Friday, June 6, 2014

First (Right?) Hand Experience of a Hospital System in Cal

This post is going to be a labor of love. Why? Because I am typing the entire thing with only my left hand and the thumb of my right hand. It's taken me about a full minute to type this much...but I'm going to take one for the team so that I can record my experience with the medical system in Calcutta over the last 24 hours. It will be worth it so that it is fresh in my mind. By now you're probably wondering why I'm typing with one hand. I'll also make a disclaimer that I'm slightly medicated for pain, so my usual flow of writing may not be a little more disjointed (no pun intended)...

Last night we decided to get out of the house for awhile and see a movie at the theater at South City Mall. Phillip, Beth, Anna, Laura and I caught a cab that would let all 5 of us squeeze in for Rs 150, and we were off. One person in front with the driver, 3 sitting in the backseat and me laying across everyone in the back. When we arrived, the person sitting in the front opened their door and got out, and we opened the back door so that I could shimmy out. On my way out, I wrapped my right hand around the metal piece of the car that separates the front passenger door from the back door. A second later, the front door was slammed shut - crushing my fingers in the door.

The person who'd just exited the front passenger seat heard a loud, long scream (that I have no memory of producing!) and then noticed from outside of the cab, the ends of my fingers sticking out of the closed door. I don't remember the door being immediately opened to release my fingers, nor do I remember getting out of the cab. My next memory is sitting on the steps in front of the mall/theater, holding a huge chunk of ice that had been immediately handed to me by a very kind street vendor selling sodas outside of the mall.

My fingers were immediately swollen like sausages and adrenaline rushed to the injured area...that mixed with perhaps some shock prevented me from feeling extreme pain. I sat on those steps laughing hysterically (clearly, I was in shock) for a good 20 minutes before the real pain set in. The surrounding vendors were so incredibly sweet. They'd seen the whole thing and continued to provide us with man even offered me his own bottle of water (which Laura took to be polite, though I did not drink from it because we can only consume filtered or bottled water here to avoid sickness). Another vendor gave me water, cut a lemon and squeezed the juice into the water and gave it to us, insisting it would help. Another man suggested I pour cold water on my face to help with the pain. A little boy of about five stood in front of me, just watching out of curiosity and concern. Luckily I had the wherewithal to remember my stash of small toys for children, Phillip helped me fish a small plastic bumble bee figure out of my purse and I handed him to him with a smile, to thank him and to show him that I was alright. He was so cute and thankful, thanking me in English and then later, when his family left, waving and saying, "Goodbye miss! Goodnight!"

Anna's mom is a nurse, and Anna was able to use her cell phone to call her internationally to ask for her advice. (Thanks, Anna's mom!) The decision was soon made to take me to the emergency room - the question was, which one? I never imagined I'd have to visit an ER in Calcutta, but our TA Laura was on top of it. Through a friend of hers who lives in Calcutta she was able to find out a reputable, 24 hour emergency room/hospital. Soon we were off to Bellevue Hospital. (I linked the hospital, Mom...I knew you'd be curious!) Flanked by Laura and Phillip, I walked into a completely empty emergency room that in it's entirety was made up of 3 beds in a row, and a desk. The whole ER was about the size of my apartment! Maybe 650 sq. ft? I'm awful with guessing sizes.

We were quickly tended to, and I attempted to tell the Bengali speaking nurses what had happened. The language barrier is usually an interesting component to our activities...not so much when I was in excruciating pain! One of the nurses spoke a bit of English, and through a mixture of English, hand gestures, and our limited Bengali, we were able to explain that my fingers had been crushed in a taxi cab door. I was told to lie down and was given a shot for pain in my buttocks (first time for everything?)

I was then sent to radiology for an x-ray. When we arrived in the x-ray room however, we soon had a new language barrier problem. The x-ray technician insisted that I lay my hand flat on the board for the x-ray. I tried to explain that I couldn't flatten my fingers. They were swollen and permanently stuck/crushed into the shape they'd been when I'd grabbed the door frame trying to get out of the cab - fingers curled. We tried to tell him, "can't bend" and he insisted in his limited English, "FLAT". I tried to show him multiple times that I couldn't unbend the fingers. He tried to explain over and over why the x-ray couldn't be done if my fingers were curled. I tried over and over to explain that I understood that, but that I physically could not flatten my fingers. He conversed with another x-ray tech in Bengali; he was clearly frustrated. He left to get someone else who spoke more English. When he arrived, he told me the same thing and I told him, "I can't." He then attempted to flatten my fingers for me, and I cried out in pain and almost sunk to the ground. Laura, ever the advocate and strong support for all of us here on the trip, took that moment to step in and say, "Enough! No x-ray." The original technician said, "Fine. No xray." And we went back to the ER. There, a doctor wrote me 4 perscriptions, told me to go home and to come back in the morning to see an "Orthopedic Doctor". We took a cab home and fell into bed by 3am.

I found it interesting that the four medications he prescribed me, without discussing with me first what they were going to be, were: voveran (for pain), alprazolam (for anxiety), a "pain gel" (basically the equivalent of Icy Hot), and another medication that we later Googled and found out is used for esophogeal issues (I didn't take that one)!

This morning Laura and I returned to the hospital to meet with an orthopedic doctor. This is where things got interesting for me, from an observational standpoint. We arrived at the hospital and asked the front desk where to go for orthopedics. He told us both "negative one" and "first floor". So, we went to the first floor. The night before the hospital had been entirely empty save for some employees sleeping on various benches, including the lift operator who was asleep on the floor of the elevator, on a bed of newspapers, with a stack of newspapers to cover his face (this we encountered around 1 am, and at that point we were exhausted and could only crack smiles at each other and say, "Only in Calcutta"...) This morning though, the hospital was jam packed and bustling with patients and lots of family members. We went to the first floor (which is what I would call the second floor) to look for the Ortho office, and couldn't find it. Eventually we found a random room with three women (possibly nurses?) typing at computers. We showed one my hand and she took us straight to radiology, where we went through the entire rigamarole of the previous night with me being unable to straighten my hand and the x-ray tech (a different one this time) becoming frustrated and possibly slightly offended. He gave us the name of an orthopedic doctor and said, "Go to him then". So we left and finally found a big board that listed all of the specialties in English, including Orthopedics, but not their locations. After asking someone at one desk, who didn't speak English at all and directed us to another desk, a woman couldn't understand what we were looking for when we said "orthopedics". We said..."bones"..."joints"...and finally mentioned the name of a doctor who'd been listed under the orthopedics sign. "Oh!" she said cheerfully. "Basement, new building" Wonderful... we thanked her, "Dhonobaad", and went down to the basement.

When we arrived there, we spoke to two people sitting at the front desk and tried to explain the whole situation. The man at the desk spoke limited English, and the woman presumably spoke none, and  eventually the man whipped out his cell phone and called the orthopedist that we'd mentioned. He got him on the phone and Laura spoke to him (he spoke English! win!), he wasn't scheduled to be in until 3 but he offered to come in half an hour early for me. At that point it was only 1:30 or so, so we went back to the Emergency Room to inquire if they could give me something for the pain. At the ER (which was still completely empty), they tried to send us back for an x-ray and we explained to a very kind and helpful doctor who spoke English that we were just trying to see the orthopedic doctor before getting the xray - extending my fingers was just too painful. She understood, and ordered a painkiller shot to be administered into my arm. After about 20 minutes, the pain began to lessen, though the swelling was still there. She advised me to take off my ring... I've been wearing my grandmother's ring on my right hand ring finger every single day since I graduated from high school. My finger was so swollen that I couldn't move it. But she said, "if you can't get it off, we'll have to cut it." "No," I said, shaking my head. I wouldn't let them cut my grandmother's ring. I was sitting in a chair and put my head between my legs, put my hands at my feet, held my breath and began to twist the ring. The excruciating pain was worth it as I considered the alternative of having the ring cut off. When it was stuck at the knuckle, a nurse came with some sort of lubricant gel. Two minutes later, the ring was off and we all cheered.

We went back up to radiology and I was able to extend my fingers enough for a proper x-ray. After some confusion and waiting time, we went back to the ER where the orthopedic doctor met us looked at the film.


We were shocked, but so grateful. We couldn't believe it, after seeing the state of my fingers after they'd been shut in the door.  The doctor told us that I'd definitely damaged the soft tissue/ligaments in my fingers and that they would be sore and would need a splint. He prescribed me some medication and we went to the chemist to pick it up. It took almost 24 hours, but the ordeal was over and I'd officially borne witness to the Indian medical system. Of course, the hospital where I went was a private hospital (and interestingly enough, I paid for each service separately, and in cash directly to each person who cared for me) and I am sure the public/government hospitals are very different. One of the public hospitals (nursing homes, they call them here) had about 60 people sleeping outside of it one night last week. On stone benches, on the stairs outside, on the ground, etc.

My experience last night and today was fascinating. I got to see a sector of Indian healthcare that I hadn't yet seen (we've experienced thus far a much smaller clinic, the clinic for the sex workers in Sonagachi, a doctor's office, and a doctor home visit - all for various reasons).

The plan for now is to keep my fingers splinted, apply ice when needed, manage the pain and let time do it's thing. I may go for a follow up visit to the orthopedic doctor - tonight I noticed that the skin on one of my knuckles that was shut in the door is entirely numb. Perhaps nerve damage?

It took me roughly 5.5 hours to type this post. If you've made it this far, thank you! You deserve a cookie. :-) I haven't figured out how I'm going to write my papers for class, take notes during class and field, wash my hair, change my clothes... everything feels like a struggle right now but I'm just chugging along. There were some great parts of today - I a particular pair of comfy new close-toed shoes for which I'd been on the lookout. I also finally remembered to buy a set of nail clippers - the one item I forgot to bring on the trip!

Also, after we left the hospital Laura and I hadn't eaten all day. So we went to our standby, Banana Leaf, and had lunch. Then one coffee turned into two, and because of an issue due to the language barrier, we ended up with THREE coffees each. Proof:

LB with the scattered shells of our caffeination
All in all, I've been looking for the positives with this experience. Does it kind of stink? Hell yes. Could it have been worse? Hell yes. But I'll never forget my "Calcutta Claw", the elevator operator taking his nap, the insane running around in circles at the hospital, and the help from my kind classmates/TA. I'm also really interested in what kind of healthcare is available to people who wouldn't be able to afford to go to a hospital like Bellevue if they're sick or injured. It's apparently one of the best in Calcutta. I suspect that many people here practice non-Western medicine and I'd love to learn more.

Signing off for the night. Time for more medicine and sleep. Update soon, and I still promise to write about the babus...


Rachel Penn said...

Gah!! Kris!! That sounds awful!! I can't beiieve you didn't break any bones. I think this is the one time that I wish you didn't write so well and descriptive because I cringed through this whole post. Hang in their trooper! Sending you some good healing vibes! XO

Anonymous said...

GAAH D: That's horrible! But you're such a champ, I mean way to power through! I hope the pain eases really soon... Damn :L -Marjukka

JustJude said...

Wow, lucky you! At least no broken bones. Hope the meds help and that the pain subsides too. The anti-inflammatory and ice will be a big help too. Ouch! Thanks for the call today to fill me in. Love ya!

Carlitos said...

I told your mom before about a possible trip to see the public healthcare system in watermelon LOL. It is sad due to the lack of resources. However like in India, lots of doctors are good doctors - to be continued.

JustJude said...
This comment has been removed by the author.
JustJude said...

Had a thought this morning, sometimes doctors do give a medication that helps to prevent eroding of the esophagus when they give you anti-inflammatory meds. That might be why they gave that to you and you might need to take it so the medicine they gave you doesn't eat away the lining of your esophagus & stomach. Esp. important too to always eat when you take the anti-inflammatory & pain meds for same reason. This message was approved by mom.

June 6, 2014 at 6:51 PM

JustJude said...

Also when Carlos ways watermelon, do you know what he means, haha?

Anonymous said...

Thank you for your labor of love! I think you are right--so many details you included were so fascinating, so I'm glad you got them down before they are forgotten.
I think I got sympathy pain this time!!
Take good care, and keep up that positive attitude!
I appreciate the disjointed pun!
Cheers from NC, Raina

Anonymous said...

Oh boy what an ordeal! Reminds me of my experiences with the South African healthcare system when I got a parasite. I, too, found the whole private vs public thing and payment system interesting. I was also amazed at the number of meds you can get OTC there! At least English is an official language, though! Feel better! Your hand will likely take several weeks to heal and the skin numbness sounds normal for now given the swelling. -Susanne

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