FROM 1/18/07:
My parents keep asking me what the food is like here. In fact I believe its been in every email my loving mother has sent. In order to finally appease them and stop deferring my answer till later I will share with you all now our menu.
But first let's talk about the stink. Actually, so far India has smelled much less than I anticipated it would. I had heard from many people and sources that due to trash and hygiene and pollution and sewage issues (in some areas sewage disposal is a cement ditch immediately outside your residence) India would be quite smelly. At times it is and a few times it definitely is -- outside the fair grounds on the way to the hospital there is about a 100 yard stretch where I think vomiting would be inevitable if you stayed too long -- but for the most part, however, India has not smelled too bad. By and large most of the time it smells like any other dusty city aside from an occasional whiff of stink here and there. The only smell that does seem to be just about everywhere is the smell of burning diesel fuel. I would gamble there is not much regulation of automobiles and motorcycles as the streets can be a choky haze at times. So while the aroma of India, or Vellore at least, may not by and large be too great, it is certainly tolerable.
The sounds, on the other hand, are a little bit crazier. There is of course the usual sound of incessant honking to accompany the smell of smog, but the sounds of the city are not too out of the ordinary. It is the sounds of nature that are nutty. The birds, primarily, are the ones out of control. There are growling crows, sonar beeping birds, and what I imagine to be little finches chirping as loud and as fast as they possibly can. Add to that an occasional monkey fight (or sexual encounter possibly) at 11 pm and you have an almost nonstop background chorus in the trees. They do all eventually calm down around 2 or 3 in the morning, but at 4 on comes the Hindu music blared for all to hear over the seemingly invisible but ubiquitous loud speakers. The songs change almost daily, as do their volume, duration, and location, but they are just about always daily. Ear plugs are a must for light sleepers here.
And now, finally, the tastes of India. At first I loved Indian food, it was great, but after almost two weeks of nothing but spicy Indian food I am confident I am ready to move on. It all tastes the same. There is some Chinese food in town which is different, kind of, and the "samozas" do taste a lot like chimichangas, but our options are otherwise pretty much only Indian or Indian. Oh wells, you guys do not care to read my complaints and whines I imagine so instead I'll get on to our eats : (I cannot guarantee by the way that I've spelled anything correctly.)
At the cantina on the CMC campus where we're staying the menu is pretty limited, but it's cheap and tasty. You have your bread type foods like "dosa," a thin, almost crepe like fried bread that I do not particularly care for; "champatthi," a good tortilla like bread; "parotta" a thicker, chunkier bread without easy comparison and my easy favorite; and stuffed "gnon," which is like dosa kind of but usually stuffed with something to make it taste a little better. There's also the "vegetable biriyani" which is basically rice with vegetables and curry, "onion uthapam" which is essentially a pancake with onions in it, and the "egg and cheese sandwich" which is essentially a sandwich with egg and cheese in it. Many of these dishes do not taste too great by themselves, but with the accompanying sauces, or "gravies" as they like to call them, they're usually quite nice. For whatever reason the cantina only serves certain items at certain times so while you can get a vegetable biriyani and ice cream at lunch you cannot at dinner.
If you want meat -- and especially if you want it without a hundred little bones -- you must go off campus, though, in which case you have three main options. Right across from the hospital is China Town, a place that despite its name is pretty good; Hotel Darleeng, which is good but generally slow service; and Hotel Shitabi, which is great and generally has fairly quick service. Here you can get all sorts of chicken, fish, and mutton dishes in a wide variety of sauces. "Chicken Tika Masala" seems very popular amongst our group. I personally think the "Dragon Chicken" is best And the "Devil's Chicken," despite all its bluster, is not too spicy or flavorful. Make sure you order rice or a bread along with the meat dishes, though, or you'll just be eating a small tin of meat with a whole lot of gravy.
As a side note there is also a YWCA cantina on the hospital grounds that is Western friendly, but it's essentially a less nice version of campus cantina previously mentioned.
The drink options are, everywhere, essentially Coke, Sprite, or Fanta with a few places offering Pepsi. There are juices in many places too but they tend to be rather pulpy and so are not really juicy in the typical American sense. The tea is all chai, for the most part pretty good, and I hear the coffee is great too though I do not care for coffee myself. Milk is usually warm.
And deserts? Well, there's ice cream. I like that. Some places offer "lassis" which I have never tried but have been told are sour and absolutely terrible. And there is a guy who bikes around the fair grounds which a huge stack of cotton candy affixed to his ride, but we've never purchased any ourselves. To my knowledge that is about the extent of the desert selection though I kind of have to imagine we're missing something. The campus store is about 40% packaged cookies, though, so there's always the cookie option.
So that is what we have been eating for the last 14 days. I've liked it all, but I cannot wait for a pizza, box of donuts, and cold glass of milk. So, in summary, India is a sometimes smelly, often noisy, and generally tasty place.
And now off to Mamallapuram for the weekend!
Tuesday, March 4, 2008
India Trip: A Meeting with the Devotees
FROM 1/16/08:
So what is it that Amma teaches exactly? Well I believe it can be broken down into two basic precepts. (1) God is love, and (2) for a good time do good unto others. Nothing terribly new or unique there. It should be noted that Amma does not demand obedience, allegiance, or really anything from Her followers, but he does charge for services rendered. (A trend I noticed also in the Jalagandeeswarar Temple at the fort in town. It seems indulgence-esque to me, but perhaps I am just ignorant and/or biased.) Apparently a blessing of the sort we received typically runs a couple hundred rupees, and though a trip around the temple is free the exit is heralded by a large donation area fully capable of accepting Visa, Master Card, and American Express. A good deal of this money does go to charity work, or so the devotees would at least claim, and a good many projects in health care, education, occupational training, and environmental repair have been at least partially funded by Amma (from what I can tell his followers often take all of the credit even if they do not provide all of the funds.) So despite his multimillion dollar temple he himself has done good in the world, and this gets me to wondering....
How much is truth worth? I have always believed that "truth," in as much as it can be obtained, is, to be a bit mundane, priceless. Real progress in the world, in affairs with each other, and in life is, I feel, only possible with the constant upholding of truth. Both knowledge and intimacy are dependent on it being sacrosanct. With such in mind inaccuracies, falsehoods, and lies such as Amma's, no matter how well intended or charitable they may be, should always be resisted and exposed for what they are. We do not necessarily have to be aggressive or belligerent about it -- and it is certainly advisable to cognizant of the appropriate time and place for such matters -- but while momentary toleration may at times be prudent ideas that are inherently false should never be accepted as equal with the truth. But then again I am not starving. I am not sick. I am not without shelter, water, or clothes. I do not stand to greatly benefit from the charities of these organizations. Championing truth is easy when it comes cheap, and so I wonder if in other shoes I would care if my caretakers are crazy out of their mind. When people are the world over suffering perhaps it is more important to be kind than correct. For the long term advancement of the world and mankind I am still inclined to disagree, but maybe I am wrong. Maybe India will teach me otherwise.
Initially I had planned to write every two or three days. Long enough to not be spending all my time on the computer but not so long that each entry became excessive and tedious. This week I will make an exception because this week, Monday, I met with God.
I do not mean I met with God in a personalized, spiritual sense. And I do not mean that I met with God in a mysterious or metaphysical sense. Rather, I actually walked up to God after a brief wait in line, and She handed me a scoop of holy water. Realizing that it is not every day one meets in person the divine I figured it would be good to squeeze in a few extra blog entries for the week. So now, too, through my hopefully supernaturally inspired fingers you also can have an idea of what it is like to know God. Or as She likes to be called: Amma.
- disclaimer -
It is likely that bringing up the topic of religion will result in my stepping on some people's toes. It is also likely that in this particular case I may dance on a great many toes. I am admittedly ignorant about a great deal of the intricacies of Eastern religion, and I am also admittedly inclined to be skeptical of the supernatural both in its ancient and newer manifestations, but I am going to go ahead and, from what I do know, say that Amma and her devotees are, straight up, a cult. I understand that for some if not a significant portion of Hindus such gurus are a significant and real part of their faith, but seriously people, Amma and her devotees are as cultish as you get without a sizable arms cache. I am sorry if this offends anyone, but even more sorry that anyone would find this offensive.
- disclaimer -
So back to the story. Looking for things to do in Vellore is not an easy task as it is a relatively small, relatively rural town. The fort was nice, and I enjoyed visiting the temple, but that, it seemed, was about all there was to do tourist wise aside from shopping. Until someone told us about the Golden Temple that is. Just 5 km outside of Vellore was India's largest golden temple, and, yes, by golden temple I do mean the temple is covered in actual gold. In this case about 1.2 or 1.5 tons of it. Not sure of the actual number, but when you start talking about gold in tonnage I don't imagine the decimal points really matter. The temple is composed mostly of other material and copper of course, but all of it, just about every square inch, is covered with at least 6 layers of gold foil that have been intricately plated on. We're getting ahead of ourselves, though, so I'll return to the beginning.
Upon hearing of this golden temple, actually more formally known as Sri Puram Golden Temple, we decided we had to go. Conveniently that Monday Rachel, Paul, Rebecca, and I had the afternoon off from CHAD. As we had been told it was a couple hour ordeal we decided that now was the time, and so, after obtaining for ourselves a few autorichshaws, off we went. About a 15 minute bumpy ride through the outskirts of town later we were there though from the outer perimeter walls we could not really see anything yet. It was only after we dispensed with our shoes (as you are to do in all Hindu temples I believe) and Rebecca's camera (cameras and phones are banned as they detract from the spirituality of the experience) that we were able to get in the first cordon of walls and begin the actual experience of Amma and Her Golden Temple.
I do not mean I met with God in a personalized, spiritual sense. And I do not mean that I met with God in a mysterious or metaphysical sense. Rather, I actually walked up to God after a brief wait in line, and She handed me a scoop of holy water. Realizing that it is not every day one meets in person the divine I figured it would be good to squeeze in a few extra blog entries for the week. So now, too, through my hopefully supernaturally inspired fingers you also can have an idea of what it is like to know God. Or as She likes to be called: Amma.
- disclaimer -
It is likely that bringing up the topic of religion will result in my stepping on some people's toes. It is also likely that in this particular case I may dance on a great many toes. I am admittedly ignorant about a great deal of the intricacies of Eastern religion, and I am also admittedly inclined to be skeptical of the supernatural both in its ancient and newer manifestations, but I am going to go ahead and, from what I do know, say that Amma and her devotees are, straight up, a cult. I understand that for some if not a significant portion of Hindus such gurus are a significant and real part of their faith, but seriously people, Amma and her devotees are as cultish as you get without a sizable arms cache. I am sorry if this offends anyone, but even more sorry that anyone would find this offensive.
- disclaimer -
So back to the story. Looking for things to do in Vellore is not an easy task as it is a relatively small, relatively rural town. The fort was nice, and I enjoyed visiting the temple, but that, it seemed, was about all there was to do tourist wise aside from shopping. Until someone told us about the Golden Temple that is. Just 5 km outside of Vellore was India's largest golden temple, and, yes, by golden temple I do mean the temple is covered in actual gold. In this case about 1.2 or 1.5 tons of it. Not sure of the actual number, but when you start talking about gold in tonnage I don't imagine the decimal points really matter. The temple is composed mostly of other material and copper of course, but all of it, just about every square inch, is covered with at least 6 layers of gold foil that have been intricately plated on. We're getting ahead of ourselves, though, so I'll return to the beginning.
Upon hearing of this golden temple, actually more formally known as Sri Puram Golden Temple, we decided we had to go. Conveniently that Monday Rachel, Paul, Rebecca, and I had the afternoon off from CHAD. As we had been told it was a couple hour ordeal we decided that now was the time, and so, after obtaining for ourselves a few autorichshaws, off we went. About a 15 minute bumpy ride through the outskirts of town later we were there though from the outer perimeter walls we could not really see anything yet. It was only after we dispensed with our shoes (as you are to do in all Hindu temples I believe) and Rebecca's camera (cameras and phones are banned as they detract from the spirituality of the experience) that we were able to get in the first cordon of walls and begin the actual experience of Amma and Her Golden Temple.
Before we could get our first glimpses of it all, however, we had to walk through an extensive series of lines. Thankfully today was a relatively light day and the lines were not nearly as long as they could sometimes be so within a few minute we were to the cages where visitors must amass before their final entrance to the temple complex itself. Here, in one of three or four holding cells, we waited with about 200+ Indians for our turn to make the trek. I am under the understanding that we are sequestered there momentarily to prevent an overwhelming deluge of people onto the temple grounds at any one time, but I am not sure. Whatever the reason we sat in metal chairs surrounded by huge metal fences for about 10 minutes before being allowed in. In order to begin to awaken our souls to the cosmic forces further within -- and likely to make it feel less like a prison holding cell -- the area was surrounded with pictures of Amma and Her cohorts and various quotes and sayings primarily from Amma herself.
Once we got through the metal detectors and x-rays we got into the temple grounds itself and it was, quite literally, a bit hard to describe. It all seemed very, very similar, and yet very, very different. It looked like a theme park, and yet felt nothing like one. The entrance was a long, stone, immaculately clean path split in two by an elaborate series of water fountains and falls. Everything was landscaped and tidy. At the end of about 70 or 80 yards of the entrance walkway the path veered abruptly left in the beginning turns of what would eventually be a Star of David design (a very spiritually charged shape we were later told.) The path itself was covered by a colorfully painted awning and on either side of the path the vedic and Amma quotes continued. We later found out that you are supposed to walk this path in silence and contemplation, but we did it as noisy, American tourists chattering amongst ourselves. I was not particularly attentive of the other visitors, but I am pretty sure we were actually not the only ones talking, though. Anyway, after about 15 minutes of walking with 85% of the star complete we made it to a separate path, again with water fountains and falls, which finally took us into the center of the star and to the golden temple itself.
Once we got through the metal detectors and x-rays we got into the temple grounds itself and it was, quite literally, a bit hard to describe. It all seemed very, very similar, and yet very, very different. It looked like a theme park, and yet felt nothing like one. The entrance was a long, stone, immaculately clean path split in two by an elaborate series of water fountains and falls. Everything was landscaped and tidy. At the end of about 70 or 80 yards of the entrance walkway the path veered abruptly left in the beginning turns of what would eventually be a Star of David design (a very spiritually charged shape we were later told.) The path itself was covered by a colorfully painted awning and on either side of the path the vedic and Amma quotes continued. We later found out that you are supposed to walk this path in silence and contemplation, but we did it as noisy, American tourists chattering amongst ourselves. I was not particularly attentive of the other visitors, but I am pretty sure we were actually not the only ones talking, though. Anyway, after about 15 minutes of walking with 85% of the star complete we made it to a separate path, again with water fountains and falls, which finally took us into the center of the star and to the golden temple itself.
The golden temple was, in and of itself, nothing entirely remarkable. It was a ring around a water filled area with another more central area inside the moat where the various Hindu rituals actually took place. The outer ring was like the path before, stone and painted wood, while the inner area was, as mentioned before, almost completely fashioned out of gold leaf. The pillars, the statues, the ceilings, and roof were all gold. It is hard to describe the dimensions, but it would have been a relatively large house in India if that is at all a helpful comparison. (And likely not.) There were also some, in my opinion, rather gaudy glass chandeliers hanging intermittently from the gold ceiling, but most everything was glinting, shining gold. There were a few people who for whatever reason had been given access to this inner area and at the most extreme end of the temple where the open air, pillar supported area gave way to a small also golden room there was some sort of swami character performing the daily pujas to better the world. He was not golden as far as I could tell.
The temple, for all its glory, was not where the real fun began, however. That came with our visit to the information center/gift shop. As we were not allowed to take photos we needed to find something with a picture that we could share with others so the gift shop seemed a good place to start. As we approached we noticed through the windows there was a white woman inside, and usually where there're white women there is easily understood English so we were excited. We began talking to her, and she did indeed speak excellent English, but within a few minutes if not seconds her excitement level kicked up a notch. "Would you like a chance to receive a blessing from Amma?!" "Amma what?" "Come there's little time. I was just about to head over there myself to receive the blessing he is such a nice man you are so lucky to have come at this time so feel people receive such an opportunity..." and so on and so forth. As she spoke quickly, friendly, and was already headed out the door we, somewhat confused, headed out after her. We crossed the street, bypassed a few lines and pushed through a few others, and finally arrived at a separate, smaller, less golden temple a little ways away.
In this comparatively boring temple we were introduced to her husband. He was a family practice physician in Canada, and she, it turned out, had a variety of PhDs in a variety of things including world religion. These Canadians were the first of a few "devotees" we were to meet and who, after experiencing a variety of miracles/magic tricks, began to believe in this Goddess called Amma. In preparation for meeting with this deity we were instructed to cup our left hand under our right, receive the blessing -- which in this case took the form of spiced water --, take a sip, and pour the rest over our heads. If Amma chose to speak to us we could certainly talk back if not initiate the conversation ourselves, but with little time to think of what to say to God in man's form we were before Her receiving our blessings. The Canadian women gave us a brief introduction which seemed to have slightly startled the otherwise tranquil Amma and, though I cannot remember who he asked this to as its blurry and he spoke softly, I believe he asked us how we were liking India. (Yes I went from "she" to "he" here, but, well, the goddesses -- there's three in all that compose the goddess that incarnated herself as Amma -- decided to take the form of a 31 year old man.) I myself said nothing to him as he was saying to us all that he hoped we enjoyed our stay when I was before him, but I simply took my blessing, sipped the surprisingly tasty water, and then poured the remaining amount over my head but mostly over my forehead. And that concluded our meeting with Amma the man goddess.
After all was through and the curtains had been drawn, we reunited with the Canadians. They told us Amma had apparently liked us as he had ordered them to give us these thin yellow booklets which were allegedly only very rarely given out. The books contained a reiteration of the quotes which surrounded the complex along with a little more information and some pictures. Thanks, I guess. The Canadians then proceeded to share with us the history and wisdom of Amma while we waited for our books, but we were all interrupted by Rebecca's startled cry of, "Oh my god is than an elephant?!" It was indeed an elephant, the temple elephant apparently, and within a few minutes were we feeding it and receiving its blessing as well -- which consists of it rubbing its trunk all over your head and face. We were honored, and then promptly all offered tea and the Western guest complex.
The complex, or compound perhaps, was a walled, guarded, and very clean dorm area full of various Westerners dressed up in traditional Indian clothes. Although we'd seen many white women in Indian garb as it seems to be a popular thing to do, this was the first time I saw white men in Indian dress as even many Indian men have traded theirs for European clothes and fashion. Perhaps my hardened heart colored my gaze, but I think we all definitely got a weird vibe from the place. Here we met one or two more devotees, who too seemed a little off and not terribly friendly, but spent most of our time with the Canadian physician and a pot of chai tea. The tea was great, but the conversation I felt got a little old after a while. I care only to spend so much of my day discussing the intricacies of what seemed to be a relatively simple theology dependent on the complete suspension of disbelief with regards to the life, times, and teachings of one otherwise ordinary seeming man. The others in our group, probably less scornful and more inquisitive than myself, pressed the conversation further, however, but within another hour or two our tea was gone, dinner was advancing, and we had to return to town. The Canadian gentleman gave us a quick tour of the complex's roof and surrounding area, and we concluded our time with Amma and his devotees.
So what is it that Amma teaches exactly? Well I believe it can be broken down into two basic precepts. (1) God is love, and (2) for a good time do good unto others. Nothing terribly new or unique there. It should be noted that Amma does not demand obedience, allegiance, or really anything from Her followers, but he does charge for services rendered. (A trend I noticed also in the Jalagandeeswarar Temple at the fort in town. It seems indulgence-esque to me, but perhaps I am just ignorant and/or biased.) Apparently a blessing of the sort we received typically runs a couple hundred rupees, and though a trip around the temple is free the exit is heralded by a large donation area fully capable of accepting Visa, Master Card, and American Express. A good deal of this money does go to charity work, or so the devotees would at least claim, and a good many projects in health care, education, occupational training, and environmental repair have been at least partially funded by Amma (from what I can tell his followers often take all of the credit even if they do not provide all of the funds.) So despite his multimillion dollar temple he himself has done good in the world, and this gets me to wondering....
How much is truth worth? I have always believed that "truth," in as much as it can be obtained, is, to be a bit mundane, priceless. Real progress in the world, in affairs with each other, and in life is, I feel, only possible with the constant upholding of truth. Both knowledge and intimacy are dependent on it being sacrosanct. With such in mind inaccuracies, falsehoods, and lies such as Amma's, no matter how well intended or charitable they may be, should always be resisted and exposed for what they are. We do not necessarily have to be aggressive or belligerent about it -- and it is certainly advisable to cognizant of the appropriate time and place for such matters -- but while momentary toleration may at times be prudent ideas that are inherently false should never be accepted as equal with the truth. But then again I am not starving. I am not sick. I am not without shelter, water, or clothes. I do not stand to greatly benefit from the charities of these organizations. Championing truth is easy when it comes cheap, and so I wonder if in other shoes I would care if my caretakers are crazy out of their mind. When people are the world over suffering perhaps it is more important to be kind than correct. For the long term advancement of the world and mankind I am still inclined to disagree, but maybe I am wrong. Maybe India will teach me otherwise.
If, despite all I have said, you too wish to become a devotee of Amma you can find more information here. If you'd like spiritual emancipation with less effort, though, just send me 500 rupees and I'll spend it on something nice. For the world I mean. Something real nice.
India Trip: Some Cases and a Fort
FROM 1/14/08:
As stated previously this last Friday completed my time with the Internal Medicine II team. Although there was a lot of time spent standing or sitting around waiting for things that never seemed to take place, a common event it seems here in India, there were a few brief moments of extreme education here and there. I got to see things I'd never seen -- and I'd gamble many physicians in the US have never seen -- in quick one hour spurts during rounds with the individual medicine subteams. I cannot go into great detail unfortunately as much of the time I was not privy to such detail not being fluent in Hindi or Tamil, but I can give you all a taste of what I saw.
For starters, I saw lots of diabetes. This obviously is not terribly different from San Antonio, but I mention it because of how unexpected it was. Much like diabetes type 2 was relatively uncommon a few decades ago in the US, the progressive Westernization and, more importantly, increased processing and access of foods in India has lead to a significant increase in their own incidence of the disease. Many have speculated that, like many subgroups in the Hispanic population, having adapted to a relatively meager diet for centuries the Indian people are particularly prone to developing insulin resistance in response to a surge of refined sugars in their diets. Thus India has been introduced to the world of diabetes. It almost made me feel at home again.
With diabetes of course comes heart attacks and strokes. Not surprisingly Indian heart attacks and strokes are much like American strokes.
Now we get to the good stuff.
DRESS. Never heard of it -- initially doubtful it really existed -- but DRESS (or Drug Rash with Eosinophilia and Systemic Symptoms) is, as its name would suggest, a violent reaction in response to the administration of certain drugs. In our patient's case it was some antibiotic he got from who knows where, and he responded with airway narrowing, significant angioedema, hepatic enzyme elevation, and, of course, a rash. I am still not terribly sure how it differs greatly from a generic anaphylactic reaction, but DRESS does sound much more dreadful. Acronyms are scary.
Scrub Typhus. Ooh, exotic. A rickettsial illness that, like apparently all rickettsial illnesses, cleans up quite nice with doxycycline, and is associated with relapsing fevers and chigger bites. According to the doctors at CMC it is also associated with an eschar (funky looking scab) that 95 - 99% of the time tells you it is scrub typhus. Now that I look at how to spell Rickettsia I have learned that the bug has been renamed Orientia tsutsugamushi. You know, just so there's no confusion.
Typhoid. Typhus would not be complete without its close sounding but completely unrelated friend typhoid and so my patients obliged. We had to go to the isolation ward to see this guy. He was infected with Salmonella typhi, and, well, there really isn't much else to say about it. The problem with not getting much in the way of a patient history on rapid rounds with the doctors is that all the patients have nice name tags attached to their illnesses, but when you look at them they just look like sick people. Being transmitted through the fecal-oral route there were no cool eschars to see so, aside from looking unhappy, this guy did not appear too out of the ordinary. Nevertheless I was thankful for my oral typhoid vaccine.
Last interesting case that I can remember and care to share: organophosphate poisoning. For those not in the know -- and a pity you are not -- organophosphates are major components of many industrial pesticides. Combine this and ready access in developing nations with the compounds' cholinergic affects and you have a great way to attempt suicide. Or so many people seem to feel. Such was the case with this young man. As usual I was not able to get much in the way of a history from this guy as I saw him only briefly during Grand Rounds, but he had apparently ingested a large amount of it and properly gone comatose. We gave him a healthy dose of atropine (an anti-cholinergic) and by the end of the day he was awake and fairly normal again. It is an interesting side note that suicide in India, like many other developing nations, has only increased significantly with its recent industrialization. Make of that what you will.
I also saw some malaria, some tuberculosis, some connective tissue disease and rheumatoid arthritis, but, honestly, I do not care to comment about them. I either did not get enough information to say much or I do not think they make for the best stories.
But this week comes CHAD (Community Health And Development!) I'll go more into this amazing project later -- and like much of the rest of CMC I do believe it is worthy of the adjective "amazing" -- but for now I'll simply wrap up with a short summary of our weekend.
Saturday we went to see the 16th Century fort, if I remember correctly, that came to be occupied over time by a wide variety of Indian kingdoms, empires, and, finally, the British. Eventually like most forts it became obsolete and so has become instead a store house for a wide variety of government programs and buildings including a number of museums -- if I may be so generous with the term -- a university, and a police academy of sorts. The highlight of the museums? The giant, green T-Rex statue out front. They were otherwise like the Dubai Museum but without the mannequins. A few artifacts here and there, but little in the way of descriptions, history, or impressive appearance. There was also a Hindu temple on the grounds, the Jalagandeeswarar Temple, which we were unfortunately unable to take pictures of, but I will hopefully be able to describe in detail in my next post. For now let me just say it was... uhh... interesting? Back to the fort, though. It was big and impressive, but being stripped of most its features there is not much to write about.
Sunday we took a quick hike up a nearby granite cliff. Being around 12 noon it was a bit hot and a bit hazy, but it was about a 25 minute hike at leisurely speeds, and so was not very taxing. It was fun to be outside, though, and the view of the city and surrounding tropical green areas was nevertheless very nice. It looked a great deal like Enchanted Rock outside Fredericksburg in Texas I felt, and I longed for my climbing shoes. Amazing how geography and geology can be so similar thousands of miles away.
The last of the weekend was spent doing the American thing. After the girls moved into the Johnson House (completing their move out of the roach friendly new building) we discovered a television and proceeded to make use of it. There were a surprisingly large amount of English channels, and, as it was late at night and we had nothing else to do, we watched When A Stranger Calls on Indian HBO. For those of you not familiar with the movie it's about an hour and a half of phone calls followed by a 5 minute chase to close the movie out. Even for those removed of a TV for a week it made for a pretty crummy movie night, but it was relaxing, though, and nice to be free temporarily from the constant churning of Indian life.
As stated previously this last Friday completed my time with the Internal Medicine II team. Although there was a lot of time spent standing or sitting around waiting for things that never seemed to take place, a common event it seems here in India, there were a few brief moments of extreme education here and there. I got to see things I'd never seen -- and I'd gamble many physicians in the US have never seen -- in quick one hour spurts during rounds with the individual medicine subteams. I cannot go into great detail unfortunately as much of the time I was not privy to such detail not being fluent in Hindi or Tamil, but I can give you all a taste of what I saw.
For starters, I saw lots of diabetes. This obviously is not terribly different from San Antonio, but I mention it because of how unexpected it was. Much like diabetes type 2 was relatively uncommon a few decades ago in the US, the progressive Westernization and, more importantly, increased processing and access of foods in India has lead to a significant increase in their own incidence of the disease. Many have speculated that, like many subgroups in the Hispanic population, having adapted to a relatively meager diet for centuries the Indian people are particularly prone to developing insulin resistance in response to a surge of refined sugars in their diets. Thus India has been introduced to the world of diabetes. It almost made me feel at home again.
With diabetes of course comes heart attacks and strokes. Not surprisingly Indian heart attacks and strokes are much like American strokes.
Now we get to the good stuff.
DRESS. Never heard of it -- initially doubtful it really existed -- but DRESS (or Drug Rash with Eosinophilia and Systemic Symptoms) is, as its name would suggest, a violent reaction in response to the administration of certain drugs. In our patient's case it was some antibiotic he got from who knows where, and he responded with airway narrowing, significant angioedema, hepatic enzyme elevation, and, of course, a rash. I am still not terribly sure how it differs greatly from a generic anaphylactic reaction, but DRESS does sound much more dreadful. Acronyms are scary.
Scrub Typhus. Ooh, exotic. A rickettsial illness that, like apparently all rickettsial illnesses, cleans up quite nice with doxycycline, and is associated with relapsing fevers and chigger bites. According to the doctors at CMC it is also associated with an eschar (funky looking scab) that 95 - 99% of the time tells you it is scrub typhus. Now that I look at how to spell Rickettsia I have learned that the bug has been renamed Orientia tsutsugamushi. You know, just so there's no confusion.
Typhoid. Typhus would not be complete without its close sounding but completely unrelated friend typhoid and so my patients obliged. We had to go to the isolation ward to see this guy. He was infected with Salmonella typhi, and, well, there really isn't much else to say about it. The problem with not getting much in the way of a patient history on rapid rounds with the doctors is that all the patients have nice name tags attached to their illnesses, but when you look at them they just look like sick people. Being transmitted through the fecal-oral route there were no cool eschars to see so, aside from looking unhappy, this guy did not appear too out of the ordinary. Nevertheless I was thankful for my oral typhoid vaccine.
Last interesting case that I can remember and care to share: organophosphate poisoning. For those not in the know -- and a pity you are not -- organophosphates are major components of many industrial pesticides. Combine this and ready access in developing nations with the compounds' cholinergic affects and you have a great way to attempt suicide. Or so many people seem to feel. Such was the case with this young man. As usual I was not able to get much in the way of a history from this guy as I saw him only briefly during Grand Rounds, but he had apparently ingested a large amount of it and properly gone comatose. We gave him a healthy dose of atropine (an anti-cholinergic) and by the end of the day he was awake and fairly normal again. It is an interesting side note that suicide in India, like many other developing nations, has only increased significantly with its recent industrialization. Make of that what you will.
I also saw some malaria, some tuberculosis, some connective tissue disease and rheumatoid arthritis, but, honestly, I do not care to comment about them. I either did not get enough information to say much or I do not think they make for the best stories.
But this week comes CHAD (Community Health And Development!) I'll go more into this amazing project later -- and like much of the rest of CMC I do believe it is worthy of the adjective "amazing" -- but for now I'll simply wrap up with a short summary of our weekend.
Saturday we went to see the 16th Century fort, if I remember correctly, that came to be occupied over time by a wide variety of Indian kingdoms, empires, and, finally, the British. Eventually like most forts it became obsolete and so has become instead a store house for a wide variety of government programs and buildings including a number of museums -- if I may be so generous with the term -- a university, and a police academy of sorts. The highlight of the museums? The giant, green T-Rex statue out front. They were otherwise like the Dubai Museum but without the mannequins. A few artifacts here and there, but little in the way of descriptions, history, or impressive appearance. There was also a Hindu temple on the grounds, the Jalagandeeswarar Temple, which we were unfortunately unable to take pictures of, but I will hopefully be able to describe in detail in my next post. For now let me just say it was... uhh... interesting? Back to the fort, though. It was big and impressive, but being stripped of most its features there is not much to write about.
Sunday we took a quick hike up a nearby granite cliff. Being around 12 noon it was a bit hot and a bit hazy, but it was about a 25 minute hike at leisurely speeds, and so was not very taxing. It was fun to be outside, though, and the view of the city and surrounding tropical green areas was nevertheless very nice. It looked a great deal like Enchanted Rock outside Fredericksburg in Texas I felt, and I longed for my climbing shoes. Amazing how geography and geology can be so similar thousands of miles away.
The last of the weekend was spent doing the American thing. After the girls moved into the Johnson House (completing their move out of the roach friendly new building) we discovered a television and proceeded to make use of it. There were a surprisingly large amount of English channels, and, as it was late at night and we had nothing else to do, we watched When A Stranger Calls on Indian HBO. For those of you not familiar with the movie it's about an hour and a half of phone calls followed by a 5 minute chase to close the movie out. Even for those removed of a TV for a week it made for a pretty crummy movie night, but it was relaxing, though, and nice to be free temporarily from the constant churning of Indian life.
India Trip: What in the Heck?
FROM 1/12/08:
As expected India has much of the unexpected. The most surprising of which occurred this last night during a concert at the Winter Symposium (a series of cardiology lectures given by various distinguished physicians and PhDs). The singer whose name I can no longer remember was billed as having "the voice of an angel," and he chose to share this heavenly gift by covering a variety of American songs including Green Day, The Police, Bob Marley, and, best of all, Billy Ray Cyrus. All this was done while he hopped and kicked his away across the stage. The audience reviews were mixed and even now I myself am not quite sure what to make of it all, but I will surely not get "Achy Breaky Heart" out of my head anytime soon.
American songs sung with Hindi accents aside, what has also been interesting is the curious head shake many Indians use to communicate. It is basically an abbreviated "no" with less rotation at the neck and more side to side lateral movement of the head. It seems to communicate everything from, "I hear you" to "yes, ok" to "I'm shaking my head though I've clearly not understood a word you just spoke to me." I did not actually notice it myself at first, but after it was pointed out by other students on the trip it became readily obvious as just about everyone seems to do it.
An unfortunate thing that I was not expecting has been the general distaste for making change and the even greater distaste for giving coins in change which is particularly problematic as many of the ATMs give only large impractical to use bills. My ticket may be 41 rupees but they will only grudgingly accept a 50. "Nope. 41 rupees," they'll say. "Give me 1 more rupee." "But I can't, you guys never give me change." "Ok, then give me 45 rupees." "I don't have any 5's either!" Today I believe I said my first words in anger for the trip as, running down to only 500 and 1000 rupee bills, the local minimart clerk refused to cash a 500. I do not understand what the source of this financial problem is, but it does agitate me sometimes. And sometimes a lot.
An at times annoying thing that I was unaware of until arriving has been the fact that the concept of a line does not exist here. Only pushing mobs. It does not matter if you are standing immediately behind someone placing an order for food and the two of you are the only ones in the area. As soon as that person is done ordering another person will come around the corner, immediately thrust themselves forward, stick out some cash, and proceed to place their own order. Unlike the change issue this does not bother me as much as it does others on our trip, but I often wonder what the source of the problem is. Do they not realize we were waiting to order? Do they not care? Is it such a nonissue here that they do not even think to care?
So some other things...
It seems the vast majority of the population does in fact use their left hand to wipe themselves after the restroom. I guess it saves trees. And spreads enteric fever....
It also seems the vast majority of the population uses their hands to eat (though predominately the right for the above reason.) Seeing as much of their diet consists of rice it is a curious sight seeing a man and woman sitting with grains of rice sticking up their forearms. As silverware is often difficult to come by at some restaurants I too have taken to eating with my hands -- which I honestly get a secret joy out of -- but as I am left handed I frequently use it primarily without thinking. I can only wonder what the Indians think of that.
And then there's the trash. The world is India's trash can it seems. Even on the relatively clean and Westernized medical school campus where a few trash cans do exist, people will step outside their place and gingerly throw a plastic cup down onto a heap of debris immediately adjacent to their porch steps. I have given it a fair amount of thought and am yet still at a loss as to why they do this. Is it cultural and just what they have always done? Is it personal and they each just individually do not care? Does trash in huge sums not bother them? Is it because the government does not provide waste disposal? Is it because the Indian people as a nation have other things to worry about? Truthfully I cannot conceive what an India without trash would look like. Even more beautiful I imagine.
Trash and change and hygiene aside, beyond some occasional irking the cultural differences have not troubled me too much. Really such things are surprising only in that I am finally seeing them in practice. The trip by and large continues to be an enjoyable and unique experience. Work yesterday was cancelled for the previously mentioned Winter Symposium thus completing my week of Internal Medicine II. I attended a few of the lectures, but they always seem to be too narrow in scope to be of practical use. Or so it seems to my simple medical student mind. They had a traditional Indian dance presentation on Thursday too, and that was nice. Hopefully I can load a video of that when I return.
As expected India has much of the unexpected. The most surprising of which occurred this last night during a concert at the Winter Symposium (a series of cardiology lectures given by various distinguished physicians and PhDs). The singer whose name I can no longer remember was billed as having "the voice of an angel," and he chose to share this heavenly gift by covering a variety of American songs including Green Day, The Police, Bob Marley, and, best of all, Billy Ray Cyrus. All this was done while he hopped and kicked his away across the stage. The audience reviews were mixed and even now I myself am not quite sure what to make of it all, but I will surely not get "Achy Breaky Heart" out of my head anytime soon.
American songs sung with Hindi accents aside, what has also been interesting is the curious head shake many Indians use to communicate. It is basically an abbreviated "no" with less rotation at the neck and more side to side lateral movement of the head. It seems to communicate everything from, "I hear you" to "yes, ok" to "I'm shaking my head though I've clearly not understood a word you just spoke to me." I did not actually notice it myself at first, but after it was pointed out by other students on the trip it became readily obvious as just about everyone seems to do it.
An unfortunate thing that I was not expecting has been the general distaste for making change and the even greater distaste for giving coins in change which is particularly problematic as many of the ATMs give only large impractical to use bills. My ticket may be 41 rupees but they will only grudgingly accept a 50. "Nope. 41 rupees," they'll say. "Give me 1 more rupee." "But I can't, you guys never give me change." "Ok, then give me 45 rupees." "I don't have any 5's either!" Today I believe I said my first words in anger for the trip as, running down to only 500 and 1000 rupee bills, the local minimart clerk refused to cash a 500. I do not understand what the source of this financial problem is, but it does agitate me sometimes. And sometimes a lot.
An at times annoying thing that I was unaware of until arriving has been the fact that the concept of a line does not exist here. Only pushing mobs. It does not matter if you are standing immediately behind someone placing an order for food and the two of you are the only ones in the area. As soon as that person is done ordering another person will come around the corner, immediately thrust themselves forward, stick out some cash, and proceed to place their own order. Unlike the change issue this does not bother me as much as it does others on our trip, but I often wonder what the source of the problem is. Do they not realize we were waiting to order? Do they not care? Is it such a nonissue here that they do not even think to care?
So some other things...
It seems the vast majority of the population does in fact use their left hand to wipe themselves after the restroom. I guess it saves trees. And spreads enteric fever....
It also seems the vast majority of the population uses their hands to eat (though predominately the right for the above reason.) Seeing as much of their diet consists of rice it is a curious sight seeing a man and woman sitting with grains of rice sticking up their forearms. As silverware is often difficult to come by at some restaurants I too have taken to eating with my hands -- which I honestly get a secret joy out of -- but as I am left handed I frequently use it primarily without thinking. I can only wonder what the Indians think of that.
And then there's the trash. The world is India's trash can it seems. Even on the relatively clean and Westernized medical school campus where a few trash cans do exist, people will step outside their place and gingerly throw a plastic cup down onto a heap of debris immediately adjacent to their porch steps. I have given it a fair amount of thought and am yet still at a loss as to why they do this. Is it cultural and just what they have always done? Is it personal and they each just individually do not care? Does trash in huge sums not bother them? Is it because the government does not provide waste disposal? Is it because the Indian people as a nation have other things to worry about? Truthfully I cannot conceive what an India without trash would look like. Even more beautiful I imagine.
Trash and change and hygiene aside, beyond some occasional irking the cultural differences have not troubled me too much. Really such things are surprising only in that I am finally seeing them in practice. The trip by and large continues to be an enjoyable and unique experience. Work yesterday was cancelled for the previously mentioned Winter Symposium thus completing my week of Internal Medicine II. I attended a few of the lectures, but they always seem to be too narrow in scope to be of practical use. Or so it seems to my simple medical student mind. They had a traditional Indian dance presentation on Thursday too, and that was nice. Hopefully I can load a video of that when I return.
India Trip: Monkeys Among Us
FROM 1/9/08:
Much as many cities of the United States are riddled with chipmunks and squirrels, the cities of India are swarming with monkeys. Although informed of their presence upon our arrival, we did not actually see any until yesterday morning when about a dozen of them commenced to migrate from one group of trees to another to do whatever it is monkeys do. We were also told not to try and befriend them as as charming as monkeys may seem, to some people at least, these are actually thieving monkeys. And they bite too. Or so the rumors go. Who knows what they're actually capable of, but I will keep my distance unless one of the little guys forces my hand. Until then, live and let live.
Speaking of monkeys, though, I myself am about to start throwing poo at some people after two days of my Internal Medicine II service. We created our schedules Monday, but it seems that is about as deep as the organization goes in this elective as I have been only given a sheet of paper with times and locations and nothing else. While that may seem sufficient, and I myself would normally be inclined to think so, I must also add that many of the activities are missing, many of the activities I am in fact not intended to go to, and when I do show up I have no idea what, if anything, I am supposed to do. That last statement goes double for the residents as whenever I ask them where I should go or what I should do I can just about guarantee I will get two different answers from two different people. Confusion was mildly frustrating but acceptable on my own in Dubai when I wasn't supposed to be doing anything in particular. Now that I am it is getting rather annoying. I would not care to only attend rounds a few hours a day, and they are quite nice rounds, but at least say that that is all that is expected. Asking too much? Quite possibly so.
Since I briefly mentioned that I am the Internal Medicine II service I will go ahead and post the rest of my clinical schedule for the next three weeks.
This week (07 Jan - 12 Jan): Internal Medicine II
Plain old internal medicine and rheumatic disease (like arthritis and lupus and stuff.)
Next week (14 Jan - 19 Jan): CHAD [Community Health something or other]
A community outreach program that takes the clinic to the surrounding areas.
Last week (21 Jan - 26 Jan): Internal Medicine I
Plain old internal medicine and infectious disease (hurray!)
Back to rounds, though, they are generally the only real education packed parts of my day, and they are generally over with in an hour. They occur just like rounds in the states but typically with much worse pathology. We go from bed to bed with the residents and the attending (or registrar as they seem to be called here) and briefly discuss each patient and the plan. Although I frequently do not hear much of what is said during Grand Rounds (all the teams together), as they speak rather softly, and I frequently do not understand much of what is said during normal rounds, as I just cannot seem to deal with the India accent sometimes, they are interesting. Where else would I see bacterial endocarditis, malaria, scrub typhus, typhoid, and organophosphate poisoning? And only in two days at that. They almost make up for the fact that I usually then spend the following two or three hours sitting around the hospital reading or staring until the next random activity.
As I am on the topic of medicine I will also just pause to say that the CMC Hospital is amazing. It's like an entire medical compound. Imagine a dusty, 1950s looking version of the Houston medical center. There are a few really nice, modern facilities, but most are fairly old and jam packed with desks, beds, and people. On the ward I am currently on there is about 3 feet between each iron frame bed and easily 12+ patients along each side of the wall separated only by what appears to be a shower curtain. There are a few more private rooms and obviously some isolation rooms, but by and large the amount of space allotted to a patient and his visitors is about the size of many small apartment kitchens. It seems they expect and are used to such conditions, however, as I am not aware of any complaints, but it is definitely medicine as I envisioned it being practiced about 50 years ago at least in regards to the facilities. The quality of the care, on the other hand, is, as far as I can tell, amazingly high in light of the undoubtedly few resources available. India for all its growth is still a poor country and the needs are ever many so the fact that they can provide top of the line medicine, CT scans, chemotherapy, and the like in such a setting is something I feel worthy of envy. CMC is an amazing place and I cannot wait to share some photos when I am able to load them back in the good ol' USofA.
And while I am on the topic of amazing things I will add the CMC campus itself. Amazing may perhaps be too strong a term, but it is quite lovely. Very green and pleasant. I know I discussed it briefly earlier as a camp setting, and it is, but it is kind of a early 1900s British colonial India camp setting. Lots of old stone buildings with thick panes of glass separated by slightly overgrown gardens. In as much as the legacies of empire can be a good thing, this is a nice place.
Meanwhile life goes on. Rachel and Rebecca moved from their roach infested squatter's roost to a much larger and nicer place similar to mine and Paul's. Luggagewise, Paul and Rachel have both finally received theirs and Rebecca is expecting hers tomorrow. There's a 50/50 chance her toiletries will be missing. No signs of traveler's diarrhea or typhoid as of yet. No histrionic longings for home. No trips to Indian jail.
Much as many cities of the United States are riddled with chipmunks and squirrels, the cities of India are swarming with monkeys. Although informed of their presence upon our arrival, we did not actually see any until yesterday morning when about a dozen of them commenced to migrate from one group of trees to another to do whatever it is monkeys do. We were also told not to try and befriend them as as charming as monkeys may seem, to some people at least, these are actually thieving monkeys. And they bite too. Or so the rumors go. Who knows what they're actually capable of, but I will keep my distance unless one of the little guys forces my hand. Until then, live and let live.
Speaking of monkeys, though, I myself am about to start throwing poo at some people after two days of my Internal Medicine II service. We created our schedules Monday, but it seems that is about as deep as the organization goes in this elective as I have been only given a sheet of paper with times and locations and nothing else. While that may seem sufficient, and I myself would normally be inclined to think so, I must also add that many of the activities are missing, many of the activities I am in fact not intended to go to, and when I do show up I have no idea what, if anything, I am supposed to do. That last statement goes double for the residents as whenever I ask them where I should go or what I should do I can just about guarantee I will get two different answers from two different people. Confusion was mildly frustrating but acceptable on my own in Dubai when I wasn't supposed to be doing anything in particular. Now that I am it is getting rather annoying. I would not care to only attend rounds a few hours a day, and they are quite nice rounds, but at least say that that is all that is expected. Asking too much? Quite possibly so.
Since I briefly mentioned that I am the Internal Medicine II service I will go ahead and post the rest of my clinical schedule for the next three weeks.
This week (07 Jan - 12 Jan): Internal Medicine II
Plain old internal medicine and rheumatic disease (like arthritis and lupus and stuff.)
Next week (14 Jan - 19 Jan): CHAD [Community Health something or other]
A community outreach program that takes the clinic to the surrounding areas.
Last week (21 Jan - 26 Jan): Internal Medicine I
Plain old internal medicine and infectious disease (hurray!)
Back to rounds, though, they are generally the only real education packed parts of my day, and they are generally over with in an hour. They occur just like rounds in the states but typically with much worse pathology. We go from bed to bed with the residents and the attending (or registrar as they seem to be called here) and briefly discuss each patient and the plan. Although I frequently do not hear much of what is said during Grand Rounds (all the teams together), as they speak rather softly, and I frequently do not understand much of what is said during normal rounds, as I just cannot seem to deal with the India accent sometimes, they are interesting. Where else would I see bacterial endocarditis, malaria, scrub typhus, typhoid, and organophosphate poisoning? And only in two days at that. They almost make up for the fact that I usually then spend the following two or three hours sitting around the hospital reading or staring until the next random activity.
As I am on the topic of medicine I will also just pause to say that the CMC Hospital is amazing. It's like an entire medical compound. Imagine a dusty, 1950s looking version of the Houston medical center. There are a few really nice, modern facilities, but most are fairly old and jam packed with desks, beds, and people. On the ward I am currently on there is about 3 feet between each iron frame bed and easily 12+ patients along each side of the wall separated only by what appears to be a shower curtain. There are a few more private rooms and obviously some isolation rooms, but by and large the amount of space allotted to a patient and his visitors is about the size of many small apartment kitchens. It seems they expect and are used to such conditions, however, as I am not aware of any complaints, but it is definitely medicine as I envisioned it being practiced about 50 years ago at least in regards to the facilities. The quality of the care, on the other hand, is, as far as I can tell, amazingly high in light of the undoubtedly few resources available. India for all its growth is still a poor country and the needs are ever many so the fact that they can provide top of the line medicine, CT scans, chemotherapy, and the like in such a setting is something I feel worthy of envy. CMC is an amazing place and I cannot wait to share some photos when I am able to load them back in the good ol' USofA.
And while I am on the topic of amazing things I will add the CMC campus itself. Amazing may perhaps be too strong a term, but it is quite lovely. Very green and pleasant. I know I discussed it briefly earlier as a camp setting, and it is, but it is kind of a early 1900s British colonial India camp setting. Lots of old stone buildings with thick panes of glass separated by slightly overgrown gardens. In as much as the legacies of empire can be a good thing, this is a nice place.
Meanwhile life goes on. Rachel and Rebecca moved from their roach infested squatter's roost to a much larger and nicer place similar to mine and Paul's. Luggagewise, Paul and Rachel have both finally received theirs and Rebecca is expecting hers tomorrow. There's a 50/50 chance her toiletries will be missing. No signs of traveler's diarrhea or typhoid as of yet. No histrionic longings for home. No trips to Indian jail.
India Trip: Foreign is Foreign is Foreign
FROM 1/7/08:
It's been a few days.
Here's what has happened.
I sat at an airport for a while.
I sat some more.
I watched some cricket on TV.
We traveled to Vellore.
That was basically Sunday. Today, Monday, has been devoted not to sitting around idly at airports, but to sitting around idly at the CMC campus. Seeing as none of us are really into planning ahead no real planning ahead took place and, with a few exceptions here and there, we were generally unprepared for our first official day in Vellore. Had to talk to Sally, but in reality we had to talk to Samantha, or maybe Sandra or Susan, and then sign this, sign that, what was that?, repeat that?, and so on and so forth. It took only about 2 hours to, in able to avoid autorickshawing back into town, to make some sketchy photocopies of our drivers licenses so as to provide the school with small, passport size photos for our CMC IDs. Mine definitely looks like it was made in someone's garage. Oh wells, at least I am official now. Huzzah!
Speaking of autorickshawing, though, that's fun. Kind of like being chauffeured around in a go cart. Also crazy cheap. About $1.50 for three of us on a 10 minute ride. For those of you who don't know what an autorickshaw is, fun cultural fact #2, it's essentially a three wheeler with a small bench strapped to the back and a carriage cover placed over it all to make it look a little safer. They seem to essentially have replaced taxis in Vellore, which is fine with me because you cannot reach out and snatch thinks from passing bikers in a taxi. Not that I have done that. Yet.
Our accommodations are rather rustic; I feel like I am at camp. Complete with the separation of sexes lest any unchristian hanky panky take place. Paul and I lucked out I think with the Big Bungalow Annex. Though everything seems to be made out of cement and stone, we have a nice big bedroom, bathroom with separated shower to prevent the entire area from being flooded with water (apparently quite rare here), a kitchen without any appliances, and a screened in patio: my pride and joy. There's no AC but it's not needed now, and the toilet has some flushing issues, but all in all not a bad place to live. Being on the heavily vegetated college campus and with about 2 or 3 guards per a square foot it's actually pretty nice. The girls, however, seem to not have lucked out as much living essentially in a third world apartment block. The especially unlucky ones, Rachel and Rebecca, have/had a roach problem, but some aggressive counterinsurgency tactics by Katheryn and her insecticide fogger may have hopefully remedied that.
Amongst all this, what has really surprised me is not the people, poverty, or place we currently reside at, which I have not discussed in any great detail, but how generic the whole experience has been so far. Although it was a long, long time ago back when I was a sophomore in high school, I feel that my experience then to Honduras was much like this experience now. Though many of the details were different as clearly no one would confuse Honduras for India, the thoughts and feelings that I have so far felt have been essentially the same. Likewise with my experiences in Dubai and some cities in Europe. Looking back I suppose there is not necessarily any good reason why my thoughts and feelings would be any different as, despite the details, I am a first world traveler in a third world country in both instances, but regardless I have so far been unmoved and unstirred. Not that I feel I do not appreciate the reality of life as it is in India, in as much as I can as a first world traveler in a third world country, just that I feel it's the same story with different characters. I am sure I will get a great deal out of this trip, but, as of now, I do not think it will be because this is experience is anything new.
It's been a few days.
Here's what has happened.
I sat at an airport for a while.
I sat some more.
I watched some cricket on TV.
We traveled to Vellore.
That was basically Sunday. Today, Monday, has been devoted not to sitting around idly at airports, but to sitting around idly at the CMC campus. Seeing as none of us are really into planning ahead no real planning ahead took place and, with a few exceptions here and there, we were generally unprepared for our first official day in Vellore. Had to talk to Sally, but in reality we had to talk to Samantha, or maybe Sandra or Susan, and then sign this, sign that, what was that?, repeat that?, and so on and so forth. It took only about 2 hours to, in able to avoid autorickshawing back into town, to make some sketchy photocopies of our drivers licenses so as to provide the school with small, passport size photos for our CMC IDs. Mine definitely looks like it was made in someone's garage. Oh wells, at least I am official now. Huzzah!
Speaking of autorickshawing, though, that's fun. Kind of like being chauffeured around in a go cart. Also crazy cheap. About $1.50 for three of us on a 10 minute ride. For those of you who don't know what an autorickshaw is, fun cultural fact #2, it's essentially a three wheeler with a small bench strapped to the back and a carriage cover placed over it all to make it look a little safer. They seem to essentially have replaced taxis in Vellore, which is fine with me because you cannot reach out and snatch thinks from passing bikers in a taxi. Not that I have done that. Yet.
Our accommodations are rather rustic; I feel like I am at camp. Complete with the separation of sexes lest any unchristian hanky panky take place. Paul and I lucked out I think with the Big Bungalow Annex. Though everything seems to be made out of cement and stone, we have a nice big bedroom, bathroom with separated shower to prevent the entire area from being flooded with water (apparently quite rare here), a kitchen without any appliances, and a screened in patio: my pride and joy. There's no AC but it's not needed now, and the toilet has some flushing issues, but all in all not a bad place to live. Being on the heavily vegetated college campus and with about 2 or 3 guards per a square foot it's actually pretty nice. The girls, however, seem to not have lucked out as much living essentially in a third world apartment block. The especially unlucky ones, Rachel and Rebecca, have/had a roach problem, but some aggressive counterinsurgency tactics by Katheryn and her insecticide fogger may have hopefully remedied that.
Amongst all this, what has really surprised me is not the people, poverty, or place we currently reside at, which I have not discussed in any great detail, but how generic the whole experience has been so far. Although it was a long, long time ago back when I was a sophomore in high school, I feel that my experience then to Honduras was much like this experience now. Though many of the details were different as clearly no one would confuse Honduras for India, the thoughts and feelings that I have so far felt have been essentially the same. Likewise with my experiences in Dubai and some cities in Europe. Looking back I suppose there is not necessarily any good reason why my thoughts and feelings would be any different as, despite the details, I am a first world traveler in a third world country in both instances, but regardless I have so far been unmoved and unstirred. Not that I feel I do not appreciate the reality of life as it is in India, in as much as I can as a first world traveler in a third world country, just that I feel it's the same story with different characters. I am sure I will get a great deal out of this trip, but, as of now, I do not think it will be because this is experience is anything new.
India Trip: Do You Understand the Words that are Coming Out of My Mouth?
FROM 1/5/08:
Being a fairly cosmopolitan town Dubai has two primary languages: Arabic and English. The English, however, is not a form I have ever heard of. Much of the time I have felt wild gesticulations communicated more than any English being spoken to me. Oh wells, I will be in India soon enough. I hear they speak proper Queen's English there. Oh I say!
Anyways, the problem with goal directed wandering is that it is still wandering, and the problem with doing this towards your hotel at night and from a different direction than which you originally started from is that it quickly regresses into just plain old wandering. After walking for more than three hours back from the mosque, interrupted a bit for some dinner at a Lebanese restaurant, I then spent another 30 - 45 minutes circling the neighborhood my hotel was located in but never quite finding it. All I wanted to do was get back to my hotel to have a sip of water and a good sit, but instead I traversed street after street which, though looking familiar enough, were generally not too close to my actual hotel. I finally did find Eureka Hotel and after washing up I promptly fell asleep watching the Orange Bowl. Good times.
The only major highlights for today have been finally finding the Dubai Museum and finally figuring out the water taxi system. The Museum was not much to write about. Just imagine mannequins in Arabic garb with a few captions strewn about. For about a $1 admittance, however, I could not complain. The water taxis on the other hand were even cheaper, and even more enjoyable. If there's anything I enjoy as much as in-flight meals it is boats. Well there are plenty of things I enjoy as much or more than in-flight meals actually, but nevertheless crossing Dubai Creek (about 130 yards across) on what seemed to be almost a glorified motorized canoe with about twenty other people was quite nice. Perhaps it was just because I was off my feet; though, I think I need some arch support.
It probably comes as no surprise that the Westerners are where the money is, but it seems in Dubai that this is also where the Arabs are. Despite being at the Eastern terminus of the Arabian Peninsula the city grew so fast and the indigenous population was initially so small that the Arab population in the city is clearly a minority and is, in general, almost as wealthy as the tourists and businessmen coming to visit. The significant majority of the less affluent population, on the other hand, would appear to be from either SE Asia or the Indian subcontinent. It almost appears to be a colony of the latter at times. Curious.
Well, off to India tonight. Dubai's alright, but I'll be happy to move on and to me up with the other UTHSCSA folk. Just need to get past sitting at the airport for 5 or 6 hours tomorrow morning. Oh bugger!
Being a fairly cosmopolitan town Dubai has two primary languages: Arabic and English. The English, however, is not a form I have ever heard of. Much of the time I have felt wild gesticulations communicated more than any English being spoken to me. Oh wells, I will be in India soon enough. I hear they speak proper Queen's English there. Oh I say!
Anyways, the problem with goal directed wandering is that it is still wandering, and the problem with doing this towards your hotel at night and from a different direction than which you originally started from is that it quickly regresses into just plain old wandering. After walking for more than three hours back from the mosque, interrupted a bit for some dinner at a Lebanese restaurant, I then spent another 30 - 45 minutes circling the neighborhood my hotel was located in but never quite finding it. All I wanted to do was get back to my hotel to have a sip of water and a good sit, but instead I traversed street after street which, though looking familiar enough, were generally not too close to my actual hotel. I finally did find Eureka Hotel and after washing up I promptly fell asleep watching the Orange Bowl. Good times.
The only major highlights for today have been finally finding the Dubai Museum and finally figuring out the water taxi system. The Museum was not much to write about. Just imagine mannequins in Arabic garb with a few captions strewn about. For about a $1 admittance, however, I could not complain. The water taxis on the other hand were even cheaper, and even more enjoyable. If there's anything I enjoy as much as in-flight meals it is boats. Well there are plenty of things I enjoy as much or more than in-flight meals actually, but nevertheless crossing Dubai Creek (about 130 yards across) on what seemed to be almost a glorified motorized canoe with about twenty other people was quite nice. Perhaps it was just because I was off my feet; though, I think I need some arch support.
It probably comes as no surprise that the Westerners are where the money is, but it seems in Dubai that this is also where the Arabs are. Despite being at the Eastern terminus of the Arabian Peninsula the city grew so fast and the indigenous population was initially so small that the Arab population in the city is clearly a minority and is, in general, almost as wealthy as the tourists and businessmen coming to visit. The significant majority of the less affluent population, on the other hand, would appear to be from either SE Asia or the Indian subcontinent. It almost appears to be a colony of the latter at times. Curious.
Well, off to India tonight. Dubai's alright, but I'll be happy to move on and to me up with the other UTHSCSA folk. Just need to get past sitting at the airport for 5 or 6 hours tomorrow morning. Oh bugger!
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