Clefting in Bombay

Trip Start May 31, 2006
1
7
18
Trip End Jul 11, 2006


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Wednesday, June 14, 2006

So back to Bombay...

This week we are experiencing another side of the Indian health care system as we are rotating at a private hospital in Anderhi, an upper class region just north of us and the Bandra district.
The BSES MG Hospital is very unique, as it wasn't run by a company or the government but an NGO. The Brahma Kumaris group, headquartered in Rahjastan in northern India administers the hospital. They were established in the 1930's as an international spiritual organization that focuses on positive change in human values by using Rajyoga meditation. Their approach at BSES was to intensively train the staff in the seven ideals of the Brahma Kumaris so that they could better serve the patients that chose to come to be treated at BSES.

As this is a private hospital...most patients are choosing to come to it and understand the level of care (and cost) that it entails. BSES seemed to have a mix of patients of both means and not, although most seemed to be of some wealth. We first met with the head of the hospital, Dr. Mheta who was a surgical oncologist specializing in head and neck. He seemed very well traveled and had been to America many times. He actually had attended a conference and Wayne State and his brother is a businessman who lives in Troy. Small world! He spent a good deal of time sitting and talking with us and it seemed that from then on our day would be a pretty good experience.

What we found for the rest of the afternoon was that most of the areas of the hospital that we were supposed to be in for the day had no idea we were coming. Justin and I (he's also from the D) were paired together and made our way to the Male wards where the nurse promptly told us she had no clue what we were doing there. After looking over a few charts we found a few young children who had cleft lips/palates. The nurse eventually told us the name of the doctor who was doing the surgeries on the kid and Justin and I went in search of him to be total gunners and see if we could get in on a surgery with him. We eventually found his office and after waiting for a bit outside, I pushed inside and interrupted him and told him who we were and what we were doing. He seemed a bit taken a back but eventually agreed to let us join him tomorrow morning at 8:30. He didn't seem to be too excited about it so we'll have to see when we show up if this actually happens. I also poked my head in the Ophthalmology office and talked to a Doc who said I could watch a cataract surgery at noon tomorrow...we'll see about that one as well. I guess I'll just have to be pushy because nobody seems to know that we are around...at least many of the rooms have AC!

Part of what Dr. Mheta wanted us to experience at the BSES was an example of a spiritual training session. That was to begin at four and since we had an hour to kill, Justin and I decided that instead of sitting around or bothering people at the hospital, we would venture out and see what was going on in Anderhi. No sooner had we walked outside when we heard a ton of shouting. We made our way up a side road next to the hospital and saw a bunch of people waving orange flags and shouting at people in the building. After talking to a few people we found out that they were some of the poor protesting against the taking of their land by the government. We ventured up and joined in, getting looks of joy from most of the people. They were excited to see us taking pictures and all wanted to be in them...it seemed they wanted us to spread the word that they were fighting back but who knows. Check out some of the pictures of the kids lying down in the road blocking the SUV. It was pretty interesting to experience and good to see that protest and democracy do actually exist here. Will something be done about it? Who knows...?

We eventually made it back to BSES and went down in the red-lit auditorium (see picture). We were met by one of the spiritualists who then took us through a session of feeling sharing about positive and negative experience and traits and a quick example of mediation. It was quite interesting and although I'm not a huge fan of the writing down and remembering experiences and sharing them with your partner/group exercises, it was good to see how they train their staff and approach patient care. I can see how meditation is and can be an integral part of the healing process, as it (with work) will allow one to truly relax.

On our way back Marcus and I shared a rickshaw ride that was one of the scariest yet...our driver seemed to enjoy playing chicken with cars coming at us then would turn around and laugh and slap us five. I guess I'm just getting used to constantly almost dying since Marcus and I barely shuttered as he did this and just continued our normal conversation. Also note in the pictures the great video and picture I was able to shoot from the roof of the BSES of the traffic on SV Road outside the hospital. That's pretty much Standard Operating Procedure in this city...

I'm off to watch World Cup Soccer and relax...

6/14

So you get two entries in one with this one...since I was unable to post yesterday.

So today Justin and I took a gamble and ventured to the BSES early to try and make our way into the "Operation Theatre" (I am saying that with a total snooty British accent...but sadly it's just the word for Operating Room here). We had talked to a doctor yesterday that told us we could watch his cleft palate surgery at 9 AM...we placed bets on whether it would happen or if it did, how late it would be. When we arrived at 8 AM the nurse said it was supposed to start at nine (which we knew) and we had come early to see the anesthesia.

It is interesting...to enter the OT you take off your shoes (and socks) and most people walk around barefoot or with sandals or clogs provided. We changed into our green scrubs and clogs and made our way into a random OT. Most of the docs were pretty nice and the first thing we watched was an appendectomy. The doc was pimping us on our abdominal anatomy and Justin and I struggled to even remember the fascia layers (I HATE FASCIA)...I pulled Scarpa's out of my ass and we somehow came up with the attachment points of the appendix as well as the muscle layers (don't forget the good old Transverse Abdominus muscles!). Man was our anatomy rusty...

The OT's at BSES are pretty similar to home...they had marble walls and seemed to have all the newest equipment. It will be interesting to see what the OT's at the government hospitals are like...

We also were able to watch a cataract surgery for a bit before moving into our cleft palate surgery. It was actually my first eye surgery and it was quite interesting to watch...we couldn't stay long however as we moved to watch the CP surgery we came for.

The doctor had been sort of an ass yesterday and he continued on his current path as he didn't even acknowledge our presence (no eye contact or vocalization to us the entire two and a half hours). Other people in the room helped us out and got stools for us so we could watch. It was really quite interesting....the doc first separated off the skin and fascia around the gum line and eventually graphed bone from the lower rib cage. He literally took it out in pieces using a hammer and chisel (take a look at the pics). He took out the small pieces and then crushed them...making a sort of goopy powdery filling that he eventually placed in the palate. He then reattached the skin that he had pulled back and sutured it all up. Since he didn't talk to us or tell us anything we were kind of figuring it out as we went along...and I'm not very familiar with the process so hopefully this is an ample explanation. Maybe some of you third years (Miss S.C.) can weigh in with your opinions and expertise!

We were pretty worn out after the 6 or so hours of watching surgeries (no comments third years) so we left for the day and stopped at a restaurant for lunch. We somehow found a "special" menu that was all you could eat for 200 rupees (about 4 bucks). Our five course meal was amazing...I think the manager was pretty pissed that we found this menu because he asked us numerous times how we knew about it. Regardless...we stuffed our bellies and then headed back to the ranch for a much needed nap.

Well that is all for now...so until next time!


Cheers,
Michael
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