Nice beginnings!

Very refreshing to hear everyone’s experience so far.  As for me, four more days before departure.  I am up-to-date with all the travel vaccines, but do have to fill Rx for malarone and start taking it, get my tickets printed, write down important phone numbers (esp gopal’s), passport and oh yes pack — then I am all set.  Most challenging thing when I go for a long trip is where should I leave my car and who will water my plants?

Micro and coffee

I had a nice discussion with the head of Microbiology at MGMCRI today. We got a tour of the facilities. They have minimal equipment, but they have great amounts of space. They are poised to take off if funding comes through, but that is not likely in the near future. There is no C. difficile to be found at this hospital, I am told. They also have OK responses to empiric treatment of infections with cephalosporins, while the government hospital has good responses treating with penicillin and gentamicin. There is a world of infection control research to be done here. Nobody is doing it. Yet.

The latest from coffee.com, as mentioned by Alicia, is that they have added the reverse osmosis info to the menu. Emboldened by this, I gave them some feedback on their website and business cards. I hope to be working here by the end of the week.

Cozy bus ride.

We are back at the official CIT2 hangout, Coffee.com and enjoying ourselves once again. I’m amazed that Desiree remembered all of our names, except for mine, which is understandable- I am quite forgettable. Paras is happy that she recalled his as he thinks she is kind of cute. She also added a note on the menu that their ice is made with water that is filtered by reverse osmosis to avoid further annoying questions such as Gopal’s yesterday. We took the bus into town again and this trip was not as pleasant as our last. I think the bus route is much more popular on Mondays than over the weekend. It was a bit hot, crowded and without the festive music. Unfortunately, it seems to be very difficult to get the rickshaws to take us into town so I don’t think we have much of a choice but to chance the bus again.

Today was our first day on the wards as the others have mentioned. Brian summed up our experiences on the peds side well. I also was very impressed with the federally-funded immunization program and the technology of the NICU. I am excited to spend more time there tomorrow. As Brooke mentioned, shoes have to be removed before entering all ICU’s and interesting enough, we had to put on a gown before entering the NICU. It is a very strange feeling to walk around the NICU in barefeet. I’m going to spend some time in the theatre with the pediatric surgeon on Wednesday which should be interesting. I’m hoping the scrub techs wear fancy scrub dresses as they do down under.

I think we are going to finish our coffee and find a restaurant on the beach for dinner. Then another ride on the rickshaws back to the hospital.

Random Musings in Pondi…

So Brian, Tim and Brooke have done a great job in expressing the feelings that we had today at our first day on the wards. There really is no reason to rehash the things that I thought about it earlier, so I will just present some musings and casual observations of the CIT2 group: (FYI this is supposed to be humorous…)

– Tim has been fervently trying to become friends with the cow-next-to-the-hostel (whom I call Betsy). Unfortunately Betsy wants nothing to do with Tim. Poor Tim….

– I have succumbed to peer pressure and now will be joining the group in trying to become more South Indian, that makes the total tally 3 men with a ‘stache. We now need to work on Brian who keeps telling us that his Asian genes only allow him to grow 7 hairs randomly on his face. More to follow on this front…

– It really only takes 50 mg of Benadryl to take down the giant we refer to as Brooke. It also makes her itch free We will keep this in mind for later times…

– Speaking of Brooke, there seems to be a fairly large following of people that are intrigued by her height. I think that we have a great entrepreneurial opportunity in charging people 5 rupees to meet Brooke and 10 rupees for a picture. Gopal would like me to point out that this is not a CIT2 sanctioned activity

– We are now on Day 4 of malaria watch. So far, most of us have >15 mosquito bites yet there are no fevers. We will continue to update you on malaria-watch ’08. This means that the malaria medication might be working and the doxycycline is making us acne free. We win on both accounts really…

– Gopal brought up an interesting notion yesterday. He wanted to know what would be our “closer music” if we were going to close the 9th inning. He was less than enthused to hear that mine would be Bon Jovi’s “Living On A Prayer”. I’m not quite sure what made him unhappy about that, perhaps the fact that it is from a hairband (when I have none) or because of the lack of confidence that I have (hence the song)

– Indeed, coffee.com has become the CIT2 sanctioned coffeeshop. One way or another we will make it there perhaps daily….

– This is day 2 of the bus rides. Today was not as good as yesterday as there were roughly 200 people on the bus that was meant for perhaps 50. We are not sure that we will be taking the bus again however it would make coming to coffee.com particularly tough.

– Last night we learned and played a rousing game of euchre. We think that after consulting wikipedia for the correct rules of the game that we actually played it right….

Dr. Kern, what do you think of this?

Today was our first day on the wards as Tim mentioned. We got to see a handful of interesting cases and I am certain our physical exam skills are going to improve on this trip – they are very precise about physical exam here, I think we gloss over it a little and just order imaging studies. (I do like to look at imaging studies.) When we were at the bedside and a 4th year medical student was presenting her patient to the team (in front of the patient, but I don’t think the patient speaks english) the attending grilled everybody pretty hard (including us) but then broke down the murmur the patient had very very carefully. It was a mid-diastolic grade 3 murmur, turns out, secondary to rheumatic fever and she had a heart failure exacerbation. Man, I think I am lucky to hear diastolic murmurs at all sometimes. I am going to resolve to listen more carefully in the future, Dr. Packer style… Oh, and when we were talking about her lab values and found an iron-deficiency anemia he asked “And what is the most likely cause of her iron deficiency?” I was certainly thinking GYN losses but it turns out in India it is actual hookworm infection – they treat empiricly. Hmm.

Tim and I took pictures of the front of the ICU where you are expected to take your shoes off before entering. Yes, dear readers, I was barefoot in the ICU!!! I got a good picture of Tim taking his shoes off so we can send it to our MICU back home… From what they’ve told me they haven’t had any acinetobacter outbreaks here… Maybe it works?