OCT-B-6
A THIRD
CLINIC DAY UNDER COVER OF RAINCLOUDS, WITH HIGH PATIENT VOLUMES,
THIS TIME IN KALIM PONG,
October 9—10, 2003
I begin this day’s typing on a significant birthday for my sister Milly, whom I had sent a card, which may not reach her for weeks after the event. So, I will try to find a live connection to the internet somewhere today to relay those greetings directly despite the half-world away 11 ½ time zones which already puts me beyond her birthday.
I am, again, perched on the porch, looking out over what would be the direction of the snowcapped range of the Kanchenchunga. Although there is heavy cloud cover over it right now, there is the possibility that the unprecedented rains of October may dissipate this cloud cover and reveal this massif to us later today. I have prepared, again, for the dawn run, and the drizzle that is all that persists from the downpour of the last several days may allow that to occur at last, although it aborted the run yesterday. It may have kept us from seeing even more patients than we did for people who might not have been comfortable coming out and standing in such a saturating rain, but each clinic day has been from 250 to 350 patients, so it is likely we will see over a thousand here in West Bengal before moving on next week to Sikkim—only thirty miles or so away, but by road many hours travel in the winding hillcrest roads along the Eastern Himalaya.
Our group is made up of senior medical students which makes my job a lot easier and the throughput of patients a lot faster. I do not have to invent the wheel before riding it for seniors who have had the clinical and complete basic science courses. The volume of patients seen in the four teams that have been organized could not be possible for the Ladakh trip in which the participants are all freshmen, who do not even know the questions to be asked or maneuvers to be done, let alone interpret them through translators of variable sophistication and enthusiasm. So, I could point out some of the subtleties to the students among the patients seen, as clinical examples, and in our case presentation and didactic clinical reviews each evening, I do not have to draw them a picture to describe what has been seen.
THOUGHTS FAR AWAY ON THE OTHER SIDE OF THE WORLD
WHILE WORKING HERE IN A FAMILIAR ENVIRONMENT
I have been thinking about many things left unfinished and unresolved on the other side of the world, mostly out of range here in the Eastern Himalayas, while making do with what I have carried here, since my bags that were pre-packed for this experience and left in Simla for forwarding to Sikkim are now impounded in Kolcata—for reasons no one can quite explain. So, once again, I am traveling with what I can jury-rig from my carry-on bag and not counting on ever seeing the supplies I had put away for this trip—a predictable, but nonetheless annoying glitch. But, the clinical program seems to be going well, perhaps because there are few distracting options in the perpetual rains that the owner of the Sood’s Garden Retreat says is unprecedented in October, which should be an ideal trekking month.
THE MORNING RUN IS WASHED OUT FOR THE SECOND STRAIGHT DAY,
THE CLINIC IS A STEADY RUSH OF THREE HUNDRED PATIENTS
It has been
a long working day, once again, with a feeling that I am a high volume
practitioner and somewhat loggy from the aborted runs I have not
performed. The one brief shining moment
at about
I have
returned wearily to recite through the case presentations of the day with the students,
have dinner and try to type a few notes before going to bed early before
getting up tomorrow to try once again to do the run, then going off for our
fourth and last all day clinic here in Kalim Pong before we decamp to go into
Sikkim at Gangkok and then on to Darjeeling.
You will follow our every move!