The patients here are…well….FANtastic

So as you can see from my blog post, it is mainly going to be about the patients that we saw at the Sivananda Rehabilitation Center. Generally in the US, most patients (except apparently in the VA) would cower at the site of seeing 8 or so random people asking to do a physical exam to see some “cool” physical findings. For those of you who are not medical, when a physician sees something that is cool and wants a colleague to see it, it is generally not a good thing.

These patients with leprosy were the exact opposite. Not only were they not timid at the prospect of us examining them, they wanted us to. They wanted us to learn from the manifestations on their body, they wanted to show us the progress that they made, and they were proud of what they had.  They would try to point to the enlarged ulnar nerve or motion to their foot to examine their foot drop. When the patients saw that we were coming to observe them, more people with leprosy came out and sat on the bench so that we could have more numbers. It was just amazing.

This pride didn’t just stop in their own selves as the pride that they had in the rehabilitation center was noticeable. Dr. Reddy was telling us that patients in the outpatient program noticed and complained that there was not enough room for them to sit outside of the hospital waiting for care. Rather than complaining about that situation and just letting the situation go (which is likely what I would have done), they did something about it. The patients got some concrete and made a circular bench around some of the trees which allowed them to have more places to sit. To enhance the beauty outside of the hospital, several of the inpatients would tend to the garden and grow some beautiful flowers and plants. Since they are not able to pay for their care, they are paying back in other ways, ways that can enhance the rehabilitation center in the future.

This time, so far, has made me reflect on what I would do if i was a patient in a hospital. I would like to say that I would love for everyone to come and check me out if I had something interesting or “cool”. I am not sure that would be the case and would much rather be anonymous.  It definitely is hypocritical of me to want to teach physical signs from other people but not want to show my own.

Naughty tomatoes

I must say that the naughty tomatoes did not stand a chance to the mint mischief.  As tantalizing as the package looked, they were very disappointing.  As you have heard, we are currently having a great time in Hyderabad.  I don’t think anyone has hardly mentioned the train ride.  I was very leery as we were walking along the train looking for our car, however it turned out to be a very comfortable ride.  At least for those of us who did not have to stay with men engaged in secretive conversations or sleep with our suitcase (right Tim?).  If you ever plan to travel by train in India, I highly recommend 1st class with a/c.  Definitely beats the open-air, overcrowded wooden benches of the 2nd, 3rd? class that we passed by.  We arrived at the station only about an hour late, which is probably considered to be on-time here.

We spent our first day in Hyderabad relaxing at the fantastic apt that we are staying in and getting to know our new friends.  Emily, a 2nd year medical student from Chicago who is staying at Sivananda for 3months, and Shobha, an ID attending from NY that Gopal has previously mentioned (you may have noticed her blogs) hung out with us for the afternoon as we went over our presentations.  I gave my leprosy talk, Tim educated us on TB and Brooke discussed the ethics of HIV in India.  Our talks initiated some interesting discussions about the various topics and International health in general.  It was very invigorating to share thoughts, ideas and experiences with others who are interested in travel and making a difference in the world.

Today we had our first visit to Sivananda, which was absolutely amazing.  I am so impressed with the work that is being done at this facility.  After researching and giving a talk on leprosy, it was very interesting to hear about the disease from an expert and see pts first-hand.  Based on the pt’s eagerness to participate, it is obvious that they have created a very supportive and accepting environment in which leprosy pt’s can undergo treatment and rehabilitation.  The results they are acheiving with the reconstructive surgeries is impressive.  I am looking forward to our next couple of days there, especially our time tomorrow with the orphan children.

Mint Mischief

Being back in Hyderabad is fantastic. I understand what is being said around me and the plans are mine and not someone else’s. We all got to meet Shobha face-to-face, finally, and anticipate that it’s going to be a great 2 weeks here. The folks at SRH, as usual, delivered the goods today; I will leave it to the team to expound on that. They also were pleased with the rest of the medical equipment we brought over from Medwish.

As Brooke mentioned, we made a trip to the local supermarket. I tried to get things with exotic names/flavors. Mango tic tacs. Clove gum (which I don’t really like in the US but am hoping will be different here). Two bags of chips, the first of which is called Mint Mischief and the second, which Tim will probably mention. Mint Mischief is the early winner, thus far, in my opinion. I will leave it to my companions to reveal what the competition was.

Tomorrow, I hope to check in on my research collaboration at Nizam’s Institute of Medical Sciences. Also, we will be having Indo-Chinese.

Lost in the supermarket…

We are living the life here in Hyderabad. We are exceptionally lucky to have a cook who makes amazing meals. Today he indulged us with toast and omelets! (There was still idly available for the health-conscious – idly is a mixture of rice and lentil flour) He’s currently involved in preparing our dinner which all signs are suggesting will be simply fantastic. I’ve offered a few suggestions as to possible dishes, but Gopal won’t teach me how to say “beer run” in Telugu. We seem to have most of the ingredients for “french toast”… Speaking of breakfast food items, mixed berry jam is REALLY good, but on the list of ingredients they do not specify the type of berries, only that they are mixed. Also, there seem to be “natural, natural-like and artificial” flavors.

Today was our first day at the Sivananda Rehabilitation Home and it was really cool. They had carefully prepared a schedule for us which included some lecturing on Leprosy, specifically a very careful attention to the WHO criteria for diagnosis and treatment. Don’t worry, Dr. Machanda, I won’t make the mistake of incorrectly thinking I’d diagnosed leprosy at the DMC ever again. I’ve got… criteria now… They gave us lots of tea (the Telegu word for… tea) and lunch was also amazing. It’s nice to hang out with our new friend Dr. Shobha. In the afternoon we went to the men’s ward and got a chance to really examine patients who had leprosy, palpating enlarged nerves, observing ulnar abscesses, testing muscle groups for motor weakness… Throughout this the patients were positively excited to have us look at their physical findings, even pointing things out as we practiced our leprosy-detection skills. Everyone was very nice. Next we Followed Dr. Biene who is an orthopaedic surgeon who came to India in 1964 and has been at Sivananda performing hand surgeries with remarkable results. We saw both pre and post operative patients – the latter of which were proud to show off their nearly normal function! He spoke very eloquently and emotionally about the importance of doing the surgery right rather than simplifying things which I think was very noble. He clearly wished we were interested in becoming hand surgeons, and I was reminded that it has been a long time since I learned anatomy of the hand…

Lastly we went to a supermarket where there were many cool finds. (Isn’t it interesting how novel something as mundane as a supermarket can be when you are halfway around the world?) I picked up some clove gum, sandlewood soap, snacks, cookies, cadbury!