How did one month go by so fast? It seems like just a moment ago that I stepped out of the Chennai airport, but now here I am again, ready and excited to go meet my darling husband for more travel adventures, but sad to leave India behind. My last full day in India was perfect. Julie, Michael and I went with Onyx, another nurse named Cristy, one doctor and a health aid on their mobile clinic run to the villages. The ride out in the morning was incredibly beautiful. The bustling streets of the small towns outside Vellore were slowly transformed to isolated dirt roads that led into small villages. Along the way we saw monkeys swinging in the branches, banana trees intermixed with palm trees, rice paddies of the deepest green and the rugged red hills of Tamil Nadu that create such a lovely background for it all. I was almost bounced out of my seat several times as the mobile clinic hit deep potholes, scrambling to grab the bottles of medications that shot out of the boxes on particularly large jolts. We arrived at our first clinic site and while the men set up the tables, Onyx motioned us to come with her and the other women on a walk. She led us on a narrow dirt embankment through the fields of rice paddies, her blue sari swishing as she walked. We continued to walk until she motioned us to stop beside a water-filled field, and we watched as one of the village women in front of us stooped down and grabbed handfulls of green plants from where they grew on the water.
"Ground nut." Onyx said.
I wasn't sure what a ground nut was but I nodded in approval and accepted what they handed to me to eat. I've learned that refusing food in India is a futile exercise. They will feed you whether you are hungry are not. Luckily it's all delicious! The ground nut basically tasted like a raw peanut, and was just a little smaller and covered in a white husk. We stayed out in the middle of the green sea of rice paddies before walking back to the clinic site, and on the way back we attracted some interested and friendly glances from the people in the houses lining the path.
The clinic site consisted of a folding table and chairs under a tree where the doctor saw patients and the mobile clinic bus which served the purpose of private exam room, pharmacy and laboratory. I loved watching the many pregnant women stroll up to the bus, their bellies round under their sarees. They were giving urine samples to be screened for albumin and glucose. Positive test results meant they'd have to make the trip to CHAD for further testing. They all were so lovely in their elegant sarees, jewelry and with fresh flowers adorning their silky black hair. I have to think that a sari would be very comfortable maternity wear, and it still looks so beautiful. They just let out the waist wrap to accomodate their growing baby. I smiled watching the efficient and caring way the nurses doled out medications through the bus window, ensuring that each patient knew the proper way to take their pills. Many of that patients were 'chronic card carriers', a term the CHAD staff uses to describe someone with a chronic disease like hypertension or diabetes because their health record is kept on a white card that the patient carries for life. The patient is supposed to bring the card with them to every visit so that their course can be monitored. The card system is also used for obstetrics patients whose pregnancy and delivery details are charted on a pink card. The system works well and the patients get good continuity of care through CHAD this way.
After finishing clinic, Julie, Michael and I walked around the village a bit and took in the sights that make up everyday life for the people there. A barefoot man in a dhoti herding twenty goats and two cows. A woman sweeping her porch with a homemade wooden broom. Children chasing each other between the palm-roofed huts. In India, there are so many wonderful things to see in the moments of everyday regular life. Even the simplest act, like washing clothes, is an intricate dance of several steps that involves the actual immersion of the clothes in water, the vigoroys scrubbing and the beating of the clothes against a rock or other hard surface. There is so much here that captivates my attention that I find myself snapping photos of things and actions that at home I'd find boring, like sweeping the floor, building a house or boiling a pot of water. India does such things with so much personality and innovation that it's constant entertainment.
Our next stop with the mobile clinic was for pediatrics, and we all grinned watching the masses of chubby Indian babies and toddlers that were carried to the clinic on the hips of their mothers. They don't wear diapers here, but instead are often stark naked on the bottom half or in open clothing that makes the whole process easier. The people here would be horrified by all the money American parents spend on diapers that are then thrown away. The pediatric patients had simple needs, like rehydration salt solutions, cough syrup or allergy medications, so we finished the clinic within two hours. Onyx made a home visit to a man with leprosy who because of the stigmata of his disease, would not leave his home to come to the mobile clinic site.
The next stop was our last, and also where we broke for lunch. Like the day before, we spread straw mats on the floor and sat cross-legged together. This time there were more people than the day prior, which meant more force-feeding attempts. :). We were all much too happy to oblige them, and we sampled spicy eggplant, a fresh and sweet carrot dish amd several other scrumptious concoctions that they brought from home in round tin containers. After we finished eating and washed our hands, Michael, Julie and I were prepared to get back to work but the group clearly had other ideas. It's very typical here to have a post-lunch relaxation time, and they were in no hurry to get back to the clinic. The doctors and nurses asked us to sing, which we three are not accustomed to but we agreed to. Julie chose to impress them with her rapping skills and performed the first few verses of 'Ice Ice Baby', while I went with the more traditional 'Amazing Grace'. They liked both, and thanked us for sharing music with them.
After the concert it was back to the clinic bus to see more patients, and we finished around 4 PM and packed up to head back to CHAD. We stopped along the way at a roadside stand for coffee, and while we waited we fed cookies to the monkeys that scampered in the trees overhead. We would extend the cookies in our hand and the monkeys would watch from above, the brave ones making their way down to reach out and grab the cookie from our fingertips. I was quite impressed by one very tiny fellow who fit the whole cookie in his mouth. We could see the outline of the huge cookie in his tiny cheeks as he tucked it in there and climbed back up to enjoy his feast.
We took pictures of our wonderful CHAD friends before we headed back to the hostel, thanking them for allowing us to experience a completely different side of healthcare in India than we saw in the main CMC hospital. After tying up a few loose ends before our departure, we decided to visit The Golden Temple just outside Vellore that we had heard so much about. Although we have toured a lot in our short time here, we really hasn't seen much of Vellore other than the CMC hospital, campus, Darling's and Gandhi Road. We took a rickshaw to the temple and arrived at the main entrance to the paths that led to the site where it stood. I was amazed at the large amount of people there for a Thursday evening. Because you couldn't take anything in, even your shoes, I volunteered to hold Michael and Julie's things while they went in and they'd do the same for me afterwards. Sitting outside the temple I made quite a few friends. Having light skin and blue eyes does not make one conspicuous in India. A group of four little girls came up, kissed my hands, gave me flowers and posed for a series of pictures which they then demanded to see on my digital camera. Soon their mothers joined in on the fun and we had quite a photo shoot. I had several families invite me to go into the temple with them, and others who just watched me with sweet smiles as they passed by. Two security guards were particularly fascinated when I took a picture on my iPhone, which led to a whole discussion on its capabilities and price. They were shocked to learn the cost of it when they asked me how much I had paid for it.
"Two-hundred." I said.
"Mmm two-hundred. Ok."
There was then a rapid-fire exchange in Tamil before he said,
"Two-hundred rupees, or dollars madam?"
I told him it was dollars and he insisted on examing the iPhone himself, paying great deal to my Peekabo Barn application I use to entertain pediatric patients on my rotations. Even after they had left, one walked by me again and I heard him muttering and saw his smile of disbelief.
"Two-hundred dollars."
Something that so many of my peers in the U.S. have completely rocked his world, and I understand why. It must seem like such a silly and frivolous expense to him, which honestly, it is. But...I still love my iPhone.
Jules and Mike re-emerged and I went in and was immeadiately surprised by the beauty surrounding me. The crowds and dirty sidewalks were transformed to peaceful gardens with statues, long rectangular pools with fountains and an intricate maze of covered tile pathways that led to the Golden Temple. I walked slowly as the evening darkened around me, my step in rhythm with the music that flowed throughout the gardens. I could catch small glimpses of the temple as I wove through the paths, its gold facade shining despite the sun having set already. It wasn't until I was right in front of it that I could fully appreciate how lavish it was. As long as a basketball court and two stories high, it was a fanciful structure resting in the middle of a blue pool, connected by a bridge and completely covered in gold leaf. It was adorned with crystal chandeliers whose light cast such a glow that it looked like the temple itself was luminescent. I circled the entire thing on the rim of the pond, listening to and watching the chanting ceremony going on at the base of the temple. It really was lovely, but I had a bit of a hard time reconciling the building of such an expensive and elaborate temple in an area where people don't have running water or access to healthcare. It seemed that the guru of the temple, Amma, had foreseen such questions and made sure to address it on a large sign outside the temple:
"One may ask why build a golden temple and not a school or hospital? The wisdom gained from the golden temple will build thousands of schools and hospitals."
I wasn't sure where these temple-wisdom-inspired schools and hospitals were, but the temple surely was a spectacle and quite an experience as I exited it and was blessed with sacred water, a silver metal cone was placed on my head, red powder was rubbed on my forehead and I was handed a cup of rice. I'll either have to read about this or ask my Hindu friends the significance of it all because I was quite baffled by it all but enjoyed the experience.
We met up with Cristine and Aylin for our last dinner at Darling's. Everyone was to order their favorite dish, and Julie was almost in a panic worrying that her favorites wouldn't be ordered. In the end, they were, and we had a savory last supper of sweet mint lime juice, fresh lemon soda, kulcha, vegetable kofta curry, bhindi masala, cashewnut masala, eggplant masala and the mushroom pepper curry. We took pictures with our favorite jolly doorman at Darling's, and he informed us that he'd counted the number of times we'd been to Darling's: thirteen. We realyzed he'd actually underestimated it because there were times when we would come for lunch as well as dinner and he wasn't on duty then. Quite impressive I must say, but Darling's is hands down the best, especially the Aradhana A/C Vegetarian Restaurant on the first floor. It was our absolute favorite. Not only because of the incredible food, but because of the charming waiters with their kind smiles and sense of personal style, wearing their white tuxedo shirts with bowties and pure class. My two favorite waiters were a young man with a cherub-like face and a winning smile, and an older man with a magnificently groomed handlebar mustache and a carefully-formed swoop at the front of his hair. We almost told them it was our last night, but in hoping we will return to Darling's for many more meals in the future, we just ate, talked, laughed and enjoyed as usual.
Last night we packed, drank red wine out of mismatched cups from the kitchen and said goodbye to our lovely friend Aylin who leaves for Australia on Saturday. I enjoyed my many chats with her during the past month. She talks with such animation in her hands, using them in a wonderful way to tell hilarious and interesting stories. She told us she wants to come visit the States soon, and we all encouraged her. With the last of our dear Australian friends gone, it really hit me that my time in India has come to an end.
I came here expecting to enjoy my time and learn a lot, but I didn't expect to fall in love with a country so drastically different than my own in so many ways. I've eaten the spiciest food of my life, walked barefoot in places I never would have before, been blessed at Hindu temples, fed monkeys and held baby goats, cried for patients that die of diseases that don't exist at home, learned another world of medicine, was welcomed into homes for food and fellowship, felt crushed by the amount of people yet simultaneously enjoyed being part of the crowd, became quite good at eating everything (even rice) with my hands, smelled terrible things and lovely things and most of all experienced the warmth and kindness of the people here every single day. When I reflect on India I will always think in bright colors because that is how my experiences will be stored in my memory. Every moment here was exciting and rich. Julie described so well how we all felt by saying that being in India was like not wanting to take a nap when you're a child. You are afraid on what you'll miss out on if you close your eyes for even one second.
I typed this at the Chennai airport, waiting for my flight to Singapore. I am happy to have had one last comical memory in my mind as I watched the airline counters opened for check-in. With four lines open simultaneously, you can imagine the cutting opportunities that provided for eager Indian passengers (refer back to 'Everyday India: Cutting). The Air India agent was beside himself trying to organize the lines in which women and children with fourteen suitcases between five of them stood in the middle to see which one moved first so they could jump in. I've learned my lesson by now, so when a man tried to inch past me with his luggage cart, I deftly blocked his move with a sidestep and a smile. One month in India has made me street savvy in a few things at least, even though i havent quite finessed the art of the Indian squatting toilet.
I can't wait to see Landon tonight. One month of watching the sun rise while he watched it set made the miles of separation between us seem endless. I'll meet him at 7:30 PM tonight in Singapore to begin two weeks of fun adventures in Indonesia, Malaysia and Thailand. I can't wait to share my pictures with him, though no one picture can fully capture what I felt and saw in the moment it was taken. I guess that means that we'll have to go back together to India. I feel like it is written.
Friday, February 25, 2011
Thursday, February 24, 2011
"Tea", A Surprise Visitor, CHAD and Mehndi
When we returned from our trip to the north of India, we were surprised by the change in weather here in Vellore. Even though it probably seemed hotter in comparison with the cool, crisp weather of the north, there was a definite change in the atmosphere. It is now hot, a little muggy, and there have been rain storms for the past couple of days. It was in one such storm that we trudged our way through the back paths of CMC to the home of Dr. Jayenth for tea. It was a little difficult to find their apartment building, but we eventually found it with the help of a passerby. The apartment building was several stories tall, and each door was marked with the name of the inhabitants. We were a little surprised to see that every door had physicians' names on them. When we found Dr. Jeyanth's residence, we took off our shoes and were excitedly welcomed by him, Nikita, his three-year-old daughter, his wife, an anaesthesiologist at CMC and his mother and father-in-law. They all lived together in the one-bedroom flat that was both simple and beautiful. Many of Nikita's drawings and photos lined the walls, and it was obvious how much they adored her. We soon found out that "tea" was a full dinner, a delicious combination of appam and a Keralan curry that Dr. Jeyanth's wife had prepared. She filled our plates over and over, even when we insisted that we were full and couldn't possibly eat another bite.
"No, come come. Fill your plate again. Oh at least have another appam. You can do that."
Their hospitality and warm generosity was so touching, and we all ate until we were stuffed. The rest of the evening was spent discussing how our time in India had been, ophthalmology training in the U.S. and just general relaxed chit-chat about life. They got out seveal albums of their most precious photos to share with us, and we leafed through the pages of their lives, exclaiming over the pictures of Nikita as a tiny baby and then at her first birthday party, which is an enormous celebration in India (there were about 100 people at her first birthday party!). The evening ended all too soon, and we snapped several group shots using the self-timer. The icing on the cake was when the mother-in-law, Mercy Christopher, asked me if I was on Facebook and told me she would add me as a friend. Taking some pictures on her phone, she said,
"Don't worry. I'll tag these on FB."
We then headed to Darling's for dinner, a farewell celebration for Thanuja who would leave for some traveling to her family's home in Sri Lanka as well as some shopping with her mother in Chennai. I was sad to say goodbye to another one of our wonderful Australian friends, knowing that we would have to part ways with Aylin on Friday. These three girls-Louella, Thanuja and Aylin-have made our time here so much fun. Along that note, we had a surprise visitor...Louella! She had been feeling a little lonely in Chennai, staying there two days before her flight, when she decided to come back to Vellore for Thanuja's farewell dinner. We were all excited to be together again, and had a lovely time at dinner sharing stories and eating my second meal of the evening.
During my second day of CHAD, Julie, Michael and I were fortunate to go on home visits with Onyx Paul, one of the young nurses that works at CHAD. As we climbed into the CMC van and drove away from Vellore and into the villages, we learned that as a nurse, she cares for approximately 25,000 people in the rural areas. On her nurse runs, she is accompanied by a health aid, and today it was young and beautiful Priya. They made quite a sweet pair, Onyx in the blue nursing sari and Priya in the pink health aid sari. Onyx explained that these home visits were essential to so many patients in these rural villages who didn't have the means to make it to the main CHAD center as frequently as they needed to be seen for various medical problems. In India, a manual laborer makes about 50 rupees a day (the equivalent of an American dollar), so skipping a day of work to go all the way to CHAD creates a huge hardship so their health becomes neglected. Hence CHAD set up these wonderful visits to distribute medications, assess new and chronic probelms, provide antenatal care, and to just share the mission of CHAD, to provide compassionate care for anyone in need.
Our first visit was to the home of a family to which a baby had been born one week ago. The infant had a proximal femoral deformity, so Onyx assessed his hips and followed up on the scan taken at the hospital with the family. They made arrangements for the child to return to CMC in a few weeks for further investigations. The family was young and beautiful, obviously happy about the new bundle of joy in their lives.
At our stop in the next village, we heard the beating of drums and loud music. I asked Onyx what it was, and she explained that it was a funeral. She pointed out a large structure across the road, made of wood and covered in flowers, and told me that that was what the deceased would be cremated on. She told us that funerals in India have lots of music, dancing and people generally get intoxicated. Obviously quite different than the ones in the United States. We passed by the large cluster of mourners on the road, and Onyx told us we had to stop by because they would be upset that CHAD hadn't been at the funeral. The dead man was in a rectangular glass box, his face painted with beautiful designs and the box adorned with multiple strings of flowers. A group of women sat on the floor, rocking back and forth with their arms around one another, a woman that was obviously his wife was wailing and had tears streaming down her cheeks. In a moment that was both beautiful and horrible, I watched Onyx take the woman in her arms and give her comfort, as the three of us stood awkwardly on the periphery, not able to take our eyes away from the dead man lying in plain sight directly in front of us.
The visit to the next home was quite sad. It was to follow-up on the death of a twenty-three day old baby boy. In accordance with local superstition and beliefs, the family had fed the baby a concoction made of tree bark to "cleanse the stomach" as according to tradition. The baby had gotten very ill from it and aspirated, leading to pneumonia and sepsis which caused his death. Onyx spoke witht he very upset mother and sighed as we walked to the next nurse visit.
"The only way to get around this is education." She said simply.
In the home of our next patient, a very sweet, very pregnant young woman, we did an antenatal check to assess the lie of the baby and check its heart rate. Onyx was alarmed at the first feel of her abdomen, concerned it was breech, but after more palpation breathed a sigh of relief that it was not. This patient was one of Onyx's helpers when she came to the village, and she accompanied us on the rest of the visits, pointing out the correct homes of people for us. As the woman walked ahead, Onyx asked me if I had noticed the large amount of bangles that the woman wore on both wrists. She explained that until 30 years ago, death from childbirth in Tamil Nadu was extremely high. There was even a saying, "that with every birth comes a death", speaking of the high rate of complications and mortality for these young mothers. So from this sad pattern came the tradition of a ceremony at 38 weeks of a woman's pregnany in which she was brought to her mother's house and decorated with beautiful bangles, flowers and an ornage sari. In the event that the woman does not survive the birth, her mother and family make sure she feels beautiful and cared for. It made me sad to think of such sadness in a time that should be so joyous, and I was glad that obstetrics had been improved over the last thirty years with places like CHAD and the primary health centers (PHCs, which are government run). The PHCs and other government hospitals are even offering incentives for women to deliver in hospitals and these centers instead of at home, paying them 6,000 rupees to have their babies in hospitals. CHAD is not yet able to compensate women for the expenses, but it is currently in the works.
As we visited another patient for an antenatal visit, we heard someone call Onyx's name from down the street. It turned out to be her first-grade teacher who invited us into her beautiful home for conversaton, fresh-squeezed grape juice and snacks. She and Onyx had a very special relationship, and the teacher's pride in her former student was evident as they talked about old times and sang one of the songs that she had taught her students many years ago. The teacher led us to her beautiful garden to show off her handiwork, and asked to take photos with the three of us an Onyx. Once again, Indian hospitality touched my heart and reminded me of how lucky I am to be able to experience this culture.
The rest of our day of home visits was full of patients who were so happy to see the CHAD patients, and constantly wanted to invite us into their home and show off their most precious things. My favorite was a tiny calf, just a few weeks old, that the family had named "Peacock" in Tamil. The way that the people here revere cows just amazes me. They pretty much have free reign wherever they choose to roam.
We broke for lunch in the back room of a daycare center that helped single mothers and mothers with disabilities. We tiptoed by rows of adorable sleeping children at naptime, many of them covered in flies which didn't seem to bother them one bit. I was particularly taken by a chubby little boy whose hiney was hanging out in the open. We sat on straw mats in the room and we all shared the lunches we had brought. Ours were parcel lunches from the campus canteen, and Onyx brought delicious food from home that her mother prepared, which she proceeded to force on us with the utmost kindness. If we ever refused her, she would just look at us aghast at how we could do such a thing. I told Onyx that she had a lot in common with my dear Grandma Mary in that they both love to feed people wonderful food and watch them enjoy it. Maybe Grandma Mary is part Indian!
To top off an already great day, we had one of the hostel staff's sister come to Cristine and Julie's room at night to do mehndi on our arms! She skillfully drew the most beautiful and intricate designs in henna on our arms, artfully sculpting flowers, birds and other exotic figures freehand without a second thought. I was quite surprised at how dark orange it stains your skin. I hope it will last for awhile, but at least it will last long enough to show Landon when I meet him in Singapore on Friday evening. I'm glad that I will have a visual reminder of wonderful India when I board the plane on Friday and say a sad goodbye to the country I have grown to love so very much.
"No, come come. Fill your plate again. Oh at least have another appam. You can do that."
Their hospitality and warm generosity was so touching, and we all ate until we were stuffed. The rest of the evening was spent discussing how our time in India had been, ophthalmology training in the U.S. and just general relaxed chit-chat about life. They got out seveal albums of their most precious photos to share with us, and we leafed through the pages of their lives, exclaiming over the pictures of Nikita as a tiny baby and then at her first birthday party, which is an enormous celebration in India (there were about 100 people at her first birthday party!). The evening ended all too soon, and we snapped several group shots using the self-timer. The icing on the cake was when the mother-in-law, Mercy Christopher, asked me if I was on Facebook and told me she would add me as a friend. Taking some pictures on her phone, she said,
"Don't worry. I'll tag these on FB."
We then headed to Darling's for dinner, a farewell celebration for Thanuja who would leave for some traveling to her family's home in Sri Lanka as well as some shopping with her mother in Chennai. I was sad to say goodbye to another one of our wonderful Australian friends, knowing that we would have to part ways with Aylin on Friday. These three girls-Louella, Thanuja and Aylin-have made our time here so much fun. Along that note, we had a surprise visitor...Louella! She had been feeling a little lonely in Chennai, staying there two days before her flight, when she decided to come back to Vellore for Thanuja's farewell dinner. We were all excited to be together again, and had a lovely time at dinner sharing stories and eating my second meal of the evening.
During my second day of CHAD, Julie, Michael and I were fortunate to go on home visits with Onyx Paul, one of the young nurses that works at CHAD. As we climbed into the CMC van and drove away from Vellore and into the villages, we learned that as a nurse, she cares for approximately 25,000 people in the rural areas. On her nurse runs, she is accompanied by a health aid, and today it was young and beautiful Priya. They made quite a sweet pair, Onyx in the blue nursing sari and Priya in the pink health aid sari. Onyx explained that these home visits were essential to so many patients in these rural villages who didn't have the means to make it to the main CHAD center as frequently as they needed to be seen for various medical problems. In India, a manual laborer makes about 50 rupees a day (the equivalent of an American dollar), so skipping a day of work to go all the way to CHAD creates a huge hardship so their health becomes neglected. Hence CHAD set up these wonderful visits to distribute medications, assess new and chronic probelms, provide antenatal care, and to just share the mission of CHAD, to provide compassionate care for anyone in need.
Our first visit was to the home of a family to which a baby had been born one week ago. The infant had a proximal femoral deformity, so Onyx assessed his hips and followed up on the scan taken at the hospital with the family. They made arrangements for the child to return to CMC in a few weeks for further investigations. The family was young and beautiful, obviously happy about the new bundle of joy in their lives.
At our stop in the next village, we heard the beating of drums and loud music. I asked Onyx what it was, and she explained that it was a funeral. She pointed out a large structure across the road, made of wood and covered in flowers, and told me that that was what the deceased would be cremated on. She told us that funerals in India have lots of music, dancing and people generally get intoxicated. Obviously quite different than the ones in the United States. We passed by the large cluster of mourners on the road, and Onyx told us we had to stop by because they would be upset that CHAD hadn't been at the funeral. The dead man was in a rectangular glass box, his face painted with beautiful designs and the box adorned with multiple strings of flowers. A group of women sat on the floor, rocking back and forth with their arms around one another, a woman that was obviously his wife was wailing and had tears streaming down her cheeks. In a moment that was both beautiful and horrible, I watched Onyx take the woman in her arms and give her comfort, as the three of us stood awkwardly on the periphery, not able to take our eyes away from the dead man lying in plain sight directly in front of us.
The visit to the next home was quite sad. It was to follow-up on the death of a twenty-three day old baby boy. In accordance with local superstition and beliefs, the family had fed the baby a concoction made of tree bark to "cleanse the stomach" as according to tradition. The baby had gotten very ill from it and aspirated, leading to pneumonia and sepsis which caused his death. Onyx spoke witht he very upset mother and sighed as we walked to the next nurse visit.
"The only way to get around this is education." She said simply.
In the home of our next patient, a very sweet, very pregnant young woman, we did an antenatal check to assess the lie of the baby and check its heart rate. Onyx was alarmed at the first feel of her abdomen, concerned it was breech, but after more palpation breathed a sigh of relief that it was not. This patient was one of Onyx's helpers when she came to the village, and she accompanied us on the rest of the visits, pointing out the correct homes of people for us. As the woman walked ahead, Onyx asked me if I had noticed the large amount of bangles that the woman wore on both wrists. She explained that until 30 years ago, death from childbirth in Tamil Nadu was extremely high. There was even a saying, "that with every birth comes a death", speaking of the high rate of complications and mortality for these young mothers. So from this sad pattern came the tradition of a ceremony at 38 weeks of a woman's pregnany in which she was brought to her mother's house and decorated with beautiful bangles, flowers and an ornage sari. In the event that the woman does not survive the birth, her mother and family make sure she feels beautiful and cared for. It made me sad to think of such sadness in a time that should be so joyous, and I was glad that obstetrics had been improved over the last thirty years with places like CHAD and the primary health centers (PHCs, which are government run). The PHCs and other government hospitals are even offering incentives for women to deliver in hospitals and these centers instead of at home, paying them 6,000 rupees to have their babies in hospitals. CHAD is not yet able to compensate women for the expenses, but it is currently in the works.
As we visited another patient for an antenatal visit, we heard someone call Onyx's name from down the street. It turned out to be her first-grade teacher who invited us into her beautiful home for conversaton, fresh-squeezed grape juice and snacks. She and Onyx had a very special relationship, and the teacher's pride in her former student was evident as they talked about old times and sang one of the songs that she had taught her students many years ago. The teacher led us to her beautiful garden to show off her handiwork, and asked to take photos with the three of us an Onyx. Once again, Indian hospitality touched my heart and reminded me of how lucky I am to be able to experience this culture.
The rest of our day of home visits was full of patients who were so happy to see the CHAD patients, and constantly wanted to invite us into their home and show off their most precious things. My favorite was a tiny calf, just a few weeks old, that the family had named "Peacock" in Tamil. The way that the people here revere cows just amazes me. They pretty much have free reign wherever they choose to roam.
We broke for lunch in the back room of a daycare center that helped single mothers and mothers with disabilities. We tiptoed by rows of adorable sleeping children at naptime, many of them covered in flies which didn't seem to bother them one bit. I was particularly taken by a chubby little boy whose hiney was hanging out in the open. We sat on straw mats in the room and we all shared the lunches we had brought. Ours were parcel lunches from the campus canteen, and Onyx brought delicious food from home that her mother prepared, which she proceeded to force on us with the utmost kindness. If we ever refused her, she would just look at us aghast at how we could do such a thing. I told Onyx that she had a lot in common with my dear Grandma Mary in that they both love to feed people wonderful food and watch them enjoy it. Maybe Grandma Mary is part Indian!
To top off an already great day, we had one of the hostel staff's sister come to Cristine and Julie's room at night to do mehndi on our arms! She skillfully drew the most beautiful and intricate designs in henna on our arms, artfully sculpting flowers, birds and other exotic figures freehand without a second thought. I was quite surprised at how dark orange it stains your skin. I hope it will last for awhile, but at least it will last long enough to show Landon when I meet him in Singapore on Friday evening. I'm glad that I will have a visual reminder of wonderful India when I board the plane on Friday and say a sad goodbye to the country I have grown to love so very much.
Tuesday, February 22, 2011
The Golden Triangle Part III-Delhi
We ceremoniously closed the point of The Golden Triangle with our last stop in Delhi. We arrived late in the evening, and were picked up from the airport by a taxi arranged by Cristine's father through one of his students with family in Delhi. We were thankful for the uneventful and peaceful ride to the hotel, enjoying passing the numerous energetic and colorful weddings along the way. No matter how many times I have seen one, the weddings here never cease to amaze me with their traditional beautiful clothing, fireworks, marching band, and just the general merriment that the whole procession embodies. We arrived at the Hotel Clarke no worse for the wear, checked into our room, dined in the rooftop restaurant, and called it a night because it was late and we needed sleep to maximize the next day of touring in Delhi.
The morning shone bright and sunny as we finished up breakfast and were picked up by our trusty drivers, and we were off to the Red Fort. As we drove, the contrast between Old Delhi and New Delhi was both obvious and interesting. Old Delhi was once the capital of Islamic India, and you can see remnants of its glory in monuments like the Red Fort. New Delhi was created by the British, and is a more modern, Westernized looking city, almost like something you'd see in Europe. We began our tour at the Red Fort, an imposing sandstone structure of splendid Mughal construction with walls that extend for two kilometers and are as high as 33 meters on the city side and 18 meters on the Yunama River side. We entered through Lahore gate, and crossed through Chatta Chowk, the covered bazaar that was both fabulous and a tourist trap. Managing to evade the scarf and bangle-sellers for the time being, we emerged into an enormous green courtyard studded with trees, fountains and different elegant structures. There were many majestic buildings, my favorite being the Diwan-i-Khas (Hall of Private Audiences) with its strong marble pillars and delicated floral inlays, much like the Taj Mahal. The Peacock Throne once graced its center before being looted from India by Nadir Shah in 1739. Comissioned by Shah Jahan of the Taj Mahal, the Peackock Throne was a two meter tall golden throne set with precious stones-most notably the 191-carat-Koh-i-noor Diamond-that cost twice as much as the Taj Mahal, and rumored to be worth one billion US dollars if it was around today. Sadly it's not, as it was dismantled after Nadir Shah's assassination, the Koh-i-noor Diamond being cut to 109 carats by the British and placed with the crown jewels. We also enjoyed the Museum of Archaelology where Michael and I complicated whether it would be more painful to die by some of the menacing swords displayed in the cases, or by the eight-bladed mase. We decided on the mase, and also decided it was time to move onto another site after that conversation.
Our next stop was Jama Masjid, India's largest mosque. It was absolutely serene and majestic with its towering 40 meter minarets, four towers and three gateways, all composed of an attractive contrast of red sandstone and white marble. Michael was not allowed to enter the mosque wearing shorts, so he had to wrap a dhoti (the long, sheet-like garments the men wear here that look like a long skirt) around his waist to be permitted entry. I thought he looked quite dashing and snapped several pictures of his new Indian attire.
Next was Raj Ghat, a peaceful botanical garden and sanctuary where India's most beloved have been cremated and are commemorated. Despite the crowd of people in the place, the atmosphere was quiet and pensive as we slipped off our sandals to walk to the simple black marble platform that marks the spot where Mahatma Gandhi was cremated following his assassination ni 1948. A flame burns eternally at one end, and the black marble is inscribed with the epitah, Hē Ram, which translates to "O God", believed to be the last words uttered by Gandhi. I truly felt the peace that the incredible man and philosopher lived and died for, and we spent about half an hour just sitting on the grass outside the memorial, watching several young Indian boys turn flips on the lawn, laughing and waving excitedly at the attention we were giving them. Several other notable Indian figures have been cremated there, and we visited the cremation sites of Indira and Rajiv Gandhi. Indira was the daughter of the first Indian prime minister, Jawaharlal Nehru, and Rajiv was his grandson. I felt great sadness that both of these leaders had been assasinated, a family wiped out by hatred and misdirected anger.
The last stop before lunch was the Lotus Temple, the Bahai house of worship. Built in the shape of the sacred lotus flower, the temple has 27 pure white marble petals that reach for the sky. We were welcomed in Hindi and English to the temple by a young man and a woman who explained that the Bahai faith revolves around universal peace and the elimination of prejudice, and that followers of all faiths were welcome to pray or meditate according to their own beliefs and religion. This attitude of acceptance and tolerance rang home to me, and I wished that all religions and states could be so open to the beliefs and backgrounds of humanity as a whole. We would all be better off, simply stated. We sat on a bench in the temple, each saying their own silent prayer, and walked back out on barefeet to slip back on our shoes that we had left at the gate.
At lunch we dined on typical north Indian food, but the atmosphere was anything but typical. We ate in a sleek, black and chrome lounge where a deejay spun our favorite songs mixed with his own funky flair. We treated ourselves to some Kingfishers in the afternoon (because it was our vacation :), and the staff must have enjoyed the dancing we did in our seats because our waiter brought over four flaming shots from the bar! We had found the hip, young, urban scene that we had imagined to be in New Delhi, and enjoyed the rest of our lunch to the re-stylized beats of the Black Eyed Peas and David Guetta.
We bade our drivers goodbye for the day and did a brief stint at Karol Bagh market, but it was only halfhearted because we were so tired. We rested a bit at the hotel, then found a fun restaurant and bar down the street with great kebabs and beer, and an atmosphere that didn't frown on our Chaco sandals, leggings and kertas. We had wanted to explore the more upscale side of Delhi nightlife, but didn't think to bring anything more than our traveling clothes which were certainly not up to the high-heeled-cocktail-dressed-three-piece-suit standards of the Delhi clubs. No matter to our group though because we enjoyed the night and turned into bed quite satisfied with our day overall.
Morning brought a brand new day and our sole mission: shopping! Michael was again a great sport as we spent hours in the bazaars, bargaining with shopkeepers for gifts to take home and reminders for ourselves of our beautiful adventure in India. We all prided ourselves on our haggling ability (though I'm sure we still paid too much, but it's all so beautiful I didn't care), and piled into the taxi to the airport laden with our treasures. Thankfully our flight home was on time and things were uneventful as our plane left the ground of India's fascinating capital city, a true blend of different worlds, both old and new. During the flight back to Chennai, the beverage cart rolled by and I ordered some tea from the servers.
"Black tea or regular tea, madame?" He asked.
"Regular tea." I said, accepting the cup with a napkin to protect my skin from the scalding heat.
Sipping it, I marveled that like the spicy, rich tea, nothing in India is regular. The tea is just one example of so many things here that constantly awaken my senses and a remind me of the joy and celebration in living every day.
The morning shone bright and sunny as we finished up breakfast and were picked up by our trusty drivers, and we were off to the Red Fort. As we drove, the contrast between Old Delhi and New Delhi was both obvious and interesting. Old Delhi was once the capital of Islamic India, and you can see remnants of its glory in monuments like the Red Fort. New Delhi was created by the British, and is a more modern, Westernized looking city, almost like something you'd see in Europe. We began our tour at the Red Fort, an imposing sandstone structure of splendid Mughal construction with walls that extend for two kilometers and are as high as 33 meters on the city side and 18 meters on the Yunama River side. We entered through Lahore gate, and crossed through Chatta Chowk, the covered bazaar that was both fabulous and a tourist trap. Managing to evade the scarf and bangle-sellers for the time being, we emerged into an enormous green courtyard studded with trees, fountains and different elegant structures. There were many majestic buildings, my favorite being the Diwan-i-Khas (Hall of Private Audiences) with its strong marble pillars and delicated floral inlays, much like the Taj Mahal. The Peacock Throne once graced its center before being looted from India by Nadir Shah in 1739. Comissioned by Shah Jahan of the Taj Mahal, the Peackock Throne was a two meter tall golden throne set with precious stones-most notably the 191-carat-Koh-i-noor Diamond-that cost twice as much as the Taj Mahal, and rumored to be worth one billion US dollars if it was around today. Sadly it's not, as it was dismantled after Nadir Shah's assassination, the Koh-i-noor Diamond being cut to 109 carats by the British and placed with the crown jewels. We also enjoyed the Museum of Archaelology where Michael and I complicated whether it would be more painful to die by some of the menacing swords displayed in the cases, or by the eight-bladed mase. We decided on the mase, and also decided it was time to move onto another site after that conversation.
Our next stop was Jama Masjid, India's largest mosque. It was absolutely serene and majestic with its towering 40 meter minarets, four towers and three gateways, all composed of an attractive contrast of red sandstone and white marble. Michael was not allowed to enter the mosque wearing shorts, so he had to wrap a dhoti (the long, sheet-like garments the men wear here that look like a long skirt) around his waist to be permitted entry. I thought he looked quite dashing and snapped several pictures of his new Indian attire.
Next was Raj Ghat, a peaceful botanical garden and sanctuary where India's most beloved have been cremated and are commemorated. Despite the crowd of people in the place, the atmosphere was quiet and pensive as we slipped off our sandals to walk to the simple black marble platform that marks the spot where Mahatma Gandhi was cremated following his assassination ni 1948. A flame burns eternally at one end, and the black marble is inscribed with the epitah, Hē Ram, which translates to "O God", believed to be the last words uttered by Gandhi. I truly felt the peace that the incredible man and philosopher lived and died for, and we spent about half an hour just sitting on the grass outside the memorial, watching several young Indian boys turn flips on the lawn, laughing and waving excitedly at the attention we were giving them. Several other notable Indian figures have been cremated there, and we visited the cremation sites of Indira and Rajiv Gandhi. Indira was the daughter of the first Indian prime minister, Jawaharlal Nehru, and Rajiv was his grandson. I felt great sadness that both of these leaders had been assasinated, a family wiped out by hatred and misdirected anger.
The last stop before lunch was the Lotus Temple, the Bahai house of worship. Built in the shape of the sacred lotus flower, the temple has 27 pure white marble petals that reach for the sky. We were welcomed in Hindi and English to the temple by a young man and a woman who explained that the Bahai faith revolves around universal peace and the elimination of prejudice, and that followers of all faiths were welcome to pray or meditate according to their own beliefs and religion. This attitude of acceptance and tolerance rang home to me, and I wished that all religions and states could be so open to the beliefs and backgrounds of humanity as a whole. We would all be better off, simply stated. We sat on a bench in the temple, each saying their own silent prayer, and walked back out on barefeet to slip back on our shoes that we had left at the gate.
At lunch we dined on typical north Indian food, but the atmosphere was anything but typical. We ate in a sleek, black and chrome lounge where a deejay spun our favorite songs mixed with his own funky flair. We treated ourselves to some Kingfishers in the afternoon (because it was our vacation :), and the staff must have enjoyed the dancing we did in our seats because our waiter brought over four flaming shots from the bar! We had found the hip, young, urban scene that we had imagined to be in New Delhi, and enjoyed the rest of our lunch to the re-stylized beats of the Black Eyed Peas and David Guetta.
We bade our drivers goodbye for the day and did a brief stint at Karol Bagh market, but it was only halfhearted because we were so tired. We rested a bit at the hotel, then found a fun restaurant and bar down the street with great kebabs and beer, and an atmosphere that didn't frown on our Chaco sandals, leggings and kertas. We had wanted to explore the more upscale side of Delhi nightlife, but didn't think to bring anything more than our traveling clothes which were certainly not up to the high-heeled-cocktail-dressed-three-piece-suit standards of the Delhi clubs. No matter to our group though because we enjoyed the night and turned into bed quite satisfied with our day overall.
Morning brought a brand new day and our sole mission: shopping! Michael was again a great sport as we spent hours in the bazaars, bargaining with shopkeepers for gifts to take home and reminders for ourselves of our beautiful adventure in India. We all prided ourselves on our haggling ability (though I'm sure we still paid too much, but it's all so beautiful I didn't care), and piled into the taxi to the airport laden with our treasures. Thankfully our flight home was on time and things were uneventful as our plane left the ground of India's fascinating capital city, a true blend of different worlds, both old and new. During the flight back to Chennai, the beverage cart rolled by and I ordered some tea from the servers.
"Black tea or regular tea, madame?" He asked.
"Regular tea." I said, accepting the cup with a napkin to protect my skin from the scalding heat.
Sipping it, I marveled that like the spicy, rich tea, nothing in India is regular. The tea is just one example of so many things here that constantly awaken my senses and a remind me of the joy and celebration in living every day.
The Golden Triangle Part II-Agra
The morning train ride from Jaipur to Agra displayed yet another new landscape to be seen in India. Fields of tall green grass interrupted by groves of trees were foreground to the silhouette of towering hills, and the sun rose languidly as it burned off the mist of the cool blue and green morning. We dozed on and off on the train, and felt energized as we walked through the station and into the bustling scene outside. We were approached by many offers for rickshaws, only one of which we accepted from the tourism company. Our driver, "K.K.", was an adorable middle-aged man whom we all liked immeadiately. He told us he'd make sure we saw exactly what we wanted to see in Agra, and he gave us his notebook, similar to Rafiq's, with multi-lingual descriptions lauding his excellent services. He took us to a cafe close to the south gate of the Taj Mahal for breakfast, and we were able to store our bags for the couple of hours we'd been in Agra before we headed on to New Delhi. With the promise that he'd be waiting for us when we returned, we struck out on our Taj Mahal mission. We made several wrong turns down side streets, accruing a group of teenage boy followers, but eventually found the south gate to the Taj Mahal.
There were separate lines for males and females, and we were intimidated by the ridiculously long line for the men that seemed to stretch back for miles. We bought our tickets, and I felt a sinking feeling in my stomach when the guard told us that the gates would be closing at 2 PM because a foreign diplomat was visting. My watch said 1:30 PM, and there was no way that the mens line would move fast enough for Michael to get in with us. The girls and I jumped in the womens line and in desperation, began pleading with the men across from us to let Michael in with them (Julie and I may or may not have told them that he was our husband, and that we'd come all the way from America to see the Taj...some of that is true:). Always willing to help out an American lady, they kindly obliged us, and in nail-biting suspense, Michael slipped by the watchful eyes of the guards and into line, and all of us made it through in the nick of time before the gate closed. We had to cross through several more towering gates and beautiful Persian gardens before the Taj Mahal came into view, and my anticipation built like an ocean wave, finally breaking as the heavenly structure came into my line of sight. I inhaled sharply as I drank in the view, feeling goosebumps break out all over my body. It was similar to the feeling I had when seeing the Colosseum for the first time, but even more powrful with the pure white set against a powerful blue sky. Something I had envisioned for so long was standing before my eyes, and the physical materialization of a fantasy becoming reality had me spellbound. Even though it's insufficient to compare the structure to a mundane object, the thought that popped into my head was 'wedding cake'. The most decadent and elegant one that even the most skilled artist could only dream about.
The walk past the long rectangular pools with shooting fountains was like a path of purification, and we arrived at the steps of the Taj Mahal in a pensive and peaceful state much different than in the hectic way we had entered. We waited in line with people of all nations and ages, from Tibetan monks to women from Missouri, all here to seek a moment in one of the greatest man-made wonders that most people will ever see in otheir lifetime. I couldn't help but think about the eternal romance that the Taj Mahal represented. Emperor Shah Jahan built the Taj as a memorial for his second wife, Mumtaz Mashal, who died in childbirth. They say that Shah Jahan was so grief-stricken and heartbroken that his hair turned to gray virtually overnight. The Taj took eight years to build and was completed in 1653, and was beautifully described by Shah Jahan itself when he said that it made "the sun and the moon shed tears from their eyes".
From close up, the seemingly simple white of the structure was actually a myriad of intricate flowered marble carvings and inlaid designs of precious stones. The detail in one square foot was incredible, and this same magnitude of detail was everywhere I looked, from the delicate honeycombing of the marble screens to the towering minarets at the top. What was interesting was that the extravagant exterior gave way to a relatively simple, albeit elegant interior. I stepped into a circular room that marked the false tombs of Shah Jahan and Mumtaz (their real tombs are in a locked basement chamber and cannot be viewed), and marveled at the peaceful, austere resting place inside the magical structure. The marble carvings and inlaid precious stone designs continued to the inside, and I learned from watching a tour guide place a penlight against the portion of the wall, that cornelion, the orange stone that made up parts of the flower designss, glows like fire when light illuminates it from behind. I wandered through other parts of the magnificent structure, and emerged on the back side of the Taj Mahal, getting a view of the Yamuna river that flows behind the monument, its natural beauty complimenting one of mankind's greatest architectural achievements.
We spent the next hour in ridiculous tourist mode, snapping photos in front of the Taj Mahal, often times being asked to pose with people in their photos. There's not many times when you're background is the Taj, so though we felt a little cheesey we took advantage of it, coming up with a variety of poses. We all whipped out our OU College of Medicine t-shirts for several of them to show our appreciation for the reason that we were able to come to India in the first place.
It was hard to leave the Taj Mahal, and as we walked away from it I kept looking back, trying to permanently fix every detail in my memory. No matter if I come back again to see it, it won't ever look the same. I tried to preserve everything: the way the Taj Mahal seemed to emit its own light, the way its reflection danced on the pools and the looks on the faces of the people as they gazed upon its splendor.
The rest of our short time in Agra was spent touring the city by rickshaw. K. K. gave us an excellent brief history of the fort, located just two kilometers from the Taj Mahal along the same river, but on different parts of its bend so you get a brilliant view of the white beauty from the fort. K. K explained that soon after the Taj was finished, Shah Jahan's son, Aurangzeb, overthrew his father and had him imprisoned in the Agra Fort where, for the rest of his days, he could onlygaze out at his creation through the windows. It was only in death that Shah Jahan returned to the Taj Mahal, to be laid to rest beside hiswife. I can't imagine what kind of selfish and heartless son could do this to his father, banishing him away, but giving him a direct line of sight to what eludes and tortures him.
We made our way back to the train station and boarded our car, sipping chai on the way and reading the good books we had brought along. I was glad that I had bought "The Space Between Us", a novel written by an Indian author about Mumbai, before the trip and brought it with me, because there were now so many references and nuances in the book that I now understand from living in India for the past three weeks. As always, we made some new train friends who helped us get off at our next stop...New Delhi!
There were separate lines for males and females, and we were intimidated by the ridiculously long line for the men that seemed to stretch back for miles. We bought our tickets, and I felt a sinking feeling in my stomach when the guard told us that the gates would be closing at 2 PM because a foreign diplomat was visting. My watch said 1:30 PM, and there was no way that the mens line would move fast enough for Michael to get in with us. The girls and I jumped in the womens line and in desperation, began pleading with the men across from us to let Michael in with them (Julie and I may or may not have told them that he was our husband, and that we'd come all the way from America to see the Taj...some of that is true:). Always willing to help out an American lady, they kindly obliged us, and in nail-biting suspense, Michael slipped by the watchful eyes of the guards and into line, and all of us made it through in the nick of time before the gate closed. We had to cross through several more towering gates and beautiful Persian gardens before the Taj Mahal came into view, and my anticipation built like an ocean wave, finally breaking as the heavenly structure came into my line of sight. I inhaled sharply as I drank in the view, feeling goosebumps break out all over my body. It was similar to the feeling I had when seeing the Colosseum for the first time, but even more powrful with the pure white set against a powerful blue sky. Something I had envisioned for so long was standing before my eyes, and the physical materialization of a fantasy becoming reality had me spellbound. Even though it's insufficient to compare the structure to a mundane object, the thought that popped into my head was 'wedding cake'. The most decadent and elegant one that even the most skilled artist could only dream about.
The walk past the long rectangular pools with shooting fountains was like a path of purification, and we arrived at the steps of the Taj Mahal in a pensive and peaceful state much different than in the hectic way we had entered. We waited in line with people of all nations and ages, from Tibetan monks to women from Missouri, all here to seek a moment in one of the greatest man-made wonders that most people will ever see in otheir lifetime. I couldn't help but think about the eternal romance that the Taj Mahal represented. Emperor Shah Jahan built the Taj as a memorial for his second wife, Mumtaz Mashal, who died in childbirth. They say that Shah Jahan was so grief-stricken and heartbroken that his hair turned to gray virtually overnight. The Taj took eight years to build and was completed in 1653, and was beautifully described by Shah Jahan itself when he said that it made "the sun and the moon shed tears from their eyes".
From close up, the seemingly simple white of the structure was actually a myriad of intricate flowered marble carvings and inlaid designs of precious stones. The detail in one square foot was incredible, and this same magnitude of detail was everywhere I looked, from the delicate honeycombing of the marble screens to the towering minarets at the top. What was interesting was that the extravagant exterior gave way to a relatively simple, albeit elegant interior. I stepped into a circular room that marked the false tombs of Shah Jahan and Mumtaz (their real tombs are in a locked basement chamber and cannot be viewed), and marveled at the peaceful, austere resting place inside the magical structure. The marble carvings and inlaid precious stone designs continued to the inside, and I learned from watching a tour guide place a penlight against the portion of the wall, that cornelion, the orange stone that made up parts of the flower designss, glows like fire when light illuminates it from behind. I wandered through other parts of the magnificent structure, and emerged on the back side of the Taj Mahal, getting a view of the Yamuna river that flows behind the monument, its natural beauty complimenting one of mankind's greatest architectural achievements.
We spent the next hour in ridiculous tourist mode, snapping photos in front of the Taj Mahal, often times being asked to pose with people in their photos. There's not many times when you're background is the Taj, so though we felt a little cheesey we took advantage of it, coming up with a variety of poses. We all whipped out our OU College of Medicine t-shirts for several of them to show our appreciation for the reason that we were able to come to India in the first place.
It was hard to leave the Taj Mahal, and as we walked away from it I kept looking back, trying to permanently fix every detail in my memory. No matter if I come back again to see it, it won't ever look the same. I tried to preserve everything: the way the Taj Mahal seemed to emit its own light, the way its reflection danced on the pools and the looks on the faces of the people as they gazed upon its splendor.
The rest of our short time in Agra was spent touring the city by rickshaw. K. K. gave us an excellent brief history of the fort, located just two kilometers from the Taj Mahal along the same river, but on different parts of its bend so you get a brilliant view of the white beauty from the fort. K. K explained that soon after the Taj was finished, Shah Jahan's son, Aurangzeb, overthrew his father and had him imprisoned in the Agra Fort where, for the rest of his days, he could onlygaze out at his creation through the windows. It was only in death that Shah Jahan returned to the Taj Mahal, to be laid to rest beside hiswife. I can't imagine what kind of selfish and heartless son could do this to his father, banishing him away, but giving him a direct line of sight to what eludes and tortures him.
We made our way back to the train station and boarded our car, sipping chai on the way and reading the good books we had brought along. I was glad that I had bought "The Space Between Us", a novel written by an Indian author about Mumbai, before the trip and brought it with me, because there were now so many references and nuances in the book that I now understand from living in India for the past three weeks. As always, we made some new train friends who helped us get off at our next stop...New Delhi!
The Golden Triangle Part I-Jaipur
Upon our arrival to India, our group was adamant about traveling through The Golden Triangle, the aptly-named route between the cities of Delhi, Jaipur and Agra. We had planned for weeks for the trip, and I was ridiculously excited as I went to bed the night before we left. The beginning of our journey to The Golden Triangle can best be described as a bit of a challenge. We woke up at 3 AM to catch our rickshaw to Katpadi, and hopped the 4 AM train to Chennai. Though it's only 2 hours away from Vellore, we haven't been to Chennai since our arrival, and after our experience this time, I have to say I'm glad. We walked by the train tracks to the main station, cringing at the rats scampering across the tracks and the stench of human waste from the train toilets that connected directly to the tracks below. We were accosted by a multitude of rickshaw drivers, one that was particularly aggressive to the point I was sure Michael was going to take a swing at him. Thankfully we got to the airport uneventfully, and had some coffee and breakfast while waiting to check in for our flight. We were in a jovial mood, anticipating our trip to the north of India, excited to see a side of India different than our beloved Vellore. It wasn't until moments before we entered the security line that we got notice our flight to New Delhi had been delayed. We took it in stride, camping out on the airport floor, thankful that though the flight was delayed, we would still arrive in New Delhi in enough time to make our train to Jaipur. It was when our plane was further delayed that we began to worry, now knowing we wouldn't make our train, and concerned because the rest of our trip was a sequential line that began in Jaipur. So Cristine and I whipped our our phones to re-book trains, and I had the delightful discovery that my phone had been switched off due to improper submission of documents (in India you have to submit your passport, visa, address and several other things to obtain a phone). I had submitted all these things three weeks prior, but given the typical manner of business proceedings in India, I honestly wasn't surprised. So Cristine spent her voice and hours on the phone trying to re-schedule our train while I dashed around the airport, exploring other possible flight options that would get us to Jaipur. After much frustration and unsuccessfil conversations with the Indian Railway Transit Corporation, we decided we'd just head to the Delhi train station upon arrival and try our luck in buying tickets to Jaipur. We were exhausted by the time we boarded our flight, and immeadiately fell asleep, only awakening when we heard the announcement that we'd soon be landing in New Delhi, the capitol of India.
Stepping outside the airport I was surprised by the crisp coolness of the air in northern India, so different than the humid heat of the south. We opted for a pre-paid cab to the train station, the morning negotiations with the Chennai rickshaw driver still fresh in our minds, and we were soon weaving in and out of five o'clock traffic in Delhi. We were amused by the wild peacocks perched on bilboards and the monkeys that scampered on top of the buildings as we passed cars that ranged from dingy rickshaws to brand new BMWs. New Delhi has definitely been touched by the hand of modernization and progress, and I thought many times how clean it was as we passed the numerous green city parks and gardens. We swung through several roundabouts and kept pointing out beautiful buildings, the imposing walls of the Red Fort and the bustling city streets that twirled by. It was all kind of a tease to see Delhi this way, knowing that we were just passing through on our way to Jaipur. I was happy that we'd be back to stay a night on the weekend on the way back because there was so much to see.
Thankfully there were tickets for the 8:50 PM train to Jaipur, and we were all grateful to stop our onward progression for a moment and sit in a safe haven at the train station: McDonald's. Their menu has a few similar items to McDonald's at home, but since they don't serve beef there are many fabulous vegetarian options, the best in my opinion being the McAloo Tikki. We felt quite relaxed as we boarded our train, especially when we realized our tickets were for the third tier a/c sleeper car! I digress at this point to comment that I had a transportation revelation. On our prior train trips in India, we had been booking the 'sleeper class' train, thinking it was the only the aptly-named sleeper car on the train where you could lie down on long padded benches to sleep. As I walked through the three tier a/c car, I realized that it was an upgraded version of the sleeper cars-nicer benches, privacy curtains, a/c and your own sheets, pillow and blanket. Also less cockroaches. So essentially, all cars on every train are sleeper cars in theory (with the exception of the chair coach cars), but we had been booking the absolute worst class because we thought it was the only place where we could recline. Oops. Anyways, we were quite comfy as we settled into our newly found luxury accomodation, and I gradually fell asleep despite the obscenely loud snoring, loud chatter and the chaiwalla's loud chants of "chai chai chai" that are ubiquitous no matter what class of train car you're in.
I set my alarm for 1 AM and when it went off held vigil for our group so that we wouldn't miss our stop in Jaipur. Since there are no announcements, it would be so easy to completely miss our stop and go straighton to the last stop in Jodhpur. I was relieved when the conductor passed by and I asked if the next stop was Jaipur. I strapped on my sandals, gathered my things, and went to wake Cristine. She and I then went to Michael and Julie's car, woke up Jules, then went to find Michael...to no avail. I began to panic as I felt the train slow down, worried we wouldn't find him and we'd miss our stop. The girls and I began frantically pulling aside curtains, shining our phone lights into the beds, loudly whispering his name. We must have woken up 20 sleeping people before the conductor came up to us, made the sign for 'glasses' by putting his fingers around his eyes, and we realized he was telling us Michael was waiting between the train cars. We breathed audible sighs of relief when we found him, a little sleepy and wearing glasses, standing on the platform between the cars. We happily disembarked at Jaipur Junction, and walked to the pre-arranged meeting spot I had set up with our driver from the hotel I booked in Jaipur. He called my Cristine's cell and I answered, listening to his voice as we walked outside the station.
"Hello Madame, are you outside?"
"Yes! Yes! Where are you?" I asked excitedly.
"I am outside Madame, I can see you."
"Where are you? I don't see you." I said, casting searching glances around the parking lot.
This went back and forth with me leading the group, talking to our driver and blindly walking around in the dark in front of the train station. After about one minute I realized that I could hear him not just on the phone, but also very close, and I turned around to find him standing with Julie, Michael and Cristine a few feet back, everyone laughing at me and enjoying his antics. And this was how we met Iswar, the 22 year-old impish, rickshaw-driving jokester from the hotel. He was quite hilarious on the short drive to the hotel, taking a circuitous route to allow each one of us to come up front and in turn drive the rickshaw. He was an expert coach, instructing us how to smoothly change gears by using the handlebar gear shift. He was quite enamored with Julie, and sang her a little song about a girl named Julie and a boy named Johnny.
"You're Julie. I'm Johnny. We can get married, I'll buy you a rickshaw, and we can have a business together."
He offered to give us a tour of Jaipur the next day, but since we had a driver booked already, we declined, though we found him quite charming. We were very pleased with our accomadationa at the Hotel Sunder Palace, a tall white structure that appeared simple on the outside, but inside held four spacious stories of rooms and a rooftoop garden terrace restaurant. It was decorated with lively colors and ornamentation on every wall, and I particularly liked the sitting area in our room, a lavish woven carpet on which were placed a low table to sit at as well as plump pillows, above which hung a red and yellow glass lamp that transformed the ordinary light in our room to a sultry yellow and scarlet hue. We had been traveling a full 24 hours at this point, and I fell into bed exhausted but very excited to be in Jaipur and to see the enchanting sights I had read so much about.
We woke up to the sounds of drumming outside our hotel in Jaipur, got ready and made our way to the rooftop restaurant of the lovely Hotel Sunder. The morning was crisp and cool, and we all appreciated the steaming kettles of hot coffee and tea that were brought to the table along with banana pancakes, fresh fruit and toast. Because we only had one day in Jaipur, we decided the best way to see all of the sights was to hire a driver for the day. Cristine had the number of a her father's former student's father's friend in Jaipur (that's like "7 degrees of Kevin Bacon right there) whom we unsuccessfully tried to communicate with several times. Because of the language barrier, we never reached a consensus about when our driver would arrive to the hotel, and these are the fortuitous circumstances that introduced us to Rafiq. Cristine and I were standing on the hotel driveway, looking for the unknown driver who we thought may have somehow shown up after I had almost shouted, "Hotel Sunder. 10 AM. Tourism. Driver!" to the poor man several times on the phone. We were a little disheartened that the driver hadn't worked out, when fate smiled our way and Rafiq walked up and said,
"Hello ladies! Good morning! I take you on beautiful tour of Jaipur. You will love it."
We were immediately sold by his jolly round face and happy smile, and agreed to the bargain price of 1200 rupees for a day of driving us around Jaipur. I liked him even more as he saw me watching the colorful clash of a wedding procession across the street, and he urged me to run over and take pictures.
We were soon packed into his small car and cruising the streets of Jaipur. He explained that we were staying in the New City, and that we soon would be entering the Old City, or the Pink City. He was a savvy tour guide, pointing out his favorite lassi stand, the post office and the theater that showed Bollywood movies. Throughout the day Rafiq told stories of his touring business, whipping out a tattered notebook in which his customers touted his impeccable driving, exciting tours and childlike charm. They were written in many languages, and Rafiq inquired if I could read any other than English. When I told him Spanish and a bit of the French and Italian, he giggled joyously and asked me,
"C'est va?"
To which I replied, "Tres bien!", which began our little comedy routine that we'd perform at every new stop, each time resulting in his supreme enjoyment. He was quite thoughtful, stopping once to get coughdrops for Cristine whose laryngitis had dropped her voice to a barely perceptible whisper.
Rafiq told us proudly that he had been born in Jaipur, had always lived in Jaipur, and loved his city. I could see why as we came upon the massive, dusky pink and majestic Ajmeri Gate that guards the entrance to the old city. We got out of the car to take pictures, and I was struck by the dichotomy of modern cars and rickshaws passing beneath the elegant beauty of such an architectural masterpiece.
Our next stop was the City Palace, built between 1729-1732 by Maharaja Sawai Jai Singh, the founder of Jaipur. The City Palace is a powerful blend of Rajasthani and Mughal architecture, an expansive complex composed of exquisite courtyards, gardens and buildings of fanciful and intricate design. The architects left no blank canvases on any facade, as each is transformed by spiraling minarets, symbolic paintings and elaborate marble carvings. My favorite room was the Diwan-I-Khas, the hall meant for private audiences of the maharaja and formal gatherings. In the center of the room was a raised platform covered in royal red carpeting, headed at one end by a beautiful gilt throne and surrounded by marble columns as a perimeter. Around the room hung portraits of the many maharajas, and it was interesting to read about their lives, accomplishments and interests. Many of them were brilliant scientists, musicians, skilled diplomats and all were dedicated to their beloved state of Rajasthan. During our visit to the palace, there was the hustle and bustle of preparing for a wedding. The columns of the courtyard were festooned with red, yellow and orange flowers, and 6-foot red crescent moons hung with shimmering strands of silver mirrors lined the walkways. We had fun envisioning the party that would follow that evening, what the bride would be wearing, and if there would be a deejay or a band (hee hee).
The next stop was the Jantar Mantar, the largest stone astronomical observatory in the world and a World Heritage Site. It was also built by Majaraja Sawai Jai Singh between 1727 and 1733, and is an enormous enclosed courtyard full of architectural astronomical instruments. The observatory has fourteen statistical instruments for measuring time, predicting eclipses and to ascertain other astronomical events. One of them, the sundial, tells the time to an accuracy of about two seconds in Jaipur local time. As I walked by each of them, reading about the intricate design and construct of each instrument (some of which were several building stories tall), I couldn't help but think that if Landon was a Rajasthani back in the Indian Medieval ages, he would certainly have had a hand in the construction of the Jantar Mantar. I know he would have loved to read about the instruments, and I would have appreciated his explanations as to the workings of such complex entities. Underlying the beautiful and abstract-looking constructions was a sense of the powerful curiosity and dedication that these scientists had possessed so many years ago.
Exiting the Jantar Mantar we were transfixed by two snake charmers, playing a haunting melody on their instruments as I watched in mixed fascination/horror as two massive black cobras silently rose and wavered from their straw baskets. Julie managed to snap a photo, and was immediately accosted for a 10 rupee photo fee, so we hightailed it out of the parking lot and Rafiq whisked us to the Hawa Mahal, or the Palace of the Winds. Built by Maharaja Sawai Pratap Singh in 1799, the palace is a five-story sandstone, pyramid-shaped facade with 953 small windows adorned with lacy lattice work. From the front, the hundreds of windows give the appearance of a giant, rose-colored honeycomb. The story tells of the women of the royal families who in strict "purdah" (cover), were only allowed to watch the procession of daily life and activity from these small windows and the numerous screened in balconies that mark the Hawa Mahal. I can't imagine living as a woman in these times, shut off from outside social contact and expected to remain unseen from all eyes other than those of your husband or family. I had Michael take a picture of me peering out of one of them, and then decided I'd go crazy if my world was confined to one I could only view through tiny stone lattice work. The afternoon sunlight filtered through the stained glass windows of the parlor rooms, coloring the cool marble floor with a dancing jewel mosaic. We climbed the steps to the top towers, and were rewarded with incredible views of the surrounding city.
We drove on to Royal Gaitor, the place of the tombs, or cenotaphs, of the maharajas. I exclaimed loudly when we saw the camel pass right outside my window, pulling his master in a cart down a busy street that was also trafficked by cars, buses and rickshaws. He was foaming at the mouth from the exertion of pulling at the cart, and I quite sorry for him as I do for the poor cows in Vellore that draggedly pull carts all over town. Upon arrival to Gaitor, we were immeadiately approached by two adorable boys, probably around sixyears old, begging for money. The begging is a constant presence in India, and every time I pass by someone asking for money, I feel a pain in my chest. If I know that I won't get mobbed by the crowd, I give money to those that I see, and these boys were no exception. I handed them coins and smiled at their camraderoe as the one threw his arm around the neck of the other and they walked away. The Gaitor was a serious of gigantic white marble tombs, nestled in the arms of two towering rocky hills, both of which were lined with rock walls and towers. Each monument had detailed carvings of elephants, horses, camels and to adorn the final resting place of the Maharajas that they guarded.
It was on our way from Royal Gaitor to the Amber Fort that I had my first elephant encounter. I saw her from a distance down the street and urged Rafiq to stop so I could get out for a better look. As I stepped from the car to get a closer view, her rider turned her towards the car so that in a few short seconds, she was standing right in front of me. I was rendered speechless for a moment, comprehending the fact that I was standing inches from this towering and beautiful creature. She was enormous, her head towering feet above mine, and her face, trunk and ears were covered in intricate painted designs in all the colors of the rainbow. Regaining my senses, I reached out my hand and was rewarded with a gentle nuzzle as she flicked her trunk to my outstretched hand. Being the socialite that he is, Rafiq knew the rider and the elephant. He told us her name was Muni, and that she was very sweet. I could have watched her forever, especially her quiet brown eyes, but Rafiq urged us on, saying we would see many more elephants on the way to the Amber Fort. We weren't disappointed because we saw many elephants, in similarly-painted fashion to Muni, on the ride to the Amber Fort. They all had riders on their backs as they plodded along the road, their natural beauty looking completely out-of-place next to the cars and buses that passed by them.
Rafiq skillfully drove around the curves that led us out of town, and we soon found ourselves in the foothills outside Jaipur. Rounding a bend, the Amber Fort came into view and we stopped a distance away to take in the way the sharp, straighr-lined geometry of the fort contrasted with the uneven crags of the mountains that supported the structure. The fort-palace of Amber used to be the ancient capital of Jaipur state, and we could see the fingers of battlements stretching in all directions over the hills with the magnificent honey-hued fort-palace nestled in the valley. The paths leading up to the fort crossed through courtyards of leafy trees and green grass, then bridged over the shining lake that surrounded the side not protected by the mountains. The fort was about a mile walk from the road up a stone path, and each step offered an increasing vantage point of the Rajasthani landscape. Upon reaching the top and the main entrance to the fort, we were met by several of its devoted guardians: monkeys! They adorned the walls and roofs of the structure like the gargoyles of Notre Dame, spontaneously changing poses to scamper across the roof to taunt one another or peer at the tourists that were equally curious about them. I was quite taken with one fellow in particular who was completely at ease, leaning against one of the towers and feigning disinterest as I snapped his picture.
We wandered around the Amber Fort for hours, losing ourselves in the hundreds of passageways that led to balconies, towers and hidden staircases. The Rajput architecture was ornate and impressive as we kept taking turns at random to see where the intricate maze might lead us. We ended our time at the Amber Fort with a trek up one of the perimeter walls to the top of one of the mountains. We climbed rough-hewn steps so crude and high at points that I had to use my arms and hands to crawl up some of them. Breathlessly we reached the top, and our efforts were rewarded with sweeping views of the nearby fort, the green valley below and the distant city just beyond the gate of the mountains. We sat in silence for a bit, marveling at what lay before us, thenstarted down to meet Rafiq at the car.
With two stops left to go, we broke for a late lunch of typical Rajasthani cuisine as well as some of our other more familiar favorites. We sat at a table next to a young Indian couple, the woman adorned with a multitude of colorful bangles and other ornate jewelry, and we surmised they were newlyweds celebrating their first week of marriage as it's the custom here that after the wedding the women continue to wear tons of elaborate jewelry in the weeks to follow. Lunch was delicious, and we thanked Rafiq for such an excellent suggestion when we returned to the car. With the sun past the midpoint of it's journey through the clear blue sky, we stopped on the banks of a silvery lake to gaze across the water at the palace that formed an island in it's center. Reachable only by boat, freestanding with no perimeter of land surrounding it, it seemed like an impossible mirage that could disappear in the blink of an eye. We snapped several photos by the lake with the Water Palace in the background, as well as several with Rafiq to remember our fabulous new friend.
The day of sightseeing concluded at Galta, the site of Surya Mandir (the temple of the Sun God), but also known as the Monkey Temple. As we climbed out of the car and walked up the stone path to the temple that jutted out over the top of the large hill, we learned that its moniker only described a fraction of the fauna we met on the way up. After buying peanuts to feed the monkeys, we were accompanied by a family of goats who insisted on walking side-by side with us to the top, hoping to catch a few stray peanuts. The path and hillsides were also home to cows, stray dogs and the occasional fat pig that lumbered by. At one point, I was able to snap a picture with all five different animals in it-monkey, dog, pig, cow and goat, cohabiting in a way that would have made Noah proud had they been roommates on the ark. However, as suggested by the name, the path to the Monkey Temple was indeed home to many monkeys of all ages and sizes. We witnessed agressive fights between males, mothers carrying their babies and brothers and sisters teasing and taunting as they scampered and climbed the walls. By holding a peanut between your thumb and forefinger, a monkey would creep up and gingerly pluck it from your hand and place it directly in their mouth, shell and all. I got a bit distracted by the baby monkeys gathered all around me, and it all happened very fast. The biggest male of the group swooped in and grabbed the entire bag of peanuts out of my hand before I could even react.
"Ugh!!! You jerk!" I exclaimed, shaking my fist and glaring at him.
He didn't show a bit of remorse and in fact was overtly rude, squatting on the wall just out of my reach and stuffing his face with his loot. I heard a cackle behind me and turned to face an old man that had watched the whole thing go down.
"That Big Boss!" He whooped, his sides shaking with laughter at my indignant expression.
I had to laugh at it all, especially when I felt a little hand spank my bottom, and turned to see one of the babies crouched on the wall beside me, beseeching me for more snacks. They were all quite eager, with one trying to pry open Julie's purse in search of more food. Extremely amused by our playmates, we continued to the top to see the Surya Mandir, the Temple of the Sun. We slipped off our shoes outside and entered the archway, feeling cold stone on our feet. We were urged by the temple keeper to come to the altar and he surprised us with a blessing from the sun god and a deft flick of the wrist and index finger that left us with a dot of yellow paint on our foreheads. Obliged to the Sun God after receiving the blessing, we each left a donation to which the temple keeper replied,
"Hmmm, only 20 rupees for the Sun God?" And shook his head.
I wondered how much of our rupees the Sun God himself would see, but just smiled as we exited the temple and walked to the stone wall at the edge of the cliff, where we could see Jaipur bathed in the hazy orange glow of a splendid setting sun. It created a homogenous beauty to the varying shapes of the buildings and houses below and the mountains on the outskirts of the town. On the walk down we stopped to let Michael feed a cookie to a bored-looking cow, and watched in fascination as another one gingerly climbed a flight of narrow stairs into a house. I completely agreed with Rafiq's comment when we returned to the car after narrowly avoiding a dog-pig-cow fight and watching a stampeding cow almost take out two girls waiting for the bus:
"This is India! It's a zoo! I love my country."
We spent the early part of the evening purusing the local bazaars. Jaipur is extremely famous for its precious stones and exports them all over the world. We were welcomed to the upstairs of a building where we watched workers polishing sapphires, rubies, turquoise and emeralds on stone wheels. The intricate shapes and facets they were able to carve into the unadulterated stones were beautiful, and I bought two pairs of earrings. Our next stop will go down in history, because it was in this quiet and lovely textile store that Julie, Cristine and I bought our sarees! The young and charming shopkeeper urged us to sit on a long upholstered red bench that ran the length of the store in order to face the massive wall of saris that also ran the length of the store but was stacked to the ceiling with sarees. A little intimidating, but very fun. And so began an endless parade of the most fantastic colors and textures I have seen and felt as he passed sari after sari through our hands. No two sarees were exactly alike, and they ranged from sequined to embroidered, shiny to matte, sheer to solid and in all imaginable colors. If I showed any interest he would quickly pull me off the bench, rapidly tie the sari around my waist and expertly form the pleats and finish with a flourish as he tossed the end over my shoulder. I tried on several beautiful ones before settling on one of brilliant blue, threaded with silver and gold, with a background of delicate tiny flowers and a border of gleaming gold embellishment. I knew the moment he unfolded it that it was the one I wanted, but he fashioned it to my body and when he was done whispered,
"Go look at yourself."
I stood in front of the three way mirror, admiring how smoothly the silk fell from my shoulder to the ground, the pleats flowing smoothly like a river.
"Ok." I said with a smile."
"Ok!" He said happily, then called for the tailor to take the seven complex measurements to make the sari top shirt that goes underneath. Julie chose a stunning indigo sari, dotted with gold, bordered with brilliant burgundy and gold, and with a stunning turquoise sari top. Cristine chose a shining deep purple, intricately inlaid with a scrolling gold pattern. We are excited to wear them to celebrate Cami and Roshan's wedding next year, and I am happy that when I'm at home, I will always have a visual reminder of the India that is so colorful and beautiful in my mind.
Mike was quite a sport during the whole sari process, and as always we were thankful for our lone male traveling companion for so many reasons, one of them being that he so kindly tolerates our shopping. He grew up with three sisters, so he's quote accustomed to the craziness of women. A fact that I believe has allowed him to survive this long. :)
Pretty tired from our whirlwind tour of Jaipur, we opted to dine on the rooftop of the Hotel Sunder Palace, sipping Kingfishers, eating scrumptious Indian food and watching the twinkling lights of Jaipur below. I hadto admit, Rajasthan was the side of India I had dreamed about from watching Aladdin. The imagery of incense-filled ornate palaces with keyhole-shaped doors, shrouded in the majesty of true royalty of days gone by is the precise image that Jaipur embodies. As I lay down to sleep that night, I wished that we could have spent more time in this jewel of Rajasthan, but I knew that The Golden Triangle had more in store for us.
Stepping outside the airport I was surprised by the crisp coolness of the air in northern India, so different than the humid heat of the south. We opted for a pre-paid cab to the train station, the morning negotiations with the Chennai rickshaw driver still fresh in our minds, and we were soon weaving in and out of five o'clock traffic in Delhi. We were amused by the wild peacocks perched on bilboards and the monkeys that scampered on top of the buildings as we passed cars that ranged from dingy rickshaws to brand new BMWs. New Delhi has definitely been touched by the hand of modernization and progress, and I thought many times how clean it was as we passed the numerous green city parks and gardens. We swung through several roundabouts and kept pointing out beautiful buildings, the imposing walls of the Red Fort and the bustling city streets that twirled by. It was all kind of a tease to see Delhi this way, knowing that we were just passing through on our way to Jaipur. I was happy that we'd be back to stay a night on the weekend on the way back because there was so much to see.
Thankfully there were tickets for the 8:50 PM train to Jaipur, and we were all grateful to stop our onward progression for a moment and sit in a safe haven at the train station: McDonald's. Their menu has a few similar items to McDonald's at home, but since they don't serve beef there are many fabulous vegetarian options, the best in my opinion being the McAloo Tikki. We felt quite relaxed as we boarded our train, especially when we realized our tickets were for the third tier a/c sleeper car! I digress at this point to comment that I had a transportation revelation. On our prior train trips in India, we had been booking the 'sleeper class' train, thinking it was the only the aptly-named sleeper car on the train where you could lie down on long padded benches to sleep. As I walked through the three tier a/c car, I realized that it was an upgraded version of the sleeper cars-nicer benches, privacy curtains, a/c and your own sheets, pillow and blanket. Also less cockroaches. So essentially, all cars on every train are sleeper cars in theory (with the exception of the chair coach cars), but we had been booking the absolute worst class because we thought it was the only place where we could recline. Oops. Anyways, we were quite comfy as we settled into our newly found luxury accomodation, and I gradually fell asleep despite the obscenely loud snoring, loud chatter and the chaiwalla's loud chants of "chai chai chai" that are ubiquitous no matter what class of train car you're in.
I set my alarm for 1 AM and when it went off held vigil for our group so that we wouldn't miss our stop in Jaipur. Since there are no announcements, it would be so easy to completely miss our stop and go straighton to the last stop in Jodhpur. I was relieved when the conductor passed by and I asked if the next stop was Jaipur. I strapped on my sandals, gathered my things, and went to wake Cristine. She and I then went to Michael and Julie's car, woke up Jules, then went to find Michael...to no avail. I began to panic as I felt the train slow down, worried we wouldn't find him and we'd miss our stop. The girls and I began frantically pulling aside curtains, shining our phone lights into the beds, loudly whispering his name. We must have woken up 20 sleeping people before the conductor came up to us, made the sign for 'glasses' by putting his fingers around his eyes, and we realized he was telling us Michael was waiting between the train cars. We breathed audible sighs of relief when we found him, a little sleepy and wearing glasses, standing on the platform between the cars. We happily disembarked at Jaipur Junction, and walked to the pre-arranged meeting spot I had set up with our driver from the hotel I booked in Jaipur. He called my Cristine's cell and I answered, listening to his voice as we walked outside the station.
"Hello Madame, are you outside?"
"Yes! Yes! Where are you?" I asked excitedly.
"I am outside Madame, I can see you."
"Where are you? I don't see you." I said, casting searching glances around the parking lot.
This went back and forth with me leading the group, talking to our driver and blindly walking around in the dark in front of the train station. After about one minute I realized that I could hear him not just on the phone, but also very close, and I turned around to find him standing with Julie, Michael and Cristine a few feet back, everyone laughing at me and enjoying his antics. And this was how we met Iswar, the 22 year-old impish, rickshaw-driving jokester from the hotel. He was quite hilarious on the short drive to the hotel, taking a circuitous route to allow each one of us to come up front and in turn drive the rickshaw. He was an expert coach, instructing us how to smoothly change gears by using the handlebar gear shift. He was quite enamored with Julie, and sang her a little song about a girl named Julie and a boy named Johnny.
"You're Julie. I'm Johnny. We can get married, I'll buy you a rickshaw, and we can have a business together."
He offered to give us a tour of Jaipur the next day, but since we had a driver booked already, we declined, though we found him quite charming. We were very pleased with our accomadationa at the Hotel Sunder Palace, a tall white structure that appeared simple on the outside, but inside held four spacious stories of rooms and a rooftoop garden terrace restaurant. It was decorated with lively colors and ornamentation on every wall, and I particularly liked the sitting area in our room, a lavish woven carpet on which were placed a low table to sit at as well as plump pillows, above which hung a red and yellow glass lamp that transformed the ordinary light in our room to a sultry yellow and scarlet hue. We had been traveling a full 24 hours at this point, and I fell into bed exhausted but very excited to be in Jaipur and to see the enchanting sights I had read so much about.
We woke up to the sounds of drumming outside our hotel in Jaipur, got ready and made our way to the rooftop restaurant of the lovely Hotel Sunder. The morning was crisp and cool, and we all appreciated the steaming kettles of hot coffee and tea that were brought to the table along with banana pancakes, fresh fruit and toast. Because we only had one day in Jaipur, we decided the best way to see all of the sights was to hire a driver for the day. Cristine had the number of a her father's former student's father's friend in Jaipur (that's like "7 degrees of Kevin Bacon right there) whom we unsuccessfully tried to communicate with several times. Because of the language barrier, we never reached a consensus about when our driver would arrive to the hotel, and these are the fortuitous circumstances that introduced us to Rafiq. Cristine and I were standing on the hotel driveway, looking for the unknown driver who we thought may have somehow shown up after I had almost shouted, "Hotel Sunder. 10 AM. Tourism. Driver!" to the poor man several times on the phone. We were a little disheartened that the driver hadn't worked out, when fate smiled our way and Rafiq walked up and said,
"Hello ladies! Good morning! I take you on beautiful tour of Jaipur. You will love it."
We were immediately sold by his jolly round face and happy smile, and agreed to the bargain price of 1200 rupees for a day of driving us around Jaipur. I liked him even more as he saw me watching the colorful clash of a wedding procession across the street, and he urged me to run over and take pictures.
We were soon packed into his small car and cruising the streets of Jaipur. He explained that we were staying in the New City, and that we soon would be entering the Old City, or the Pink City. He was a savvy tour guide, pointing out his favorite lassi stand, the post office and the theater that showed Bollywood movies. Throughout the day Rafiq told stories of his touring business, whipping out a tattered notebook in which his customers touted his impeccable driving, exciting tours and childlike charm. They were written in many languages, and Rafiq inquired if I could read any other than English. When I told him Spanish and a bit of the French and Italian, he giggled joyously and asked me,
"C'est va?"
To which I replied, "Tres bien!", which began our little comedy routine that we'd perform at every new stop, each time resulting in his supreme enjoyment. He was quite thoughtful, stopping once to get coughdrops for Cristine whose laryngitis had dropped her voice to a barely perceptible whisper.
Rafiq told us proudly that he had been born in Jaipur, had always lived in Jaipur, and loved his city. I could see why as we came upon the massive, dusky pink and majestic Ajmeri Gate that guards the entrance to the old city. We got out of the car to take pictures, and I was struck by the dichotomy of modern cars and rickshaws passing beneath the elegant beauty of such an architectural masterpiece.
Our next stop was the City Palace, built between 1729-1732 by Maharaja Sawai Jai Singh, the founder of Jaipur. The City Palace is a powerful blend of Rajasthani and Mughal architecture, an expansive complex composed of exquisite courtyards, gardens and buildings of fanciful and intricate design. The architects left no blank canvases on any facade, as each is transformed by spiraling minarets, symbolic paintings and elaborate marble carvings. My favorite room was the Diwan-I-Khas, the hall meant for private audiences of the maharaja and formal gatherings. In the center of the room was a raised platform covered in royal red carpeting, headed at one end by a beautiful gilt throne and surrounded by marble columns as a perimeter. Around the room hung portraits of the many maharajas, and it was interesting to read about their lives, accomplishments and interests. Many of them were brilliant scientists, musicians, skilled diplomats and all were dedicated to their beloved state of Rajasthan. During our visit to the palace, there was the hustle and bustle of preparing for a wedding. The columns of the courtyard were festooned with red, yellow and orange flowers, and 6-foot red crescent moons hung with shimmering strands of silver mirrors lined the walkways. We had fun envisioning the party that would follow that evening, what the bride would be wearing, and if there would be a deejay or a band (hee hee).
The next stop was the Jantar Mantar, the largest stone astronomical observatory in the world and a World Heritage Site. It was also built by Majaraja Sawai Jai Singh between 1727 and 1733, and is an enormous enclosed courtyard full of architectural astronomical instruments. The observatory has fourteen statistical instruments for measuring time, predicting eclipses and to ascertain other astronomical events. One of them, the sundial, tells the time to an accuracy of about two seconds in Jaipur local time. As I walked by each of them, reading about the intricate design and construct of each instrument (some of which were several building stories tall), I couldn't help but think that if Landon was a Rajasthani back in the Indian Medieval ages, he would certainly have had a hand in the construction of the Jantar Mantar. I know he would have loved to read about the instruments, and I would have appreciated his explanations as to the workings of such complex entities. Underlying the beautiful and abstract-looking constructions was a sense of the powerful curiosity and dedication that these scientists had possessed so many years ago.
Exiting the Jantar Mantar we were transfixed by two snake charmers, playing a haunting melody on their instruments as I watched in mixed fascination/horror as two massive black cobras silently rose and wavered from their straw baskets. Julie managed to snap a photo, and was immediately accosted for a 10 rupee photo fee, so we hightailed it out of the parking lot and Rafiq whisked us to the Hawa Mahal, or the Palace of the Winds. Built by Maharaja Sawai Pratap Singh in 1799, the palace is a five-story sandstone, pyramid-shaped facade with 953 small windows adorned with lacy lattice work. From the front, the hundreds of windows give the appearance of a giant, rose-colored honeycomb. The story tells of the women of the royal families who in strict "purdah" (cover), were only allowed to watch the procession of daily life and activity from these small windows and the numerous screened in balconies that mark the Hawa Mahal. I can't imagine living as a woman in these times, shut off from outside social contact and expected to remain unseen from all eyes other than those of your husband or family. I had Michael take a picture of me peering out of one of them, and then decided I'd go crazy if my world was confined to one I could only view through tiny stone lattice work. The afternoon sunlight filtered through the stained glass windows of the parlor rooms, coloring the cool marble floor with a dancing jewel mosaic. We climbed the steps to the top towers, and were rewarded with incredible views of the surrounding city.
We drove on to Royal Gaitor, the place of the tombs, or cenotaphs, of the maharajas. I exclaimed loudly when we saw the camel pass right outside my window, pulling his master in a cart down a busy street that was also trafficked by cars, buses and rickshaws. He was foaming at the mouth from the exertion of pulling at the cart, and I quite sorry for him as I do for the poor cows in Vellore that draggedly pull carts all over town. Upon arrival to Gaitor, we were immeadiately approached by two adorable boys, probably around sixyears old, begging for money. The begging is a constant presence in India, and every time I pass by someone asking for money, I feel a pain in my chest. If I know that I won't get mobbed by the crowd, I give money to those that I see, and these boys were no exception. I handed them coins and smiled at their camraderoe as the one threw his arm around the neck of the other and they walked away. The Gaitor was a serious of gigantic white marble tombs, nestled in the arms of two towering rocky hills, both of which were lined with rock walls and towers. Each monument had detailed carvings of elephants, horses, camels and to adorn the final resting place of the Maharajas that they guarded.
It was on our way from Royal Gaitor to the Amber Fort that I had my first elephant encounter. I saw her from a distance down the street and urged Rafiq to stop so I could get out for a better look. As I stepped from the car to get a closer view, her rider turned her towards the car so that in a few short seconds, she was standing right in front of me. I was rendered speechless for a moment, comprehending the fact that I was standing inches from this towering and beautiful creature. She was enormous, her head towering feet above mine, and her face, trunk and ears were covered in intricate painted designs in all the colors of the rainbow. Regaining my senses, I reached out my hand and was rewarded with a gentle nuzzle as she flicked her trunk to my outstretched hand. Being the socialite that he is, Rafiq knew the rider and the elephant. He told us her name was Muni, and that she was very sweet. I could have watched her forever, especially her quiet brown eyes, but Rafiq urged us on, saying we would see many more elephants on the way to the Amber Fort. We weren't disappointed because we saw many elephants, in similarly-painted fashion to Muni, on the ride to the Amber Fort. They all had riders on their backs as they plodded along the road, their natural beauty looking completely out-of-place next to the cars and buses that passed by them.
Rafiq skillfully drove around the curves that led us out of town, and we soon found ourselves in the foothills outside Jaipur. Rounding a bend, the Amber Fort came into view and we stopped a distance away to take in the way the sharp, straighr-lined geometry of the fort contrasted with the uneven crags of the mountains that supported the structure. The fort-palace of Amber used to be the ancient capital of Jaipur state, and we could see the fingers of battlements stretching in all directions over the hills with the magnificent honey-hued fort-palace nestled in the valley. The paths leading up to the fort crossed through courtyards of leafy trees and green grass, then bridged over the shining lake that surrounded the side not protected by the mountains. The fort was about a mile walk from the road up a stone path, and each step offered an increasing vantage point of the Rajasthani landscape. Upon reaching the top and the main entrance to the fort, we were met by several of its devoted guardians: monkeys! They adorned the walls and roofs of the structure like the gargoyles of Notre Dame, spontaneously changing poses to scamper across the roof to taunt one another or peer at the tourists that were equally curious about them. I was quite taken with one fellow in particular who was completely at ease, leaning against one of the towers and feigning disinterest as I snapped his picture.
We wandered around the Amber Fort for hours, losing ourselves in the hundreds of passageways that led to balconies, towers and hidden staircases. The Rajput architecture was ornate and impressive as we kept taking turns at random to see where the intricate maze might lead us. We ended our time at the Amber Fort with a trek up one of the perimeter walls to the top of one of the mountains. We climbed rough-hewn steps so crude and high at points that I had to use my arms and hands to crawl up some of them. Breathlessly we reached the top, and our efforts were rewarded with sweeping views of the nearby fort, the green valley below and the distant city just beyond the gate of the mountains. We sat in silence for a bit, marveling at what lay before us, thenstarted down to meet Rafiq at the car.
With two stops left to go, we broke for a late lunch of typical Rajasthani cuisine as well as some of our other more familiar favorites. We sat at a table next to a young Indian couple, the woman adorned with a multitude of colorful bangles and other ornate jewelry, and we surmised they were newlyweds celebrating their first week of marriage as it's the custom here that after the wedding the women continue to wear tons of elaborate jewelry in the weeks to follow. Lunch was delicious, and we thanked Rafiq for such an excellent suggestion when we returned to the car. With the sun past the midpoint of it's journey through the clear blue sky, we stopped on the banks of a silvery lake to gaze across the water at the palace that formed an island in it's center. Reachable only by boat, freestanding with no perimeter of land surrounding it, it seemed like an impossible mirage that could disappear in the blink of an eye. We snapped several photos by the lake with the Water Palace in the background, as well as several with Rafiq to remember our fabulous new friend.
The day of sightseeing concluded at Galta, the site of Surya Mandir (the temple of the Sun God), but also known as the Monkey Temple. As we climbed out of the car and walked up the stone path to the temple that jutted out over the top of the large hill, we learned that its moniker only described a fraction of the fauna we met on the way up. After buying peanuts to feed the monkeys, we were accompanied by a family of goats who insisted on walking side-by side with us to the top, hoping to catch a few stray peanuts. The path and hillsides were also home to cows, stray dogs and the occasional fat pig that lumbered by. At one point, I was able to snap a picture with all five different animals in it-monkey, dog, pig, cow and goat, cohabiting in a way that would have made Noah proud had they been roommates on the ark. However, as suggested by the name, the path to the Monkey Temple was indeed home to many monkeys of all ages and sizes. We witnessed agressive fights between males, mothers carrying their babies and brothers and sisters teasing and taunting as they scampered and climbed the walls. By holding a peanut between your thumb and forefinger, a monkey would creep up and gingerly pluck it from your hand and place it directly in their mouth, shell and all. I got a bit distracted by the baby monkeys gathered all around me, and it all happened very fast. The biggest male of the group swooped in and grabbed the entire bag of peanuts out of my hand before I could even react.
"Ugh!!! You jerk!" I exclaimed, shaking my fist and glaring at him.
He didn't show a bit of remorse and in fact was overtly rude, squatting on the wall just out of my reach and stuffing his face with his loot. I heard a cackle behind me and turned to face an old man that had watched the whole thing go down.
"That Big Boss!" He whooped, his sides shaking with laughter at my indignant expression.
I had to laugh at it all, especially when I felt a little hand spank my bottom, and turned to see one of the babies crouched on the wall beside me, beseeching me for more snacks. They were all quite eager, with one trying to pry open Julie's purse in search of more food. Extremely amused by our playmates, we continued to the top to see the Surya Mandir, the Temple of the Sun. We slipped off our shoes outside and entered the archway, feeling cold stone on our feet. We were urged by the temple keeper to come to the altar and he surprised us with a blessing from the sun god and a deft flick of the wrist and index finger that left us with a dot of yellow paint on our foreheads. Obliged to the Sun God after receiving the blessing, we each left a donation to which the temple keeper replied,
"Hmmm, only 20 rupees for the Sun God?" And shook his head.
I wondered how much of our rupees the Sun God himself would see, but just smiled as we exited the temple and walked to the stone wall at the edge of the cliff, where we could see Jaipur bathed in the hazy orange glow of a splendid setting sun. It created a homogenous beauty to the varying shapes of the buildings and houses below and the mountains on the outskirts of the town. On the walk down we stopped to let Michael feed a cookie to a bored-looking cow, and watched in fascination as another one gingerly climbed a flight of narrow stairs into a house. I completely agreed with Rafiq's comment when we returned to the car after narrowly avoiding a dog-pig-cow fight and watching a stampeding cow almost take out two girls waiting for the bus:
"This is India! It's a zoo! I love my country."
We spent the early part of the evening purusing the local bazaars. Jaipur is extremely famous for its precious stones and exports them all over the world. We were welcomed to the upstairs of a building where we watched workers polishing sapphires, rubies, turquoise and emeralds on stone wheels. The intricate shapes and facets they were able to carve into the unadulterated stones were beautiful, and I bought two pairs of earrings. Our next stop will go down in history, because it was in this quiet and lovely textile store that Julie, Cristine and I bought our sarees! The young and charming shopkeeper urged us to sit on a long upholstered red bench that ran the length of the store in order to face the massive wall of saris that also ran the length of the store but was stacked to the ceiling with sarees. A little intimidating, but very fun. And so began an endless parade of the most fantastic colors and textures I have seen and felt as he passed sari after sari through our hands. No two sarees were exactly alike, and they ranged from sequined to embroidered, shiny to matte, sheer to solid and in all imaginable colors. If I showed any interest he would quickly pull me off the bench, rapidly tie the sari around my waist and expertly form the pleats and finish with a flourish as he tossed the end over my shoulder. I tried on several beautiful ones before settling on one of brilliant blue, threaded with silver and gold, with a background of delicate tiny flowers and a border of gleaming gold embellishment. I knew the moment he unfolded it that it was the one I wanted, but he fashioned it to my body and when he was done whispered,
"Go look at yourself."
I stood in front of the three way mirror, admiring how smoothly the silk fell from my shoulder to the ground, the pleats flowing smoothly like a river.
"Ok." I said with a smile."
"Ok!" He said happily, then called for the tailor to take the seven complex measurements to make the sari top shirt that goes underneath. Julie chose a stunning indigo sari, dotted with gold, bordered with brilliant burgundy and gold, and with a stunning turquoise sari top. Cristine chose a shining deep purple, intricately inlaid with a scrolling gold pattern. We are excited to wear them to celebrate Cami and Roshan's wedding next year, and I am happy that when I'm at home, I will always have a visual reminder of the India that is so colorful and beautiful in my mind.
Mike was quite a sport during the whole sari process, and as always we were thankful for our lone male traveling companion for so many reasons, one of them being that he so kindly tolerates our shopping. He grew up with three sisters, so he's quote accustomed to the craziness of women. A fact that I believe has allowed him to survive this long. :)
Pretty tired from our whirlwind tour of Jaipur, we opted to dine on the rooftop of the Hotel Sunder Palace, sipping Kingfishers, eating scrumptious Indian food and watching the twinkling lights of Jaipur below. I hadto admit, Rajasthan was the side of India I had dreamed about from watching Aladdin. The imagery of incense-filled ornate palaces with keyhole-shaped doors, shrouded in the majesty of true royalty of days gone by is the precise image that Jaipur embodies. As I lay down to sleep that night, I wished that we could have spent more time in this jewel of Rajasthan, but I knew that The Golden Triangle had more in store for us.
Finishing up at Schell Eye Hospital and starting CHAD
The rest of the week on ophthalmology working in Schell Eye Hospital was delightful. Surgery patients stay overnight prior to and after their surgery, so I had the pleasure of attending eye ward rounds with the ophthalmologists, something that is almost never done in the United States because ophthalmology is an outpatient service. I watched one of the residents be endlessly grilled about one of the cases, the attendings him pushing himt to the point where he couldn't answer anymore. The more aggressive style of teaching seems normal to me now and I am constantly impressed by both the resident's and physician's bank of knowledge. Because medical students mainly study theory and participate in didactic learning during medical school, I feel that their knowledge base is more extensive than ours in some areas like knowing the appropriate dosages of medications off the top of their head. However, they lack the clinical teaching during medical school that we have during our third and fourth years. It's hard to say what is the best way to educate a future physician, but as my resident Dr. Shilpa said,
"When it's all said and done, we all know what we need to know."
Dr. Shilpa was a fun resident to work with, stopping to explain things and show me findings as she chattered back and forth with patients in several different languages-Hindi, Tamil, Bengali-because the patients came from many parts of India, each with their own dialect. She was shocked to discover that I only knew two, explaining that as a doctor in India, it's necessary to understand many in order to be able to communicate and treat patients. She herself spoke seven.
One of the most interesting ophthalmology patients I saw was a seven-year-old girl with an intra-fourth ventricle grade III anaplastic ependyoma that had caused a bilateral internuclear ophthalmoplegia. Dr. Jeyanthan had me conduct her interesting neurological exam (she also had a right-sided CN VII palsy), then sent me with her and her parents to visit the orthoptist down the hall. With my interest in pediatric ophthalmology I have worked with several orthoptists, but this one had to be one of my favorites! She fixed me with a stern glance when I entered the room, but brightened when I told her I was interested in pediatric ophthalmology and wanted to learn about the management of the little girl's condition. She deftly worked through a series of tests and exercises, making everyone in the room jump when she abruptly banged the old flashlight she used for tracking eye movements on the table because it stopped working. She laughed at my startled response then held the light up for me to see.
"Look! Brighter!" She said.
I was said when the week of ophthalmology was over, but very excited because on our last day Dr. Jeyanthan, our favorite CMC ophthalmologist, invited us to his home next week for tea with his family. We were thrilled to accept and arranged for tea on Tuesday night. I also had the opportunity to speak with several of his optometry students. Dr. Jeyanthan is very dedicated to their education and has helped found a beautiful new school and program for the students. They all looked extremely young to me, and peppered me with questions about how to apply to optometry school in the United States. Michael and I gave them our emails and encouraged them to contact us if we could be of any help.
This week is my final week of medical rotations in India and I am very sad that my time here is almost over. However, I couldn't have ended on a sweeter note than spending my last week at CHAD, the Community Health and Development program run by CMC. The CHAD is its own self-sustaining hospital on the outskirts of the CMC campus (the actual medical school campus, not the hospital in downtown Vellore) that also provides rural health initiatives, public health services and education to the people in Vellore and the surrounding areas. It was nice to be able to just walk to the CHAD after breakfast in the canteen (literally five minutes through the beautiful tree-lined paths of campus), and I started my day off in the OPD clinic (outpatient clinic) with a kind resident named Ashim. He took the time to explain not only the patients' heath conditions, but also the social and financial aspects of practicing not only good but realistic medicine in this patient population. For example, diabetic patients are managed by checking pre and post-prandial glucose levels instead of a hemoglobin A1c, because these measurements are easy to obtain while an A1c costs 150 rupees. Ashim said that if you order these expensive lab tests, the patient will end up paying for them and will then have no money for the medications. I couldn't help but think how at home we order A1c's without thought, even at the free clinic I work out because the supporting lab does it for free. The physicians have to be so cautious in prescribing medications and treatments here, having to assess each patient's resources in order to determine what medical issues and treatments take priority. A barrage of patients passed through the clinic that morning, ranging from severe diarrhea to run of the mill COPD, and mid-morning I wanted to see the other CHAD clinics so I went to labor and delivery.
The "Labour" department was expertly run by Dr. Divya, a resident in community medicine. Community medicine here is much like our family medicine programs back home, but with the added component of public health and community development. I spent the rest of the morning and early afternoon with Dr. Divya, walking from bed to bed in the dingy rooms with privacy between patients only provided by a thin curtain. She visited each patient every half hour to manually feel the taut, pregnant abdomens for the strength and duration of the contractions, as well as to feel the lie of the baby and to listen to their heart rate with her stethoscope. I couldn't believe that the women weren't on monitors as they are back home, but Dr. Divya said that if they were to use the monitors here, they were unable to distinguish between a contraction and the fetal heart rate, which obviously can have devastating consequences if something goes wrong. She was shocked that often times we watch the progression of a woman's labor on the computer monitor that is updated with infrequent exams. She also spoke of the benefits of manual monitoring of labor in the way that it was a soothing, reassuring tool for her patients. She explained that women in India don't discuss childbirth with one another, even mothers to daughters, so when these young women come in the painful throes of labor, they think they are dying. Thus, the constant presence of a physician laying hands on them is not only necessary for monitoring, but also reassurance. It was quite a different story than the U.S. where we have birthing classes and so many women want the ultimate "birthing experience" complete with music and other elaborate rituals. As I looked at the thin young women, groaning in pain with absolutely no epidural or pain medication, I was acutely aware of this gaping difference between our cultures.
Dr. Divya's one concern with the facilities at CHAD was the difficulty in monitoring the pitocin drip when inducing labor. Because the facility can't afford IV pumps, the pitocin is injected into a hanging bag of saline and the rate calcualted by counting the number of drops per minute on a handheld watch. She said that it happens infrequently, but there are errors which have led to fetal complications.
Today was a complication-free day, however, and I got to assist on the delivery of a beautiful baby boy who promptly peed on me as I toweled him off under the heating hood (which at that time was not working because the power went out, an everyday occurence that happens at least 4-5 times in one day). I enjoyed my time on labor and delivery, and hope I'll get to work with the lovely and brilliant Dr. Divya again this week.
My last assignment of the day was a community visit in which the residents conducted an antenatal clinic and a chronic disease clinic. About ten people piled into the CMC van, and we were off to the site where we'd set up the makeshift clinic. The clinic ran quite smoothly, with one side devoted to pregnancy education and antenatal check-ups, and the other a walk-in clinic for patients that needed follow-up or had new complaints. I spent some time with the resident doing the antenatal check-ups, and he emphasized how important patient education was to CHAD because it could prevent many complications caused by patient beliefs and superstitions. For example, many women in the rural villages believe that drinking too much water will give the baby hydrops, and that drinking too much milk will make a baby too large to be delivered, so many women become dehydrated in their adherence to this superstition, also predisposing themselves to urinary tract infections which can then trigger preterm labor. For this reason and many others, a young nurse stood in her crisp white sari in front of the group of pregnant women gathered outside, reading a colorful book which outlined how to follow a healthy regimen in pregnancy and how to deal with complications.
The clinic concluded after a couple of hours, and we helped pack up the supplies and headed back to the CHAD. It was a fantastic first day, and I am very excited to start home visits to patients tomorrow. CHAD represents a sector of people and healthcare in India that I have not previously seen, and I am grateful for this unique experience after the previous more formal weeks in the CMC hospital.
"When it's all said and done, we all know what we need to know."
Dr. Shilpa was a fun resident to work with, stopping to explain things and show me findings as she chattered back and forth with patients in several different languages-Hindi, Tamil, Bengali-because the patients came from many parts of India, each with their own dialect. She was shocked to discover that I only knew two, explaining that as a doctor in India, it's necessary to understand many in order to be able to communicate and treat patients. She herself spoke seven.
One of the most interesting ophthalmology patients I saw was a seven-year-old girl with an intra-fourth ventricle grade III anaplastic ependyoma that had caused a bilateral internuclear ophthalmoplegia. Dr. Jeyanthan had me conduct her interesting neurological exam (she also had a right-sided CN VII palsy), then sent me with her and her parents to visit the orthoptist down the hall. With my interest in pediatric ophthalmology I have worked with several orthoptists, but this one had to be one of my favorites! She fixed me with a stern glance when I entered the room, but brightened when I told her I was interested in pediatric ophthalmology and wanted to learn about the management of the little girl's condition. She deftly worked through a series of tests and exercises, making everyone in the room jump when she abruptly banged the old flashlight she used for tracking eye movements on the table because it stopped working. She laughed at my startled response then held the light up for me to see.
"Look! Brighter!" She said.
I was said when the week of ophthalmology was over, but very excited because on our last day Dr. Jeyanthan, our favorite CMC ophthalmologist, invited us to his home next week for tea with his family. We were thrilled to accept and arranged for tea on Tuesday night. I also had the opportunity to speak with several of his optometry students. Dr. Jeyanthan is very dedicated to their education and has helped found a beautiful new school and program for the students. They all looked extremely young to me, and peppered me with questions about how to apply to optometry school in the United States. Michael and I gave them our emails and encouraged them to contact us if we could be of any help.
This week is my final week of medical rotations in India and I am very sad that my time here is almost over. However, I couldn't have ended on a sweeter note than spending my last week at CHAD, the Community Health and Development program run by CMC. The CHAD is its own self-sustaining hospital on the outskirts of the CMC campus (the actual medical school campus, not the hospital in downtown Vellore) that also provides rural health initiatives, public health services and education to the people in Vellore and the surrounding areas. It was nice to be able to just walk to the CHAD after breakfast in the canteen (literally five minutes through the beautiful tree-lined paths of campus), and I started my day off in the OPD clinic (outpatient clinic) with a kind resident named Ashim. He took the time to explain not only the patients' heath conditions, but also the social and financial aspects of practicing not only good but realistic medicine in this patient population. For example, diabetic patients are managed by checking pre and post-prandial glucose levels instead of a hemoglobin A1c, because these measurements are easy to obtain while an A1c costs 150 rupees. Ashim said that if you order these expensive lab tests, the patient will end up paying for them and will then have no money for the medications. I couldn't help but think how at home we order A1c's without thought, even at the free clinic I work out because the supporting lab does it for free. The physicians have to be so cautious in prescribing medications and treatments here, having to assess each patient's resources in order to determine what medical issues and treatments take priority. A barrage of patients passed through the clinic that morning, ranging from severe diarrhea to run of the mill COPD, and mid-morning I wanted to see the other CHAD clinics so I went to labor and delivery.
The "Labour" department was expertly run by Dr. Divya, a resident in community medicine. Community medicine here is much like our family medicine programs back home, but with the added component of public health and community development. I spent the rest of the morning and early afternoon with Dr. Divya, walking from bed to bed in the dingy rooms with privacy between patients only provided by a thin curtain. She visited each patient every half hour to manually feel the taut, pregnant abdomens for the strength and duration of the contractions, as well as to feel the lie of the baby and to listen to their heart rate with her stethoscope. I couldn't believe that the women weren't on monitors as they are back home, but Dr. Divya said that if they were to use the monitors here, they were unable to distinguish between a contraction and the fetal heart rate, which obviously can have devastating consequences if something goes wrong. She was shocked that often times we watch the progression of a woman's labor on the computer monitor that is updated with infrequent exams. She also spoke of the benefits of manual monitoring of labor in the way that it was a soothing, reassuring tool for her patients. She explained that women in India don't discuss childbirth with one another, even mothers to daughters, so when these young women come in the painful throes of labor, they think they are dying. Thus, the constant presence of a physician laying hands on them is not only necessary for monitoring, but also reassurance. It was quite a different story than the U.S. where we have birthing classes and so many women want the ultimate "birthing experience" complete with music and other elaborate rituals. As I looked at the thin young women, groaning in pain with absolutely no epidural or pain medication, I was acutely aware of this gaping difference between our cultures.
Dr. Divya's one concern with the facilities at CHAD was the difficulty in monitoring the pitocin drip when inducing labor. Because the facility can't afford IV pumps, the pitocin is injected into a hanging bag of saline and the rate calcualted by counting the number of drops per minute on a handheld watch. She said that it happens infrequently, but there are errors which have led to fetal complications.
Today was a complication-free day, however, and I got to assist on the delivery of a beautiful baby boy who promptly peed on me as I toweled him off under the heating hood (which at that time was not working because the power went out, an everyday occurence that happens at least 4-5 times in one day). I enjoyed my time on labor and delivery, and hope I'll get to work with the lovely and brilliant Dr. Divya again this week.
My last assignment of the day was a community visit in which the residents conducted an antenatal clinic and a chronic disease clinic. About ten people piled into the CMC van, and we were off to the site where we'd set up the makeshift clinic. The clinic ran quite smoothly, with one side devoted to pregnancy education and antenatal check-ups, and the other a walk-in clinic for patients that needed follow-up or had new complaints. I spent some time with the resident doing the antenatal check-ups, and he emphasized how important patient education was to CHAD because it could prevent many complications caused by patient beliefs and superstitions. For example, many women in the rural villages believe that drinking too much water will give the baby hydrops, and that drinking too much milk will make a baby too large to be delivered, so many women become dehydrated in their adherence to this superstition, also predisposing themselves to urinary tract infections which can then trigger preterm labor. For this reason and many others, a young nurse stood in her crisp white sari in front of the group of pregnant women gathered outside, reading a colorful book which outlined how to follow a healthy regimen in pregnancy and how to deal with complications.
The clinic concluded after a couple of hours, and we helped pack up the supplies and headed back to the CHAD. It was a fantastic first day, and I am very excited to start home visits to patients tomorrow. CHAD represents a sector of people and healthcare in India that I have not previously seen, and I am grateful for this unique experience after the previous more formal weeks in the CMC hospital.
Tuesday, February 15, 2011
The Robin Hood Policy...I like it
Today was surgery day at Schell Eye Hospital. It started out with a little frustration that was quite hilarious in hindsight. Julie, Michael and I reported to the O.R. this morning, and were told to go change into the hospital scrubs. Julie and I walked into the womens dressing room and found piles of blue, paper thin, old, bleach-stained scrubs that were about four times too big compared to the scrubs we normally wear. The pants could have fit a family of five in the waist, and the top came down to my knees. They were literally so worn-out that I ripped them when I pulled the drawstring too tight. Julie and I threw them on over our clothes and started to walk to the O.R. hallway in our sandals to get footcovers. We were chastised (but very kindly) by a sister (I think I've mentioned that is what they call nurses here) who said we had to enter the O.R. hallway barefoot, then put the footcovers on our bare feet. We did so accordingly, giggling at the floppy cloth material that was also four times too big with a thin plastic sole. We thought we were ready, but oh no. The sister said we had to go back in and remove our street clothes, even though not one part of them was sticking out and we wouldn't be scrubbing in. We headed back to the dressing room, did as we were told, then re-emerged, only to be told we had to change our footcovers again. To make things even more interesting, I had forgotten to leave my valuables at home (camera, two phones, passport and wallet) and didn't want to leave them in the dressing room (a student last week had everything stolen from passport to new SLR camera at the hospital), so they were now tucked into my sports bra with my camera dangling from the drawstring in my pants. Lovely. I thought we were finally done, but then Jules had to go to the bathroom after all the delicious coffee we drank this morning so she had to do it all over again. After learning all the rules and idiosyncracies of the O.R. at home, I felt like a new third-year medical student again who doesn't know proper O.R. edicate. It was quite funny.
So, suited up in our surgery attire, we met Michael down the hall who was dressed similarly, but in white scrubs (all the men wear white, the women blue). We then met Charles (I'm pretty sure that was his name, though I haven't met an Indian man named Charles here yet), who was the head nurse of the O.R. He gave us a nice tour of the eye O.R. which included 4 operating rooms (or theaters, as they're called here), one which was reserved for paying patients, and one that was reserved for camp patients. (Brief explanation of camp patients: Back in the 60's and 70's, ophthalmologists traveled to the rural villages to do screenings and performed surgeries in makeshit operating rooms (schools, homes, etc.). Obviously the conditions weren't exactly sterile, endophthalmitis was a frequent occurence as well as other complications, and the government started mandating certain operating outcomes and parameters for the eye surgery "camps". Needless to say, that shut many of them down but established better rules, regulations and patient safety, and now great eye hospitals like Schell and others exist. Ophthalmologists still go out to the rural villages, but only to perform vision screens and bring these indigent patients in who need surgery but can't afford to pay. Hence the term "camp patient" was born.)
Our first surgical case was with Dr. Jeyanthan, a young, very kind comprehensive ophthalmologist from Vellore whose special interest was in neuro ophthalmology. However this morning he was doing a dacrocystorhinostomy on a woman who had chronic complicated dacrocystitis with cutaneous fistulae formation. I have seen several at home at Dean McGee and felt comfortable walking into the procedure, but was quite surprised when I saw the large amount of blood (large for ophthalmology, not large for general surgery...Carla) during the case and even more surprised by the lack of pain medication and sedation for the patient. She had some local anaesthesia, but it had pretty much worn off by the middle of the case when things got quite complicated and Dr. Jeyanthan couldn't thread the punctal tubes through the ostomy in the nasal mucosa. I was trying not to cringe as the patient cried and groaned in pain in Tamil, and was relieved when the case was over. I have a very high tolerance for blood and guts at this point, but hearing a patient in pain makes my stomach churn. The next patient was having a similar procedure, but he was a darling boy of four years. He was not happy to be in the O.R. without his mother and struggled as they administered general anaesthesia (little kids can't hold still enough like adults can for these procedures), and I tried to calm him by talking to him and stroking his arm before he conked out. The procedure went much better this time, and Dr. Jeyanthan was an excellent teacher who made sure that Julie and I understood every step of the way. He answered all of my questions, and I left the operating room quite satisfied that I could now describe every step of the procedure, something I hadn't been able to do before.
I was extremely curious about how the sterilization of drapes, gowns and instruments were done here, because absolutely everything was recycled and re-used. In the U.S., all of the drapes, gowns, towels, etc. are disposable and thrown away after each use with a new package opened for each patient, no matter if they have insurance or not, can pay for the surgery or not. Because resources are so precious here, they re-use everything! Charles explained the lengthy autoclave cycle for linens and the gas sterilization method using ethylene oxide for the instruments. It was obvious how much pride he took in the excellent job he did. He even made Julie and I take off our foot covers to walk outside with him to show us the roof pipes that carried away the carcinogenic ethylene oxide gas. Seeing how they re-use everything here makes us seem so wasteful at home when after a case at least two or three trash cans are brought in to the O.R. to cart away all the materials.
The afternon was spent watching small incision extra-capsular cataract surgery, something I have wanted to see for a long time! Because phacoemulsification is quite costly (the machine and the disposable tools), the small incision surgeries are more cost-effective and practical for most patients. The incision (8-9 mm) is almost three times the size of the one made in phacoemulsification (around 3 mm), but both surgeries can achieve excellent visual outcomes with low complication rates (though small-incision complication rates are higher than phaco due to the incision itself and the pressure placed on the vitreous body), so the manual small incision extra-capsular surgery is the preferred technique in developing countries like India where the cost of phaco is prohibitive for most patients. It was very interesting to watch him make the trans-conjunctival incision, followed by a three-plane U-shaped scleral incision. Then he carefully removed the nucleus and the cortex through the incision...voila! Very cool, and a surgery I want to learn how to do because I think it is vital to my desire to do ophthalmology in developing countries. Dr. Jeyanthan was again a wonderful teacher, allowing me to watch through the teaching microscope the whole time so I had stereopsis, which makes cataract surgery even more exciting when you can appreciate the depth and contours of the eye and the cataracts.
Most of our afternoon patients were camp patients, and they had some of the most mature cataracts I have ever seen, which makes them very difficult to remove. Because they are very poor and from such remote areas, they are often very malnourished and in poor health. One patient's eyes were so recessed from a combination of orbital fat atrophy with old age and her malnourished state that Dr. Jeyanthan had to do a lateral canthotomy to get better access to the eye to perform surgery. I asked Dr. Jeyanthan how the camp patients are able to get eye surgery, and he said that the government pays 650 rupees for each camp patient as well as pays for the lens. However, that's still not enough when a small-incision extracapsular cataract extraction is about 6, 500 to perform. I asked him how Schell is able to do these operations without losing money, and Dr. Jeyanthan explained that the ophthalmologists operate for free, and they also employ the "Robin Hood Policy".
"Sara, do you remember the first patient of the morning?" He asked.
"I do." I said, thinking of the bloodbath.
"Well, she was a paying patient and we used her leftover silk suture and some of the other materials she paid for in the little boy's surgery that immeadiately followed hers, because his mother couldn't pay and he needed the surgery."
Steal from the rich and give to the poor. I like the Robin Hood policy, and I like Dr. Jeyanthan.
So, suited up in our surgery attire, we met Michael down the hall who was dressed similarly, but in white scrubs (all the men wear white, the women blue). We then met Charles (I'm pretty sure that was his name, though I haven't met an Indian man named Charles here yet), who was the head nurse of the O.R. He gave us a nice tour of the eye O.R. which included 4 operating rooms (or theaters, as they're called here), one which was reserved for paying patients, and one that was reserved for camp patients. (Brief explanation of camp patients: Back in the 60's and 70's, ophthalmologists traveled to the rural villages to do screenings and performed surgeries in makeshit operating rooms (schools, homes, etc.). Obviously the conditions weren't exactly sterile, endophthalmitis was a frequent occurence as well as other complications, and the government started mandating certain operating outcomes and parameters for the eye surgery "camps". Needless to say, that shut many of them down but established better rules, regulations and patient safety, and now great eye hospitals like Schell and others exist. Ophthalmologists still go out to the rural villages, but only to perform vision screens and bring these indigent patients in who need surgery but can't afford to pay. Hence the term "camp patient" was born.)
Our first surgical case was with Dr. Jeyanthan, a young, very kind comprehensive ophthalmologist from Vellore whose special interest was in neuro ophthalmology. However this morning he was doing a dacrocystorhinostomy on a woman who had chronic complicated dacrocystitis with cutaneous fistulae formation. I have seen several at home at Dean McGee and felt comfortable walking into the procedure, but was quite surprised when I saw the large amount of blood (large for ophthalmology, not large for general surgery...Carla) during the case and even more surprised by the lack of pain medication and sedation for the patient. She had some local anaesthesia, but it had pretty much worn off by the middle of the case when things got quite complicated and Dr. Jeyanthan couldn't thread the punctal tubes through the ostomy in the nasal mucosa. I was trying not to cringe as the patient cried and groaned in pain in Tamil, and was relieved when the case was over. I have a very high tolerance for blood and guts at this point, but hearing a patient in pain makes my stomach churn. The next patient was having a similar procedure, but he was a darling boy of four years. He was not happy to be in the O.R. without his mother and struggled as they administered general anaesthesia (little kids can't hold still enough like adults can for these procedures), and I tried to calm him by talking to him and stroking his arm before he conked out. The procedure went much better this time, and Dr. Jeyanthan was an excellent teacher who made sure that Julie and I understood every step of the way. He answered all of my questions, and I left the operating room quite satisfied that I could now describe every step of the procedure, something I hadn't been able to do before.
I was extremely curious about how the sterilization of drapes, gowns and instruments were done here, because absolutely everything was recycled and re-used. In the U.S., all of the drapes, gowns, towels, etc. are disposable and thrown away after each use with a new package opened for each patient, no matter if they have insurance or not, can pay for the surgery or not. Because resources are so precious here, they re-use everything! Charles explained the lengthy autoclave cycle for linens and the gas sterilization method using ethylene oxide for the instruments. It was obvious how much pride he took in the excellent job he did. He even made Julie and I take off our foot covers to walk outside with him to show us the roof pipes that carried away the carcinogenic ethylene oxide gas. Seeing how they re-use everything here makes us seem so wasteful at home when after a case at least two or three trash cans are brought in to the O.R. to cart away all the materials.
The afternon was spent watching small incision extra-capsular cataract surgery, something I have wanted to see for a long time! Because phacoemulsification is quite costly (the machine and the disposable tools), the small incision surgeries are more cost-effective and practical for most patients. The incision (8-9 mm) is almost three times the size of the one made in phacoemulsification (around 3 mm), but both surgeries can achieve excellent visual outcomes with low complication rates (though small-incision complication rates are higher than phaco due to the incision itself and the pressure placed on the vitreous body), so the manual small incision extra-capsular surgery is the preferred technique in developing countries like India where the cost of phaco is prohibitive for most patients. It was very interesting to watch him make the trans-conjunctival incision, followed by a three-plane U-shaped scleral incision. Then he carefully removed the nucleus and the cortex through the incision...voila! Very cool, and a surgery I want to learn how to do because I think it is vital to my desire to do ophthalmology in developing countries. Dr. Jeyanthan was again a wonderful teacher, allowing me to watch through the teaching microscope the whole time so I had stereopsis, which makes cataract surgery even more exciting when you can appreciate the depth and contours of the eye and the cataracts.
Most of our afternoon patients were camp patients, and they had some of the most mature cataracts I have ever seen, which makes them very difficult to remove. Because they are very poor and from such remote areas, they are often very malnourished and in poor health. One patient's eyes were so recessed from a combination of orbital fat atrophy with old age and her malnourished state that Dr. Jeyanthan had to do a lateral canthotomy to get better access to the eye to perform surgery. I asked Dr. Jeyanthan how the camp patients are able to get eye surgery, and he said that the government pays 650 rupees for each camp patient as well as pays for the lens. However, that's still not enough when a small-incision extracapsular cataract extraction is about 6, 500 to perform. I asked him how Schell is able to do these operations without losing money, and Dr. Jeyanthan explained that the ophthalmologists operate for free, and they also employ the "Robin Hood Policy".
"Sara, do you remember the first patient of the morning?" He asked.
"I do." I said, thinking of the bloodbath.
"Well, she was a paying patient and we used her leftover silk suture and some of the other materials she paid for in the little boy's surgery that immeadiately followed hers, because his mother couldn't pay and he needed the surgery."
Steal from the rich and give to the poor. I like the Robin Hood policy, and I like Dr. Jeyanthan.
Monday, February 14, 2011
Everyday India IV
1) Helpfulness
One of the many amazing characteristics of the people of India is their kindness and willingness to help when you seem lost, afraid or in need. They are constantly going out of their way to lend a hand to us hopeless Americans. Prime example was this weekend when we were lost and couldn't find the correct bus to the ferry jetty in Ernakulam, and one of us really needed to use the bathroom. We stopped at a nice-looking restaurant and in desperation went inside to beg to use the bathroom and look at the Lonely Planet map. When we asked the owner to use the bathroom and sit for a moment in the restaurant, the owner smiled and greeted us as if we were his long-lost children just returned home. He not only let us use the bathroom without purchasing anything, he turned on the air-conditioning unit adjacent to our table, helped us locate where we wanted to go on the map, then proceeded to walk us to the correct bus stop then waited with us until it came to ensure we got on. We profusely thanked him, and he just head bobbled and smiled happily. The people here are so willing to help, whether it's putting an arm out to steady you on a particularly wild bus ride, pulling your tunic down when it gets caught in your purse strap during rounds or explaining what each type of foreign vegetable is on the menu, they always do it with such kindness.
2) Tatkal train tickets
This was such a phenomenon in itself, though very specific, that it just has to be mentioned. We knew before coming to India that we very much wanted to visit Kerala, and were disappointed when we tried to book train tickets from here and found out that they had been sold out for months and that there was a waiting list for them of about 100 people. Frustrated and disappointed that we couldn't go, we tried to come up with other plans. However, Julie came bouncing home after work one day with an interesting tidbit. She had made friends with a med student from Chennai who told her about tatkal train tickets, a magical way to purchase tickets for an already-sold-out train. Too good to be true? Absolutely not. We had to go to a travel agent on Gandhi road who I had to communicate with by writing and gestures due to lack of English, who agreed for a fee to purchase the tatkal tickets online when they became available. To my understanding, the train companies hold a certain amount of tickets for emergencies, and these become available 48 hours before the train leaves and can only be purchased by licensed travel agents. Michael and I made the arrangements and I left the travel office feeling like there was no possible way we'd get them, but what do you know, we did and got on the Thursday night train. It was quite an ordeal trying to get them on the way back however, since they went on sale while we were in Kerala and I had to try to communicate with the agents by phone (see paragraph above regarding communication with hand gestures and writing). However, it worked again that we got on a sold-out train back to Vellore and arrive at 2 AM last night. Apparently this is a normal way to go about booking transportation here, and just another one of the idiosyncracies that makes India so mystifying and enjoyable.
One of the many amazing characteristics of the people of India is their kindness and willingness to help when you seem lost, afraid or in need. They are constantly going out of their way to lend a hand to us hopeless Americans. Prime example was this weekend when we were lost and couldn't find the correct bus to the ferry jetty in Ernakulam, and one of us really needed to use the bathroom. We stopped at a nice-looking restaurant and in desperation went inside to beg to use the bathroom and look at the Lonely Planet map. When we asked the owner to use the bathroom and sit for a moment in the restaurant, the owner smiled and greeted us as if we were his long-lost children just returned home. He not only let us use the bathroom without purchasing anything, he turned on the air-conditioning unit adjacent to our table, helped us locate where we wanted to go on the map, then proceeded to walk us to the correct bus stop then waited with us until it came to ensure we got on. We profusely thanked him, and he just head bobbled and smiled happily. The people here are so willing to help, whether it's putting an arm out to steady you on a particularly wild bus ride, pulling your tunic down when it gets caught in your purse strap during rounds or explaining what each type of foreign vegetable is on the menu, they always do it with such kindness.
2) Tatkal train tickets
This was such a phenomenon in itself, though very specific, that it just has to be mentioned. We knew before coming to India that we very much wanted to visit Kerala, and were disappointed when we tried to book train tickets from here and found out that they had been sold out for months and that there was a waiting list for them of about 100 people. Frustrated and disappointed that we couldn't go, we tried to come up with other plans. However, Julie came bouncing home after work one day with an interesting tidbit. She had made friends with a med student from Chennai who told her about tatkal train tickets, a magical way to purchase tickets for an already-sold-out train. Too good to be true? Absolutely not. We had to go to a travel agent on Gandhi road who I had to communicate with by writing and gestures due to lack of English, who agreed for a fee to purchase the tatkal tickets online when they became available. To my understanding, the train companies hold a certain amount of tickets for emergencies, and these become available 48 hours before the train leaves and can only be purchased by licensed travel agents. Michael and I made the arrangements and I left the travel office feeling like there was no possible way we'd get them, but what do you know, we did and got on the Thursday night train. It was quite an ordeal trying to get them on the way back however, since they went on sale while we were in Kerala and I had to try to communicate with the agents by phone (see paragraph above regarding communication with hand gestures and writing). However, it worked again that we got on a sold-out train back to Vellore and arrive at 2 AM last night. Apparently this is a normal way to go about booking transportation here, and just another one of the idiosyncracies that makes India so mystifying and enjoyable.
Ohhh yeah ophthalmology!
Today was my first day at Schell Eye Hospital and it was fabulous to be doing ophthalmology. I worked the whole day with Dr. Zia Sultan Pradhan (but she wouldn't let me call her Dr. Pradhan, only Zia). She was one year out of residency, very smart, sweet and quite sassy I learned from listening and watching her shoo out patients who wandered into the exam room out of their turn (see "Cutting" in "Everyday India"). I have gotten used to the teaching methods here in which attendings (called consultants) constantly pepper medical students and residents (registrars) with questions to assess their knowledge, and Zia was no exception. She was happy that I had some background in ophthalmology already and that I had matched for residency, so she was very excited to teach and let me examine each patient after she was done with the slit lamp and the indirect, asking me to describe the findings I saw and draw them out for her on paper. It felt surprisingly comforting using the slit lamp because it was a constant in medicine between here and home.
We saw many interesting cases throughout the day, many of which were simple cases that we would see back home and some more exotic. Ocular trauma is extremely prevalent here due to the high number of manual laborers in India, and patients have many complications from such accidents. The worst was a 14-year-old boy losing his vision due to angle recession glaucoma caused by blunt trauma while helping his father farm. However, there were many happy patients just there for follow-up on surgeries or routine eye care. It was very exciting to see my specialty in action here in India, and I am so happy that I have chosen a specialty that can make such significant and lasting impacts on people's lives if I come to perform surgeries on international trips in residency and in the future.
I realized that Zia also shares my love for the awesome equipment of ophthalmology when she showed off their fancy photo suite in the back of the eye clinic as well as her new retinoscope that cost her 14,500 rupees.
"Getting new tools is so fun." She said. "Except for your checkbook."
Tomorrow is surgery day at Schell, and I'm looking forward to it! We offered to wear our own scrubs from home, but because ours have short shirts instead of the long tunic-like ones that the women wear here, we were told to just wear theirs. I have become accustomed to being so conservatively-dressed all the time here, but was surprised that this even carried over to the operating room.
Tonight we go to celebrate Cristine's birthday with dinner at Darling's (of course) and a birthday cake that Julie and I picked up from a bakery. The best part is the "candle" I found. It's an enormous plastic flower with candles inside that when you light them, cause the flower petals to open while simultaneously playing music. It's going to be exciting, especially if Darling's goes up in flames...:)
We saw many interesting cases throughout the day, many of which were simple cases that we would see back home and some more exotic. Ocular trauma is extremely prevalent here due to the high number of manual laborers in India, and patients have many complications from such accidents. The worst was a 14-year-old boy losing his vision due to angle recession glaucoma caused by blunt trauma while helping his father farm. However, there were many happy patients just there for follow-up on surgeries or routine eye care. It was very exciting to see my specialty in action here in India, and I am so happy that I have chosen a specialty that can make such significant and lasting impacts on people's lives if I come to perform surgeries on international trips in residency and in the future.
I realized that Zia also shares my love for the awesome equipment of ophthalmology when she showed off their fancy photo suite in the back of the eye clinic as well as her new retinoscope that cost her 14,500 rupees.
"Getting new tools is so fun." She said. "Except for your checkbook."
Tomorrow is surgery day at Schell, and I'm looking forward to it! We offered to wear our own scrubs from home, but because ours have short shirts instead of the long tunic-like ones that the women wear here, we were told to just wear theirs. I have become accustomed to being so conservatively-dressed all the time here, but was surprised that this even carried over to the operating room.
Tonight we go to celebrate Cristine's birthday with dinner at Darling's (of course) and a birthday cake that Julie and I picked up from a bakery. The best part is the "candle" I found. It's an enormous plastic flower with candles inside that when you light them, cause the flower petals to open while simultaneously playing music. It's going to be exciting, especially if Darling's goes up in flames...:)
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