Sunjay R Devarajan
I am a 4th year medical student at Texas A&M College of Medicine. I will be entering a combined Internal Medicine/Pediatrics residency program in July 2012. I am blogging from Mumbai, where I am spending the entire month of February doing an Infectious Disease rotation at King Edward Memorial Hospital. KEM is an enormous government hospital that is affiliated with Seth GS Medical College, one of India's premiere medical schools. I hope you enjoy the chronicles of my trip, and please leave me your feedback!sunjayd
Travel Blog Posts
February 28th 2012
Dr. M studied the toddler. Unconscious, the whites of the child's eyes were partly visible, and her mouth was widened by the long tube which had been carefully guided through her mouth, past her throat, and into the terminus of her windpipe. And then the good doctor noticed something amiss. The left hand. Why was it so blue...and swollen? He studied the right side. Perfectly normal, nothing to be concerned about over there. But what about this left side? He touched it, manipulated it, felt for pulses, checked the capillary refill. Not good. The IV line, which had been placed on the dorsum of the left hand, was surrounded by evidence of multiple placement attempts. Suddenly, the source of the cyanosis and swelling became clear. He dropped the puny hand, summoned all of his residents into ... read more
February 23rd 2012
There are separate male and female wards here. Just to emphasize that fact, the two gender-based wards are separated by 2 floors. These wards, as I've demonstrated in some of the photos posted earlier, are essentially colossal rooms crammed with beds from end-to-end. It makes sense that the two adult sexes should be separated, right? But what about the pediatrics population? Did you know that there are no children above the age of 12 in the Pediatric wards? The reasons are fairly straightward: the hospital does not want male and female children, who are "of age", to be placed together in the same area. Due to bedside procedures and general physical exams, it can be necessary that the adolescents disrobe, so the inevitable embarassing situation is mitigated by moving the adolescents to their respective gender's adult ... read more
February 21st 2012
In my outpatient clinic last Friday morning, I saw about 15 patients with my team. Tenof them had Tuberculosis in one form or another. So far, during the last 3 weeks, I have seen pulmonary TB, TB meningitis, TB peritonitis, TB tuberculoma, disseminated TB. I had always heard that syphilis was considered to be the "Great Imitator," but how it could eclipse Mycobacterium in its various forms is beyond me. Due to the advent of multi-drug resistant TB in Mumbai, all patients diagnosed with this infection are started on AKT (Anti-Koch's therapy, as it is called here) immediately in the hospital setting. When they are stable for discharge, they return within 1-2 weeks for follow-up on their condition, where they receive an update on the sensitivities of their cultures. This follow-up is a great time to ... read more
February 16th 2012
I figured it out! There is a local government body called the Municipal Corporation of Greater Mumbai (MCGM), which amongst other things, funds and operates KEM Hospital to serve Mumbai's urban poor. It has allowed the hospital to evolve into the massive tertiary care center that is has become. Cost of care for the citizenry is heavily subsidized by the MCGM, which operates on an enormous budget funded by taxpayers. I suppose this is not unlike how our county hospitals operate under state tax revenues in the USA, but because of the high volume of generic pharmaceutical manufacturers in India, KEM is able to provide cheap medicines that would be enormously expensive in the USA. For example, Zosyn (Piperacillin-Tazobactam), our famous shotgun-approach IV antibiotic, is priced at a mere fraction of the cost here. I would ... read more
February 13th 2012
Saturday was a very low-key day at KEM. The emergency room was calm, the medical ward was only sparsely occuped, and the highly unusual cases were nowhere to be seen. Sunday is a holiday for medical students, so I took advantage by doing non-medical stuff! On Saturday after rounds, a Seth GS Medical College student named Rahul, whom I had met a few days prior, invited me, Khaled, and Nasir to his home in Virar, a suburb that is found on at the very last stop of the Mumbai Western rail line. It was a good 1.5 hours from the hospital. This is actually a very common practice in Indian culture as a whole. Whether north, south, east, or west Indian (or any other differentiation you feel like making), the rules of hospitality remain congruent throughout ... read more
February 10th 2012
As a medical student, going on rounds at KEM is very fun, plain and simple. As I mentioned before, your clinical responsibilities are fewer than back at home, but the learning opportunities are arguably better. You are expected to listen attentively, take notes, and examine patients when interesting physical findings pop up on your patients. Not only that, but the sheer number of people managed by a single doctor is so vast that the diversity of pathology is unparalleled. You see just about everything here, and you definitely have the time and flexibility to assiduously examine the patients with the most noteworthy findings. Because there is usually such a large group of students (I'd say 3 or 4 layers worth) sheepishly following their senior doctor, there is a lot of background discussion amongst the students about ... read more
February 8th 2012
To start off, KEM Medical students = awesome. So friendly, so smart, so hard-working. I am very impressed with what I have seen from them so far. I've also been able to become friends with the foreign medical students that are here. Khaled and Nasir Khan are originally from Afghanistan, but they go to medical school in China (and they speak Mandarin!). They are my suitemates, and we have spent a great deal of time together. They have been invaluable to me as patient translators, as their Hindi is so solid. I have also had the pleasure of meeting Katie Dickson & Sam from the UK, Genevieve Verrastro from the USA, and Ninad Apte from Germany. During the last 2 days, I have had the pleasure of spending time with Dr. Nikhil Karnik in different clinical ... read more
February 6th 2012
Namaste, everyone! Glad you're here! I'm reporting live from an internet cafe across the street from King Edward Memorial Hospital in Parel district of Mumbai. This is one of the most famous teaching hospitals in the entire nation (probably behind AIMS in Delhi), and I will be here for the next month or so. Initially, I was set on doing only Infectious Disease work, but I have had a change of heart and am going to be on both the General Medicine and General Pediatrics teams. Apparently, I'll get my fill of infectious diseases in these realms though. Mumbai appears to a wonderfully large city with a friendly populace. I can already tell that my inability to speak Hindi is definitely going to dull the experience to a certain degree, but I find that my skill ... read more
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