Fabulous Teacher

I appologise in advance for those of you who just don't want to read about more OB-GYN stuff. Don't worry I am going to do something else next week. I also wanted to mention that I added some pictures to previous entries if you want to check those out (one the first part of our group with Aruna's family, another of Ghandi street that I couldn't figure out how to turn, a picture of this cow in sitting on the side of the road (a common sight) with an autorickshaw about to pass it, and at the bottom is a picture the courtyard in front of the church at the school). In this entry I have included a picture of the main enterance to the hospital.

Didn't get a chance to write yesterday. We had a full day. I started it off by going to OG OPD (Ob-GYN out-patient clinic). I got to work with the chief "consultant" (that's what the attendings are called here) who was one of the greatest teachers. Despite being very busy, I think that he said he normally sees 40 patients in one day (plus all of the patients the residents have questions about), he always talked to me about each patient and some times would even translate for me when the patients didn't speak English! Each state has it's own language so there are a ton of different languages and dialects spoken in the country and even Hindi is not spoken by a majority of people in India. Often times English is spoken bc it is more widespread as it is taught in school.

Clinic doesn't quite work the same way that it does in the US. The patient shows up with their chart and brings it into the doctor. They don't just bring it in while the doctor is in between patients they just bring it in whenever they feel like it. Right in the middle of talking to another patient...no problem. Not only that but if they have a question they forgot to ask or just want to know how much longer it's going to be they just walk right in! It's not just the patients either. When the residents have a question about one of their patients they walk in, wait for the "consultant" to pause and then in front of the other patient tells the consultant about their patient! It was very different. I don't think that HIPPA would appreciate that :)

We saw quite a few OB patients throughout the day. I was very embarrassed bc even though I want to do OB we are so bad back home about relying on a dopplar and ultra sound that out OB physical exam skills are quite poor. Dr. Abraham (I couldn't say his last name) was great about helping me to feel the position of the baby and talking about how to describe the what I felt. I know that it may sound basic but we never do that back home and so I learned it but it had never really stuck. I think another important factor was that most of the women we saw were not obese and so you could actually feeling the back versus in San Antonio where it's some time even hard to feel the top of the uterus.

In addition to seeing the OB patients we saw a quite a few GYN issues, many of the same that we see at home. So the table that the he used for exams was literally a table with two extra pieces of wood at the end for the women to put her feet on and a very think pad on top, no stirrups. There were quite a few women who needed pap smears, which they don't start doing until at least after the age of 25, and what do they use to collect their sample...a tongue depressor! It was crazy.

Another neat experience getting what how Dr. Abraham taught the medical students. Midway through the morning four medical students showed up. Dr. Abraham was also wonderful about including them into the discussions about the patients. I wished that more of the doctors that I had worked with 3rd year would have been like him. It was all fun and games though he would ask them question and expected them to know the answers. When they didn't he gave them a lecture on how to remember lists of causes of medical conditions. All of this was done in a very respectful way. They students were very smart. I don't think I knew near as much as when I was in their position.

It was a really great learning opportunity but very draining. It's hard being at the end of medical school and just shadowing a doctor all day. I was very greatful though that he was so willing and excited to teach. I found Seema, Jenn, and Kathryn shopping on Ghandi so we ran a few errands and then stopped by a glasses store on the way home. We had a blast trying on different frames. It is like $30 for a new pair of glasses with lenses!!! For dinner we met up with some of the students who are working at the leprosy hospital at a nice hotel in town. Even at a nice hotel dinner is still under $5. After dinner we went up to the rooftop and had a beer. Despite not being very good it was nice.

Today I tried to go with my OG team to the OT (operating theater/room). After standing around waiting in the room for quiet a while right before they were about to drape and prep the patient I got pulled out by the nurse... Apparently the patient was HIV+ and so even though I wasn't scrubbing in I was not able to even be in the room. :( I spent the rest of the time in the labor room after that. It still freaks me out when they cut their huge episiotomies. We were watching one ladies delivery and this woman was tough. No pain meds and then they closed the lacerations that she had and neither Bimpe or I saw them give any local anethesia! There are those though that just can't take the pain (not like I would be able to) and she just would not keep her legs open during the delivery. When the baby actually came out I think that the women had her legs almost together.

Tomorrow more OG and they we are heading out for Pondicherry (Puducherry) which is an old French colony on the coast about 4hrs away.

Covered in sweat and DEET,
Nicolette