7.19.11. 2:09PM. Day 18. American Idiot.

Yesterday was an interesting day. We were to begin our rotation with Dr. Sanjay Gandhi. We had heard quite a few stories about him, none of which were positive. People had said that he ignored them, would show up late, and would only give them one word answers, or just very short. People had built up such a hype about him and his pompous ways that we were completely ready to hate him.

We looked at our schedules and we had him bright and early at 10AM. We thought Mayank would come to guide us again, but it was nearing 9:15 so we decided to head out on our own. We figured he had other people to deal with and probably felt that we could handle it solo. We misread the map and once again got lost. At 9:50 we called Mayank so that he could hopefully dictate to us how to get to the hospital. He spoke to Mary and according to him we were not supposed to start until noon. We were hot, sweaty, and flabbergasted. He was soon forgiven because he said he would meet us at a nearby coffee shop, Cafe Coffee Day, in a little while to help us get to Dr. Gandhi's.

Sure enough, true to something Mayank would pick out, Cafe Coffee Day was this swanky step-above Starbucks looking place. Since their ice machine was apparently broken and neither of us  wanted caffeine we both got some yummy hot chocolate. Maybe 10 minutes after we arrived, Sunny, Mayank's fairly amazingly  good looking, studmuffin of a right hand man, walked through the door.

He came and sat with us (next to me) and waited with us for Mayank to appear. Talking was slow as it seemed we were both quiet people. He added Mary and I to Facebook, and eventually I asked him his age, since Mary and I were talking about age brackets. He said he was 17. Ugh. Jailbait. We had to laugh because Mary pointed out that she was a whole 10 years older than him. He also told up that he was about to start med school in one month in Hyderabad - in the south of India. Mary and I both agreed, later on, that who ever gets this one will be a very lucky girl indeed. Beautiful babies. Sigh - just kidding. Mayank came and we all hang out and talked until it was closer to 12.

 When we got up to leave we saw that it was raining at about a moderate pace. No vikrams were about so Mayank offered for one of us to go with Sunny on his motorcycle. Guess which one of us jumped on that band wagon! It was awesome. I was nervous for a while but not scared. I couldn't help but feel that this could have been straight out of a bollywood film - hot guy takes girl on the back of his bike, in the rain, zooming toward the hospital...I just waited for the music and dancing to start. Sadly, the ride was soon over and we stood at the hospital waiting for the other two to arrive. When they got there, Mary came and stood with us  while Mayank went to talk to Dr. Gandhi. After a while he came to get us and brought us into the doctor's office.

In a nutshell, after just 1.5 hours with Dr. Gandhi, we completely  retracted our previous fears and preconceptions about him. He was....kind of amazing. He was funny, and friendly, and very much brought us into the consultations as much as possible. We'd decided afterward that it must have been both the attitudes and expectations  of the other students that ultimately led them to think so poorly of him. I related a lot to him. I could see that he, too, was a soft-spoken, quiet person. This often makes people think we are pompous, stuck up, or unreachable. But he was charming and playful. I noticed this when amongst the hustle and bustle of his office, his wife came in and he was so formal with her, but had a twinkle in his eye that showed he was just being playful. It was quite apparent that his patients not only revered him, bowing and such, but they also liked him. He made them laugh and smile even through their pain. He's great. I approve.

We left his office in high spirits and were thoroughly pleased to change our opinions about him. He's the medical director of the program here, after all, there had to be some good in him. Yes, he is full of subtlety, but I wish the other groups could have seen him the way we saw him.

The rest of the day had a downside with a strong dash of upside. Barely mentioned in the beginning, the Globe Trekkers have left quite a wake after every rotation they've done. Either from the other students, during the weekly meetings, or from the doctors themselves, these girls had left quite an impression on everyone. Just as a warning - this may just be the biggest rant about a person I will have in this journal - so brace yourself.

This week we were supposed to deal with them for two back to back classes for 5 days. That would equal a whole 10 sessions, 20 some odd hours of having to interact with them. Mary and I decided before going to Dr. Prem Nath's that we would try to give the girls a chance instead of just the hearsay like with what happened with Dr. Gandhi. We walked in and found Pompous Ass #1 sitting alone with Dr. Prem Nath at the table. I soon found out that #2 was in the bathroom. We sat down and had small talk with PA#1. She asked us how our trip has been so far and when we said that we absolutely had a fantabulous time - she gave us a quick look and a completely ingenuine smile, "Oh, us too..." The other one came back and we began class. The class itself was fairly uneventful, though it became apparent that #1's pompousness was completely real and not just hearsay.  Overall, #2 was quiet and seemed completely overshadowed by the ego-eclipse that was #1.

The week before, Dr. Prem Nath would always continue to lecture for half an hour after our time was over. We were always eager for more so we never minded staying longer and then we even got to expect it everyday. This week, however, he decided to stop abruptly at 5PM. Mary and I only saw one factor change in the whole situation and that was the presence of #1 and #2 - mostly #1. Mary and I were off to Dr. Nanda's. I'd wondered if we were going to share a vikram or something since we would have the next clinic with them too. But they went somewhere and we got a vikram by ourselves. We got there 20 minutes early and so decided to go to the sweets shop across the street, Kumar's Sweets, to try some Indian yummies. We spent some time there and then five minutes to 6 we crossed the road and waited on Dr. Nanda's stoop for him to arrive. While we were waiting, some other people from our program, the boys from Georgia who were on the train with me, walked up the ally. I was confused because I thought there were only supposed to be 4 of us here, which was already 2 too many. The boys said that their doctor canceled so they were reassigned to Dr. Nanda.

Dr. Nanda came and opened up the clinic. We added another bench inside the already crowded office. No patients showed up yet, but the girls showed up almost 20 minutes late. They'd apparently gone shopping and had lost track of time. The shopping must have been more important than food because Pompous Ass #1 basically put her stuff down and declared that she was going out for food. Not even 1 minute into her already late being there and she was already disrespecting the doctor's time. By the time the little princess came back, there was a patient in the room. She plopped herself in a chair and , fairly loudly, demanded patient symptoms. Right off the bat she acted like she was a full blown doctor, where in reality she was just a first year med student - like half of the people here. She kept on trying to diagnose a problem and prescribe a solution even though Dr. Nanda had already done all of that. Every time a patient came, this same upchuck of uselessness and disrespect would occur. She was constantly undermining the decisions of Dr. Nanda. It became quite apparent that she believed absolutely nothing about Homeopathy because she kept inserting her wanting to refer every single patient to a western specialist of whatever problem it was. It was not only this complete and utter disrespect of all parties involved, but there was also the blatantly obvious fact that she was embarrassing herself every time she opened her mouth. First of all, she wore a bindi (the dot) on her forehead. She has no idea what it's for but since some nice lady on the train gave her one on the first day, she has been wearing them ever since. One lady pointed to it and laughed. #1 said, "oh my bindi! Do you like it? Haha." And then every time  anyone would walk in she would put her hands together and sing-song "NAMASTEEEEE." Most of the time people would just giver her a weak reply or jsut acknowledge her with a who-are-you glance. SOme would smile and respond. But then if somebody ignored her completely, she would, "Na, nam, na, Namaste" every time she thought he or she would look her way. The rest of us didn't speak much, but we would smile quietly and the people would usually do it back. It was intimidating enough to have 6 extra strangers in the room while you're at the doctor's. It must have been overwhelming for them to have Ms. Can't-Shut-Her-Mouth-For-One-Second in their faces too.

My annoyance of this one person pompous ass circus festered and boiled until finally she scratched the scab one too many times and I let my venom ooze out. She kept going on and on and on and on about how this one patient (who was still sitting there) should go get Cognitive Behavioral Therapy for his panic attacks. "It worked for me," is what she kept saying. The doctor had already prescribed the man a medicine (a placebo) because his eventual goal was to get the man off of his meds all together. Mary tried to point out her her than CBT is probably  not available here and even if it is, this man probably couldn't afford it - as is why he was at the office of a homeopath to begin with. Her response to that was to tell Dr. Nanda that he should teach himself some CBT so that he could do it to his patients. At this point I'd had enough. I pointed out the total unethicalness of that statement, saying that she just told him to do the equivalent of me picking up a book about medicine and then practicing on people.

She said, "Well, we self teach all the time."
I said, "No, no you don't."
HER: I'm sorry, do you have an issue with how I'm doing this?
ME: Yes. You are being rude and disrespectful.
HER: This is a preceptorship and I'm just asking questions.
ME: No. You've been rude and argumentative in front of patients.
HER: I have great repore with the patients, they like me.
ME: (smile) right....
HER: If my way offends you, I can stop.
ME: (smile).
After that she didn't say much. She would wait until the patient was leaving to ask the doctor. Good. My anger still boiled, but I let it go and simmer down. By the end of the night she stopped talking so much and so I had nothing else to say. We all left and were waiting by the street to hail vikrams home. She came up behind me.
HER: Hey, I just want to clear the air. I feel like you are upset with me and that there is tension.
ME: (wait).
HER: I don't know if you've ever done a preceptorship before, but you're supposed to have a dialog with the doctor.
ME: No I haven't, but you were arguing and were rude.
HER: No I wasn't. In America this is how we interact with doctors and patients. We're supposed to talk to the patients. I just want you to know that because I don't want tension.
ME: I've said my piece.
HER: I'm feeling tension.
ME: I've said all I've needed to say.
HER: I didn't do anything wrong.
ME: OKay. (blank stare).
HER: I just want everything all right so we can work together. You still seem angry. Do I need to explain more? Do you want to say something?
ME: I've said all I need to say.
HER: Okay...well I hope we're okay then.
ME: (smile).
Our groups parted ways and Mary and I decided to walk to the vikram connection since we both had much needed venting to do. It basically consisted of us pointing out how she is the embodiment of every thing negative perceived of Americans. She's loud, argumentative, opinionated, and doesn't seem to be able to pick up on physical cues - subtle or otherwise. A few major points to bring to light are as follows: First off, when she said that "this is how we do it in America." I said (to Mary), "That's great, but we're in India." Things are not the same here. Yes these are preceptors, but their clinics are not teaching hospitals. The patients did not know that you would be there before they got there. We are here, as stated in the program guide, to observe different kinds of medicine - not practice playing doctor in some other country. We have found that if you sit quietly during the visit of a patient, the doctors are more than happy to answer any questions before the next one arrives. Plus, it is more respectful of the doctor/patient relationship. Diplomacy can go a lot farther than dictatorship. Secondly, she said that the patients like her. No they don't. She made a few nervous, and just amused the rest of them. They plainly made fun of her "silly Americanness" and her ego took it as being complimented. Her behavior was more embarrassing for us, as she reflected negatively the image of Americans. And the whole fact that she thinks she's not doing anything wrong - is what I feel is the worst. This is why I did not allow the argument to escalate - I could have let it all out and let her have it. But no, I know better than to argue with concrete. Once it sets - there's no making it change its form.

We'd talked about it, and agreed that we were wrong about #2. Her name is Mati (Mathilde - French Canadian) and she was just placed with a bad partner and the stigma stuck to her too. We felt so bad for her. She'd made it quite clear to us  during clinic that she wanted to go off with us without the dead weight she was burdened with. We desperately wanted to reach out to her, but our schedules conflicted so we couldn't really get some alone time with her. We went home and told Aunty all about it.