LWH

I thought a detailed entry of Lady Willingdon was in order so that those of you reading this can understand what goes on there and what exactly we as students are experiencing. 

First of all Lady Willingdon is a Christian based hospital located in a primarily Hindu area. In the mornings, before doing rounds in ICU, we attend devotion. Typically this is led by the head doctor and surgeon, Dr. Philip Alexander. He speaks a few inspirational words, someone may read a few verses from the bible, they sing a song in Hindi, and we have a closing prayer. Not everyone attends but many of the nurses do and whatever doctors are available to come as well. 

Throughout the hospital you’ll find biblical verses and images on the windows, walls, and doorways. It’s a very spiritual place to be, and for me at least, I find it quite calming and hopeful. When speaking with the doctors they have told me that they are doing God’s will and that he helps them in what they do and drives them to continue doing it. I really loved the picture inside of the operation theater that hangs on the door which depicts several surgeons working on a patient and Jesus stands behind them with his hand on their shoulders. 

Dr. Alexander is referred to as “Sir.” The staff and the patients admire him and his passionate work. He can be very rough at times, which to Americans is a bit intimidating to watch, but he works with such precision and confidence that he is able to do complex surgeries quickly and efficiently. It’s an amazing sight to see. 

I think there is a common misconception of the available resources, work ethic, and knowledge/skill of Indian hospitals and the staff. I must admit, I had several misconceptions before I arrived.  But these doctors do not make the money that ours do. They’re not about business and profit, they’re here for the patients and their faith. They take time out of the several hundred patients seen every day and multiple surgeries to be performed to explain to undergraduate students what they’re doing, how they are doing it, and why it needs to be done. I have learned so much about this culture, this hospital, Indian people, and myself from the staff of LWH. 

Yesterday I sat with Dr. Parvesh who, after every patient seen, stopped and explained to me what was discussed. He told me the patient’s history, let me read their records, told me what their symptoms were, and how they could be treated. We also looked at X-rays. He answered all of my questions, which I thought at times seemed so trivial. We talked for quite some time comparing the Indian school system to American school system, about why he became a doctor and the differences between the health systems here and back home. Apparently in 10th grade (age 14) you decide what field you are going to enter. Then your 11th and 12th grade years are spent preparing and testing for it. Right after 12th grade you enter medical school, if that is the direction you had chosen. Unlike America, once this decision is made, there is no changing it. The amazing realization after that conversation, was that as much as I learned from him, he may have learned something about our culture from me as well. 

I saw a women who had an induced abortion and many young boys suffering from tuberculosis complications. Through all of them he was calm and collected. And yet, he saw about 20 patients in the time that it would take me to be called out of the waiting room for an appointment at my family doctor’s office back home. 

Today we were called out of rounds to attend 3 surgeries. One on a young boy’s neck to remove a lymph node, a testicular biopsy, and a urethral blockage. Each procedure took less than 20 minutes, with 2 being performed simultaneously. These were much harder for me to watch than the major surgeries for some reason and I felt myself getting sick several times so I was in and out of the room. After the 2nd surgery, Dr. Alexander explained to us what he had done which was really wonderful since, at times, we were thinking “Oooohh my goodness WHY is he doing that?!” 

Tomorrow I’m finally meeting the dietician, who has been on leave for the past week. Hopefully she can offer some insight to my personal research. It is also our last day at the hospital. Next week we leave to go 3 hours away to Jibhi, in the middle of nowhere. Apparently it is beautiful and peaceful according to the other 2 groups so it should be fun. Just am sad to leave the hospital because I feel like I am learning so much and I really enjoy the people. Even some of the sickest ones can manage a smile when you walk through their room. 

Naggar

Sunday morning we left for Naggar which is a small village, used to be the capital of Kullu. It was a very relaxed atmosphere in comparison to Manali. It was about a 35 minute trip from the hotel but it was an amazing ride. We had to drive up the side of a mountain down a thin road which just dropped off. For most of the road there was no barrier but if you can trust the driver and admire the scenery, you can ignore that little fact..


Our driver also played some great Indian music. When we got to Naggar we walked down and saw the castle there. It was made of wood and stone and you can rent rooms and dine there. Pretty nice. Afterward we stopped at a cafe and everyone got sandwiches and shakes. It was so nice out and peaceful so we just sat a while and talked. Then we split into smaller groups and walked, just exploring the main road. There wasn't a whole lot of shops or anything but it was just a nice atmosphere.

We stayed until about 2:30 then took cabs to a waterfall. There was a small cafe at the bottom of it which was really neat to see! Aubrey and I climbed to the top of the waterfall. I put my feet in the water but that crazy kid went underneath the water. We met a family up there too who were really excited to talk to Americans. They spoke english very well, especially the young girl.

We got back, had dinner and went out to a cafe in old Manali called Drifters. We lounged around and talked, some people had dessert. And I got a job offer haha they want me to host karaoke there and they're going to pay me! So we're going back one day this week to actually DO karaoke and feel it out. Then as a whole group (when the Jibhi kids get back to Manali) we're going to all go out and do it. I'm so excited!! My favorite pastime :) 

Surgery

Today is my birthday!! And what better way to spend it than in surgery. You don't have to know me well to know that blood and I do not go together well. I still cry and expect a lollipop when I get shots.
So I told myself that in order to overcome this fear I needed to jump in and try something I had never done before and may never get the chance to do again.

After we went on rounds with the doctors through the ICU, we got into our scrubs and walked into the "operating theater". They told us originally that only 2 could go at a time and since there were an odd number in our group we were worried about how to split things up. The boys went to the first 2 surgeries this morning while the girls did rounds. They ended up letting all 3 of the girls into the room at once.

The first surgery was a hysterectomy. The patient had a large fibroid on her uterus. The scary thing about these surgeries is everyone is awake! It took a while for her to go numb but once she  did they got right to it. The worst part was the initial cut. It is a very delicate procedure, meaning... extremely long. Half way through the surgery they started another one in the next room. That one was a cholecystectomy, which is removing the gallbladder due to gallstones. They inserted a camera through the belly button and the instruments through the upper abdomen. We watched the surgery on the screen and could see them remove the stones and bile and detach it from the liver. 
By this time, they had finally got the uterus detached in the next room so I decided to stay there cause I really wanted to see what a uterus looks like! It was about the size of my fist. We could see the cervix and the severed fallopian tubes. Then they cut it open and showed us the fibroid which was huge! 
It was really fascinating to watch, although I got a bit squeamish in some parts, overall I'm proud of myself for sticking it out. They were long surgeries and the doctors let us stand SO close to the table and the students and assistants were really awesome about explaining what was going on. 


I thought it was interesting we all wore our scrubs over our regular clothes. Also everyone had to wear croc sandals haha including the surgeon! The phone was ringing and people were coming in and out which would have been too distracting for American doctors I think. But everyone here was so calm and relaxed. I was impressed. They were talking and laughing and I was wondering, is this comforting or terrifying for the patient laying awake on the bed?

Birthday Celebration!!

WELL
 Yesterday we only visited one school but we were there for quite some time. This was a much larger school than the previous ones, with children ranging from toddler to about 10 years. Unfortunately, these kids were probably the most sick of all the ones we had seen. The doctors were writing up prescriptions and referrals for several of them. Dr. Kathleen thinks that 1 may even have tuberculosis. The kids all had runny noses and many sounded very congested. They cried for the majority of the time we were there and one girl wet herself in the corner and no one addressed it. She just stood there for several minutes until I had to leave the room and step outside.

 I went out and attempted to assist the boys with getting the gps system to work. No luck there. I ended up watching some of the older kids who were showing off by doing cartwheels and backflips. I was totally impressed, couldn't hide it.

 Then Heather spoke to us some about grad and med school which was very insightful to hear. Especially since she is doing her masters in public health, which I plan to do as well.
 It was our last day in the community. I wish I had gotten a picture/video of our car rides out to the villages. 11 of us in one van. Kelly sitting on top of 4 of us in the back and 4 people stuffed in the front going over roads compiled of huge jagged rocks. No air flow in the back and the car sickness begins to hit hard. It was pretty hilarious, and horrible. But lots of bonding going on when you're forced to be that physically close.
  When we got back to the hotel, Liz (the supervisor from UMD) had arrived! We're all really excited to have her here. Liz lived in India for a while and has done some work here already. She has great stories and experiences to share and is really interested in getting to know everyone.
  We have another rotation on monday, so a group leaves for Jibhi :( we will miss them!! But my birthday is apparently tuesday so we are celebrating all weekend! Last night we hung out in the boy's room and talked, played some music, ate WAY too many cookies, and then we headed out to a lounge called Johnson's. They were playing a lot of techno music so the boys told the DJ it was my birthday and he announced it and started playing American music instead haha! So we all danced and made fun of each other cause we're all terrible, and had a wonderful time!
  When we got back we had a wonderful disney sing a long for about an hour and a half. What better way to celebrate my birthday than disney music in India?! It was kind of silly on our parts to have done this the night before our 7 hr trek :/ Needless to say, we didn't get much sleep but we all were at breakfast by 8 and left at 9 am. We trekked an INSANE mountain! It was so steep we had to take breaks every 10 minutes because no one could breathe! It was the most crazy work out my poor body has ever taken on. And the view was of course gorgeous. We hiked up to a spot that overlooked Manali which was awesome. We had dinner at Bella Vista in Old Manali which was really funny cause the seating arrangements consist of cushions and couches so we all just fell asleep! Haha

  When we came back to the hotel, everyone took showers and I brought my computer out to the tables outside. The boys surprised me with 2 vegan almond honey cakes!!! Oh my goodness I was so surprised! It was so sweet of them to do that, I can't imagine how long it took to hunt something like that down. Everyone sang happy birthday and then I made Mili sing it in Hindi! It was really exciting and the cake was so delicious! I ate 3 pieces...

 Now the girls are out shopping and the boys are taking naps. Not sure what's in store for tonight. Hopefully just sleep.. Tomorrow we are leaving around 10 for a day trip to Nagar. Dr. Kathleen recommended it to us. Only a 30 minute trip and the girls want to get Thai massages and henna on our hands! But mostly we just wanna get the heck outta Manali for a day!

Chinese food & jungle gyms

Today is thursday.

Yesterday my group went out into the community and visited 2 schools. The doctors let us check vitals of the kids which was really cool cause I've never done that before, although most of the other students have because they're pre-med. Each school only had 3-4 children when we showed up and they were very quiet and reserved. Several of the children had ringworm. You could see red patches on their cheeks. The doctors also looked at the whites of their eyes and could see that many were also anemic. Apparently many children in India only have 1 to 2 meals a day and usually those meals are provided by the school. I think that probably correlates with how relaxed they are in comparison to American children who eat a lot of carbs and sugar throughout the day. 

You can definitely see a relationship between the environment and the health of the children. The schools we visited on tuesday had children with the worst health of the ones we have seen thus far. On all other visits, the streets and air were clean, there were people out working and greeting us as we walked by. On tuesday the visit consisted of a long walk stepping over cow pies, swatting off bugs, and holding our breath due to the lingering smell.

But today we got to check the kids' pulses, and listened to their hearts and lungs. They were all really calm which made this a pretty simple task. 

It rained a lot which sucked cause there was a lot of walking to get to the schools. 

After the second school though, one of the mothers invited us back for chai and, SO WEIRD, her husband is the guide we had for our trek! He showed up half way through us having chai. We are planning another trek to a hot spring and he said he would take us.

After class we went out to a place on the main strip called Chopsticks. I have to admit, even I am getting sick of the Indian food :/ So we all ordered a crazy amount of chinese. The whole table was covered with bowls of all different foods. It was really exciting! Afterward we went to Dylan's in old Manali to get freshly baked cookies (I just tagged along since I couldn't enjoy one) It poured the whole time. When we got to Dylan's we met a man who was backpacking from Israel. He told us funny stories about his travels and all the people he had met. I love how friendly everyone is. You can just sit down and talk to a stranger for hours. 

Today we saw two different schools. Nothing too exciting. But afterward we went to the orphanage. This place was AMAZING! It was absolutely gorgeous. All of the children were healthy and happy and spoke english so well. They had regular scheduled classes and the kids were all really obedient and polite. We all really loved it there. We were expecting a really depressing experience. I got some great pictures of the kids being silly.

Afterward we worked on some more TB mapping, had class, dinner, and then our first Hindi lesson :) We all needed that pretty badly. The children here speak english really well because they are taught in english at school. The adults are the ones that don't speak it so well. 

Emily, Christine, and I just got back from a cookie hunt/shopping excursion. It was really fun but the streets are insanely busy right now. And there were a lot of cows out..

and a few yaks. Still trying to get used to that. 

Oh, and yesterday while I was walking to the first school, I tripped over a rock going down a hill and snapped my sandal. So out of desperation I put a hair tie around my shoe and foot. Stylish.

Photo Entry

Picture Perfect

Today was our 2nd day in the community and I have SO many great pictures! We went to 2 different schools and the children were so precious! We brought a slinky and they were all amazed. They loved playing with us and the mothers loved posing for our pictures. I have never seen mothers care for their children the way they do. It's so laid back but so so loving. The children are very young but really take care of themselves. They're calm and collected, when they fall down they get right back up. They raise their children to be strong people, which you can see from how strong the mothers are.

In the 2nd school we went to the environment was completely different. The walk there was filled with huge piles of cow poo, flies and bugs swarming, animals wandering through the yard and walkways. And unsurprisingly almost every child was ill. They were all anemic, all of them had worms, and the majority of them had pretty severe colds. The children had rags safety pinned to their shirts because their noses were continuously running.
These kids were the happiest kids though. We played for so long. One little girl kept holding my hand and showing me all around. She loved my earrings and treated me like I was her show and tell :) There was also a new born baby there and it was SO tiny and adorable! Today we had another doctor in training named Lucy join us. She's a med student from New Zealand. She was really good with the kids and she showed us how to check vitals and filled us in on what she was finding in the children.

After that we came back and did more mapping for the tuberculosis research. We all got together after we ate and shared pictures and talked with the group from the hospital about what they had done. Today they watched 3 major surgeries! Hearing about it made me lose my appetite.

We all hung out for a while in the boys room and began collaborating on what we wanted out of the trip and what our expectations of the staff and of our own research was. We all came to the conclusion that the trip was not what we were anticipating. So we compiled a list of the things we wanted clarification on and things that we wanted out of the experience. Once Heather and her mother came back from the market we all sat down and talked for several hours about how to meet these standards and what things needed to change. I think it went really well and we now have a better understanding of how to best manage our time for work while also enjoying the environment and the country itself.

Enjoy my adorable pictures!