being human*

I took a detour this week and visited the Medico-social work department. I was interested in what kinds of things they dealt with in order to get a better idea of what the hospital was like. They gave me a list of services and then mentioned what they do with dead bodies. At no point since I had set foot in the hospital had I thought about loss of life or death. There is really no indication in the hospital that people die, even when I've walked around the ICUs and wards. It kind of struck me how much I had failed to see this obvious aspect of the hospital, as I had spent so much time focused on getting appointments with doctors and observing their work as much as possible. I had nearly removed the patient from the equation, reducing them to an abstract concept I only get to ask the doctors about.

I also had the opportunity to observe a few surgeries. And by a few, I mean around seven. The call volume is so high at this hospital, I couldn't keep up with the doctor I had been following, but I managed to catch the beginning, middle, and end stages of various surgeries within a four or five hour span. At no point did I feel discomfort watching people go through these invasive procedures or feel squeamish about the blood, etc. I remember even thinking how desensitized I was to the human aspect of the surgery. I really didn't know the people or interact with them, so that might be a factor.  It's strange, but I think it might be necessary to preform surgeries well. Again, seeing open abdomens, blood, unconscious bodies (some people were only anesthetized from the waist-down, so some semi-conscious bodies), death never really crossed my mind. Perhaps I have so much trust in these doctors myself, that I failed to realize this important factor in medicine and medical work. The people here are so good-natured and dedicated, it seems difficult for me to comprehend that things can go wrong. I may get the opportunity to follow a resident while she's on call next week, so maybe the late night shift will bring to light some new perspectives.

*"being human" shirts are really popular in India. I suspect it's because the hippie tourists from the west think it's really deep.

Now for some field work!

Bangalore traffic.

Hello world! I've officially started busy-bodying in the hospital & it's been a lot of fun. The doctors are amazingly welcoming and have been quite interested in my study. What I'm basically doing is following around whoever can tolerate me (and willing to stand still long enough to read the consent form) and also conducting interviews with whoever has a moment to speak. In a previous post, I mentioned that a doctor had asked me to come in between some ambiguous hour and I had to wait a lot. In India this hospital, I have discovered, there is no system of appointments. The patient volume is too large and a much more informal system of getting in line to speak with a doctor and jumping in when possible seems to work organically without much chaos and unfair line jumping. It works a lot like traffic in Bangalore or any sense of line-standing in general. It's taken getting used to, but I've gotten the hang of it.

Since starting, I have met a few foreigners who are doing internships/electives/studies at the hospital as well. There are three French girls, two American boys, and two girls from Dublin. It's kind of nice to not speak Hin-glish and to speak with a little less reservation. Also, a natural topic of conversation is what differences exist in Indian & Western biomedical healthcare.. soo that's kinda nice.

hi! (Hampi, Karanataka July 9, 2011)

It's surprising how tiring interviewing people can be. Especially since my tape-recorder broke (what kind of horrible anthropologist am I) so I have to write like the wind & listen with five ears. I took a break last weekend and went to Hampi and I'm going to Mysore this weekend. Hopefully, I'll get a chance to visit fellow Cotlow-er Claire & compare notes.   Hampi was awesome. It's a holy city with a lot of temple ruins and nice people. I went with the American boys and the French girls and none of us really wanted to leave.

guess which ones are Peter & Jon

the bad feeling so bad makes the good so good

Disclaimer: feel free to skip the whining & go straight to the pros & cons of India list 

I have been thinking about this blog post for a while, now. I have never particularly liked India, but I don't dislike it. Most people don't understand why I don't looove India, as it is a privilege to travel here and  it is my homeland. With the buffer of family, it is difficult to really get out and explore. So, my association with  India is restriction, although I believe that I allow this because I am somewhat not entirely comfortable here. People see me and I act like an American--that's what I am. There's really no other way to say it. While I have a cultural understanding of India that Americans don't have, I also lack a great deal of knowledge about how things happen in India (see above: buffer) so I can't claim to be as Indian as much as I can claim being American--and I don't feel like there's anything wrong with that. It's taken me a long time to admit that to myself.

However, despite my own conviction of my personal belonging/heritage/identity, in India, I have no sense of belonging anywhere. No white person thinks I'm American here, because they fail to see me feeling as out of place as they are. Indians can see that I'm doing some things wrong, but aren't ready to make the leap to calling me American. I don't know the customs, I only nod my head up and down and shake it right to left, I'm bad at eating with my hands, I use toilet paper, and I like to say 'please' and 'thank you.'  I believe that because I speak English with an American accent, that people think I'm just being uppity or think I'm dumb and laugh at me when they think I'm not looking or don't understand what is going on (this has happened multiple times). I don't have a place in India and get treated as such.  My missteps are much more difficult to forgive because the assumption is that I should know what I'm doing. Foreigners get treated very well in India; when outsiders come here, they rave about how wonderful everything else. True, outsiders tend to exoticize everything about the country and kind of miss out on some subtle things, but they still come out with a positive view of India. It still sucks being not Indian and not being a foreigner here.

So, the best and worst parts of India. I'll start with the worst, because it's nice to end on a positive note.

taken from "how to use an Indian toilet"

  

CONS: 

• no toilet paper & no soap (this is gross when you realize why there is no TP)
• most parts of the country smell like a toilet
• people stare openly
• people try to feed you until you die/are overly concerned with what & when you eat
• no peanut butter
• men are openly creepy
• there is no such thing as phone etiquette--that is not a cultural value statement
• Indians will always challenge what you say, even when it's inappropriate, just to prove their skepticism outwardly
• generally, the Indians are quite racist (rude to Africans & fall all over white people)
• traffic
• no toilet paper 
• I'm not allowed to travel anywhere alone (unless it's by plane) 
• no one understands my American accent 
• people only use the gym for like 20 min, although it's kind of a pro because it makes my normal 50 min workout look really badass (it's not)
• the electricity goes out 3-5 times an evening 
• Tamil & Kannda sound really aggressive and strange to me
• people straight up SHOUT on the phone. I wish I could emphasis how startling it is, but it's something you have to hear for yourself
• puking adventures in Banares/double pneumonia in Dehradun 
• people are obsessed with hierarchy and "suhs" and "madddums" 
• caste system in general (quite visible) 
• cotton mattresses are hard and not fun to sleep on
• I am pale & fat 
• no dryers/fabric softener
• no toilet paper 
• no booty shorts/mini skirts allowed 
• picking your nose, spitting, brushing your teeth with you finger, weird body sounds in general ok in public (although this could be a pro for some people visiting India)
• women are definitely not equal by any means (must be modest, must be unseen, always show deference to men blah blah blah) 

PROS:

there's a 4th passenger up front!

• this is a really crappy pro, but I kind of feel colonial here, which isn't something you can really complain about
• the sound of light switches
• you don't have to feel like Jason Bourne every time you take a cold shower
• pepsi, soft drinks, etc are made with natural sugar (but a LOT.. like 60g/bottle a lot)
• you send your clothes out to be washed & pressed 
• chocolate doesn't have corn syrup (but it has hydrogenated veg fat, also known as "trans fat" but it tastes AWESOME)
• mangoes
• food in general  
• even though it takes a while for people to warm up to you, they are quite friendly once they finally do
• shopping is cheapo (unless it's imported, I'm looking at you $13 (Rs. 595) I Can't Believe It's Not Butter!) 
• not weird to see mosques & burka-clad women everywhere or people with tilaka on their foreheads   
• Gandhi's face is on money & the bills are different sizes, making it disability friendly
• the air (when it doesn't smell like piss) smells like jasmine & coconuts from the ladies' hair
• god/temples everywhere
• ladies in saris on the backs of motorcycles
• mustaches (this one goes out to the ladies as well) 
• the weather in Bangalore is perfect (mid 70s-mid 80s. Not terribly sunny & no need for AC) 
• chai 8-20 times a day 
• weird colonial influences that makes everything seem east/west-ish (also the reason Wes Anderson <3s India)

That's about it.  I still have a month & a half so maybe things will get better or I'll get the hang of things.

Happy Father's Day!

"All of my daughters, money and power strips are in DC."

Thanks for supporting me through all of my crazy adventures! I promise to bring you more power strips in the future.. and maybe be a doctor one day. Have a great day :]

On "Missing the Revolution" & the Lokpal Bill

One of the most well-known and influential medical anthropologists is Paul Farmer. As an MD/PhD, he balances the line of medical authority as well as legitimacy in the field of anthropology. His name resonates across multiple disciplines for his work on structural violence. Structural violence is felt by individuals who are at the complete mercy of the society's structure and are unable to help themselves. Individuals are more likely to endure unnecessary illness and disease and have little or no access to adequate care. It is violence to the body, internal and external, the mind, and overall wellbeing.

In Infections and Inequalities, Farmer writes about early anthropology and ethnography which involved university-educated anthropologists entering the field--most likely a poor, peasant population (where 'authenticity' is found)--gathering information about rituals and then leaving. 'Objectivity' intact, these anthropologists are said to have "missed the revolution."  While they were able to describe the Peruvian method of harvesting crop, marriage rituals, and male/female kinship patterns, they missed the Shining Path guerrillas bringing revolution to the peasants, while also creating a dangerous atmosphere for the Peruvians who were now at the mercy of the government & Fujimori as well as the Shining Path. They had no voice. However, as educated anthropologists failed to note this, they, again, missed the revolution.  So the argument goes, could these anthropologists have been a voice to these individuals? Beyond describing their rituals and beliefs, could they draw a more critical perspective on the peasant social position? Could they write about how outside failures are what contribute to the health of the individual? By this, Paul Farmer calls for a more critical view of social structure when conducting anthropological study.

Baba Ramdev

I, by no means, am equipped to write about structural violence in India. To stay in this country for only three months, it would be insulting to say I have any better insight. However, as I am here to study health and health care, I have noted some political ideology that pertains to my project. India suffers from a great deal of government corruption and 'black money.'  I even sheepishly asked my mom if she had ever bribed a cop in India (she has not, but it was not as awkward as I thought it would be to ask. Almost obvious).  This corruption has been around as long as this country and before (see: colonialism). A bill, titled the Lokpal Bill seeks to mitigate corruption by creating a third party entity that will have government oversight. It is proposed to even have oversight over the Prime Minister. What is interesting about this bill isn't that India is attempting to end corruption, but how they are doing it and the major players in the battle to get the bill before parliament for the upcoming session later this summer. Well, as luck would have it, one high-profile media presence is Baba Ramdev, a yogi with a large following has gone on a hunger strike, here in Bangalore. I also have his yoga DVDs. This guy is no small fry, he has an island in Scotland that's meant to  be a yoga retreat. 

PM Manmohan Singh, INC party

Well, not only is it interesting that in India, many government issues reach the media only though this obvious spectacle, namely with a man who is thought to be a religious leader. It can't be compared to Pat Robertson in the US, because the pervasiveness of Hindu ideology is more obvious here, whereas Christian revivalists are a loud minority. It's another breed of extremism, but one that seems oddly reasonable. He is ready to lay down his life in order to promote an anti-corruption movement, relying on his influence as a popular yogi. What really caught my interest wasn't that it was the only news story that was on the Indian channels (or the deranged elephant in Rishikesh that gored a cow). The Lokpals would use 'educated' individuals as the ombudsmen, meaning doctors and engineers. The idea that scientists are better at being anti-corruption watchdogs. The idea that an academic would somehow be un-corruptable speaks to the Indian faith in knowledge as a prime mover of modernity. It seems naive to me, but I can't make a properly formed opinion of the anti-corruption efforts just yet. I have seen minor effects of this movement on the streets and on tv, but who can say what kind of success it will have. I wouldn't characterize this as a "revolution" per se, but I will keep my eyes on this issue, as I believe it has a lot to do with my topic.

illness & health

“Health is not a commodity. Risk factors are not disease. Aging is not an illness. To fix a problem is easy, to sit with another suffering is hard. Doing all we can is not the same as doing what we should. Quality is more than metrics. Patients cannot see outside their pain, we cannot see in, relationship is the only bridge between. Time is precious; we spend it on what we value. The most common condition we treat is unhappiness. And the greatest obstacle to treating a patient's unhappiness is our own. Nothing is more patient-centered than the process of change. Doctors expect too much from data and not enough from conversation. Community is a locus of healing, not the hospital or the clinic. The foundation of medicine is friendship, conversation and hope.” —

—David Loxtercamp [sic], author of A Measure of Days: The Journal of a Country Doctor, as read in his interview with NPR’s Liane Hansen.


source: Dr. Jay Parkinson's tumblr

Travel Air India! Scented with armpits to preserve authenticity! Now running on Indian Standard Time (if your flight leaves on time, you get a refund!)

I decided to go to New Delhi on Tuesday, June 7th, to visit family after encountering a few more setbacks with the hospital, etc. I took Spice Jet (my aircraft was affectionately named "Corriender" in case you were wondering) and watched as the clouds turned from white to brown as we approached the capitol city. In Delhi, I'm staying with my mama, my mother's brother (MB, for you anthropologists). The Indian naming system for relatives is a bit more precise and great at letting the listener understand who is being referred to exactly. Out captain informed us it was 44 degrees outside (times 9/5, plus 32. I'll give you a minute....... YEAH, with 3000% humidity). As my lungs adjusted I arrived for about a week of family times. I had hoped to take some day trips to Rishikesh, Haridwar, and Dehradun (where I was born), but I have only really been to temples and malls, the two great urban pilgrimages, so I might squeeze Jaipur and Haridwar in at the end of my trip.

Yesterday, I went to Lucknow to visit even more family, this time my dad's side. I had to wake up at 5am to catch the flight and I would be going back to Delhi later that same day (a prime minister's visit my bua (FZ, for the anthropologists) called it), so was in a pretty cranky mood. I have been quite upbeat, positive, and overly friendly since I have gotten to India. I have been easy-going and just happy to be in the motherland and have been quietly enjoying the sights, sounds and smells (well up until I got to Dilli, here the smells are not too kind). However, tired and menstrual, I was not in high spirits. Waiting at the check-in counter, I waited as the Air India employee pretended to be busy on the phone while I stood next in line. A man darted ahead of me in line and tried to talk to the employee, who stood up and walked away. Annoyed, literally for the first time in India, I tapped my foot and said "Excuse me! There is a line." He said "okok go, fine." which just annoyed me more. He retreated by trotting to the counter where the phone-bound Air India employee had moved. I was pretty disgusted at how rude this guy was. Indians are not much line-standers, I know. At the mall check-out counters, it's pretty much all elbows to get what you want. It's annoying, but cultural relativity and all that crap.

Well, I passed this tasteless fellow a few more times in the airport and then didn't see him again. I knew he was on my flight, but didn't pay much attention as I waited at the gate. As we got ready for take off, I glanced up and saw him in the pilot's uniform.