Thursday, 7 April 2011

All the days since day 1: Steph

Luckily things are still going well for Joe and I in India.  We have been busy working in two different clinics since we've been here.  In the mornings we work with an ophthalmologist (Dr. Ramola) at a government hospital.  No offense to all you future eye docs out there but I wasn't really too jazzed about spending hours of my morning looking at eyes.  To be honest, eyeballs gross me out.  However, much to my surprise, it has been an amazing experience.  We see a lot of crazy pathology that you would never see in the US where most people have easy access to doctors.  We've seen leprosy, tons and tons of cataracts (even in children), and some crazy injuries and infections. 

The clinic experience in general is unreal.  Much like the traffic, it is loud, unorganized and  every man for himself.  There are no appointments, in fact for cataract surgery everyone is given the same appointment.  That day, everyone shows up and then they just go down a list.  When it's your turn you gratefully accept and go to the OT (operation theater).  In the OT they do a nerve block with lidocaine to paralyze the eye for the operation.  There are no other sedatives given, just a quick warning and a syringe to the eye.  Amazingly, hardly anyone even flinches.  There are always three patients in the OT at a time, two waiting and one being operated on.  The conditions are clearly less than what we know as sterile and there is no semblance of privacy.  However, the cost and time are greatly reduced and the complication rate doesn't seem to be any higher when we see his post-op patients from the days and weeks previously.  The patients graciously thank the physician who seems to be placed on a pedestal in the minds of most Indians (even though they get no pain medication after the procedure and when they complain about pain their comment is not even acknowledged).  The power to deny pain medication someone is something physicians in the US don't seem to have as we have now all been taught that pain should be regarded as the fifth vital sign, something that needs to be addressed just as a fever or high blood pressure. 

Outside of the clinics we have an absolutely wonderful homestay, Ms. Mehta.  She's just awesome.  The food she cooks is delicious and she is a very sweet lady.  We come home after ophtho, eat some amazing lunch walk around town and then head over to Dr. Gandi's.  He is an emergency physician, but the emergencies are much different here since there is no "911" to dial and ambulances are a rarity; most people who are seriously ill die at home.  The patients he ends up seeing are more like family medicine cases- people with a cough or cold, although he gets a fair amount of chest pain patients.  When the patients come in, since I don't speak Hindi I often don't know who the patient is at first.  There is usually an entourage of people who speak for the patient, but the patient himself remains pretty quiet and a physcial exam may or may not be done.  The family usually brings in the medical record, as hospitals do not keep records for you, it is your responsibility.  The doctor looks everything over, writes some suggestions and you go to the pharmacy (no prescription needed) and buy what he suggests.  Later on, you could just go to the pharmacy and ask for the same thing if you felt the same symptoms again, but most people here amazingly don't self treat.  Crazy, I know.

All in all, I am incredibly grateful to have been born in America where my access to healthcare is so great.  As much as I complain about the inefficiencies of Wishard and the VA, Americans really are so lucky.

For those of you who don't like medicine, I am so sorry that this has been nothing but a long blog about how different medical treatment is here.  This weekend Joe and I are planning on going to the Taj Mahal so look forward to an exciting post about our adventures there!!

1 comment:

  1. I love that the word jazzed was used in this post. I hate eyeballs, but it seems like you guys are adapting well. I would like a description of what in tarnation you are eating. XOXO