a week late

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I'm back in Dehradun this week...I have an Internal Medicine rotation in the moring and then an ER/caridology rotation in the evening. My IM rotation is very frustrating...but very entertaining. Frustrating because I'm alone on this rotation and the Doctor basically ignores me. Since he only speaks to his patients in Hindi I can't even guess whats going on....every now and then he'll flash an x-ray infront of a light box just long enough for me to figure out what part of the body it is, yell some gibberish and then smile like he's just impareted the wisdom of hippocrates on me. I was pretty pissed the first day but by an hour into the second I was just entertained....he also can't seem to get the hang of a pump-bottle of hand sanitizer either...where as you and I would place the bottle on the table, hold one hand under the pump and apply gentle downward pressure untill the sanitizer was dispensed...this guy slams it on the table and squeezes the living bejesus out of it for about 15 seconds..then gets frustrated and tosses it into thecorner of the room...and he must forget about it because 10 minutes later he trys again....this prompts the phrase "its so easy, a cave man could do it" to pop into my head several times a day.

On the other hand, my evening rotation is pretty amazing. First off there are three of us..which makes the inevitable "down time" much more enjoyable....secondly we're rotating with the medical director (Dr. Ghandi...no realtion) of the entire program so he takes his role as mentor very seriously. He's shown us some very basic physical exam skills. He's a cardiologist by training so hes been spening alot of time showing us EKGs and how to interpret them. Its still pretty fuzzy to me but I atleast know what a normal EKG is supposed to look like and which part of the heart is represented by each lead...The best part is he doesn;t just show you something once..he shows it too us about 20 different times and quizes us. Its the first real teaching I've had on this trip.

Tonight we're going to a fundraiseing Bar-be-que in the Than Gaon village (whoch shoudl be interesting since I've had meat twice since I've been here). since this meants there would be no eveing rotation and our AM rotation was awful, we went to Dr. Ghandi's this moring to get the best of both worlds (more tie with the teacher and less time with the "Cave-doc"). Dr. Gahndi took us with him to an another hospital to see some terminal cancer patients. When we walked in to the first room I immediatly noticed that the patient's entire face was covered with this green paste. I asked Dr. Gahndi about it and he just kind of nodded and told me he'd explain later. As we made our rounds it didn;t take long for me to observe that every patient had this paste some where on their body..abdomens...face. chest...legs. It was every where. We saw patients for about 30 minutes, Dr. Ghandi was paid, and we left. On the ride back to the hospital he explained that this was an example of "quackery." He said the doc claims to be a practitioner of aruvedic medicne (an alternative but legitamte field...when done correctly) Apparently this doctor exploits the little bit of hope a terminally ill cancer patient has, claiming that the paste (the contents of which are not known to anyone..even the doctor) MAY cure them. From a business stand point this is genius because the worst that could happen is death (which they were facing anyways)...and if they get better...evben temporarily its just drums up more business. From an ethical stand point though...its just wrong. This doc is praying on the hopes of desparate people for monetary gain. Dr., Ghandi says there is nothign the gov't can do about it.(which doesn't suprise me...as theonly form of government intervention I've seen since I've been here is a guy blowing a whistle frantically in an intersection while doging rickshaws) ..."luckily" the quack has enough sense to have Dr. Ghandi come once a week to check up ont he patients...although I'm not really sure what for.... It seems to me they could be palliated in thier own homes or even a hospice setting with out paying for the "paste"....


Anyways...its hot...and I'm having a hard time thinking straight to type....sorry if this one was a bit dry..not much has been happening...

I'll try and get off one or two more of these before I leave but we're leaving for the mountains tomorrow night or friday moring and won't be back for a week...if internet presents itserlf I'll be in touch..otherwise you know where to find me.....I'll be the only kid with red cheeks in India...

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