I finished up with Dharampur on Saturday. I am incredibly confused about my experience—it was a wonderful one, but not what I had expected. I think it is going to take me a little bit of distance until I am able to truly appreciate it for what it was. I learned a lot about health care, my perceptions of health care and medicine, and even discovered some of my own demons (health care demons that is). I inadvertently and shockingly realized that I didn’t exactly equally value all human lives (their access to health care) as I want to. At times I found myself thinking “why give them the medicine, they aren’t going to change their behavior anyway,” I also thought some other, more evil things, but I’m as shocked as you will be so I am not going to put it in the blog. Ask me and I will be happy to explain in person.
My last days in Dharampur I spent working on a reproductive health project. Daxa Auntie gave a lecture on reproductive health to Adolescent girls in 7th and 8th grade. I would follow up her lecture by showing them images and clips from The Miracle of Life (all of our favorite, funny how much I appreciate that movie as an Adult) and The Nine Month Miracle. The girls were incredibly responsive and really enjoyed watching real life fertilization and the different stages of the embryo. I asked them if the images were scary and they said no, they were happy to be able to learn so much. It was by far the most fulfilling thing I have done here so far, and I was happy to end on that note.
Achyuta came Saturday night and now we are getting all set for our one month Himalaya adventure. We have all our camping supplies all set to go. I tried out my sleeping bag this morning—it was glorious! Achyuta’s pack is as tall as me (slight exaggeration), I have no idea how he is going to carry it. I practiced cooking…once…hopefully that wont be a problem.
I am both nervous and excited and even scared! Altitude sickness might be a real problem, so I am trying to mentally prepare and tell my body to be good and acclimatize right away. We are flying to Leh, which is in Ladakh (near Tibet). We are going to do a few treks between Leh and Kargil. The plan is to do one 5 day trek and one 10 day trek. The rest of the time will be spent traveling, acclimatizing, and making our way to Srinagar, which is in Kashmir. We will keep Srinagar as our base and do several treks from there. I am a bit disappointed because I am not as physically fit as I would like to be for a trip like this—I have been rotting in the sun here. But, hopefully my youthful legs will serve me well for 30 days. Ok! So! We’re off! Pray that we have a healthy safe trip and that Ach and I don’t kill each other along the way (yes I am worried about that too)!
Sunday, July 15, 2007
Tuesday, July 10, 2007
Surgery!
My dad came on June 23rd and I met him at home in Ahmedabad. I had so much fun with him and my family, I extended my stay for a week. Total I was there for a little over two weeks shopping, hanging out with my cousins, AND shadowing my Uncle (Shrikant Mama) who is a plastic surgeon. This last Saturday he started me out by taking me to the public hospital burn ward. We saw one woman whose throat and neck was completely burnt. He told me that most of his burn patients are female and their burns are a result of attempted suicide. He added that most of the time they are socially driven to such extreme measures. For this case in particular, he agreed with me that it could have been abuse but he wasn't sure what the cause was. The next woman we saw had been completely burnt from head to toe. You couldn't even see her eyes! They had been sunken in (I think), and essentially, she had no face. The resident said that she suffered from Schizophrenia which accounted for her attempted suicide.
After the ward, I congratulated myself on being able to see all the open wounds and I knew I would be fine in the operation room. The first operation was trivial--a young girl who wanted a scar on her hand revised. I stood next to Shrikant Mama and watched as they prepped her hand and injected the local anesthetic. As I watched, I suddenly felt everything in my intestines shuffle about and my face went cold. I felt light headed and knew that I must be on the verge of fainting. I put a piece of candy in my mouth and try to play it cool. I was so embarrassed, how could the sight of an uncut, perfectly normal hand make me woozy when I had JUST seen terrifying sights? Shrikant mama caught me putting the candy in my mouth and ordered the nurse to take my pulse. It was normal but I was sweating. I sat down and luckily I was fine. The wave past and I coulnd't help but laugh at myself, as soon as he started cutting, I was fine. It must have been the anticipation.
Our next patient was a young man who had a severe motorcycle accident. He was in critical condition for months and now that he is more stable he was brought to Shrikant Mama for facial reconstruction--he had several fractures that had healed improperly. His teeth weren't meeting properly and he could not chew. The floor of his eye socket had shattered and Shrikant Mama would have to insert an artificial floor made of synthetic material or a bone graft. I stood for 4 hours of the 7 hour surgery. I was tired and not feeling well so I left for lunch. I missed the bone graft ut he showed me the fractures. Honestly, it was hard to tell. Everything looked like a big bloody mess to me (literally).
The next day our patient was a 16 year old girl who had been born with a uterus but no Vagina. Doctors suggested that the vagina be created when she reached puberty. Shhrikant Mama and a OBGYN performed that surgery a year ago but she was back with immense menstrual pain. They concluded that her cervix was not opening properly and thus holding in all the menstrual fluid. They would have to go in and widen her cervix. Shrikant mama said that the surgery should last no longer than 1 hour. But of course nothing goes as expected. When they opened her up they discovered that she had an odd shaped uterus. The next few hours went on with the doctors just trying to FIND her cervix. In the process the OB nicked her bladder so they had to call in an Urologist (turned out to be fine). We also called in another OB for advice. Seriously this was like watching a movie. Halfway through the surgery the anesthesiologist said that she was in cardiac arrest. Everyone panicked for a moment--cardiac arrest for such a simple surgery?! He then quickly revised his statement and said that she was merely in shock because of one of the drugs. 5 doctors and 4 hours later they decided that she didn't HAVE a cervix. At this point they concluded that she wouldn't be able to conceive and that they should save her the time and effort and just perform a hysterectomy. They went out to ask her family, but her father wasn't present and her mother wouldn't (couldn't) make the decision. Instead they had to create a cervix and they inserted a catheter that she would have to keep there for 6 months to make sure the passage doesn't close. What an experience. Hungry and tired Shrikant mama and I drove back home.
Now I am back in Dharampur and Ach comes on Saturday!! My medical adventures will be over and we will start our trekking adventure in Ladakh/Kashmir! More to come
After the ward, I congratulated myself on being able to see all the open wounds and I knew I would be fine in the operation room. The first operation was trivial--a young girl who wanted a scar on her hand revised. I stood next to Shrikant Mama and watched as they prepped her hand and injected the local anesthetic. As I watched, I suddenly felt everything in my intestines shuffle about and my face went cold. I felt light headed and knew that I must be on the verge of fainting. I put a piece of candy in my mouth and try to play it cool. I was so embarrassed, how could the sight of an uncut, perfectly normal hand make me woozy when I had JUST seen terrifying sights? Shrikant mama caught me putting the candy in my mouth and ordered the nurse to take my pulse. It was normal but I was sweating. I sat down and luckily I was fine. The wave past and I coulnd't help but laugh at myself, as soon as he started cutting, I was fine. It must have been the anticipation.
Our next patient was a young man who had a severe motorcycle accident. He was in critical condition for months and now that he is more stable he was brought to Shrikant Mama for facial reconstruction--he had several fractures that had healed improperly. His teeth weren't meeting properly and he could not chew. The floor of his eye socket had shattered and Shrikant Mama would have to insert an artificial floor made of synthetic material or a bone graft. I stood for 4 hours of the 7 hour surgery. I was tired and not feeling well so I left for lunch. I missed the bone graft ut he showed me the fractures. Honestly, it was hard to tell. Everything looked like a big bloody mess to me (literally).
The next day our patient was a 16 year old girl who had been born with a uterus but no Vagina. Doctors suggested that the vagina be created when she reached puberty. Shhrikant Mama and a OBGYN performed that surgery a year ago but she was back with immense menstrual pain. They concluded that her cervix was not opening properly and thus holding in all the menstrual fluid. They would have to go in and widen her cervix. Shrikant mama said that the surgery should last no longer than 1 hour. But of course nothing goes as expected. When they opened her up they discovered that she had an odd shaped uterus. The next few hours went on with the doctors just trying to FIND her cervix. In the process the OB nicked her bladder so they had to call in an Urologist (turned out to be fine). We also called in another OB for advice. Seriously this was like watching a movie. Halfway through the surgery the anesthesiologist said that she was in cardiac arrest. Everyone panicked for a moment--cardiac arrest for such a simple surgery?! He then quickly revised his statement and said that she was merely in shock because of one of the drugs. 5 doctors and 4 hours later they decided that she didn't HAVE a cervix. At this point they concluded that she wouldn't be able to conceive and that they should save her the time and effort and just perform a hysterectomy. They went out to ask her family, but her father wasn't present and her mother wouldn't (couldn't) make the decision. Instead they had to create a cervix and they inserted a catheter that she would have to keep there for 6 months to make sure the passage doesn't close. What an experience. Hungry and tired Shrikant mama and I drove back home.
Now I am back in Dharampur and Ach comes on Saturday!! My medical adventures will be over and we will start our trekking adventure in Ladakh/Kashmir! More to come
Sunday, July 8, 2007
Trains
Just a quick note on the colorful train system here. I think India is famous for having the most expansive national rail network (thank you Britain). Thus, much more than the US, the railway is heavily utilized by all classes of people. When I went to Baroda, I traveled second class and sat in the Ladies Car ( I figured only women would be less smelly). When I was waiting to get on, the woman who was waiting for me asked "you dont have a handkercheif?" I had no idea what she was talking about until an hour later.
Second class has open windows and no air conditioning. The seats are wooden. One side has single seats and the other side is long benches that can usually squeeze atleast 6 people. Since mine was the first stop, I got a seat easily. I sat on one of the single seats and prided myself on having picked the prime location. The first hour was comfortable and then suddenly the train started to get packed. There were MANY more people than seats and to my surprise, a woman sat down and shared my seat with me. Before I could protest, I realize that everyone was doing the same thing. As we approached Surat, one of the larget cities, people ran along side the train handing in handkercheifs. I just watched, because I had no idea what was going on, but apparently this is a well accepted system of "calling seats." When the train stopped, most of the crowd got off the train. As the car slowly emptied, people who had been given hankersheifs placed them on the benches. Then, when the arriving crowd boarded the train, they looked for their personal hanky and sat down. I was amazed that amidst all the chaos, this system worked flawlessly. Everyone honored the hanky-placements!
I haven't traveled in the 3rd class car yet. I actually should have tested that out, because I won't have a chance to now. 3rd class is reserved for the poorest passangers, whom, as you can imagine, are quite poor. I'll definately blog if I get to have that experience!
Second class has open windows and no air conditioning. The seats are wooden. One side has single seats and the other side is long benches that can usually squeeze atleast 6 people. Since mine was the first stop, I got a seat easily. I sat on one of the single seats and prided myself on having picked the prime location. The first hour was comfortable and then suddenly the train started to get packed. There were MANY more people than seats and to my surprise, a woman sat down and shared my seat with me. Before I could protest, I realize that everyone was doing the same thing. As we approached Surat, one of the larget cities, people ran along side the train handing in handkercheifs. I just watched, because I had no idea what was going on, but apparently this is a well accepted system of "calling seats." When the train stopped, most of the crowd got off the train. As the car slowly emptied, people who had been given hankersheifs placed them on the benches. Then, when the arriving crowd boarded the train, they looked for their personal hanky and sat down. I was amazed that amidst all the chaos, this system worked flawlessly. Everyone honored the hanky-placements!
I haven't traveled in the 3rd class car yet. I actually should have tested that out, because I won't have a chance to now. 3rd class is reserved for the poorest passangers, whom, as you can imagine, are quite poor. I'll definately blog if I get to have that experience!
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