Home Stretch

Alas, I’ve been neglecting the blog. Indian standard time has sped up for me, and I now have just under six weeks to go. I spent the last two weeks “on leave” in the north with my sister Shannon, Aparna and friends Shoba and Meena, which was a very welcome change from the dusty desert of Vellore. I say this in “I can make fun of my brother but you better not” speak, as Vellore has earned itself a small corner of my heart. However, it’s getting freaking hot here – it’s been hitting 40º C all week, which converts to about 105º F. Damn.

So for my last six weeks I’m on research data collection hyper-drive. I have four years of snake bite data that needs to be compartmentalized into SPSS boxes… and boatloads of ICU SAPS scores to calculate. This is why I never blog about my work… it’s pretty boring.

Yet there are aspects of the hospital world and the rural space of Vellore that are worth mentioning. While at first I was struck by the sheer magnitude and depth of CMC, over the last several months I’ve witnessed the cracks in its armor. It cannot quite cover the satellite population it serves and people slip through these cracks. When you cut to the chase, healthcare here is pretty simple: there is none. There is no emergency response system, no insurance, no system to navigate at all. Everything is out of pocket pay, which is a bargain for medical tourists, but stretches the funds of the average person and forces many patients to “abscond” after receiving life-saving care. The majority of patients have a blank slate for past medical history, because they’ve never been to the doctor. The top three causes of death in Vellore are road traffic accidents, strokes (two points for preventive medicine and the power of controlling HTN, hyperlipidemia, etc) and suicides (hanging and organophosphate poisoning most commonly.) The emergency department is of the largest and most specialized departments in India. Yet, trauma patients with two blown pupils wait hours for urgent head CTs. Patients are brought from miles away by motorbike, draped over the handlebars with their bare feet dragging the whole way. As I review records there are many cases I’m familiar with only through board questions: leprosy, tetanus, Leishmaniasis, a veritable smorgasbord of TB from Pott’s to TB peritonitis to TB induced adrenal failure. TB is always the dark horse of any differential diagnosis. Here people wear the hardness of life – cataracts, amputations, congenital hip dysplasias, leprosy eaten limbs – and command you to bear witness.

This is rural Vellore. Sorry to be a downer. It’s just one picture. I’ve found India to be beautiful, severe, enchanting, hostile, imposing, pungent, frenetic, welcoming… the list goes on. Even though, as Jay Desai has informed me, “I’ll always be a white person here” (touché) I feel privileged to have witnessed this kaleidoscopically crazy country.