APR-C-6
OUR FIRST DAY AT WORK AND “ON STATION”
BEGINS WITH A GLORIOUS LONG RUN
THROUGH THE BIRDSONG OF TROPICAL DAWN
TOWARD THE “WHITE RIDGE” DHAULADHAR
APRIL 24, 2001
THE NEXT STAGE IS A SPECTACULAR CEREMONIAL
OPENING OF THE MEDICAL CAMP AND THE DIPLOMATIC
RECEPTION BY THE SPEAKER OF THE H.P. PARLIAMENT AND I
AS WE ARE GARLANDED WITH FLOWERS, AND PROCESS TO OUR
MAHARAJAH’S TENTED RECEPTION PAVILLION FOR TEA AND AUDIENCES WITH THE
PEOPLE
AFTER A FULL AND BUSY CLINIC, WE ADJORN FOR DINNER
AT THE GOVERNMENT GUEST HOUSE AFTER A FORMAL SESSION
IN INSTRUCTION IN THE TECHNIQUES OF BUDDHIST MEDITATION
Wonderful! It was a near perfect surprise decision. Since I knew I would be getting up early, and with the help of the time zone changes eastward, I had the full effect of the dawn birdsong. The birds included the beautiful long-tailed white tropicbird, which flitted around in the canopy over the garden in this idyllic green retreat from the mixed smells and rot of the India aroma everywhere around the polluted poor. But they are what got me here, not just the birdsong in a carefully tended garden of the leftover royal palace of the Maharajah’s enclave—but I could enjoy it, as I walked slowly to the roadway outside the gate on my way to the run. I turned uphill—the direction we have not been coming and going from our school clinic, but toward the Dhaulidhar—the “White Range” beyond a formerly British Army “hill station “ post called “Gunner’s Station” and through some roadside tea plantations climbing up the sides of what is the Kangra Valley behind me.
Under the good sense that it should be reasonable to go uphill first, and come back after this long hill work out last, I planned to run for 34 minutes up and 20 minutes back. Bingo! Rig on! And a spectacular run it was! Kim and Habeeb were going to be joining me, and they started out, but I kept going and found myself at the summit of my run when I heard Habeeb’s cough as he came up later. I passed the Gunner’s Station with its motto “Clean, Green and Fragrant”---not a typical Army barracks motto I would think. The also have an imposing sign that should give one pause: There is a hand-painted sign that says, “Wildlife have the right of way” over a painting of a stalking Bengal tiger! Right! I need a photo of me in front of such a sign to put next to the stories in my Out of Assa book about running over fresh leopard spoor and across lion pugs and Cape buffalo tracks. I did get such a photo, but they despoiled their effect by also portraying an elephant a little further along. Now we had seen elephants on the road—hard working elephants of the Asian variety with mahouts leading them to wherever they were working, even in New Delhi. But this one was obviously painted “not from life” since the elephant was standing at alarm posture with trunk raised and flapping its big Africa-shaped ears out-stretched with a mountain b behind him that looked suspiciously like Kilimanjaro. Oh, well, I quibble about the biologic purity when they were just trying to call attention to wildlife. And I did encounter a bit of that wildlife—the most frequent species being an almost luxuriant spread of the canine—scrounging everywhere, in all sizes and shapes and interbreeds, including some trying to stir up the breeds even while I ran past them. They did not appear to be interested in the rats I saw rummaging in the garbage—and during the day they seem to lie in the middle of the road, awaiting the two AM wake-up call to howl at the moon and each other
I had a lot of people staring at me, although I seemed to be ahead of the time when most of the inhabitants from the squat shelters along the way emerged. I was also very gratefully ahead of almost all the heavy bus and lorry traffic that we have to compete with all day, with the exception that I am not breathing in a s much air to be filtered of the carbon soot they exhale at me. It was still gritty, but the reward was just visible at the end of the long up [hill push. I could see the wall of the White Range “Dhaulidhar” as I came close to the summit of my hill run, before this hill gave way to more tea plantations on the margin of the Kangra Valley deeply flattened out before me. It was perfect enough for me to try to shoot a few photos with my back-up NTT camera I had carried as the sunrise came over the White Range chasing the moon away. I saw Habeeb coming up the last of the rise, and asked what had happened to Christa and Kim who had set out, but they had dropped out after two miles—but he hung in the to catch p with me about ten minutes behind.
Now comes the easy part, I said to Habeeb, as we opened up in the long downhill—right on time for the twenty-minute return. I had to stop for an interesting sign, put up along the tea bushes by the Indian Army showing a graded series of human head outlines variously colored in requesting “integration and tolerance of r all colors and religions.” Now I saw more people coming out of their housing and sweeping the dusty street with the twiggy brush that the locals use to throw grit in your eye. It seemed they had noticed me after all but were eager not to show that they had seen me one way, but they were trying see who it is that would deliberately work up an uphill sweat this early in the morning.
I had seen three elderly men who had passed me in identical caps looking like Harry Trumans out on their morning constitutional, and they were careful not to notice me directly the first time, but on return they had to salute my hand gesture and the brief Hindi greeting. And others seemed to be awaiting me to address them or even acknowledge their presence before making any sign of seeing me. Unlike the Philippines, where every one stopped and looked at me with a very loud reaction to the idiocy of a man running in the heat and humidity for no apparent purpose, but there was no more precedent for seeing any other runner here than there. I worried a bit about both Christa and Kim not only running alone, but also being so bold as to expose their thighs. The woman I had talked with in my Corral in the Number 7 starting position at the Boston marathon had described how she would run in Mauritania, but had to do so in a black robe that covered her down to her feet, a tricky business in a hot desert country like Mauritania. She got to Boston from continuing her running.
I would flash a “V:” at the kids I passed who had fewer inhibitions than their adults as they would run along behind me for a while, until they or the dog got weary of the pursuit. I heard a sound I recognized as I approached the site of the Taragarh Palace Hotel. I could even give the name of it which I was trying to remember for Jenna when I was talking about it yesterday, by talking about the meter of the galloping horse, as in: “The Assyrian came down like the wolf on the fold” in the “Charge of the Light Brigade.” ANAPESTIC!
I shouted to no one in particular as I continued on the run, as I pulled up from the hard disc of my college information storage. I have done that often on this trip, trying to remember the data forgotten from long lost course work, to recall it later, like when I was asked to name the Seven Wonders of the Ancient World, and got them all but after a half day of thinking of something else. I heard the anapestic rhythm and then turned off to see them—the polo ponies being exercised by their Sices—each leading a horse on a rope and riding one—for a total of a dozen pretty horses in their Morning Exercise—I of the same kind I was doing. The horses were beautiful in the morning light and I thought that I had the better option of being able to go out without the necessity of having to hire the Sices and feed the horses for their once a year use on the polo fields. I enjoyed my morning and will try to repeat it as often as I can wake up in time to do the exercise that needs no hired hand to help me pursue it.
JUST WHERE I HAPPEN TO BE,
AND ON MY WAY TO WORK
I am at TARA at 32* 03.42 N, 76* 37. 27 E or at the following relationships to places I have passed through:
Deli = 243 miles @ 172*
DHAR = 21.0 miles @ 172*
FRAG = 3,617 miles @ 310*
HOME = 7,233 miles @ 338*
Tara means “Star” as in Taragarh Palace, or “Tara” the plantation in “Gone With the Wind” whose female lead Vivien Leigh was born in Simla. The Garh part means station or fortress, which presumably is the adjacent Gunner’s Station of the “Star Fortress.”
Further, the closest mountain in the Dhaulidhar is 4,471 meters whereas the highest mountain in this range is 6,248 meters, Sikar Beh, just before Manali, over the Rohtang Pass, near the Maln Village which I will visit in the fall on my trip; to the Spiti Valley when I will go on trek through the Pin Valley which proved to be such a disaster for the people from the Swedish party that kept on trekking during the 1998 season when it had rained hard in the Spiti Valley which had proved to be such a disaster for their team which continued the trek in the snow toward the village of Mudd, when five Sherpas were lost by freezing to death in the snow. This should prove some good judgment we have used at least some of the time, so it should be a good omen for the future.
We will now pack up and get to work, but not before an elaborate and extravagant ceremony is about to engulf me for political purposes which are mainly engineered by the Speaker of the Parliament for the Province of Himachal, who comes from Mandi, but includes the whole of the Kangra valley in his jurisdiction. So, something good is happening in his jurisdiction so he is here to make political capital of it and to show what good things he is doing for his constituency, in which he was uninvolved, except for the flower strewn petal snowstorm which hit both of us, as the clinic is opened officially with the blessings of all those who wish to have credit for it but are essentially uninvolved in its operation.
In India one can see knock-off copies of anything under patent protection elsewhere, so there is a Mahindra here that looks exactly like a jeep, or the AIDS drugs that the world congresses are now insisting on getting at near cost production prices, can be made in India without concern about the piracy of patented materials elsewhere. The books, including “The Study of Surgery” were printed in cheap sale copies here, as was the ruin of a couple of Kurt Johnson’s sales
As I look around, I have seen NO women drivers, and when women are on vehicles, they are almost always sitting side saddle on the back of motor scooters, with their long scarves and the flowing saris flowing gracefully in the breeze. This may look good, but is a public health disaster waiting to happen. The nooses and degloving injuries are just asking to happen, as these trailers get caught in the spokes and other moving machinery to garrote or decapitate the women or at the very least yank them off the scooters to be left to the mercies of the diesel and the buses in the slippery manure of sacred cows and barefoot porters. A lot of India is sumptuous disaster and ruin in progress, with what looks good being a transient step on the high wire platform for a tentative hold on the life that they are so fatalistic about. Helmets are less frequently worn on motorcycles than the bandito style masks from the grit and smoke they are trying not filter.
Signs are often comical with at least one mis-spelling, often in a crucial part of the message of the text. Almost all are, as the Brits would say, “one-off” copies of something once seen on Asian hyperkinetic MTV, just missing the mark. The one I see along my run is “The Finest Launch in the World”—an ad for a kiosk roadside stand—which may be true, since I do not see a gold seal of sanitation approval anywhere along the line!
When we drove up to the school, there were evergreen bows tied over the arch over the road, and a red carpet on the dusty packed clay around the entrance leading to a tent-like pavilion, with flower petals strewn everywhere. We waited as a motorcade of very old looking ambassador coupes drove up to about a suitable 500 meters away, at which point the honorific Speaker of the Himachal Province parliament got out and walked with his hands clasped in front of him, along with his wife in sumptuous sari and ample exposed midriff, as functionaries ran alongside passing out baskets of petals and kati scarves to uniformed school children who lined each side of the road, singing and praising him in the foresinger mode of African praise-singers who are appointed to go before any dignitary and heap upon him good words. The Speaker was eating it up and playing the role to the hilt, coming up the road way to meet our group with me standing as the target in the center of our group and directing me to the red carpet where the three of us—I, speaker and frou, were escorted by toadies on all sides to the couch seated at the head of the tented pavilion as pasha princes in a desert Majlis must have to do for ceremonial receptions. At a signal, several dozen small children, came for ward toward me, each on a serious mission you could see in their frightened eyes, but determined not to blow it. Each held a garland of flowers, and these garlands they had made were to be strung around my neck like being smothered in a dozen leis, while each made a little serious bow and hands clasped before them, a kind of feudal curtsey. Since the Speaker and wife were already about as heavily decked with floral tributes as they could get, it was my turn as leader of the medical team and the delegation from America to carry my burden of floral tributes like a thoroughbred entering the winner’s circle at Churchill Downs—and as yet we had not done anything. In fact, this ceremony was taking up a good deal of the morning in which we could otherwise be working.
We three sat enthroned under the canopy with a crowd of curious standing at long corridors of kids and adults on each side as I introduced each m ember of our team and where they were from. The Speaker would then summon someone to come forward and introduce them with the usual statement that Mister so-and-so had worked faithfully in this district of his constituency for the last twenty years—“Thirty five years, Excellency!” and doing a little praise singing of his own for the faithful civil servants, some of whom had been here since the British Raj before independence “Freedom at Midnight” of 1947.
We had a bit of back-slapping good ole boy humor exchanged between us, as he introduced me to his good wife, who was even better because she did not understand English, but she did everything else a good wife should do, he added, and he could keep her busy enough on this tour that she could cause him no trouble—you know the kind of extremely politically correct statements any US politician would love to have on the evening news as the cameras clicked away—at least half of those cameras belonging to our group, and one of the tape recorders being mine sitting between us on the covered couch. Now would be the right time for me to run for high office in this district of India, since I was getting a lot of free prime time publicity—which, of course, was the Speaker’s purpose for taking advantage of our visit. He explained to me that his district included the Mandi area, where he was born---“with five lakhs” and this area which had a budget of “three crore” Fortunately, I understand this part of India-speak from reading the newspapers and their different way of counting up large numbers. A “lakh” is 100,000 and a “crore” is 10.000,000, so the former referred to population and the latter to rupees. The speaker explained that he was graciously taking this opportunity to get out and about among his people so that they could see him and press the flesh, and schoolchildren could express their adoration of their leadership of the VJP, as it just happened the district would be contested in an election in the near future, and he wanted to hear from us about their problems and just how well they were doing under his benign and paternal administration—read “Any good usable quotes from a visiting American professor would be appreciated for newspaper attribution.” I am not a part of the political process here, and did not so much enjoy this experience as admire how it was all pulled off by the many people who had to have been involved to get this public congratulatory ceremony done. I certainly did not need it, but they obviously did, and they were getting their maximum mileage from our visit. If this ceremonial function helps the Himalayan Health Exchange get done what needs to be done, I am willing to play this game, but would not like it as a full time job, the way Bill Clinton drank this all up as life giving water. This ceremony was really to the liking of the Speaker, who explained that he was going forward when he could take our leave to yet another similar such function to be received in another part of his constituency today, so he and his honorable wife were having a good day among their people. A floral bouquet had been arranged for me still wrapped in Saran Wrap, and laying crosswise in my arms, so that I felt a little like the Miss America Pageant crossed with a wreath-laying ceremony—Ah, the glories of public office!
WE were served the inevitable Chai (tea—always Kangra first pickings of the tiny leaves of green tea sweetened and with milk) and little sweet cakes, which I staqcked up in front of me while watching the eager eyes of a few of the students who latger got my uneaten dessert cakes. I ate a few of the almonds and pecans, and looked around the tent in the course of our small talk, waiting for a signal from someone that our necessary reception was over and that we could get to work. But the Speaker was still enjoying his moment of a few quick remarks and small messages regarding new marriages and births and such social events among a few of his voters. Finally it was I who moved to say that we appreciated his blessings upon our work, but it may now be time that we actually got to it. At that point he gave a formal little speech commending us for what we had not yet done, and he and his entourage swept away to go somewhere to another flower strewn tent reception, the little kids ebbed into the tent and scooped up the candies and little cakes, and I unlayered from the dank heavy load of floral leis, and set about going to work.
OUR FIRST CLINIC DAY,
NOT AN ANTICLIMAX TO OUR RECEPTION
BUT THE REAL ACT FOR WHICH THE CEREMONY WAS SOMEONE ELSE’S NEED WHILE WE WERE LOOKING AROUND AT THE POTENTIAL PATIENT POPULATION AWAITING US
From the regal splendors of a Maharajah’s tent to the crumbling plaster and dung white washed school room with no furniture but our collapsible camp stools and no light except a wooden shuttered window, I more comfortably retired to the latter. Kim would sit at my right with a translator, and another student, Christa or Jenna to my left, each doing the interviewing and screening to the degree they could get an accurate translation, and I would make rounds through the thick crowds clogging each door, to over see the other rooms with similar set-ups, with one having the Indian dentist in attendance, and the other having one of the local Ayurvedic Indian doctors mainly available for translating or Raj Kumar overseeing, and Carrie and Elizabeth seeing the kids in the front building. If there were interesting patients with specific findings, I would either take them around to show the findings—usually by not telling them what it was until they had guessed it after several false starts in a differential. The were a couple of WHO Class III goiters, an ataxic kid with some form of infratentorial cerebellar lesion, and a lot of “failure to thrive” kids who looked a bit like normal three year olds, except that they were seven.
We saw almost unlimited aches and inflammations, mainly in the knees. There was very little rheumatoid arthritis, and a lot of understandable osteo arthritis. The knees are especially critical, as I asked the students “How come so many people complain of dysfunction in their knees when they would not do so for their shoulders or other similar joints?----Have you not seen an Asian toilet?”
There was a lot of reflux peptic esophagitis, a few duodenal ulcers, one herniated disc, one stone passing flank pain, anemic patient with hookworm. There was some otitis with one having hearing loss and a cholesteatoma, one Duchenne Muscular Dystrophy for which they called me out to see this “acute case” since he could not walk but was carried in—it turned out he had been unable to walk for the last eight years and had already been diagnosed and as under reasonably good management already. There was a post-meningitic syndrome, a number of rashes, for which Carrie was very helpful.
When it came close to about three hours work, we stopped the patient flow and loaded everybody into the Tatas, and went to the Himachal Government Guest House for lunch, returning for another four hours of work on the fewer patients that remained awaiting us.