Exploring the World : In the O.R.

Each morning I ride to work as my cab zips through the chaotic traffic, people bustling around the streets, and markets on the side. There are intense noises and smells, people honking, yelling, and walking the streets barely dodging the cars as they whip by (today some guy got his arm dinged by my cab driver... : / ...). There is so much going on that it's hard to take it all in.

Then I reach the Hinduja Hospital. The "old building" (built in 1950) is similar to the less developed hospitals like I've seen in Nicaragua. Cement walls and hallways lead to the outside where there are places for people to sit in a dusty area tucked between two buildings. There is a small room with a counter and some snacks. Then a bridge connects the old building to the "new building" (built in 1987). This is the side that google shows. It is beautiful, modern, and clean. It was built for physicians who train around the world like the UK and US and then come back to India to practice. There are spots to buy food- sandwiches, coffee, and snacks- just like in the states, and cafeterias. There are elevators designed with marble at the entrance and a guy pushing the buttons for you as you go up to the 16th floor. The patients' rooms are less fancy, with basic sheets and blankets, and a seat or two for family members. There are no EMRs and their xrays are actual films. They don't have computers and TVs everywhere like we do, but they have the basic needs of a hospital. Again, it is a mixture of modern fanciness and old hospital basics. People are speaking another language and I'm picking up on a few of the words and phrases. Then we head to the floor with the operating rooms.

Like in the States, we walk into the OR wearing our caps and masks. Anesthesia is at the head of the table, and there is a hierarchy of surgical attendings to residents to students surrounding the table. They have a scrub tech, circulating nurse, and most of the same surgical equipment. There are differences as well. They have cloth drapes and scrub gowns that are rewashed, slipper/sandal things that you switch into once you reach the pre-op area, cricket playing on the tv in the lounge instead of football, everyone else tilts their head side to side to communicate while I nod my head up and down, and other subtle differences. As we get ready for the case, I forget that I'm in India. It is almost the same, but people are speaking another language while Indi-pop and bollywood music are playing in the background. Then the case starts and I remember how much I love being in the OR- the lights, the focus, the precision, the anatomy- the whole atmosphere. I appreciate that medicine, the human body, and anatomy are universal. They are speaking Hindi but I know their anatomical terms. I love it- watching the surgeon's hands carefully reconstruct the human body. I forget that time is going by and I feel right at home.

Today our last case was a right sided mastectomy with a latissimus dorsi myocutaneous flap. She had breast cancer that had spread throughout her right breast and most likely positive lymph nodes. She will get radiation and chemo next. I felt sad that she had to lose her breast and go through this terrible ordeal, but at least we were able to offer a solution, a chance to be ok, and hope.

In a city with beautiful buildings, wealth beyond comprehension, gorgeous privately funded hospitals, health care access to those who can afford it, and cancer treatment for those who need it- is the same city filled with men, women, and children sleeping on the streets, making fires by their wood huts, squatting on the filthy ground in bare feet, urinating on the street next to where they puddle water to bathe their kids, and lose limbs or die if they get disease. Side by side, completely juxtaposed, are these two completely different worlds living their lives together.