Sleep and food

What you can see in front of the hospital if you get out early 

The internet has been out since I arrived.  Dhen mentioned they had hoped to have me review the hospital’s website, but that is now not possible.  He said yesterday that it will be tomorrow earliest before the problem may be fixed.  It’s nice not to have it.  There is more time for reading, meditating, and reflection.  And now I find myself perhaps with time to write, something I haven’t done much since Kathmandu.

I have slept quite a lot in the last two days.  10 hours last night, 12 the night before.  Typically I sleep only 7 or 8. Part of this is catching up with lost sleep during a night of travel, but perhaps it is also catching up with sleep over a very long semester.

The food here has been rather basic – rice, potatoes and lentils, with a smattering of okra and some kind of gourd.  But mostly potatoes.  Not a bite of fruit since I arrived, nor any tea or coffee. 

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Lurking

The Mahindra

Day 2 at Kalinga and I just finished an English lesson with 20 of the paramedics.  These women function somewhere between a nurse’s aid and a nurse.  They are all female, largely single and below 30 years of age, and have been with the hospital for a few months to a couple of years.  Their training seems to have been conducted through the hospital, and not an external institute.  I was told before I arrived that I might be doing English lessons.  I wasn’t terribly excited with the idea of doing what I always do, but when I was asked for lessons so earnestly by one of the paramedics, I could hardly refuse.  Especially since there’s nothing else on my to-do list.

I arrived in Bhubaneswar yesterday morning after a grueling night of travel and only a couple hours of fitful airplane sleep.  The 4WD Mahindra with no aircon and only the slightest suspension made for an exhausting hot, windy, noisy, bumpy ride to the hospital.   Fortunately after I was shown my room I was left alone until lunch.  I don’t remember the last time it felt so good just to lie down.  Sleep was pretty good, too. 

Since then I’ve been waiting to meet with the director to find out what he might have in mind for me.  He asked me to help composing with a couple of promotional letters, but so far that’s been the entire extent of my involvement with the hospital.  There is another volunteer, an American college student, who has been here 10 days already and seems equally bereft of direction.  He jokes that what he does most is lurk about the hospital.  This seems like an awfully poor use of labor on the part of hospital management.  They know when people are arriving and what their skills are.  They should have a plan that can be set in motion as soon as the volunteer arrives, but it seems they may be having difficulty conceptualizing how best to use this resource.

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Training Day 2: Surgery

My second day at Moorfields began with a walk through the surgery wing with the theatre manager, who explained how the layout of the facility is designed to create a circle that reduces opportunities for contamination.  All surgical tools and materials are labeled and inventoried so that should there be an episode of contamination, it is then possible to go back and trace all potentially contaminated items. 

I've had my share of being left in hospital or doctor waiting rooms, but until this week only as a patient.  A surgery was scheduled for first thing in the morning of my visit, but was delayed because one of the doctors was involved in a minor car accident and had to sort things out with the police before he could get work.  And so we had to wait, and as a result all the surgeries for that day got pushed back.  

I observed three surgeries and was most impressed by how busy the staff were.  There was no down time, no time to have a coffee and discuss a case.  As soon as one procedure was complete, the doctors and nurses washed up and went on to the next.  I didn't stay the whole day, but I imagine many of the staff on many days eat on the run, if they eat at all.  To be able to keep up such a pace requires great confidence in one's knowledge and abilities.  I was suitably impressed.  

And I image I may be even more so once I arrive in India.  But perhaps in a different way.  The Moorfields theatre manager was telling me about some of his procurement issues and how he is often able to leverage the hospital's name and reputation with suppliers.  Part of that reputation comes from the use of leading procedures and technology, a condition that will be quite different in rural India.  

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First day training at Moorfields

I was surprised how easy it was to gain access to a hospital.  I emailed, followed up with a phone call and was then penciled in for a couple of days.  I showed up, was introduced around and spent the day sitting in with doctors as they consulted with patients.

It was an amazing day.

All the things I had been studying came to life:  seeing patients being given eye exams, hearing people use words that I had only read, meeting patients with conditions I had only imagined.  It all seemed very vital and alive, quite unlike the rather lifeless medical texts.

The first ophthalmologist I was assigned kindly provided a private anatomy and pathology lesson.  As patients came in for consultation, he showed me how his instruments were used and even let me have a look at a patient's eyes.  Mid morning I switched to a second ophthalmologist until a VIP patient necessitated my departure, after which I visited with the optometrist.  Following lunch I was supposed to sit in with a retinal specialist, but he had a couple of emergency surgeries, was running far behind in his consultations, and obviously didn't have time for me. A male nurse kindly walked me through the visual acuity test and his routine for gathering basic data before patients meet with doctors. And I finished out the day with one of the ophthalmologists and about a half dozen of his patients.

I'm scheduled to observe some surgeries this coming week and look forward to learning a whole lot more.

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