Sunday, February 22, 2009

guesthouse continued

Read the post below then finish with this one, I had some internet troubles when publishing!
we had passed a Pizza Hut not far from the guesthouse. But the manager shook his head and said,that we had cooked for us!  We are ecstatic. He proceeded to sit us down and bring out several courses of awesome Indian cuisine.  This trend has continued for several other meals as well.  Now this is an India that I can get on board with!
On Saturday we went shopping for silks and scarves and other gifts. I can't tell you much more because they are for my family, but it is all good stuff, I am excited! Then we found out that Bangalore had an English speaking movie theater, so we decided to make a girl's day.  We had iced coffee and lunch on the veranda of the nicest hotel in town, then we got pedicures for 400 rupees ($8), and went and saw "He's just not that into you." We had to surrender our camera batteries and boys had to get pat down searches.  At first we thought, bomb threat! but it turns out that pirating is huge over here so they are very strict. The Indian movie theater is an experience in itself. There was an intermission where waiters ran to us asking our orders for popcorn or full out meals, and Elena enjoyed her new favorite India snack, a tub of steamed corn. Nope we are never going back to popcorn, it's extra sweet niblets at the movie theater all the way now! We finished the evening by meeting our friends from CMC at Hardrock and eating cheeseburgers.  I think that the red meat shocked our digestive system and we have all paid for that meal in the past 24 hours.  Still. worth. it.  We are such girls and such American's but it was just what we needed!
Sunday we met our friends again and rented an minivan!!! to take us the Mysore, a city of palaces and temples of the royal Woodeyar family that ruled there until the British came into power in the late 1940s.  The palace was awesome, but checking our shoes, bags, and cameras, outside was annoying.  Also unsettling was our driver.  He was perhaps the worst that we have had in India. which if you know anything about driving in India, this is saying A LOT.  We feel very lucky to be alive and not have vomited with all of the swerving and stop and go action that happened during our 3 hour car rides both there and back.  Tommy, I will never complain about your Dallas-style merging again!

Amitabh's guesthouse

So this Friday there were no clinical experiences scheduled, so we headed to our pool Oasis on the CMC campus. We ate french fries and drank coke in bottles and basked in the luxury of our pool.  We definitely used sunscreen but found ourselves a little crispy by the time we left.  We ate lunch in town at Dhaba and enjoyed the fresh garlic naan that we are sure to miss when we go home.  Then we went back to our hotel to set off for Bangalore for the weekend.  A car something the size of a geo metro with no trunk pulled up and something like 7 Indian men tied every one of our bags to the luggage rack on the roof, and we have a lot of luggage. We loaded in and watched in amazement as our driver after each major bump would reach his hand out the window to see if our bags were still there. We were pretty uncomfortable with the situation, but hey it's India and I really cant remember the last time I was comfortable about the way things run.  Throughout our 4 hour car ride our driver, a twenty something male with no English vocab whistled and sang to Bollywood soundtracks...it was a long ride.  When we got to the city of Bangalore, much bigger than Vellore, we gave our driver directions to the guesthouse where we were going to stay.  He not only did not understand our directions but he didnt understand the directions of the 15 or so people that he pulled over to ask.  After 2 and 1/2 hours of driving in circles around some foliage called Cubbin park (we decided to skip that during our weekend sightseeing as we saw it sufficiently 9 times I think throughout the evening), we hired a rickshaw to drive in front of us and lead us to the address.  We finally walked up to our destination at 11pm exhausted and pretty frustrated.  We are staying at the guesthouse of a work colleague of Carly's sister.  We walked into the sleek modern building into our flat.  It was complete with dining room, kitchen, 2 bedrooms, and some of the nicest bathrooms I have seen in India and America. It was awesome.  We asked the guesthouse manager if we could use the phone to call Pizza Hut (we passed one 

Thursday, February 19, 2009




So I finally was able to upload some pics! The pics on the left are of nurses at the hospital and on the left is a pic of a boy with a monkey that Elena took. She gave him a rupee and he was so happy! It really is like slumdog millionaire, we saw him with the monkey and his handler later handing over our money. So sad! One of them is of Liz, Elena, and me at the beach in Varkala, so fun! One of them is the "Indian Starbucks" that I mentioned. Classy, huh? Once again, how are we not getting sick everyday?! Another pic is of the roof of the CMC hospital. This is where scrubs and linens are sent for washing and then they are dried on the roof! American healthcare is so different! The last is of Carly and me in Kerala near the backwaters.










Elephant Hill

We have spent the past few days working at a hospital called Karigiri. This hospital is just a hop, skip, 25 minute bus ride on the #1 and 15-20 minute autorickshaw ride away. Karigiri is translated as Elephant Hill, named for the flat topped hill that can be seen in the distance. This hospital was built by an American doctor, Paul Brand, in the 80s. This hospital was built for people with Hanson’s Disease or Leprosy. Yes leprosy. During our first day we were able to learn a lot about the research projects they are working on here in India where leprosy is much more prevalent than in the United States. We have learned that though this disease has been plaguing people since the time of Christ, no one actually knows how it is transmitted. There are theories and the researchers here are swabbing the nares of relatives and neighbors of newly infected patients to see if there is a correlation. Though they don’t know the route of transmission, doctors have known for some time that Dapsone can treat it. And they are testing drug regimens as well.
On the second day at Karigiri we went on surgical rounds with an orthopedic surgeon. It was amazing, horrifying, and so humbling at the same time. We walked along busy leprosy wards seeing patients, mostly men as they are more susceptible to the disease. Leprosy is caused by bacteria that attack nerves, especially those on “cold” areas of the body such as fingers, toes, superficial leg and face nerves. This nerve destruction leads to a deadening and then a total loss of pain sensation in these areas. It is similar to the neuropathy that diabetics experience on a larger scale. Due to their lack of pain they are prone to infection, ulcers, abscesses, and absorption of bone and tissue. Many of the patients we saw had little more than nubs on the tip of their hands; they had multiple contractures and ulcers on distal surfaces. Some of these ulcers were as deep as the tendon and bone with tracking fissures and sinuses. The doctor unwrapped saturated gauze as the patients looked on unflinching. They could not feel these sores that made me cringe deep within. The most horrific wound was an ulcer on the medial aspect of the ankle on a middle aged man. We unwrapped the gauze to find a terrible odor and saw that they wound appeared to be moving! Upon closer inspection we saw hundreds of maggots crawling inside of the wound. We couldn’t believe it! We spent the afternoon observing wound debridement with the surgeon. One of our patients was a man with osteomyelitis on his foot with infection tracking along the tendon. The surgeon debrided the wound and the anesthesiologist sat back monitoring blood pressure. No anesthetic was administered as the surgeon crunched infected bone out of the open bleeding wound. The patient lay their oblivious to the pain. It was incredible.
Another afternoon was spent touring physiotherapy and occupational therapy and saw countless boots, splints, and devices used to help these patients eat, drink, walk, and brush their teeth despite the loss of their fingers and toes. It all seemed very primitive, but it worked for the patients and it was made affordable to them.
This experience was amazing, only slightly marred by the very questionable conditions of the mess hall they keep sending us to for lunch where we wash our own plates in the sink after eating and where they are continuing foisting papaya upon us.
In the evenings after work I am spending my time washing my clothes in the shower and eating wonderful Chinese food from the rooftop restaurant at the top of our hotel. Two of the Vellore four have finally had India catch up with them and began taking Cipro for intestinal issues yesterday. Hopefully a cure will be near before we embark on our four hour train ride to Bangalore for the weekend!

Tuesday, February 17, 2009

Diet Pepsi and Death By Chocolate on the Arabian Coast

This past weekend the Vellore four decided to leave the grind of village medical life and hit the coast of the Arabian sea for a weekend of sun, food, and shopping. We took a 13 hour overnight sleeper train to the Southern state of Kerala. The train, or slumber party on rails as I like to think of it, was an experience in itself. We found our way around the train station and walked a quarter of a mile down the tracks to the spot where we were supposed to board our top tier luxury train. We stepped aboard around 10pm and were met with the smell of stale urine and fried food. We found our seats/beds to be filled with Indian travelers fast asleep stacked three deep in open compartments. We felt like rude Americans as we politely asked for our seats, but our slumber party had to commence. We climbed onto our bunks, popped ambien pills, and awoke rested but somewhat bruised from jostling on very hard “mattresses” all night. In the morning we grabbed our toothbrushes and face wash and headed to the bathroom. Unfortunately, we were greeted with the most dire bathroom situation we have seen yet. Two small footholds were situated around a funnel like hole that was open to the tracks below. To use the restroom you had to maneuver your clothing and squat over this hole as the train bounced along its merry way. And of course, no soap or toilet paper! Needless to say, I kept myself dehydrated for the return trip home as to not repeat this experience.
We arrived in Varkala the next morning ready for beaches and fish. We checked into our super charming bamboo huts with bathrooms open to nature and we were mere feet from the cliffs of Varkala. Then we hit the beach where we jumped in super strong waves and sacrificed Elena’s sunglasses to the sea. A voodoo woman convinced us to buy a whole watermelon which we munched happily until a naked Indian boy came up looking hungrily at our dripping fruit. We surrendered the melon then hit a rooftop restaurant for a much needed cocktail. The rest of the day was spent shopping for colorful scarves and shirts and eating delicious fresh seafood.
So, I have never really liked diet pepsi, or even diet coke for that matter. If you know me at all, you know that I prefer regular soft drinks in general and Dr. Pepper in particular. In India where they only serve mildly chilled 7up, sprite, regular coke, orange fanta, maaza (a mango soda), and mirinda (another orange soda), diet coke and diet pepsi have become very precious, and Dr. Pepper is absolutely unheard of. So, when on our relaxing weekend we found an awesome restaurant that served up these low cal treats, we were beyond thrilled. I believe we attempted to high five our nice waiter, but he did not understand this gesture and just looked at us strangely.
We woke bright and early and found some chocolate crepes and fresh juice at the Juice Hut. Then we hopped on a 2 hour long train ride and hit the town of Allepee for a backwater tour. A bamboo covered boat carted the four of us through villages and backyards to see people bathing, fishing, and cooking in backwaters that seemed like Venice meets African safari meets the slum. It was beautiful and relaxing. Then halfway through the tour our guide pulled over and told us to stopped by the coffee house. We wandered into some pinetrees to find India’s premiere Starbucks. It was an unventilated hut where a man and his wife showed us to a beat up table and made delicious homemade coffee and fried onion doughnuts. Only in India.
We spent Valentine’s day dinner eating some good Chinese food at a candlelit table poolside at a hotel in town. Then back to the hostel that we were told by other students that was one of the most charming in Kerala. We found our rooms to be bleak with hard mattresses and rough bathrooms, but we are now troopers with Indian standards so we hunkered down for the night. Liz and I were roomies for the night and were about to fall asleep as she noticed two toothpick sized antennae poking out from behind a mirror. Open further investigation there were definitely some eyes back there with what I am sure was a record sized body attached. We fled to our mosquito nets for the night and prayed that they did not leave their dark refuge. The next day we ventured by bus to the Fort Town/island of Kochin. We watched Chinese fishing nets being pulled in and contemplated buying coconuts carved into monkeys (we decided it would be a tourist mistake and as the coconuts still held milk inside they would probably get confiscated by customs anyway). Then some friends from Malaysia and Kansas bought fresh red snapper and giant prawns from a fishmonger and needed some help eating it all. We sent the fish ahead to a nearby restaurant and feasted on seafood and tomato rice. Delish! Then we viewed Santa Cruz Cathedral and Saint Francis Church. Beautiful old churches build by Europeans.
Then we took high tea at the teapot. They had the best iced raspberry tea that I have ever experienced and a “death by chocolate cake” that finally fixed my chocolate craving in India. It was absolutely heavenly. I could have eaten many slices, but there were still sights to see. We also checked out Jew town. A tourist area filled with antiques and the regions only synagogue. To end our trip we ate soup at a cool Chinese restaurant and proceeded to use their non-gross bathroom to change clothes for the slumber party on rails part deux. We arrived at the train station with time to spare so we gave the Indians a show by brushing our teeth and washing our face at a sink on the platform and using several baby wipes to clean our hands and feet for our journey. Unfortunately round 2 was even less pleasant than round 1. We had no a/c on the route home so we were sure it would be sticky and hot. However, India must have had a cold front because it was absolutely freezing with the open windows on our train. We had only beachware so we bundled in our mosquito nets, sandy towels, and paper thin scarf purchases. It was miserable, but at least I never used the bathroom (liz had to go twice!!) We have never been so happy to see our lovely Darling residency and take a steamy hot shower (our first in 10 days!)

Thursday, February 12, 2009

Cockroach Buffet

Our second day of surgery was spent in outpatient clinic. I was assigned to the chair of the department, the same one that was mentioned in Elena’s blog tapping his toe to elevator music. I spent the morning getting pimped about venous stasis, and pretty nasty non-healing food wounds. There was also some cool stuff, carotid body tumors, a hydrocele on a twenty year old the size of an ostrich egg, thyroid nodules.
Wednesday we rounded with the same chair and several interns and 2 upper levels. I have learned a very universal lesson…attending rounds are BRUTAL. We marched all over the hospital rounding on nearly 50 patients and by the end I think that the resident had shrunk several inches in size due to the disappearance of his confidence. Then we went to dinner at our favorite Punjabi restaurant and ate some awesome North Indian vegetarian food. Unfortunately, the single cockroach that we saw at the restaurant last week seemed to have found a friend and performed some major reproduction as there were several bugs crawling on the wall. The chickpea masala and garlic naan is so yummy though that we merely acknowledged the creepy crawlers and went right on munching. I think that my expectations of hygiene and bug infestation have drastically changed in the past 2 weeks and I suspect that I am going to be very good camping from this point on.
Oh and on another note, for some reason they changed the bus schedule Tuesday. We got cocky because we had a string of successful commuting, but due to this unannounced change the number 2 bus did not take us home on 3 separate occasions from 3 separate starting locations. We spent quite a bit of time walking along mysterious roads and even more time asking people who did not speak our language for help that they were not very interesting in giving. So we get it India, we did not figure you out in a week. Back to square one.
Tonight we are leaving on a 13 hour overnight sleeper train to go to the town of Varkala in the southern state of Kerala. It boasts some of the best beaches in the country and we have some bamboo huts with our names on them! There are also rumors of pancakes there too which will be awesome since breakfast is the least impression meal of the deal. Sure they have decent coffee or tea and there is amazing juice where I am pretty sure that place whole pineapples in a blender, but they have subpar toast and idly. Idly is some kind of round yeasty rice cake that we loved at first by now after eating them everyday I am pretty sure that they are just sitting in our intestines clogging our cecums.