congratulations, bombay, you win.

we were having one of those days yesterday, you know? my computer was supposed to be coming back, fixed, and when i got there it hadn't even been sent out yet. so we tried to go to the internet cafe and get the address of our hotel in delhi (we're going to the taj mahal this weekend!) to bring to the travel agent, but the internet cafe did not have internet. we had a list of errands, including getting fabric and meeting the tailor who is making us dresses. we were supposed to meet the tailor outside a cinema, but when he called to give us more specific directions, the taxi driver refused to take the phone and talk with him, then attempted to overcharge us. when we met the tailor's man at the cinema, he ran us through some back streets of the city and i almost got hit by a car in the process, at which point i was so angry that i started shaking my bags at the driver while an old man behind me clucked in dismay. i'm not sure who exactly was the object of his dismay. probably me. we hopped back into a taxi to go to the travel agent, in dalamal tower, but neither we nor the driver could find it. seems everyone was directing us to dalamal house. after three loops around nariman point we got out and walked (it was actually right there) and all went smoothly inside, but we couldn't find a cab willing to take us home. perhaps they were waiting for some rich businessman to head out to the suburbs. and then, just when i thought i couldn't take anymore, i felt something hot hit my arm.



yes, the pigeons were fighting back.

yes, a pigeon pooped on my arm.



fortunately, we carry purell and tissues at all times for bathroom emergencies. generally, we do not expect these to be pigeon-bathroom emergencies, but what can you do?

technical difficulties.

we're having a technological meltdown over here. my computer is succumbing to the virus and the memory card on my camera has stopped functioning. with any luck, we will remedy these things soon.
until then, we were in the times of india on monday. page 2!
unfortunately, my picture didn't make it to the online version, but you can read the article about how we spent our sunday:
http://timesofindia.indiatimes.com/articleshow/4422124.cms

comfort me with mangoes, for i am sick of pigeons.

as i was getting ready to leave for india, my mother asked me if it would be monsoon season. of course not! i said. i was mostly hoping, as i had no idea when monsoon season actually is. but it is not monsoon season. it is something less widely publicized, but infinitely better. mango season!


these mangoes. they're stacked in cases all over the place. and they are so good. sweet, and soft, and juicy. nothing like the mangoes at home. foolishly, we bought only 6 at first. those set us back 50 rupees each, and i think we were ripped off. the next time, we bought a case of 12 for 450 rupees. we ate those in about 5 days. last night, our main fruit man was not there. he had promised our hosts that he would not rip us off just because we were not indian, but his underlings tried to charge us 600 rupees for a box! we protested loudly, and they explained that these were "bigger", and "settled" for 500. pshaw! these were the same mangoes, but we wanted them so we agreed to 500.


just look at them.

i am on a two mango a day plan. mango and yogurt parfaits for breakfast. mangoes with ice cream. mango milkshakes. this perhaps is helping me to ward off sickness. or so i tell myself when i want mangos and ice cream. speaking of sickness, though, our computer has something viral going on, so while i run symantec over and over, please ignore any emails offering weight loss, male enhancement, or the ability to help out a nigerian prince whose bank account is frozen.

next topic: pigeons. i am being driven to the brink by the pitter-patter-scritch-scratch of tiny pigeon feet as they pace on my air conditioner. it makes a god-awful noise that started this morning at 6 and didn't stop until 7:15 when i got out of bed, threw the windows open and banged on the air conditioner. now when i hear their gnarly little feet land i run to the window and scream. i'm turning into that crazy lady.

tonight, earplugs.

tell me more.

tell us more about the hospital, you say.
well, fine, i will tell you about our morning on saturday.

on saturday, we came into the hospital to round on the patients. as friday was the team's admitting day, there were now about 60 patients on our team (one attending, one intern, one resident). in our ward , which we share with one other team, there were over 80. it was overflowing, and they had resorted to mats on the floors again. as we were waiting for the attending, an old woman came up to the other american student, who is indian, and dragged her over to an old man. we saw the intern and a nurse go over, too, and so we went. the man wasn't breathing and didn't seem to have much of a pulse, either, and the intern was doing chest compressions while waiting for the airway stuff to arrive. chest compressions are one thing we can do, so once he was intubated, us three students started to take turns doing compressions while the nurse attached the bag to the tube (you know, the giant bag you squeeze to give breaths). but the bag wasn't working. so we kept rotating compressions on this tiny man's startlingly compressible chest. finally, (minutes?) another bag arrived. the intern was gone at this point, and the nurse hands the bag to the man's son and leaves. so to recap, we have three foreign medical students and one family member running this resuscitation effort. at one point, i saw the nurse coming back with a syringe of something. oh, good. epinephrine, perhaps? actually, it was meds for our patient's neighbor. then she left. so there we are, perched on this little rickety bed, compressing away with the son. there was an emergency kit, but it seemed not to contain much more than glucose.

once, as we were switching off (those compressions are tiring!) i looked up and saw that despite their meager efforts to pull a screen across the bed, we had the rapt attention of the whole ward. after a few minutes, the intern returned and decided this was futile, but what happened next remains a little unclear to me. as best i understand, we stopped chest compressions but left the son with the bag, giving respirations, because the family would need more time to process what was going on, and we would just tell them we needed time to see if he would respond. so we went to start rounds and left the son bagging.

incidentally, the first patient we went to round on was also lying in bed, deceased. 0 for 2, good start to the morning.
so, some time later, having rounded on the other 58 or so patients, we returned, and someone finally told the family that their continued efforts were futile, and, of course, they did not take it well. then, with the patients in neighboring beds each about a foot away, he stayed there until the morgue folks came up, and with the same futile attempt at screening and same rapt audience, stuffed his nose and mouth with cotton and wheeled him off. at least they wheeled this one. the other patient's family had to wheel his body to the morgue.

so that is what the hospital is like sometimes. it isn't that the doctors aren't smart, or that they don't care. it's just that they're overwhelmed and if two of your patients die, well, there are still 58 more that need your attention so they don't. so i guess sometimes you just have to accept your losses.

now i know how paris hilton feels. (sort of.)

what i perhaps have not really discussed yet is how much we stand out. we really do. sometimes, when we're in touristy areas, there are other non-indians. for example, at easter services at the anglican cathedral, we thought for sure there would be a whole slew of british, etc. there were about 5. other times, like around our house or the hospital, there are none. this manifests itself in a variety of ways. charmingly, little children poke their parents and point at us or smile shyly. everyone stares and nobody tries to hide it. when i tried to feel an old woman's thyroid the other day, she jumped up and tried to run out of the room. "it's ok," said the other patient. "she just got scared because she was expecting to see brown skin." fair enough. the more tiring side of this is that we're a constant target for people trying to sell things or begging in the streets/ at our taxi window.

so, anyway, we had the day off today owing to the birthday of b.r. ambedkar (http://en.wikipedia.org/wiki/Ambedkar) and went out to the banganga tank, a very old water tank surrounded by temples. it was bigger than we expected and lovely and quiet, with not a honking horn to be heard. it was also pleasantly free from the begging/selling variety of attention, although a gang of cricket-playing youth did stop us to ask where we were from. they were overheard repeating our names to themselves as we walked away. the tank itself was full of all kinds of birds, and turtles and what seemed to be enormous carp. and swimming children. i don't even want to think about what sort of zoonotic diseases were in that water, but they were enjoying themselves. there was lots of people-activity, too, with women drying chilies on the side, and cricket being played, and prayers being said, and washing being done.

(the tank)

(aforementioned swimming children)

after that, we headed to see a jain temple, which was also very beautiful though hard to appreciate fully without knowing all of the jain stories that were depicted.

(statues outside)

we also stopped into the hanging gardens. the hanging gardens was full of families enjoying the holiday who immediately commenced staring at us. one little boy came up to us and asked "excuse me madam, one picture?". we thought he was asking us to take a photo of him and his mother, but in fact there is now a photo of us and some indian woman we don't know floating around out there. like taking photos with animals at the zoo, elizabeth remarked. unfortunately, i don't have a copy of that one.

we also were ambushed by an old man who, without warning, gave us candies, dabbed red paint on our heads, and wrapped red and yellow strings around our wrists while chanting a blessing . he then charged us 200 rupees (which is like $4 but an exorbitant amount of money for string, i think). short of slapping his arm and running away i'm not sure what we could have done. of course, even before the chanting commenced we had been the center of attention, but when this started, everyone around us fell silent and turned into one giant, gawking circle of mumbaikers. there was nothing to do but stand there and take it. the dye from the string is now running down my arm, making me look jaundiced. i think this totally makes us look indian, right?



i thought so.

brief musings on a cow.

we pass this cow every day on the way to the hospital. i wonder a lot about the logistics of the cow, and her neighbor who hangs out down the street. where does she live? where does she go in the afternoon? who takes care of her? does someone own her or does everyone share her? did the people of the neighborhood pitch in to buy her? do you even buy cows? either way, i'm pretty sure her existence is better than that of 95% of the patients we see.
i also find it to be totally wild that in this gigantic city there are still cows hanging out on the street.

rules to live by.

i know some of you (those whose hearts have not been hardened by four years of medical school) are chomping at the bit to hear about the hospital. all in due time, my little grasshoppers. i've tried to write a few posts that encompass all of the aspects of the hospital, but it's just too much. so for today, we will start with signage.

i must first point out that the hospital is, in general, chaos. patients are in big old wards with upwards of 90 patients, which is clearly above capacity given that there are often people lying on floor mats in the aisles. their families are all in bed with them. the hallways, which are more like open-air porches, are packed with more waiting families, who apparently sleep there overnight, as well as stray dogs and pigeons. yesterday, on rounds, i heard a meowing sound and looked over to see a feral cat wandering amongst the patients. jcaho* would have a field day.

so, with all this chaos, how does one know how to comport oneself?
handy instructional signs! these are a source of of neverending amusement to us. i will highlight two of my favorites. first, this one.


should i just open my tiffin** and bisleri*** and eat lunch on the floor in the hallway? let me check the sign. X! you should not do this. instead, you should head to the canteen. i hear if you are a westerner, you should not, in fact, head to the canteen as you will regret this for the rest of your trip. however, the non-indian population consists of us, one other american, and two hardy-looking swiss students, so in general this strategy works.

next, with so many patients, how will we ever get in to see the doctor? waiting in line takes so long... perhaps that guard could "help us out". X! do not attempt to exchange money with the man in the khaki uniform. this is frowned upon (although perhaps not by the guards).


others include vigorous red check marks next to photos of a man tossing his trash and spitting appropriately into the trash bins, as well as one we can't figure out which seems to condemn both sitting on patients' beds and standing around them. unclear what the appropriate action is. although i can't speak about the illicit exchange of money, i do have to vouch for the fact that most of these signs go unheeded, but it's a nice thought.



p.s. happy easter to those celebrating it!

*joint commission for accreditation of healthcare organizations
**metal lunch tin
*** indian bottled water

bandra or bust? both.

i want to start out by saying that the taxi drivers here in mumbai have my ultimate respect. they are a hard-working bunch of guys who probably don't get paid enough to navigate this humongous, busy city, and obviously it's not their fault that their english is less than perfect. after all, it's better than my hindi/marathi.

with that disclaimer, our excursion to bandra was a bit of a bust. bandra's in the north of mumbai (we're in the south) and we decided to venture out to see this highly advertised photo exhibition featuring the recycling sheds of dharavi. (india factoid: per our guidebook, anyway, 55% of the population of mumbai lives in slums/shantytowns - so that's like, what, 9 million people? - and the largest of these, in fact in all of asia, is dharavi, home to one million people. some of these people make a living picking rags/cardboard/whatever. think slumdog. ) so. we knew it would be a little bit of a drive but went with it. things were going well until we got into bandra, and told the address to our cabbie. he had no idea where it was. of course, neither did we. we handed him the slip with the address, but of course he couldn't read english (again, not like i can read hindi). so we've got the guidebook map out and he looks all nervous, clutching the scrap he couldn't read, and flags down a man on the side of the road, who gives us directions involving a barista (the starbucks equivalent) that we didn't see until later, when we had u-turned and were practically on top of it. long story short, we ended up stopping for directions two more times before safely arriving at our destination.

but the photos were worth it, right? meh. while they were nice photos of cute kids, there were about six of them hanging on the wall of the restaurant, and they looked like any photo i might have taken of kids anywhere. so, ok, at least we'll go shopping at this giant open-air shoe mart. (sam, you would have seized if you saw it.) well. that turned out to be totally overwhelming, with people tugging at us trying to sell pashminas, dora the explorer t-shirts, purses, belts, shoes, etc. it cleared out a little when someone yelled "police!" and all of a sudden handbags wrapped in tarps were being hoisted over the median, but we left there pretty quickly, too. i will say that we had a lovely dinner at this restaurant, a change of pace from our usual indian fare, even if the photos were a bit less that what we expected. so not a total loss.

the nadir of the trip, though, came as we were driving home. there's never actually a point in mumbai when you feel alone on the street (given the other 16 million inhabitants), but we had come to a reasonably dark/deserted stretch with a concrete wall on the one side and only a few pedestrians on the other when our cab driver pulled over and said something to us that was not in our language. of course, all we can say is "peddar road!" "yes madam, peddar road, but (something something something)." he's getting more agitated. we're yelling, "peddar road! peddar road!" hand gestures. i'm thinking, oh my god, this is it. he's leaving us here. he points to the sidewalk, says something that sounds like gun to me, and in my panic, makes a gesture that i think looks like firing a gun. and i'm like, "gun? you have a gun? you're robbing us? who has a gun?" then he jumps out and runs around the car, and we're like, oh dear god. and the poor man finds a post, squats down beside it, and relieves himself in the street. yes, he just had to pee. he delivered us home safely after that. did overcharge by 50 rupees, but we were too worn out to haggle over a dollar by then.

well, the food was good anyway, and i have some leftover mushroom risotto for dinner tonight.

i brought my camera in the taxi this morning.

originally, i had great plans to write about the hospital. the hospital is interesting and different, in so many ways. but then i thought maybe it would be better to wait until i had some pictures to go with it, in case you get tired of reading and just want something to look at. so perhaps we can talk about the drive to the hospital (and taxi rides in general). while there is a public transportation system here in the city, it involves hopping onto an often still-moving bus with the destination labeled in hindi on the front, which seems less than ideal to us. similar situation with trains, though one would hope they come to a full stop. so with taxis being plentiful and cheap (about $1.25 each way to the hospital), they're our default option.

and what an adventure they are. first of all, they're these 1950's fiats or something. (dad? looking to you on this one.) but definitely not from anytime recently. when you get in, they pull a little lever to reset the meter that's mounted on the hood, but the meters are also from 1950 and so when you arrive, the driver pulls out a card that converts the price displayed to what you actually owe, based on 50-60 years of inflation. no seatbelts. we thought we hit the jackpot the other day when we got into one with seatbelts, only to discover that there was nothing to buckle the belts into. alas.

then, the driving itself. lanes, as far as we can tell, are optional, and there's only a rough sense of where the middle of the road is. the honking is near-constant, despite the establishment of so-called "silent zones" in the city. half the time, the honking is at pedestrians who are wandering across the street, although to be fair, that's the only way to get across. when we met our attending the first day, his words of advice were "two things you need to know. only drink that (points at our bottled water) and the cars will not stop for you. they will. not. stop." nay, they pretend to speed up, although if you walk forcefully enough they actually do stop (so far). so, in the road, everyone's honking and beeping and it's a giant cluster of motorbikes, buses, taxis, pedestrians, bicycles, and the occasional oxcart. sometimes, people on horses. i could not capture the oxcart on film, but i will. note the family of three holding their one helmet in their hands. i think the law is like lifejackets on a boat. as long as they're there, it counts.

and then, the sidewalks. the best way to describe what's happening on the street is that it seems to me like a giant anthill. people are pouring out of everywhere and everyone's doing something. folks are selling things, they're rushing off to places, they're leading cows around, and they have everything you can imagine on their bikes. we've seen bikes with bricks stacked across the whole frame, bikes with 20 or so trays of eggs strapped to the back (disastrous should he have a run-in with an unyielding taxi), bikes used to wheel plywood along. then there are folks like this guy. why does he look like he's working so hard?

oh, because he's walking downhill and holding this back.


finally, a topic i would like to address. begging. this generally happens when we're stopped in a bunch of traffic, and until now we've generally avoided handing out money and stick to buying candy for the cute street kids who follow us around. but after a man who was missing both arms and his teeth popped his head into our window, we decided to separate out our coins to have them ready to hand out. this seems to have backfired on us today, as giving a coin to one woman (who then lingered, disappointed, and waited for more) today prompted the three other beggars at the intersection to run to our car, as our taxiwallah shook his head and sighed/laughed. so, really i'm open to suggestions about how to best handle this, because i feel like a jerk for not being willing to give my money up to some double-amputee or a four year-old darting between cars, but once you start it spirals out of control. until, i suppose, the light turns green.

*

we don't need no dobi wallah.

well it's 3 am in mumbai and i can't sleep. initially the jet lag thing wasn't too much of an issue, and maybe that's not even it, but this is the second time i've woken up super early and can't go back to sleep. so what did we do today? well, we didn't leave the house due to concerns over possible gi upset and also being wiped out after yesterday's adventures. what we did do was laundry. not as easy as it seems, mostly because we couldn't figure out where to hang it. BUT, my ingenious travel companion elizabeth macgyver noted that while we didn't have rope, we did have a lot of plastic bags at our disposal. so:

step 1: cut the bags in half.

step 2: loop them together in a chain.



step 3: attach the chain of bags to your freezer and faucet.



step 4: voila!


at the rate we're sweating through clothes, we should be doing this about every other day.

95 and smoke.

in an effort to more objectively define the level of heat yesterday, i checked the weather for mumbai. the temperature was 95 (at 5pm), and instead of the usual "sunny" or "partly cloudy" the accompanying descriptor was "smoke". i might try to pass this off as some quaint mistranslation, but this was my trusty weather.com. and it's also pretty accurate. we took a boat out to the elephanta islands today, and it was like riding through a giant cloud. you couldn't even see the skyline of mumbai while riding back in because of the pollution. i have a lot of deep thoughts about this, and frankly it makes me a little depressed, but you're not here for depressing thoughts. you're here for pictures!

which leads me to...
these women. these are not sweet old village women. these are sharks.
i was pleasantly attempting to photograph a monkey when these women saw their chance. they kept posing, saying "madam, nice photo!" and surrounding me. there was a fourth. now, we all know i don't react well to being flustered, and these grandmother types were racing around me, and i had this fleeting thought of, well, i'll have a photo and i'll give them some money which they can probably use. oh heavens, no. i certainly should have negotiated my price first. i pulled out 100 rupees, the inital asking price, which then went up to 150. i declined that but they were not having any of it, circling me and yelling until i snuck past. they got me again on the way out, pointing and yelling, but i avoided eye contact. so i'm getting my money's worth out of this photo, and sharing it. to be fair, the monkey didn't like having his picture taken either, and tried to attack elizabeth, teeth bared and hissing. a kind stranger chased him off while i was running for the hills. the running meant we didn't actually get a good photo of him.

but the caves were nice.

hot enough to melt a jolly rancher.

that's how hot it is today. we decided to carry hard candies around for the kids who beg from us, and when i reached into the bag, they were a sticky mess. that's hot.

our doctor friends warned us that we should stay inside between 12 and 4, but we pressed on. how bad can it be? at least i'm not the man standing at the end of our drive who irons your clothes in the sun. he has a reason to complain. also these guys, painting the outside of our building. note the scaffolding made of bamboo. note also the lack of safety harness. this kind of scaffolding goes up even the skyscrapers that are 30+ stories tall.


so, anyway, we ventured out into the heat. we got enthusiastic waves from the peanut and chickpea roaster as well as the fruit vendor. i suppose as the only white girls walking out on the streets, we make an impression. we stopped out of the sun into mahatma ghandi's house, bought ourselves some mangoes and watermelons and were thinking about other errands when all of a sudden, we just couldn't take it. so we came home and lay on the marble floors with the air conditioner running. i finally understand siesta cultures.

gandhi's bedroom (to prove i was there):

we're here!

after 18+ hours of traveling, we arrived yesterday. bombay (as everyone still calls it), for its part, welcomed us with 106 degree weather. and no, it's not been a dry heat. anyone with curls can imagine what my hair looks like right now, and i choose not to document that photographically. what completely blows my mind is that everyone is walking around in jeans and long-sleeved shirts while i'm pouring sweat through my t-shirt. i guess not unlike when people from warmer climates are wearing their parkas in worcester in october.

what's fantastic here is that it seems like people will bring anything you want to your door. we literally ran into a man selling bags of snacks door-to-door here in our building - and then our hosts bought us plantain chips and roasted chickpeas and something else i can't identify. he'll be paying us weekly visits. we're also arranging for coconut deliveries on the weekends and fruit service from the fruit lady. and the tech support guy came right on over to connect us to the internet. lovely.

also, i'd better hope for some sort of gi bug, because at this rate i'm not fitting into an bridesmaid dresses when i get home. three kinds of paneer yesterday alone! and the naan! heavenly.

of course, the downside of having everything delivered today is that we didn't leave home today - which i think is justified, as we're dealing with a 9.5 hour time difference. so no real photos to share, but i will leave you with this one, of our water supply:


no ehec for us!