OCT-B-3

THE ARRIVAL AT DESTINATION SIKKIM:

KALIM PONG, FOR THE START OF CLINICS

IN THE NEW MEDICAL MISSION TO SIKKIM-03

October 7, 2003

The good news is I am here. The bad news is that my bag , of course, is not, nor did the lens get picked up, and to make all this inevitable bummer more deeply snafued, the A-drive on my laptop appears to now officially be “toast.” I could not copy anything to a disc after typing it into the C-drive after which the A-drive would go into a terminal indefinite spin without getting a retrievable document. A one line file saying that I had arrived in Delhi was attempted to be attached when I was in the Ajanta Hotel in Delhi, and that attempt to attach this single sentence crashed the whole system. I worked for a few hours to try to get the disc to take and give back files for transfer out of the laptop and into, for example, email, and each results in a long noisy and futile spinning of the wheels in the floppy drive. So, now I have no way of typing in reports and getting them out of the laptop for transmission. So, on that technological high pint, this trip is finished before it started.

I will introduce the group whom I am getting to know, and will tell something about them, after I try to see one more time if the text typed into the C-drive can ever be got out by exporting it through a floppy disc. You will hear about the success or failure very soon.

KALIM PONG: AN OVERVIEW OF THE CLOUDY VALLEY

AT THE FOOT OF THE KANCHENCHUNGA RANGE

I am sitting on the porch of the Sood’s Garden Retreat, as a holiday group of Indians is recovering from the festival of Durga, when a statue of the nine-armed goddess is submerged, as fireworks crackle around her and flowers are tossed to the wind. I am looking across to where Kanchenchunga is, but is unseen, since it is hidden by its own cloud cover. I have met the whole group and after breakfast this morning we went to a Gompa on a hill crest not far away. We toured this large temple which has a statue in front of it honoring Norgay Tinseng, who died in 1973, for his efforts to raise the money to refurbish the Gompa. He is the father of the Norgay Tinseng who is now a prince in Nepal and the owner of the trekking company we will use later, and was the first Nepali summiter of Everest along with Edmond Hillary. One of the interesting features of the temple and its environs, and I learned from the group here a plague for their trekking, is that the grasses and area around are covered with leeches, which would attach to the passerby. My roommate has about twenty leech bites on his ankles. Like African leeches, they are not in the water as they would be in northern Michigan, but hang on the undersides of leaves and foliage in the wet tropical rainforest. A chicken is a good thing to have along with you on trek since they go around pecking at and eating the leeches!

We adjourned from the temple and its colorful collection of statues to the founder of Tibetan Buddhism, Padma Sambhava and dense forest of fluttering prayer flags, and went to the Ministry of Health to meet the new administrative Health Officer of this district, a recent graduate who is a radiologist, and who is going to go with us at our camp tomorrow. I divided our group of now-veterans into four teams and made the group aware of who was on the teams and what their responsibilities would be. We will sort out the medical packs and then go over the drill on the patient presentations and the didactic program tonight around the dinner time. It has been a slow day for a start up, and it gives time for a nap to accommodate the time zone changes, and also got a few of them to stop in town for the rite of shopping for souvenirs, which they are out to do again just now. It is also time when I might be able to type up the data obtained so far on this, the first excursion through Sikkim—if only the laptop and its a-drive do not make this a futile enterprise

THE TEAMS AND THE DRAMTIS PERSONNAE

Team 1: General/Family Practice:

Captain: Jackie, US Air Force FP resident, and daughter of an Air Force orthopedist, is an army brat who has lived in Germany and now is at Travis Air Force Base near Sacramento. She owes the Air Force the rest of her professional life, so she thought she would take advantage of the flight school medicine and try a sports medicine fellowship. She is a runner---not beyond half marathon slow status, but she and I will go for a run tomorrow morning to test out the hills here at Kalim Pong.

Candace Hunter, previously introduced as the Abilene Texas-born, Nashville-raised, senior UT medical student at Memphis going into a psychiatry residency. She was one of two coming up with me from Delhi.

Sarah Pawley, the Boulder Colorado MD/PhD student who is finishing her second year at Creighton Medical School in Omaha, Nebraska, having applied earlier to medical school and not got in, she joined a faculty advisor on the development of the inner ear and is going to pursue a Ph D in this subject. She came with me from Dulles. Already mature, she is the youngest in terms of the medical expertise of this rather experienced yet junior group, now almost veterans in the medial camps!

Shelly is an oriental young woman who is interested in family practice. She was born in Minnesota and goes to the University of Minnesota, where she is a senior medical student at Minneapolis.

Team 2 Women’s Health, Ob/Gyn

Captain: Mary She is a veteran of three trips out here in other parts of the Himalayas, and is from San Jose California now in solo practice after she and her partner split this year. She is worried having left two midwives behind. She is very much a “town” practitioners, and complains that he “gown” of the Stanford –associated Santa Clara Valley Medical Center, with which I am familiar, is not interested in them as practitioners. She will head up the Ob group

Christine is at Dartmouth and is living in the Connecticut River Valley. She is wearing a tee shirt that says “Galehead Hut” since she has been very familiar with the AMC Mountain Huts of the White Mountains where I had once hiked up through the Lake of the Clouds and Tuckerman’s’ Ravine. (I need to have a “Galehead Hut” tee shirt, which she assures me is available on the AMC web site—it could stand as the symbol of the new Derwood!) She is on an extended year from Dartmouth and will be traveling around the world for the next eight months, a program that fits in the Dartmouth program for another $500 tuition, stopping next at Thailand after Kathmandu and then on to Australia. She is trying to match with her boyfriend for residency in something like Med/Peds but he is taking a year off for the MPH program and is writing a novel based in Tibet for which she is gathering some bibliographic reading materials.

Patrick West—one of two Patricks and another who is in the University of Virginia program born in Lynchburg. Although assigned to the Ob team, it may be that the cultural acceptance of a man on the women’s team may be an inhibition to doing histories or exams , and for that reason he is exchangeable with the FP team and Candace—we will be able to tell later as we find out about the culture.

Team 3 Peds

Linda—formerly a Dartmouth medical student she has just moved to San Francisco to start a pediatric residency. This is her vacation and she was at first upset about the idea of being graded on her performance, a necessity for the senior medical students to get credit for this rotation, and a need for some of the residents in order to have an accredited leave from their residency that does not count as a vacation. She met a former Dartmouth boyfriend here in the Delhi Ajanta restaurant as he was leaving from the previous trip neither knowing that the other was coming to India. She is going to marry her current boyfriend with whom she has just moved in.

John wearing a St. John’s tee shirt makes it easier for me to remember who is who is a Wayne State University medical student senior who is interested in emergency medicine residency. He was born in St Clair; Alma College was his undergraduate school.

Jane Klaes—as yet not arrived, since she has been held up at a border crossing, having toured a bit before her arrival here. She is a practicing Buddhist convert and had tried to set up an HHE medical camp in the area across the border where she is now trapped by avalanche slides. She was born in Plymouth Michigan and went to the UM for undergraduate and is now a senior osteopathy student at MSU.

Team 4: General/Surgery

GWG -Chief of the whole medial mission, and floating over each team, so I am assigning the captaincy to my roommate and Wayne State senor medical student

Patrick. He comes from the Flint area of Michigan and is interested in an emergency medicine residency, interested in shock research, a senior medical student from Wayne State who had gone to College at Michigan State.

Marti Peters: the other Wayne State University senior medical student who cannot believe I know where she was born and as much as I do about her environment and background. She comes from Overisel, Michigan, between Holland and Zeeland, and went to Overisel Reformed Church, and graduated from New Groningen School and then went to Central College in Pella Iowa. Therefore she has danced the “Klompen Dance” at both the Pella and the Holland Tulip Festival! She has relatives named Verduin, Peters and familiar west Michigan names. She was an English teacher of two years when she went to Japan outside Yokohama. She never expected to be talking about Overisel and Drenthe in the Eastern Himalayas with someone who knew about each. She knows no Dutch.

Crystal is the only non-medical person, and she graduated from California State and got married. When moved to Buffalo, where she would really rather not be, but that is where her advisor is in the Anthropology program she is pursuing, having started on the first part of her Comps. She is going to be dealing with the subject of Tibetans in their displaced regions, and will follow her advisors lead on this. Her husband left California without a job and got a good job in Buffalo as a Sherwin Williams paint salesman. She had been on the Anthropology tour of the Spiti and Kinnaur Valleys earlier this spring with HHE.

We have had our general introduction and my break down into the teams and what will be expected of them, and each has a drug list for prescriptions. Tomorrow we test this system on a high volume of patient flow in the clinic set up at Teesta—the village we had just come through along the Teesta River and expect about a thousand patients to appear to be handled by this more experienced senior medical student team.

Now, we will see if the laptop is up to saving this file on a separate disc through an A-drive that may or may not function. Here’s hoping!

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