Mark has been sending out very nice notes to our families and friends and I wanted to share them with my side of the equation. This explains a little about his job and mine (orig. sent on Sept. 13)! No pics this time around…we had a fantastic weekend and I’m posting Update #5 in the next day or so. Stay tuned!
*****
Hi,
How have you been?
Katie and I have just returned from our weekly trip to the market to pick up groceries. We went to Khan Market initially to get some breakfast and ended up finding a great shop nearby. We had been driving out to a part of Delhi called Vasant Vihar for our groceries, but this market is more centrally located, so we may end up switching. The store had a great selection of greens, herbs, vegetables, and fruits (including a dragon fruit, which we didn’t know how to eat so we took a pass on it for now). Nearby is a great indepedent bookstore (Full Circle Books), where we picked up another Indian cookbook so we can do something with all of this food. This time we chose a vegetarian cookbook so we can serve some local dishes for our veg guests (at restaurants, the split is veg/non-veg, making veg the default), and we just don’t have the variety of dishes in our repetoire.
Last night we were invited to one of the AIIMS’ attending’s home for dinner. Kathik (his name) and his wife (Niveditha) were gracious hosts and also invited over the other visiting fellow from Kenya (Bernard), as well as one of the AIIMS cardiology fellows (Navrit, along with his wife and their two sons). Bernard is here for a year-long clinical fellowship so that he can acquire sufficient skills to practice cardiology back home. He is originally from the area around Mount Kenya (where Jon and Cecilia were engaged) but now lives near Nairobi. His wife (an ER doc) and son are still back in Nairobi for the year, again making me appreciate Katie’s willingness to all of this. We were trying to convince him of the benefits of Skype for keeping in touch (even via his iPhone)!
Navrit is a half-colonel in the Indian army and was previously stationed in Botswana, which he and his wife loved. Apparently three (out of ~18) AIIMS cardiology fellowship spots are reserved for army applicants. Navrit will continue to serve in the military after his training and will likely be stationed outside of Delhi. He’s a very jovial, funny Sikh, which seems to fit into many of the Sikhs we have met so far. Earlier on Saturday, he presented the weekly case conference whereby he meets the patient on Friday evening once he has finished his work for the day (I’m not sure who selects the patient) then prepares his history and physical presentation for the following morning. The patient comes to the conference and sits quietly with his family member where some of the attendings will examine him. Navrit is then pounded with question after question about percentages of patients with problem X and various minutiae. I was amazed when the whole room of cardiology fellows jumped at the answer, “Noonan syndrome” when asked about a congenital cause of an atrial septal defect and pulmonic stenosis along with several abnormalities that this patient did not have (it’s an extremely rare disease that I only have a passing understanding of). Yesterday’s patient was a 21 year-old man with a 12 year history of chest pain and exertional shortness of breath that turned out to be congenital pulmonic stenosis with an atrial septal defect (without the other features of Noonan syndrome, so not that diagnosis). Navrit got the diagnosis on his second attempt, which seemed great to me since he was not given the luxury of seeing the echocardiogram (a heart ultrasound–which essentially makes the diagnosis). The next step will be to see whether or not the atrial septal defect can be closed with a device inserted percutaneously (inserting it through the vein in the leg and opening up the closure device in the heart). If so, then the tight pulmonic valve can also be expanded percutaneously; if not, he will need surgery.
Back to the dinner….we had dosas (South Indian crepes), idlis (pronounced idd-lees), plenty of good veg food, and ice cream for dessert. Niveditha started preparing the batter for the idlis on Friday morning with some major equipment (an electric millstone!), so we really appreciated how good the food tasted. She even let me take a crack and make my own dosa (it turned out pretty well). And per usual South Indian style, we ate with our fingers, making sure not to let anything touch below our topmost knuckle (a few crumbs might have slipped). At the end of the evening, their son played the sitar–it was a great end to a fun night. I was really amazed at how people have opened up their homes to us–it just makes it so much more enjoyable than going out to a restaurant.
As you may have heard, Katie has recently landed a free-lance position at the American Embassy School, working in their development office. She is working with the only other person in the development office (Preeti), trying to increase participation from alumni in the school’s activities (which might enhance donations), increase awareness of cultural activities/exhibits at the school (a Grammy award-winning folk singer is playing there next Friday for ~$4), and help with regular online newsletters. It’s ~20 hours per week, which still allows Katie to meet up with the Delhi Network folks (expat social club) and explore Delhi during the day. I am proud of her landing a job that fits her skill set (and pays pretty well), all within a short while of arriving.
As far as my work goes, I have finally completed all of the paperwork for AIIMS and will be meeting with the head of the department (Dr. Bahl) this upcoming Monday for my formal “start”. I received access to the charts I had been seeking last week and have had to make significant updates to the dataset, which calls into question most of the previously collected data. Therefore, I am going through each chart individually and trying to squeeze every bit of information from it–a time-consuming process for sure. Once we have a better sense of where things stand, then I think we can start planning to start the quality improvement part of my project (hopefully, at least). CCDC has been humming along. I have been working on a manuscript based on the cardiovascular risk factor incidence data from the New Delhi Birth Cohort. This cohort began in 1969, and there are >1000 participants who have been followed since that time. As they are reaching the age when problems like hypertension and diabetes begin, those data have been collected prospectively. It is the first prospective cohort in all of India looking at these problems and provides the best insight into the burden of cardiovascular disease risk factors to date (from what I have seen so far, the burden of disease is startling).
We can hardly wait for our first visitor in early November–my sister, Susan! We have planned a trip around the Golden Triangle (Delhi-Jaipur-Agra) and are working on some of the details already. It should be a blast, and we are very appreciative of Susan making the effort to come and visit (and being courageous enough to be the first). We look forward to our visitors as well.
We miss you all very much and are trying to make Delhi “home” as much as we can. Skype has been such a great means to stay connected, and we look forward to talking with you soon.
Love,
Katie & Mark
Delhited 