Caduceus Newsletter: Summer 2005.03 -- August

 

 

1.  More news from Dr. Mzungu Lungu, AKA Manny Patel, reporting from Hope Village, Uganda.
2. A free Guide to Science Writing Manual, from The Journal of Young Investigators (JYI).  (Thanks to Donald Samulack, Ph.D., Director, Department of Scientific Editing of St. Jude Children's Research Hospital for sending me this.

Stacey Bourg’s account of traveling to and practicing medicine in Manali, India, in 6 parts:
3a.  Stacey Bourg (CBU alum and M-2 at LSU) diary:  Part I – July 4, 2005:  Half-way there!
3b. 
Stacey Bourg (CBU alum and M-2 at LSU) diary:  Part II – July 5, 2005:  Manali at last!
3c.  Stacey Bourg (CBU alum and M-2 at LSU) diary:  Part III – July 7, 2005:  Surgery Indian Style
3d.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part IV – July 13, 2005:  Culturally different social manners
3e.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part V – July 15, 2005:  Traffic Jams – Manali Style
3f.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part VI – July 19, 2005:  Old man Giardia


4.  Received this month
5.  All in a day’s work…tracking jaguars in Brazil – a report by Jenny Bernard, who is participating in the MIRT program.

 

 

1.More news from Dr. Mzungu Lungu, AKA Manny Patel, reporting from Hope Village, Uganda.

 Hey guys,

 

I am glad to hear that everything is going great for everyone in their respective places (Brazil, Cali, and Memphis)...I regret to inform you that this will be my last email for about 2 and a half weeks.  We are heading back to the village and will finish up our study.  We will be passing through Kampala to pick up some medications and latex gloves and some antibiotics for the village because our supplies have run dry.  We are also going to pick up a birth kit since one of the villagers is pregnant and will be due sometime in the next 2 weeks.  And as you shall know,

they still have this premonition that I am already a doctor so they want me to assist in the delivery.  But don’t worry, there is a midwife, and I have been reading up on how to deliver a baby in my book:  Where there is no doctor:  African edition.  The women in Uganda and in this particular village are known to give birth and than tend the fields right afterwards.  So now I think it would be appropriate to talk about some of the funny things that have happened in the

village.

 

For one, I have never been so appreciative for a washer and dryer.  Men in Uganda really don’t do laundry or cook.  But since I am living with 3 AMERICAN women, I have to do my

daily set of chores like cooking (I make a some damn good Garlic Mash Potatoes) and laundry (Ed. Note:  YOU POOR THING!!).  I make sure that when I do laundry, I do it inside our hut so that the other women don’t see me doing it.  I don’t want the women to start a rebellion against the other men in the village since they don’t do their laundry.  Another thing that I am appreciative for is clean water from the taps (only in Memphis).  Every morning I get up and go and fetch 10 gallons of water from a bore hole located about a quarter of a mile away.  It is real sad when you see kids half your age carrying water faster than you.  The men usually get the water so as you can see my 3 roommates decided that this particular trait is fine and they have no problems following it.  (Ed. Note:  Once again, in unison:  YOU POOR THING!!)

 

The bad part about the bore hole is that it has been contaminated with typhoid.  About a week ago there had been some heavy rains, and since the bore hole taps a very shallow spring, the water may have been contaminated by some urine or feces from a nearby pit latrine.  A couple of

people got infected from the water since they didn’t bother boiling it.  In response to this, I went into town and bought 4 jerry cans and also a huge pot as well as a funnel and some other equipment.  We held a town meeting that same night and decided to implement a new program on boiling water for the village.  So far it has worked and we even have the kids involved in the program.  We have also taught some HIV and sex education classes.  This was real interesting and the students had lots of questions (can’t go into details since it is confidential).  When we get back we will continue our research and start teaching classes about malaria prevention and basic tropical diseases.  This will be interesting because many of the people believe that whenever they get sick, they always say it is Malaria.

 

Outside of research, we have been teaching the students kick ball.  They love the game.  I have also taught them a different kind of game with soccer (Purvin, you know the game.  It is the one with 4 teams and each team is named for a country).  Well I guess that is about all I have to say,

so I will talk to you later and I hope that everyone is doing fine.

 

Manny Patel

 

p.s. I get back into the States on Aug 2, and I will be glad to share many of my photos.

 

2. A free Guide to Science Writing Manual, from The Journal of Young Investigators (JYI).  (Thanks to Donald Samulack, Ph.D., Director, Department of Scientific Editing of St. Jude Children's Research Hospital for sending me this.

The Journal of Young Investigators (JYI) recently launched a Resources Section, which features a Guide to Science Writing Manual. This 45-page manual is free for download at http://www.jyi.org/resources/rs.php/.

You will also find a PowerPoint seminar for use along with the manual. 

 Donald Samulack, Ph.D.

Director, Department of Scientific Editing
St. Jude Children's Research Hospital

Tel.: (901) 495-2162
Fax: (901) 495-3600
E-mail:
donald.samulack@stjude.org

 

3a.  Stacey Bourg (CBU alum and M-2 at LSU) diary:  Part I – July 4, 2005:  Half-way there!

I arrived in New Delhi very late last night due to a 2 hour engine repair at Amsterdam.  Aside from that, the 25h trip was quite enjoyable.  I sat next to nice people on all 3 flights/  My pre-hired driver was not be found in the mass of folks waiting so I just hired a pre-paid taxi- complete with driver who spoke not enough English.  But praise God, we made it to the YWCA.  A no frills kind of place.

 

Dr. Philip called just as I arrived at the Y to let me know they had accidentally booked my bus ticket for the wrong day.  They have rebooked, but I am now on the NON-air-conditioned coach!

 

The adventures are already piling up and I am off to get some more sleep.

 

Grace,

Stacey

 

3b.  Stacey Bourg (CBU alum and M-2) diary:  Part II – July 5, 2005:  Manali at last!

Yesterday afternoon, I went to the bus office to collect my ticket.  Prayers from everyone must be working because I utterly avoided "true Delhi" with respect to taxis.  Drivers like to take you 3 or 4 different places before they take you to your requested destination.  Not only did I not have that problem at all, but the driver who brought me to the bus actually came back to drop me closer to the bus when he saw the load of tourists milling about around the corner.  IT sounds small, but truly it is unheard of in Delhi for a tourist to have that good of a taxi experience.

 

There was a small snafu at the bus office, I believe generated in large part due to my lack of Hindi-speaking abilities.  The man insisted they had no ticket for me.  I had the man call Dr. Philip to help sort out something only to find that the number was essentially long distance from Delhi.  I was given directions- enough to make a lab rat dizzy-  to an international phone.  But a very kind Swiss climber allowed me to use his cell phone to ring Dr. Philip.  All worked out well and I had a window seat at the very rear of the coach- helpful when traveling without a/c.

 

Most of the people on the coach were European.  I sat next to 3 very nice Danes who were headed for some "extreme trekking."  They were all too happy to share that the good people of Denmark were ready fro George W's visit to be over and have live return to normal.  It rained the last 13h of the ride- necessitating the closing of the windows.  Once we got into the mountains, however, it was quite chilly.  After 16h 13m 05s, our bus finally arrived in Manali.  I hired a rickshaw to carry me and my enormous luggage to the hospital.  Had there not been rivers running down the streets, it would have made for a lovely walk.  I did get scammed in the price there.  The charge was Rs.50 (~1.20USD)- high for the short duration of the trip, but my smallest note was Rs.100- naturally the driver lacked change.

 

I finally tracked down Dr. Anna and got squared away after the best cup of tea I have ever had!  I had a wash- there is not shower, just a faucet sticking out of the wall at about 4'- and went to the mess for lunch.  SPICY!!  It was curried vegetables of some sort and rice.  There I met Sam, from England, here working at the school on the campus.  Then i was told to go to my room and rest.  I got to meet my roommate, Lucy from Scotland.  I also met her friends here with her- Colin and Ian.

 

Next came dinner.  SPICY!!  Curried vegetables of some sort and what is essentially a pita.  I have walked into town with Ian and Lucy to use the internet. 

 

It feels so good to be here and not on my WAY here!!!  A 3.5 day journey makes you truly appreciate your destination. 

 

Tomorrow I am in the wards.  Hopefully the rain will stop and I can take a dry walk at lunch.

 

Thank you for all of your prayers, thoughts, and support.

 

Grace,

Stacey

 

 

3c.  Stacey Bourg (CBU alum and M-2 at LSU) diary:  Part III – July 7, 2005:  Surgery Indian Style

Surgery in India is quite different- perhaps not so much the procedures, but the execution.  For example-

      Everyone scrubs for surgery with the same bar of soap- and definitely not for 6 minutes

      Gloves are REUSED!!!  Although they tell me they are sterilized between uses. 

      You wear the same cap and mask for the entire day in theater.

      Everyone wears open sandals that have been autoclaved with NO booties- my feet were covered    in a mix of used saline and urine after a urological procedure today- not to worry, though.

      Everything here is TB- a mass in the ear, a tumor on the thumb, a cyst in the foot- TB.  I have seen some of the most amazing chest films and from what I gather here- they aren't that impressive for the seriousness locally.

      No post-op Abx until you look nearly septic!

 

I did get to assist in most procedures and do some sewing.  I hear I may get to do some spinal blocks before I leave. Today we did a placenta previa C/S, grade III hemorrhoidectomy, l. node removal, two growth resections- one in foot and other breast, a tumor resection on the thumb with grafting, an RPG, 3 EGD, and an appendectomy.

 

It finally stopped raining today!!!  It started raining on 3 July.  It is now evening of  7 July and the rain has just stopped.  It does not stop us though.  The Scottish students and I trekked through town up the hill to Old Manali last night in the rain.  The Beas River is furious with white water.  If you wait for rain to stop here, you would be inside every night.  Hopefully it will warm a bit.  But if you are cold, you can just take your washing bucket down the way to a hot tap source and fill it for a warm wash!

 

So far I really like it.  Some of the doctors are taking a bit of time to warm to us, but Dr. Philip and the other surgeon are brilliantly warm.  I really enjoy being in the operating theater and today was the small cases.  Tuesdays are for larger cases and I cannot wait!

 

Grace and peace,

Stacey

 

 

3d.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part IV – July 13, 2005:  Culturally different social manners

I am having a bit of difficulty adjusting to what are some fairly different social graces here in Manali, if not most of the region.  To say please or thank you is rather foreign to most people.  I have been in the OB clinic the past couple of days, save Tuesday which I spent in theatre.  Dr. Shiels, the Sr. doctor, demonstrated how to conduct a proper OB USG and then had me do them the better part of the day.  I naturally sought a bit of assistance on the first couple as I got acquainted to the machine- primarily from Dr. Jasmeet, one of the Jr. docs.  At the end of the day I thanked her for her help and patience and she just gave me the most quizzical look.  She had no clue why I was thanking her.

 

Similarly, I apologized for an incision that I made that was not totally correct and Dr. Philip looked at me as if I had just made the strangest comment he had heard.  It is very strange for me not to say please and thank you.  Moreover, it is quite bizarre to me that some do not apologize for having a rotten attitude because it was a bad day.  We all have them, but I am quite accustomed to people amending their sour attitudes. 

 

Really it is nothing bothersome, but it is quite strange.  We have al;l noticed it.  Lucy, my roommate who I believe has visited the better part of the world, said that this is the first time that she has encountered such social behaviours as well.

 

This weekend I am heading up to Rohtang Pass (13,500') for a visit.  While I hear that it is not that pretty, it is apparently fantastic to watch the Indian tourists from the south muck around up there. 

 

Hope everyone at home is well! 

 

Lots of love,

Stacey

 

 

3e.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part V – July 15, 2005:  Traffic Jams – Manali Style

Let me preface with this- I wish the connection was not dial-up, because a picture is truly better than words in this case.

 

Here in Manali and Old Manali, the roads are truly just plain chaotic.  Sidewalks abruptly end, not that you use them because here it is not common for large crowds to sprawl the entire width of the sidewalk and just linger.  So here is a glimpse at what you encounter on the roads, which will lead nicely into the unexpected sightings of this afternoon.

 

Rickshaws working to squeeze into spaces too narrow or too full of people and having a war of the horns to see who will give way first.  Common.  Rickshaws blazing down the hills without their engines because the grade is steep enough to allow for a rapid coast and clipping you in the side with their wing mirrors.  Common.  In fact, it has happened to me twice- luckily as most of you know I am quite "graceful" when attempting to recover my balance!  A herd of cattle just meandering down the road. Common.  A man offering to sell me the finest hashish in all of the Kullu valley- which incidentally, grows like kudzu here.  Common.  Traffic yielding to a stray yak moving up the hill.  Common.  Gimpy goats and donkeys idling in the middle of oncoming traffic.  Common.  A sudden increase in Tibetan monks wandering around Manali and the surrounding villages- a retreat at one of the temples perhaps.  Common.  The stench of failure to wash from the hippie-like trekkers and backpackers

  from Europe and Israel.  Common.  A wee tyke offering to shine my shoes, despite the fact that I am wearing sandals with nylon straps (and I must confess, today, a pair of woolie socks since it was chilly outside and boots did not appeal since I have some blisters I am trying to get to heal a bit before I trek this weekend).  Common.

 

A gigantic elephant prancing past the gates of LWH- totally unexpected.  And let me just say, that this is not simply me being a westerner who has never seen an elephant outside of the Shriner's circus or zoo.  There was quite a crowd following and cheering as this giant gentle creature quietly plodded down the road up to the main road.  Sadly, I did not capture a picture, but I am hoping to see it again.  I really should learn to never leave my room without my camera.

 

I must apologize for always saying road, but most of them are not named here.  For example, the bookstore I visited yesterday has the following address-

The Bookworn

Manali, dt. Kullu

(near the post office)

Himachel Pradesh, India

 

One other quippy story- I bought a sachet of Tide washing powder to do my wash.  Truly it is Tide made for India.  The back instructions state-

1. Fill a bucket half full with water.

2. Rinse the dirt from the clothing.

3. Refill the bucket half way with clean water and add the contents of sachet.

4. Let sit for 30 minutes.

 

Find me a pack of wash powder at home that tells you to fill a  bucket!  I just hope that ti is cleaning and not simply refreshing the smell, since I see 10-15 cases of TB/day and get covered in a myriad of juices from any number of orifices in the theatre.  Graphic- I know!  I love this place! 

 

A very busy day was had in OPD.  But, mostly bread and butter things for India, especially during the monsoon season.

 

Hugs to everyone,

Stacey

 

3f.  Stacey Bourg (CBU alum and M-2 at LSU diary:  Part VI – July 19, 2005:  Old man Giardia

Giardia lamblia trophozoites become metabolically active in the small intestine.

I thought that I was in the clear- only a week to go and I have had no run-ins with any sort of personal health problem.  So much for wishful thinking- old man Giardia has begun to take up residence in my small intestine.  Early stages and you can buy Flagyl to treat it in the Chemist stores on the street.  So no worries- but I guess this means no curry for me for a couple of days.

 

All of that aside, it has been an amazing time.  As I enter my last week, I can say I have seen things I am not likely to see in the US, and certainly not with the frequency.  There was today a man on the wards with Pott's disease (TB of the spine), a woman with TB of the tonsil, a man with TB of the epididymis, a girl with severe Guillane-Barre requiring a trache, a dog running through the theatre, and TB in any number of other places (external ear, ankle, numerous lymph nodes).

 

I have had what I came for- continuity of community.  I have developed relationships with several of the foreign patients (namely easier as they speak English).  Many of the patients who were on the wards for a while when I arrived or I assisted on their surgery, or I have seen them in the antenatal care clinic see me on the street and we exchange pleasantries.  I have seen them working in their stalls and selling their wares.  I have had discounts all over town as well as in Old Manali from people I have treated or recognize me from the mission hospital.  I am quite saddened not to have more time in community with them.

 

I have become quite fond of my phone calls to come to OPD, no matter where I was, to see the foreign backpackers and hippies.  Most of the doctors at the hospital are quite cynical with them and do not really care to treat them if they do not have to do so.  I have relished some of their stories of why they are here and what their situations are- even if some of them are blowing smoke up my rear.  They are the most colourful group of characters.  I have seen a darker side- of patients wanting to speak with me and taking my word, but not the doctors- despite it being one and the same- simply due to my lighter skin tone.  It is not so frequent, but it is not unexpected either.

 

I have relished my time just sitting on my verandah hearing the very western sound of basketball at the school intermingling with the sounds of drums and flutes sounding for an event at one of the Tibetan temples.  All the time, gazing upon the most magnificent scenery I have had the opportunity to view on God's earth.  To top that, it surrounds me in 360 degrees.  My walks have been equally wonderful- mucking about and not so much worrying about the destination, but what and who you see along the way. 

 

In my last longish week of Manali and LWH, and all of their characters and faces, I am going to wring out as much as is possible.  The monsoons, the chaos of the streets, the oxymorons of healthcare here, the streams of monks in town, my fantastic new Scottish and Canadian friends, the amazing doctors and nurses who give over their lives to the hospital and people of the region- just a taste of my time here.

 

Thanks for all of the encouragement, prayers, emails and phone chats.  See you at the end of the month.

 

So this is the last mass email from India

 

Grace and a hug,

Stacey

 

The view from here…

 

Giardia lamblia doesn’t cause any old type of diarrhea – it causes EXPLOSIVE diarrhea!!

 

YEE-HA!!

 

4.  Received this month

Stony Brook University Health Sciences Center (Stony Brook, NY)

  • Medical Scientist Training Program booklet

 

5.  All in a day’s work…tracking jaguars in Brazil – a report by Jenny Bernard, who is participating in the MIRT program.

I am working on the jaguar ecology and conservation project in the Pantanal.  I am staying at Caiman ranch which is absolutely gorgeous.  We ride horses a lot because the roads don't all go where we have to in order to radio-track the jaguars.  The capture was in June and was awesome.   Totally crazy, but it was awesome to be chasing jaguars through the woods.  The jaguar in the picture is the only one I have seen while I've been here.  I work with Dr. Claudia Ferro full-time but Dr. Leandro Silveira is my mentor for the summer.

 

 

Dr. Stan Eisen, Director
Preprofessional Health Programs
Biology Department
Christian Brothers University

650 East Parkway South
Memphis, TN 38104

E-mail: seisen@cbu.edu
http://www.cbu.edu/~seisen/
Caduceus Newsletter Archives: http://www.cbu.edu/~seisen/Caduceus.html