I try my best not to talk shop here on the blog. After all, it is supposed to be my extra-curricular interest, a chance to escape the highs and lows of the day job. (Plus, I find it hugely uninspiring to find medics, who aren’t capable of talking about anything other than medicine). But when Kelly, Emma and Rebecca chose the theme of Fish out of Water Experiences for their monthly blog link up, this travel memory leaped to the front of mind, like a gold-medal winning, Olympic long-jumper.
At medical schools in the UK and many other parts of the world, students are often required to undertake a “ medical elective.” This is essentially an opportunity to spend two months in an external organisation (hospital, community clinic, research establishment etc) to provide exposure on what the vast field of medicine can encompass and the electives are usually self-funded. Most opt to go abroad, which is very much encouraged. Who’s going to turn down an opportunity to travel in the name of learning right?!
St John’s Medical College, Bangalore
After much deliberation, I decided to head to Bangalore, India. To those who knew me, this may have come as something of a surprise. Being of Indian descent, life has been peppered with visits to India so why wasn’t I opting for a new country? The truth is, the only part of India I had ever seen was Northern India, where most of my family are based. I knew it may have been my only opportunity to head to Southern India and grasped the opportunity with apprehensive palms. It was to be my first trip alone – the first of many reasons why I felt like a fish on dry land.
It wasn’t actually the bugs crawling out of the drain in my accommodation on the first day or even the daily “bucket bath” shower experience that came as a shock, both of which I was prepared for and managed. You’ve either roughed it in India or you haven’t and you’ll know exactly what a “bucket bath” is if you have. To be honest, as basic as it was, the fact that my room was en-suite with a flushing toilet came as a pleasant surprise!
What did surprise me was the launderette around the corner, making redundant my mini-pack of hand-washing detergent. It was the fully equipped gym, a stone’s throw away from the hospital and the plush shopping mall equally nearby. Having met a fabulous bunch of fellow medical students from England, Germany and the US, we spent many evenings in swanky bars and restaurants for a fraction of the price we would pay at home.
Far from being the small town India experience that I had become accustomed to as a child, suddenly being slap bang in the middle of the large metropolis of Bangalore was an India I found perplexing – immensely good fun but strangely unfamiliar. Even Bangalore’s temperate and breezy warmth, afforded by its hilltop position, was a far cry from the choking humidity I had so frequently struggled with in the past.I had brought all my baggiest clothes, having previously always dressed conservatively to respect the customs of smaller towns and villages and older generations. Here in Bangalore, I had never felt more frumpy being in my slacks whilst so many local women ambled confidently down the streets in perfectly coiffed hair and nails that can’t have been manicured more than an hour ago. If I was portraying the face of London fashion, then I was doing a hopeless and embarrassing job. The goal of the trip though, wasn’t about socialising (delighted as I was to have been able to do so).
I was here about the medicine and St John’s is one of the most prestigious medical schools in India. With an enormous range of medical specialties and renowned doctors, I will forever be grateful for the knowledge I acquired during my time there. I wrote reams in my ring-bound notebook because almost every patient I came across had an ailment that was rare and intriguing compared to what I had seen back in England.
I saw patients with spleens the size of footballs, afflicted by tropical diseases that most UK doctors will never come across, young adults with advanced heart conditions that would often have been detected in early childhood with the advances of Western medicine and women who were reaching the end of their pregnancies, having never had a scan. It is both a difficult and an inspiring feeling watching medicine performed in a system so different to your own. India’s’ bigger cities are home to some of the best hospitals and doctors in the world but for poorer communities in more rural environments, healthcare can be both inaccessible and unaffordable.My time was mostly spent on the wards of the well-staffed and well-equipped St John’s Hospital in Bangalore but I did spend one week attached to a community outreach team, where a team of doctors, nurses and support staff go out in a van into small rural villages, setting up camp in schools or small buildings, converting them, just for a day or so, into makeshift clinics to provide health checks, such as basic ante-natal checks for the women of the village. I was impressed by the innovation and the initiative taken to try and tackle some of the barriers to healthcare faced in India. But I was also unable to forget how much, back in England and in the west, we can take for granted the system we have. I am well aware that the NHS has its flaws but we are fortunate to be in an environment, where regardless of our bank balance or location, we can almost always access healthcare.
I also observed the role of family members on the ward setting in India to be quite unfamiliar to that which I had seen at home. In England, the presence of family members on the ward often conjures up images of cards, magazines chocolates and questions for nursing staff. On the wards of St John’s, the presence of relatives is very much a necessity to provide ongoing basic care needs. Nursing staff are present but perhaps not in the way that we are used to in England and certainly I saw many patients depending upon family for bathing, cleaning and for their meals.What I found most alien was the way in which patients over there generally treated their doctors like Gods. Literally. Some of the gestures offered by patients, when they walked into the clinic room, were akin to those seen in temples; having sat through endless communication skills lectures at medical school in London about the importance of being patient-centred, it was such an inexplicable paradox to see the patients themselves in India being so doctor-centred!
Their expansile gratitude permeated through the grey, hospital corridors and I had a hunch that morale among doctors in India may be higher, since they seemed to be practising in an environment where complaints and opportunistic medico-legal battles have not yet infiltrated the healthcare culture. But I accept this was eight years ago and things may have changed.
On my return flight to London, away from the clothes and gifts I brought back, I carried a melange of thoughts that weighed more than my laundry load. The experience had been educational, inspiring, challenging, motivational and at times, emotional but despite the moments of confusion and unfamiliarity, it left me with an irreplaceable insight into medicine in a different world and one which broadened my sense of perspective.