India Day 4: Miche's 2nd blog

As Nick and Ben plunged into the warm, fetid waters of lake pichola, I was reminded of the opening scene from slumdog mlllionaire when a young boy, locked by his friend in a Mumbai outhouse, plugs his nose and drops into the sewage laden muck below.   

India is a land of contrasts.  As I look out upon the beauty of lake pichola, surrounded by mountains and opulent palaces turned hotels, I see a loveliness fractured at the edges, where tell tale blooms of algae rise from tepid waters like the arms of some deformed Frankensteinian creation to grab plastic bottles, empty bags of chips, toilet paper and other spices and stir them into man's special stew.

If lake pichola, a relatively clean and quaint tourist town, is fractured around the edges, mumbai is broken down the middle.  The train from here to there has a bathroom with a hole in the floor opening directly to the tracks below.  Looking out the window, a sea of trash creates an umbilical cord to the third world which has not yet been severed.  

Mumbai's waterfront has a promenade stretching for miles and miles serving as a respite for millions of people to escape chaos and concrete.  The serenity that I typically feel when gazing out upon the open waters of the ocean was thwarted in Mumbai by my sense of smell and the ubiquitous stench of raw sewage that became strongest near the rivers and the estuaries, where once clear waters, blue like teardrops, have been transformed into some form of monstrous excrement, like Godzilla's diarrhea.

The contrast of people in Mumbai is as evident as the landscape.  Many sleep in the streets and many more in the slums.  As far as the eye can see, ten by ten rooms have been built using cinderblocks and rocks for walls, and tin and tarps for roofs.  These adjoining Swiss army homes stretch into the horizon providing shelter for thousands and thousands of families, servicing as bathrooms, bedrooms, kitchens, and living rooms.  Next to the slums are decaying apartment buildings, arcing their backs to the heavens like some primordial amphibian crawling onto land for the first time.  Further down the evolutionary block, are apartment buildings under construction, holding promise for the human species.  And among a skyline where miles and miles of skyscrapers cast shadows on the slums below, one super structure symbolizes both gloom and hope, and serves as a living testament to the ambition and inequity of man, a 570 foot behemoth with 27 floors. 11 elevators, 3 helicopter landing pads and 400,000 square feet of living space.  This is what $2 billion dollars can buy one family.  It seems as if this home, named 'antilla' should be 2 billion miles from the slums upon which it casts a shadow, but India is a land of contrasts.

In a land of kings and serfs, for my fortieth birthday, I chose to live like a king.  We are staying in a palatial suite with beds that have ornate carved wood frames and a ceiling inlaid with tile.  A daybed in the corner is surrounded on three sides by windows overlooking the lake with enchanting views as far as the eye can see.  We dined on the rooftop of our hotel and were served as sultans while lying on a king sized daybed with views of the sun bleeding into the horizon.  For $80 per night, the cost of this hotel is in stark contrast to the United States.  

As I think of home and the memories I will take back with me, the gut wrenching feeling of looking at the dirty face of child after child living in abject poverty with no chance for education or advancement will remind me how lucky I am to have grown up in a land and environment of opportunity.

India Day 4: Udaipur

India Day 3: The Train

India is massive. Last night we boarded an overnight train on our way to Udaipur. It was late, but Mumbai was bustling with the drop in mercury. In fact, there was a wedding celebration just outside of our hotel. We were keyed into this fact by the seal-bomb-like-explosions on the street dispersed intermittently between drumming and singing. Of course (like my sister before me) when I heard explosions I stepped out to see what was going on, and was immediately engulfed in a crowd of dancing Indians, with an elaborately dressed couple in the center being blessed from above their heads by various crowd members. The air was filled with joy and dancing from all ages. Young persons setting off fireworks as if they were going out of style and in the crowded street no less.  We made our winding way through Mumbai one last time as we headed for the train terminal. Ben booked us on a sleeper train

for the 15 hour ride to Udaipur (A/C, thank god Ben planned ahead!!). It was late, so we slept most of the way. However I enjoyed a true Indian moment this morning; I sat next to my window watching the countryside roll by with a great book in one hand and a hot chai in the other, it felt surreal. 

We finally arrived in Udaipur, India's most romantic city, and it's title is well deserved. Now, I am used to sleeping in some questionable places while traveling super cheap, but this time I am traveling with employed peoples who have chosen (and paid for) a spectacular hotel

that overlooks a magnificent lake. Words cannot express how incredible our hotel is, not to mention that we are the only occupants. After getting settled we walked around this cute little lakeside town and found ourselves on a peninsula sporting a plain temple. There were many locals swimming, bathing, doing laundry, etc in the steps leading into the lake from the temple. While we stood there admiring the spectacle the temple keeper came up to us and chatted about the city, where to go, how much to pay, and even gave us a private tour, which included walking around on the roof with great views! After watching all of the kids swimming I came up with a crazy idea that Ben and I should dive in and swim to our hotel. Ben was a little reluctant to say the least (perhaps because of swimming in contaminated water or the crocodiles the guide books warned us about). Needless to say I talked him into it. I mean, come on, swimming in India!! So we stripped down to our skivvies (much to the chagrin of the locals) and dove in. The water felt warm and amazing. We swam, heads up of course, across the little lagoon to our hotel where we met up with Miche who had carried our clothes back around. Next we retired to our hotel's restaurant for miche's 40th birthday dinner

. As we watched the beautiful sunset the lake became inundated with large birds, which upon closer inspection turned out to be giant bats!! Hundreds of them! Incredible! We ate and drank to our hearts content sharing stories and setting new bucket lists. Miche seemed to be very contented with his birthday. What a day!!

India Day 2 by Miche Hogan

India day 2: (Miche). There were many laughs involving India, Indian food, bathrooms and the "traveler's curse" in the weeks leading up to our departure.  On our second full day in Mumbai, there was bathroom event that took me by complete surprise and has made my fears grow even larger.

The day began early when the non-stop honking of our continuous alarm clock grew to a deafening roar in the streets below.   Our cab drivers have hit their horn on average 20 times a minute, and it seems an entrepreneur could do well with a custom horn shop to replace the ubiquitous beeps with an occasional "quack" or a "moo". 

We made our way out onto less unfamiliar streets after a lazy morning, growing more and more aware of the enormity of the city around us.  The skyline, as far as the eye can see, is filled with skyscrapers.   New beasts are bursting from the ground everywhere and it seems as growth is only limited by a shortage of cranes.  As we drove through miles of skyscrapers in one small section of Mumbai, our taxi driver told us they had all been built in the last 15 years to support the textile industry, at least that is what I think he said.  I think it must be like watching New York go through its Big Bang.

The people that fill these buildings come at you from everywhere in every type of vehicle imaginable.  My favorite so far is a tie...watching 14 people emerge from a five passenger microbus, or getting passed in our taxi by a man and a wife riding a one seat motorcycle with a baby between mom and dad and a small kid hanging off the back.  Luckily, dad was one if the few motorcyclists in Mumbai to actually be wearing a helmet.

The people stare at me when I am looking and I stare back when they are not.  I see faces shrouded by every color imaginable and most of them are smiling.  The melting pot of Hinduism , Buddhism, and Islam is fascinating in its diversity and beautiful in its vibrancy.  Bright colors come at you from everywhere and please my greedy senses.  A child wearing a pink and plaid dress and a bright pink hat rests on the lap of her mother, clashing against purple henna pants, a purple and blue striped skirt, a light and dark green patterned shirt, a green, purple, black, tan and turquoise scarf, and a black and gold necklace pressed against chocolate skin.  

The colors come at you from everywhere, But what  caught my eye and captured my heart was a faint silver and black henna embroidery which was barely visible on the sleeve of a woman wearing a black burqa.  Through a sliver in the burqa I saw her dark eyes, radiant against dark fabric covering her from head to toe, revealing an inner beauty of a people to whom I am a stranger.

With the chaos and confusion of millions of people bustling in all directions, we needed a plan in case someone got lost.  'Stop and look for the white guy' was executed to perfection when nick disappeared in the bazaar.  We have seen only a handful of other tourists, probably because it is the middle of the hot season.  After visiting the grand rail station which was built by the British in the late 1800s and gawking at its stunning architecture, I was soaked.  But I only sensed a much richer history to this strange and exotic land on which we travel after boarding a ship destined for elephant island.  The island contained a series of caves which had been enlarged and filled with 30 foot tall statues carved out of rock with elaborate murals chiseled into the cavern walls.  Buddhist monks labored over centuries long past working day and night to pay tribute to gods with statues they would never see finished in their lifetime.  

Sightseeing works up an appetite and we have been fortunate to find some incredible food on which to dine.  Service is a priority and during each meal we have had at least four waiters.   They like to stand close by and stare at you while you eat, so it does take a bit of getting used to.  Nick likes to challenge the waiting staff to very very spicy food which brings me back to the bathroom event that has taken me by surprise and very very fearful for our 15 hour train ride which leaves the station in 1.5 hours.  All quiet on the western front.  Number two has not come to visit.  There have been rumblings, but no major seismic activity.  Quite unusual for me especially considering the spicy Indian food.  Stay tuned....what is life anyway without a bit of adventure?

1st day in India!!

India Day 1: we arrived early this morning at the airport, which was recently renovated and looks amazing. Of course, my bag was one of the last ones off the belt leading to an extra hour stay but it was not that bad. Next we found a pre-paid taxi to our hotel. I have read in several books India being described as "an assault on the senses", even though it was late at night, the smells emanating from this metropolis laid siege to my nostrils. These smells were not necessarily malodorous but rather overwhelming in their complexities.   Ben had neglected to mention our hotel was in ghetto-ish territory,

which made Miche and I nervous as we were dropped off in front of a group of "interesting" fellows and told that our hotel was "around the [sketchy] corner". Luckily, it WAS just around the corner and Ben was waiting in the lobby (a sight for sore eyes indeed)!! After a good night's rest we set out in the early morning, only to discover that Mumbai does not awaken until after 10am. After a brisk walk to unveil our surrounding area, we enjoyed a simple breakfast and then hopped into a taxi headed towards the center of town. Now I have traveled to many countries, and I have experienced impressive traffic before, but nothing could have prepared me for the shear sphincter puckering insanity that occurs on the streets on Mumbai. It is as if there is a Lord-of-the-Flies-mentality on the road, where cars will honk then accelerate towards their street-crossing prey, where fitting as many cars across as few lanes as possible is "sporting good fun", and  honking must be India's favorite pastime. After seeing our lives flash before our eyes (several times) we arrived at our destination the Arch of India, it was crowded and impressive. We walked around the city as the mercury rose until our thirst drove is to seek refuge in a nearby restaurant that just so happen to serve cold pitchers of Kingfisher beer. Ahhh! Heaven. 

Our exploration continued as we visited mosques, street vendors,

and hanging gardens. Finally, after several hours of walking we decided to get some grub and found ourselves at a quaint little cafe where we let our palates rummage through some of India's finest cuisine; red chicken, butter chicken, and chili chicken. Spicy and deliciously  fabulous!!

After this exquisite late lunch we made our way back to our hotel for a much deserved nap, which turned into a 14 snooze (jet lag is a bitch). This is were you find me. Stay tuned for more updates!!

A medical school note 06/19/13

I have finally made it to fourth year of medical school and sadly I have found medicine to be somewhat disenfranchising. Because of electronic medical record keeping I will become one of the highest paid tempests in the country. There is almost a 1:3 ratio time spent with my patients to typing and charting. I understand the value in good notes but even the notes are bogged down by useless inserts, tables, legal commentary, and templates ROS. I don't know which is harder trying to translate a doctors hand writing or sift through pages of useless data and billing info. Then comes my training, they have shortened my hours, hurray I guess but now I have to learn as much as my predecessors in almost half the time! Now all of our procedures are becoming more and more dependant on advanced imaging that may not be available in many settings therefore docs will not learn how to do specific procedures by hand.  It's no wonder we are cranking out some poor doctors. I also find it sad that the most crucial physicians (primary care) work the longest hours, are responsible for the largest scope of practice, are paid the least, and do not command much respect from the medical field.  Residents appearently still have to take out loans during residency!! When will I ever make enough money just to pay back what I owe?

Ugh. As of this moment I am waiting for residency interview invitations. Nervous as can be, I will admit I was not stellar in school but I did okay. All I want is to have good training so that I can provide great care to rural residents.  I want the ability to travel abroad and make a difference, to be that doc that hits his call light when there is a medical emergency on a plane.  I want to be challenged everyday and feel as though I am making a difference in other peoples' lives.  But at the moment I feel like I didn't use the angles/tactics I should have to get to where I needed to go. I picked hard assignments for their learning potential rather than their grading reputation. I feel as though I have taken every opportunity to learn as much as I can and I feel more and more like a "real doctor" everyday but still fighting an uphill battle.  But enough of the "I's".

This has been a hard year but a fun one. I discovered drop in soccer at Seattle Central with a bunch of international guys and the Huskies are doing great this year.  My Patriots and Seahawks are doing well too.  With interview season coming up I will get to travel around a bit.  Lidia and are no more, which ends a great and sad chapter of my life. 

And.. saw my first concert this year.. It was amazing!  See you out there...

Clinical Medicine Day #1

Well, I survived my first two years of medical school.  I don't know how or where I rank in my class but I did it.  Last week I took the USMLE Step 1 exam, which I had been studying for 2 months prior.  I must admit that it was the worst two months and subsequent exam in the history of me.  The results come back sometime this week and to tell you the truth I am utterly terrified to look at my results.  For the first time in two years I will be objectively compared to my peers and and my future career options hang in the balance.  I need a 190 to pass and anything above a 220 is a  must as far as applying to any field other than Family Medicine. Right now I feel like I may have achieved a 191...  But as I sit here preparing for my first day learning clinical medicine I am driving the exam as far from my mind as possible.  This past weekend my mom celebrated her 60th birthday.  The whole family met up in Seattle, dined, and watched a spectacular play Les Miserable that my dad bought us all tickets to see.  It was spectacular and I enjoyed every minute with the family, especially beach time with the Hogans.  This first two week clerkship is Anesthesiology.  I may be interested in this field so I hope to achieve Honors.  I realized that I have not written in a while and I have skipped over some amazing/terrible experiences but hopefully I will start writing more frequently now that I don't have to take my work home with me every night.  Wish me luck and stay tuned!!

Fainted

Fainted.  Today sucked. I was up all night with Laila grumbling about how no one wanted to go out and live a little while we sat in bed and did nothing all night.  The next morning we had a skin clinical tutorial where we see over 20 patients with different skin diseases.  We woke up late, as it was the 8^th day of the week we had to be up early and missed our bus to the clinic so we walked the 1.5 miles there (waiting for the next bus would have taken longer). We arrived just in the nick of time and were thrust into a group of my peers some of which I knew.  Our first rotation was in the break room where we enjoyed pastries, water, and coffee.  Then we went to our first patient who had alopecia universalis (baldness all over their body).  It was a very interesting case and even though we only had 5 minutes we were able to ask plenty of questions.  The second patient was their with their mother and we all crowded into this tiny exam room (all 13 of us).  I was at the far end and as we got started I knew something was wrong.  The room felt incredibly hot and I could feel the blood draining from my face.  I thought to myself “5 minutes, only 5 minutes and we can get out of this hot room”.  I leaned back hard into a counter and braced myself as best as I could.  It was like I started to dream and then I awoke to standing in the middle of the room with everyone’s hands on me.  I dazedly looked around and asked what was going on.  “You fell over” was the reply.  I couldn’t believe it.  They sat me down and lifted my legs while the dermatologist asked, “Was it something you saw?” Ya, sure, it was the scared skin that sent me over the edge… Luckily the only thing I hurt was my pride, which didn’t get any better as I laid out in the hallway and every 5 minutes a group of my peers past by on their way to another patient and inquired as to why I was there. I finished out my rotation still a bit light headed and everyone joked with me, which made the embarrassment tolerable.  Though I worry about surgery and standing for long periods of time… We’ll see how this will turn out.  Now I am on a bus up to Bellingham to see my sister, brother, and nieces.  It’s going to be a lonnnnggg week.  Until next time….