Girls Just Wanna Have Fun...And Eat Beef

Sunday February 22nd
Last Friday the Vellore Four successfully completed our rotation at the Christian Medical Center. We had exactly one week until our jet left for home, so we decided to attempt to tour the entirety of India before that time. Carly revealed that she might know some people who know some people in Bangalore and we quickly took her up on hunting down her snazzy connections and living it up in the big city. After a request for a “Big Car with Big Trunk for Big Bags and Big Girls” we were surprised to see Smart Car’s Miniature Little Sister Car pull through the circle drive and pop the so-called “trunk”. After teetering 8 overpacked female suitcases on the roof of the car and receiving a bonus lesson in skillful knot tying from our driver, we began the 4 hour journey from Vellore to Bangalore. Over the course of the evening our ETA was extended from 8:30pm to 11:30pm with a rather large glitch in travel plans owing to Smart Car driver being the ultimate worst male driver of all time. Imagine this…stubborn male driver in front seat and four overly opinionated back seat female drivers in a town that ZERO of the FIVE persons has visited in their lifetimes and what you end up with is THREE hours of Smart Car stuck on India’s version of the Dupont Circle from Hell. An anonymous member of the V-four eventually offered the intelligent suggestion of electing two members to hail a rickshaw operated by a Bangalore local and to have stubborn male driver follow the local, while the two elected members hang precariously out the sides of the rickshaw wearing headlamps and providing instructive hand signals to stubborn male driver. In what can only be ascribed to as an act of God, the Vellore Four arrived at Carly’s snazzy set up, a “guesthouse compound” of Amitabh, Car’s friend of a friend. I will define “Guesthouse Compound” for you now. This term means 6 stories of sheer gorgeous heaven constructed of glass and marble and security guards and personal chefs and fresh cut flowers and really squishy pillows. We were all pretty happy to say the least, and in the words of Liz, “I don’t know if I’ve ever been this happy. Maybe my wedding day. But I don’t know. This is a really close second.” On Saturday we decided to have the ultimate Girl’s Day Out and started by burning some Rupees on silk scarves at the infamous Mysore Silk Emporium. After some overpriced salads at the popular Leela Palace Hotel garden restaurant, we begged a spa joint to allow our filthy feet inside for the best pedicures of our lives. We probably should have autoclaved from the toes up before making those unsuspecting women touch our feet, but nonetheless it was wonderful. After our pedis we caught a rickshaw to the movies where we spent 200 rupees each to indulge in the ultimate chick flick “He’s Just Not That Into You”. Although entrance into the Indian Cinema involved the most violating security screening and pat down experience of our lives, the surprise allotted Intermission time during the show and the concession stand menu totally made up for it. What’s happening here is that about halfway through your movie these people are pausing the flick just so you have a chance to visit the “Hot and Savory Corn Stand”. This stand is cooking up a revolution in movie corn snacking. Boiled corn kernels, buttered and salted, and placed in a tiny popcorn bucket. Spoon included. Carly and I already have a plan for the U.S.A. branch of “Hot and Savory”. So you just go ahead and back off. After the movie it was a race against the clock to make it to Bangalore’s Hard Rock Café before close. We know, we know. It’s the ultimate pathetic tourist thing to do. But dammit, we needed some beef and it’s the only place in town selling it. Four cheeseburgers and fries later, it was back to our “compound” for a good nights sleep. Sunday was a road trip to Mysore, home of a gazillion palaces and shrines to guys we’ve never heard of. The trip was made in a minivan, the price for which we split with some med students we met back in Vellore. We scrunched 8 people into a 6 person minivan for a 4 hour car ride with the worst driver in the ENTIRE UNIVERSE. (second only to stubborn male driver mentioned above) A bunch of oncoming cars and curvy cliffs and hail Mary’s later we arrived at the tomb of a guy we’d never heard of and then we visited the same guy’s summer home. So that was memorable. We took pics. And then it was back in the car and on to Mysore Palace. Ok now this place was actually very legit. Huge. Gorgeous. Awesome. Beautiful. And, oh yeah. Sorry, they don’t allow cameras so you will never lay eyes on this wonder unless you visit India. But I’ll summarize in a nutshell for you that this is a big palace for the Maharajas in the area. It changed hands quite a bit throughout history and burned down one time after a wedding cake caught fire. But it’s here now and they offer elephant rides in the driveway and like all other tourist spots have a shitdevil monkey infestation. The best part about the palace was a gigantic Marriage Pavilion room with all these murals and arches. I would have enjoyed this area longer if it wasn’t for my unfortunate run in with the Indian police who wrongly accused me and confused me with another short white female who was photographing in the palace. The last stop on our minivan tour was Chamundi Hill. This is basically a big hill that unexpecting travelers drive all the way up to discover the only thing to see here is another monkey colony. Only these little guys are way more evolved and are actually just asking tourists for spare cash and minivans. Uh, so we left and went back to Bangalore and the “compound” and packed our bags for an early morning Varanasai flight. And we aren’t inviting any of those monkeys.

If The Shoe Fits

I have some serious updating to do...So let's timewarp back to Thursday...
As you all know we have been at Karigiri working and learning about the leprosy patients this week. Today we were invited to attend a mobile clinic with a dermatologist. This morning was somewhat like what we did with the nurses at CHAD, only this time we set up shop in an old building and the patients in the village stopped in if they had a medical concern. We saw quite a few patients who needed basic hypertension/diabetes check me ups. One of the most interesting patients was this lady here in the photo. First of all this beautiful lady is absolutely the tallest Indian I have met so far. I mean this gal's like Andrea Dillard model height type of tall. So that was crazy. But anyhow, she actually has seizures and came by to talk about medications. We noticed her prosthetic leg and asked her how it had happened. Turns out about 10 years back during one of her seizures she fell into a fire and lost her leg due to flame burns. She walks very well with the prosthesis, though. One of the best parts about the mobile clinic was getting to chat it up with the dermatologist physician. She was a super teacher and, even more important than medical knowledge, she really cleared up alot of my confusion regarding who the heck actually owns all these damn cows. So that was just oober helpful and even more importantly, she let us in on the ultimate secret. The secret the locals have kept from us for 3 weeks. Folks, the secrets out. Theres a Baskin Robbins in town and we heard they're selling hamburgers. We took the docs advice and hailed a rickshaw to the so called haven of cake and ice cream and meat. After a detailed examination of the menu, however, we discovered the small Hindi script next to the photo of the juicy delicious Hamburger. It read "AMERICAN STYLE chickenBURGER!!" And so we got icecream to go and dreamt all evening of a day when beef will be available to all and Filet Mignon will rain from the sky. We headed back to Karigiri for an afternoon in the Prosthetics/Orthotics Dept. This guy in the pic who's showing off all the stylin' footwear works in the department and he led a portion of our tour of the facility. He explained that leprosy, diabetes, and polio patients benefit immensely from the specialized footwear they make in the workshop at Karigiri. There is a ridiculously long process that all this tree sap goes through to become black leather that then becomes a variety of prosthetic or orthotic devices. So after our tour we got to looking at the Wall-O-Shoe options that they give the patients to pick from. I'm not sure if the curry is starting to affect our judgement or if the shoes were legitimately attractive but either way these guys can throw together a good looking pair of kicks. And I swear, this has to be the best bargain in town. We paid 300 Rupee ($6.50ish) for these crafty men to make us black leather sandals, specifically molded for our foot idiosyncracies. (Arch supports and everything!!) As we made our way home in our new orthotics I couldn't stop thinking that the whole operation was absolutely an Indian version of my mother's lifetime dream come true. And since I am becoming my mother, I'll admit I'm now on their mailing list.

Karigiri: A village without pain.

"Leprosy (from the Greek lepi (λέπι), meaning scales on a fish), is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract. During the disease course, skin lesions develop that are lighter than normal skin color. These lesions have decreased sensation to touch, heat, or pain and often do not heal after several weeks to months. Patients also develop numbness in the hands, arms, feet, and legs and with long-term leprosy may lose the use of their hands or feet due to repeated injury resulting from this lack of sensation. The M. Leprae bacteria often causes a "lion like" facies due to a destructive infectious process in the nasal cartilage and eyebrow area. Loss of hair, respiratory difficulties and cataracts also develop. The exact mechanism of transmission of leprosy is unknown although the most widely held belief is that the disease is transmitted by prolonged contact between infected persons and healthy persons. Treatment is with a multidrug therapy of dapsone, rifampicin, and clofazimine. Worldwide, two to three million people are estimated to be permanently disabled because of Leprosy. India has the greatest number of these cases." -University of Maryland and Wikipedia online resources.
Karigiri is a leprosy treatment and research facility on the outskirts of Vellore,India. In the 1950's several physicians from CMC developed the concept for a center for leprosy and within 10 years they broke ground in a desert area known as "Elephant Hill" and completed plans for a 200 bed Inpatient facility, operating theater and laboratory. This week the Vellore Four have had the amazing opportunity to work at this facility. On Monday morning we were given the grand tour including a video over the history of Karigiri. The hospital boasts a specialized PT/OT department where patients learn how to complete daily tasks even with their disabilities. There is also an ophthalmology center for the treatment of cataracts and other leprosy related eye conditions. One of the coolest things at this facility is the reconstructive surgery center where many orthopedic surgeons provide hand and foot reconstructions for leprosy patients. One of these surgeons is Dr. Paul Brand, an orthopedic hand surgeon and author of the book "The Gift of Pain". This book is really amazing and describes the importance of pain in the human life and the devastating consequences for leprosy patients due to the absence of pain. During our tour we also saw an extensive lab where microbiologists are performing drug resistance research on mice. The leprosy bacteria cannot be cultured in a lab requiring the researchers to inject the leprosy bacteria into the feet of immune compromised mice to grow the bug. They then use the mice to see what meds are working for the disease. Another really cool thing about Karigiri is this really big prothesis and orthotics workshop area and agricultural and dairy farms that the leprosy patients work at. This outlet provides the patients a sense of duty and also a means for making a little cash on the side to pay for treatments. (Side Note: something I really appreciate about India is that they require patients to pay for at least a small portion of their healthcare. I mean they might only make a leper pay 5 Rupees for a walking boot but somehow it gives the patient's a little respect and ownership over their care and I think the U.S. could learn alot from that.)
Today we spent the morning doing surgery rounds with an orthopedic surgeon.(attached pic is of some nursing students and this guy teaching us about a non healing ulcer) The surgical wards house about 20 people per room and are separated into male and female wards. Every patient in the ward has at least one extremity if not all four with major deformities and amputations. They are wrapped in bandages and on rounds the nurses remove countless layers of gauze, allowing the surgeon to review and make assessments and plans for treatment. One lady in the ward had the classic "lion features" With her permission I took her photo and it is above. I don't have a great photo of her full body, but basically the disease has caused her so much numbness in her hands that her fingers are completely worn off on both hands and her legs are covered in non healing ulcers and amputated to the ankle. NOTE: THE FOLLOWING DESCRIPTION IS SUPER DISTURBING AND NOT FOR THE WEAK STOMACH....The most horrifying wound we saw during rounds was a man who only yesterday presented to Karigiri. On the anterior portion of his left ankle he had a 15-20cm gaping lesion with deep creveces of necrotic tissue which seemed to me to be moving. On closer inspection his wound was crawling with at least 100 tiny white maggots eating the dead tissue. After puking up everything I've eaten since January I got my wits about me and learned from the surgeon that most patients come to Karigiri with maggots in the wounds, but this is actually a blessing as they remove the dead tissue and keep the wound clean. Yeah maybe so. But it's still disgusting. After the marathon surgery rounds we were invited to go to the operating room to watch the debridement of several cases of osteomylitis. Turns out they've got the same sexy scrub suits and communal flipflops as Vellore CMC. So that was awesome. And we took a pic. Tomorrow we head out to the mobile clinics to see leprosy patients in the villages. Should be totally amazing and I will post again with our adventures.

CMC FoTo's

These are just a few pics of the hospital in Vellore (Christian Medical Center). We spent last week at this hospital for our surgery rotation. One of the photos is of the roof of the CMC building. This is where they are doing the laundry for the operating theatre and wards. In the pic you can see all the bedsheets and surgical drapes hanging out to dry. Under the covered area are all the surgical gowns hanging to dry. After they dry the surgical items they send them to the autoclave. I’ve discovered the big theme for Indian hospitals is “Reuse”. My experiences in India have taught me a lot about the wastefulness of the healthcare system in the U.S. Another pic is of the bustling nursing students on the surgical ward.

A Three Hour Tour

Kerala is an Indian state located on the southwest coast of the country. During the V-Four’s time in India we had heard amazing stories of this faraway land. The legends told of Ayurvedic massages, white sandy beaches, and all you can eat jumbo prawns. So we booked an overnight 14hr train ride to visit this land of promise and possibility. After our crash and burn bus experience, we decided we might be better suited for train travel. It turns out that just because you have a “Class 3A Sleeper Car Beds for Four” train ticket does not necessarily mean that there won’t be at minimum 3-4 Indians already sleeping under your covers. So we decided to call it a 50 person Indian style slumber party and managed to nuzzle our way into the bunks. On arrival in Kerala we first toured Varkala. This place is a beachy paradise with delicious cocktails and fresh fish and lots and lots and lots of t-shirts with a lifesize photo of Gandhi’s face on the front. (Don’t worry. We got one for each of you.) So we spent our day at the beach and even made an attempt at bodysurfing which sadly resulted in the sacrifice of my fave blue sunglasses to the Arabian Sea. These were quickly replaced with snazzy aviators during the most intense power shopping event of all time. During this event the V-four finally gained the upperhand in the Indian bargain sector by introducing boardwalk salesmen to the puppy dog protruding bottom lip. After a Keralan feast and four Diet Coke’s (these are a rarity in Indian culture and for some reason taste like liquid heaven) we bedded down at the Kerala Bamboo house. This place is the best bargain in town. For 20 bucks a night you get your own little bamboo hut complete with pink mosquito net and a roofless bathroom with jungle painted walls. It is quite an experience to look up from your bathroom to see palm trees swaying, the occasional bird flying overhead and the constant fear that shitdevil monkeys may have migrated west in the last week. After a breakfast of crepes we checked outta our huts and bused over to a town called Alleppey. It was in this town that we boarded our “Deluxe Three Hour Guided Tour of the Keralan Backwaters…complete with tasty snacks and cool beverages…all aboard an elegant wicker cruiseliner” Ok. No no no no no. That brochure is a bold face liar and we know it. The truth is that the Vellore Four were sent on a never ending Eufaula Lake float trip with a non verbal teenage boy who, when asked if it was snack time, pulled over to the side of a canal to an establishment I would describe as “Starbucks of India Village”. This joint is run by this lady who’s making chai and onion donuts in her hut kitchen and then these two jokesters that basically just stand around and eat all the donuts. (that’s them waving at the door of the “Starbucks.”) We bonded with the locals and proceeded to experience longest float trip ever. And I do have to say that the Backwaters are actually very gorgeous and a lot like India’s version of Venice with all these little canals and villages and you should definitely go there next time you’re in India. We washed off the backwaters at our hotel which I have to give a little shout out to for providing us with a large turning point in our travel plans for the remainder of India 2009. Liz happened upon 4 inch antennas, likely belonging to biggest ever cockroach peaking out from behind a mirror, and thus..Readers…The Vellore Four are no longer selecting hotels from the Budget section of the travel book and from now on will only take suggestions from items under the bolded heading “Luxury”.
So anyways we notified the authorities and got the heck outta dodge and spent Sunday in Kochin. This town is wonderful and has a forever long row of big Chinese fishing nets where some guys climb all over this unstable wooden structure to catch fish that they’ll sell you for super cheap and then grill it up with some rice on the side. So we ate that and then managed to squeeze in a tour of a basilica, a cathedral, a Jewish synagogue, and a little Indian antique shopping. We even had time for Chinese take out before boarding our overnight train towards the east where we battled the Indians in a cruel game of freeze out and don’t give the Americans bedding. But we bundled our bodies in mosquito nets, new scarves and head lamps and as soon as the frostbite lets up we’ll carry home the gold and deposit our love letter to India in the big red box pictured above.

When you’re slidin’ into home and you’re feelin’ something groan….

Diarrhea. Diarrhea. So the vomiting and stomach gurgling finally started and we’ve had one V-four member vomit in a flower bed during the walk to work and another puke it up on the balcony of our hotel banquet hall. (I will not disclose names of these persons) But we’re taking it like champs and nothing stopped us from beginning our rotation on the General Surgery service at the Christian Medical Center this week. We decided to bust out the scrubs we brought from home for this event. Turns out that was completely inappropriate as Indian scrub suits are required to be worn in size Gigantor only. So we changed and entered the OR. What’s happening back in that OR is just so hysterical I have to let you all in on it immediately. I preface this by saying that everyone in India is wearing flipflops. I mean I have not seen one set of closed toeds anywhere. And it turns out this trend extends into the OR with surgeons, techs, nurses, and patients donning the flipflop style. The other wonderful part about the OR is watching the Chairman of the Department of Surgery tap his toe and whistle to an album on continuous repeat of elevator music gone techo versions of “I’m on top of the world lookin down on creation…” In our spare time on surgery we have been visiting our favorite restaurant in town which is a family run Punjabi place. Punjabi means the food is all veg and completely awesome. They have a pretty thick cockroach infestation going on but their naan is so out of this world that the bugs have started to seem like an endearing quirk. This is a pic of the guy that runs the naan maker. (naan is basically an Indian breadstick) That’s all the blog time I’ve got tonight as the Vellore Four are about the catch a night train to Kerala. (a beachy paradise on the west coast where no one has the ria and the streets are made of gold).

Dancing Monkeys

This past weekend the V-four were brainstorming ideas for an exciting weekend getaway trip. We flipped to the section on Pondicherry and read the description of this former French colony with legendary pancakes, beaches, and a Ralph Lauren store. Immediately we knew this was sooo our kinda place. We shoved the essential swimsuit and flipflops into a communal backpack and headed to the bus station. The process of getting on a bus in India is one that deserves a little blog time. Ok the way this works is there is like 200,000 Indians, a herd of goats, 4 lost Americans, and of course your standard 25 lazy cows. (And just as a side note I’d like to say to the cows that Yes, We get it. You’re special. But just get outta the damn middle of the road. ) So anyhow all of these people and animals are all trying to ride on a bus to some town in India. This is complicated by the fact that none of the buses have numbers and everyone including the driver is somewhat unclear on where the bus is actually headed. 4 lost Americans have the added disadvantage of being lied to about where the bus is going so as to try to get 4 lost Americans to pay for a bus ride that 4 lost Americans think is taking them to pancakes and shopping. The other interesting part of public bus transport is that 200,000 Indians plus 4 lost Americans on a bus that holds 50, equals many Indians hanging on like Tarzan to bumper stickers. This also makes it extremely treacherous to exit the bus with your flipflop filled backpack at your stop. (see photo of me in the blue shirt trying to hurdle my body and the backpack through 200,000 Indians, and our new 5th lost American friend Robert trying to save the me/backpack combo) An added bonus for 4 lost Americans is getting to play in the obstacle course of buses going fullspeed toward oblivious Americans and leaping over the puke vomit of car sick Indians…only to be puke vomited all over at the end of the day. (really so sorry about your left foot Andrea)
But enough of the bus talk. So we finally did make it to “Pondi” and found the legends to be true. The pancakes were huge and fluffy and scrumptious and the mojitos were even better. The Vellore Four spent a lengthy amount of time with an Indian bartender explaining the delicate method for creating the ultimate Mojito. Our efforts only added to our extreme satisfaction with our Mother Teresa effect on India. Other humanitarian efforts include introducing fellow Indian bus travelers to pocket size hand sanitizer gel and GPS. Pondicherry highlights included visiting an ashram which is this big spiritual mecca which was started by “the Mother” who was this old woman who died back in the 70’s but they have a gorgeous shrine of flowers to her and they make a killing off of this gushy book which is basically “Chicken Soup for the Soul” by the Mother. We also took a beachwalk where we met a boy and his sidekick pet monkey that is supposed to dance for money but doesn’t actually move much and looks a bit on the sick rabies side of things to me. (We saw the boys old man boss in an alley later in the day. He was dressing the animal in pink doll clothes. I guess everybody knows a monkey is way better in a pink dress.) On the way home we made a side stop at Gingee which is a town that boasts two famous ruined forts (Rajagiri & Krishnagiri) . We trekked an hour to the base and a bagillion steps up to this thing and it was totally worth it. Somehow our group managed to pick up these two geriatric tour guides along the way and they did a slambang job of warding off adorable monkeys who morph into shitdevil monkeys before your eyes.
We eventually made it home safely after another 3 hour bus station adventure which resulted in more puking and the V-four ditching the buses for a private cab with A/C. All in all it was an outstanding trip and we learned lots about Indian weekend getaways. So next time we’re hiring a personal driver. And he’s taking us to a massage spa and lots and lots of mojitos.