinic/hospital he runs six years ago. At the time it consisted of a single exam room where he did everything and also where he slept at night on newspapers on the floor. Today he has a staff of more than 15 people, 16 in-patient beds and he is planning on opening an Operating Room and Echo room in the next week.

Dr. Gandhi said his secret to practicing successful medicine is ABC: Availability, Behavior and Competence (in order of importance A being most important). He gives all of his patients his cell phone number so they can call him anytime of the day or night. He told us this is half the battle of providing good care. According to him, most of the time a patient just wants to be listened to so if you are available and your behavior reflects active listening they will feel better. He said often times when a patient comes to him for a second opinion he does not change their plan of treatment he merely reassures them to give the medication or lifestyle changes time to work. Lastly, Dr. Gandhi emphasized that your gut is better as a diagnostic tool than your brain so competence is not the most important aspect of practicing medicine.

We asked him how his wife felt about his hours. He said she comes to the clinic for a few hours in the afternoon and then they have dinner together (around 1:30-2:00AM). His marriage, like 99% of marriages in India was arranged. He said most of the time these work out not only due to a bit of luck, but also because of a little patience on the part of both the husband and wife. Perhaps this is the way to go...just kidding.

On to the birthday celebration...Jen bought a cake, Indian sweets, heart-shaped balloons and a Dora the Explorer hat (with the help of J.P. and Leigh) to mark the occasion. An uncle (Shylender) was visiting from Delhi and he apparently LOVES birthdays, in his own words, "365 days is too long in between birthdays, I wish it were more like 165 or even 125 days!" He speaks very good English and has two children who attend college in the US. The party started with the singing of the Indian Birthday Song which consisted of singing and blowing out one candle and cutting the cake. Then a piece of cake was cut off by Uncle Shylender which he proceeded to feed to me, then I had to feed a piece to a friend (Jen). More singing ensued and then more feeding people cake and then the last candle was blown out. My Mom and Dad, who called in the middle of all of this celebrating, can attest to the joyousness of the occasion as I could barely here them on my phone.

After the cake was eaten and sweets were tried, Uncle Shylender insisted we "get the party started! We must have more Whiskey and beer!" He insisted we start dancing and then asked us if we wanted to listen to a CD had in his car of "90s hits from USA". We agreed, but did not realize this involved going outside to his car to listen to the CD...He proceeded to turn on his stereo as high as the volume would go (this is at around 11pm) and shouted: "Dance party, dance party on the car!" I thought Mrs. Metha was going to have a heart attack. We convinced him to bring the music inside after Leigh showed him how to eject the CDs. These CD's consisted of a three disc set by the name of "College Hits" which had a color photo of a pint of beer on the front and included songs like Karma Chameleon, Crazy Little Thing Called Love...

When we got back inside the dining room table had to be moved to make way for a dance floor which then moved to dancing on the chairs: "Don't worry! If we break the chairs we will buy a new set! We must have a dance party!" Mr. and Mrs. Metha joined in on the dancing and I even convinced their son to dance with me for a few seconds. Uncle Shylender then wanted everyone to dance on top of the table, but was appeased with only me getting on it for a minute. It was really a memorable birthday.

Jen, Leigh and J.P. all agreed that they were glad it was my birthday so they could witness such a celebration.