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!
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!
posted by david.m.marcus at 2:52 AM
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