So, things in hospital land are getting a little better as far as seeing patients is concerned. I'm starting to understand the way the system works and also what are the typical conditions seen here and how they usually treat them. I think it's much easier than coming from here and landing in the US because there is a much smaller range of diagnoses and treatments that can be given. However, I'm trying to understand better whether certain things I know from home are not seen here, or whether they just can't diagnose or treat them because they don't have the facilities for tests etc, so they "don't have them" because they cannot prove them in any given patient. That said, the Tamilnadu AIDS control group, TANSACS, has provided free medications both for antiretrovirals and for any opportunistic infection people might have. So while we have a limited variety of drugs to proscribe, we have plenty of free medication for people. As long as it's related to infections. For example, if a patient showed up with blood pressure or diabetes, we'd have nothing to give them (but the rest of the GH provides free/cheap care so they'd go to the general medicine clinic for that i guess).
I'm starting to see patients either by myself or with the help of a translator first, before comparing notes with the medical officer to make sure i'm not missing anything and am thinking of the right treatments. Kungum Tamil Teriuum= "I know a little Tamil". I can ask a patient their name, age, if they have any problems. I can ask about fever, cough, sputum, blood, all the fun things your guts can produce, etc....and I can ask for how long they've had the symptoms, if they're eating, drinking, sleeping well. Sometimes this works alright. Sometimes I ask a patient "how many days have you had a fever?" and they talk very rapidly for 4 minutes and point to every spot on their body. At which point I say "Mother, I know a little, little Tamil" and ask the question again. Some patients understand that I don't speak much Tamil and speak slowly. Sometimes I ask them a question in Tamil and the patient leans over the table towards the doctor and tells them "Sir, I don't understand English. " The Dr. then tells them I am speaking Tamil to them and that I asked the question correctly and they should refer their answer to me.
Slowly, it's coming together...between the language part and the clinical part. Feeling more confident, but also still feeling like I couldn't fix a lot of the problems that patients have even if I had all the Tamil and time in the world....
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Congrats on the Tamil you have learned. You have described exactly how residency was for Mom and I, except it was Spanish instead of Tamil. That is why we speak the kind of Spanish that we do. I could more easily know if you had some bad bodily problem than if you and your uncle enjoyed going the movies together.
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