Happy Friday the 13th everyone! In my family, we consider this day to be good luck, so it is a good thing that the six of us, man is separate, are traveling today. I can't believe that this is our last weekend trip of our stay in India! I think I have figured out the formatting issues of my posts... So here is hoping this one ends up being easier to read...
KJ and I finished our week of dermatology today, and I am so glad we did this rotation! As you read in her posts, we have seen some crazy stuff here that we will probably never see at home. Even things like chicken pox, which we will probably not see at home anymore (one, because we are not pediatricians, but two because of the varicella vaccine given to kids at home these days). Today was another good day of rounds and clinic, where we got some good teaching from the residents and our awesome attending. We learned today that both HIV medications and leprosy medications are provided to patients free. KJ and I were shocked to hear the word free. I suppose at home if a patient has HIV, or TB, or something, they get the treatment even if they cannot afford it in most cases, but we never really call it free. Here, the government provides the normally very expensive HIV medications. The leprosy medications are provided as a donation from a pharmaceutical company. The resident was surprised to hear that we don't have leprosy in the US. She was also surprised to hear that as interns we have a 16 hour work day limit. She and the only other dermatology resident spend every other night in the hospital taking call, admitting patients, and taking care of the patients on the derm ward. And it is like that their entire (3 year) residency!!! Crazy. But many of the attendings have said that the US training system is "smarter" than the Indian one, in terms of knowledge that is emphasized, and the progression of our training. Perhaps this is true, but the docs here are just so darn smart. Even the dermatology docs know the intricacies of treating all kinds of ailments. It feels a bit more fragmented in the US, and we rely a bit much on our handy dandy smart phones.
I had an embarrassing moment in clinic today, that reminded me that knowing the basics and not relying on all our fancy technology is always a good thing. One of the public health nurses, who documents and tracks all the leprosy patients and teaches them about how to properly take their medications, needed her blood pressure checked before she left for the day. The doctor was busy, so she asked if I knew how to work the manual blood pressure cuff. I said yes, of course, Katherine and I had just used it the other day. So I go over and have the very nice lady sit down on the bed, attach the cuff to her arm, and begin inflating it. Something isn't right. The mercury isn't going above 75mm and the cuff is about to pop off her arm. So I think, oh, I must have it on inside out. So I switch it. Or so I think. Second try is as equal of a failure as the first. The lady is being so nice, and telling me that she is sorry she is wasting my time (wasting my time?? I am the one who can't figure out how to use a simple BP machine...). I call KJ over and we troubleshoot. Fail again. The lady says, oh, it's ok, I will just check it tomorrow, and after giving my cheek a squeeze and telling me I have a bright future (haha, right. With my amazing blood-pressure-checking skills) and leaves. About 15 second later, Katherine and I realize that the cuff was in fact on inside out, and that I never properly flipped it around when I thought I had. Katherine rushes out and brings the poor woman back... At which point, 10 minutes later, I successfully checked her blood pressure. Not embarrassing at all. Note to self: practice checking my patients blood pressure with the manual cuff, and see if it correlates with the (much more experienced) nurses who do it before I get in the room in our clinics at home. Lesson learned.
Next week I will be doing chest medicine, which is the same as pulmonary. It should be an interesting week! And then it's back home. We are heading off to Hampi tonight on a bus that leaves at 11pm. I hope all of the adventures we had surrounding our last bus rides (almost missing the bus, and some impressive motion sickness) will not be repeated. Hampi is going to be HOT, around 100-103oF, but we are still looking forward to it. We might even rent bikes and bike around to the different ruins! With many water and air conditioning breaks, if those can be found, of course. Thankfully, our hotel has AC again.
-Sasha
KJ and I finished our week of dermatology today, and I am so glad we did this rotation! As you read in her posts, we have seen some crazy stuff here that we will probably never see at home. Even things like chicken pox, which we will probably not see at home anymore (one, because we are not pediatricians, but two because of the varicella vaccine given to kids at home these days). Today was another good day of rounds and clinic, where we got some good teaching from the residents and our awesome attending. We learned today that both HIV medications and leprosy medications are provided to patients free. KJ and I were shocked to hear the word free. I suppose at home if a patient has HIV, or TB, or something, they get the treatment even if they cannot afford it in most cases, but we never really call it free. Here, the government provides the normally very expensive HIV medications. The leprosy medications are provided as a donation from a pharmaceutical company. The resident was surprised to hear that we don't have leprosy in the US. She was also surprised to hear that as interns we have a 16 hour work day limit. She and the only other dermatology resident spend every other night in the hospital taking call, admitting patients, and taking care of the patients on the derm ward. And it is like that their entire (3 year) residency!!! Crazy. But many of the attendings have said that the US training system is "smarter" than the Indian one, in terms of knowledge that is emphasized, and the progression of our training. Perhaps this is true, but the docs here are just so darn smart. Even the dermatology docs know the intricacies of treating all kinds of ailments. It feels a bit more fragmented in the US, and we rely a bit much on our handy dandy smart phones.
I had an embarrassing moment in clinic today, that reminded me that knowing the basics and not relying on all our fancy technology is always a good thing. One of the public health nurses, who documents and tracks all the leprosy patients and teaches them about how to properly take their medications, needed her blood pressure checked before she left for the day. The doctor was busy, so she asked if I knew how to work the manual blood pressure cuff. I said yes, of course, Katherine and I had just used it the other day. So I go over and have the very nice lady sit down on the bed, attach the cuff to her arm, and begin inflating it. Something isn't right. The mercury isn't going above 75mm and the cuff is about to pop off her arm. So I think, oh, I must have it on inside out. So I switch it. Or so I think. Second try is as equal of a failure as the first. The lady is being so nice, and telling me that she is sorry she is wasting my time (wasting my time?? I am the one who can't figure out how to use a simple BP machine...). I call KJ over and we troubleshoot. Fail again. The lady says, oh, it's ok, I will just check it tomorrow, and after giving my cheek a squeeze and telling me I have a bright future (haha, right. With my amazing blood-pressure-checking skills) and leaves. About 15 second later, Katherine and I realize that the cuff was in fact on inside out, and that I never properly flipped it around when I thought I had. Katherine rushes out and brings the poor woman back... At which point, 10 minutes later, I successfully checked her blood pressure. Not embarrassing at all. Note to self: practice checking my patients blood pressure with the manual cuff, and see if it correlates with the (much more experienced) nurses who do it before I get in the room in our clinics at home. Lesson learned.
Next week I will be doing chest medicine, which is the same as pulmonary. It should be an interesting week! And then it's back home. We are heading off to Hampi tonight on a bus that leaves at 11pm. I hope all of the adventures we had surrounding our last bus rides (almost missing the bus, and some impressive motion sickness) will not be repeated. Hampi is going to be HOT, around 100-103oF, but we are still looking forward to it. We might even rent bikes and bike around to the different ruins! With many water and air conditioning breaks, if those can be found, of course. Thankfully, our hotel has AC again.
-Sasha
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