Medical speak

For the past two days, I've had a taste of internal medicine, India style. Yesterday I went to a general medicine clinic. There were a variety of patients with all sorts of complaints, including hip pain, memory loss, persistent cough, etc. I was surprised at how far many of the patients had travelled to get to Vellore. Apparently CMC's reputation is so great that patients (and their families) come from all over the country because it is a tertiary referral center. I saw several patients who came from as far as West Bengal, Rajasthan, and Bihar. They come down to Vellore over a period of several weeks with their family, and many of them get check-ups too since they're already down here. Many of these patients are only Hindi speaking, but luckily my attending was fluent in both Tamil and Hindi and so there was no communication barrier. My comprehension of both languages is at about the same level, that is, very basic. But when I know the context in which somebody is speaking I can get a good idea of what's going on. The medical record system here is quite modern, though. All patient labs, imaging, and discharge summaries are online. This isn't even the case for many hospitals in the U.S.!

Today I went to rounds in the E.R. The team consisted of a group of 5-6 interns and residents with one attending. As in the clinic, the patients presented with a spectrum of complaints: myocardial infarction, uncontrolled diabetes, altered sensorium, and even a random snake bite victim. The frustrating part, though, was trying to get a sense of what was going on with the patients. The rounding style here is very different from what I'm used to back home. The presenting resident speaks directly to the attending, instead of the team and speaks very softly and quickly. I don't usually have trouble understanding Indian accents- if anything, I think they are easier to understand because in Indian English the words are articulated very well. But in the setting of a crowded, noisy ER with nurses bumping into you it proves exceedingly difficult to understand what's going on with the patients. After rounds, we had a mid-morning coffee break (this is very common here) and then one of the residents presented a power point on dementia assessment scales. Again, hard to understand...or maybe I just have a hearing problem!

This weekend a bunch of us are going to Pondicherry. It's about a 4-5 hour drive from Vellore. It should be fun. I'm looking forward to having a change of scene for a bit. Even though I've only been here for less than a week, it almost feels like forever. Perhaps this is because I've been to India so many times and this is why it feels less "foreign" to me than other places. But being here on my own has definitely made me more confident about small things, like bargaining with auto rickshaw drivers in my broken Tamil and being more bold when crossing the street (which actually is a very scary thing to do here).