Thank You India, Hope to see you again soon!

I came to India with a plan. I quickly learned that India is a place that rarely adheres to planning; it is in constant motion, always changing and so alive. The sights, sounds, and smells are overwhelmingly powerful and unavoidable. The many senses evoke emotion that I have found you have to openly embrace to prevent them from consuming you. From the moment the wheels hit the tarmac in Delhi, the chaos began. Standing at my seat patiently waiting to deplane, I watched in amazement as the crowds of people anxiously rushed past me. Suddenly, I was pushed out into the exiting parade of passengers, struggling to keep my balance and stay on my feet. What I realized that day was something that held true for the entire ten weeks: if you do not jump in and become part of the craziness, it will pass right by and you will be left behind. As I was forced into the crowded aisle, I was swept into everything that is India.

The whole time in India I was learning, whether it was learning to take blood pressure, to be more patient, about the rich Indian culture, or more about myself. I spent the first five weeks in north eastern India visiting a wide variety of clinics. Each week was spent in a different location shadowing cardiologists, OBGYNs, general physicians, and surgeons. Some days were spent hiking to remote villages and setting up a medical camp. As we hiked further into the wilderness, it was like going back in time. The villages were completely isolated, the people lived off their land, and they were very curious of us outsiders. Other days were spent in doctor's office observing and taking notes of outpatient walk-ins and appointments. I'll never forget witnesses my first birth in the third week of the internship. It was graphic and fascinating, the sounds and smells are forever etched into my mind. The last five weeks I was in Pune, an established city four hours east of Mumbai, shadowing OBGYNs. While here, I saw either a birth, surgery, or direct doctor-patient interaction everyday. I was amazed to learn that for such a well 'educated' city, forty of the four million people lived in slum areas. I got to spend a week participating in activities at these undeserved areas. Cooking classes, health awareness, eye clinics and medical camps were just some of the projects taking place.

Being in a place with so many senses activated, made me feel more alive and aware of the new world around me. Because there is so much going on, my mind was activated all the time. Whether or not I had my camera out, I was mentally storing images all day. Cows wandering carelessly through traffic, families of three to five riding on scooters, women dressed in colorful saris, and fruit vendors lining the streets were all part of the normal daily scenery. Of all the senses that India provokes, sight was the one that effected me the most. My eyes were constantly accosted with vibrant colors, beautiful landscape, and startlingly poverty.

I found that it was not so much of seeing the poverty, but the contrast that was the most difficult for me. Things seemed to be in a state of development or in disrepair; the people had plenty or nothing. A brand new shiny skyscraper protrudes out over millions of people living in the slums below. I left lavish wedding reception and walked out onto the street where a family and all their possession are gathered under a tarp tied to the concrete barriers outside the magnificent hotel. At the reception, waiters were scrapping left over food off the already overweight individuals plates and throwing it into a huge garbage bin; while there are starving people right outside the gates. These extremes around me, penetrated into my own experience as well. Personally, I was either constantly surrounded by people with all of my senses on overload or I was removed from it all in a secluded, self-created bubble. Emotionally, I either was on a high and was loving the whole experience and other times I found my self becoming cynical of the world around me. Physically, I either felt great or I felt like my body was revolting against everything in India. As an outsider, I was able to step back and recharge myself before facing it again. However, I realized that so many of these people never get that break and live in such extreme situations every day.

I came to India for a professional, medical internship, but leave with so much more than what I learned within the walls of the clinics. There was never a dull moment and I was daily challenged either mentally, physically or emotionally. There were so many wonderful, eye opening experiences and memorable moments. The constant state of senses in heightened awareness was contagious and I leave feeling invigorated, concerned, sad, appreciative, and focused to name a few. Everything that happened, all that I learned and everyone I met were all part of India's plan for me. While traveling through Goa, I met a fellow traveler, only he was much older, wiser, and probably knew the secret to life. He poignantly put into words my experience while in India when he casually stated, “As you travel more, it's not what you do; it's what the trip does to you.”

Unforgettable memories!

The last two weeks have been filled with so many fun experiences and great memories. Going back to Thanksgiving, I had yet another turkey day abroad. This year, the four of us interns went out to dinner and took our driver along to help us celebrate. We were all really excited to eat non-veg, and although turkey wasn't an option, we opted for tandoori chicken. Due to a miscommunication while ordering, instead of one FULL order of chicken, we ended up with FOUR full orders of spicy chicken on the table. I'm not sure if you can visualize it, but that is A LOT of chicken. Not to mention the three other dishes plus the orders of butter nan. After stuffing ourselves with as much food as we could, we left with two bags of left overs in hand and almost the full after-effects of the thanksgiving spread in our belly. Not a bad way to celebrate, but I'm still eagerly looking anticipating the real thing in December! The next week we were able to attend our program driver's wedding which was in a very rural area- probably the most removed from society I've been. We stayed in a... very memorable hotel. Our room was painted pepto-bismol pink, had plush red velvet couches and looked as if it hadn't been cleaned within my lifetime. Luckily we all brought our travel sheets and found plenty of humor in the whole scene. The wedding was totally different than the urban ones, and still mesmerizingly amazing. I felt so lucky to be part of the event. I think I was surrounded by a minimum of five (brave) children at all times The shy children were not so sure about us- we were the first foreigners they'd ever seen- I think I would be scared of us too! I watched at the families preformed traditional rituals, a fully decorated white horse danced rhythmically along to the live band, and the men from the village dance with more intensity than any step-up dance movie I've ever seen. I had so much fun being there- it was definitely a highlight of my time in India! My last weekend in India was spent in a town about 5 hours northeast of Pune, Aurangabad. There are two very old, famous religious caves carved into a mountain side that the guides book raved about, so myself and two other girls went to check them out. The weekend was full of laughter, lots of pictures and lots of time spent admiring the stunning caves. Some dated back to 4th century AD and were intricately carved with Buddhist, Hindu, and Jain religious figures and symbols. There were two sites and each had about 30 caves in all. By the end of the weekend, I was all caved out but left with a fascinated appreciation for the time, skill, and effort spent creating these masterpieces. On a lighter note, the bus rides to and from were worth noting... Since we were three of us, one person ended up sitting with a stranger on each bus ride. Now in the states, that is (usually) not a problem, but here we kind of stick out and I couldn't bring myself to rudely ignore the friendly older man next to me the whole time. The problem was he knew minimal English but was still jazzed to be attempting. We spent a good five minutes of him repeating “Would you like (l-i-t-e) to meet (m-e-t) a school?” The girls sitting in front of me got a good laugh as I tried to interpret what he meant. I never figured it out, and ended up saying over and over “I hear you, but it does not make sense!” So much for being polite. And the ride didn't get much better. I knew I was in trouble when the young guy across the aisle conveniently switched seats with the man next to me. It was like a movie. I sat there, attempting not to make anything that looked like eye contact and instead engrossed in watching the lights passing by, but to no avail. I hear him break the silence with “So, are you interested in software development?” I can laugh about it now, but at the time It was not funny. I think I replied something along the lines of... “umm... well not particularly in development but I like software...?” oh goodness, the girls got another good laugh at that one. It all comes full circle though, because on the way home Catherine had the open seat and I kid you not, had a guy sing Brian Adams- Everything I do, I do it for you (which was his favorite song) to her. We now break out in a little Brian Adams diddy randomly and it hasn't got old yet. My last week of rotation have been at a slum clinic in town. The town I am in, Pune- is known to be “the oxford of India,” and has ~4 million people, 40% of which are living in the slums. I spent the last three days learning about and seeing the different educational, health camps that are taking place everyday within the slums and also went to the medical camps that were in the area. We saw so many women and children- mostly standard, cough/cold/fever patients. It was really nice to see the work that is being done to bring aid to this often overlooked population. Seeing so up close the way so many people are living was difficult, and also fueled within me a fire to get more (medical) training and return back here with useful skills. I came to India unsure of what career path to take, and leave feeling pretty sure of where I am going. Medicine is such an incredible field, I love that no matter where in the world you are, the human body- all it's structures, ailments, and needs are universal. I loved watching the surgeries, was truly amazed at the birth process (yikes), and also really enjoyed being part of the typical clinical interactions and appointments. I cannot believe that in a few days I will be leaving India- but I am looking forward what the God has planned for me and am so incredibly thankful for every experience I had here!

and this is why!

If I don't come home...I'll be in Goa!

Other than the ridiculous long (10+ hour), uncomfortable, cold, loud, sleepless bus ride, everything about my short weekend escape to Goa was incredible. It really could have gone either way- we arrived into Goa without set sleeping arrangements or any plans. With just our backpacks on our backs, we (luckily) were woken up to get off at our stop and after a few minutes of grogginess, decided to take a taxi to Anjuna, a smaller town up north we had read about in the Lonely Planet guide. Another CFHI participant was planning on staying in a guesthouse in that area, and we hoped to find a place close by. The only landmark I knew in Anjuna was a chapel's name and the name of the other participants guesthouse. I ask to be taken to St. Anthony's Chapel and from there ask direction to Vanila Guesthouse. Perfectly, the guesthouse was just down the road past the Chapel and again perfectly, they only had one room left for only one night. We were welcomed by the sweetest old lady, Clara and her daughter-in-law Paulina, into their guesthouse as if we'd known them for years, a comfortable relationship forming in a matter of minutes. We readily accepted and are shown to the room complete with our own private terrace. The sun was shining and our stomachs were grumbling so we leave our belongings and set out to find the sand, sun, and FOOD! The guesthouse id quietly nestled back about 50 yards from the beach, and we go into the first restaurant we see. We sit down at a table looking out over the ocean; the restaurant is completely open- no outer walls, with the ocean, blue sky, and palm trees as it's borders. We all order a tropical drink- papaya and banana smoothie for me, and are instantly in love with Goa! Our breakfast of banana and nutella crepes tastes amazing and gives us just enough energy to make our way (slowly) through the colorful stalls down to the beach where I order another delicious fruity drink and sit lazily in the shade looking out over the vast Arabian Sea and sun shining down on the tanned foreigners, colorful locals, and...cows. Yes, cows roamed about on the beach- looking for any left over fruit peals and sometimes not the left overs- I witnessed multiple of times cows going up to a unsuspecting, distracted people's food and making out with quite a good meal! The rest of the 48 hours in Goa were just as wonderful- amazinggggggggg food! (fresh fish, more crepes, tasty Indian food...), fruit drinks- I think I had about 4 a day!, alternating between swimming in the warm blue ocean and relaxing on the beach chairs, sitting on the terrace and shooting the wind with the other guests, bartering my way down the endless line of colorful, plentiful stalls, talking with the local women and children, and soaking up the sunshine. It couldn't have been better. Goa is a dangerous place! I wanted nothing more than to leave everything and set up camp right there in Vanila guesthouse with Clara and Paulina and live happily every after. I could go on and on about those 2 days, but I'll leave you with just a couple more highlights-We had the pleasure of meeting a kind, open French man named Francios who was also staying at the guesthouse. One afternoon we all sat in the terrace together and were talking about traveling, our internship experience, and life. Every word that he spoke was poignant, wise, and true. For example~“As you travel more, it's not what you do; it's what the trip does to you”Catherine: “Did you do anything interesting today?”Francois, paused thoughtfully for a brief minute and replied: “Well, yes but I can't really remember what” as he quietly laughed and continues, “all things are interesting depending on your frame of mind”“The people of France can be very cold, like the weather and thats the opposite of here. There they are very compressed in space and in mind.”Me: “So are you planning on seeing Agra?” Francois: “Yes and no, it depends. Planning is a funny thing- deciding on what to do in the future is difficult as you may change your mind” Every word out of his mouth was poignant and wise and true. I felt like we were talking with someone who knew the secret of the living, but wouldn't tell us, he would rather show us. Like I said, it is hard to imagine a sweeter family than Clara and Paulina and to top it off, they gave us the most heartfelt sincere send off. We all hugged, exchanged information, and were walked out to our taxi where they blew kisses and waved us away. If I ever come back to Goa, which I really hope I do- I know where I'll be staying!“Come see my shop, I give you good price...” After hearing this throughout the whole weekend by every shop owner in Anjuna we got a little tired of it, but still got a good laugh at the store literally named, with a huge sign up top- “Come See My Shop, I Give You Good Price”

"That's a damn good uterus!"

I love my new clinic posting! It is in Sutika Seva Hospital- which is a private clinic mainly for lower class pregnant woman. The OPD (outpatient department) is general a couple hours in the morning, and last Wednesday we saw 50 patients. It was NUTS. I was taking BP, weight, and FHS (fetal heart sound) with a Doppler like mad (with the help of the resident). the doctor is a character, so knowledgeable, approachable, and funny!
some of my favorite quotes....
-"that's a DAMN good uterus!"
-slapping a woman's postpartum loose abdomen and replying to her complaints of the appearance... "i told her to do abdominal exercises" (sounds harsh but we were all laughing, including the woman!)
-she ends many, many statements that she wants us to be in check with.... "isn't it"
-after nurses showed up to work 2 hours late, "today i came in such a good mood but now im pissed, if i see them i might start fuming again!" (she is so dedicated and loyal to her work that she can't stand people wasting her time, not being efficient, and being LATE!)

Also, the first day while waiting in the OT with a women needing suturing from a medio-lateral episiotomy, the resident comes rushing in and asks- 'which one of you is going to assist me?' I immediately have red flags- out of my scope of practice and voice my concern that we are NOT trained, to which she replies- I'll show you! So nicole steps up, scrubbed in and helped by holding the speculum and cutting the suture thread. Later that day we talking about the ethics of that scenario and decided, she wasn't doing any skill persay and felt like it was safe. The next day, while watching the same resident about to give an intramuscular injection in the gluteus region (bum) that she turned and said 'do you want to give?' I pipped up right away- no we don't know how, so she says 'watch this one, i'll show you, and you can give the next one'. sure enough not more than 5 minutes later, a woman comes in for a tetanus injection and I prepare the syringe and as confidently as i can, slowly inject the fluid into the specific area pointed out from the resident who is holding the skin taunt. it went well! I don't plan on making a habit of preforming the tasks, but it was a pretty cool experience!

So... low of the day yesterday...
There I am using the Indian style toilet before ~2 hours of watching surgeries and while i'm awkwardly balancing, trying to squat and hold my purse from the wet concrete smelly ground at the same time as turning on the facet. Not a good idea. I turn the facet and am immediately shot in the face with a stream of water spraying straight up. I try and turn it off, but it's very clearly malfunctioning and the normal righty tighty is backfiring right into my face. I final twist it every which way to find a position that slows and eventually stops the stream. I managed to keep my mouth closed and stay out of most of the spray. I shake off what water I can and step out of the bathroom half laughing half crying. Later Nicole had a fitting insight... "in India... if you're not laughing you're probably crying!"

Now I'm off to Goa, land of sun, sand, and coconuts! After a 10 hour bus ride, we arrive in the morning and take a bus ~30 minutes north a smaller town, Anjuna, and get a room in one of the many guest houses there. I can't wait for a relaxing weekend on the beach!

More soon on my thanksgiving meal mishap, weekend in mumbai, and daily happenings!

pictures!

Just a couple pictures from the last week- at another Indian wedding in Mumbai; our hands after getting traditional Mehndi!; view of slums from the local railway in Mumbai; enjoying playing doctor with my official white coat and lunch in the "doctors room"; what? no thats not be hanging out of the moving train...

half way !

I am now officially half way through my time in India and also have one week in Pune under my belt The transition from Dehra Dun to Pune was an interesting one. On the train ride to the airport, our train hit and killed 5 men that were working on the track. Apparently they were working at a section with a lot of rail traffic and got off the track they were working on to let a train pass and didn't see ours coming the other direction. I heard that about 16,000 people/year die this way in India. It was gruesome. By the time the train stopped, the men were in pieces and the car we were sitting in happened to unfortunately stop right in front of some of the main body parts. I'll spare the details, but it was horrible. And even more so, the fact that while this effected me for about an hour, the lives of these men families will be forever marked. With that disturbing start to my day, we finally made it to Delhi and had climb the ridiculously long flight of stairs up and back down with 59.5 lbs of luggage. Yes, I know the exact number because I had to pay $20 US for those extra 10 pounds. I guess it's not so bad but when everything else here cost me about $3-4 dollars... it was hard! Because our group was splitting up with one person catching an earlier flight to Mumbai and Nicole and myself to Pune on a later one, we arrived at the airport early. What was suppose to be a 5 hour wait time, turned into an 7 then 8 then 9 hours before finally departing due to... well India. But I did have some nice down time to journal, blog, play cards, eat pizza (!), etc. We arrived in Pune a little after 1 am and were picked up by a CFHI driver and taken straight to our flat where we promptly passed out until the next morning. It was SO nice to know I'd be in ONE place for more than a week. All the moving around and living out of my suitcase for... 8 weeks now, was getting old! I unpacked my clothes and set up camp in the guest house provided by the program. It felt so good to be settled. We spent the first week in an 'upper class' government hospital, Deenanath Mageshkar (don't worry I still don't know how to pronounce it correctly either). Posted in the OBGYN department, I saw 3 births, a vaginal hysterectomy, laproscopic salpingectomy (removal of fallopian tubes), cervical biopsy, and joined a paediatrician and a gynecologist for their daily out patient appointments/walk ins. The most amazing thing was the laproscopy procedure. I was able to see the surgeon scalpel into the abdomen from the inside out! I am feeling really good about where I am; medically I am exposed to so much and I am looking forward to the rest of my time here. The end is in sight- how crazy! We started making weekend plans (this weekend- staying in Pune and seeing the sights around and in the city, next going to Mumbai to meet up with friends and see another wedding!, next going to Goa- beach vacation, yes please!, next going to some famous caves in the area, and next...flying to Malaysia to see my best friend Shannon!!) I have found that sometimes, the time just flies by- like when making plans or realizing I have been gone for 2 months now. And others...it seems like the time is suspended, barely moving- like when I am stuck in between 4 lanes of traffic with cars, rikshaws, and bikes coming at me in every direction. But some how, I manage to take a step forward, weaving between the obstacles, and reach the other side- proud to look at what I have accomplished!
I am excited to see what our next week in a 'lower-middle class' government hospital has for us!