Thursday, August 28, 2014

Broken Hearts in India

This is Sam.


Sam is a little under the age of 3 and lives in Kodaikanal, in the mountains of southern India. Like many of the other local families, Sam's parents probably make less than $1.50 a day... which has to go a long way towards housing, food, clothing, water, and other necessities for the whole family.




Sam spends his days at one of the creches along with many of the other 3-5 year olds in the community.  Here, he is provided with high-calorie meals, multivitamins, and regular health checks in addition to the lessons taught by the teachers and the opportunity to play with other kids.




Unfortunately, Sam doesn't get much of a chance to play with the other children at the creche or participate in some of the activities. 



That's because Sam was born with multiple ventricular septal defects, meaning he has several holes in his heart. 


 Sam stole my heart my very first day at the creche before I even knew about his condition.

He was an adorable, quiet, very small boy in an inside-out red sweater who seemed a little sad and was keeping mainly to himself. I couldn't figure out why he wasn't participating in the activities with the other kids. Then, when the doctor came for the weekly health checks I learned about Sam's congenital heart defect.

I listened to his heart and heard the loudest, most obvious murmur I have yet to hear, distinctly hearing the whooshing of the blood being shunted from one side of the heart to the other through the holes. The oxygen-rich blood in the left side of the heart goes through the holes back to the right side of the heart and mixes with the deoxygenated blood. This puts an enormous strain on the heart and lungs. In order to try to compensate, his heart has become enlarged and pumps at a much faster rate than normal. He also has pulmonary hypertension, which means that breathing is not easy for him, and he must take a host of daily medications in order to combat his heart failure (including digoxin and furosemide for the medical people who are reading this).

Despite how young he is, Sam is by no means oblivious to his condition and is an extremely smart little boy. He doesn't play with the other kids because he knows that just a little bit of activity is too much for his heart to handle. We could tell that there were some days when he felt worse or was more sad. One week he would sit and play, shyly smiling and laughing as I showed him pictures of my dog, the next week we couldn't get him to smile despite all of our best efforts.

All of the volunteers felt invested in Sam's case and we wanted to know what was going to happen to him.VSDs are actually one of the more common congenital heart defects but can often close on their own with time or conservative treatment based on how large they are. In cases such as Sam's where the VSD results in pulmonary hypertension and heart failure and is too large to close on it's own, surgical intervention is required to close the holes.

While open-heart surgery on a young child is a big deal in any part of the world, finding the means to have the surgery done is not much of a hardship in the US and other developed countries. This is not the case in Kodaikanal. The doctor informed us that for now they were waiting to see if his condition improved and if he became stronger for surgery, but even if that was the case, the resources and funds that he would need were just not available. He told us that Sam would most likely not live to be a teenager.

I struggled in that moment, feeling overwhelmed by so many emotions: frustration, sadness, anger, gratitude, determination...

Here was this sweet little boy, who should have his whole life in front of him, but because he was born in a part of the world that has less opportunities than where I was born, he isn't going to get the chance to live a full life.

Saying goodbye to him my last day at the creche was a very difficult moment, and my heart still breaks every time I think about Sam, but he is my reminder for all of the reasons I want to be a doctor.


In those moments when it doesn't seem worth it, and I lose sight of why I am doing this, I'm going to remember Sam and keep working towards a world where all children, no matter where they live, have access to the care that they need.

If you would like to also help make steps towards my goal, please consider donating to the organization that I volunteered with so they can continue offering medical care and nutrition to underserved kids all over the world: http://www.fimrc.org



Thursday, July 17, 2014

India Week 2

I have now been in India for over two weeks and still feeling so happy to be here. Our group now has 8 people, all from different backgrounds, religions, and cities but our quirky little group somehow works pretty well. Riding in a van with 11 (soon to be 12) people can get pretty interesting though. 

Our days still consist of going to the hospitals in the mornings and the crèches in the afternoons. The crèches are still my favorite for obvious reasons:

                                  


The difference in healthcare is astounding mainly because most of the people here can not afford much care. One thing that is particularly interesting is that Indians have a notion that an injection, or "oozie", will make them better, so I've seen several patients who ask for an injection even if they don't need it. The doctor may then give them a vitamin injection so that they don't go looking for treatment from someone who is not qualified (also common here). However, parents use the threat of an "oozie" to discipline children so kids are often terrified of seeing the doctor or getting a shot, no difference there I suppose though.


                              

Pasam is the charity hospital here that was started by a doctor, Dr. Maskarenez who is now 85, still practicing, and probably the most incredible person I ever met. He got his medical degree in Germany and then came back to India to practice. He traveled in a van from village to village seeing and treating people who had no local doctor. People would line up by the hundreds to come see him as he practiced in a hut or out the back of his van. He then started the Pasam hospital in Kodaikanal, where patients are not charged (although they have had to start charging a little due to limited funding) but even now still goes out to the more rural villages to see people who would otherwise have to travel long distances on the mountain roads. Since he has medical ties in Germany, every spring a team of German plastic surgeons comes to Pasam to evaluate and operate on 100-200 people who would never be able to afford such surgeries otherwise. The majority of the patients are burn victims, many who had attempted suicide after believing they brought dishonor on their family or women who disappointed their mother-in-law or future husband ("dowry death"). As a result, people who had previously been debilitated and needed care can once again lead normal lives. 

Dr. Maskarenez is traveling to Delaware soon to visit his son and he said he would give me a call if he goes to Philadelphia! In between visiting terminally ill patients of course as he does whenever he is in the US.

Last week at Pasam I got to debrie and dress a diabetic foot that was so bad you could see many of the muscles in her foot (I'll spare you guys the picture). Diabetes is very common here and difficult to control due to the local diet (lots of rice) and medication. This poor little old lady probably cut her foot at some point but didn't realize it. She then got a staph infection that spread resulting in cellulitis and necrosis over most of her foot and part of her leg. It was the first time I ever had to "treat" someone who had something really wrong with them. I hated causing her more pain even though I knew that it was helping her, but it was still difficult. Afterward, she was so incredibly grateful, as she is every single day when we redress the wound and clear off the slough (those of us who aren't helping, hold her hand and sing her songs to make her feel better).

All of the patients here are always so grateful to their doctors, no one gets mad about having to wait or complains about their treatment. They are just glad that someone is trying to help make hem feel better. And I'm grateful too that I can be a part of it.

                  

Switching gears: this past weekend we took a trip to Kanyakumari, a beach town at the tip of India where the Indian Ocean, Arabian Sea, and Bay of Bengal meet.

                 



It was so nice to be around warm weather (it seriously has not been warmer than 70 degrees here) and relax a litte. We had a great time seeing the Gandhi Memorial, Vivekananda Rock Memorial (to the left in picture below) and one of the biggest statues in Asia of Tamil poet-saint, Thiruvallular (to the right), and just walking around the colorful town and sitting on the beach (we couldn't go in the water since a local had disappeared while swimming two days before). Because it is on the tip of the continent you can see both the sun set and rise over the water. However, despite getting up at 5 am, we were unable to see either due to the clouds on the horizon. We were lucky enough to watch the Super Moon rise over the ocean while we sat on a rock pier that extended out into the ocean.



Overall, it's been another week of eye-opening experiences and fun silly times. 

Saturday, July 5, 2014

Kodaikanal

So. I'm in Kodaikanal (Tamil Nadu region in southern India) for the next three weeks (I've been here for a full week) volunteering with the Foundation for the International Medical Relief of Children (www.fimrc.org). 

In my first week here I've already seen so many things that are entirely different from what I'm used to seeing in the US. One question I got asked a lot this week was: Why India (FIMRC also has sites in Peru, El Salvadro, Costa Rica, Nicaragua, Costa Rica, and Uganda)? My answer: It's something different.

The Indian culture is beautiful and unique, something that I become more convinced of each day I am here. But I think that many people forget that India is a third world country. In a culture with women who are dressed in beautiful colors and gold jewelry, large weddings, and Bollywood, it's easy to overlook the villages where people work 7 days a week doing hard labor to provide for their families and children are often malnourished. 

Kodaikanal is one such place, but you may not realize it at first glance. High up in the mountains of Tamil Nadu, many people come to Kodaikanal for vacations to escape the scorching temperatures of the plains (even in summer it doesn't get much hotter than 75 degrees) and take in the sweeping views. As a result, there are many large and beautiful summer homes and hotels here that may only be occupied for a few weeks throughout the whole year. In sharp contrast to these empty mansions are homes made of pieces of tin, mud and sticks where entire families live in a single room. In these households both parents must work all the time in order to provide for their families but it oftentimes is not enough. 

Due to these conditions, in addition to the fact that the only way to get to the town is a several hour drive on narrow roads that wind up the mountain, many of the people who live here, especially the kids, do not have access to adequate healthcare. Malnourishment and respiratory infections are extremely common in the child population while osteoarthritis, diabetes, and muscle strains are a part of life for many of the adults here. 

My first three days here were spent in the crèches (similar to preschools, for children age 2-5 whose families can't afford to send their kids to other schools) measuring the kids' heights, weights, and arm circumferences. The majority of them were underweight for their age. In the afternoon, the doctor came to examine the children who were sick that week. Out of 40 or so kids, about 15 were sick. Many of the kids had handkerchiefs pinned to their clothes because runny noses and coughs are everyday occurrences for children who live in houses with several people and little ventilation. It broke my heart, but they were still just normal kids playing and trying to get our attention, completely oblivious to their missing buttons, inside out sweaters, and runny noses.

Hopefully in the coming weeks I'll write more about the differences in healthcare, life here in India, and my experiences in the hospitals and crèches and all that I've learned, but for now I just wanted to say that I'm here in Kodaikanal and I'm here because there are people and kids who need help even though it's sometimes easy to overlook. 

P.S. Sorry for the lack of pictures..next time!!




Sunday, June 22, 2014

Hitting Reset

I made it through my first year of medical school. 

There were moments when I wasn't sure if I would make it through, but even in those times, I have never once regretted my choice. But I certainly have come out on the other side a different person than when I started school.



I could write this post about all of the ways I've changed this year and all that I've learned, but to be honest, I'm not quite sure yet myself. I know that I had many good moments filled with laughs and met lots of wonderful people that I hope will be life-long friends. But I've also had many learning experiences, some that were challenging and disheartening, and saw some of the ugly parts of society and life (an inevitability in the medical field).  And now that I have a chance to stop and take a breath before starting the next year of my medical education, I'm going to take the opportunity to hit the Reset button.

There are the everyday types of hitting reset. But I think that it's also important for everyone, at pivotal moments, whether that's a milestone birthday, a career change, a break-up, or coming off of a particularly challenging year, to stop and take a moment for themselves. "Reset" doesn't mean that you erase and forget all of the bad stuff, because bad experiences, even more so than the good, are how we learn and grow. To me, Reset just means letting go of everything that is weighing you down: the worries, regrets, and what-if's, and instead reflecting on and embracing the lessons learned, successes and achievements, and all of the blessings in life. 





If you are anything like me, this may be easier said then done. I've found that the best way for me to get out of my own head is to get away from everything that I know (my safety zone) and go back to the things that I love. 

This is not the reason why I decided to go to India with the FIMRC. But it's what is keeping my anxiety about traveling to Asia for 6 weeks at a minimum. I love traveling and seeing new places and people and it's always been a dream to help offer medical relief to kids in other countries who truly need it, but I'm also looking forward to getting away from my life here for a bit. 

Kodaikanal, India

The key though is to get away, not run away. You can't run away from your problems or the difficult parts of life, but it's good to sometimes take a step back and then look at things with a new perspective. And what better way to do that than to get out of your comfort zone and have new experiences? Although, your version of getting away does not have to be as extreme as volunteering in a country on the opposite side of the world. 

Don't worry, my entries when I'm in India won't be this self-centered. I hope to share everything that I see and learn which I know will be a great deal. And I plan on coming back (the day before classes start, ah!) feeling "reset" and with a greater appreciation for all of the opportunities that I have been lucky to have, and hopefully feeling as if I made even a small difference in the world. 

So, on Friday I will be off on a new adventure, and maybe you too can hit "reset" and have a fresh start this summer. 

Friday, May 16, 2014

50% Happier and Summer Travels

Checking in halfway through the #100happydays challenge, and guess what? I feel happier! Go figure!

Don't get me wrong, I was happy before (I will forever be that annoyingly optimistic person who says "Things could always be worse!"), and there were plenty of non-happy moments these past 50 days (read: med school), but like I said, I was starting to focus too much on the negative and forgetting about all the little happy, positive things in my day-to-day life. 

So starting on my 25th birthday, I began to try to focus on and capture one (or two) things that made me happy each day. Sometimes it was very easy, like having great friends who spoiled me for my birthday:





Sometimes it was something as simple as looking up while walking home and seeing the full moon, a silly note, or making pizza on a rainy Friday night.


I started noticing patterns of things that make me the happiest. My happiest moments seem to often be related to being outside (especially running), music, and food...but most importantly, spending time with my family and friends.






My favorite picture is still the very first one I took.
A mother-daughter birthday dinner (and some awesome Belgian beer) 


Around Day 20-25, I also started noticing that I was going about smiling for no reason, feeling extra appreciative, and had an extra bounce in my step again. 

Back when I used to bounce and hop a lot more.
And didn't have hands apparently.

And more and more I realized that it helps to smile, even if you don't always feel like smiling, even if there is nothing in particular to smile about (cue the Charlie Chaplin music), because eventually there will be something to smile about, and worrying and frowning is not going to make the time go by any faster or easier.

In short, I can say that only halfway done and the 100 happy days challenge has been a success. So if you were considering doing the challenge, but haven't yet, hopefully this will convince you to give it a try.

The second half of the challenge should be even more interesting. I will be finishing up my first year of med school and then doing this:



Oh, you know, just going to spend four weeks in India working with kids in a health clinic followed by traveling to Vietnam, Thailand, and Bali. Just an ordinary summer. 

You can bet your bottom dollar that I will be chronicling those adventures here, so stay tuned if you're interested in following along with my (hopefully) exciting and (slightly...probably...definitely) scary adventures this summer!

Thursday, March 27, 2014

100 Happy Days

It has been more than 100 days since I last wrote here. And they certainly were not all happy days. It was a long, cold winter spent studying the "Cellular and Molecular Basis of Medicine". And I'll admit it: I let it get to me. My cynicism (and even bitterness) related to school, which equates to my life in general, reached a peak this winter. 

I generally consider myself to be an optimistic and positive person. I try to look on the bright side, find joy in the little things, and I truly believe that things will always work out for the best. But, between the bitter cold that prevented time outside and the massive amount of studying I had to do just to keep up with school, I became pretty negative. And I don't like being that kind of person.

But now there are signs of spring in the air (not counting that snow we had a few days ago), I passed my second semester of med school, and, oh yeah, I turn 25 tomorrow. There's no better time for a fresh start. 

So, in order to get my "happy" back and to start off my quarter of a century year in a positive way, I've decided to join the #100HappyDays challenge, starting tomorrow. 
Haven't heard of it?

All you have to do is share a picture every day, for 100 days straight, of something that made you happy that day. You can share it via a social media platform (Instagram, Facebook, Twitter... just use the hashtag #100happydays or your own hashtag), or it's something you can just keep to yourself. It's not meant to be a happiness competition, but it certainly is a challenge: 71% of people who started the challenge have not finished due to "not having enough time". We shouldn't have to make time in our day to be happy.

By consciously trying to find something in each day that makes you happy, by the end you hopefully will remember to appreciate all the good things in your life, and about life in general, as well as be more optimistic and a happier person. At least, that's what I'm hoping to get out of it. 

Sometimes, it's easy to get caught up in the busyness and stressfulness of everyday life, but I think that if you really look, even on the worst days, there's always little moments and flashes of joy. 

So no matter how much you have to do, or how little time you have (see what I did there?), there's always time to be happy. Sometimes, we just need reminding. 




Feel free to follow along with my 100 happy days on Instagram @mandilyn. Or, even better, start the challenge yourself! Just sign up on the website at the link above!

Here's to a happy Spring!




Monday, November 11, 2013

Why I Run

I have officially survived my first term as a med student.

Getting through anatomy has not been easy by any means, but I ended up coping with it easier than I thought I would. 

One thing that really helped me to stay sane these past few months was running.



I've always loved running, but I've often fell victim to the "I don't have time" argument in the past. But over the past few years I've learned that being outside and taking the time to do something for myself are usually the times when I am happiest (#tooniceadaytobeinside). So I knew that if I wanted to make it through school without being a total mess, I would have to make no excuses and try to get outside and run (or bike, or hike, etc.) as much as possible.



There were many many days when I had to combat the panicking feeling that I couldn't take time out from studying or the overwhelming need to just take a nap, but I knew that once I forced myself to put on my running shoes and just do it (that's not a Nike endorsement by the way) I would feel better and not regret it.

Those runs, whether they were a quick 20 minute study beak or long and steady, have been the times when I feel the most confident and happy. For a brief period of time, I can look at the sky and the trees, get lost in my steps or whatever 90's pop-punk song I'm jamming out to, and let my mind be completely free of everything in my life that I don't have control over. 



Taking a bit of time each day to do something for myself when I don't feel like I have to prove anything to anyone, means that I have a few minutes in which I can feel confident and in control of my own life.  I can't control what my professor is going to tag on the anatomy lab final, but I can control how far I run. I can't control the cost of my tuition, but I can control how fast I run. And in a society and time in my life where there are a million things that I have no control over...that's a pretty great feeling.



But it doesn't just have to be running, it can be the same for someone who loves to bike or swim; or artists have control over their colors and lines and writers have control over their words and stories...the list goes on and on.

Just make sure that you take some time to do something that makes you happy and that you have control over; something that you do just for yourself and no one else. Those few minutes will help get you through the times when life seems too overwhelming.

That's why I run.



So, this weekend, one week after being able to check "Get through first med school term" off of my list, I can check off "Run first half-marathon", which is something I have been wanting to do for a long time. I certainly won't be the fastest, not even close, but that's okay, because I won't be running to try to prove something or because someone said I have to. I'll be running just for me, because I want to. And I'm going to feel darn good doing it too!