Chillin'

So, the last few days in Mumbai have been pretty relaxed. Most of us decided that since it's the last week, we needn't spend our time sitting around in clinic. Therefore, we've basically just been hanging out and relaxing (as much as you can realistically do that in this city). Umm, let's see...the other day, I don't remember which, we went to the Crossroads bookstore in South Mumbai and hung out there for a while. Nothing all that exciting.

On Wednesday, we went to see a Bollywood movie called Krrish. Basically this was the weirdest movie I've ever seen, but it was actually really fun. I couldn't figure out what was going on, and Jesse kept elbowing us and telling us to look at the main character's freakish accessory thumb. I think he was some sort of superhero who got his powers from aliens or something, and the whole time he was sort of courting this REALLY hot girl. Apart from that I have no idea what the movie was about. Every once in a while they'd speak little bursts of English, but definitely not enough to clue me in to what was going on. Oh well, it was a great experience, I can now say I've seen a Bollywood movie!

Yesterday was another chill day. We hung around Bandra for a while, and at 3:00 we went over to the home of Dr. Mahendra Chinai, who is the father of a friend of Mom's. He couldn't have been nicer, and his house was very nice. It was built in the 1930's by a British architect. Incredibly, Dr. Chinai has lived in that house his whole life. He was very hospitable, and we hung out there for a while drinking chai and discussing India and America. I've put up a pic of Dr. Chinai and me relaxing on his swing.

Afterwards, we went down to a restaurant called Khyber in south Mumbai, which is known as the best restaurant in India. The food was actually pretty phenomenal, especially the chicken Tikka Masala. The decor was really cool, too, and we all really enjoyed it. It was kind of crazy since we had 25 people, and they were probably really tired of us by the time dinner ended, but whatever, I guess we're just perpetuating the image of loud, obnoxious Americans. The craziest part was that Jesse was feeling sick, so he took a cab back to our guesthouse, and we basically all thought that he was done for the night. As it turned out, he's a trooper, and he pulled the classic "boot 'n rally". Right after getting back to the guesthouse, he booted, and then he turned right back around in a cab to South Mumbai to finish the night of partying with us! Very commendable.

After dinner we went to Insomnia, which is the dance club inside the Taj hotel. It was really fun, and we were basically the only ones there. We danced quite a bit, and the DJ was playing a lot of 90's rap and hip hop, which made for a fun dancing environment. Everyone was well served as far as alcohol is concerned, and we finally made it back to the dorm at around 2:30.

Today we're basically chillin, getting ready for our trip to Delhi tomorrow. We're taking our local coordinator, Sampada (who we call Sampadizzle) out for dinner tonight, and then we're off in the morning. Namaste!

Last week in Mumbai...

First of all, here's a pic of Jesse and me in the Ajanta caves. Good times!

So, I'm nearing the end of my Mumbai experience. We leave on Saturday morning at 6am for Delhi, and following that we'll be all over the place for 2 1/2 weeks, visiting Agra (the Taj Mahal), Jaipur, Shimla, and either Dharamsala, Manali, or Rishikesh. Mumbai has been a great experience, but I'm looking forward to moving on from here and checking out more of what India has to offer. I think I've done a pretty good job of taking advantage of the experience here, and I feel like it's been an amazing and eye-opening couple of weeks. Somehow over the last few weeks I've gotten quite used to the insanity of Mumbai. Jesse and I were discussing earlier that riding in a rickshaw doesn't even faze us anymore, whereas during the first few days we were constantly fearing for our lives. It's probably going to be a bit weird returning home, where you're not constantly being bombarded with noise, beggars, merchants, and the overwhelming smell of trash, car fumes, and shit. Yes, I know, I'm probably not the best candidate for the job of Bombay Tourism Director, but whatever, this is the reality. It's pretty crazy that people grow up here and know nothing else. I guess one of the things that this trip has already done for me has been to make me realize how lucky I really am to have been born in the US. Too bad we can't cheer for them in the World Cup anymore. Let's go Ghana, I guess!

Anyway, our clinical rotation during the last week is at V.N. Desai Hospital in the Santacruz neighborhood. Out of all the places we've been, this is definitely the most ghetto. It's a government hospital, and most of the patients that come in are from the slums...keep in mind that these are not slums like we have at home. These people basically live on the street, but there are so many of them that they're just big "homeless neighborhoods." Most of the homes are nothing more than a tarp over an area of concrete, sometimes with a tin roof, sometimes not. They're often situated right next to malarial swamps, and there are no real public health initiatives, etc. So this is the population that comes to V.N. Desai. Yesterday, Justin and I were in the orthopedics outpatient department, and after that we went on rounds with a few docs in the ortho ward. Many of the patients have bad fractures, etc., and they often get infected because of poor hygiene (and I also suspect that a lot of the infections are hospital-borne, since the place is pretty dirty). It was very cool, and the docs were nice. They pimped us a bit, and we basically know nothing, but that's ok, we're learning all the time. Last night we went to a community clinic near Andheri, which ended up being pretty good. The doctor saw about 20 patients while we were there, which was only about 2 hours. He would bring in 3 or 4 patients at a time, and he'd sort of treat them all simultaneously. Then they'd leave and 4 more would roll in. He was very good about teaching us, so we definitely learned a lot. We returned to V.N. Desai this morning, where we rotated through pediatrics. We got to go into the NICU, which was amazingly clean and full of expensive machines, etc., which is quite a contrast from the rest of the hospital. It was incredible to see such an impressive NICU in such an otherwise sketchy setting. Most of the patients that we saw in the peds outpatient clinic and on the wards had respiratory or GI problems, which are all very common here, especially during the monsoon.

So that basically brings us up to date....we are debating whether we'll go back to clinic tonight. We might watch the Brazil game instead. I think this afternoon we may go see a Bollywood film, as I think that's kind of a must-do in Mumbai. More fun times!

Caves, caves, and more caves

Hello again, loyal readers. Come sit on Grandpa's lap as he tells you a grand tale of a weekend of cave exploration.

On Friday afternoon, no more than 3 hours after arriving back in Mumbai from Virar, we hopped in a rickshaw and headed to the airport where we were magically whisked away to the mythical land of Aurangabad, about a 45 minute flight from Mumbai. We flew on Air Deccan, which we had heard is pretty sketchy, but it turned out to be ok. Upon landing in Aurangabad, we were picked up by a van from our hotel, and this was truly the most hilarious van I've ever been in. There were lights flashing in different colors (red, green, blue, etc.) on the ceiling, and the interior had upholstery that was straight from the 1960's, with tassels and the whole deal. Oh, I almost forgot, there's a bed in the back of the van....pretty hilarious. We called it the Shaggin' Wagon and/or the Mystery Machine, because we basically felt like we were out solving mysteries with Scooby Doo. It was great.

We arrived at hotel Shree Maya at about 6:30 or so, and I think we were all pleasantly surprised by the accomodation. The rooms had A/C and supposedly hot showers, plus we had a TV (although we later found out that it didn't get any channels, so it was basically just a box on the table with some dials). So we were happy. After getting settled and resigning myself to the fact that I'd be sleeping with Jesse for another 2 nights, we headed out to dinner at a place called Tandoor that was recommended by both the Lonely Planet and Rough Guides books. The food ended up being excellent, especially my Chicken Khorma...yummy. After dinner, we walked back to the hotel in the rain (yes, the monsoons have finally come), and we returned to find that all of the power was out. So, in the end, all that A/C that we were so excited about turned out to be elusive once again. I took a shower by candlelight, and we slept over the covers in a warm room full of non-circulating air. It really wasn't so bad, but I think it was probably responsible for the weird dreams that I had.

Anyway, we woke up at around 8am on Saturday, had a quick breakfast, and hopped in the Mystery Machine for our trip to the Ajanta Caves. The ride was about 2 hours long, but it was actually really cool to see the Indian countryside. We've been so confined to cities for most of the trip that it's really nice to see some rural places. So basically, I had my eyes glued to the windows while I listened to Pink Floyd and checked out the wilds of India. It was very cool. We arrived at Ajanta, and aside from the throng of annoying merchants trying to convince us to buy their rocks, it was really peaceful. We drove to a spot from which we could see all of the caves down below, and it was a beautiful sight. We walked down into the cavern, past some monkeys, and over the river in the gorge to the caves themselves. The Ajanta Caves have a really cool history. Basically they are from the 2nd century B.C., and there used to be a large community living there, including over 200 Buddhist monks and a bunch of laborers that completed the excavation. The crazy thing is that after the 8th century, the caves were abandoned, most likely because of the rise of Hinduism in the area. After that, no one even knew that the caves were there until they were rediscovered in the 19th century by some soldiers from the East India Trading Company. Hence, they're really well preserved because they've seen remarkably little traffic over the years. The caves were basically amazing to see, with all kinds of cool nooks and crannies, plus incredible amounts of Buddhist painting (mostly chipped away) and sculpture. There are 26 caves in total, and it's quite a sight to see. Needless to say, we enjoyed the day, but we were totally exhausted after it was over. We ended up having dinner and a beer at the hotel, and we fell asleep quite quickly. Thankfully, the electricity was on, and we had all the A/C we could handle.

This morning, we woke up around the same time, had breakfast, and once again boarded the Shaggin' Waggon, this time heading to the Ellora Caves. Unlike Ajanta, the Ellora Caves are not only Buddhist. The first 15 or so caves are Buddhist, but after that there are a number of Hindu caves, and finally there is a series of 4 or 5 Jain caves. I have to say, Ellora was even more magnificent than Ajanta. The setting was not quite as grand, but the caves were more spectacular, with more intricate carvings and more sculpture overall. Not to mention the fact that we got to see the relics of three religions in one place! We got some great pictures, and we hiked around quite a bit. I think the Hindu caves were my favorite today. When we got to the Jain caves, everyone was pretty exhausted, and I hiked up a small hill by myself. I found a small Jain cave that looked like the Water Temple from The Legend of Zelda (for all those reading who are over the age of 40, it's a video game). No one was there, and it was pretty secluded. I found a little perch inside the cave, and I just hung out and meditated for about 10-15 minutes. It was a much-appreciated few minutes of peace and quiet...I remember thinking that this must be how Superman feels in his Fortress of Solitude. It was very cool. That being said, by the end we were all pretty "caved out." Overall, it was awesome, but I'm all set on caves for at least the next 6 weeks, thank you very much.

The way back was once again a nice ride, and we stopped at some random place in Aurangabad that is known casually as the "Mini Taj Mahal." It was actually really cool, but we were crunched for time, so we only stayed about 5 minutes, got a look, and peace out. We then stopped at a silk goods factory, where we got to see this old Indian dude hand-weaving silk scarves and blankets. Pretty much everyone bought something, and then we were off to the airport. The flight was basically smooth, although the landing was as close to a plane crash as I ever hope I'll be. I'm alive and well, though! I'm now off to continue reading the Kite Runner (I finally started it, it's pretty good so far). This week is clinic at a hospital in the slums called V.N. Desai, and then we begin our North India travels on Saturday. I'll try to post some more pics soon, but the broadband internet cafe was closed tonight, so hopefully it'll open up soon. Peace!

A quick update and a clarification

Starting with the clarification...Some of the three of you that are reading this blog might be a bit confused about the fact that I've been writing about seeing all kinds of cool surgeries, procedures, etc., but at the same time I've written that I'm disappointed in the clinical side of this program. Here's why. Basically, before coming here, I was under the impression that I would be directly involved in patient care. The organization that has set up this program definitely made it sound like we would be playing an integral role in treating patients. I didn't know exactly what form that would take, but I was pretty certain that I was coming to India to help some people. Unfortunately, that hasn't really been the case. We've had great opportunities to go to some amazing hospitals, see some very cool things, and I've certainly learned a lot about healthcare in India. The problem is that my expectation of coming here to help treat patients turned out to be very far off from the reality. We're really just shadowing doctors here. It's more like medical tourism than medical outreach. Of course, what we are doing is certainly valuable, and I've taken a lot away from it. The problem is more that I don't feel like I've had the chance to give much back. So hopefully that explains a bit of my frustration. Check Jesse's blog for a more in-depth (and more eloquent) discussion of some of these issues.

Anyway...enough of that. Clinic in the last 2 days has been pretty cool. Right after leaving the internet cafe following my last post, Jesse and I returned back to the OB clinic and waited downstairs for the doctors to return. No one ended up coming down, and at about 5:05 someone came in and told us that the doctors were upstairs. We were guided into the labor room, and we quickly came to realize that we had just missed a live delivery by 3 minutes! As it turned out, Dr. Ashok had been calling downstairs, but of course we didn't pick up the phone in the clinic, so we missed it. Oh well. We did end up seeing the delivery of the placenta and the suturing of the episiotomy, which was very cool. I guess I'll have to keep waiting a bit for that first live delivery!

After that, Dr. Desai, who had returned from his farm, took us to his home, which is conveniently right next door. We had some pineapples and starfruits from his farm, and he spoke to us a bit about his philosophy and thoughts on medicine. As it turns out, he's a pretty amazing dude, and it was very cool to have the chance to get to know him. He speaks 8 languages, including Hindi, Maharati, Gujurati, Punjabi, English, Latin, and I guess two more that I can't remember. Dr. Desai talked to us for a long time about some of his ideas regarding wound healing and nature, and it was actually quite captivating. He has introduced some new techniques for surgeries, including a hysterectomy (removal of the uterus) that uses a 4 cm incision and a different type of episiotomy. Very cool.

This morning we went to Dr. Desai's clinic to watch a hysterectomy surgery, and he was very cool, describing what he was doing each step of the way. The patient was afflicted by adenomyosis, which Joel will know, and I guess the medical therapy had failed and she needed a hysterectomy. After the surgery, we went to Dr. Desai's for breakfast, and it was again very cool to chat with him. Unfortunately, we had to cut breakfast a bit short, though, because we needed to catch the train back to Mumbai. As expected, this was a pretty crazy train ride, and I actually think this was the most insane one we've been on so far. Every stop was like a mosh pit, and we kind of got pushed to the side of the car like cattle. I almost broke my arm a few times just trying to keep myself from getting crushed, but in the end we made it out ok.

In a little over an hour, we're headed to the Ellora Caves (I love being able to embed links in these posts, expect more of that), and we'll be there until Sunday. Should be good times! Namaste!

Hernias, babies, and heat, oh my!

After taking a few days off from writing, I can pretty much guarantee that this will be a long post. Proceed at your own risk...

For the past few days, we have been in the town of Virar, which is about an hour's train ride north of Mumbai. Basically, this is the "rural medicine" portion of the program (I might debate the use of the term "rural", but that's neither here nor there). We're staying at a local home, where the owners of the house, who are a couple of older ladies, are sleeping on the hard marble floors and giving us their own beds! The hospitality is wonderful, and they really are so sweet. They only speak a few words of English, and of course my Hindi could use more than a little work, so communication is a bit tough. Even so, it's all kindness and smiles, so we couldn't be happier. I'm sharing a (small) bed with Jesse, and there's no A/C, so it's a bit hot, but whatever...it's perfectly fine. One of the ladies who lives in the house cooks 3 meals a day for us, and the food is quite good. I've gotten used to the Indian cuisine, and my system is no longer bothered at all after eating it. In fact, there have been WAY fewer GI issues than I expected before coming here...it's been pretty easy.

On Monday evening, we started our shadowing at Shushrusha Hospital, which is about a 10 minute walk from where we're staying. The head doctor is a guy named Dr. Patil, who is a pediatric surgeon and a very cool dude. He's extremely busy, though, so he isn't able to give us that much time, and we pretty much ended up hanging out with the residents. I can't remember their names, but there are 2 of them, and they're both really nice. Basically we stuck with them on Monday night and Tuesday morning in the outpatient clinics, and we got to observe some real life medicine in action, mainly stuff like abscesses and minor trauma. It was a lot of sitting around, and we really didn't do much, but the guys were nice, so it was ok. On Tuesday, after the outpatient stuff was done, we got the opportunity to observe some of Dr. Patil's surgeries, which were quite cool. He performed 2 pediatric inguinal hernia surgeries (which I quite enjoyed, since I had the same operation done when I was 5 years old), a lymph node biopsy, a cosmetic mole removal, and an adult hernia. It was a good experience getting to see all of that, and it's also interesting to note the differences between Indian and American OR procedures. For one, everyone's wearing open-toed shoes. I'm pretty sure that wouldn't happen in the US. Two, while it seems perfectly clean, they are definitely not nearly as obsessed with sterility here. The surgeon puts on his own gloves, and the scrub nurses aren't the same whip-cracking maniacs that they are in the United States. That being said, it seems that all the surgical techniques that are used are totally up to date (although what do I know, I'm not a surgeon). Overall, it was quite impressive.

Tuesday night was quite boring, with really nothing to do except sit around and wait for patients. There were none. Yesterday morning (Wednesday), we returned to clinic with pretty low expectations, and although we had a lot of sitting around, we did see some cool stuff. There was one child who was only 15 days old and had an embryological abnormality known as imperforate anus with a rectourethral fistula (basically that means that the kid has no anus, and his rectum connects to his urethra, so the feces comes out of his penis). Obviously, that's a big problem, so at 2 days Dr. Patil had made an opening in his abdomen where the feces could come out of his sigmoid colon. It's going to be a few months before this kid will have the surgery to give him an anus. Pretty wild stuff, poor kid. We also cleaned out a few abscesses, etc., but that was pretty much the bulk of what we saw in clinic yesterday. Overall, again, mostly sitting around.

In the afternoon yesterday, Jesse and I went to the beach down the road in Arnala, which unfortunately leaves a lot to be desired. It's a pretty area, but the whole beach is covered in trash. Sanitation is obviously a huge problem here, and pretty much wherever we've been so far we've been totally surrounded by garbage. It's really a shame....hopefully it won't be that way up north in the Himalayas. Anyway, after our little stroll around town, we began our 2 day rotation at the obstetrics clinic of Dr. Desai in the town of Virar. Unfortunately, Dr. Desai is out of town, so we ended up spending all of our time with his second-in-command, a young doctor named Dr. Ashok. Over 4 hours, we only saw one patient, and that was for about 2 minutes. That being said, the patient visit was cool...it was a woman who's about a month into her pregnancy. Dr. Ashok showed us the ultrasound, and we were able to see the baby's heart beating (day 22), etc. Very cool. The rest of the time Dr. Ashok talked to us about everything under the sun (he's quite long-winded). Afterwards, we returned to the guesthouse, read our books, and went to bed. This morning was more of the same. No patients, and more lecture from Dr. Ashok. He's a great guy, but it's a bit frustrating to know that we've spent all this money to come on this program and we're spending most of our time sitting around. Oh well, I think there's something to be gained from every experience, and we're certainly not coming away totally empty-handed. Overall, everyone's a bit frustrated with the clinical experience here, including me, but whatever....there's not much we can do about it now, so we might as well try to take what we can from it.

This weekend, a bunch of us are heading to the Ellora Caves near Aurangabad, which is an overnight train ride from Mumbai. From what I've read, it's basically a huge version of Elephanta, with a bunch of cool Hindu, Buddhist, and Jain carvings in a series of caves. It should be really fun! After that, we only have 5 more days in Mumbai, and then we're off for our travels around the North. I can't wait to get up there, and I'm especially looking forward to visiting Shimla and hopefully Dharamsala in the Himalayas. It will be so nice to not be sweating all the time!

Anyway, despite my complaining about the clinical program, I hope no one gets the impression that I'm not enjoying myself. It has been a great trip so far, and I'm excited about what's to come. I've been learning a lot, and I'm really glad to be here. Check back soon for an update on Ellora!

Elephanta!

Yesterday was another fun day of Mumbai exploration. After a night of partying until 3am at a Mumbai dance club, we woke up late, shook the cobwebs from our heads, and headed down on the train to south Mumbai. Michael and I decided to spend the extra cash for first class tickets (78 rupees versus 7 rupees, a difference of about $1.50). We were told that the first class car was right next to the women's car, so we lined up right next to the girls and prepared to board. Unfortunately, when the train arrived, we found that we had been misinformed, and the first class car was nowhere to be found. After it became clear that we couldn't possibly find it in time, we jumped up into the 2nd class car, threw some elbows, and made it on safely. It ended up being as crowded, hot, and smelly as ever, and we basically ended up wasting our 71 rupees.

Nevertheless, we made it downtown, and we hopped a quick cab to the Gateway to India, where we caught the ferry across Mumbai Harbor to Elephanta Island, which is a really cool island that has a number of caves containing ancient Hindu carvings. The ferry ride was about 45 minutes long, and it was really peaceful and relaxed. When we arrived at the island, we walked for about 2km up a pathway on a hill lined with vendors selling souvenirs and a bunch of monkeys jumping around. I got a few great pics of the monkeys...the baby monkeys were the cutest ones, by far. At the top of the hill, the vendors disappeared, although there were still some weird Indian ladies that kept asking us to give them money to let us take their picture. Finally, though, once we paid our entry fee and entered the actual government park portion of the island, the vendors and annoying picture ladies couldn't talk to us anymore, and we had a pretty peaceful walk around the caves and the general area. The caves themselves were amazing. I always like the feeling of walking through places that are extremely ancient, especially those places that have some sort of religious significance, etc. I don't really know what these particular caves were used for, since a lot of the history of Elephanta isn't known, but there were all kinds of cool Hindu statues, etc. We also got to hike around the island for a while, which was really nice. Again, it was just great to get away from the craziness that is Mumbai.

More on this...as great as it is to be here in Mumbai, I think we're all kind of ready to get out of this city. The traffic, pollution, poverty, beggars/annoying people trying to sell you stuff on the street, and the basic rush and hassle of everything just kind of wears on you after a while. I really can't wait to get up to north India, especially the mountains, where it will be totally peaceful. This is not to say that I am not having a good experience here in Mumbai. It's a really cool experience, but like I said, the city just kind of wears you down, and it will be SOOOOO nice to have some peace and quiet.

On that note, we've been doing a bit of planning for the post-Mumbai portion of the trip, and we've come up with a tentative plan. Basically, we're going to spend a day in Delhi, a day in Agra (where the Taj Mahal is), 2 days in Jaipur (the capital of the state of Rajasthan, also known as the "Pink City"), and then we're going to take the Himalayan Queen train up to an old British hill station called Shimla. It's supposed to be beautiful, and we're planning on staying there for about a week to unwind. If the urge strikes us, we can also go from there to Dharamsala/McLeod Ganj, where the Dalai Lama lives. That would be a really cool experience, but we don't want to get too travel-crazy. I guess it will depend on how we feel.

As for the more immediate future, I think tonight we're going to find a theater and check out a Bollywood movie. I have no idea what to expect, but that's kind of the norm in this country! I'll be sure to include something on my next post on what it's like.

First of all, here's a pic from the radical neck dissection surgery that we scrubbed in for. As doctor-like as I appear in this pic, keep in mind that I was pretty baffled for most of the 4-hour procedure. It was an amazing surgery, though, and I was glad to get to see it.

Moving on...yesterday was a very cool day in Mumbai. We left clinic after an hour and a half in favor of spending the day in south Mumbai checking out all of the touristy sights. Also, we thought it would be a good idea to take the train, which ended up being quite an experience in itself. The trains in India are legendary, and taking the local is a real process. The trains are amazingly crowded, basically bursting at the seams. There are people hanging out of every car, and being on the inside you sort of have to get used to having your head right in some dude's smelly armpit. The idea of personal space is completely different here....scratch that, it just basically doesn't exist. People have no problem shoving you aside and getting right up next to you. It's just the way things work here. The craziest part of the train experience, though, is getting on and getting off. It's pretty much a free-for-all. The train only stops at each station for a very short period of time, so you damn well better push and shove as much as you can or you aren't getting on/off the train. I ended up getting popped in the head once, but I threw my share of elbows and made it on and off the train with no problem at all.

When we made it down to Churchgate, we walked around for about 30 minutes looking for the cricket stadium so that we could buy some cricket jerseys. Alas, we were unsuccessful, and we were baffled that no one could tell us where to go. Umm, excuse me, don't you live around here? We're looking for the cricket stadium, something tells me it's kind of big. No? It's really crazy that people here generally have no idea where they are. Cab drivers and rickshaw drivers invariably have no idea what we're talking about when we give them an address. Once again, are you not a cab driver? Isn't this your job??? We ultimately did find the cricket stadium, but we weren't able to find a place to buy jerseys. Oh well. We came to terms with the fact that our search was futile, and we consulted our guidebooks to find some cool places to check out in the area. We followed a "walking tour" that was suggested by Lonely Planet, and it ended up being pretty cool. There were a lot of cool buildings that were constructed by the British during the period of the Raj (this is apparently the name given to the British rule of India). I got a lot of great pictures...i'm up to over 220 pics on the trip. At a certain point on the walk, we stopped at a place called Reid and Taylor that makes custom suits, sportcoats, etc. I got fitted for a sportcoat made from very nice fabric, and I'm going in for the 2nd fitting tomorrow. The whole thing is going to cost me about $115. Beyond that, we went to a store called Fab India, where I got a few shirts, and I also picked up a very cool shirt at a place called the Bombay Store.

We also stopped at Bombay University, which was beautiful. We went into the library, which has an interesting mix of Gothic and Hindu architecture....apparently that's typical of the Raj buildings. In general, South Mumbai is really cool. The streets are wider, there isn't garbage everywhere, and the nasty smells are much less infrequent. It was very cool to get down there and experience some of the nicer things about Mumbai. We had dinner at a really nice place called Gaylord's (insert joke here), which was relatively fancy compared to the places we've been to so far. They even had white cloth tablecloths! Unbelievable. I had a REALLY spicy lamb dish, and they brought me yogurt to help with the spiciness of the dish. Surprisingly, it actually helped! The food here is actually really good, and still very few GI issues. (As a side note, I lost the bet to Jesse last week, but only by a day.)

A few more random observations...Yesterday in the hospital, I had an interesting conversation with some doctors about the proportion of males & females in Indian medical schools. Incredibly, the breakdown is about 50-50, which is a big change from even 10 years ago. It sounds like women are beginning to take their place in Indian society. There are signs on rickshaws all around town that say "Women Empowerment," and opportunities for women in India are apparently growing quite a bit. The reason I bring this up is because I recently read a quote somewhere (I can't remember where) that made the observation that the degree to which women are empowered in a society provides a very good idea of that society's potential for prosperity. I think this is a pretty astute observation, and I'm encouraged by what I've learned about the changing role of women in India's society.

Another random thing....today we had a meeting with one of our program coordinators in which she taught us a bit about Hinduism. I'm not going to go into what she talked about, just basically that it was very cool and I'm interested in learning more. Maybe more on this later. Namaste!

Can it be true? Real clinical exposure!!

So, just as I was starting to get a bit frustrated with the pre-med style of our clinical program, BSES hospital came in and saved the day! We arrived at BSES Hospital in Andheri (a Mumbai neighborhood near Juhu beach, yes I know you all know exactly where that is) yesterday morning. We first met with the director, Dr. Ashok Mehta, who is also a cancer surgeon. After introducing himself and asking us a bit about ourselves, Dr. Mehta proceeded to describe the hospital to us, and I'm not quite sure any of us really expected to hear exactly what he said. As he explained, BSES Hospital is run by a group called the Brahma Kumaris, and their overall aim is to provide healthcare in a setting that is based on a core set of values, including positivity, cooperativity, compassion, etc. It's a truly cool way to approach healthcare, and after hearing him speak about it, I'm quite sure that we could use more of this kind of thinking in the states. Apparently every single person that works in the hospital, from the surgeons to the janitors, go through a week long training in which they examine and meditate on a different value each day. We were given the opportunity yesterday to participate in an abbreviated module on positivity, and it was very cool. Even this short 30-45 minute exercise was very helpful, and it made me think quite a bit about how I approach the world. I would love to start meditation regularly....maybe I can go meet some crazy guru up in the Himalayas who can teach me the ways. That would rule...

Anyway, after the meditation and a tour of the hospital, we kind of just wandered around, and there wasn't much to do. I did get the chance to go into the NICU, though, and that was pretty amazing. There was a pair of twins who were born prematurely, and each one of them only weighed 1.5 kilos a piece (for those of you counting at home, that's about 3.3 pounds). They were TINY. I found out today that they were transferred to another hospital that is better equipped to take care of them, so hopefully they're ok.

I have to admit, I woke up this morning a bit discouraged, because even though I got to go to the NICU yesterday, most of the afternoon was spent wandering aimlessly. Luckily, that all changed today. I started the day in the peds outpatient clinic, which ended up being very educational. We saw another premature baby, and this one had come even earlier. At birth the baby had been 900 grams, and now it was 2 months old and was 1.8 kilos. Once again, this baby was SO small. Another girl came in with respiratory symptoms, and it turned out that her PPD reading was 28 mm. Turned out it was latent TB (chest x-ray was negative), but the doc prescribed medicine anyway because any sort of immunosuppression, from measles, for example, would send her into full blown TB disease. We got the chance to talk to the pediatrician quite a bit about children's health in India, which was really interesting.

Afterwards, we had lunch (I had a Dosa Masala, a kind of weird crepe with potatoes inside), and it was quite tasty. We then headed up to the operation theater, and we were invited to watch a trans-urethral resection of a bladder tumor. Basically, the doctor stuck a camera/cauterizer through the tip of the man's penis, up the urethra, and into the bladder. The whole thing was done on the TV screen, and it was pretty amazing to watch him work. I have to admit, though, it made me cringe every time he put that thing inside the guy's John Thomas. The thing was WIDE! That can't feel good. Nonetheless, it was an impressive procedure, and the doc was very cool about explaining what he was doing.

After that surgery, we took about a 10 minute rest for tea, and we scrubbed in for a surgery with Dr. Mehta. This one turned out to be a radical neck dissection, along with a laser hemiglossectomy for a patient with stomach and neck cancer. For all of you non-docs (read: everyone except Becca and Joel), this basically meant that Dr. Mehta removed an entire side of the patient's neck, sparing only the major nerves and vessels (vagus, phrenic, CN XI, carotid arteries), followed by using a laser to remove half of the patient's tongue. The whole procedure took about 4 hours, but it was pretty captivating to watch. He kept coming SO close to the crucial nerves/vessels, but he totally avoided them....unbelievable! Becca, that's going to be you one day, you bad ass! Anyway, it was really cool. One interesting side note was that Dr. Mehta kept encouraging us to take pictures (I guess there's no HIPAA in India), so I have a bunch of really cool surgery shots.

So, overall, today was pretty bad ass. I was really impressed by the docs, and I was also quite amazed by the technology that they are using. Isn't this supposed to be a third world country? I guess only in certain places.

Ok, so I guess I've written another LONG ass post, so I'm off to get some sleep. GO MAVS!!

Pics!

Ok, I'm finally at an internet cafe that has broadband, so I can upload some pics. Enjoy!

Here's a dude that I bought some mangoes from at the Kalina market in Mumbai...they were only 20 rupees (less than 50 cents) for a kilogram!

This is Jesse and me at a restaurant called Souza Lobo last night in Goa. Good food, but I think the girls got sick from their seafood.

This is the first evening in Goa, right around sunset. It's a pretty relaxed place, and as you can see I was pretty happy to be there!

Here's the group in Goa at Mambo's, where we proceeded to get quite hammered. Good times!

Karaoke and sunshine

First of all, I guess I should give a synopsis of the night of karaoke with Dr. Apte. Basically, after clinic, Dr. Apte invited Sarah and me over to his place for a drink, and then we rode with him in his car to the Irish Pub in Bandra. About 30 minutes after we arrived, the rest of our American crew showed up, and we had a great time hanging out, drinking beers, and smoking hookah. After a bit, Dr. Apte got up to the karaoke machine (the guy is a maniac) and sang Hotel California, all the while passing the microphone around to all of the Americans. I made the mistake of picking Bohemian Rhapsody, which ended up being the most difficult karaoke song of all time. Basically, as predicted, I made a total ass of myself in the karaoke bar....Hmm, I wonder why people around the world think Americans are buffoons. Not sure I helped our case any that night, but oh well! Anyway, the funniest part of the night was that once the night wound down, Dr. Apte left and stiffed us with the bill! Some people in our group have chosen to believe that he paid, and we just got double billed, but I think he stiffed us. Not a big deal, but kind of hilarious!

The next day (Friday) began with a very chill morning. We had told Sampada, our group leader, that we wouldn't be in clinic, so basically we just hung out and walked around. I got 3 mangos for 20 rupees, which is less than 50 cents. I also learned how to eat mangoes the Indian way (you kind of mash it up inside, make a hole in the end of the mango, and suck all the tastiness out). In the afternoon, we headed to the airport for our flight to Goa. Everything was smooth at the airport, and we boarded our plane on Kingfisher Airlines, which is basically the nicest airline I've ever been on, even if you didn't count the hot flight attendants. The whole plane smells like a spa since they pump in fresh scents throughout the flight. Also, even though it was only an hour flight, we got a meal, and it was quite good. Overall, the flight was a cool experience.

Moving on to Goa....this place is quite cool. It's basically the exact opposite of Mumbai, with as chilled-out a feel as you'll find anywhere on earth. Our hotel is nice, with all the amenities that we care about, including TV and A/C. We have cold showers, but that comes with the territory. Anyway, we're situated right on the beach, and it's really beautiful. Also, even though we're in the middle of monsoon season, we've had nothing but clear skies and sun. It's really quite cool. Anyway, after arriving on Friday, we basically chilled by the beach and drank Kingfisher beers for a few hours before strolling down the beach to check out the area. As it turned out, we're only a 10 minute walk from the town of Calangute, which is a chill little place with a bunch of streetside vendors and restaurants. Most of the shops close for monsoon season, however, so pretty much nothing is open. After a very relaxed afternoon, we had dinner at the hotel and then went out to a bar/dance club called Mango's which is a 10 minute walk down the beach in the other direction. It was a really fun time, and after many beers and a few tequila shots, we were pretty wasted. As I recall, we hung out on the beach for a while, and we finally got back to the hotel around 3am. Of course, in our drunkenness, it didn't make sense to go to sleep until we'd been in the pool, so we jumped in and splashed around for a while, finally getting to bed around 3:45.


Yesterday afternoon was pretty chill (I'm not writing about the morning because we slept through it). We walked through town, and the rest of the dudes got mopeds. I opted out of the moped thing, as I'm totally terrified of two-wheeled motorized vehicles. Basically we checked out some of the shops in town, and I picked up a few little trinkets, etc. There are some really cool crafts and stuff here, and it's all pretty cheap. For example, today I got a really cool carved wooden box with a secret lock for 450 rupees, which is $10. The same thing in the states would probably be closer to $50. After cruising through town, we headed back to the hotel, and as it turned out, I made the right decision on the mopeds...one of the dudes on our trip had taken a fall, and even though he was perfectly fine, he twisted his ankle and got a little scraped up. That totally reinforced my fear of two-wheeled motorized vehicles. After we all got back, Jesse and I went up to the room, and we were lucky enough to catch a replay of game 1 of the NBA finals (GO MAVS!). It was great to watch Dirk and JET perform their magic, and I'm feeling really good about our chances in the series. When the game ended, we went downstairs, and we were lucky enough to get involved in an impromptu cricket match on the beach with some of the dudes that work at our hotel. It's actually a pretty cool game, although I definitely could use some practice. I'm not really good at cricket as much as I really just kind of suck. Hehe.

Moving on to dinner. Since a few of our more luxury-minded travel mates decided to stay at the Taj Holiday Village, which is a 5 star resort, we all went over there for dinner. The resort really is quite nice, and I could envision staying there on another trip if I ever return to Goa. The food was great, and I think only one person in our group didn't order the lobster. It was great to eat a nice meal, and we all really appreciated it since we've been going a bit more budget overall. After dinner, we returned to Mambo's, but we were all really tired and didn't party nearly as hard. I walked back on the beach with Frankie and Justin (two dudes on our trip), and we had another little adventure. As we were walking, a dog on the beach started barking and snarling at us. We moved a bit further from the dog, but all of a sudden he just took off running directly at us, snarling and barking the whole time. Justin yelled out, "This fucker's rabid!", and we all just took off, fight or flight, running as fast as we could away from the dog. I was able to run up the hotel stairs and get away, and Justin had to run into the ocean to avoid getting attacked. It was pretty insane, and totally a "fight or flight" situation (not really fight, just flight!). Luckily we all got away totally rabies-free!

Today has been very chill, just hanging out in town and relaxing. Unfortunately another girl on our trip fell off of her moped, and she got a little banged up too, but nothing too bad. Again, I'm quite glad I stayed away from the mopeds. They're so dangerous, I'll never get on one as long as I live. Right now we're about to go back to the hotel and probably just kick around the hackey sack on the beach. I could use a Kingfisher, too, so we'll probably do that.

Anyway, this has been the longest blog post ever, but a lot has happened. Sorry for being loquacious (I just really wanted to use that word). Peace!

I'm Ron Burgundy?

First of all, let me say that even though I am halfway across the world, I'm SO psyched that the Mavs are in the NBA Finals. Dirk is well on his way to the pantheon of the NBA greats. Plus he's a bona fide lock for the NBA All-Ugly team.

In other sports news, I've learned a lot about the Indian national sport of cricket, and it's actually a pretty cool game. It's a bit confusing at first, and it definitely has its quirks. For example, at some pre-determined time during the game that I can't figure out, everyone just stops playing and goes for tea. They then come back an hour or so later and finish the game. Weird, right? Apart from its idiosyncrasies, though, it's a pretty cool game, and we all want to find a place to play. Apart from that, the hackey sack skillz are still on the rise, and Jesse and I think we might even be decent by the end of the trip.

More fun stuff...this weekend we are going to Goa, which is a beach province about 100 miles south of Mumbai. It's a bit risky since the monsoon is coming, but the worst case scenario is that we sit around drinking beer in our hotel instead of on the beach. Goa is supposedly really nice, kind of like the Saint Tropez of India. If nothing else, it will be great to relax and get away from the mad rush that is Mumbai. Apparently Goa is also the one place in India where the majority of people are Christian, so it will be interesting to contrast that with the many religious affiliations that are seen in Mumbai.

Onto the medical stuff we've been doing. For the past 2 days, we've been at Savurdaya Hospital, which is a private (yet completely run down) hospital about 15 minutes away from us. Yesterday we walked through the TB ward and observed some patients. We didn't wear any masks or anything, so I'm quite sure that I'll seroconvert and not be able to drink for 9 months upon my return to the US. I seriously hope that doesn't happen, but if it does it's not the end of the world. Don't worry Mom, there's not much of a health risk, just that I'd have to be on meds for a while. After touring the TB ward, we went down to the HIV testing clinic and saw patients there for a bit. It was a good experience, and we got to learn quite a bit about the Indian health care system. I'm quiet impressed with health care here, as it is definitely more advanced and comprehensive than I expected. There are some huge public health issues, but in some ways access to care is better for the Indian poor than it is for the US poor. Probably more on this later...

Anyway, I'm off to clinic with Dr. Apte, and then I think I have to fulfill my promise that I will sing karaoke with him at a bar in Bandra. This has the potential to be quite a scene. Namaste!

More fun and adjustment

First of all, here's the pic of me with the kids who we played soccer with. Great times....onto the blog.

So after almost a week here in Bombay, I'm starting to feel like I've adjusted a bit to the culture. The first few days here felt like a whirlwind, but I'm not quite so overwhelmed now when I'm walking around, etc. It's nice to feel a bit more comfortable now, and even though I am as white and foreign as I have ever been, I don't feel like I'm sticking out quite as much (it's all in my head, of course I am sticking out like a sore thumb).

Anyway, since our last little blog-visit, a few things have happened. Yesterday afternoon I went to a community-based clinic where I'll be shadowing for the rest of the week. The doctor's name is Dr. Apte, and he is basically the coolest dude ever. He spent the first 20 minutes or so asking us about ourselves, what kind of doc we want to be, etc., and he made sure to ask about our interests. As it turns out, he's an avid cricket player, and he loves to sing. In fact, for better or for worse, I told him I would do karaoke with him on Thursday night, so who knows what that will amount to. This could cause a lot of international embarrasment for the United States. Let's just hope there are no cameras around, I don't want to be the next William Hung. Anyway, Dr. Apte's clinic was pretty obviously for wealthy people of Bombay, and it seemed to me that he was "family friends" or "cousins" with every other patient. He was a very warm doctor, and his patients obviously love him. A few interesting observations...1) Since money is a bit more scarce here, they don't rely quite as much on expensive tests to make a diagnosis. They tend to use more clinical diagnosis, and I was amazed by how quick his H & P went. 2) After the visit, which was usually about 5 minutes, the patients paid Dr. Apte directly, usually only a few hundred rupees, which comes out to about $5-10. Anyway, it was a cool experience, and I'm looking forward to heading back there in a few hours.

This morning we went back to the leprosy hospital, and we actually got to see some patients this time. As I said, there's not much of an inpatient unit because leprosy cases are generally manageable on an outpatient basis. The patients that we did see were staying at the hospital to take care of their foot ulcers. Many of them had some pretty significant deformities, which looked pretty horrible. We also saw one patient who was coming in for the first time, and she had the infectious (early) form of the disease. She had hypopigmented lesions all over her back, and I think she was starting to get some deformities as well. It's pretty crazy to see this disease, since it's something most American doctors never think about. I doubt I'll ever really see it again unless I'm traveling to 3rd world countries.

Beyond that, all is well. I'm enjoying the food, and I'm eating plenty. My diarrhea bet with Jesse is still going strong, both of us have been without problems. I think my system is adjusting to the food, so I might start getting a bit braver with the foods that I eat (within safe limits, of course, don't worry Mom). The Indian people are really nice and helpful, and I'm enjoying getting to learn a bit about the culture. I'm hoping to pick up a few phrases in Hindi, as it's turning out to be less English-friendly than I thought it would be. So, basically, all is well. Check back soon for more fun updates!

More Mumbai Fun

Well, as usual, a lot has happened since the last post. After our adventures in South Mumbai, we came back to the hotel, and Jesse and I just chilled downstairs, had some Tandoori Chicken, and smoked the hookah (see Jesse's note on this, yes, I know, it's smoking and it's bad, but it's also India, and it was a cool cultural experience). It was great to just hang out and chat for a while, as everything has been pretty fast paced so far. Relaxing and doing nothing has been a rare commodity, and it was definitely nice to relax and shoot the shit for a while. Again, to echo what Jesse said, he and I make a great travel pair, as neither of us gets too worked up about things, and we can hang out and get along pretty much stress-free. There are other great kids in the program, too, but sometimes people get a little too excited, and it's nice to have the chance to get away from all of the hustle and bustle.

Anyway, yesterday we moved to the university dorms, where we'll be staying until the end of the program here in Mumbai. The dorms are nice, although not quite as nice as the hotel we've been at. We have A/C, though, and we get breakfast, lunch, and dinner cooked for us. The food is good, and still no GI problems. The mattresses have the softness of a block of concrete, but whatever, at least we're not sleeping under a tarp on the shoulder of the highway. My roommate for the next few weeks is a guy named Marcus from North Carolina who seems like a very chill dude. So far so good with the living situation.

After coming over to the dorms yesterday, we had our orientation for the program. I'm in a group for clinical rotations with Jesse and 5 other dudes, along with a girl named Sarah who goes to med school in Ireland. Anyway, during orientation, we were waiting for the program director to come over to talk to our group, so we decided to go outside to kick around the hackey sack (thanks Lindsay, this thing rules!). No more than 2 minutes after starting to kick it around, about 15 kids descended upon us with their soccer ball. They were so excited to meet us, and they kept wanting high fives and asking us our names. Ultimately, we decided that we would play soccer with them, and it ended up being Jesse, Marcus, and me against the entire crew of kids. I think the kids won, although I don't remember. I ended up looking like an idiot because I was trying to dribble past a 5 year old kid, and I slipped and fell onto the concrete (yes, I got schooled by a 5 year old). All the kids were so sweet, asking me if I was ok, etc. Of course, I was fine, it was just a hilarious moment. I got some pics of us with the kids, which I'll post later when I have a better internet connection. This was definitely the most fun I've had on this trip so far.

After a chill night last night and a good night's sleep, I got up at about 7:30 today for breakfast before heading out to our first clinical rotation. We started out at Acworth Leprosy Hospital, where we arrived today at around 10:00. As it turns out, there aren't a whole lot of patients there anymore, and it's really more of a leprosy museum. It used to be a huge leper colony, but they've gotten a pretty good handle on the disease now, so they don't have a lot of inpatient treatment. We didn't see any patients today, just had a few lectures on health care in Mumbai and a bit of an introduction to leprosy. It was interesting, and it will be cool to go through these rotations. We were done around 1pm, and we came back for lunch at the dorm. I'm leaving in about 30 minutes to spend the early evening at a community-based clinic, which should be a little more hands-on and hopefully interesting too.

Anyway, that's basically it for now. Hopefully I'll be able to get to an internet cafe with a faster connection to upload some more pics, especially the ones of the kids we played soccer with. I hope all is well at home...Namaste!

I think I'm on another planet...

Whew! Back in the air conditioned, in-touch-with-the-world, internet cafe. It's been a wild ride so far, even since my last blog post. I feel like yesterday was my real introduction to India. We went down to the Gateway to India in south Mumbai, which is a landmark right in the middle of the tourist district. After checking that out for a while, we hung around the area, and it was basically an intense and amazing afternoon. After grabbing a bite of some kind of crappy Indian food, we walked around the area known as Colaba. Again, we stood out like sore thumbs, and after being approached to be extras in a Bollywood movie (we declined), the beggars were all over us. I bought some rice for a young woman carrying a baby (who knows if it was actually hers), but they really didn't let up on us. It was a difficult experience because I felt very sorry for them, but I obviously can't give money to every beggar. I'm a bit morally conflicted about how to deal with the beggars, and I really need to give more thought to the most compassionate and appropriate response.

Walking around Colaba, we saw some cool things, along with quite a bit of poverty. I don't think I'll ever forget walking down the sidewalk, only to look over and see a small toddler sleeping on the curb. There are some pretty arresting sights in Mumbai, and it's impossible not to be affected by it all. We constantly had children walking up to us and begging for money, and it's SO difficult to turn them away, but there are so many that you can't give money to them all. One child asked me for money, and when I refused, he got very angry and pulled up the leg of his shorts to reveal what appeared to be an infection of some sort on his thigh. It's hard to know how to react. Later, when we were driving in the cab, we saw people all over the streets, even living under tarps on the shoulders of the highway. It's weird, I've been told all my life how fortunate I am, but I'm only starting to realize that there is more to that statement than I ever understood. Again, I think it will take me a while to come to terms with what exactly my moral responsibility is in a world where I'm on the lucky end of such inequality. More on this later...

Another really crazy part of being here is that there are VERY few tourists. I expected to see a lot of Europeans and even some Americans walking around, but our group stood out like you wouldn't believe. On one occassion a group of Indian guys came up to us and asked us to take a picture with them. They wanted to shake all of our hands and meet all of us, just because we were Westerners. We're kind of celebrities down here just because we're American, which is weird.

After walking around Colaba for a while, we were exhausted, and we took cabs back to the hotel. It was only 5 miles, but it took an hour and a half, and I am pretty glad to be alive following the cab ride. The driving here is INSANE. Cutting people off is pretty much the norm, and no one even gets mad, they're just used to it. It's pretty wild. We drove through all kinds of neighborhoods on the way back, and it was unbelievable to me that every single street was packed with people walking all over the place. The population density is truly incredible.

That's it for now...i'm posting some pics, and I'll write more later. PEACE!

We're THERE

Well, we made it. We're finally here in Bombay. Here's the story so far.

The adventure began with the flight from ATL to Frankfurt. Jesse and I had originally booked seats near the front, but when we arrived we were told that they had changed planes, so we were stuck near the back, and we weren't even together. After a bit of haggling with the gate agents, they set us up with two seats together. Little did we know the deal wasn't as sweet as it sounded. We ended up in the last row of the plane, in the only two seats that didn't recline. Pretty rough for a 9 hour flight. What a way to start out the trip! It wasn't that bad, though. Jesse plowed through a 300 page book, and I got a little sleep and listened to Dane Cook (SOOOOO funny!). When we arrived in Frankfurt, we were quite glad to get off that plane.

In Frankfurt (where we were temporarily "Frankfurters"), we took the train into town to pass the time during our long layover. The lady at the train office told us to go 5 stops into town to the main station. After the first stop, though, the train sat still for quite some time, and we soon realized that everyone else on the train had gotten off. We looked outside, and we saw that we were at the end of the line. Apparently we had taken the express train, and we looked like idiots sitting on the train for 5 minutes after it arrived. Oops. In Frankfurt, we found a cool restaurant and had some really tasty sausage and stout German beer. Quite a good meal for our final send-off.

The flight on Air India was great. I was nervous about the food, but Jesse made fun of me sufficiently to make me eat it, and it was actually pretty good. I was really impressed with the airline.

Upon arrival in Bombay at 3:30am, we waited for about an hour and a half for our bags. We were met by a driver from our program, and we were taken to our hotel. The hotel is WAY better than I expected, although it's not quite the Taj (hehe). We have A/C, TV, and warm showers (sometimes). We're kind of in a slummy area, but I think we're finding that everything in Bombay is a slummy area. We tried to get some sleep, which was tough, but it was just nice to be at our final destination.

Yesterday we walked around near our hotel, and it was a pretty crazy experience. I don't really know how to describe India except to say that it's full of sensory overload. There are SO many people around, so much going on, cars going in every direction, little kids tugging at your shirt asking for money, etc. I'm quite culture shocked at the moment, but it will pass. It would be impossible to not be culture shocked here.

As for our bet, neither Jesse nor I have had diarrhea yet, but it's only a matter of time. We've been pretty careful with food and water, and I plan on being really vigilant throughout the trip. That being said, I don't think it's realistic to hope to avoid GI problems altogether.

Anyway, we're done here for now, so I'll update more later. Hopefully I can get some pictures up here soon as well, but that will have to wait for another time. Check Jesse's blog for some more stories and in-depth color commentary. Peace and love!