Speculations in Sight

What can someone do in 10 minutes?

 

Run from Leidy to DRL?

Sleep a little more after slamming the snooze button?

 

At the Aravind Eye Hospital branch located in Puducherry, India, 10 minutes is enough time to perform a cataract surgery.

 

After reading the articles and case studies about Aravind, I was dumbfounded with how simple yet incredible the hospital system was. Dr. Venkataswamy (known as Dr. V) earned his degree in ophthalmology and following his retirement in 1976, he had one goal: eliminate needless blindness in India. Today, Aravind has come a long way since starting out as an 11 bed hospital. To put into perspective the scope of Dr. V’s achievement, as of 2012, the Aravind Eye Hospitals have collectively treated 32 millions patients and performed 4 million eye surgeries. .

My co-intern Maggie and I were dropped off by our tut-tut driver at 7 am in front of a pathway lined by floral shrubbery that led to a pastel-blue colored building. Exhausted as I was from traveling overnight and being lost for 2 hours afterwards, I was still filled with excitement as I was finally going to be involved in something so inspiring to me. A few hours later, we listened attentively as someone gave us a brief tour of the hospital and some of the unique aspects of it that intertwined with spirituality and the principles of service.

 

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In the days that followed, I had the opportunity to meet with several of the doctors including Dr. Venkatesh, the head chief medical officer, Dr. Kavitha, Dr. Swati, and several others who were incredibly  sweet and welcoming. I was ecstatic when I realized how easy it was for me to enter an operating room and observe the different types of surgeries. Eye surgery in the operating room is a lot calmer than I expected — I was naively disappointed it wasn’t a real-life simulation of Grey’s Anatomy or House. In contrast, I felt a sense of calmness as I entered the room and observed the cyclic process that Aravind is famed for.

 

We have three stages of the cycle

Stage 1: A surgeon performs eye surgery on Bed #1 as nurses escort another patient and prep them on Bed #2, which sometimes is not more than 5 feet apart.

Stage 2:  The surgeon finishes operating on Patient #1 and walks over to Bed #2 to immediately begins surgery. Half the nurses usher to Bed #1 to wrap the eye and escort Patient #1 out while the other half of nurses are trained to assist the surgeon.

Stage 3: A new patient, Patient #3 is escorted to the empty bed (#1) to be prepped for surgery. And then the cycle repeats once the surgeon is finished with Patient #2.

The purpose of this cycle is to maximize time efficiency while maintaining surgery efficacy. This goes on for hours, and by the end of the day, countless of surgeries are performed, and countless of people’s visions are improved. Today, I casually timed a cataract surgery that involved breaking up the cataract with a device/technique called Phaco and the replacement of the lense. Everything was so fluid, from the transition from one patient to the next to the surgery itself. It took 6 minutes and 43 seconds to perform the surgery. Less than 10 minutes. As I looked down at my own hands, wondering if they would ever be steady enough to perform such a meticulous surgery, I was overwhelmed with questions about the system and reflection about my own reasons for following a pre-med path.

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Dr. Venkatesh performing a cataract surgery with Phaco

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A board in each operating room had all the information of each patient (name, type of surgery, age, etc.)

After about a week, we were briefed very quickly about potential projects that we may be assigned to during our stay here. My first project sounded simple enough: create materials for the counselors to use in the glaucoma clinic so that the information passed on to the patients and circulated through the new influx of counselors is completely standardized. This ensures that the information is accurate and dispersed equally to all patients.

Easier said than done.

Although the surgeons themselves are highly skilled and perform surgeries at an unbelievable pace, the work pace for us interns is slow. I have noticed that I must advocate for my project and what I need in order to get the information and guidance that is required. There are barriers that I didn’t think would cause me much of a problem like the Tamil language and even self-motivation. It is different than how I have experienced other job opportunities in the U.S  because I expect most things to be plainly laid out in front of me. Instead, here I am forced to utilize my social skills (haha) to shyly ask the doctors for help  and blindly create the materials that I hope will be sufficient. As I Skyped with my sister and her boyfriend, Dan, we talked about how it may be difficult for me to adjust to this pace because of how trained I was to Penn’s environment prior to coming here. At school, I am constantly under the strain that I do not have enough time, that I have too many things to do. My schedule is jammed with studying, extracurriculars, and work that I barely have time for myself. Penn has forced the impression on me that I have to do things quickly in order to get anything done. To some extent, this is true, as seen by the highly skilled doctors at Aravind, but I also think that doing things so fast does not allow time for reflection, thought, or purpose. The unfamiliar downtime I have here is something that I am not used to, which I fill with many reflections that I have not necessarily had time for before (incredulous as it sounds).

Everything is work in progress here, from my current project and my future ones, to my own personal growth. Perhaps as I become more familiar with the environment, more comfortable with the workers and vice versa, my path will be clearer.

 

 

Until next time!

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About Quan Quan

Upcoming junior at the University of Pennsylvania studying Biological Basis of Behavior while struggling to stay on the premed track. Interning at Aravind Eye Hospital for the summer of 2017 in Puducherry, Tamil Nadu.