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SEQ CHAPTER \h \r 1Trip to Amritsar, India
Part 1
Only 33km from the Pakistan Border.There was the Golden Temple and several other impressive temples and at the border was the 'Changing of the Guard'That was our goal this weekend as our final trip as a group before the six of us who have been together since the beginning were finally going our separate ways.
It all started on Friday.The only clinic on the schedule was Doctor Gandhi in the afternoon.After that we had our weekly meeting and then we would leave.The morning went pretty much like clockwork.I would wake up around 9 am, read some passages, stretch then walk to the other house for some breakfast.We were staying at Mrs. Mehta's place in Dehra Dun and her neighbor sister's place.Only a room was offered in Mrs. Mehta's of which Clinton and I shared and everything else was provided at Mrs. Mehta'sThe living room, kitchen, and dinning room was all at Mrs. Mehta's.Katie, Zoey, Alex, and Eric were the students staying at Mrs. Mehta's along with Jade, the alumni student who was our coordinator for most things.Because we stayed with Jade I feel like we got to know her a little more than everyone else but she was still responsive to all the students.
Breakfast was prepared for us by Mrs. Mehta.It would usually consist of toast, egg sandwiches, potato sandwiches, or bananas.For some reason everyone here started eating peanut butter and was also available.We just loved our peanut butter so we would spread it over almost everything.I myself always put it on the plate and just licked it up plain but starting spreading it on other things later on.One thing that was always provided was Chai tea.Indian's love their Chai.Every breakfast their was Chai.Even though I am not always a tea person (I have been in the past) I have indulged in this tradition and life seems pretty simple with a banana and a cup of Chai to start the day.We usually all make it for breakfast so this is where the story begins and ends: with us drinking Chai and talking about our day.
On that particular day Clint, Zoey and I had not yet committed to going to Amritsar because we had so much more time to do the trip.The other three Alex, Eric and Katie were only here for 4 weeks not 10 weeks like us.The problem was that to get to Amritsar they were planning to take a taxi which we were told would last a whole 14 hours.Not something I was excited about because we could book a train early in advanced and go later.The train would be a sleeper train with AC.I had some preconceived notions on what a taxi would be and I imagined it would be us sitting in a car struggling to find a comfortable enough position to sleep.However, my fears were soon replaced with a sense of guilt and comradery.Katie was talking to us about how this would be our last chance to have a trip together than we would likely never see each other again.This rallied us to believe that, "hey, maybe it won't be as bad as we think."It took no more than 10 minutes before the whole of us agreed that would make it an adventure to remember.Katie was happy and the other group left for their morning rotation to the OBGYN.
Having the excitement of the trip to look forward to we cleared our plates and got ready to go.I stuffed my backpack with all the stuff I would need.In a large plastic bag I put my book, Gift of Pain, (something I have been trying to get through since the plane ride, I am a slow reader), my umbrella (because last time it rained I got poured on and my waterproof jacket proved that it is no match for a monsoon), my notepad (that I had to buy from the market because I didn't like carrying a full size notebook), a pen, a flashlight (my wind-up one, thanks to my sister), hand sanitizer (obvious reasons), tissues (not just for blowing my nose), sun tan lotion, bug repellant (that I never use because it proved corrosive; in Than Gaon I had put some on and than sat on a wooden chair.it had successfully removed the finishing and reapplied it to my skin.I decided to then on just suffer the inconvenience of mosquito bites), and finally my white coat.I was well prepared for the day.In my pocket I had my cell phone, and about 150 rupees in change (mostly 10 for the rickshaws).We set out for the day.To get to Dr. Gandhi's hospital we walk for 6-7 minutes in the back alleys to get to a main road.Main roads here are the ones with actual painted lines for lanes despite the fact that they hold absolutely no barriers by any means to anyone, driving, riding, or walking.Mostly people stay on the left side of the road but always or hardly enough.Anyway they call their intersections Chowks here.We take Vikram 8 from Anurag Chowk for 25-30 minutes downtown to near clock tower, the unofficial center of the city.We've gotten pretty used to the fact that we have to stuff ourselves in this tiny car with absolutely no personal space.Because it solely depends on your driver, Vikrams can be nice and relaxing looking at the activity of the city as they begin their day.Setting up their shops, talking with neighbors.Men in button up suits riding their scooters and motorcycles off to work.Cows all over the road.People getting in and out of Vikrams everywhere.There is just a lot of things going on all the time and it is really hard to capture it all.Other times, if you're lucky enough to sit in a crazy Vikram driver, and your one of the two people who only manage to get one cheek on the seat (happens to everyone), everything is zooming past and your really holding on for your life.Early one you really weren't paying attention to anything other than how on earth you were going to keep yourself from flying out the side door (take someone with you that's how).The crazy Vikram drivers are the ones who zoom through the street, cut by every car by inches, passes everyone not going as fast as him, honks at everyone to let them know yes we are passing you, and has little respect for any vehicle smaller and slower than himself.Because motorcycles, scooters, bicycles, and people all fit into the cracks of traffic they are always moving but that doesn't mean that our driver will provide anymore than the bare minimum of space to let this occur.Several times I thought we were about to plow into a motorcyclist only to stop inches so he could barely manage to cut in front of us.
When we reach our Chowk we get off and walked for 20 minutes East to get to Gandhi's hospital.On that particular day we were a little short on time so we walked our usual Dehra Dun pace, ("We need to be somewhere soon, I hope were not late so let's go a tiny bit faster but not much because being late here doesn't matter that much but it would be nice to get there sooner than later").We cross a couple of intersections where cars, motorcycles, and people are just coming from every direction, every lane and even places your least like to expect.As a group we've adopted look 4 ways before you cross, meaning look for car driving on the left both ways than look for cars driving on the right both ways.It's actually quite impressive how this whole mess most of the time works out pretty well and as a group we usually cross streets with little trouble just by going with a flow.You're not really sure what that flow is or when it was that you picked it up by all you know is that it works 90% if you don't let your instincts from childhood take over.The moment you hesitate is when you realize I really could have gone then or now I just walked in front of a car when I shouldn't have.We have successfully crossed about a hundred streets and every time we came out whole.Close calls become only when they car only missed by less than and inch.2 inches or more and the driver was nice enough to give you a wide berth.Finally and successfully we made it to Dr Gandhi's.
The day was pretty routine thus far except we were now going to Amritsar for the day so this was our only clinic.We did our usually thing.We sat down in front of Dr. Gandhi, except Jade at gotten there before us and would join us. She really admires Dr. Gandhi and likes to visit with the students that go to his rotation.Most of the time we start a 1-2 min conversation with Dr. Gandhi before patients start flooding in.Then our conversation is reduced to him explaining the more interesting cases as they walk in.He gives us ECGs to look at, let's us look at x-rays, echos, listens to patients heart beats, and than at the end asks us to tell him what we see.Usually we never get it right on the ECG.A couple of times I have been right on the ECGs because I took a really good course before I left for India on them.For those who don't know ECG stands for Electrocardiogram which is a measuring device that measure the electric activity of the heart (whenever you watch the ER or something the readout that goes flatline with the long beep is a ECG).We can look at what the heart is doing by looking at a ECG.We can look at things like ischemia, heart blocks, heart attacks, and other heart problems.Most of the time patients come in with ischemia or hypertrophy.I have successfully found a couple things: a regular sinus rhythm, bradycardia, a heart block (although I couldn't tell which side), and hypertrophy of the left ventricle.The heart block was my favorite.Although today wasn't all fun and games.We had a patient who had suffered a stroke come straight into the office and was laid down on the table.We knew he had some neuropathy because of a neat trick you can do with a set of car keys.If you run keys on the bottom of the foot for a healthy person the toes flex downward.For a neuropathy patient they extend up.It's a weird phenomenon and I am not really sure that I got it right but it was interesting nonetheless.I wish I had a book of clinical practice so I could identify some things.
I had made a mistake of trying to read my book in the office while doctor Gandhi was examining the patient and Jade caught me.I didn't really like her disciplining me at first.I reasoned my way through it.If I couldn't understand what was going on because I couldn't understand what they were saying it would be alright for me to read my book while I waited patiently for Dr. Gandhi to start talking to us.This was something that had never been talked about before Jade had been there so I felt it was a little unfair for her to start telling me what to do when I felt it was doing no harm and Dr. Gandhi himself hadn't said anything or even hinted that he cared.I had to control my bitterness and I was already dreading the end of the day when Jade would have the opportunity to prove her point of how I was being rude and inconsiderate of Dr. Gandhi and that I represented the program and her and etc.I didn't like these feelings.Why was I blowing something so out of proportion and why was I getting so mad a Jade for something so small.It took a while a long while to get over it.But I kept most of my thoughts to myself and really bite my tongue.I had reasoned that perhaps that I had probably been wrong.Regardless, if I was right and Dr. Gandhi didn't care or my feelings about Jade I had to admit that she was right.It probably took most of the day to get over the whole thing but admitting being wrong when I thought I was right has I guess never been easy for me or anyone.I had just been telling myself of how ashamed I get sometimes that many people back home refuse to be wrong in anything and refuse to let anyone tell them what to do.No one tells me what to do, I am my own boss.I feel many people have a strong apprehension towards any kind of authority figure or which I learned that I myself am also guilty of.It's a deeply rooted characteristic in me that I believe had to be challenged and fought against constantly to overcome.I couldn't spend too much time wondering though because an emergency had just occurred and we all chased Dr. Gandhi who just dodged out of his office.
A man showed up in and was placed in a wheelchair with a crowd of people rushed around him.It was obvious that something serious was wrong with him as Dr. Gandhi wasted little time to rush him upstairs to get him treated with the four of us and several other people right behind them.They set the man on the bed, unconscious but still breathing.I remember trying to put myself in the best vantage place and see what was happening but also to stay out of the way.I wanted to see the action.I guessed someone must of told them that he was diabetic because off the bat they took his blood glucose levels.We ordinally thought it was something like 15 (fasting glucose stays at about 60 in healthy people)but later realized he was at 300, which using my skills I concluded was the opposite of good.Still unconscious Dr. Gandhi had the nurse take a 12 lead ECG to get heart readings.I had just watched this nurse set up an ECG in the office and watched all the details.She did the ECG with all the pressure of a dire situation and did it exactly the same way, the skill of someone who has done this procedure many times in her lifetime.I couldn't tell what the ECG reading was but things didn't change much.I dashed to the other side of the bed just behind Dr Gandhi and Jade.In the room was Dr. Gandhi, another Doctor who I found out later was the man's primary physician, nurses, assistants, patients, family members of those patients, and other spectators.I haphazardly counted but later came to the conclusion that there were at least 30 people in that room.Before I knew an IV hand been placed in his hand and it seemed pretty routine and nothing really struck me as new.Even though I had never seen an emergency patient nothing was too striking or anything.That's before I saw something that really shook me.Dr. Gandhi started doing CPR.
Clearly, I had severely misjudged the situation and before I knew it that man was no longer breathing and a little panic was starting to settle in.It was the first time I had ever actually see CPR perform on anyone.It truly is a horrible sight.Not because of how the procedure looks or anything but solely because I know from my class in CPR that someone who was breathing and than suddenly needs CPR has gone someplace really bad really fast.I have Corey to thank for his class on CPR and ECG for this knowledge but part of me realized that I didn't like knowing what I knew.Unless, a AED and some air came quickly this man would not live long.CPR is a very dire situation and I hope no one ever has to give CPR to anyone.Air was brought up and finally and AED.Dr Gandhi made three attempts to shock this man's heartbeat back to life.During this time the man's wife had come in to see her unconscious husband lying there unable to breath on his own.She had realized that her husband was not doing well and was becoming inconsolable.She looked everywhere for hope, answers, and a place to sit.In and out she came during the 20 minutes CPR had been started, not being able to decide whether she should be on the phone calling family or watching her husband slip away.The whole ordeal was difficult for everyone.The one beautiful thing that I noticed that as we all sat there watching this man; [the doctors, giving him oxygen, CPR, and electric pulses, the patients sitting with on their beds helpless probably wondering if this was in the cards for them someday, the staff trying to give the doctors whatever they needed, and the wife weeping beside her husband] everyone wanted this man to make it.In the time of someone's suffering I feel that everyone regardless of their relationship to that person, can find that their compassion and hope are expressed.We all tend to cheer for the underdog even though we know in the long run if not now than later.I was able to smile a little when I noticed everyone hoping this man gets another chance; another chance to tell his family he loves them, another chance to see another day, maybe accomplish one last thing before his time was up.Sadly for us this man wasn't blessed with more time.He had died on that bed with all of us helpless to change it.
Clint, Zoey and myself stood outside on the railing as we waited to leave.The moment was really draining and I was surprised how little things I wanted lost most of their importance at that moment.Some other things had happened after that but are probably best to be omitted.Our time at the clinic had run past 1:30 as usual and it was time to get some food.Jade and the 3 of us took an Rickshaw to Rajpur Road and went to get some lunch.You may think it was silly but because we wanted something tasteful and quick we actually went to McDonalds for some Chicken sandwiches and fries.I had just been reading about in my book about how pleasures in life often follow the pain.And that they are inseparable and without one the other would be insignificant.Well I do not thing anything quite tasted as good as McDonalds did that day.I remember specifically enjoying my food grateful that I was able to eat and be alive.That my time is still not up and I have the ability to live.It's funny how a little scene can pretend to be so life changing and to say that I have completely change my view of the world would be untruthful.I believe I had come across an experience of my life which proves to be more memorable now as I am writing this than it did even an hour after it was over.It didn't take long for me to go back into my original state of mind before Dr. Gandhi's although I knew I had tucked my thoughts away for reflection later.
The meeting started at the Barista store and everyone in our group told about what their early expectations were of India and how they think they have changed since then.How has India effected them.I didn't come up with a very satisfactory answer.I talked about how I've so easily able to adapt to things in India and how I have a confidence in myself.Looking back I am not so sure that is true.I think what I have really done is adapted a routine of which I have been so good at home that I have been able to refocus my environment around me.It's weird but going everyday from clinics and lunch doesn't feel all that different than when I went back and forth to school everyday.I was pretty good and establishing a routine of transportation and figuring out works best.Besides enjoying some fun conversations I haven't really changed my perspective on medicines and haven't learned what I want to do or have a good idea of what it takes to be a doctor.These were all my expectations going to India, that it would sort of show me my destiny, my dream, were it was I was to be heading.What part of me needed to change.What part would make me a good doctor.So far I have had a couple of experiences that I wanted to pretend showed me a new light; taking care of Alex and watching a man die under the care of doctors.Neither of them changed me that much or given me that epiphany, that enlightenment that I was looking for.I am not really sure what it is I am looking for or what will be there to guide me.
The meeting ending and I walked to the back to buy a book.My friend pointed to one of two books that my teacher had given me and that I vowed I would buy if I ever found them again.They were the Alchemist and something Seagull. I do not remember the name of the second one but I know it if I saw it.My friend just happened to show me that this store had the Alchemist.I was really excited and bought it right away.This would be perfect in showing me something about myself and this adventure I was on.It had easily become one of my all time favorite books when I read it the first time and if you haven't read it you probably should if your looking for direction about following your dreams.Alex had also given us some bad news at the same time that he found my book.Apparently, Katie who had convinced us that we should go to Amritsar wasn't feeling well and would have to stay behind which meant Eric was also going to stay.This meant the four remaining people would have to split their 1700 rupee fee; a total of 2500 rupees just for the taxi.This was somewhat burdensome and Clint was having second thoughts about whether he could afford a trip like that.We knew Alex really wanted to go because it would be his only chance and he was also the kind of guy who would never tell us he really wanted to do something if it burdened us; he was a very selfless kind of guy.We weren't really sure what we were going to do but it was getting late (4:30) and we were supposed to leave at 5:00 IST (India Standard Time).We quickly jumped into the Vikram and went back to Mrs. Mehta's to pack and get ready to go.
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