My first day on Internal Medicine Ward III was wonderful. I met my intern Dr. Divya Bala Thumaty, a very beautiful and sweet young woman. She walked with me to the medicine conference room, where we started the day with the rotating residents and the chaplain for a daily devotional. Although Christian Medical College is obviously founded on Christian values, I didn't know that the staff had devotional time together, and I found this very neat, especially because of the subject matter we addressed. The chaplain discussed with us that caregivers are expected to heal pain and suffering, but are often in pain and suffering themselves, be it the stresses of life, emotional health, spiritual health, etc. In order to provide comfort to others and to our patients, we must let ourselves be allowed to be comforted and healed by God. The chaplain, who is also a physician, said "Our qualification in this field isn't our degree, it's being comforted by God ourselves." Although this may be extremely simplistic in theory, it gave me peace. There have often been times as a medical student when I have been so stressed that I feel like I don't give good care to the patients I am seeing, and I know that as my responsibilites grow as I mature as a person and a physician, I am bound to encounter even more stress, and it's my conscious choice to receive comfort in order to give comfort. From the devotional book we read,
"Those who have gone through pain and gained comfort from God can face life more confidently. In order to become an effective caregiver, we may have to go through brokeness and pain. It sharpens our sensitivity to other people and their pain. Since we are comforted by the Lord, we are able to impart that comfort to others. After all, we are called to be "wounded healers".
I know many friends and family members who have gone through such unthinkable struggles in medical school and life who act as caregivers, and I think this is something inspiring to read.
After devotional we had a typical medicine presentation on the use of ultrasonography in diagnosing enesthitis in ankylosing spondylitis. During the powerpoint presentation, the power went out twice, which didn't seem to bother any of the residents and attendings one bit. They instead took it as time for a coffee break and I had my third cup of the creamy, sugary concoction that is coffee "Indian style". I enjoyed how easily they laughed together.
Wards the rest of the morning and afternoon were as fascinating as ever. Hemorrhagic tuberculous pericarditis (got to examine the patient and finally felt pulsus paradoxus with my own hands), tetanus (the patient was in complete opisthotonus) and a medical mystery in a young man with severe bronchiectasis and lung disease of unknown origin that led to heart failure (cor pulmonale). If I had viewed his CT and known his age and history in the US, I would have had cystic fibrosis on my differential in a snap, but my resident said that in India it's almost unheard of, and she had certainly never seen it. It was likely some form of interstitial lung disease that had become severely complicated by tuberculosis or aspergillosis. Either way, his diagnosis was unknown and I got to assist with a bedside supraclavicular lymph node biopsy (yes, bedside). The resident used local with epinephrine and I draped towels over the patient's face so he couldn't watch. Throughout the dissection the resident and I nervously watched his heart rate on the outdated monitor, nervous that even such a small dose of epinephrine could disrupt the delicate homeostasis that his failing heart had accomplished. I almost lost it when the resident murmured, "Hmmm, is that lung tissue?", fearing we had dissected into the pulmonary apex, but I maintained composure since the patient was awake and breathing right under my hands. After the biopsy was done I breathed a sigh of relief and my resident just grinned at me.
"You don't do these at the bedside at home, do you?" He asked.
"Nope!" I said.
Tropical medicine rounds were as fabulous as ever-adrenal histoplasmosis and an enormous splenic hydatid cyst! The leading attending was a local physician who was excited to meet the American students, which is always nice. I sometimes feel guilty for attending the tropical medicine symposium since many of the international visiting attendees paid about $2,500 to attend, but everyone has been so welcoming to us during our few hours at bedside rounds that we keep coming back for more!
Cristine and I went for a lovely run around campus this evening, giggling at the salutes we got from the guards along the paths as we passed by. Tonight there was a gathering for all international students and staff, and we were given a warm welcome by Mr. Skiel, the director of development for CMC and a transplant from the UK to India for 11 years. He and is wife, Debbie, were absolutely charming as they gave us a formal welcome to CMC and allowed us to raise our hands to respresent the countries we were from. By far the largest amount of students are from the US, but there are significant numbers of others-Sweden, Norway, Germany, Singapore, Australia, to name a few.
He gave us a brief history of Ida Scudder, who is considered the "founding mother" of Christian Medical College. Ida Scudder was an American, born in India to her missionary parents (her father was a physician). Mr. Skiel explained that for her early life, Ida often hated living in India, and was resistant to her parents' wishes that she become a doctor and instead planned on returning as soon as she was able to the US to marry and start seminary school. It wasn't until one night when three pregnant women in complicated labor came to her father's clinic seeking help from a woman doctor, but there was no woman doctor, only Ida's father and Ida herself. The women's husbands refused to let their wives be treated by a male doctor, and begged for Ida's help as she was a woman. As just a teenager with no medical training, she was helpless to their cries of need and watched them turn away into the night. She sent a servant into the village the next morning, and found out that all three women had died in the night. It was then she felt her calling, to help the women and children of India. She completed medical schoool at Cornell and returned to India and opened a one-room dispensary (that is now the Schell eye hospital here, so cool!), and that was the early and humble beginnings of CMC. I won't bore you with all the details of the in-between from when she started the clinic in 1918 until now, but essentially CMC has grown from a one-room tiny clinic to an incredible medical institution that is one of the most well-respected in India. Despite all of this, I can still see the simplistic beginnings in the comprehensive rural health and developement programs that replaced Dr. Ida's initial "roadsides", such as the Community Health and Development (CHAD) program as well as many others offered through CMC. These places still continue to serve people like the three women who came to Ida that fateful and tragic night. If you are at all interested, I highly recommend reading more about this amazing woman (you can just Google her, of course :). She's quite a hero to me.
Lastly, we ended the evening with a lesson in sari!!! I feel like I have been invited into a secret club, now that I know how to put one on. I of course volunteered to be the guinea pig/model, and several of the CMC teachers skillfully wrapped me, pleated the cloth and gracefully draped it over my shoulder in about 5 minutes flat. I tried to replicate the result, but my efforts were not quite as graceful. The female teachers spoke about how you can tell the region of India where a woman is from by her sari, and that saris have many uses even when they are not being worn (to use like a blanket to keep warm, to suspend a baby in like a hammock, to make curtains, etc.). They said a decent sari can be purchased for as cheap as 200 rupees, but that wedding saris start around 50,000 rupees! The reason the weddings ones are so expensive is that they often have actual gold woven into the fabric. The eldest teacher lamented that the sari is becoming a dying art form in India because the young women prefer the Punjabi pant sets over the traditional garb. She said only one of her daughters knew how to wear a sari, but that neither actually wore them. Looking at the teacher who was absolutely majestic in her sari of deep reds, golds and blues that complimented her silver hair, I couldn't imagine why they could do just a thing! Cristine and Jules were also aghast, and we made a vow to find some beautiful saris to bring home with us from India.
A wonderful day of learning in so many different forms.
"Those who have gone through pain and gained comfort from God can face life more confidently. In order to become an effective caregiver, we may have to go through brokeness and pain. It sharpens our sensitivity to other people and their pain. Since we are comforted by the Lord, we are able to impart that comfort to others. After all, we are called to be "wounded healers".
I know many friends and family members who have gone through such unthinkable struggles in medical school and life who act as caregivers, and I think this is something inspiring to read.
After devotional we had a typical medicine presentation on the use of ultrasonography in diagnosing enesthitis in ankylosing spondylitis. During the powerpoint presentation, the power went out twice, which didn't seem to bother any of the residents and attendings one bit. They instead took it as time for a coffee break and I had my third cup of the creamy, sugary concoction that is coffee "Indian style". I enjoyed how easily they laughed together.
Wards the rest of the morning and afternoon were as fascinating as ever. Hemorrhagic tuberculous pericarditis (got to examine the patient and finally felt pulsus paradoxus with my own hands), tetanus (the patient was in complete opisthotonus) and a medical mystery in a young man with severe bronchiectasis and lung disease of unknown origin that led to heart failure (cor pulmonale). If I had viewed his CT and known his age and history in the US, I would have had cystic fibrosis on my differential in a snap, but my resident said that in India it's almost unheard of, and she had certainly never seen it. It was likely some form of interstitial lung disease that had become severely complicated by tuberculosis or aspergillosis. Either way, his diagnosis was unknown and I got to assist with a bedside supraclavicular lymph node biopsy (yes, bedside). The resident used local with epinephrine and I draped towels over the patient's face so he couldn't watch. Throughout the dissection the resident and I nervously watched his heart rate on the outdated monitor, nervous that even such a small dose of epinephrine could disrupt the delicate homeostasis that his failing heart had accomplished. I almost lost it when the resident murmured, "Hmmm, is that lung tissue?", fearing we had dissected into the pulmonary apex, but I maintained composure since the patient was awake and breathing right under my hands. After the biopsy was done I breathed a sigh of relief and my resident just grinned at me.
"You don't do these at the bedside at home, do you?" He asked.
"Nope!" I said.
Tropical medicine rounds were as fabulous as ever-adrenal histoplasmosis and an enormous splenic hydatid cyst! The leading attending was a local physician who was excited to meet the American students, which is always nice. I sometimes feel guilty for attending the tropical medicine symposium since many of the international visiting attendees paid about $2,500 to attend, but everyone has been so welcoming to us during our few hours at bedside rounds that we keep coming back for more!
Cristine and I went for a lovely run around campus this evening, giggling at the salutes we got from the guards along the paths as we passed by. Tonight there was a gathering for all international students and staff, and we were given a warm welcome by Mr. Skiel, the director of development for CMC and a transplant from the UK to India for 11 years. He and is wife, Debbie, were absolutely charming as they gave us a formal welcome to CMC and allowed us to raise our hands to respresent the countries we were from. By far the largest amount of students are from the US, but there are significant numbers of others-Sweden, Norway, Germany, Singapore, Australia, to name a few.
He gave us a brief history of Ida Scudder, who is considered the "founding mother" of Christian Medical College. Ida Scudder was an American, born in India to her missionary parents (her father was a physician). Mr. Skiel explained that for her early life, Ida often hated living in India, and was resistant to her parents' wishes that she become a doctor and instead planned on returning as soon as she was able to the US to marry and start seminary school. It wasn't until one night when three pregnant women in complicated labor came to her father's clinic seeking help from a woman doctor, but there was no woman doctor, only Ida's father and Ida herself. The women's husbands refused to let their wives be treated by a male doctor, and begged for Ida's help as she was a woman. As just a teenager with no medical training, she was helpless to their cries of need and watched them turn away into the night. She sent a servant into the village the next morning, and found out that all three women had died in the night. It was then she felt her calling, to help the women and children of India. She completed medical schoool at Cornell and returned to India and opened a one-room dispensary (that is now the Schell eye hospital here, so cool!), and that was the early and humble beginnings of CMC. I won't bore you with all the details of the in-between from when she started the clinic in 1918 until now, but essentially CMC has grown from a one-room tiny clinic to an incredible medical institution that is one of the most well-respected in India. Despite all of this, I can still see the simplistic beginnings in the comprehensive rural health and developement programs that replaced Dr. Ida's initial "roadsides", such as the Community Health and Development (CHAD) program as well as many others offered through CMC. These places still continue to serve people like the three women who came to Ida that fateful and tragic night. If you are at all interested, I highly recommend reading more about this amazing woman (you can just Google her, of course :). She's quite a hero to me.
Lastly, we ended the evening with a lesson in sari!!! I feel like I have been invited into a secret club, now that I know how to put one on. I of course volunteered to be the guinea pig/model, and several of the CMC teachers skillfully wrapped me, pleated the cloth and gracefully draped it over my shoulder in about 5 minutes flat. I tried to replicate the result, but my efforts were not quite as graceful. The female teachers spoke about how you can tell the region of India where a woman is from by her sari, and that saris have many uses even when they are not being worn (to use like a blanket to keep warm, to suspend a baby in like a hammock, to make curtains, etc.). They said a decent sari can be purchased for as cheap as 200 rupees, but that wedding saris start around 50,000 rupees! The reason the weddings ones are so expensive is that they often have actual gold woven into the fabric. The eldest teacher lamented that the sari is becoming a dying art form in India because the young women prefer the Punjabi pant sets over the traditional garb. She said only one of her daughters knew how to wear a sari, but that neither actually wore them. Looking at the teacher who was absolutely majestic in her sari of deep reds, golds and blues that complimented her silver hair, I couldn't imagine why they could do just a thing! Cristine and Jules were also aghast, and we made a vow to find some beautiful saris to bring home with us from India.
A wonderful day of learning in so many different forms.
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