Wednesday and thursday proved to pass quite quickly. On wednesday there was an ENT clinic which would have been quite interesting and educational had I observed someone who was more interested in teaching. I took for granted that Dr. Sunil and Dr. Sushil (village visit on tuesday) were the norm at LCECU and that everyone there were as interested in teaching... Observing conversations and examinations in another language already puts me at a disadvantage and I had forgoten what it's like not to be able to communicate or simply listen since my year in Barcelona. I shouldn't be so harsh, I did get to see some interesting pathology, such as a cholesteatoma, and they did explain what a tympanoplasty was. I just really enjoyed Dr. Sunil's and Sushil's enthusiasm, so the contrast appeared quite stark to me.
I had been told that I would be able to observe the tympanoplasty later that morning, but then when I showed up at the alloted time I was told that they had already started and that I should take my lunch break.
Thursday morning was somewhat unique as well. They had a Psychiatrist give a talk on the importance of and growing need for primary health care professionals to identify and either address the psychological issues or refer them for care. A good majority of the lecture was lost on me because demonstrations on how to interview patients efficiently were conducted in Tamil, however the discussions afterwards were in English and I did walk away with at least one pearl. It doesn't seem to matter what culture you come from, every human being has a need to be wanted and valued. Apparently it isn't uncommon for many women in India to come to GP's complaining of vague pains and ailments, yielding no physical findings and chasing procedure after procedure with more labs and prescriptions, without an impromvment of symptoms. My classmates here have seen similar cases of fibromyalgia in their rotations. The psychiatrist proposed that these women were actually just seeking some form of attention, no matter how small or insignificant. For them, coming back to the Dr. for more procedures or lab tests was the high light of the month. He suggested that in his experience all these patients really need is a friendly ear to listen, to acknowledge that they exist. He encouraged the lecture room to stop and truly listen when a new patient presents with such symptoms, it will save both parties involved much time and expense and produce improvements quicker then briskly ordering a lab test and dismissing them, much like these women are probably dismissed at home. This insight reinforced why on Tuesday afternoons, LCECU goes out to villages for "mother's meetings". I don't believe that all women here are treated like this or that all men in India are this inhuman... i'm positive this isn't the case. However, just like in the US, we must watch for signs of abuse, both physical and mental.
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