First full day at work, and our first weekend

Well, my first full day at work was a bit of an eye opener.  I got to dig in a bit more about my patients, and talked to the docs.

The docs were extremely nice, genuinely happy to see me again. We chatted about the year’s interval. Although the nursing staff had made some changes, the docs really hadn’t made any. The blood gas analyzer was taken out of service because they ran out of reagents and cartridges. The company from which they obtained these materials had been blacklisted because of corruption, and so there was apparently no longer a vendor available on the Indian subcontinent. I was told that they had reviewed their statistics for the last three years, and had decided that from their perspective and analysis, they did not need blood gases.  I ventured that perhaps one did not for one or even two days of simple postoperative ventilator care, but not for anyone who was really sick or for a prolonged vent stay.  This will require some work.

To the positive, there appear to be fewer drug shortages.

Some of the patients will be quite challenging. The young fellow who embolized from rheumatic heart disease, infarcted his brain, and then hemorrhaged  has now bled into his ventricle and has new areas of ischemia. Our presumed leukemic will hopefully go shortly to Vellore Christian Medical College, which is the site of choice for patients from Bhutan who need true tertiary care. Our patient with depressed consciousness unfortunately developed subtotal atelectasis of the left lung. I gave instructions for aggressive pulmonary toilet, and hopefully I can avoid bronchoscoping her.  We’ll see what Monday holds.

We were lazy and got up late on Saturday, and went to the market. Vegetables, cheese, fruit and a couple of souvenirs from the vendors.  All the guidebooks say that the prices are fixed, but we consistently were able to get prices knocked down by 10-20%. I made us a tame version of ema datse, the infamous cheese and chilies dish, using a fair number of chilies but softening the blow with a flat bean similar to a snow pea. Pretty good, if I do say so myself.

We went to see the Buddha today. Long climb, exacerbated by a number of wrong turns. However, we were rewarded with the site of a couple of women weaving at the side of the road.

The day was chilly and overcast, so the view wasn’t quite as good as last year. Eileen actually let me take her picture:

There continues to be work on the base of the Buddha, and here’s a picture of some Indian workmen ( a lot of construction is done by Indians) crushing rocks  

  The Buddha himself is quite striking. .

We dragged our middle aged bodies back to our apartment, had some lichi nectar and some  sweet fried dough snack, and took a much needed rest. Eileen made some nice vegetarian fried rice, and we split a bottle of Red Panda (a very nice unfiltered Weiss beer).

I am not going to report on Eileen’s clinical activities. She will tell her own story in her own way.

Back to work tomorrow!