Hostile to Humor, who needs a Honeymoon?

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So here I am in India! It's taking me awhile to really realize it. I still think I'm getting over being done with first year and exams. =P

They say you're supposed to go through about 4 stages of culture shock. First Honeymoon, then Hostility, then Humor, then finally feeling like this is Home. I think I skipped right over the Honeymoon and went straight to Hostility and then to Humor. Probably because within 2 seconds of stepping out of the airport terminal a bunch of porters tried to take advantage of my ignorance and general confusion and get me to pay them "5 - 10 American dollars each," all for putting my bags (without asking by the way) into a car about half a foot away. In my general overwhelmedness (yes I know that's not a word) I was actually 1/3 ready to actually do it too, except that it just sounded absolutely ridiculous. Luckily the guy who picked me up from CFHI - the organization I'm doing this through (who spelled my name, along with the rest of the Indians here, as "Anjela" like as in the Indian name Anjeli, which I find rather amusing) saved me and off we went on the crazy ride through Delhi.

What a crazy city Delhi is. In little ways it kinda reminds me of Taipei (capital of Taiwan for those less familiar with tiny islands in the Pacific =) ) in the crazy drivers, and the general crush of people, only it's been magnified about 400X. I think it was probably around 11 pm when I finally got out of the airport, and there were people _everywhere_ - riding bikes, driving tiny cars, walking, riding mopeds (often 3 to a seat), all running around in complete disarray. And honking! All the time honking. Here if you ever want to pass someone, tell them you're coming up behind them, or generally move at all, you honk. Delhi is also a city of contrasts. There are beautiful apartments worthy of the center of any American city, standing right next to the dirtiest, poorest slums you'd ever see in your life. It's really true what people say about the poor in the US being rich compared to the poor in some other areas of the world. This was especially evident in the 7 hour bus ride the next day from Delhi to Dehradun, where we passed through lots of other cities and the countryside. You know those pictures on the TV you see of people trying to scrape a living after horrible hurricanes, tornadoes, the tsunami, or refugees fleeing from some sort of genocide? That's how some of these people live *all the time*. There were tons of dwellings right by the road that we passed, that were literally made of nothing more than some big tree branches propped up with either a plastic tarp, or some scrap metal as a roof overhead. Rubber tires thrown on top, either to hold the stuff down or for some other reason I really don't know. People sleeping on their cars, in the dirt, or pretty much wherever. It was incredible.

I don't want to give you guys the impression that it was all like this or anything, though. Definitely not. This was just striking to me. Other interesting stuff I saw included, of course, the cows that continuously wander the streets (it's interesting - they're holy, but it's not like people stop and bow to the cows as they pass by or anything... people just... avoid hitting them... unlike the humans in the road that they don't seem to mind at all =P ), all the stray dogs everywhere, and monkeys that also seem to roam around in various little parks in the city.

Ok, enough Delhi. Dehradun I like much better. It's still crazy and confusing and I still nearly get run over by an auto-rickshaw (something like a 3-wheeled bike, only with seats in the back, and sides and roof, and a guy driving it in front) or moped or car nearly every day, but it's kinda a "do-able" crazy. Plus it's just *slightly* cooler and cleaner, which really does make a difference. I'm staying in a home stay with 4 other students and the American local coordinator, who's actually also a student who did CFHI last year in Africa and is working for the program here this year. There are 2 other girls that I share a room with, and 2 guys that have their own room. The house and rooms are much, *much* bigger than I expected. Every bedroom has it's own bathroom, which is much more like the bathrooms in Taiwan, with no tub and just one side of the room reserved for the showerhead (a bit unusual here to even have a showerhead) and the buckets that people use to wash with, and drains in the floor. We're also quite "well off" in Mrs. Mehta's house, because she has Western-style toilets, instead of the shallow depressions with drains that make up most of the bathrooms in India. Another interesting thing that I didn't expect - no on here has toilet paper!! In Taiwan you have to bring your own to the public toilets, but here even in people's houses there's no toilet paper! It's just the whole wipe-with-one-hand-and-eat-with-the-other thing... All the bathrooms come with a spout and a little pitcher that you wash the waste away with, and luckily every bathroom seems to have soap, but... eww! Luckily the convenience store down the street sells some because all I brought are those pocket-tissue packs, which I was running out of real fast. (Oh, the one exception to the rule - Barrista Restaurant in the middle of Dehradun, which serves "Italian food" (since when was Chicken Tikka Italian?). Basically it has coffee and Western cake... and toilet paper!! Yes!!)

As for clinical stuff I just finished off the first week, which was cardiology in Doon Hospital (government, with free care) with Dr. Joshi who's a cardiologist, and what was technically pediatrics but really was just about everything at Dr. Vaish's "Nursing Home." I don't know what Nursing home means here but obviously it's not the same thing as in the states. Dr. Joshi works in this tiny little room with people just crowded everywhere in it, spilling even into the hallways sometimes. There is absolutely no privacy whatsoever as everyone is standing over your shoulder as you're seeing the doctor and he's examining you, listening to everything that's going on and pushing to get themselves forward. People will wait for so long to see him or his assistant, but only get to actually see him for a good 40 - 60 seconds! I'm sure he might like to spend more time with each, but he sees, the told us, **150** patients a day!! 50 in the morning, 50 in the afternoon, and 50 at his house. It's incredible. He pretty much listens to their heart, take a bp, listens to their lungs, asks them to cough, maybe looks at an EKG reading, and sends them on their way. It's very much clinical medicine and not so much investigative. There's just no time for that. As for Dr. Vaish, he pretty much runs the entire clinic on his own, which is *truly* an impressive deal. He has about 150 patient beds, a PICU with 3 beds, and a NICU of a good 10 - 15 units. Plus, he does pretty much *everything*. Deliveries (with the help of his wife, and OB/GYN), kids, adults, geriatrics, ER, plus assists with the occasional surgery "about once a day." I've seen *so* many things we've talked about in class, plus a whole bunch of stuff we didn't cover. Typhoid, Hep A (yay for vaccines...), Hep C, tons of gastroenterotidis (sp??), hypoxic children from mothers with hypertension, uncontrolled diabetes, lots of malnutrition and dehydration (especially of little tiny babies, which is especially sad), patent foramen ovale, etc. One of the most interesting procedures was with this poor boy who'd had measles, and the infection had demyelinated his spinal cord and gone up to the medulla such that not only was he paraplegic but had lost respiratory control (thank you Proff Gagliardi!!! =) ). He kept building up this thick mucus in his endotrachial tube, and Dr. Vaish, with lack of a good enough suction apparatus I guess, would *mouth aspirate* the child to get the gook out!! It was crazy. Seriously, this stuff was thick - like the stuff from cystic fibrosis children. He would mouth aspirate this stuff up and then blow it into a cotton wad, over and over again until he'd cleared the kid's airways, and then they're re-intubate him. Amazing.

Ok I'm about to be kicked out of the internet cafe. Everything here closes at 9 pm, despite being a city, and I need to go. Overall though I'm having an awesome time. This place is just crazy and amazing at the same time, and I can't wait to see what happens next week when we go up to the mountains to Moussouri. This weekend we're going rafting on the Ganges (don't worry, we're far far upstream, so the water's pretty clean) and then going trekking in the Himalayas!! Our guide's getting us up really early so we can see the sunrise, and then we're going to trek down, which should take about 5 - 6 hours. I'm so psyched!!

Ok, truly must go now. I hope everyone's having a great time with their own adventures, and I'll write again when I get the chance!

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Comments

[Travis]

Travelblogs...
I have two friends of Chinese descent right now living in developing Asian countries for the summer, both of whose names start with "An-" and end with "-a." (The other is my friend Ana who is doing an archaelogical dig in Syria.) It's just a funny coincidence is all. It sounds like you're having a very interesting time - I empathize for your lack of toilet paper. Even in the most boonies boonies areas of Japan we had toilet paper. This travelblogging really makes me wish I were in Japan, or somewhere similarly interesting, on a similar sort of adventure, so that I could write a travelblog, and it would say at the top something like Asia >> Japan >> Tottori Prefecture >> Innakacho (Innakacho isn't a real place; it's Japanese for "boonies-town".) My only experiences with seeing these sorts of really poor third-world societies was in crossing the so-called "Green Line" which separates Israel from the Palestinian Territories. It is truly amazing how little so many of the Palestinians have, when so many Israelis are as well off as Western Europeans, Brits, or Americans. In any case, I eagerly await your next update. Though, I wouldn't call Taiwan a "tiny island in the Pacific." Formosa's a pretty big place, or so I'd imagine. Take care, Ange.