The Grandest of Rounds

(^ view of vellore from the top of the hospital library)

The next day at the hospital was "Grand Rounds." In the US, that generally involves a speaker standing in front of an auditorium of exhausted housestaff picking at their free coffee and bagel educating about their research. Very different in India. This was all 3 sub-teams of my giant medicine 1 team rounding together on ALL 45 patients (that's about 5 times the normal team patient load). This started around 8 am, and had I stayed the whole time, ended after 4 pm. Straight rounding, if you're not in medicine you may not truly appreciate how brutal (and holy crap, inefficient) this is, especially since we were rounding with a team of at least 20 people from bed to bed.

As before I could hardly understand (or hear) anything that was being quietly mumbled, which is incredibly frustrating. Then I turned around and saw a random middle-aged white guy with a back pack. He was accompanied by a middle-aged Indian guy. Turns out the former is the head of an ID department back in the states doing research in a disease fairly prevalent in India and was just there to observe for the week. The wonderful part about this is that it upped the ante for rounds. That Indian dude stepped in (he must be the top dog of the department) and snatched rounds from the director who had been leading them up to his arrival. He spoke loudly and clearly and even told the presenting resident to "speak up so people can hear you," amazing-- it's the simple things. Sadly that won't last. Also it turned into more typical rounding as I'm used to, with the residents being pimped and studies being cited, etc. He trained in the US apparently and it showed.

This was also great because I learned what all of our patients were in for! And man, it was all the stuff you learn about for board exams in medical school and never see... dengue, malaria, and chikungunya (yeah, I've been wearing DEET like white on rice), and more rare infections like listeria (though I'm still eating tons of unpastuerized dairy here 'cause it's delicious), leptospirosis (transmitted by rat urine in water supplies, mmmm), mucormycosis in a diabetic (textbook.), spotted fever, scrub typhus, etc.. Really sick patients with these diseases, but it's medically interesting to put a face to all of these diseases.

(^ internet whenever we can find a wifi signal)

I'd heard from students who had been here in the past that the local medical students play soccer every evening. I didn't have any more details than that--ie where or when--but I asked around for the "oval" and after crossing the street outside the campus gates I found a brown, dusty "field" surrounded by a brown, dusty "track." There was a cricket game and some kids playing soccer shooting browned balls into a holy net, though attached to a sturdy metal frame. The people power walking around the track were dressed in their normal day clothes--saris and sandals for women, button downs and pants with sandals for men. Clothing which is not super conducive to exercise, but I was impressed with their efforts regardless.

A shot through the holy net made it's way over to me so I passed it back and began approaching the group of 20 male Indian med students... I was both the only white person and the only female. One nice student introduced himself, his name was Jonathan, and once I had the in I was able to easily join. I was afraid to take off my jogging pants and play in shorts despite the oppressive 95 degree heat, especially with all the women around in saris. But it was too hot, so shorts it was. (It's disrespectful to show shoulders or knees although midriffs--no matter how fat--are allowed. I also don't think it helped that I was wearing only shorts when I accidentally kicked the ball into an Indian woman's face. Not my fault that the field and track overlapped and there was vulnerable passerbys though, am I right?).

We played full field in the dirt as the sun was setting. Every time the ball was kicked there would be a cloud of reddend brown dust that blew right into my eyes and mouth and made it difficult to breathe.

The guys had impressive foot skills, one was even playing really well in flip flops against others in cleats! Sad story about that guy though is that he is only in vellore while his brother is in rehab from a motor vehicle accident that paralyzed him from the waist down. But on a lighter note, despite being unable to see or breathe it was tons of fun and given that they have no expectations for girls playing sports, I earned their approval.

They continued to play as the sun went down and the ball became increasingly harder to see. As the sun set over the trees there was prayers on loudspeakers nearby and a flock of hundreds of bats started flying over the field. It was pretty magical.