Our first week at the hospital is coming to an end. It has been an interesting week to say the least. Wednesday was our first day attending postings in OB/GYN. Postings are similar to clinical rotations and lasts from 10:00 AM -12:30 PM. Here in India 2nd year medical students receive and introduction to clinical rotations. The OB/GYN rotation is 9 days long, so Eva and I have joined a group of 5 other 2nd year students who study here at SDM for the time being. I'm not sure what we will be doing after they move onto their next posting as we are scheduled to be in OB/GYN till the 9th of June, I believe.



On our first day, Wednesday, we received an introduction of how to perform an obstetrics exam. A faculty member, with the assistance of a patient, demonstrated how to take a history and perform a physical/obstetrics exam. The teaching style/vocabulary used were very similar to medical school in the States (history of present illness, chief complaint, etc). The lesson was interesting and I felt like I learned a lot.



The second day, Thursday, was a little different. Upon arriving at 10 we were told it was OPD= out patient day. I figured that this meant going to the out patient clinic and shadowing a physician as he saw patients. However, I was mistaken. We proceeded downstairs to the out patient clinic to meet with Dr. Maht. He began by giving us a summary of the previous days lesson. Then he brought in a patient and basically said "go to it"... we were to take a history, do a physical exam, and give report when he returned. Seeing as Eva and I don't speak the language (all teaching is done in English but the majority of the patients only speak Kannada- the local dialect)... it seemed unlikely we could assist. The 5 medical students we are accompanying looked confused about how to begin. After much discussion amongst themselves, in front of the patient, they began. The history taking and exam were done in an unorganized incomplete fashion. All 5 of the students approached the patient at once, asking random questions, taking blood pressure, and palpating her abdomen. Eva and I observed both thinking how different things are in the States. Patients at home would definitely complain about this, however our patient seemed amused as the med students scrambled. Dr. Maht returned after about a half an hour and the students began to give report, which he quickly interrupted and corrected. He then proceeded to talk for about 45 minutes, instructing the proper way to perform a history and physical exam. Eva and I were both getting restless and were pleased when he dismissed us around 12:30. We then met up with the son of a family friend who attends medical school here for lunch. He is very nice and showed Eva and I where most of the students eat/socialize.



On the third day, Friday, we were to observe two vaginal hysterectomies in the operating room (OR). Eva and I came early so we could see the entire surgery. After a bit of confusion about where to be, we changed into scrubs, and walked into the OR. Shortly after arriving, while the anesthesiologist was giving a spinal, Eva began feeling faint and left the room. I was still doing alright and observed as Dr. Maht began the procedure. It wasn't a half hour when I also began to feel faint. Luckily some nice gentleman in the OR offered me his chair. I sat for a few minutes (cold sweats and shaky) and then felt sick... so proceeded to the bathroom. It appears that both Eva, her father - who got sick the night before, and I are adjusting the food/water here. After making 3 trips from the OR to the bathroom I decided to give up on seeing the rest of the surgery and just sat in the locker room feeling nauseous. So needless to say it wasn't the best day...

Today, Saturday, we came early for seminar. They have lecture every Saturday morning at 8:30 for staff and students. Today's lecture was on monoclonal antibodies... the majority of the information Eva and I had been exposed to in Imunology. After lecture we reported to posting which turned out to be another day in the OPD. This time was similar to last. We saw three women, all were over 7 months pregnant and three to four years younger than me. For two of the women it was their second child. Again, Eva and I didn't understand much of the interview/exam because of the language. All in all it was still an interesting day.

After returning home, the power went out three times.... really not a huge deal except no power = no fans = sitting and sweating :) We also had our first monsoon rain which really cooled things down and made sleeping wonderful. Monday we are supposed to report to the OR at 8:30 again... hopefully this time around will be a better experience.

So... today we went to the hospital to meet with the Dean of the medical school, the head of the OB/GYN department, the head of the pediatrics department, and the principal of the public health program. After much conversation... I think... we have our summer figured out :) Eva and I will be spending 1/3 of our time in each department beginning with OB/GYN and ending with public health. We are to be at the hospital tomorrow at 10 AM to go on rounds (yes rounds are at 10, a little later than rounds in the States I would say). We toured both the obstetrics and pediatrics departments today. Our time with the public health program will be at rural clinics... so we will have to wait to see what those are like. The wards that we did see seem relatively nice. Like most hospitals I have seen in developing countries, the wards consist of large rooms with lots of beds. There are no private rooms. The staff seems very receptive to having us there and the patients maybe a bit hesitant. (I still have yet to see another white person) The hospital we are working in is affiliated with a medical school (similar to the set up at the University of Iowa) so there are medical students all over the wards. This makes me feel more at ease as the staff physicians are used to teaching students.

After leaving the hospital we spend the rest of the afternoon reading and napping. It has been very hot the last two days, which makes both Eva, her father, and I very sleepy. I have finished one book and started the second since arriving. It is so nice to read for pleasure. Eva and I discovered a new part of life in India today... cockroaches... large cockroaches. Eva's farther Shiva killed them for us. I'm not sure what we will do when he returns to the States. We may have to recruit her uncle's assistance. The sewers are open in India meaning that cockroaches can climb up drainage pipes from sinks/showers into the house. The bathrooms in the house have one common drain for both the sink and the tub... we put a screen over the one in ours today :) Hopefully this helps.

We went to market tonight to buy some fruit, cereal, and juice. Eva's aunt has been cooking non stop for us... we are hoping with these purchases she won't feel the need to cook us breakfast before going to the hospital each day. We plan to eat lunch at the medical school or a restaurant close by. Since arriving I have yet to feel hungry. Eva's family is always feeding us... and everything has been wonderful. My stomach has been doing okay... no major illness yet. The market is crazy. It is streets and streets of small "mom and pop" stores as well as street vendors. There are people, cars, motorcycles, bicycles, buses, and rickshaws (small three wheeled open air taxis) everywhere. Walking around is a sensory overload... the sights, sounds, and smells are all new. We also stopped by a book store. Eva is trying to learn Kanada, the local dialect, which is what the majority of her family members speak (in addition to English). I picked up some books on India festivals and the gods of the Hindu religion. We also got mats made so that Eva and I can do yoga/ pilates before going to the hospital.

I am very happy to be here and things are going well. The pace of life is very different from the US and I am still getting used to it (it took 1 hour to exchange money yesterday). Family is extremely important here so I feel very safe/comfortable living with Eva's family.

I have arrived :)

So I am finally in India. We arrived to Dharward after three flights and a night stay in Bombay. Eva's family, who I will be staying with for the summer is wonderful! The house is very large, Eva and I will be sharing a room and have our own bathroom. They have a Great Dane at the house named Sparky... he is kind of the watch dog I guess. Her family had a party to welcome us last night at her aunt's mango farm. There were about 30 family members there and tons of Indian food. I am currently trying to figure out the internet situation so this post will be short... but I just wanted to let everyone know that we are here and safe. Today, we went to the hospital we will be working at this summer. The facilities were surprisingly nice and I am looking forward to learning a lot :) It is a private hospital with around 700 beds. We will be working there for 2 months and then traveling around the country the remainder of the time. On a side note... since arriving in Dharward, I have yet to see another white person :) I get a lot of strange looks and a group of children at the hospital all waved at me today. I'm not sure how large Dharward is... I have asked a few people and the responses have varied from more than 10,000 to about 2 million. I will investigate this one further.