In my final week here in Vellore, I opted to go back to LCECU as I enjoyed my first week there... and partly because I originally had designed my time here to be split up into 2 one weeks rotations and 1 two week rotation. This morning was kinda of slow to get going, as monday mornings usually can be - those in charge not showing up till 8 am. I had a nice chat with a OB/Gyn physician origonally from Detroit who once tried some tropical medicine courses in the Amazon where she met a group of people who were headed to Vellore, she accepted an invitation to travel with them and decided to stay for a while once she got here. She had just returned from a trip to Mysore this weekend and so we chatted about what I should see while i'm there during my travels. She was also the second person to discourage me from going to a wild life park as they aren't designed to allow people to see any wild life. Instead she recommended I visit a nearby town with some old ruins of a fort that she particularly liked. It was a nice chat!
One chore I wasn't looking forward to was asking whether or not in the week that I've been gone, with a friendly reminder this last thursday, if they had managed to get my required evaluation form filled out. I know KU needs some tangeble way to evaluate the month, but it truly is a pain and inconvenience to everyone involved to make it happen. It's hard enough to get evals filled out by our attendings back in the states, let alone a physician over seas that we've only worked with for a week. So, I did ask, and of course nothing had happened. I didn't make a big deal out of it, but it did seem like I had put them at an inconvenience for bringing it up again. Oh well, it finally got done today and what's done is done... I've got my required eval.
On a brighter note, I got to see some interesting pathology with the most classic case of Molluscum Contagiosum that i've ever seen. We also had an interesting talk about how patients manage to keep their insulin useable at home after a lady presented in possible DKA or lactic acidosis from being on Metformin while in renal failure. With insulin it's important to keep it refrigerated or cool, otherwise it starts to breakdown and does not work. So with the lack of refrigeration available to the typical LCECU patient, I wondered how the insulin did any good at all. Apparently by storing the insulin in a small clay pot that is set into a larger clay pot with water and out of the sun... it stays cool enough to have some activity, and they learn to adjust the amount accordingly. It's not the best medicine model, but it is the most effective model for these patients.
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