Everybody knows Devrani–or the village “Cleopatra”. She finds a home in the company of any foreign intern who is gullible enough to give her attention. My attention came in the form of secret peanut butter biscuits each night after dinner and in return I received the little black dog’s faithful presence at my side twenty four hours a day. Don’t get me wrong–I absolutely love having a dog join me on my afternoon hikes and late night walks, when leopards prowl in the deep jungle behind the wall of trees surrounding Chirag. Devrani has survived two leopard attacks and fiercely jumps to my defense with any strange dog or person we encounter. Loyalty like this should be cherished, and honored. I have unconditional love and trust for a dog who is willing to give me the same.
However, in rural Himalaya it is not very common to display unconditional love and trust for any animal, whether it exists inside the person or not (except maybe cows). Dogs are not “pets” in the American sense. It is not always appropriate for a dog to accompany you–especially not inside the clean comforts of a home. Dogs are not cohabitants in the household like our bed-sharing pugs and kitchen-floor-dwelling golden retrievers. Unlike the many gnarly flea-ridden street dogs who prowl around the village, Devrani has been treated and fed well since she was a puppy. You can tell by her shiny, thick coat and sweet demeanor. Devrani’s sleeping spot outside my door in the Chirag dormitory is an exception made for exceptional behavior on her part. Like I said, Everybody knows Devrani. Most people love Devrani. But nobody loves dogs–especially not wedding guests.
Barely five minutes had passed since arriving to the Barat by the time we were already walking out. The day before we had spent the afternoon drinking chai out of melting plastic cups, dancing to Indian pop, and serving as guinea pigs for a little girl learning how to draw Henna designs (the aftermath of which is still staining the skin of my hand brown, one week later). The Sangit is a ceremony reserved for women to lament and celebrate the bride’s last day before she technically belongs to the bridegroom’s family–this “transfer” of sorts happens the following day at the Barat. Devrani, was not supposed to come to the Barat–the holiest of all the wedding ceremonies–but I cannot walk by Sitla, Devrani’s more permanent home, without her running out of the gate to walk by my side. Little did we know, she had eaten a few apricots beforehand, which litter the ground come June. Dogs cannot eat apricots. By the time we heard her hacking it was too late. Devrani had thrown up the foamy white contents of her stomach, apricot pits and all, onto the pristine green carpet surrounding carefully designed colored sand and flowers of the Barat shrine. Because we were Devrani’s pseudo-owners, we were also accused of “bringing filth to an auspicious place”, according to the father-in law. We were temporarily removed from the wedding until we could return without the dog. Of course, we had to pay 100 Rs each as a wedding gift beforehand in case we didn’t make it back later that afternoon. I felt like I was living some absurd scene from a David Sedaris essay. I was the girl who brought a dog to a wedding and let it puke on the alter. Whoops.
The wedding weekend turned out to be considerably more disappointing than we expected–but we still managed to have some fun and embrace the strange turns. I suppose I expected something different–something more open and joyous, free–but aren’t all weddings a bit hectic? The only other wedding I’ve been to was between two men in New York City so I suppose that doesn’t make for the best comparison.
The following Tuesday, I was excited to finally catch a car to the village of Sarangkhet, where you will find Chirag’s hospital. It’s a bumpy one-hour drive full of rocks and sharp turns through the mountains–the uncomfortable Jeep ride was ameliorated by Chirag’s exceptionally charming driver, Krishna. I had been waiting to see the Chirag hospital for three weeks already; luckily, my first visit was as an intern rather than a patient. After one course of powerful antibiotics and too many packets of oral rehydration salts I am finally recovered from my illness after drinking contaminated water two weeks ago.
I was not expecting anything special at the hospital. I would be kidding myself if I expected anything–this is a NGO hospital in a severely resource-poor region, where simple transportation and technology is limited for everyone who lives in the region, whether you have money or not. The hospital was tiny, only two floors with maybe four or five rooms each. The cracking, burnt orange exterior paint job gave it a tired, old vibe. It was disturbingly quiet–you could still hear the sound of the wind howling through the Himalayan peaks once inside the lobby/ad-hoc/examination room. A nurse was treating a large head wound on a small boy, who barely flinched except for a small wince during his shot of penicillin. Beyond this room there was a general consultation room, a special “lady doctor” room for examining pregnant women, a tiny “lab” and pharmacy, a dentist office, and eight hospital beds upstairs. There is no labour and delivery unit.
Besides the small line of patients waiting for x-rays, it was empty. According to Dr. Sonia, my mentor, the hospital beds remain unoccupied with the exception of occasional 3-4 hour stays during which patients get IV drips for dehydration. There is no night staff and the hospital closes at 5pm sharp, which makes the mere idea of beds seem ironic. In empty beds made the upstairs feel quite eerie. The lab technician had an exceptionally upbeat and energetic attitude; he brought us deliciously spicy chai in porcelain tea cups. I was surprised by his positivity mostly because the lab is a tedious, frustrating place. Every test is done by hand–there is no microbiological testing (tough out of luck if you have a STI). Simple tests such as blood pressure and blood sugar can take three times as longer to complete–not to mention, they all come at a price for the patients.
When they went to examine a pregnant woman, Dr. Sonia pulled out this ancient machine that looked like a stereo from the 1950s with a small ultrasound-like attachment. They use it to hear the baby’s heartbeat, a soft tapping sound which comes through the waves of loud static. Everything was ready to go but the container of jelly was empty– Mary, a german nurse, used a ruler to scrape the sides of the bottle and get just enough to smoothly roll the instrument along the woman’s 28-week protruding stomach. To be frank, it just made me feel sad. It made me feel sad because it seemed as if hospital funding was perhaps allocated to too many different things. The end result wasn’t only under-utilization, but a seemingly unfortunate effect on the incredibly poor and hard-working people of this region. The upbeat nature of the staff at the hospital helped tremendously–they all greeted patients with utmost dedication and patience. I was especially impressed by Dr. Sonia’s command of Hindi, which she speaks with the most faint and interesting British accent.
But I was most shocked to meet Dr. Daya (sp)–the chipper 82 year old woman who is one of the key practitioners, and translators, in the hospital. Despite her sons’ pleads for her not to return to Kumaon and practice on her own, she lives on a quiet farm by herself and drives to the hospital each day to examine patients. I have never in my life encountered such wisdom and intellect from any practictioner. I suppose nearly fifty years of practicing in different countries, speaking multiple languages, and being open-minded will do that to you. The best part? She’s still learning. Dr. Daya laughs and explains that she often feels out of place because her real speciality is anesthesiology and all this general practitioner business is really jogging her memory. Her commitment to studying pharmacology and keeping up with new findings in maternal health is outstanding. If I was ever looking for some inspiration, I found it. While my plans for post-bac studies and medical school are still up in the air, it’s women like Dr. Daeya who inspire me to bring a passion to my profession. She makes me want to go through the horrors of medical school just so I can do what I love, be a doctor, until I am physically unable to do so.
I admire the strength of these doctors, especially when dealing with cultural issues of noncompliance. Many woman arrive at the hospital with musculo-skeletal injuries. This makes sense, as it should to anyone who spends a day here to witness the women carrying absurdly large loads of sticks and hay up and down the mountain roads. They take x-rays, give diagnoses, and write a course of treatment. Treatment includes rest, especially in those cases where the injury occurred months earlier leading to improper healing. For example, a older woman came in with joint pain and the x-ray revealed that she had suffered dislocation of her posterior shoulder joint–unfortunately, this happened six months ago and the joint had healed to the extent that the it could not be displaced to its regular position. Physical therapy, pain medication, and rest was the only solution. Rest is not practical–especially for husbands. Dr. Daya explained that there are countless cases of women who come in and leave with diagnoses but will never be able to take a day off. Who will take care of the animals? Sort the grains? Carry the hay for cows? If you take a look around you in Kumaon, you will not find a man doing any of these jobs. Who steps in for even one day so that a woman can heal a fracture? It’s more than often the injured woman herself, trapped in a cycle of exhaustion and physical degredation. That being said, husbands can be a big problem. This seems like a theme in the region.
As I prepare for a week of research, I condition myself to be open-minded and ready to learn: ready to wait, forget, be late, hike to my interview, eat a cliff bar lunch, and so on. India is full of surprises and let-downs, but like any relationship it’s best to be calm and honest with yourself. Overall, I learned a lot about my own perceptions and expectations this past week. Having no expectations is unrealistic. There’s a CASI survival guide quote “expect the unexpected”. I disagree with this: I think expectations are inherently too high and that’s a persons way of protecting themselves from being let down by the world. But this is what life is about; this is how we learn–by being repeatedly disappointed. I often consider myself a blind optimist, but I think it is time to take off my rose-colored glasses–for the time-being, at least. The process of learning to lower ones expectations is never ending. So let yourself expect; let yourself dream and be let down. It’s what makes us human.