Monday, April 20, 2009

Day 6

Day 6
>
> April 16, 3:40 pm, Vellore
> India struck back today. The honeymoon is over. Not a good day at
> all. Last night at dinner I had started feeling a little rumbly and
> used the bathroom. I went again when we got back to the hotel and it
> was a little softer. When I started to worry, though, is when it
> woke me up in the middle of the night and I had to go. Very watery.
> Sorry if this is too much detail, this is what we talk about here.
> How's your stool? Anyway, I was feeling pretty bad when I got up to
> get ready this morning and had another watery one.
>
> I decided maybe I ought to try to knock it out quick since we were
> planning on taking the bus out to mamalapuram this afternoon. So I
> went and bought 10 tabs of cipro down the street for a mere Rs 40.
> However, I kept feeling worse and worse when I was outside in the
> heat and everything. Very nauseated. It was aweful. I didn't make it
> back to the hotel before it came up. So I sat there and hurled on
> the side of the road. It was awesome let me tell you.
>
> I came back, took 500 mg of cipro and 4 mg of loperamide but I think
> the cipro was really rough on my stomach. I kept it down for about
> an hour then vomited again. Then again and again. I had nothing left
> but kept heaving. Oh man I hate throwing up. Getting all sweaty and
> feeling like you are going to die. It sucks. I'd rather have
> diarrhea any day. As long as I'm by a toilet anyway. Haha.
>
> So anyway, I've been here at the hotel sleeping and watching animal
> planet an feeling awful all day. I'm starting to feel like I'm
> getting better though, so hopefully... I haven't thrown up for a few
> hours.
>
> Well that's the news here. Hope things are better in your neck of
> the woods, wherever you are, reader.
>
> 10:00 pm
> Well I'm feeling much better than I was this morning. That's not
> saying much, but I'll take what I can get. I slept so much today and
> know the girls are asleep and I'm not feeling very tired. I think I
> can still fall asleep though.
>
> I didn't throw up anymore today... none since like 11:30 this
> morning. My stomach is still feeling somewhat more rumbly tonight
> though, and I had some more diarrhea. Here's hoping it finished up
> quick. I ate nothing today.
>
> Okay I'm going to close for the night.
>
>
>

Day 5




Day 5
>
> April 15, 7:07 am, Vellore
> I slept much better with my blanket! I still woke a few times and
> had to turn off the AC at one point, but I actually slept until
> Katherine's alarm went off. Finally.
>
> 11:34 pm
> Well I'm exhausted tonight. I went the whole day without a nap, so I
> think my clock has finally reset itself to Indian time. But yeah,
> i'm tired so I won't write too much tonight. It was a pretty good
> day though.
>
> We were with pediatrics again today. I really like them a lot. They
> are super nice to us. They are very careful to make sure we are
> included and answer all of our questions an stuff. Especially the
> doctor that I was working with yesterday. She is great.
>
> I was impressed today by how much they know! I don't feel like there
> is any lack of knowledge or skill in the physicians here, only,
> perhaps, in their resources / facilities. But I really feel like
> they know a lot and provide high quality of care to their patients.
>
> First thing this morning they had one of the MD candidates present a
> case. Sort of a morning report type meeting. I guess I should
> explain. My doctor explained to me that after medical school here
> you have something called an mbbs or something like that. It is a
> bachelor's degree in medicine and surgery. Then you do a year
> internship, where you rotate through specialties, and then finally
> you take an entrance exam and depending on how well you do you have
> a choice of what specialty program you get into. This would be the
> equivalent of our residency, except that they get they're MD at the
> end of that, instead of at the end of medical school. Anyway, so he
> presented a case of possible systemic JRA, SLE, or maybe even acutle
> leukemia. It was an interesting case. But the doctors grilled him
> pretty good and they went into tons of detail. It was kind of
> impressive. I think they memorize their text books here.
>
> Then later we rounded in the ward. We seemed to see a lot of
> encephalopathies. We saw some asthma, a pneumonia with an
> parapneumonic effusion, along with some other patients I can't
> recall. Oh, a couple of atypical febrile seizures too. Again, they
> were very thorough and provided as good or better of teaching as any
> of my attendings back home.
>
> Later today we finally managed to get tickets booked to Kerala for
> next weekend. Such a hassle, like everything else! I'm excited
> though. We'll leave next Thursday evening at like 9 something and do
> an overnight non-AC sleeper car and get there at like 6 in the
> morning. Should be fun.
>
> Then we went around trying to find a new place to stay for next
> week. It was a trek. We walked all over. I'm not sure what we'll end
> up doing. I think we want our own rooms, at least I know I do. It's
> just to cramped in this tiny little room with 3 people. I have to
> get out of there. Plus the people here are so shady! They actually
> charged my credit card twice when I checked in and put down some
> advanced money. They doubled it!! Can you believe these punks?
> Anyway, I've had enough of Aavana in. We looked at stuff over by the
> college campus, but everything was either full or didn't have shower
> and/or toilet. I'm okay with just a bucket shower and the little
> squat toilet (really just a porcelain hole in the ground), but
> Katherine wants a real shower and Aurora wants a real toilet, which
> are understandable I guess. Haha. Anyway, we'll see hat happens.
>
> We went and had dinner tonight at the hotel darling. Every wed night
> all the international students go and eat up in their rooftop
> restaurant. It's pretty nice up their, nice breeze and view. We
> didn't really get to talk to many people because we got there
> later... but maybe next week. The hotel darling special ice cream
> was tasty though. Grape, vanilla, pistacchio and mango ice creams
> with some fruit mixed in. Mmm. Okay I'm off to bed.
>
>

Day 4

Day 4
>
> April 14, 10:46 pm, Vellore
> I'm pretty tired tonight, so this may be a little on the short side.
> I haven't had a really good night sleep in some time. For some
> reason I keep waking up at like 5 am and can't get back to sleep.
> It's annoying. Besides that I usually wake up a few times in the
> night too. I'm excited though because they brought me an actual
> blanket to use, as opposed to just the sheet, and I think I may
> sleep better with that. At least that's what I'm hoping.
>
> Breakfast was great again this morning. I'm really enjoying the
> food. I need to remember to get some pictures of the food. I can
> never remember all the names either, but they eat a lot of fried
> stuff for breakfast that is delicious.
>
> After breakfast we went to the hospital and did some pediatrics. It
> was out-patient clinic day, so we split up and each went with a
> different doctor and saw patiets. It impressed me that although the
> details are very different, medicine is fundamentally the same
> wherever you go. It is a common language between strangers from
> different worlds. I would say that I felt more comfortable- or more
> at home- today in the hospital, seeing patients, than I have
> anywhere else here. It's kind of a neat thing to experience.
>
> Even though the circumstances here are completely different, much of
> it is exactly the same. We saw a number of worried parents bringing
> in their kids for regular old viral URIs, or fusiness, or "my child
> just hasn't been eating well." it was funny to see that parents here
> worry about little things that are nothing, just like they do back
> home. I guess we're not really all that different are we?
>
> But then we also saw some more interesting things. A little girl
> with a wide open anterior fontanel at 1 year old, which made the
> doctor suspect vitamin D defficiency. A boy that was being treated
> for TB meningitis. A boy with failure to thrive, frequent loose,
> fatty stools, and possibly a cyclic neutropenia. That one is still
> under evaluation. I think they are actually going to do an ERCP
> because there was some common bile duct dilitation. I guess a main
> difference is just that you consider different things higher on your
> differential than you would in the States.
>
> The doctors were great. The lady that I was with was very friendly.
> Of course, they are pediatricians, so I would expect no less. Haha.
> But yeah, she as very nice and explained a lot to me. It was good.
> The facilities are basic, but I guess they are sufficient for their
> needs. They have computer with electronic records, though much of
> the charting is done on paper... sort of like at home.
>
> This afternoon we made it over to the computer lab at the hospital.
> The wifi worked pretty well. Later we made a trip out to the train
> station to try and get some tickets to Kerala for this weekend. Like
> everything else here, it took a lot of effort to get anything done.
> We went from person to person, getting a little bit more information
> from each one until we finally had an idea of how to reserve train
> tickets. Much harder than you would think it should be. But again,
> that seems par for the course. In the end, the train was full so we
> got on a wait list. Not really clear on the details of how we find
> out if we get on or not, or how much advanced notice we get, if any.
> I guess we still need to figure that out. Hopefully it works out.
>
> There were some monkeys just hanging around the train station. That
> was fun to see. The ride back on the auto was death-defying, as
> usual. We actually saw a little boy almost get hit on the way over
> there. The auto (rickshaw) was only inches from smacking into him as
> he darted out into the street. Though he was spared from the auto,
> he was not spared from his mother who gave him a good smack for
> jumping out into traffic. Then our driver proceeded to hurl some
> unintelligible (at least to us) insults to the mother as we rode past.
>
> We went back down Gandhi again today. This time I was a little more
> adventurous. I bought a nice shirt for Rs 290 (about $6) and then
> got some mangoes and even enjoyed some fresh coconut juice straight
> from the (young) coconut. I used to love that stuff in the
> Philippines, and it was just as I rmembered it. I'm waiting for the
> mangoes to ripen a bit, but I think they'll be good.
>
> At dinner Aurora tried to order a veggie burger but instead got a
> cucumber and tomatoe sandwhich. It was pretty funny. They must not
> have any concept of a patty. We tried.
>
> Anyway, we're enjoying ourselves, for the most part. It's great
> being here. More fun tomorrow!

Day 3

Day 3
>
> April 13, 10:58 pm, Vellore
> Another day down. Today was registration. We found our way over to
> the CMC college campus this morning and met Sheela from the
> principal's office. She was very nice and friendly, which put me in
> a good mood. I love meeting happy people. The campus is a little
> ways out of town and it is beautiful, a stark contrast from the
> madness of the city. It is very well manicured and well kept. It
> almost seems out of place in this town. We filled out some paperwork
> and got registered, which took pretty much all morning. We visited
> the canteen and got some pineapple juice, which was delicious.
>
> Oh, I almost forgot about breakfast. Katherine and I had dosas here
> at the hotel restaurant. Dang. So good. They are kind of like big
> crispy crepes. I'm not sure how else to describe it. But then there
> is stuff inside it, like potatoe and stuff. Then you have 3
> different sauce things you can dip it in. One of them is like hummus
> but with more of a peanut flavor. It was great.
>
> Anyway, we also signed up for Internet access at the campus, but
> apparently it takes a couple of days to get the account set up?
> We'll give it a shot tomorrow.
>
> We took the bus back from the campus to the hospital. It was stuffed
> pretty well but hey, Rs 3 beats the Rs 50 that we paid for an
> autorickshaw on the way out. When I was getting off I had to squeeze
> through a bunch of people and apparently my CMC ID fell off. I
> didn't realize it until the bus was starting to pull off and this
> guy runs up and hands it to me and says "excuse me, this belongs to
> you", and then he ran and got back on the bus. Can you believe that?
> I thought that was awesome that he would do that.
>
> We talked to Beulah (also SUPER sweet... she was so concerned about
> us getting some lunch and staying out of the sun and telling us what
> to eat and not... very funny. again, made me happy) at the hospital
> when we got back and found that there really is no campus housing
> available. Apparently it fills up months in advance. So I guess
> we're going to stay here at Aavana. First impressions of the CMC
> hospital? It's very big, and seems fairly well kept and clean... but
> it is just so far from what we would consider a decent hospital in
> the States. It was somewhat sobering to think that this is one of
> the best hospitals in India. It is an open campus and the buildings
> and rooms do not have AC. They just have windows open to the
> outside. Of course, the quality of the hospital cannot be judged
> based on the building. They could still provide great care. It's
> just very different than what we're used to.
>
> We went and strolled down gandhi street this afternoon. Lots of
> little shops. The girls bought some Indian clothes. Unfortunatley,
> the guys pretty much dress similar to us, so I don't know if I'll
> buy many clothes here. It was good to get out into the town a little
> though. Well, I think I'm going to wrap this up for now. Until
> tomorrow...

Day 2

Day 2
>
> April 12, 1:46 am, Chennai
> Okay I'm counting Friday and Saturday together as day 1 since it was
> just one big travel marathon. Time zones and days melted together as
> we sat on plane after plane. Overall, I think it was about 30 hours
> of travel time, or a little under that. But we are here!
>
> The highlight of yesterday was the layover in Brussels. Neuhaus
> Belgian chocolates. Need I say more? Those who know, know. It was a
> trip down memory lane biting into those sweet morsels filled with
> soft fluffy cremes.
>
> The Brussels to Chennai flight was not too bad. A little over 9
> hours but the food was pretty good. I'm already getting excited
> about the food. Such flavors! It's exciting to put things into your
> mouth and realize that you have never experienced these flavors in
> your life. And that was just on the plane. We also had personal tv
> screens and choice of movies, which was nice. I only watched one,
> but Katherine was able to rack up 4 and a half.
>
> Walking out of Chennai airport was an experience. You're never fully
> prepared for that initial shock of... let's see... heat and humidity
> that just doesn't seem possible at midnight, then there are tons and
> tons of people standing there where you come out, waiting and
> staring and make you feel painfully aware that you stick out like a
> sore thumb. It does definitely take me back to the Philippines
> though. Smells the same, sounds the same. It's such a trip. It
> honestly felt great, made me feel very happy.
>
> We were in kind of a bad position because we didn't have anywhere
> set up for tonight and didn't really know where to go. So we were at
> their mercy. We found a guy that said he would find a place for us
> to stay and get a car to take us. We were very wary but didn't
> really know what else to do, so we said okay. We waited a while for
> the car, which he said would be free. In the end, the only catch
> seemed to be that he wanted Rs 100 for arranging it for us.
> Reasonable enough. The ride was a little scary. We seem to be in a
> pretty scary area and the streets were empty. The cows in the road
> were about the only forms of life. Thoughts started to race through
> my head. I started to think about the movie "Taken" and how this guy
> could be taking us anywhere to do anything with us. It was a little
> scary.
>
> It was a big relief when we saw the sign for Suvi and knew it was a
> real place. Thank goodness. It was even the same price the guy at
> the airport told us, so maybe not that shady afterall. We're
> probably paying more than we should be, but oh well. We have a king
> size bed (for the 3 of us) and AC and a shower, so I guess we can't
> complain too much.
>
> In the morning we'll head to the bus station and catch a bus to
> Vellore. But for now... try to catch some sleep. It's hard with all
> the excitement.
>
> 9:41 pm, Vellore
> Well it's been a fun day. I'm waiting for a computer at the Internet
> cafe right now, so I thought I'd put down some stuff while I'm
> waiting. The night was uneventful last night. It actually got pretty
> cold in our room with the AC all the way up and be fan all the way
> up. I slept pretty well, but woke up kind of early an then couldn't
> really fall back to sleep.
>
> The shower was nice and cool, which actually felt pretty good in
> that sweltering bathroom (it had a window open to the outside).
> Again, it felt like I was back in the Philippines, taking cold
> showers.
>
> We got out and had them drive us to the bus station in their car.
> Paid 300 for it... not really sure if that was a good price or not.
> It probably wasn't too bad. Once we got there this guy jumped on our
> luggage and wanted to help. They are very insistent about helping
> because they want you to pay them. He was actually quite helpful
> though. This was a pretty huge bus terminal and we would have been
> clueless as to where to go. Computer is open... more later.
>
> 11:33 pm, Vellore
> Anyway, so we managed to get all our stuff on the bus and only got
> charged one extra fare for the luggage. The trip was about 3 hours.
> It's pretty crazy driving. I had the front row seat, so I was able
> to see how many times we almost hit people or cows or other buses.
> The roads were actually not too bad as far as quality, but they are
> chaotic. There is no observance of lanes or anything like that. Just
> a lot of honking. It's funny how the cows just wander around and
> walk through the street. Apparently they have the right of way here.
>
> We talked to a nice guy on the bus who told us where we should get
> off. He then was waiting for us when we got off and was like "come
> with me, I'll show you". He took us over to the rickshaws and talked
> to someone and told us how much we should pay. It was really nice of
> him. We were talking while we walked and he saw I was from Texas so
> he started asking me about WWF wrestlers that are from Texas. Haha.
> I didn't know who he was talking about but it was funny.
>
> Amazingly, we fit all of our luggage and the three of us in one of
> these little rickshaws, which is basically a motorcycle modified to
> have a little cab on the back. It only has 1 little bench, so it was
> quite hilarious that everything could fit.
>
> We made it to the Hotel Aavana Inn without trouble and then the
> checking-in process began. Oh boy. The price was more than the CMC
> had told us it was going to be, but it was printed on their little
> flyer, so we couldn't really argue. Well, I mean, we did argue, but
> we were unsuccessful. They probably have a separate flyer that they
> give to foreigners with higher rates. It's still only costing us
> like $9 a day each though, so I don't know how much we can really
> complain. Anyway, but then they have this whole deal about
> registering with police. They ask for copies of your passport an
> visa but then they want money to process stuff with the police.
> Right. Except that we already knew that tourists don't have to
> register with the police. We argued with them for a long time about
> this and it was actually quite comical. They kept trying to tell us
> that we were students and we told them about 50 times that we are
> here on TOURIST visas and we don't have to register. Then they start
> trying to tell us that if we don't do it then the police are going
> to come looking for us and harass us. Sure. An then they tell us
> okay, let's just take you over to the police station and we'll see
> how much they want you to pay. They said it would be ever more. Us:
> we're TOURISTS! We don't have to go to register with the police!
> Them: but there have been terrorist attacks recently and blah blah
> blah. Us: We read the form when we came into the country that said
> tourists do not have to register if they are there less than 6
> months! Them: oh but the rules are different here than in Chennai.
> Anyway, this carried on for a while until we finally agreed on the
> fact that this was just money to keep the police happy and they
> basically said as much. We told them that was their problem, but
> they insisted we pay them. In the end we gave in and gave them Rs 50
> each, but at least this was less than the 300 they started out
> asking for. We couldn't stop laughing about it later, once the
> annoyance had worn off.
>
> We had a couple of meals in the restaurant here at the hotel.
> Delicious food and super super cheap. We ate lunch for a total of $9
> and dinner was like half that. Mmmm. We ate lunch with our hands but
> decided to resort to asking for forks at dinner.
>
> I have to say the thing that cracks me up the most is the way they
> do their little bobble head thing. I think that it is our version of
> nodding in the affirmative, but it looks more like they are shaking
> their head no. It cracks me up whenever they do it though.
>
> We found the Internet cafe nextdoor tonight, after our 4 hour naps,
> so we got to check email and stuff.
>
> Oh yeah, the room. It's not bad. It has a queen size bed I think and
> then we are paying extra for this little pad that they brought us
> for a third bed. Pretty funny. They made us sign for it, I guess to
> make sure we didn't take off with it when we leave here. ;) The AC
> works fine though and there's a tv. The bathroom also is fine,
> though it has a number of little bugs... just visitors I guess.
>
> It was interesting to get a view of the area from the bus. Lot's of
> people that appear to just be scraping by. It hits you how well most
> people are living in the States. It also made me wonder.. what do
> these people do? All of these people going from place to place,
> sitting, walking, riding... I just couldn't help thinking that I
> have no clue what these people do, how they live, how they put food
> on their plates. Back home you pretty much know what people do more
> or less, but here... I have no idea! It's a completely different
> life. I guess there is a fundamental gap there. It's like you could
> probably never really comprehend India and it's people unless you
> spent a lot of time an were willing to live among them and do the
> things they do. But what American would ever do that? We're happy
> with what we have, so why bother trying to really understand how
> this huge bulk of humanity lives? So we come and we look and we
> stare and we feel like our eyes are opened. And they are, a little.
> But I feel that we are really only scratching the surface here. And
> perhaps this is what keeps us from doing more.

Day 1

Day 1

April 10-11
12:10 pm
The adventure is underway! After a hectic past week, it's nice to find myself sitting on an airplane and finally able to relax. I still can't believe I managed to fly up to Rochester, find a house, settle on a price, sign a contract, squeeze in an inspection and still have time to get all of the loan application done all in the past week. Oh, and squeeze in time to get ready for this trip! So I guess it's understandable that I only slept for two hours last night.

Did I finish everything on my endless to do list? Not quite, but I came suprisingly close. I didn't hear back from my realtor about the furnace inspection, so that's one loose end I left. And then there's the stack of paperwork from the residency program that remains on my desk. I briefly flipped through it at about 3 am and decided it was not going to happen. It'll be waiting for me on my return.

Anyway, so yes, here I am. The dog and fish and plants were all left at Janet's mercy and here I am on a flight from Dallas to NY JFK. We left from San Antonio at 9:45 am and flew to Dallas. Now Dallas to NYC. From there we have a 7 and a half hour flight to Brussels, followed by a 9 and a half hour flight to Chennai (Madras). We'll arrive at about 11:00 pm tomorrow night.

As far as what happens from there? Well, that's the fun part isn't it? I'm not sure where we're staying that night, but Sunday morning we'll find our way to Vellore.

I'm excited to be heading over. I'm sure it is going to be an experience I'll never forget. I'm wondering how much it will remind me of the Philippines, and how well I will readjust to poverty. I lived in it for 2 years in Cebu but I'm afraid that over the past 8 years (wow) I've forgotten what it is like. I will be good to be reminded.

As a side note, it's a very strange feeling to be untethered from my cell phone. Naked, yet free. Haha.