In the States Looking Back...

I made it safely home to the States, and am reminiscing over the India I came to know.

On our last night at the Annex, a couple girls joined me in the ER to just hang out for the evening. There were rooms designating the level of attention required by each patient, and it was interesting to just walk through and read the patient reports prepared for each. Everything seemed fairly calm and under-control, so we had a chance to chat with one of the doctors, who happened to be the same one that treated the girl in our group who had heart palpitations, and he was pretty concerned about her. He was a younger doctor, so he was doing something along the lines of "residency", and as a result was never allowed to have breaks. If he wasn't "working" he was on call, and the way he described it, he had been "on duty" or "working" with no days off for 2.5 years straight. He said he was thinking about applying for a world record documentation, and it sounded like a joke, but at the same time, considering the circumstances, I kind of think he was serious.


Early the next morning, we got all packed up and drove about an hour away to the beach at Mahabalipuram, where we stayed at the Chariot Beach Resort... which was very nice! The staff were all dressed in tropical t-shirts, and greeted us on the drive way area and showered us with strings of shells and cold soda. We were brought to our rooms, which were up stairs, so I was happy they were so willing to help with my bags since I didn't have access to an elevator.
We spent the morning in the extremely large pool, which had the softest water I have ever felt. I felt like asking for the secret to their lovely pool, as I am a lifeguard and am excited to find out how to make pools so nice, but in the end they didn't really understand the question. My theory is that they have tons of jets pouring into the sides making it soft with bubbles, but that is just a thought. It was refreshingly cool, and the deepest it got was about 5.5 feet, so good for wading and floating, but also deep enough to enjoy. It was incredibly clear and clean, and an all-around relaxing situation. The first day and a half we were about the only guests, so we had all of the facilities to ourselves, and I was the only one in the huge lovely pool, several times.
Meals were very fancy, and they were very attentive to our every need, opening doors for us and serving us super quickly. I felt rich and famous. I was trying to decide if it was because it is their job (it is their job, but they seemed to go above and beyond the call of duty) or if they were bored since we were the only guests, or if they were specifically interested in us because we are mostly American girls. They were definitely excited to see us for the later reason, as they kept asking to take pictures with us on their phones, which is not part of the job description, I'm sure. Who knows.... Meals were usually buffet style with lots of labeled pots of fancy Indian cuisine, and sometimes more western influenced dishes. I usually went for the "little of everything" approach. It was a large spread of dishes though, including a separate table for a display of salads, and another for desserts. It was very tasty! We spent a portion of each day listening to our final paper presentations, and it was actually very interesting to hear what each person had learned from the trip, and find how they were all interconnected. I gave my presentation in a fancy conference hall with table cloths and things that looked something like a restaurant. Half way through, they brought in tea/coffee and sandwiches for our "tea break" which almost all Indians stick to faithfully. After presentations, we had a group meeting to de-brief on an event that happened the night before to some girls walking in a group back to Sri Ramachandra in the early night, which showed it is important to be careful and aware of one's surroundings. During the meeting, the power at the resort went out approximately 5 times, which was difficult, as it was dark out and thus could not be aided by the window, and it lasted long times each time because during a power failure, someone has to go all the way out to some separate building on the other side of the resort campus to turn the power back on. Dinner was again a nice selection of yummy Indian food, and afterward, I took a girl down to the beach who was leaving for home soon... the first to go. I had been to the beach earlier in the day, to see it, and had not come with proper foot ware so the sand would get all over my feet and burn (as it was hot) so I had to run, then throw down a towel and stand on it a while, to recover, then run again, until I finally made it. The guards, who were wearing boots, did not have that problem, and were highly amused by my crossing of the sand. The guards kind of followed me out to the water and kept a close eye on me, and warned me in broken English not to swim as it was pretty dangerous and rough. The beach itself is a steep hill, but the waves are so strong they often make it to the top. There did not seem to be much tide, as every time I visited the ocean, it was about at the same level. So, I stuck my feet in, and got a guard to take a picture of me for evidence, though it was hard to explain that I wanted a picture... he finally understood though, and it turned out fine. So... I went to the beach again after dinner with this girl, and we got to the start of the sand and were intercepted by the guards, who were confused as to what we were doing. I explained that we weren't swimming, but just wanted to look, which seemed to ease some of the tension in his face, so we kept walking, and they followed closely, but then sort of stopped us and talked in Tamil to each other, and started flashing their flashlights at each other in some kind of code, and one escorted us to the beach. He still seemed anxious for some reason, especially when we put our feet in, and I thought he thought we were swimming, so I tried to reassure him that we weren't, but he told us 5 minutes! And, like 2 minutes later he started corralling us back in. I decided it would be best not to argue, since he had a big weapon, so we left, though the ocean was beautiful and peaceful at night, and as we walked back the guard explained in broke English that there were terrorists around... and that it wasn't safe. Based on his body language, I believed him. He also demonstrated what he meant by terrorists by pretending to slice his throat and jab himself with a knife in the stomach, which did not seem safe at all. I asked the front desk people about it, since they had better English, and apparently the locals sometimes hide in bushes along the beach and jump out at people walking by and rob or kill them, and apparently there has been trouble with both foreign visitors and Indian visitors, so the resort policy is simply to not allow visitors out on the beach at night. I appreciated their concern for our well being. The guards seemed very nice, and very attentive!

The next morning a group of us woke up early to see the sunrise over the ocean, and we beat it by a few minutes so we were able to see the bright orange ball quickly rising. It was very beautiful, and as we were at the ocean there was not as much haze, which made it feel a lot hotter, and make us more prone to sunburn, but also let us enjoy the sun rising. The guards were still up and about at their little post, and were watching us closely, but didn't hinder us at all. Throughout the morning we did our final paper presentations, and this time they were by the pool, so the presenter sat in a chair by the pool while everyone else lounged in the shade or relaxed in the pool. The staff brought out a fancy long table to our area and served us tea and cookies and sandwiches, so we had our coffee at the pool side. It was amazing. In the afternoon, after lunch, we went down to the beach again and went swimming. As the only lifeguard in the group, I made sure everyone stayed close enough to shore to be safe, as the waves were strong, and often went over our heads, and knocked us over backwards easily, while the current as the waves flowed back had a strong suction. It was fine, but aggressive, and not a good spot for a weak swimmer. The guards did not stop us, but watched us closely. The manager also cautioned us a couple of times from the resort, so we were well informed of the danger, and the resort was by no means going to be responsible for our deaths. A little later, some buses were ordered for us to shop or sight see, so I got on the sight seeing bus, and we went to a "temple" that was built around a cave where a tiger used to sleep, and saw another temple which I believe, based on my rough interpretation of the thickly Tamil based English our driver had, that the recent Tsunami a few years ago had uncovered. Then, we went to a place called butter ball rock, which is a huge round boulder sitting on a hill that looks like it will roll down, but apparently it got hit by the Tsunami, and is still there, so it must be solid. The butter ball park is very large, and people were everywhere hoping to sell their services as a guide, or advertise their stone creations, (it was a major marble stonework area, and we saw the shops everywhere, and stone images of the gods seemed to be the most popular product), or attempt to practice their English with us. There were a bunch of goats wandering around, and some monkeys. We hiked up the park/hill surrounding butterball and saw a bunch of temple/worship areas carved into the hills, and some appeared to be very old. The goats were really cute and funny, and one tried to climb a tree to get at the high up leaves, even though there were plenty lower down. It must have been a picky goat. A little later on we went by the light house that we can see from the beach at the resort, and there was a great view of the ocean and the surrounding area. When we made it through the park, we found the road, but didn't know where our driver was, who said he would park at the parking lot. We had no idea where that was, so tried to ask around but were not able to communicate effectively with the largely Tamil speaking population. So, we started walking back to the entrance along the road, and a car full of boys drove by and slowed down to a crawl to stare at us, so we shooed them along, and we thought we were done with them until we turned the corner and found they had halted the car in the middle of the road and got out to get a better look. Some of the girls picked up stones for protection, but I just ignored them and kept going, and nothing happened. I think these people are generally just blatantly curious about these crazy foreign people, as even in tourist locations there are not very many white travelers, and it would be a curious sight. Even in Seattle, where everyone comes from everywhere, some cultures represented are very curious and people stop to look. So, I felt it was good to be careful, but generally these people seemed more curious than hostile. We finally found the driver who was parked along the road, not in a traditional parking lot, and we went to the Shore Temple, which is a World Heritage site. It kind of reminded me of the communities at Chaco Canyon, and I wished I knew more of the history, since it is super old and probably from one of the early Indian civilizations. Most of the explanations were in Tamil, and we didn't nab a guide for the trip. We ran into the shopping group there, so I joined them, and we went through a couple of shops and I bartered with a few of the aggressive sales people outside the Temple area, and ended up at a little craft market where we worked with a friend of our driver to secure most of our last minute purchases. He was fun and chatty, and aggressive, but would eventually understand if you didn't want something. When we got back, some people were getting ready to catch buses to go back to Chennai and fly home, which was sad. Right before dinner, another girl and I noticed a new family in the resort who was speaking French, so we introduced ourselves and tried to learn about them. I was surprised by how much of my high school French came back to me, and the other girl, who had studied more recently was able to fill in the gaps I forgot. It was maybe the highlight of my stay at the resort, besides swimming in the Indian ocean. They were from Paris, on a tour, so were with 15 French people staying at the resort, and the airline had lost their luggage. They told us about Pairs, and the Louvre, and their trip in India, and some of their history, and names. They were very kind and understanding and spoke in slow easy sentences for us. Another lady from their trip joined us, who could speak a little English and helped us convey more complicated ideas, but mostly spoke French. She was a nurse working just outside of Paris, so we told her (mostly in French) about our stay in India. It was so nice.
Throughout the night, various groups left for Chennai, and I was about the last to leave the next day, so I spent the morning swimming in the Indian ocean and pool. I wasn't planning to be in the ocean, just to look and say farewell, but I met a lady from Russia who was swimming by herself and begged me to swim with her so the guards would not be watching her so attentively, so we swam a bit, and she was glad to meet someone who shared her love for the ocean. She was chatty and fun, and was apparently spending a few days at the resort as her holiday from work. It seemed like an expensive holiday, but a good one! I got cleaned up and packed up, and then discovered that we were delayed in leaving for Chennai because political unrest had caused our road to close (I think a statue got knocked down somewhere) so we had tea and sandwiches, and when the drivers finally arrived we took the back roads to Chennai. One of the girls with us still was very sick, and was suspected to have both Dengue and Typhoid fever at the same time, so there was a big struggle to get her flights changed and her mom's flight changed (her mom was one of the teachers) so we went to a mall in Chennai where the travel agent was for a few hours and had dinner and went shopping one last time, while we left our stuff in a hotel room at the Trident hotel, since one girl was leaving the next day and thus staying the night. Finally, it was time to leave for the airport, and it took us a while to figure out how to work the airport system, as it was very different from what we were used to, and my travel partner was feeling ill, so I was mostly in charge of figuring out our next steps. We kind of got forgotten at the check in counter, as they wouldn't give my partner her boarding passes until she paid her overweight luggage fee, but forgot to have her pay for it, so we were awkwardly standing around waiting. Finally, I decided we were forgotten, so I asked someone for assistance, and then they realized we were forgotten and took her money, but had to go across the airport to process it, so we kept waiting. I was glad we got there early. We went through exit customs, and security (which was pretty intense, where army people in camouflage patted us down with their guns slung over their shoulders) and at last made it to the waiting area. However, we didn't know our gate, and our flight was the only one without a published gate, so we were nervous we would not make our flight. At boarding time, it was finally posted, and we got on, but it was a little scary for a little while. Tons of security later, we made it on the flight, and were on our way home. I sat by a Chennai lady on her way to visit America (New York) for the first time, and I knew she would be in for a culture shock. I watched some Tamil movies and ate Indian food for the last time, and tried to sleep and get over my cough. In Brussels, I bought some chocolate and waffles with my Euros, and figured out how to get our new American Airline boarding passes, and soon we were off to Chicago. I slept most of the time, and didn't have a seat buddy so I had more room to stretch out. Then, in Chicago we re-checked our luggage, and made it through customs, and figured out how to navigate the airport, and re-checked in, and soon were on our way home! I sat near a lady off to Alaska who had never been to Seattle before and apparently it seemed kind of like a different culture, as she was from Michigan. She was nervous. Finally, we landed, and I was home, in the night of Seattle, where the weather is much cooler than I was used to. So, I made it there and back again.

If I have time, I may do one more post to expand on the culture differences I have found, especially since coming back... so possibly stay tuned. :) That being said, however, you could spend a lifetime in India and still have much to learn!

Last Day at Sri Ramachandra

This may be my last post for the trip, as we are leaving Sri Ramachandra and again, Internet access will be ambiguous until I get there and scout out my surroundings. If this is my last post, I will attempt to write a conclusion post once I am back in the states. Otherwise, I may be in touch in the next couple of days.

Yesterday morning we went to SEED orphanage and played with the kids. On the way there, we stopped at a Gandhi memorial, built on the place where Gandhi, son of Indira Gandhi was assassinated. There were several plaques in Tamil, Hindi and English explaining what happened, and a stone path was built through the lawn on the path Gandhi walked before he died. A small stone was placed where he died. Apparently he had come to honor a memorial to his mother in the area, after she was killed, and a woman bent down to touch his feet because he was a highly honored man, and she exploded, as she was a suicide bomber, killing him as well. There were huge pillars around the stone representing his 7 ideals or something, and the largest Indian flag in India flew over the spot. The orphanage is not far away. It is a different kind of orphanage than I am used to, and am not sure if this is the Indian concept or an exception. It is something of an Indian style complex with a courtyard in the middle for play, and a classroom on one side, living space on another, and a kitchen in a corner. The kitchen is an outside cooking area where the big Indian style "gravies" are cooked on an open fire. The dining area is in an upstairs room just over the kitchen, though in a close, separate building. The kids are adorable, and we were mostly with the elementary age students. They took us into their class room and showed us their projects and went through their English flash cards with us. Apparently, private schools these days are only teaching in English, and public schools are teaching in Tamil and testing in English because English is India's only common language, and therefore unites the country. Some are worried that with too much emphasis on English, Tamil will be lost. I don't know if that is possible right away, as many still speak only Tamil among the youths included, but I can see it happening eventually if they don't deliberately attempt to preserve it. Then, we played ball with them for a while and had fun, though I kind of tried to stay out of it since yesterday morning was the climax of my sickness, and I was sure my head would explode. Then, the kids put on a program for us, and some sang, some danced, some put on an Indian version of the play "Little Red Riding Hood" and it was pretty good. One of the older girls did some amazing traditional dance in full costume! It was actually very exciting and put me back to the days of Mrs. Sokol, who took great pride in the performance of little kids. Then, we were served a "friendship" lunch which we couldn't refuse, but we tried to eat as little as possible because they have limited food supplies and we were not at all confident in the safety of the food. So, no one drank the water. The food was probably ok because it was cooked, but we were a little nervous. So far no one has gotten sick from it though. Apparently Sri Ramachandra supplies free of charge all of the medical costs of the orphans and donates significant funds throughout the year. Most of the kids are the children of parents in prison, and most of the prison charges are for accidental murder- I think- I was not really understanding that part. The kids will be supported until their parents are released, and then they will return to their parents, and as I understood it, take care of their parents. Others have lost their parents in natural disasters, and others have parents who are very sick with leprosy and cancer and cannot take care of the children. For those who do not return to parents, I believe the orphanage helps build skills and find employment when they turn 18.

I finished my paper when we got back, and then went to dinner at the house of one of the nurses at Sri Ramachandra. Apparently she is a Christian, and I have been finding many Christians here, despite it being a Hindu College. I think for the most part, I have decided, Christianity is an accepted religion like Hindu or Muslim, and means not so much apart from being religious, especially when people are Christian because their parents are. Faith tolerance is very good around here, and many of the Catholic nurses I have come across have "boyfriends" of sorts who are Hindu, and they plan to marry. The families generally seem to be ok with this arrangement, as long as the man is honorable and has a good position in society. That is just my limited experience, so I'm not sure how it is across the actual population. When I asked about the potential religion of their future children, the nurses would say they will choose, and that will be ok. Apparently couples are satisfied to be of different religions, and say that they don't force their religion on their spouse and visa versa. I did meet one girl who converted to Christianity of her own free will, and her dad did as well, though the rest of her family has not, and she seemed much more passionate about her faith than other Catholics/Christians I have met. By the time we got to the house the worst of my sickness was finally passing and I felt half reasonable. It was a very different experience... it was apparently a typical middle class home. On the porch was drawn a chalk pattern that I have seen around, which apparently means "welcome" like the little wood signs people hang on their doors in the US. It was in a crowded, dirt road neighborhood, and some houses were typical Indian and some were nicer Indian style with pillars and such. The house had 5 small rooms, I believe- at least that was all I could notice- a entrance/living room, a kid's bed room, a kitchen, a small master bed room and some other kind of room that I couldn't quite define. The nurse introduced us to her family and had us come into the master bed room, which is smaller than the room Hannah and I share, and ALL of us were asked to sit on the bed! The bed was maybe a little smaller than queen size, and all 14 of us managed to sit on it! Apparently, that is the greeting custom! So, we sat there and the nurse's daughter served us some kind of Indian fruit cake and trail mix as an appetizer and passed around family albums. One showed the house warming party when they moved into the neighborhood, and there was a cow standing in their house! Since cows are holy, apparently a tradition is to bless a new house by bringing it in. If it defecates, the house is blessed, so if it is not in the mood to poop, they feed it all kinds of bananas until it does! There was a TV just above the bed, which was provided by the government for free. I think the Tamil writing on it some how advertised the political party that provided it. Some politician said if people would vote for him in Tamil Nadu, he would give all of Tamil Nadu a free TV, so he won, and delivered! I have seen the TV's everywhere, and often thought it was strange to see a mud hut with a grass/palm branch roof with a satellite dish sticking out. It was free apparently. She also passed out strings of jasmine flowers, which the women tie into their hair. They are probably the sweetest, strongest smelling flowers I have ever seen, and it is no wonder that they are used to complement the human fragrance! Eventually it was time for dinner, so we were led up onto her roof, where mats were laid with blankets over them. We sat in a circle under the clothes line and next to the power lines going next to the roof, and could see the moon shining through the haze of the night sky. It was absolutely beautiful. Dinner was a hard boiled egg and lemon rice. The eldest guests were given chairs, so since there were 3 chairs, both of our teachers and a student who is 27 where honored, and served first. We were all served, and given more until we were stuffed. Apparently, the hosts don't eat at all until everyone is done, so she only has left overs if there are any. That is the custom. Then, since Isaac (the master nurse student who let me ride on his bike) was there, we played some games together and with the kids while the older people and family talked. It kind of seemed like our family get-together s with the Meyers. So, we played telephone, and eventually said our good byes. the older student, who is already a nurse, started having heart problems while we where there so the husband of the nurse took her to Sri Ramachandra on his bike and brought her to casualty. Her EKG was fine, but they wanted to admit her for observation, but she refused as it seemed unnecessary to her. Apparently, since we are the guests of the Chancellor, the hospital is treating us like royalty because if anything were to happen to any of us, they would have to answer to the Chancellor.

By the end of the night, I had gained symptoms of a severe headache and was ready for bed while almost everyone else went to Isaac's house to have a dance party on HIS roof and drink. I preferred to sleep and take Motrin. This morning, I have felt much better, and though not perfect, believe I am finally on the mend. This afternoon we are having lunch with the Chancellor, and are supposed to dress up a lot, so I will wear my Sari again, I think. It is a sparkly orange with a green blouse which is kind of short around the waist, but I learned a technique to cover that up a little better, though not perfect. Apparently, it is ok to show different parts of the body as long as you are wearing different kinds of clothes. If it was just a t-shirt, it would not be ok to show midriff. If it was a skirt, it would not be ok to show ankles, unless it is a traditional wrap around skirt, when even knees are acceptable. Since the Internet cafe was having problems this morning, I went on a field trip to buy more salwar kameeze, as my other purchases need sewing, which must wait until I am home. One is red, and one is gold, and both are pretty. I love the style, and am determined to keep wearing them in the states. This lunch should be quite a major deal, as it is founders day, celebrating the birthday of the man who founded Sri Ramachandra. I can't remember the founder's name, as it is not Ramachandra, so I'm not sure where the name came from. This afternoon, I am hoping to spend some time hanging out in the emergency room, and maybe do some more shopping. Tomorrow morning we are leaving for the beach, mahably pourem (sp?) where we are staying in a resort. Apparently we are presenting our papers from that location. Then, I am hanging out in Chennai on Wednesday and flying home with Jenny and possibly the teachers on Thursday morning, at 1am!

I will miss India, and all of the strange customs I have come to accept, sort of, even if I cannot understand. All of India is different, and apparently the north is a foreign country compared to the south. When you are talking to an Indian, they wobble their heads back and forth to indicate agreement or continue the conversation, as when we nod our head yes, and it took forever to get used to the idea that they were saying yes instead of no. Sometimes, a more violent back and forth movement means no, and sometimes they nod like us to say yes, so it is still confusing, but I am getting better at it. The girls on campus have a strict curfew that they have to uphold, at 9 o'clock, so they are always rushing to get back with almost no time to spare. If a boy keeps a girl out much later than that without permission, it is generally assumed to be dishonorable and more than rude. To show respect, one's shoes must be removed in every home. Power failures are common. It is possible to cross busy streets- you just have to know what you are doing. The bendi (sp?) -red dot on forehead- sometimes has significance but now days is mostly just fashion. The youth of Chennai are very aware of American pop culture, though other places like Vellore are more traditional and limit their knowledge to India. I have passed mosques, with prayers and music blasting out of the big speakers, but no one ever seems to heed them, and I don't see Muslims kneeling on the street on command. Maybe there just aren't enough Muslims around here, or maybe the prayers/ songs I heard don't call for action... I'm not sure, but the Muslim influence seems to be significantly less around here than Christian and Hindu, where Hindu is most common. Many of the women are excited to be our friends, and are anxious to keep in contact with us. It is not hard at all to make friends with the Hindu ladies. When food is ordered, it comes out in waves, where anyone who ordered juice gets juice, and anyone who orders dosi gets dosi at the same time, instead of waiting for all of each person's meal to be complete. So, in the restaurant setting they don't seem to care much about waiting until all food is ready to serve, except in the nicer restaurants. I could go on and on about the things I have noticed, and maybe will write more when I get back to the states.

I have been consistent with my Malaria pills, and have been very conscientious about it. I checked my e-mail for the first time yesterday, since I was sending my paper to myself, and only had time to glance through, so I apologize to anyone demanding a response.

I can hear the music of India in the streets in honors of Founder's Day... I am excited and am leaving soon to put on my Sari.

While in open heart surgery, I was very careful, and was not at the height of my symptoms, and was thickly garment-ed in protective barriers.

Well, ta-ta for now, and hopefully I can write again soon!

Meeka Nandre!

Last Day of Clinicals, Sri Ramachandra University

This morning, we concluded our clinical portion of the exploration seminar, and it was quite impressive! My rotation brought me to an open heart surgery! I got to see the beating heart in the chest cavity, and watched the doctors artificially redirect the blood flow into a series of tubing, and then stop the heart! Apparently, the heart is not always stopped in these procedures, but was in this situation becuse the surgeon also had to replace the aortic valve, which requres severing the aorta, so blood flow was re-directed. So, we got to watch him cut off the valve and sew in a artificial one that seemed to work splendidly, as demonstrated by the surgeon. Sometimes animal valves are used as replacements, but it depends on the case and patient. We watched him sew in a vein harvested from the patients chest or leg (I wasn't sure which as we missed the harvesting) to serve as the by-pass. The surgeon was talking to us, and I was very impressed, as he sounded like a sports announcer. He was discussing Seattle, of which it would seem he is familier, directing his helpers, and commenting/describing the surgery in a fluent, continuous, effortless breath. Sadly, we had to leave before it was finished, to see the surgery ICU before going back to lecture and our farewell/thankyou tea party for the staff at Sri Ramachandra. I am hoping to be almost done with my paper by this afternoon, and tonight our journals are due so 1/3 of our grade will be complete!

Tonight, I am hoping to go to the final cultural event, which is Indian dancing. Last night I went to the Indian singing, and several very famous actors and movie directors made appearances and performed, and I was sitting not far from them at all. One of the young doctors who was sitting with us was trying to explain them to me, but for the most part I was lost, and their fame was wasted on me. Everyone else was excited. Now I really know what it is like to be a foreign exchange student. Tonight is the main event though... there will probably be many sightings of the rich and famous of Chennai! One of the songs last night was from a Tamil movie we watched on the bus last weekend, and I was excited to recognize something at least.

Tomorrow morning is the orphanage!

The sickness of the group seems to be worsening, and now I think everyone is about equal on worse-ness. My respiratory ailment has evolved from a sore throat to a cough to now a very runny nose with lots of sneezing, and most others have followed the same progression. It is not fun at all. I hope everyone is doing well in Seattle!

Oh, please tell Grandma Fay "thank you" for the kind birthday wishes, along with everyone else!

Sri Ramachandra, Thursday

I am electing to take some time to re-discuss a place I visited in Vellore. RUSHA, not to be confused with Russia, was a health care center supported and run by CMC, which catered primarily to the poor and villagers in rural India. They have an elaborate system, where they have divided villages into blocks, and have offices in each block, and each block trains members of each village to meet their specifications as a health care diplomat of sorts. This "diplomat" goes throughout the village and checks on people and helps to educate them in health care. This "representative" is usually a married woman with children, as they deemed that important for one reason or another. RUSHA is an acronym, which I cannot write here as I have forgotten it precisely, and the book I have it written in was checked in at the front desk, as this library (at Sri Ramachandra) is extremely strict and only allows us to bring in a pen and a few sheets of plain lined paper to take notes. So, RUSHA was about an hour and a half drive out of Vellore into the rural areas of India, and we saw their health facilities. They also have a school for young men, designed to train them in skills to do some kind of work, like fix cell phones or other things like that, which gives them an opportunity to find employment and thus an honorable income. They focus on education, and have programs meant to go directly to the community. It is the ideal model for this kind of care, and is cited globally as a success story for bringing care to rural populations.

We have mostly been around Sri Ramachandra, apart from going to dinner with the master students. Today I was supposed to go to OBGYN, and I did, but at the last minute we were invited to the beginning of a national conference on child abuse being held on campus, so I was only there for an hour and a half, and thus was not able to see a birth. :( Perhaps tomorrow afternoon it can be arranged to go back and try again. Tomorrow I am assigned to surgery, but it is again cut short as there are lectures and conferences cutting into clinical time. Perhaps we are more guests of honor here, or perhaps it is the Chennai or Sri Ramachandra way, but we seem to be involved in far more ceremonies and "pomp and circumstance" than we were at Vellore, which in some ways is nice, but is crippling my efforts to see health care. The OBGYN ward was in the free area, so there were considerably fewer luxuries than I have seen in the pay ward, though it is still much nicer than the general appearance of CMC. At CMC, everything was free with the exception of a small pay area that was nicer, and at Sri Ramachandra, everything is pay with the exception of this small free area, set up specifically as a unit for students to practice. So, these patients get free care as long as they are willing to give up all privacy and have anyone watching, and have students working on them who may not be the most experienced people. As one doctor said however, the worst part of Sri Ramachandra, or CMC for that matter (since they are both private hospitals) is far superior to the care and appearance of government hospitals, which also offer free care, but which is full of corruption, infection, hospital induced disease, bribery, and unskilled care anyway. Apparently, you have to bribe care takers for food, care, or basic items of comfort. I am still not sure where these private and government hospitals get all of their funding, but I think at CMC at least, the motto is to take from the rich to give to the poor, like Robin Hood, so those who can pay must (I think at reasonable rates) and if you can prove you can't pay, you are given free care easily. If you say you can't pay and can, they have ways to find out, so apparently people have a hard time cheating the system. They take such good care of their resources and are very careful with what they have, that I do believe that the fees of those who can pay are substantial to cover the fees of the poor without burdening anyone. This is a private hospital, so their practices do not necessarily indicate success if it became a nation wide phenomenon.

For the next couple of days, the students of Sri Ramachandra are putting on cultural dances and events, so last night was American dance. I went to about 10 minutes of it, at the end, in a large auditorium set up like an American style concert hall for hip hop etc. Apparently, famous movie stars and movie directors were making appearances throughout the night. Tonight is Indian music, and tomorrow, the main event, is a long night of traditional and modern Indian dance. It is quite an event for just a campus location. I believe, though, that these events are the reason we are at Sri Ramachandra now, as the chancellor invited us at this time specifically to attend.

This Saturday we are spending the morning playing with kids at SEED orphanage, and Saturday night having dinner at the house of one of the nurses who has been working with us a lot. On Sunday, we are having a fancy banquet with the Chancellor, who is the son of the founder, whose picture covered with garlands is all over the hospital, and which you can find on Sri Ramachandra's web page. The founder and his wife are buried in a big memorial/tomb on campus, which is pretty and well lit at night.

Well, I must get back to writing my paper! Sri Ramachandra is very different from Christian Medical College!

The set up of Chennai is quite striking, as it is much more western in many ways, but traditional in others so moder and poverty/tradition are side by side among the trash. The KFC (the first American restaurant I have seen, besides one McDonald's I saw yesterday) is right next to a small grass hut complex with goats grazing, trash and sewage running by, and the big main traffic filled street going front (which I walk along to get to the Internet cafe), so poverty and the west are side by side, almost without reconcilliation. In more downtown, which we got to see more when we were travelling to the clinic for leprosy yesterday, large sky lines are bordered by poor communities, and a nice western car dealer is smack in the middle of rubble. It is very different from Vellore, where everything was about the same in appearance, and significantly more traditional, though surrounded by trash.

Another Day at Sri Ramachandra

On my weekend excursion, the Muslim festivals took precedence over our sight seeing adventure so our travel agent was unable to find even the worst tickets, so we had to use the temple traveller vans the whole time. I think I may have written the wrong information previously- we were travelling west to the next state to the left. The elephants had been dangerous at one point, but when chained and guarded by people with sharp spears, were convinced not to do anything rash- these were not tame elephants, but instead the real deal. We couldn't ride them, as it was knowledgeable tribal people on top, and we were pretty much breaking a bunch of laws to even touch them, as our safari driver was rushing us through the process. There was apparently a tame elephant for riding at the palace, but we got there so late with all of the frustrating previous delays, that we couldn't by the time we were ready. At least I have touched one. A Ganesh (sp?) is an elephant shaped Hindu god that was the feature of a Hindu festival around here all week. Also, I was going to mention that I haven't been able to use my cell phone since the US, as the service is poor to nothing, and right now I am trying to leave it off while it dries out after going through a major water incident. I hope it will be ok, and will attempt to find out when I am back in the country. Yes, I found all of Jasmine's friends, Neil.

My birthday evening was fairly low key, but nice. One of the master second year nursing students was going to take a group of us to KFC, which is near the Internet cafe for dinner, but my stomach was feeling delicate still and I wasn't too thrilled with American food while enjoying the wonderful tastes of India. Also, Ardie had said she wanted to bring me to dinner somewhere, so I felt bad eating there, as I had no way to contact her. So, the master student brought me on a ride on his motor bike back to Sri Ramachandra, in my Sari! I felt like one of the locals, as some man is always driving bikes with some lady in a Sari clinging behind. I had to ride side saddle, so one foot was on the peg and the other was dangling for dear life. Since it was later at night, the traffic wasn't as bad, and he knew it was my first time so he drove slow and easy. It was very exciting! It turned out Ardie had eaten already, so I just ordered from the canteen (Tiffany's), which is a sit down place with a food court feel- you can order food from many countries, but they bring it all to your table. Then, she took me on a night walk around campus which was nice. The Indian's were excited to see me in a Sari.

Chennai is much larger than Vellore, and in many ways more western, but much more dirty. The women are rebelling a bit from the sari, and when possible seem to prefer the salwar kameezee, which was opposite of Vellore. The traffic is much worse, and we aren't allowed to ride the autos here, which are black and yellow instead of yellow, and much faster and less cautious. So, there aren't as many journey's away from campus. The hospital itself is much nicer to look at than Vellore, though tomorrow I will see the free area, which so far has been reported as shocking. I will be watching the delivery of babies, and am quite excited! Today, we went on a field trip to a leprosy clinic where we learned about some rehabilitation efforts for patients with leprosy. Again, it seemed much nicer to look at than RUSHA, which also caters to community needs, in Vellore. I think over all, I am liking the concept of CMC better though- they have limited resources that they use wisely to reach as many people as possible with quality care. Sri Ramachandra has a smaller capacity, and has fewer programs to help the poor, and invests their resources in the building too much almost- there are crystal light fixtures, marble floors, and with the recent remodels have many luxuries.

My room is quite comfortable, though a window in the bathroom is unable to close so my roommate wants to keep the door to the bathroom closed to keep the rats away. The laundry system here will not do undergarments, so yesterday I spent a long time doing old fashioned washer woman work with a big bucket and soap in the shower, and did my laundry by hand. It is still drying in my room. It is something as a hike to get up to my room since it is on the 4th floor, so 8 flights of stairs, and we pick up our key on a separate floor from where our room is. We can't really use the elevators because they are slow and power failures are very common.

Yesterday after pediatrics, where I was in the PICU (pediatric intensive care unit), we ended up going out to dinner with the masters students, who are all mostly our age since they start nursing so much sooner, and it was fun to talk to them about their culture, and especially their concept of arranged marriages, which seems in many ways to be deviating from their parent's views.

Health in the group is beginning to fail, as almost everyone is sick to some extent, including myself. I haven't been too nauseous since yesterday morning, but have developed a bad cough and fatigue, and am packing on the meds and water. I hope it gets better before long, as I think I am among the top 3-4 worst hit cases. Right now I'm ok, but I also had some medicine.

It is very much more hot and humid in Chennai than in Vellore, and even the locals complain of the heat and prefer to remain indoors in the air condition.

The agenda for the rest of the week is to go to OBGYN tomorrow, and surgery on Friday. On Saturday we are going to an orphanage, and having dinner with one of the nurses. On Monday, we are leaving Sri Ramachandra to go to the beach!

I hope everyone is doing well at home, and all! I haven't heard from the Rotta family yet- I hope they are doing ok!

San doch e ma. :)

on to sri ramachandra...

the shift key on this key board is problematic, so please forgive the lack of uppercase letters. i am in an internet cafe just off campus from sri ramachandra. it costs 20 rupees an hour, so not bad at all. it is a bit of a walk at night, but i will do my best.

it is neat to watch surgeries, because you know it is in the best interest of patients and at least an attempt is being made to improve their lives over all. on tv, most gore is violent and disgusting because someone is willing the harm of another, and it is disgusting to watch something eat humans or murder them out of malice.
this weekend was quite the experience, and gave me a good taste of india in ways i was not really expecting, but are india none the less. we left at like 5am on Saturday morning in the temple travellers, and most of us slept, but it was not the most comfortable sleeping situation. Then, we had some movies get put on... and the first one was not particularly thrilling and an american movie on top of it which i thought was inappropriate to be watching in inda, so i tried to ignore it and watch the scenery, but the sound was dominating my thoughts. Then, we started watching that icky 'predator' movie, and i made extra effort to ignore it, and they finally turned it off. my travel companions have great tastes in movies, must be said. finally one of our 2 drivers who learned english well from tourists put on a historical romance about an english governor's daughter who falls in love with an indian peasant at the time of india's separation from England. it was very interesting, and reminded me a lot of the titanic story, in some ways. Between all of this we stopped for a couple of meals, and i decided i would rather risk the restaurants than starve, and they weren't just fruit stands on the side. We finally made it to our jungle inn in the next state over from Tamil nadu- going east- around 2 pm. They speak a whole different language there, so most Tamil i have learned was not of help. the jungle inn was one of the best experiential places i have ever stayed. it is run by an indian man who lived on the east coast of the us for 30 years, and some of his indian family says he is too american to be indian any more. he has only been back 8 months. since he was so well versed in india and us, we had a great conversation about india ways and politics, comparing the 2 countries. it was just the 17 of us and another family of 5 or 6, so we had the place to ourselves. We stayed in big canvas tents, like at cascade's camp that had screen doors, clear plastic windows with curtains, wood frame beds and a bunk bed, and a seperate room where a bathroom was installed. i really felt like i was camping in the jungle, since we were surrounded by jungle. Then, we went on the safari, provided by the inn, so the jeeps came right up to our door. my tour guide was funny, and could speak some english but not a ton- just enough to make tons of jokes that no one really understood with the language barrier, but were still funny for all. he just brought us along a forest road in a big national park, and pointed out things along the way. we saw a couple of king fishers, some niger birds - which you can tell because they have red glowing eyes at night, and some black faced monkeys jumping on the branches, and a bunch of peacocks, spotted deer, jungle fowl, and a bison. we also saw 4 big white elephants! they were in a tribal village, brought to the area by the people for the ganesh festival. apparently, all of the elephants have killed people, so instead of killing the elephants, they are captured and sort of tamed. one of them had people riding on it, so we got out to pet it while the riders kept it from killing us- seriously- and we got a bunch of pictures. our last stop was a coffee plantation that was also growing black pepper on vines up the trees. the owners gave us each a cup of coffee and again i decided to be brave and try it. the coffee is always in small cups and super hot, so it takes forever to drink despite the size. there were also a bunch of rice fields around us, so we got a taste of the local agriculture, but i haven't seen any wheat. We came back in the dark to see nocturnal animals, and then hung out with the owners until dinner, which was kind of family home cooked just for us, so everything was very flexible and fit our needs. it was a nancy drew kind of resort. after dinner, the tribal people came to a bonfire just out side of our dining area and did some tribal dances and had us join in going around the fire. it was a lot of fun, and so peaceful, and we made friends with the owners and safari drivers. we were supposed to leave early the next morning to make it river rafting, but it took the vans forever to come. 2 hours later, the inn owners offered to help them, and suddenly they were working, and we were ready to leave. the inn owner cautioned us that they were trying to be lazy/cheat us and nothing was wrong with the vans, since it was easily fixed when assistance was offered... apparently that is a common problem. They took us to the rafting place, and it looked like a fun river, though muddy, like the kind we often travel. however, since we were delayed with the vans, the boat place had given up our spot, and the next opening was not until the afternoon, and we had no time to wait. i was super disappointed and frustrated with our group who was not particularly charged to make rafting happen, as it was either too boring or too scary. so, we drove another few hours to mysole, to see the grand palace. we ended up stopping for lunch first though, and everyone took forever, so we didn't get to the palace until an hour before closing, and i was super discouraged because now everyone was saying they didn't care about a palace and wanted to go shopping, and i really wanted to see it. i kind of forced the issue, and finally got up a support team, and we made it in. a bunch of boys kept swarming toward us to take pictures with us, and that was frustrating because everyone was humoring them, which was delaying entrance to the actual palace. After wheeling and dealing, we made it in, and only had a half hour to whip around, so there was no time to rent an audio or hire a guide, which was also discouraging because i love to spend hours and hours in grand museums- especially foreign palaces in india. at least we made it in though, and saw it. it was very nice. a ceremonial king still lives there apparently. outside again, people kept trying to force us to buy stuff. it was all very nice, and not too expensive, but i was almost out of small bills... maybe that helped though, because i couldn't settle for anything but my price, as i couldn't afford more without paying like 500 rupees. i bought a sandal wood -which mysole is famous for- fan, and some post cards. now that the palace was closed and not an option, i wanted to do some more shopping, but all of a sudden there was a downpour of rain that was flooding the streets and flooding us all. some tuk tuks couldn't drive anymore and were abandoned in the street. also, it was dark, so we just kept driving. we were considering staying in bangalore, but had so much further to go that we couldn't waste time stopping to get back to chennai in time for orientation at sri ramachandra. the drivers were much more helpful too, as they had talked to ardie, who had given them the what for. if they had showed up on time in the morning, we would have been able to do the river trip, easily see the palace, and not be driving so late at night. oh, in mysole one of our drivers got hit by a motor bike while walking and broke his foot and had to go to the hospital. we ended up driving for 9 hours plus, and finally pulled into sri ramachandra around 4 in the morning, and went straight to bed in our new rooms. i was astonished a few minutes later to hear a loud buzzer sound, and thought it was the fan breaking, so i turned it off. a few minutes later, it happened again, and i heard a faint knock outside, so it thought someone in our group was out in the hall, so went out to ask what that sound was. when i opened the door, a man came barging in and thrust some paper work into our hands and told us to fill it out about our room. apparently the buzzer was a door bell. so there we were in our pjs at now 5am filling out our visa/passport/room info, and he couldn't speak english so we were having a terrible time communicating, and it took way too long, and i was frustrated. we finally finished, and he decided to show us the tv, and started flipping through all the channels! i was trying to decide if he didn't realize it was the middle of the night, or if he just woke up early and thought we did the same, or if he was just determined to be rude. apparently he did the same thing to all of us. i was too shocked to really think it all through, and in the end decided it was really funny. We woke up around 7;30 this morning, and made it to breakfast at tiffany's. i wasn't too hungry, and as i ate my puddie, suddenly felt really sick and made a run for the non- flush bath room, and made it just in time to lose my breakfast. i felt much better after that. it was just the one time, and while my stomach feels delicate and i am not very hungry, i don't think i am sick, but we shall see. The hospital is much more welcoming than cmc was and held a celebration in our honor, and the clinicals were much more organized, and the building is in general much more modern. i'm not really sure that i prefer it to cmc though... it just looks more westeren. i have yet to see if that is a good thing. i was in pediatrics again, and got to help interview a patient, and hold a new born baby. after our lecture this afternoon, ardie got one of the nursing master students to help me wrap my sari, and everyone signed a HUGE card for my birthday, and a master student brought in a beautiful cake, and Elizabeth - a girl in my group- gave me some gold colored bangles, and we had a little party for my birthday. then, another girl named dayl took me outside for a fun photo shoot. i enjoyed it. i'm not sure what my plans are for tonight- there is a lot of stressful planning that i am trying to stay out of, as bed sounds good right now. Ardie was saying something about taking me out to dinner, but i don't know how that will work, as i have not seen her in a while. a bunch of other people are going to a ganesh festival, where the hindus through their ganesh into the ocean, and everyone is drunk and dangerous. it wasn't seeming that great too me, in any way, so i am boycotting. there seem to be a lot of cultural events to participate in this week. oh, i found a birthday card in my suitcase from home...
i found the girls who know jasmine, and they say hi back, Neil.
i am not sure how long med school takes, but i am sure it is much shorter than in the us, and i know that they start younger.

Again, I'm not sure when i can write next, but that is the scoop from chennai!

Last Day in Vellore Continuation

I was just interrupted, so here is the last of my story...

So, some people wanted to go to the fort, and I needed to go there to pick up my sari, which after a lot of conversations was finally established to be done. I did not go with them though, because I was supposed to look for my new German friend (who worked in surgery as an international med student) Katha, because we were going to go together. So, I walked back to the hospital in Vellore (a 10 minute walk or so) and we got our first dose of Indian rain. It poured. And poured. I was soaked to the bone by the time I got back to the hospital, and the papers inside my backpack were soggy. I spent a long time trying to find my way back to surgery to wait for her, but it was confusing and took a while. I hadn't seen her all morning, but thought she must be somewhere around there, since she was still doing surgery, so I waited at the door to the operation theater, and finally the time came that she should be done, and she did not come. I asked some nurses, and they either didn't know who I was talking about, or said she was in there. So, I waited. But, without scrubs and a badge I couldn't go too far. Twenty minutes later I decided she must be in surgery ICU or something, and the guard let me in because of my lab coat, and helped me find my way in, and laughed at me to some nurses as a foreigner, but I heard. What ever. She wasn't in there either. So, I decided to find a pay phone to call her, since I had her number. The first phone wasn't working, the second was jammed so I could not put in my 1 rupee coin, and I couldn't find any more after that. The rain was slowly stopping, but the streets were pretty well flooded by Seattle standards, and it was hard to walk in the street. Sunset was approaching, and I still had to get to the fort, so I decided to go alone. It took forever to hail a tuk tuk, (I don't really know how to spell them, as that is our local name for them- not the official- they are officially "autos") since it was closing time, rainy and everyone was trying to get home. Finally someone stopped for me, and was way over pricing his fare- like 30 rupees for a 10 rupee ride, but I didn't care. I just wanted to get done. I found the shop, and along the way everyone was staring at me and wanted to know my nationality. The shop owner was waiting, and apparently had come in on a shop holiday just for me. He had another problem though- the sari blouse was not finished. I finally convinced him that I was leaving Vellore tomorrow, so he set me up with a cheap ready made blouse, and got everything figured out. He must have seen how disappointed I was that after a week, there was still trouble, because he finally said "come back in an hour and I will have it finished" so after all that waiting, I decided I would try it. So, I went over to the fort, which was closing shop for the day and was looking abandoned. And, it was starting to get dark, so to avoid a ton of attention I sat on a nice set of steps into a big sports field right across from the big temple tower in the middle of the fort, which looks a lot like the Aztec/Mayan wonders/castles in Age of Empires II. There was a pack of dogs in the area and they seemed like a little gang among themselves, but left me alone and one fell asleep near me. I just sat and wrote for an hour. The sun was setting just as it was time to go back, so I hurried back to the shop, and no one bothered me. One man asked me for directions though, which I though was kind of funny since he was Indian and I was obviously foreign, but I was still wearing my lab coat to look official and less like a target, so maybe I looked official enough to know what I was doing. He spoke pretty good English though. I got back, and had to wait a little while because "the boy" was bringing it back, and the shop owner was just about to call me, which wouldn't have done any good since he had Ardie's number- not mine since I used Ardie's phone to call him earlier. A few minutes later, "the boy" came, and I switched my cheap blouse for the tailored one, but still had to pay the full price. It seemed like he would reduce it, but I suppose he was "kind" to get it finished so quick, and I just wanted to get back to Bagayam and not be alone there any more. So, I left. He seems nice enough- his tailor is apparently a problem though. So, I quickly hailed a tuk tuk and told him to go to Bagayam, and I offered him 50 rupees, even though it is a 30-40 rupee trip, and he insisted on 70, with a smirk smile. I was livid, but finally agreed since I just wanted to get home, and didn't feel like dealing with other drivers, and I suppose it was dark which is a legitimate reason to raise prices slightly. He picked up another family of women, and dropped them off first, and I kept telling him Bagayam, and he kept saying ok, but is was obvious he didn't know where to go exactly. I had to give him directions, and he kept smirking back at me. I wished there was someone else in the auto with me. He ended up asking a guard for directions, and I had him bring me in a little, and got out and payed him 70 rupees, but he had a pill and said I owed him more, because he brought me in and didn't leave me at the gate. I was really livid, and told him we had agreed to 70, and that we were at Bagayam, and had not gone somewhere else, and he was already overcharging me. He kept arguing, but so did I. I didn't have an extra 10 rupee bill- just 100s, and didn't want to give him that much. He finally let it go, and we parted friends, I suppose. All of the other drivers take us all the way from CMC to our Alumni house doorstep and don't have a problem, for 50 rupees... I wasn't liking to be taken advantage of. I was just glad to be back, as a couple of times I wondered if he actually would take me back. So, that is my adventure with nighttime Vellore... thankfully all was well.

Tomorrow morning, most of us are leaving at 5am for a place half a day drive east of here to go on an Indian Safari. There are supposed to be lots of elephants there, though I doubt we will ride one. the original point of the trip was to ride elephants, but the only place available is far away and would only give a 15 min ride, or so saith our travel agent. Instead, we are doing the Safari, and going rafting, and touring an old town with a beautiful old palace, then taking the public train back through the night Sunday evening, and starting back up with clinical in Chennai on Monday- my birthday. Ardie wanted me to make sure to pick up my Sari so I could wear it on my birthday... I guess I will find out why. I can't remember any of the places we are going's name, but I'll be able to tell all about it if I get a chance when I get back. Trains are well booked these days, so I think our seating is just about the worst, so it will be something of an adventure. I am only bringing my carry on case, as Ardie will take our luggage to Chennai. She is letting us use temple travelers (the buses we rode in from Vellore) so our travel costs are greatly reduced on the way there, which is nice. We are staying at a lodge of some sorts- it is so nice to have a travel agent for all this stuff!

Apparently, Chennai has a different relationship to UW than CMC, so we have a much more structured set of rotations, but more freedom in the afternoons to wander where we want without a whole ton of paperwork. I am planning to "hang out" in the ER a couple of times... because I am sad I didn't get that rotation here. We are staying on campus, where Internet is not available in a dormitory annex. Apparently traffic is worse there than it is here, so we won't be getting off campus very much or very far, it would seem. Our clinical will be shorter however, giving us a study block for discussions and time to find information and write our paper, and prepare presentations. There is a rumor at some point we will be assigned nurses, or a group of us will be assigned a nurse "sister" who will help us shop/sight see and help us get local rates. That would be nice. So, Sri Ramachandra will be a whole new set up for a week.

I will miss CMC a lot though, and Bagayam and the monkeys and banyan tree out my window. Lovely the nurse got my e-mail and wants to keep in touch with me, and my German friend Katha gave me hers, so we can also keep in touch. She is a true kindred spirit, and a strong Christian, and says in ten years or less I have to come stay with her in Germany. The supervisor in surgery also gave me her number, and is expecting me to call her. I probably will- though figuring out the international call will be an adventure. I will also miss the front desk boys at the Alumni house. They are so kind, and are Christians, and always play Christian music really loudly. One might come visit us in Chennai, as he has made a lot of friends in our group... he is maybe 25 years old? Hard to tell... so a lot of the people (nurses, staff etc) are our age, and many are Christians. I haven't heard of a single conversion story though, as I often ask why they are Christian, so it would seem many are because their family is. It must be hard to convince the other faiths to give up their faith and become Christian. At least they are tolerated. Sri Ramachandra and Hindu land will be a little bit different me thinks, but interesting. Well, I have to look up a couple of articles, so am signing off for now! Bu-Bye!

Last Day in Vellore

This may be my last post in a while, but I will try to keep it up next week, though I likely won't have as much time to be detailed, which is already difficult now. I'm glad you like the white text, as the overwhelming opinion seems to be. I will ask around, but so far no one has mentioned friends in Ecuador.

Today I was in surgery again, so I sat in on some more interesting surgeries. The first one was a biopsy (meaning you go into the body and get body part samples to test and discover a diagnosis for a problem- in my last post I used some medical terms on purpose as I did not think the general public would want to know the names the general public would use). They made small incursions and screwed in some tubes that they used to put cameras and knives down into the stomach, which was inflated. They used the camera to explore the abdominal cavity, so I was able to see the working liver, small intestine, large intestine and several other major features. It was very interesting, and the color was clear! They removed several samples. The second surgery was a thyroid removal, like mom had. They put her to sleep, then made a slit along the throat, and cut through the muscle. Then, they used strings to tie off a whole bunch of blood sources, and used a hot wire to burn through the organ to make a clean cut. I could smell the burning flesh whenever it turned on. The patient started to wake up half way through the surgery, and they had to quickly put her back under. Some of the blood sources were not tied completely, and a fountain of blood would spurt out, and one stream almost hit me, but I dodged out to the way. :) It was very interesting! Then, they sewed it back up (the muscle layer, then the skin layer on the inside, and then the outer layer, and the stitching was good, and after all that I saw, I think it will work out quite nicely for her. I got to close a tube, so felt like I was part of the surgery, and a med student got to help do one stitch on her, and it was his first ever and he needed a lot of help, and it was kind of exciting and I felt like I could understand him. He was one of the international students from Europe. We had to end our rotations early to make it to a thank you celebration we were throwing for CMC (Christian Medical College) to thank them for letting us stay. I helped Ardith (the teacher) buy cold drinks from the local markets, and we had to get like 10 big soda bottles, and we were something of a spectacle. We took an auto to the new school of nursing, and some other students brought a huge sheet cake, and it was rather nice. Sadly, we also had to turn in our CMC badges. Afterward, a bunch of people went to the fort.

Carrie the Surgeon

Vadecome! After another long day in Vellore, I have at last managed to secure a relatively decent computer, where both the Internet, automatic re-start and letter "w" are working. I attempted to fix the difficulty reading my blog- whenever I look at it as an Internet user or signed in it looked fine, but for the convenience of all it is adjusted. Please let me know if further modifications are necessary. Also, I spent more time than I had for the convenience of others to figure out how to enable unnamed comments, so again, please let me know if you have need of adjustments. It is essential to understand that I have less than 1 hour per day to spend on Internet with extremely slow Internet with issues that make me think I have returned to the dark ages of computers in the 90's. Yesterday, my day was from 5:30am to 12am non-stop. Our standard work day is from 5:30am wake up, to a quick shower (being careful to keep my mouth closed) since a shower is absolutely necessary each day, to 6:30am breakfast, to catching the bus at 7am, making it to clinical rotations by 7:30am, working in a rotation until around 10:30am when the universally upheld coffee break is initiated, continuing until 12:30pm when lunch occurs, and ending the clinical around 4:30pm. We then catch the bus at 4:45pm, get back to Bagayam in time for discussion groups and lectures with our teacher Ardith, having dinner around 7pm immediately following, and around 7:30pm I head to Gault Library to attempt to communicate with y'all, and with computer problems and library closures looming, I leave around 8:30pm or 9, and go to bed by around 10pm, to repeat it all again. This whole schedule, I should inform you is of course by Indian time, meaning it is subject to much change, and much fluidity, and it is almost impossible to stake your life on something occurring at a particular time. It has been fascinating to get to know CMC a little better. The nurses all wear white saris with old fashioned, plastic nurse caps. They are all called sister, and report directly to one lady, who no one can interfere with. The nurses are not even allowed to criticize the nurses unless they go to her first, so westerners (doctors) get in trouble with her when they say "nurse!" instead of sister, and then yell at them. They learn quickly. It is neat how protective and family like the nurse staff is. Our clinical this week have been very interesting. I believe I mentioned I was in pediatrics for the first two days this week, while other groups were sent to other departments such as community health, surgery, emergency, mental health, rehabilitation, and a couple of others. Our supervisor, Rema, arranged for the 4 of us sent to peds to spend half of each day at a different ward, so the first day our assistant teacher Barb's daughter, named Becky, and I were assigned to the medical ward in pediatrics and the surgery recovery ward in pediatrics. Yesterday, Becky and I went to oncology first in peds, then pediatric ICU. In the medical ward, we were given an extensive orientation about pediatrics in general, then were given a facility tour. The hospital is very unimpressive in general, and seems to lack basic sanitation that is much expected in the US. The beds are close together, and protective barriers are of limited use. Equipment is cleaned and re-stocked, and there is a lot of dust, as with the rest of India. As you get to know the hospital better, initial shock becomes admiration, as we learned that there are few diseases obtained by stay in hospitals, and it is purposely not remodeled as often as rich Americans take on to keep costs low and fees affordable. Supplies are well maintained and carefully re-cleaned so that large fees would not be used on equipment, where recycled materials do fine. Waste is limited, costs are reduced, and the care really is world class. Who says a building has to be pretty, as long as it is maintained? I still see some practices used that make me cringe, like bare hands on sterile procedures, but they clean their hands well, and are much more motivated to keep their personal space sterile without extra barriers. It is a very different concept, but it seems to work! Anyway, we saw the ward, which has about 30 beds. In pediatrics, a parent or guardian is required to be present at all times, so dads take time off work, or moms leave their other kids in someone else's care and come stay for days, weeks or months with their child, either sleeping on the floor under the bed, or in the bed with the child. They don't seem at all put out by it, and it is very apparent that family takes great ownership in their child's care. The hospital does not often provide food- there is a kitchen that the parents are able to use to cook food for their children. If special dietary restrictions exist, the nursing staff gives them appropriate recipes. The parents help give medicine, and a whole bunch of other stuff. So, to visit a child, look for an adult as well. The kids were sleeping, so our nurse, Lovely, talked to us about care, and when we exhausted that topic, turned to arranged marriages, and the ease with which nurses can transfer their knowledge of Tamil to Hindi and other Indian languages, as there are many, and all of India comes to that hospital (one man Barb met came on a 10 day train ride for care), so even within India the nurses must deal with diversity. It kind of sounds the the US! After lunch, we went to the surgery ward, and Lovely was again our nurse. She introduced us to several children recovering from burns. Most burns seem to happen when children spill burning oil lamps all over themselves, in the night in particular, or when they have to carry oil lamps on their heads up mountains in the middle of the night. Apparently it happens. Other burns happen when mothers leave children alone in the kitchen, which is simply a burner on the floor with a big cooking pot, and the child touches the burner or fall into the "soup". One little 2 year old girl fell into the "soup", and was burning, so her 3 or 4 year old older brother dived in after her and rescued her. They were both admitted together, and the nurses were all amazed that the brother had the sense to pull her out. Rather than covering them with bandages, the nurses recycle portions of the products of giving birth, retrieved from the department where babies are born, and cleaned for this purpose. It is apparently a good way to recycle and keep the burn sterile. Again, we ran out of things to do, so Lovely talked to us for about 2 hours about India. She told us many things, such as: the buildings are brightly colored just because the people get board of the color, so it changes to a new bright color every couple of years. Hero worship is a major problem in India, as famous movie stars become "hero's". The poor and unemployed will become full time fans, and throw huge celebrations on their birthday, or spend all day watching movies featuring them. Many politicians are movie stars who are elected because they have a strong fan club. They become gods, in fact, and the fans will set up big cardboard cut-outs of them under a shelter and poor milk (a ritual done for gods) all over them, and cover them with flower garlands. One famous movie star died a few years ago, and Lovely tells us 20 people seriously died of shock, and another 70 committed suicide. Though it is not always this dramatic, hard-core devotion is not uncommon. She also told us of another woman who a few years ago nearly convinced the government to give her a castle because she was so convincing at claiming she was a famous India princess from 4000 years ago who had been reincarnated in her body. Many people were convinced, like the Anestassia myths. Marriages are still often arranged, but since she is a Christan, she has more freedom and is unmarried because no one "is to her liking". She told us a shot history of their government, and some of the local myths etc. She is quite a lady, and very young! They start nursing school by age 17, so are well into the field by the time US nurses are graduating. This is just a fact, by the way, not an opinion. Talking to Lovely has probably been the most insightful part of my trip to India so far. Yesterday, we started at Oncology. We received a brief course in Oncology nursing basics, then were assigned to follow a nurse, and watch her give chemotherapy treatment, medication and treat medication side affects in each of her patients. Then, we watched a doctor do her rounds, and I got to talk to 2 male nurses who are just starting. It was very interesting. There are few male nurses in India, because the women are protecting it as their "thing" and not encouraging males, and males in general look down on nursing as a profession. Nurses, after all, are much more like the nurses of old, who do everything from cleaning the building, to doing CNA work (they do not have a CNA position) to passing meds, and doing the advanced work known to Americans. It is also not payed as well as American nurses, though they are just as qualified. One of the male nurses was forced to become one by his family, who were all nurses, and whose uncle was one of the first male nurses in the hospital. His family is Christian, and he comes from a long line of missionaries. I think one is even a missionary to the US. Don't quote me though- his accent is much different from mine. In the evening, we went to the PICU. It is much different from the rest of the hospital, as it is air-conditioned, and much more sterile. You have to change your shoes to go in. There is a lot of suffering, and most of the babies won't survive very long. Many suffered from fever, and we could see their heart slowing before our eyes. We mostly just watched and observed, but looking at them was very self-explanatory. Toward the end of our shift, a little boy was brought in with a bandaged head and a neck brace. I found out later that another girl in our class (Heidi, who is an RN) saw him come into emergency. He was in a bus accident (which made it into the news) and was tossed out of the window to avoid burning, and cracked his skull open, and his brains were coming out when she saw him. It was very distressing for her. When he came into PICU, he was doing much better and was conscious. Heidi was in PICU (Pediatric Intensive Care Unit) today, and got to see him, and says he is much improving. People from our group saw several hard cases that day, including an incident where CPR was required, but I don't think the patient survived. Today, I was in the surgery department! It was a unique experience like would be very hard to find in America, or most other places in the world. We got to put on scrubs, hair nets and face masks and shoe covers, and were given absolutely no supervision. Be warned, the next paragraph may be graphic. We were allowed to go wherever we wanted, read anything, go into any surgery at will, and even take pictures! I was with a girl named Dayl. At first we went to a surgery where a gall bladder was being removed. They made an incision and inserted a tube, which they used to manipulate the scapulae etc, and watched what they were doing through a camera monitor. When the gall bladder came out, they dissected it in front of us and I could see all the bile. It was so fascinating! The next surgery was a mastectomy, which was in progress. One of the surgeon assistants was a girl from Germany that I became friends with at the International tea at Bagayum a few days ago. I sat by her at dinner at a nice restaurant in Vellore as part of Darling's Residency where we went after our late lecture to again meet with international students/workers doing a short term stay at Vellore. She is named Katha, and is defiantly a kindred spirit. Anyway, she was helping with the surgery, and we watched them pull out all of the tissue and stitch it back up. I am nearly certain the US surgery are more sterile, but then I decided that the US may be over cautious with the constant threats of fine, and these surgeries seem to work out ok with lower standards, though I do defend that it is often better to be safe than sorry. I just don't want to give the impression that they are not doing quality surgery, but their technique for touching things, removing gloves and gowns, throwing body parts across the room and into the trash etc could probably not hurt for some assistance. Then, we watched her get all cleaned up and sent to recovery. It was an excellent surgery, I must say, and I am impressed by the quality they are able to do with limited resources. Next, we watched another mastectomy all the way through, and saw the first incision to the last stitch. When all of the tissue was removed, the doctor had us come over and look at the muscles underneath, so we got to brush up on anatomy, and where certain muscles, arteries, bones and such were. It was a live dissection, and that part of anatomy finally made sense! I doubt I will have many opportunities to see that kind of thing again! The anesthesiologist also gave us a brief crash course in the little meter next to the bed that monitors vitals, so by the end of the surgery I was able to press a couple of easy buttons on my own volition, with the blessing of the doctor. Our next surgery was a bypass surgery of some sort on a leg, but we left soon after to see a little boy brought into a room near by that had an obvious case of hyper-extension of the knees, so we watched them make some incisions, and I helped the doctor tie up his sterile green outer gown, and they sliced a couple of tendons/ligaments (not sure which- no one was explaining) and it looked terrifyingly like the poor child would never be able to walk again at that rate, with his muscle attachments all severed. We were not able to see how that surgery concluded, as by then it was time to leave, and I had to get to the fort to pick up my tailored Saree and get back to Bagayum in time to listen to a lecture by the man in charge of emergency. He had been to America for a few months so understood our culture shock, and was there to clarify misconceptions and give advice about Indian culture. Since he was a Christian, it was very interesting to hear what he had to say. So, I got to see a lot of blood and live dissecting, and some blood spurting everywhere, and it was pretty cool. I think I will be back in that area tomorrow.

I did not end up getting my Saree today after all, as the tailor lost my measurements, and went missing today, so I have to wait until tomorrow and hope it is done, even though it was due in yesterday but I was gone all day so couldn't get it, and pay for another ride in a tuck-tuck, and wrangle with the people there over what went wrong, and hope the correct measurements were found. I had the young man at the desk call the shop this evening to make sure it would be there, by Ardie's suggestion, and I was glad he called as he can deal with the Tamil, and knew how to dial the phone number, as there is some local area code I was struggling with. He is very nice, and has been such kind help to us all in so many ways.

Health in general seems to be improving among our group, though this afternoon it was suddenly apparent that Barb had a case of laryngitis, so she has no voice. I have a mildly scratchy throat and took some air born, but I think it is mostly because I am tired. I was up until midnight doing "homework" by writing in my journal, which the teacher will grade this weekend, and had to wake up around 5:30am. Water and rest will hopefully cure that. No one has had the runs yet.

I briefly read some of Neil's posts, and am sorry he had the revenge... that sounds no fun t'all.

Just as a warning, it is rumored that Internet connection is much worse where we are going in Chennai than here, so I cannot guarantee the frequency of posts next week, and this weekend I am going to be gone on a rafting/safari adventure, so will also be out of touch. Hopefully I can borrow a computer once in a while next week and go to an Internet cafe. The schedule there sounds very different, so it will be like starting a new trip!

It was good to see a few new faces on my blog comments!

Meeka Nandree!