PICU and SICU

We made it safely to Vellore after spending a comfortable night in Chennai. I started my rotation this week on pediatrics, following a team around the PICU. Vida and I started on rounds with the attending and three residents. Past visitors to CMC mentioned the whispering rounds and they were not kidding! With the kids crying, the sound of overhead fans, honking cars outside and everyone else on the ward talking I could not hear very much. The attending seemed a little better than the residents and actually explained some of what they were talking about and pimped me a few times but I ended up taking the liberty of going around and looking at dignoses and talking to the patients and their families. There seems to be an uncanny number of kiddos with congenital heart defects and I also met a little guy with rheumatic heart disease, something that I would never see in the USA. It seemed we spent most of our time on rounds discussing fluid management for varying degrees of dehydration, something I am guessing is a larger problem here where the hospitals are not air-conditioned and patients probably lose considerably more fluids during their hospital stay than they would in a nice AC room in the US. I know I lost a lot more fluids on rounds in the morning than I would usually at University Hospital in San Antonio!

Changing dressings in the SICU. This was the first obese person I saw in India and the docs were trying to figure out why.

This is the everyday scene in San Antonio but 300 pound men are VERY rare here.

We met up with some of our other classmates a bit later who were on the SICU rotation who said they got to see quite a bit and had somewhat meaningful interactions with the residents and attending. So I went to the SICU today. The SICU takes care of any surgical patients that are not neuro or cardiac care patients. It runs very similarly to SICU rounds in the US with looking at xrays first of all the patients for the day then going around to each patient. Anesthesiologists run the show in the SICU. They do all the dressing changes on top of pain and medication management. The general surgeons come in for brief periods of time, eye ball their patients and maybe put their two cents in before going back to wherever they emerged from. The SICU rounds felt a lot more beneficial to the American students than the PICU rounds were. The attending and residents were more excited about explaining what was going on with the patients and what were current methods of treatment in India and how those compared to treatment in the US. There were a huge variety of patients in the SICU, from transplant patients to those with septic complications from amputations. Surprisingly there are not very many people from car accidents, we are not sure where all those people go but if I figure that out I will let you know because I am sure they are being sent somewhere!

This is the crash cart, but like most things in India nicely colored, i.e. makes for a good photo.

I will have to write more later when I get a bit more free time. India is fast paced and I feel like my senses are just totally overwhelmed as I adapt to the culture. From all that I see, hear, smell, feel and taste it seems there is so much thrown at you at once it is hard to take it all in. The country is beautiful yet harsh, peaceful yet chaotic. I have rare moments to sit and think and contemplate all that is around me. Currently I am just taking each day at a time, getting accustomed to the heat and getting over the jet lag. We are looking forward to a great trip to the Taj Mahal this weekend and an elephant ride at some point along the way! Hope everyone is well at home!