Wednesday-Sunday

I just returned home to Dehradun from being away in Rishikesh for the weekend and of course forgot my notebook, but this is a brief catch-up of the happenings here in India:

Wednesday:
Today while reviewing EKGs with Dr. Joshi he noticed a piece of paper Dr. Gandhi had written on with drawings of ST elevations. He recognized Dr. Gandhi’s signature fountain ink pen writing and asked, “Did Dr. Gandhi give you that?” I think he was a little jealous so he proceeded to make us drawings throughout the day, ensuring we held on to them…duel away my friends, it is only to the benefit of Leigh and I!

At the end of the day, we saw quite a few echoes done. This time there was a baby with Down’s syndrome and a few patients with rheumatic heart disease (caused by a strep infection that can infect their heart muscle). One patient even did a non-pharmalogical, stress (or treadmill) echo. Leigh and I were quite confused after Dr. Joshi said a few words to the patient and the patient proceeded to jump off the exam table and briskly walk up and down the hall of the ICU for about 10 minutes. It took us five minutes to realize this was the Indian version of a treadmill echo. Just yet another example of “Green”, cost-cutting Indian healthcare.

Today is Leonard’s birthday. Yesterday a man told us that he wants “Anan Fam” (unsure of spelling) which in Hindi means “quick and easy death.” Leonard lived an incredible life and left this world as peacefully and beautifully as he entered it. Happy birthday, Leonard.

Thursday
One of the many differences between the US and India is the fact that, as I stated before, 99% of marriages are arranged. This really seems to make a difference in the management of healthcare in India. There is almost a calmness around a family conference involving a medically-complex patient, as if the people here are secure they will be taken care of. One of the best examples of this is the previously mentioned baby with Down’s syndrome: Her parents were almost proud of her, telling Leigh and I, “She is weak” and smiling. There is so much less stress about how a person will be cared for, perhaps in part due to the intricate family network. It is very humbling that a population of people who work so hard and endure beyond difficult living situations are so at ease with one another.

Friday
Today while waiting for Dr. Gandhi to finish up with a few patients in the ICU, Leigh, Valerie and I had a chance to sit down and talk with two of Dr. Gandhi’s patients who were also waiting for him. The husband and wife both spoke English very well and were eager to hear our thoughts on Obama and the differences in the healthcare systems of the US and India. They could not believe how much it cost for us to get lab work, x-rays done and were astonished by the monthly costs of our healthcare premiums. In India you can get a CT scan done for less than a $100. We were all joking that we should get a full body MRI just to see what it would show. They seemed indifferent about Obama and were more interested in our thoughts on the matter. Of course I am thrilled, but also skeptical of what November will hold. Here in India the concern seems to be more with the US’ trade relations with India so that this country can be more of a competitor to China.

Today we had our weekly meeting with the other 8 students who stayed in Dehradun this week. The reports from most people included their surprise at the lack of sanitation in India. Leigh and I have not had a chance to see any real procedures but we were surprised to note that we have never seen the doctor’s wash their hands in spite of the hundreds of sick people they come in contact with everyday. Others spoke of wearing flip flops in the exam room, the reuse of gloves or the overall lack of wearing gloves (including during a delivery of a baby) and rarely if ever seeing anyone wash their hands. This is definitely a difficult sight to see considering all of the patients we see who have conditions caused by exposure to infection, not to mention what stark contrast this stands with the somewhat obsessive practices of the US (which aren’t always that great either). That said, we are all here to see how a medical system can function in a large population with very limited resources. Perhaps this is one of the ways they are able to do it.

Saturday and Sunday
We left Saturday morning for Rishikesh and took a public bus, which cost less than $1 for a two hour bus ride. It was so crowded it was incredible. I can’t wait to put the photos online! There were 14 of us who went there so it was quite the crowd of white people. Rishikesh is more of a tourist town so there were more white people, but that didn’t seem to cut down on the number of stares or the amount of people asking to take their pictures with us.

We got to go river rafting down the Ganges River, some of the rapids were even class 4! It was so much fun! We all got out of the raft and body surfed down the river and jumped off a cliff. It was incredible. For dinner we were fairly sick of India food so we found a “Health Restaurant” where this man cooks all of the food and I had vegetable PIZZA (!!) and other people had home made spinach pasta with veggies. We went there again this morning and had buckwheat pancakes.

We got to attend a Hindi religious mass at 6:00pm where there were a ton of people because some prominent politician was in town. It was a huge crowd of people all pushing to take photos, but it was gorgeous to watch and hear everyone sing (even though we had no clue what they were singing about). In true American style (and my style) I completely embarrassed myself. People were passing around these gold three-tied plate things with a handle that had literally fire balls in them and people were sticking their hands in the fire to “purify” them. I touched the gold handle and before I knew it, it was handed to me. I didn’t know what to do so I tried to hand it off and in the meantime one of the balls fell out and this guy goes to pick it up and then stands up and knocks the gold thing and balls of flame go everywhere. Excellent. Always good to keep it low key and not stand out in a crowd. Right.


This morning we went on about a 3 hour hike to waterfalls in Rishikesh and it was so beautiful. For awhile we were the only ones there so we actually got to swim a bit and take off our t-shirts and be in our swim suit tops which felt so good. Women here do not wear shorts or tank tops, in fact there were women going rafting in their full sari outfits! So in 95 degree weather it gets old quickly wearing pants and t-shirts with sleeves.

Okay I have to sign off, but next week when I have internet I will write more. Today I am off to ThanGaon to work with Dr.Paul and trek to local villages to provide health care. We also have daily yoga at 6am. It will be a nice change from the fast past of Dehradun (and an escape from all the honking!).

Miss you all lots.