Tag Archives: medicine

On Doctoring: A lesson from a patient

I spend my days, and often my nights, in the hospital caring for patients – or so I think. As a physician, although I’m providing the care, more frequently than not I come out of the interaction  feeling that I gained much more than I provided. 

Today, I encountered an elderly gentleman who accosted me with a cheerful ‘Good morning, young lady!’ This was a patient with metastatic cancer who was admitted with a urologic emergency, bound to his bed and frustrated as a child who’s stuck indoors during recess. 

 He asked, “Did you win the lottery last night?” 

I clearly did not – I wasn’t sure where he was going with this.

“Your smile is glowing all the way down the hall,” he remarked.

I gave credit where it was due – a bright sunny day, a hot cup of coffee and finally, enough sleep at night. 

Mr. A, however, had another thought.

“It’s all in your head, young lady,” he said. How could the sun be in my head, I wondered.  What he said next may just be one of the most profound things I have heard in a very long time.
 

The sun is always shining, he said. The sun is always shining. It’s up to you to rise above the clouds to find it.



Now how’s that for a doozy?

N.b. The photo is from our trip last year to Yosemite, halfway up the hike to the top of Yosemite Falls. 

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nutrition – cooking and discussing

We travelled to a place called Chittalapakkam today, where we discussed nutrition first with very small children and then with their mothers. We met in a balwadi or creche. We discussed the importance of fruits and vegetables, drinking milk, and washing hands. After this, we went to someone’s home, which was really a hut, and made high-nutritionrotis (indian flatbread) out of wheat flour and gram flour, carrots, spinach, and other vegetables. They were made with minimal oil and and not fried. We took these back to the balwadi, distributed them to the children, and discussed them with the mothers.

It was actually interesting to see what the mothers know. Some know that carrots are high in vitamin A, which is good for the eyes. Others still think eggs aren’t good for kids who have jaundice. The level of general education is very low in these communities – among everyone but especially among the women. But the health education is somewhat reasonable in the places that are being reached by the government health centers, which speaks well for Tamil Nadu’s implementation of the national health programs.
One program that we saw here was the mid-day meal scheme. Under this scheme, children are fed a well-balanced meal, including an egg, everyday for lunch at the creche and even at the schools, up to the 7th grade, I believe. This serves two purposes: one, at least one good meal per day for the children, lowering incidence and severity of malnutrition, and two, incentive for parents to send their children to school. This is another highly successful program.

The phenomenon of the were-professor

Back in medicine posting now. It seems like we’ve been on a long hiatus from actually being in the hospital. It’s nice to be back in the wards but it is of course a real challenge. To top it all off, we’ve been posted with the toughest unit in this hospital. They are strict, ruthless, and incapable of being satisfied. It was naturally our instinct to shudder and moan and play the “why me” game. But after thinking about it a little bit, I realized that it’s more likely than not that I will have to encounter these people at some point during my stay at this medical school. I’d rather encounter them as teachers than as examiners. Although you can’t say they’re ever really on “our side”, at least their aim is to teach us, not to fail us.
When I first came to India from the States after 16 years in the American education system, I really thought that the professor-student relationship here was bizarre and absolutely unheard of in American medical schools. We stand up when the professor enters the classroom, we only call them sir or madam, we greet them with the humblest “Good morning” we can muster, and we try not to look them in the eye. Coming from a small liberal arts college in Boston where I had lunch with my professors and still send them postcards, I took some time to get used to the way things work here. But considering that medicine is one of those “old guard” professions that don’t really change much, a la Patch Adams, I don’t think my Indian colleagues and I are alone in this culture of “what doesn’t kill ’em will make ’em stronger”. Today we had a twenty minute lecture on pleural diseases after which we had a five minute rapid fire interrogation, followed by a twenty minute lecture on how useless today’s medical students are and how we will probably become horrendous doctors. I’m not sure if the professors honestly believe that this is the way to turn us into conscientious, studious students, or if they just enjoy taking out all of their frustrations on us. I’m sure there’s a rational explanation, but I have to say sometimes it’s difficult to see. More on this later. Kidney calls.