In the previous posts I talked about how things were becoming normal, well now they definitely are, to the point that all this adventure is starting to get a little boring! I’m no longer labeled as an outsider in this community, and I’ve settled into my own niches which have brought some fresh perspectives while closing off others. For example, I’m now quite blind to the variety of fauna that wander around my room, quite deaf to the nighttime recitations of the Mahabharata, and have caught myself on more than one occasion saying “Acha” or “Tikay” in conversations instead of “I see” or “ok”. So hanging out with blood and guts and the interesting smells of the lower colon are just as automatic to me as pouring milk on your cereal or putting the car in reverse are to you.
This is another long but disjointed post that certainly marks a change from the sort of things I’ve seen or talked about before. I’ve been having a lot of trouble finding time to sit down and write and as a result I’m not very happy with the outcome – but I owe you guys some stories so here goes. I’ll start with a copy of the written entry I made in my journal on a day that I finally felt I fit in.
Fri 1/30
Up for 30 min run and routine on roof, bkfast (eggs and toast and orange type fruit served with salt and pepper) with Ash, school – 7th and 9th grade kids were great and taught me to count in Hindi. Gave them books from the library for tonight and assignment to look up history of the Olympics in two different encyclopedias. Back for snack and over to empty OT and ran into Arun and Swaran – we looked at the physics of wheelies on the net then over to OT for steel rod insertion into a shattered pinky toe, a failed attempt at a shoulder relocation, and a very sick woman with terrible abdominal abscesses and some mad septicemia. Held her arms during surgery, helped intubate, and breathed for her on the way to ICU. Dr. Teresa saved caesarean baby’s life (blue, not crying long after birth, etc) and moved on in an astoundingly automatic manner, and then watched Dr. Sonal close mother. Now I’m doing more smaller tasks – getting gloves, wash, IV bottles, holding here and there, it’s cool to be more accepted and be comfortable with procedures. Haven’t been in OT all week and I love the teaching/OT schedule. Lunch of plain rice and snacks as Kavita is gone until Monday…hope we don’t starve. Played some TT and helped Avinash more on his application. Came back and worked out with Ash, showered and made dinner with a couple bottles of Haywards 5000. A drive to town for some chicken at the seedy joint and ran into Arun’s friend the silversmith! Back for soup and papaya and chicken and peanut dinner…hehehe thanks Kavita. It’s good to have a friend and it’s good to make new memories zpooming through Mungeli in 2 minutes 40 seconds watching movies with Dr. Teresa and learning how to make dentures. Today might be my favorite day in Mungeli so far – done everything I like with people I know and care about.
Since I’m running out of deep insights into life, I’ll try to make do with just talking about my days here. I’ve scripted a nice daily routine: up at 7:20 for chapel, morning rounds, breakfast with Ash (and now the Danes), over to school around 10:15 where I teach class 7 (and sometimes
before recess, and class 9 for the last hour, then back to my room to wash up and get a snack around 1:15. The afternoon is often more flexible – I’ll see what Arun is up to, or come and write (happening less and less frequently), or most likely, head over to OT to see what’s going on. I usually end up getting stuck watching the gore until somewhere between 5 and 7, when a few of the nurses and I will go play ping pong for awhile. Then Ash and I have a workout from 7 to around 8:30 before dinner either with a movie and Dr. Teresa (while Dr. Anil is traveling), or down in my apartment before bed somewhere between 11 and 1:30. It’s a good schedule, solid enough for me to feel comfortable and flexible enough to allow some time for the unexpected.
I can’t even begin to adequately describe or tell of all the experiences I’ve been fortunate enough to enjoy in the time since the last post went up. Today itself (Sat 2/7) has been a whirlwind. I was awoken by Felix, a 26 year old German who visited the hospital for three months five years ago and is back for a very brief visit to India and who has become a friend in the past three days. I was sleeping in after an epic evening with Ash and the Danes, Tanya and Habib, which began with a toast to new friends and processed with spectacular conversation about many of life’s greatest issues centered around Habib’s Iranian heritage and his struggles in defining himself in a foreign and often hostile land. We touched on issues of God and the meaning of love and how we interact and relate with other people in this context. O it was awesome and we left with moistened cheeks and swollen hearts and definitely with new friendships formed from drinking in the human waters.
Man I’m afraid I’ve lost my ability to write, even my poorly scrawled 3 am journal entry says it better:
How can I explain the cohesion of hearts, the understanding of a loving bond upon which nations and cultures rely. Here an Indian, a Dane, an American and an Iranian Dane discover each other and find God with tears and joy for one another and for the excitement of times ahead. It’s not about what you believe or what you know, it’s about what you’re willing to explore. So happy – put Ash to bed and about to do the same – nothing like making new friends.
Ahhh this what life is about. So anyhow Felix woke me that morning because he wanted to talk about some disturbing images he had seen the night before and we sat on my bed while he told me of a burn patient who had been admitted the previous afternoon, a middle-aged woman with 100% burns. One hundred percent. He saw her only briefly in the ward but the image still haunted him almost as much as her whimpering cries of pain which kept him up in the night (his room in Ft. Henry being just 20 yards from the burn room in the lower ward). She passed on sometime this morning, but the impression she unknowingly left in her last few hours on this student from a place she had probably never heard of was so powerful that he needed to vent. So wow zip zing zoom welcome to life – my concern for my throbbing head was quickly overcome by the emotional onslaught he spilled forth. And then, not fifteen minutes into our conversation three guys from Orissa showed up on my doorstep wanting to meet me, the foreign guy visiting Mungeli. I hadn’t even put on a shirt yet. This is another topic for another post but Orissa is a state which borders Chhattisgarh that has been experiencing a wave of violence targeted at Christians and carried out by a group of radical fundamentalist Hindus. I briefly referred to this in the hospital tour story with the place where they live inside their walls under protection of arms – that was Dipdipur. Alright fine, you convinced me, now I’ll talk about that.
I don’t understand all the facts but I’ve gotten enough pieces of the story to give a rudimentary account. The violence is carried out on religious lines but was inspired, of course, by social and political issues. Much of this has come from Dr. Vijayakumar, much from Nancy Henry, Anil’s mom, and bits and pieces from other random people I’ve met. I’ve gotten two different dates on this fact so I’m not sure which is true – either back in the mid 80s or just two years ago an important Hindu Swami was killed in Orissa. The Maoists, a communist group, claimed responsibility for the murder, but this was not widely recognized and, in fact, it was blamed on the Christians (who are a tiny percentage of the population) by a small group within the Hindu majority. Now, it’s important to understand that this blaming was done by a radical fundamentalist minority group of Hindus, a group which has been gaining a foothold in Indian politics through representation in the BJP – one of the two major parties – the other being Congress (which currently runs the government). The Indian system of government is taken after the British model, so the party system is a bit more complicated. Basically people don’t directly elect their representatives; they elect parties which appoint their own members to government posts. So anyhow, the BJP is very pro-Hindu, Hindus being the overwhelming majority religious group in India, which opens up a lot of room for this radical minority to push its agenda. And their agenda is exactly what you might imagine – get rid of these other people with their other ideas and use violence as the way to go about it – blah, blah, same old, same old. So this group really just needs some excuse to come in and the assassinated Swami is a great one. But it’s more involved than just this – in Orissa (I’m sorry I can’t be more specific on districts I don’t remember all the names) there are also two groups of people who came into conflict, a tribal group and the low-caste untouchable type Hindus (I’ve also forgotten their names, but bear with me). So the tribals in India are given a lot of help and protection by the government, a lot of which are affirmative action type programs to provide opportunities to these “backward” people. These particular tribals have their own language, and it so happens that the wording of the government aid documents specifies that these privileges are to be given to the people who speak this language. However, many of the low caste Hindus also speak that language and used this to piggy-back on the tribal aid to advance their own positions which, needless to say, leads to resentment on the part of the tribals. It also so happens that many of the tribals are Christian because the earlier Christian missionaries had a much easier time converting these populations. So here my understanding breaks down as to exactly how the tribal/low caste Hindu tensions relate to the eruption of the violence, but I imagine these were also easily twisted into a discrepancy across religious bounds. There are a lot of amazing and horrible personal stories about homes and churches being destroyed, men being pulled from their cars and killed with axes, the rape of a nun in full view of the police, a little girl killed in the streets, a Catholic priest who was severely beaten and thrown in his house which was then set afire who managed to crawl to the bathroom and douse the flames with a single bucket of water. But universally, it seems that this violence is caused by outsiders, young men who subscribe to the radical views who are imported to do the work. The big wave of attacks in the fall was not neighbor attacking neighbor, it was more organized – convoys arrived and cut down trees to block the roads before moving into villages to do their grisly work. But now the national government has sent police units (like our national guard) to keep the peace in Christian areas like the hospital in Dipdipur. Still though, many of the Christians have left to seek refuge in the surrounding states. Anyhow, I admit that I’m not the most reliable source because I haven’t taken up a proper study of what’s happened but I hope you get a sense of the persecution and an appreciation of the amazing perseverance that Christian community in the face of great hardship.
So anyway, three of these guys from Orissa showed up to chat and we ended up having a really awkward and strange time. I invited them in and Kavita made tea and Felix and I sat and listened to their stories, all the while trying to figure out why they actually came. Anyhow I eventually showed them out, apparently without giving them whatever it is they were after. Hah, all this before I’ve even wiped the sleep from my eyes. So Felix and I then went off to school, where he’s been a huge help with his ideas and demeanor with the kids. We finished off three days of lecturing on WWII and the Holocaust with the 9th graders (quite a change in topic from telling stories about magazine pictures and translating Hindi songs) which was, itself, full of amazing moments that I hope to write about later. Then we walked back to the hospital and started discussing plans for German students to come do their national service (mandatory military or social service either in Germany or abroad – which I think is a fantastic program) teaching in Mungeli. After a quick early lunch I went out with the intention of doing some serious writing to get another post up, but I was distracted by a wonderful chat with Dr. Teresa, Ash, and Felix and then by an extraction case in which Ash taught me how to give nerve blocks. Geeze – it never ends. I just stabbed a guy in the mouth with a giant needle – three times!
Ash is really straightforward with his teaching, and giving nerve blocks is second nature to him now so he also sort of ignored the whole preface thing – this was some mad OJT. So he sat me down next to the patient, an older man with an awesomely full freshman year Conference style moustache to sideburn affair, set they syringe on his chest and went straight into it. He showed me the necessary landmarks and gave a finger waving explanation of the area I was to work in before handing me the syringe with a warning that a mistake would mean piercing an important group of blood vessels and some serious hematoma. Hah! This reminded me a lot of his warning not to get my foot near the tire on our trip to Bilaspur – I’ll talk about that soon! So in I went, stabbing away, and with a little assistance on one of the blocks he was all set for his extraction. Simply fantastically incredible and totally ridiculous – third year med students can’t do the stuff that I’m casually invited to do in afternoon conversation, and that was easily the best experience I’ve ever had with lidocaine… But the best part came when Ash took the next half hour to explain facial nerve structure on a skeleton in the OPD waiting room, and then got carried away and just started talking – bone structures and injuries, muscle attachments, locations of important blood vessels, the beauty of the elbow, where epidurals are injected, ahh it went on and on for almost forty five minutes and I ate it up. We collected quite a crowd of onlookers who watched as the skeleton came to life, his bones now wrapped with a fleshy knowledge of the life construction he used support.
But now to talk a little more about the personages inhabiting these environs, for in addition to the doctor’s starring roles, the Mungeli performance has quite a large cast. There’s Arun in maintenance, a mellow and contemplative type who helps keep me busy on slow days and is my main translational link with the rest of the staff. There’s Raknesh, the goofy compadre who’s next mission is to teach me some basic ophthalmologic techniques and take me out into the surrounding villages on promotional ventures for the Feb. 16 Eye Camp so I can help generate some buzz posing as a foreign doctor. There’s Abejeet, an 11-year-old sixth grader with whom I walk home from school with every day and who enjoys quizzing me on my Hindi numbers and days of the week. There’s Wasim, an eighth grader who also sells me live (or freshly butchered (it’s quite the spectacle – I’m going to try to get a video on my camera next time)) chickens at his father’s shop in town. There’s the other hospital goofball, Lakshmi who works in OPD (out-patient department) and who always busts in the ECG room when I’m working on the computer to give me a brown-toothed smile that’s somewhere between friendly, formal, and how-the-hell-are-you-still-on-that-thing.
Then there are the nurses. Avinash is a ward nurse from Tamil in South India with an exhaustively rapid verbal style and whose written English I’ve been correcting on his B.Sc. (post grad nursing degree) application to CMC Vellore (one of two Christian Medical Colleges in India – the other being in Luthiana, both of which are top 20 med schools in the country). There’s Swaren, a soft-spoken senior OT nurse whose shell I’ve begun to crack with evening ping-pong matches. There are the older, sweatered and saried ward nurses who taught me how to remove sutures and catheters and who belt hymns in Hindi with impressive force in the forum which allows them to transcend their usually quiet demeanors. Then there are the three female OT nurses whose names I’ve forgotten but who patiently allow me around their workplace and who have started to offer smile-tagged waves when they’re not wearing scrubs. One has very pretty eyes, whose bashful gaze mine has caught over more than a few sliced abdomens, and whose subtle flicks I misunderstood during the production of that delivery-seared birth motion.
Then there are the supporting cast, mostly professional servants or laborers, whose roles pepper this experiential production with human masala. There are the saried women laborers whose patchy greetings serve as momentary interruptions to their work of making cement from gravel and sand, digging foundations with spades, and hacking down brush to keep the snakes away. There are the half-dozen members of the maintenance staff who double as chefs, bus mechanics, and watchmen and who bemusedly taught me in Hinglish how to drive a scooter. There’s the peanut lady who keeps me well-stocked with her sand-cooked produce, and who may be the first vendor on Earth to whom I’m a “regular” and who prepares “the usual” without my having to ask. There’s Kavita, whose daily “Good morning, sir” lets me know I’m still in India while the products of her dish and pan remind me why I came in the first place. There’s the little girl at the roadside stand who waves and says hello every morning as I pass by on the way to school, excited to make use of her only English word.
Lastly come the animals. There is hospital pig who’s startled me on more than one occasion rooting around bushes outside the dental department late at night. There are a clutch of stray dogs, one of whom recently became a mother to four adorably flea infested pups that sleep in a pile on the tiles outside OT when their space isn’t taken by the pensive relatives of a patient in surgery. There are the chickens and roosters, owned by Arun’s aging mother (who was a nurse under Dr. Victor Rambo, the eye guy who started the hospital) that are actually a special, and very valuable (and very delicious), breed of poultry. Hahaha while this is only a short list I hope you can get a better feel of the production of a day in Mungeli.
O my, so I really want to tell this story properly, but I also want to get up another post so I’ll keep it short (plus there are videos that are way better than words). On Sunday the first, Ashwin and I went to the zoo and spent the afternoon in Bilaspur. Yeah there’s a zoo – full of lions and tigers (the white variety) and bears. O my! There are also giant pythons and hyenas and leopards and deer and crocodiles and more bird varieties than I can count. The setup of the zoo is more like you would picture an animal preserve, a huge amount of land to wander amongst between different animal enclosures, and I had almost as much fun watching all the colorful patrons as I did seeing the animals. From there we continued on to Bilaspur for a mega spicy Indian style Chinese lunch and some shopping at a supermarket. I was initially really sad to be at a supermarket, but Ash was very excited to show it off (another theme of the trip – I want Indian things, they all want western things) so I ended up buying over a thousand bucks of groceries to stash in my backpack for the ride home. O boy I’ve forgotten to talk about the driving. We rode on his bike, a 180cc Indian made pseudo sport affair with is missing a headlight, part of a rearview mirror, and the passenger footrest on the right side as a result of a slight tumble Sudeep took on his way through Mungeli the week before he left. The headlight is only an issue at night (remember bicycle guy on our way back from Durg) but the missing foot peg meant that I had to either rest my sandal on the side of the bike or share the driver’s peg with Ash while trying not to interfere with the brake pedal. I know that sounds silly, but if I rested my foot in a more comfortable position above where the peg used to be there was a very high risk that it would slip into the chain or the tire and send us end over end to instant death. Hahaha the bumpy roads made the journey interesting – it’s quite fun to be airborne on a bike – as did a couple of cracks at the 100km/hr threshold. Like I said, I’ve got some awesome videos on my camera that do the experience of weaving traffic far more justice than I can here so I hope to get those up when we get home. Did I mention we weren’t wearing helmets? Hah! He also had quite a crick in his neck and was having a lot of trouble with the dust in his contacts, so when it got dark on the ride back our exhausted selves prayed our way in. The whole trip was awesomely dusty and I was almost brown and he was Ash(yer) by the time we pulled in for dinner, again some fun pictures of that on the camera.
This morning (Thu 2/5) I was awoken in the predawn hours by the blasting of my doorbell and a messenger who used sign language to tell me that I needed to go to OT and asking where the Danes lived. So I put on a shirt and jeans and marched over, determined not to be shown up again. The patient was being wheeled in through the double doors as I arrived, a big woman with an even bigger belly, with a baby inside trying his level best to get out. I groggily stood and watched the nurses flit about preparing the table (for night shift there are only two nurses and one doctor on call) as Anil went this way and that barking orders making sure the scene was set for the dual combo of surgeries (another caesarian was just behind this patient) and also feeling the crunch of his need to get on the road to head to Kodikanal, to visit his alma mater and Sheeku Jeetu. So anyhow, he invited me to scrub in and assist, and what person in their right mind would refuse an offer to help slice someone open, poke around a bit, and pull out a baby on the way. So I rolled up my long-sleeve “Come and See” shirt, washed my hands and arms with the OT bar soap, and for the fourth time, worked my way into a gown and gloves. Surgeries with Anil are about as no-nonsense as they can get, to the point that I’m no longer comfortable calling him Anil without that preface that knowledge earns. Anyhow, he’s a furious worker and demands the same of his staff and there were many instances that I was glad to still be wearing my cloak of ignorance. But that only works for so long, because, despite my best efforts, I just keep learning things! This morning was no different, and I’m now probably 10% effective as an assistant. Hahaha twice during the operation, once as I had my fingers fanned out clutching a contracting uterus in the open air and once when I held a pair of babcock-laced segments of fallopian tube, I couldn’t help but think to myself, “This is way cooler than morning practice.” After helping the patient get settled into the ward, I had to stop back in OT to drop off my cap and mask and pick up my sandals. There I ran into Kiati, one of the OT nurses, and enjoyed a few half signed, half broken English answers to questions about assisting technique and instrumentation. She was awestruck that I had scrubbed in without learning the names of all the tools – hah! What a convoluted and inside out introduction I’ve had to surgery! But she’s promised to teach me the names in exchange for some help with her English.
But all these happy stories are also tempered with the sad. I got pretty attached to the septicemic abdominal abscess patient I told you about earlier, so I checked up on her a few times after her surgery and the next morning on rounds – it’s interesting the connection you feel after breathing for someone. Though I didn’t understand all the science behind her case, I couldn’t help but appreciate how fragile her grip on this life had become. Later in OT the following day, I was sad to hear from Dr. Teresa that she had “expired”, an interesting term that reminds me of a conversation with Stoyel and Coach outside the market on the evening of commencement day – the issue of parting is too potent to deal with time and time again, so we mask it behind a benign term, a term designed to function without connection, to sever the link of caring effort with a distant finality that plainly says – your work here is done.
I came here to see, but can see no longer in the original way. It’s been fun helping the Danes get settled and to remember the feeling their faces betray of the exhaustion constant stimulation in a new environment brings, but it’s also been a bit of a shock to be shown just how settled I actually am. Ahh I don’t often like talking about myself in the public forum, but for lack of a better perspective I’ve been given my own lens through which to filter existence and project experience, and I can’t help but make this trip a bit about me. I’ve come to realize a few things about myself in the last few weeks, but I’ve realized them in that subtle way where you feel you knew them all along, you just had to reach your hand into your experiential chest to grasp the forms that reignite the spark of familiarity. In a concrete recognition of my strategic obsessions, I’ve found that once I learn the parameters of a system and understand the tools at my disposal my talent is in drawing the connections necessary to solve problems, and my satisfaction comes from putting each tool to its most efficient use (that and creating things; for while my training is in numbers, my passion is in letters, and I find another type of satisfaction in unleashing the Muse (even though my sentences are often run-on and I employ commas and hyphens under different rules)). I’ve seen here how these are valuable capacities in a surgeon, and perhaps explain why I’ve come to appreciate surgery in a way I never thought I would. Who knows where things will go, but if I ever do become a surgeon, I’ll definitely buy a sweet sound system for the OT to blast philharmonics over diced up patients, and this one won’t be donated to charity after we scrub down the theatre with Ajax.
Well the ECG rat has started his 7:30 tour of the periphery, and I must be off for a workout and dinner. It’s been an amazing ride these last few weeks, I really hope to get up another post in the coming days if time allows, but that will probably have to be my last in India. I’ve arranged to visit a friend in Ahmedabad this weekend and I probably won’t return until the 17th, which won’t allow much time to sit and write with all the goodbying that must be done. So this is likely the end of the blog’s voluminous postage – I do hope you’ve enjoyed the stories even a tiny bit as much as I’ve enjoyed living them. I look forward to these coming days with melancholy excitement as I live in the keen awareness that the end of this journey is drawing near.
