Apologies for the delay in telling you all about Mamallapuram. In my defence, I finally managed to get ill, not in the conventional diarrhoea & vomiting fashion, but in the sore throat, swallowing-like-eating-razor-blades, muscle aches, headache, fever fashion. So the first thing I did after we landed was to accept Charlotte & Arthur's kind offer of a lift home, and then head in to St. Thomas' A&E, which was conventionally manic. Happily, I didn't have to wait long, as my temperature rose from 38 celsius (100 fahrenheit) at booking to 39 (102 ) when they did it a second time, and the nurse even gave a little "oooh" to show how impressed she was. This meant that only the elderly gent who looked like he was having a heart attack and the man fitting in the corridor beat me to being seen.
So they bundled me off to a cubicle, dosed me up with paracetamol, stuck a line in, took an impressive selection of bloods, put a drip up, took throat swabs, and did an arterial blood gas just to complete the set (this involves sticking a needle into your radial artery, and is said to be extremely painful. Mine was fine).
Then I got to go home, feeling a little less sorry for myself. Perhaps I should have gone to Worthing after all?
Monday, November 13, 2006
On poor timekeeping, fictional guide books, untrustworthy hoteliers, and reasons not to eat street food.
9th November (I know, it's very late)
Arriving in Mamallapuram hasn't been nearly as bad as arriving in Pondicherry, but it also shows fewer signs of redeeming itself in the morning. The reasons for this will become apparent later, when I critique the two guidebooks we stupidly believed might have visited the places they were talking about (Jacob, you were oh-so-right).
Before leaving Vellore, we had final meals at the Darling Residency (great name, great food) on Tuesday, at the university canteen on Wednesday (dinner) and this morning (breakfast), and the YWCA canteen. All were excellent. We also tried to pick up our tailoring - Ben and my suits are great and were delivered bang on time; the shirts took daily visits to the other tailors from Monday, when Toyin and Charlotte went to collect their stuff. The discussion then went something like this:
Charlotte: Valakum. [hands over receipt for her and Toyin's trousers]
Tailor: [looking nervous] Ah! [sends lackey running from shop] Please - sit, sit! Tea, coffee?
Me: I'd love a tea. [Toyin demurs as she's a lactard; another runner returns with three cups of sweet, milky coffee. Charlotte is thus forced to drink two coffees and I have to drink a coffee rather than a tea, but hey.]
[we wait some time]
[runner returns with small parcel]
Tailor: [to Charlotte] Please! [Charlotte inspects the trousers]
Toyin: Where are my clothes?
Tailor: Ha ha ha ha! [points hopefully at Charlotte's trousers]
Toyin: My clothes?
Tailor: Tomorrow!
Toyin: You said today!
Tailor: [headwaggling apologetically] Tomorrow for you.
Me: Just checking... [handing over my receipt] Shirts tomorrow?
Tailor: Ha ha ha ha!
Me: Tomorrow? [this being the agreed day for delivery]
Tailor: Ah! [sends lackey running upstairs; he returns in a moment carrying about half of the material Ben and I had left, all completely untouched by scissors]
Tailor: [looking at it] Wednesday for you.
Me: But... [I notice Ben's appalling ochre cotton, which I had avoided purchasing because I have eyes, in the pile]...this isn't for me.
Tailor: [looking at my receipt] Yes.
Me: No - this is for the other one.
[Thankfully, I was eventually able to prevent him making Ben's shirts in my size, so I avoided the ochre monstrosity, and Ben avoided my diagonally-striped peach number.]
Toyin: You said tomorrow, and we leave on wednesday. It must be tomorrow.
Tailor: [further ambiguous headwaggle]
Toyin: So - all ready tomorrow?
Tailor: [defeated headwaggle] Ok - all tomorrow.
How the shirt confusion arose I have no idea, as Ben and I spent about quarter of an hour methodically checking they had everything written down correctly first time, only narrowly stopping short of running a brief test. However, when we arrived the next day, not only had they come through and delivered the goods, they all fitted like a dream, including the ochre (Ben: "Mate - I should have gone for off-white." Charlotte: "It fits very well. And you can rescue that with the right tie.") and the peach (Charlotte: "That looks much better on than I was expecting.")
In keeping with her luck over the course of the holiday, poor Charlotte was the only one whose tailor let her down. When we turned up on Monday, a full two-and-a-half weeks after she'd given him a dress she'd brought from England specially to have copied, he span her some yarn about the woman he needed to do the work being off sick with chikungunya, and said it could be ready in a week. When we revealed that this was not okay, he told her to call again in the morning. The upshot was that Charlotte, who sorted her tailoring out before any of us, ended up with the dress she came with which the tailor managed to draw on in two places with biro, two silk saris she'd bought to have incorporated into the copies, no copies nor silk dresses, and no time to find anyone else to do the work for her. In the unlikely event that you should find yourselves in Vellore looking for a woman's tailor, do not use City Garments - the owner is a bastard.
Finally this morning we took a bus from Vellore to Kanchipuram which took one and a quarter hours and was smooth as you like. At Kanchipuram we had a slight wait for a 212A. Although the numbering system suggests the bus company have given themselves a minimum of 999 bus numbers to play with, they also have at least A through N just on 212; we almost got on a 212H by accident, which would doubtless have been disastrous. I used the time to play colon roulette with the bus station onion bhajees [this was a grave, grave mistake. Ed.] - the two bullets I put in the gun both tasted excellent, and Ben is the control in the experiment ("Mate - I'm sticking to a zero-tolerance policy on street food"). The second leg of the trip reverted to type, as Charlotte sat down and got someone's sick down the back of her dress, the ride was bumpy as hell, and was made even less comfortable by the fact we had all our bags with us (we bought a ticket for one of them to get the bus conductor off our backs), and by the arrival onto the bus of approximately fifty schoolchildren who swarmed into the aisle and spent most of the journey surreptitiously touching Toyin's hair. All I could think of was (1) whether Toyin was going to snap and begin throwing them through the open door and (2) the immensity of the likely death toll if we crashed.
Mamallapuram itself started off unpromisingly in that the bus station was full of cows and touts, and our hostel turned out to bear precious little resemblance to both guidebooks' descriptions of it as "a charming hotel by a lake and set in gardens which are shared with an artists' gallery and are filled with sculptures. Has a pool." Closer to the mark would have been: "Marble-floored rooms with noisy and erratic fans by a slime-filled mosquito-spawning ditch set in a sandpit full of unidentifiable rubble. Has a pool which is full of six inches of slime and 30,000 mosquitos; beds sized for pygmies; place run by established confidence-trickster." We walked from reception down to the rooms through clouds of mosquitos, and Ben commented "There are a lot of mosquitos here" to which the owner replied brazenly "No, no mosquitos here." The only positive thing was that they were so gorged on the blood of gora that they couldn't fly very fast, and so we embarked upon mozzie genocide as soon as we got into the room. We then discovered that the beds were at least a foot too short for Ben or I to lie down in - and had footboards.
In the morning, however, we went for a very respectable breakfast during which I got sunburn on one arm which was in the sun and Ben got generalised sunburn because he'd forgotten that doxycycline photosensitises you. We then wandered around the local temples, and saw a very good mural of an elephant, which you can see opposite, and the relatively famous shore temple, which should be further up. While there, we amused ourselves by videoing one another doing the headwaggle I have mentioned previously, and I will post links to these at a later date. After that we met up with the Australian members of Team Egg Puff, Jim and Clint, who you can see in the photo below. If you want an alternate viewpoint on Vellore, Clint has a travelogue which is well worth a read. I then went to bed as I'd begun to feel horrendous, getting up only to eat some beautiful fish at a place called Moonrakers which the guidebooks criminally undersold; alas by this stage even swallowing water was rather as I imagine swallowing ground glass to be, but thankfully - as it was the first time I had ordered something genuinely good - I soldiered on.
Our last day in India was spent just outside Mamallapuram at a beach resort (the "Ideal Beach Resort", in fact). I spent much of the day asleep, emerging at sunset to find the other three ensconced on the beach, Ben in a hammock. We then had a last supper at the restaurant with Clint, Jim, and Nok (another Aussie friend of theirs), and had to endure another taxi not turning up to take us to the airport, resulting in our having to book one through the Ideal Beach Resort and getting royally shafted on the price. However, we had left our room key with Jim and Clint, so we got our money's worth!
On arrival at the airport, Toyin and Charlotte plumped for a samosa each to tide them over until the flight left (at 4am); they are both still suffering the after-effects now. For my part, the flight back was deeply unpleasant, as I was running a huge temperature, had constant muscle aches and headache, had to drink lots of water to stay hydrated even though it hurt, and was forced to watch Stormbreaker or whatever that film about the teenage spy is called. Whatever it is called, it was rubbish. Only sickly Ben, with his zero-tolerance policy on street food, has survived unscathed.
All in all, though, India was a great success, and unlike Charlotte, Toyin, and I, Ben is getting neither first-hand experience of antibiotics, nor the benefit Charlotte's got of her consultant discussing her case with the entire firm ("Guys! Charlotte's had D&V for ten days now, and the microbiologists have given her cephalosporins. What would we give her?"). It is reassuring to see how literally some people take the description of medicine as "the caring profession"...
Hope you've enjoyed reading - normal intermittent service will now be resumed, probably after exams.
Arriving in Mamallapuram hasn't been nearly as bad as arriving in Pondicherry, but it also shows fewer signs of redeeming itself in the morning. The reasons for this will become apparent later, when I critique the two guidebooks we stupidly believed might have visited the places they were talking about (Jacob, you were oh-so-right).
Before leaving Vellore, we had final meals at the Darling Residency (great name, great food) on Tuesday, at the university canteen on Wednesday (dinner) and this morning (breakfast), and the YWCA canteen. All were excellent. We also tried to pick up our tailoring - Ben and my suits are great and were delivered bang on time; the shirts took daily visits to the other tailors from Monday, when Toyin and Charlotte went to collect their stuff. The discussion then went something like this:
Charlotte: Valakum. [hands over receipt for her and Toyin's trousers]
Tailor: [looking nervous] Ah! [sends lackey running from shop] Please - sit, sit! Tea, coffee?
Me: I'd love a tea. [Toyin demurs as she's a lactard; another runner returns with three cups of sweet, milky coffee. Charlotte is thus forced to drink two coffees and I have to drink a coffee rather than a tea, but hey.]
[we wait some time]
[runner returns with small parcel]
Tailor: [to Charlotte] Please! [Charlotte inspects the trousers]
Toyin: Where are my clothes?
Tailor: Ha ha ha ha! [points hopefully at Charlotte's trousers]
Toyin: My clothes?
Tailor: Tomorrow!
Toyin: You said today!
Tailor: [headwaggling apologetically] Tomorrow for you.
Me: Just checking... [handing over my receipt] Shirts tomorrow?
Tailor: Ha ha ha ha!
Me: Tomorrow? [this being the agreed day for delivery]
Tailor: Ah! [sends lackey running upstairs; he returns in a moment carrying about half of the material Ben and I had left, all completely untouched by scissors]
Tailor: [looking at it] Wednesday for you.
Me: But... [I notice Ben's appalling ochre cotton, which I had avoided purchasing because I have eyes, in the pile]...this isn't for me.
Tailor: [looking at my receipt] Yes.
Me: No - this is for the other one.
[Thankfully, I was eventually able to prevent him making Ben's shirts in my size, so I avoided the ochre monstrosity, and Ben avoided my diagonally-striped peach number.]
Toyin: You said tomorrow, and we leave on wednesday. It must be tomorrow.
Tailor: [further ambiguous headwaggle]
Toyin: So - all ready tomorrow?
Tailor: [defeated headwaggle] Ok - all tomorrow.
How the shirt confusion arose I have no idea, as Ben and I spent about quarter of an hour methodically checking they had everything written down correctly first time, only narrowly stopping short of running a brief test. However, when we arrived the next day, not only had they come through and delivered the goods, they all fitted like a dream, including the ochre (Ben: "Mate - I should have gone for off-white." Charlotte: "It fits very well. And you can rescue that with the right tie.") and the peach (Charlotte: "That looks much better on than I was expecting.")
In keeping with her luck over the course of the holiday, poor Charlotte was the only one whose tailor let her down. When we turned up on Monday, a full two-and-a-half weeks after she'd given him a dress she'd brought from England specially to have copied, he span her some yarn about the woman he needed to do the work being off sick with chikungunya, and said it could be ready in a week. When we revealed that this was not okay, he told her to call again in the morning. The upshot was that Charlotte, who sorted her tailoring out before any of us, ended up with the dress she came with which the tailor managed to draw on in two places with biro, two silk saris she'd bought to have incorporated into the copies, no copies nor silk dresses, and no time to find anyone else to do the work for her. In the unlikely event that you should find yourselves in Vellore looking for a woman's tailor, do not use City Garments - the owner is a bastard.
Finally this morning we took a bus from Vellore to Kanchipuram which took one and a quarter hours and was smooth as you like. At Kanchipuram we had a slight wait for a 212A. Although the numbering system suggests the bus company have given themselves a minimum of 999 bus numbers to play with, they also have at least A through N just on 212; we almost got on a 212H by accident, which would doubtless have been disastrous. I used the time to play colon roulette with the bus station onion bhajees [this was a grave, grave mistake. Ed.] - the two bullets I put in the gun both tasted excellent, and Ben is the control in the experiment ("Mate - I'm sticking to a zero-tolerance policy on street food"). The second leg of the trip reverted to type, as Charlotte sat down and got someone's sick down the back of her dress, the ride was bumpy as hell, and was made even less comfortable by the fact we had all our bags with us (we bought a ticket for one of them to get the bus conductor off our backs), and by the arrival onto the bus of approximately fifty schoolchildren who swarmed into the aisle and spent most of the journey surreptitiously touching Toyin's hair. All I could think of was (1) whether Toyin was going to snap and begin throwing them through the open door and (2) the immensity of the likely death toll if we crashed.
Mamallapuram itself started off unpromisingly in that the bus station was full of cows and touts, and our hostel turned out to bear precious little resemblance to both guidebooks' descriptions of it as "a charming hotel by a lake and set in gardens which are shared with an artists' gallery and are filled with sculptures. Has a pool." Closer to the mark would have been: "Marble-floored rooms with noisy and erratic fans by a slime-filled mosquito-spawning ditch set in a sandpit full of unidentifiable rubble. Has a pool which is full of six inches of slime and 30,000 mosquitos; beds sized for pygmies; place run by established confidence-trickster." We walked from reception down to the rooms through clouds of mosquitos, and Ben commented "There are a lot of mosquitos here" to which the owner replied brazenly "No, no mosquitos here." The only positive thing was that they were so gorged on the blood of gora that they couldn't fly very fast, and so we embarked upon mozzie genocide as soon as we got into the room. We then discovered that the beds were at least a foot too short for Ben or I to lie down in - and had footboards.
In the morning, however, we went for a very respectable breakfast during which I got sunburn on one arm which was in the sun and Ben got generalised sunburn because he'd forgotten that doxycycline photosensitises you. We then wandered around the local temples, and saw a very good mural of an elephant, which you can see opposite, and the relatively famous shore temple, which should be further up. While there, we amused ourselves by videoing one another doing the headwaggle I have mentioned previously, and I will post links to these at a later date. After that we met up with the Australian members of Team Egg Puff, Jim and Clint, who you can see in the photo below. If you want an alternate viewpoint on Vellore, Clint has a travelogue which is well worth a read. I then went to bed as I'd begun to feel horrendous, getting up only to eat some beautiful fish at a place called Moonrakers which the guidebooks criminally undersold; alas by this stage even swallowing water was rather as I imagine swallowing ground glass to be, but thankfully - as it was the first time I had ordered something genuinely good - I soldiered on.
Our last day in India was spent just outside Mamallapuram at a beach resort (the "Ideal Beach Resort", in fact). I spent much of the day asleep, emerging at sunset to find the other three ensconced on the beach, Ben in a hammock. We then had a last supper at the restaurant with Clint, Jim, and Nok (another Aussie friend of theirs), and had to endure another taxi not turning up to take us to the airport, resulting in our having to book one through the Ideal Beach Resort and getting royally shafted on the price. However, we had left our room key with Jim and Clint, so we got our money's worth!
On arrival at the airport, Toyin and Charlotte plumped for a samosa each to tide them over until the flight left (at 4am); they are both still suffering the after-effects now. For my part, the flight back was deeply unpleasant, as I was running a huge temperature, had constant muscle aches and headache, had to drink lots of water to stay hydrated even though it hurt, and was forced to watch Stormbreaker or whatever that film about the teenage spy is called. Whatever it is called, it was rubbish. Only sickly Ben, with his zero-tolerance policy on street food, has survived unscathed.
All in all, though, India was a great success, and unlike Charlotte, Toyin, and I, Ben is getting neither first-hand experience of antibiotics, nor the benefit Charlotte's got of her consultant discussing her case with the entire firm ("Guys! Charlotte's had D&V for ten days now, and the microbiologists have given her cephalosporins. What would we give her?"). It is reassuring to see how literally some people take the description of medicine as "the caring profession"...
Hope you've enjoyed reading - normal intermittent service will now be resumed, probably after exams.
Thursday, November 09, 2006
Correction & CHAD
I must make two corrections to my last post - first, I suggested that the reason Toyin and Charlotte didn't have a wonderful hot shower while we were in Pondicherry was that their shower wasn't working. It turns out that they actually just didn't try it because "it looked a bit rusty". Second, I forgot to mention that the legendary Shankar also revealed (under direct questioning) that Toyin doesn't count as gora - rather, she's kala, which I believe is Tamil for black. Logical though this is, it means we've had to drop the moniker "team gora", so we've replaced it with "team egg puff", in honour of one of the more curious-sounding CMC snacks.
CHAD (Community Health And Development) is the community arm of CMC, and it's a very interesting model. Although it's technically part of the main hospital, it's on a different site and runs along very different lines - they have their own outpatient clinics (which are even busier than the ones in the main hospital), their own wards, their own labour room and so on, and they only refer patients on to CMC proper if they don't feel they can handle them. From that point of view it's like a secondary referral centre in the UK (or a district general hospital), but it also does the primary care work which is done back home by GPs. This involves looking after about 120,000 people in the various villages around Vellore.
They've done this in a very interesting way - they essentially assimilated the traditional birth attendants, who were already part of the community, and paid them retainers to be part of the community work done by CHAD. Straight off the bat that gave them a lot of local knowledge and direct access to these communities. They then send nurses out to the villages every week or so to check up on any people who are pregnant or have illnesses (TB, HIV, etc), and to keep track of what's going on, and send doctors out every month to run clinics. They then refer anyone needing a higher level of care on to CHAD back in Vellore, and the really tricky ones get referred on from there to CMC.
At a practical level, what this means is that they know just about every person in every village "personally" through the birth attendants, and they know how to find people when they need to and vice-versa. It means they have an enormous amount of trust and goodwill built up in that community. On top of that, they got a visiting guy from NASA to satellite-map the entire area for them - and have all those people mapped to where they live on the map. They then plot the incidence of diseases and so on on this map - the example they gave was that if they had a number of cases of diarrhoea in a village, they could go down to the level of detail that would tell them if there was a drain linking the houses affected, and act accordingly.
Bloody impressive, basically, and something which the NHS would probably kill to be able to replicate in any number of South-East London council estates.
My own trip out to the villages was in the back of a van; we did the rounds of the expectant mothers, bereaved, and ill in the morning, and were fed a lot of dangerously brown-looking peanuts (the main crop round here) which tasted a little as I imagine wet wood to. We also visited some of the creches they run for kids whose parents are working the whole time - the teachers had the classes singing for us, and Toyin drew a blue sheep-like thing for one of them which totally baffled the children even when she began saying "Baaaa!" hopefully. The creches are entirely free and aim to ensure literacy among the local population, social interaction, and above all nutrition - they weigh them and so on - and are yet another impressive aspect of the program. In the afternoon we went to one of the rural clinics, which were insanely busy, and took turns examining pregnant women - should have that clinical skill nailed, anyway.
This is all contributing to my general opinion that actually, given the resources they have to work with and the problems they're up against, healthcare is probably better here than in the UK. On which depressing-or-happy note (depending on how you look at it), I'm off to pack for the beach and look up the Tamil for "lobster thermidor for me, please".
Wednesday, November 08, 2006
Gora Gone Wild, Redemption Through Bakeries, and Postcolonial Dining.
5th November
Pondi has just about redeemed itself. While calling it "Gallic" is still a stretch - the people are friendly, for one - it's not the gora-gone-wild hellhole it seemed last night as we exhaustedly passed a succession of street corners with whey-faced dreadlocked gap-year students vomiting excitably into gutters or dour sanctimonious hippies tutting at them. Pondicherry still has a hippie-'n'-hooligan air to it, but the streets are paved in stone, have pavements and gutters, some of the buildings are attractive, and there's a promenade alongside the Bay of Bengal which looks like you could swim in it.
Saturday started well; for all my you-can't-polish-a-turd- by-giving-it-marble-floors griping yesterday the hotel had outstanding showers, prompting Ben to comment that it had "almost made the entire utterly miserable experience worthwhile". This upset the girls enormously, as their room's shower didn't work - but as I'd gone and got us all pains-au-chocolat and pastries for breakfast by the time I relayed news of Ben's insensitivity to them, he only suffered a glancing blow to the head with a bottle of water for it.
From there we wandered through town to the Dumas Guest House where we'd initially tried to stay at the previous night, and checked in to a homely sort of appartment with two bedrooms, two bathrooms, a living room and a balcony.
By the time we'd sorted that out it was near enough to noon that we felt we could start on lunch. This was when Pondi really started looking up - we had salads, and shrimp soup, and Ben's bleu steak in blue cheese sauce, and prawns in garlic and parsley, and lemon tart, bitter hot chocolate, and above all proper tea. After a fortnight of curry, it was basically food porn, and we went there again for lunch today (Sunday) and added more steaks, coq au vin, and perfect chocolate mousse to the list. Rough Guide to India (mine, on loan from my sister Susie) 1, Lonely Planet Guide to South India (Ben's) 0.After the three or so hours we spent lunching, we ambled through town looking at the sea, buildings, things in shops (where Toyin comfortably took the "Shopper of the Day" award by buying as much as the rest of us put together), and then began to think about where to have dinner. Midway through our meander, my seafood-related reverie was interrupted by someone dropping an armful of tupperware down some stairs. I was about to suggest to the others that we let Toyin add some tupperware to her list of purchases when a carefully bedraggled-looking guy in his early 20s who asked if I wanted to buy one of his bongo drums.
"Thanks, but I don't want one," I replied, silently cursing the lost tupperware-buying opportunity.
"For you, special price." His response had a reassuring feel to it; I'd forgotten what it was like to be worked over by someone trying to sell tat to tourists. For all Vellore's flaws, being off the tourist trail has its advantages.
"I'm sure your prices are excellent, but I still don't want one."
"Come on, they're very good! As a present for someone."
"I don't want one." He was beginning to sound really whiny at this point.
"I'll do swap."
"No, really - I don't-"
"Ok, ok - I'll swap it for your watch."
"No - you won't." Mercifully he gave up at this point; I'd been expecting his next offer to involve swapping it for my passport, wallet, or perhaps one of my kidneys. Curiously, he and his ilk left the (numerous) Indian tourists entirely alone, evidently relying on the gora-gone-wild and hippie clientele.
After everyone but Ben had had the obligatory ayurvedic massage - which prompted Toyin to comment that "I've always known that I would know true love when I found it, and I'm sure Lina's the girl for me", Lina being her masseuse - we resorted to type by going for dinner. The evening's meal was billed by Ben's Lonely Planet as the best place to eat in Pondi, and somehow we'd managed to work up an appetite again by the time we arrived. The rooftop terrace was a bit of a let-down as places featuring green-painted bamboo and no views can be, but we had high hopes for the food - two types of salad, bouillabaisse, seafood gumbo, silver pomfret, sear, crab, and beef lasagne. Actually, this is only partly true - my hopes for the crab were deflated when they said they couldn't serve it in the shell (implied: because it comes from a tin), and they were dashed entirely when, seized by a desire fora post-colonial eating experience, I eschewed "baked" and "garlic" in favour of that well-known Indian staple, masala crab. The instant regret I felt after placing the order was alleviated somewhat by my seafood gumbo being very good while the salads were unremarkable and the bouillabaisse gloopy and full of gelatin - but after the crab the others have begun changing their order if I ask for the same thing: it was the worst of a bad set of mains. The pomfret was roasted to within an inch of the life of a fish twice its size, the lasagne had gristly bits in, and the sear was bland. All this culinary disappointment was accompanied by the most expensive bottle of Indian wine on the men (an insane ten pounds) which tasted like benelin and was barely drinkable when chilled almost to freezing point, and crowned by three puddings (Charlotte sensibly having abandoned hope after her pomfret) which tasted like they'd been freshly bought at Costcutter. Rough Guide to India 1, Lonely Planet Guide to South India -4. Not a success, in short, but we bought a few beers on the way home and sat up drinking in the appartment and setting the world to rights.
Sunday involved a fantastic breakfast (fresh fruit, toast, eggs, bacon, tea and coffee) and a lunch I've already praised, a trip to the botanical gardens where we entertained a dozen or so local kids by letting them take pictures of one another with our cameras (and unlike our bongo-selling friends, they didn't ask for a thing and were just a joy), and then a five-hour bus journey back to Vellore. This was actually preferable to the taxi ride as the buses have wheels like tractors and so can take the potholes and speed humps at speed without sending you too far into the air, and it's an eight of the price. On the trip we saw our first Indian elephant being ridden through Villampuram, and I had a long and endlessly entertaining discussion with Shankar, the Tamil man sat next to me. We started out with the usual where-are-you-from chat (he lives in Pondi but works in Vellore during the week making shoes for export), and then paused while he read Indian Marie Claire, which Fenulla and Sarah (two of the Aussie girls) had given to Toyin and Charlotte. He seemed particularly appalled by the article on transsexuals here, but gave it back without comment; from here, however, the conversation got markedly stranger.
Shankar: "People are healthier in England than here, no? Why do you think this is?"
Me: "Well, we spend more on healthcare, people are better fed and educated, and-"
Shankar: "No - it is because of the roofs! We get healthy by absorbing cosmic rays, and how do we do that?"
Me: [thinking correctly that there is no way I would be able to guess] "Er..."
Shankar: [triumphantly, making an arch with his hands] "The roofs are sloping in England! This means you absorb more cosmic rays."
He also enlightened me about babies being heavier when they were asleep ("I will give you an example. Take a baby who weighs ten kay-gees. Then when it is asleep, perhaps it will weigh twelve kay-gees."), summarised several ghastly management books with titles like "The ten types of person in business" and "How to create an ideas-culture", and explained how breathing through your right nostril slowly will cure headaches. There were some sane elements to the conversation, however, and not only was he thoroughly charming, but he also arranged for the bus to drop us just by Ananda Bhavan where we're staying and not 20 minutes' rickshaw ride away in town - so if, as he said while we were getting off the bus, that we would see one another in heaven, at least I know I'll be entertained. Odd thing for a hindu to say, come to think of it.
This week I'm doing community health for three days, and then we're skipping school to go to the beach and eat more seafood before flying home on Sunday. I also apologise to those of you who've wanted to hear about the head-waggle; I'm hoping to persuade my fellow students to be filmed illustrating it for educational purposes, in which case it will have to wait until I'm back and am able to add photos to the blog. Bye for now.
Grim Portents, Bespoke Suits, and Night Drives.
4th November
We've come on holiday by mistake. With one exception, friday has been a disaster. It started innocuously enough for CMC with the removal of a huge abdominal mass from the elderly woman who'd presented with it. The initial incision exposed part of this thing, but wasn't big enough to get it out, so Dr. Peedicayil extended it almost to her ribcage; the lump was about the size of a basketball. However, the longer cut let him get hands under it, and heave it free, whereupon it burst spectacularly, spilling five or six litres of yellowish fluid all over the surgeons, the floor, the patient, and a poor student nurse who'd been made to scrub in for her first ever surgery and looked like she was going to pass out as she was showered in ichor. Even after the thing had burst the remnants of the ovary it had grown from were the size of eight or so stacked dinner plates.
This was the first of two omens, the second being the colossal thunderstorm which broke shortly thereafter, and soaked us all on the way to lunch - which would be the last meal we'd have for a while. Around 3pm, after we'd seen a nun have a hysterectomy for her endometrial cancer (which is very common in nuns, in case any of you were considering donning the habit), Ben and I headed to the tailor's for the second stage of our suit fitting. I've neglected to mention this before, but we realised early on that having clothes tailored here is pretty reasonable, so we'd both been and ordered suits fitted. This turned out to be what I understand to be a fully-bespoke service (although I'm sure my lawyer acquaintances will correct me if I'm labouring under a misapprehension here), involving a measurements and specifications session at which we rapidly devolved all decision-making to Charlotte, and then a second fitting with the suits at the not-quite-made stage. This followed the same lines as the first, with Ben and I meekly obeying orders and the tailor rapidly skipping directly to asking Charlotte what adjustments we needed. This was the exception to the disasters of the day.
Our final CMC appointment of the week was back at the university campus for a meeting with the vice-principal, Anand Zachariah, and the other elective students. Spectacular though his name is, I was disappointed not to meet the principal, Molly (not a woman) Jacobs. However, the meeting reinforced my impression of the general loveliness of the doctors at CMC, and their desire to make everyone's time here as enjoyable and beneficial as possible - it was a full-on "what could we do better?" conversation, and the tea and samosas also helped.
Then it all started to go wrong. Knowing the meeting would finish after five, we'd booked a car to drive us the 3-4 hours to Pondicherry that night, meaning (worst case) we'd get in at half nine and have plenty of time to check in somewhere, and begin the weekend's eating, and would then have a full day there on saturday.
It didn't show up.
After waiting half an hour or so in the monsoon rain, we took a rickshaw back to the chemist where we'd booked it (there was a sign outside saying "tourist cars", in our defence) to shout at the man behind the counter. He seemed rather baffled by Ben's open hostility, but did eventually call the driver who he quite clearly hadn't bothered to organise in advance or tell to meet us where we'd agreed despite our deposit. Toyin's ruthless negotiation got us a bit off the fare - but we still left more than an hour and a half late.
You'd think the worst of this would be a late arrival in Pondi - but you'd only be half-right. First there was the drive itself to contend with, the first unsettling part of which was the lack of seatbelts in the car. Second was discovering that the driving on Big Roads in India is very similar to the driving on Little Roads - but when you're in a car doing 60kph and are up against lorries, the stakes are higher than when you're in a rickshaw doing 20kph against other rickshaws. It was also pitch black, and Samson our driver tends to drive in the middle of the road until he sees something heading for us, whereupon a game of chicken ensues to see who ends up swerving into the potholes at the side of the road. The game is made all the more exciting by the cunning use of headlights (it being pitch dark by now) - some oncoming drivers just leave them
permanently on full beam, which makes it impossible for either driver to see the road while they pass one another, but the clever ones dip their lights at the normal distance, then flick them back to full beam at the last minute, completely dazzling you. Passing another vehicle in either direction, or sitting behind one, is done to a score of horn usage, with painted signs on the back of lorries inviting this, often just below "DANGER - HIGHLY INFLAMMABLE", or advice on what to do if you get the toxic material inside on your skin ("wash in warm water", it appears). Many conversations were interrupted by a sharp intake of breath, by hitting a pothole or one of the vertical speed bumps at pace. Particularly brutal are the triple humps, which - especially sans seatbelt - are close to chiropracty. Even when you fall asleep, as I did briefly, the victorious blare of a horn would make my eyes start open just as the juggernaut bearing down on us flicked its light back to full beam. This went on for four hours, and about three hours in three bad things happened:(1) We realised the fuel gauge was just above empty (it later turned out it was just broken)
(2) Samson's headlights failed for a couple of minutes, so we were driving blind
(3) Our ETA slipped past 11pm, when everything would be shut.
When we did eventually make it, the place we wanted to stay in was shut, so we got Samson to tour Pondicherry until we found somewhere to stay. In the process he tore up the bottom of his car on a particularly ropey section of road, and we finally reached a place called Soorya International, whose marble exterior started incongruously enough from a debris-filled drainage ditch, and sat opposite a sign saying "Don't urinate here". The marble floors throughout, including in the rooms, belied the shifty, rude receptionist, and the pack of lies they fed us about restaurants which were open until midnight and when we began to check in but had mysteriously shut when we came back to order food, and about 24-hour bakeries. So I tramped up to my room, where the A/C didn't work, the windows didn't close, and my pillow appeared to have been run over by one of the lorries we'd passed on the way here, tired and hungry.
Monday, November 06, 2006
Special Days, the Four Gora of the Apocalypse, and Choosing the Right Bucket
2nd November
Today has been a special day for Dr. Peedicayil, who’s the doctor responsible for us during our time at CMC. Charlotte and I met him on the Bumper Admin Day, when he was both friendly and efficient, the four of us all saw him again the next day, and then Toyin and Ben spent part of the rest of the week with him doing gynaecology. It would have been all of the rest of the week, except that his immune system only resisted Toyin’s chest infection for about 48 hours, so that by Thursday he was off sick. Although Toyin claims it wasn’t her, both of their coughs sounded like a tractor being started in a vat of custard, so the rest of us are pretty convinced despite his chivalrous denials. Today, then, has been special because it’s the first day he’s managed to drag himself from his sickbed to come back to the hospital. It has therefore also been a special day for Charlotte and me as we’ve got to go on a ward round with him. In the UK, with honourable exceptions, ward rounds are housekeeping – are the drug charts up to date, does the house officer know the patient’s mother’s dog’s name, when can we send them home, have they died in the night, that sort of thing. Surgical ward rounds are particularly entertaining thanks to the intense focus in recent medical education on InterProfessional Education, which is a pompous way of saying “be nice to patients”. It’s generally taught self-importantly and badly by people who give the impression that they believe Being Nice can cure the common cold. Thus a surgical ward round often includes exchanges like:
Surgeon [pointing at patient’s heavily bandaged leg]: Good morning, Mrs. Jones. How’re you feeling today?
Mrs. Jones: Oooh, terrible, doctor. My arthritis is playing up something rotten, I’ve got a terrible headache, the tea tastes like dishwater, and the food gives me wind.
Surgeon: Good, good – let’s have a look at that wound, shall we? [tears off bandages and begins prodding]
Here, however, ward rounds are an all-singing, all-dancing affair which actually involve teaching. The round today ran from 9.30 till after 1pm, and featured three consultants, three registrars, and six or seven house officers of various grades, the two of us, and the irregular sputtering of Dr. Peedicayil’s gora-infected lungs. It was fantastic – we’d arrive at a patient, watch the house officers present them at absolutely lightning speed, and then get grilled by the consultants on the particular condition. There was no malice in it, either – no one got shouted at for not knowing things – they’d just move on to the next house officer until someone got it right. The whole thing had a very schoolmarmly feel, partly because Dr. Peedicayil is the only male consultant of the three, and partly because here consultants are addressed as “sir” and “ma’am”, even when they’re being talked about, as in: “So sir is still off sick? Perhaps he’ll be back tomorrow.”
In theatre, too, when many surgeons are so focused on what they’re doing that even the good teachers often just get on with what they love doing, the doctors here take time to point things out. I’ve seen a couple of hysterectomies this week for fibroids (painful, bleeding lumps in the womb) and endometrial cancer, and in every case the surgeon has either dissected the specimen up with us and shown us the extent of the tumour or the fibroids or had a house officer (the very entertaining Arpudh) do it for us. I know it sounds trite, but it’s amazing how having someone pointing to the thickness of the wall of the womb and highlighting the white, sloughy tumour will help you remember how endometrial cancer’s staged. The long and the short is that, perhaps because there are less students per consultant here and perhaps because of something about the place, the quality of teaching is just *better*.
Toyin's impressive infection of key members of the hospital staff has meant that we have assigned ourselves nicknames based on our gora status - Ben is tall gora, Charlotte is small gora, I am sleepy gora, and Toyin's lurgee gora, all for fairly obvious reasons (I am still prone to falling asleep in warm rooms when I am bored, as happened slightly embarrassingly with the only bad consultant we've run into who essentially totally ignored my presence in outpatients).
She has been the exception, however, and the afore-mentioned Arpudh is entertaining both because he's really easy-going but extraordinarily helpful, and because he told us the famous Seven Things about Vellore.
(1) It has a Fort with no King. (The fort in Vellore wasn't ruled by any one person)
(2) It has a Moat with no Water. (and its moat is normally dry)
(3) It has Mountains with no Trees. (the mountains are, as suggested, treeless)
(4) It has a Temple with no God. (the temple in the fort was originally dedicated to a now-forgotten god, although they've shipped in a bunch of Hindu statues now, along with several metal filing cabinets with what look like names and addresses painted on them)
(5) It has a River with no Water.
(6) It has Women with no Beauty.
(7) It has Men with no Brains.
I suspect that finding this funny is more likely if you've spent some time here, but hey.
I've also run into some of the other gora here - there are a heap of Australians over, presumably because India's not that far away. They're a really good bunch, although one (Jim) told an anecdote which worried me. Just after he'd arrived, he was getting to grips with the bucket showers, and thought he'd check he was going to use the correct bucket (there are normally three in a bathroom). So he called one of the hotel staff, who took one look at the bucket full of water and the dumb gora, looked utterly horrified, and whisked the bucket away. This suggests Jim was about to shower in the bucket used for washing the left hand after using the lavatory.
I have no idea which bucket I've been using to shower and indeed shave in at our hostel, and given that Jim's story came about ten days into my stay here, I don't plan to ask.
Today has been a special day for Dr. Peedicayil, who’s the doctor responsible for us during our time at CMC. Charlotte and I met him on the Bumper Admin Day, when he was both friendly and efficient, the four of us all saw him again the next day, and then Toyin and Ben spent part of the rest of the week with him doing gynaecology. It would have been all of the rest of the week, except that his immune system only resisted Toyin’s chest infection for about 48 hours, so that by Thursday he was off sick. Although Toyin claims it wasn’t her, both of their coughs sounded like a tractor being started in a vat of custard, so the rest of us are pretty convinced despite his chivalrous denials. Today, then, has been special because it’s the first day he’s managed to drag himself from his sickbed to come back to the hospital. It has therefore also been a special day for Charlotte and me as we’ve got to go on a ward round with him. In the UK, with honourable exceptions, ward rounds are housekeeping – are the drug charts up to date, does the house officer know the patient’s mother’s dog’s name, when can we send them home, have they died in the night, that sort of thing. Surgical ward rounds are particularly entertaining thanks to the intense focus in recent medical education on InterProfessional Education, which is a pompous way of saying “be nice to patients”. It’s generally taught self-importantly and badly by people who give the impression that they believe Being Nice can cure the common cold. Thus a surgical ward round often includes exchanges like:
Surgeon [pointing at patient’s heavily bandaged leg]: Good morning, Mrs. Jones. How’re you feeling today?
Mrs. Jones: Oooh, terrible, doctor. My arthritis is playing up something rotten, I’ve got a terrible headache, the tea tastes like dishwater, and the food gives me wind.
Surgeon: Good, good – let’s have a look at that wound, shall we? [tears off bandages and begins prodding]
Here, however, ward rounds are an all-singing, all-dancing affair which actually involve teaching. The round today ran from 9.30 till after 1pm, and featured three consultants, three registrars, and six or seven house officers of various grades, the two of us, and the irregular sputtering of Dr. Peedicayil’s gora-infected lungs. It was fantastic – we’d arrive at a patient, watch the house officers present them at absolutely lightning speed, and then get grilled by the consultants on the particular condition. There was no malice in it, either – no one got shouted at for not knowing things – they’d just move on to the next house officer until someone got it right. The whole thing had a very schoolmarmly feel, partly because Dr. Peedicayil is the only male consultant of the three, and partly because here consultants are addressed as “sir” and “ma’am”, even when they’re being talked about, as in: “So sir is still off sick? Perhaps he’ll be back tomorrow.”
In theatre, too, when many surgeons are so focused on what they’re doing that even the good teachers often just get on with what they love doing, the doctors here take time to point things out. I’ve seen a couple of hysterectomies this week for fibroids (painful, bleeding lumps in the womb) and endometrial cancer, and in every case the surgeon has either dissected the specimen up with us and shown us the extent of the tumour or the fibroids or had a house officer (the very entertaining Arpudh) do it for us. I know it sounds trite, but it’s amazing how having someone pointing to the thickness of the wall of the womb and highlighting the white, sloughy tumour will help you remember how endometrial cancer’s staged. The long and the short is that, perhaps because there are less students per consultant here and perhaps because of something about the place, the quality of teaching is just *better*.
Toyin's impressive infection of key members of the hospital staff has meant that we have assigned ourselves nicknames based on our gora status - Ben is tall gora, Charlotte is small gora, I am sleepy gora, and Toyin's lurgee gora, all for fairly obvious reasons (I am still prone to falling asleep in warm rooms when I am bored, as happened slightly embarrassingly with the only bad consultant we've run into who essentially totally ignored my presence in outpatients).
She has been the exception, however, and the afore-mentioned Arpudh is entertaining both because he's really easy-going but extraordinarily helpful, and because he told us the famous Seven Things about Vellore.
(1) It has a Fort with no King. (The fort in Vellore wasn't ruled by any one person)
(2) It has a Moat with no Water. (and its moat is normally dry)
(3) It has Mountains with no Trees. (the mountains are, as suggested, treeless)
(4) It has a Temple with no God. (the temple in the fort was originally dedicated to a now-forgotten god, although they've shipped in a bunch of Hindu statues now, along with several metal filing cabinets with what look like names and addresses painted on them)
(5) It has a River with no Water.
(6) It has Women with no Beauty.
(7) It has Men with no Brains.
I suspect that finding this funny is more likely if you've spent some time here, but hey.
I've also run into some of the other gora here - there are a heap of Australians over, presumably because India's not that far away. They're a really good bunch, although one (Jim) told an anecdote which worried me. Just after he'd arrived, he was getting to grips with the bucket showers, and thought he'd check he was going to use the correct bucket (there are normally three in a bathroom). So he called one of the hotel staff, who took one look at the bucket full of water and the dumb gora, looked utterly horrified, and whisked the bucket away. This suggests Jim was about to shower in the bucket used for washing the left hand after using the lavatory.
I have no idea which bucket I've been using to shower and indeed shave in at our hostel, and given that Jim's story came about ten days into my stay here, I don't plan to ask.
Wednesday, November 01, 2006
Rice dumplings, Words of Wisdom, Chay, and Advice to new mothers.
Tuesday 31st October
I’m afraid that Hallowe’en isn’t celebrated here, and as gynaecology is less easy to write delicately about than obstetrics, instead I’m going to tell you all about the food. As most of you know, India’s reputation is both very good – chicken tikka masala is Britain’s favourite food - and very bad – everyone who comes here gets the shits. Although Tamil Nadu, where Vellore is, has slightly different food to what the British palette is used to – which is more Northern / Bengali cuisine – it’s been much more good than bad. I must at this point congratulate Padman, who’s also on the graduate medical course with me, for being the only one of us to get the runs. His family are from Jaffna in Northern Sri Lanka and so he’s Tamil and basically a native, so he must have thought he’d be pretty safe, particularly when he was coming here with Tom Pollak, who’s not only pale-skinned, but also managed to get typhoid while in India over the summer. Alas not – Pad had the runs for the whole of his first week. As he himself put it: bit embarrassing when the gora’s absolutely fine. Given that he also arranged for the two to go to Mangalore when they wanted to go to Bangalore, a mere eight hours away by train, it’s also possible Padman is lying about his heritage.
However, tempting fate, the four of us in Vellore have been fine. Breakfast has been the biggest culture shock, perhaps because you’re that little bit more vulnerable at that time of day. For most of the first week we tackled either idly or poori masala. Idly are steamed rice dumplings served with a little pot of very liquid vegetable curry which we’ve affectionately dubbed ‘pond water’ because of the close resemblance of the two. Happily it tastes fine, although picking up rice dumplings at 7am with your fingers, dipping them in curry, and then getting them to your mouth without dripping pond water down your shirt takes some getting used to. Poori masala is a thicker vegetable curry with some quite oily, thin, savoury wholemeal pancakes. That these two dishes feature on the breakfast menu tells you several important things about Tamil food:
(1) It’s vegetarian.
(2) Its major components are fat and starch in various forms and invariably fried.
(3) Cutlery is not routine (as toilet paper isn’t either, it’s important not to use your left hand to eat with).
(4) Every meal, from breakfast on, is curry.
We eat breakfast without exception in the YWCA canteen at the hospital. For those of you who’re confused by this, I should explain that CMC, standing as it does for Christian Medical College, is quite a religious place, although only occasionally overtly so. Although there are morning prayers on the days there are ward rounds, no one has yet sat us down for Earnest Conversations, nor asked if we Believe or are Going To Hell. On the upside, the college is studded with plaques bearing bible quotations, and many are also written on the top of ward whiteboards; although “If God is with us, who can be against us?” may not be to everyone’s tastes (and as Ben pointed out, the obvious answer is “Satan”), it’s a lot better than “You don’t have to be crazy to work here, but it helps!!!”. Some are a little bizarre – the bins have the biblical-sounding “wealth through waste” and “health is wealth”, which leads to the baffling conclusion that waste is health – one for those who believe in the constitutional power of a glass of urine, perhaps. Best of all is the incinerator tower, which bears the legend “God’s presence will go with you in spirit”. There are also lots of great pictures of the missionary doctors who set the place up, chief amongst whom is Ida S Scudder. Her family have, as one plaque not unreasonably trumpets, dedicated 1,047 years of life to CMC Vellore. The library in which I’m typing is named for Gertrude Dodd, a plumpish lady whose photo, which hangs over the door, makes her look sallow and sunken-eyed but somehow also matronly, sort of like a vegan zombie. While praying over the incision you’ve just closed, as a lovely doctor from the Labour Room does, is perhaps taking things too far, it’s actually a very tolerant and cohesive place. Granted, I was unsure what to make of one nurse with a <bindi being called Sister Sebastian Ignatius, but even if she isn’t Hindu, a lot of the patients are that or Muslim and get treated identically to the Christian ones. The main advantage of the place’s religious leanings, however, is unquestionably the canteen, which while serves excellent food cheaply – and of course, being a good Christian establishment, beef biriyani makes the menu most days.
Breakfast, however, was a battle at first, particularly for Charlotte, who reached curry saturation point earlier than the rest of us, and Toyin, who had to battle with the coffee not giving her the necessary fix because of its contamination. All of us have had problems on this front due to the unusual nature of tea and coffee in Southern India. Tea is not Darjeeling, nor Assam, nor Ceylon – instead it’s some unidentifiable black stuff boiled in what looks like a metal sock and immersed in hot milk. To this mix is added (unpredictably) cardamom and (predictably) about an equal weight of sugar. Despite the skin which invariably forms on it as it cools, it’s fine – but I was hoping for real tea, and instead I’m getting something closer to a boiled cardamom milkshake. Toyin and Charlotte have now persuaded the canteen, which is a small-scale model in production-line efficiency, to make them black coffee specially in the mornings, and our favourite chef indulges the gora by bringing it over. We’ve also regressed from idly and poori masala to “egg fry” and toast, although Ben and I occasionally brave the porridge (equal parts hot milk and sugar, with either semolina- or spaghetti-like stuff in) or the pongal (like kedgeree without the fish and with the curry).
After that, though, there’s pretty much nothing but curry, with the main difference between lunch and dinner the availability of biriyani at lunch. This is a healthy portion of spiced rice with bits of meat in (chicken as well as beef, and allegedly mutton, although they never have it when I order it despite there being plenty of goats around), and a yoghurt-and-chopped-onion raitha. In addition, lunch offers the mysterious “chicken cass roll” – see if you can guess what that is before I tell you. The other options with rice are a “veg meal”, which is four or five little pots of pond water, rice, and a poppadum, or something western-sounding on rotation (“lemon chicken rice” one day, “tomato chicken rice” the next) which is curry variant. All the little pots, including the “chicken fry” and “beef fry” which are delicious, focus on the fried fat part of the diet – they are swimming in oil. When starch isn’t supplied by rice, it comes as some sort of bread – not naan, but rather chapathi (doughy fried flatbread), parotta (moister, thicker dough in spirals), or uthappam (thick dough often with red onions or something fried into it). These all come with a pot of vegetarian fat of some description.
This leads neatly on to pudding, which covers the other staple of the Tamil Nadu diet – sugar. Their attitude to pudding is, to quote Ben, “pretty much spot on. If you’re gonna have pudding, make it very sweet and have a little bit of it, d’you know what I mean?” Some of them are similar to the porridge only with nuts in, some (gobi) are a dough ball in a little pot of syrup, some (“pine apple cream”) are basically milk, sugar, and fruit juice, some (“pineapple upside down”, “caramel custard”) are english puddings. I love them, particularly as they make the tea taste less sweet.
That leaves only snacks, which you can perhaps guess about: samosas (vegetable or chicken wrapped in butter, albeit in the form of filo pastry), egg puffs (eggs and filo pastry), strange things which can all too easily be bought as doughnuts but which are actually tasteless deep-fried suet with bits of spice in and are the only bad thing I’ve eaten so far. Sweet snacks are cakes (sponge with sugar icing), genuine doughnuts, biscuits (quite like shortbread), or a sort of fudge made from ghee (clarified butter), sugar, and occasionally nuts and topped with more sugar. You can also get fruit, thank god – but a pineapple costs 35 rupees (~40p) where ghee fudge costs 5 rupees (~12p), so small wonder everyone here’s diabetic. I’d give myself at least another couple of months.
As Ben discovered recently, however, you can get gora food in the canteen. He had noticed the excitement of the chefs as they served his chicken cass roll up – half a roast chicken, and some cold potato and carrot slop. It took Toyin to point out as he and I wondered where the roll was that it was chicken casserole. I’ll leave you with a final example of how deep the differences run. All over the world, you try to persuade new mothers to breastfeed, as it’s better for the baby every which way. This runs into problems in the developed world, where mothers may be on medication which makes it unsafe, or just feel they’ve better things to do with their time, or they may not produce enough milk. In the developing world, corporations like Nestlé prey on very high infant mortality rates by aggressively and utterly dishonestly marketing bottle formula as “safer”. This means not only that the baby’s immune system does not get the benefit of breast milk, but that formula is often made with contaminated water; this directly causes about 1.5 million infant deaths per year according to UNICEF figures. If you can do without that kitkat… In India, the problem is rather different – the mother-in-law often believes baby will be stronger if they’re fed on diluted cow’s milk (the same problem exists in the UK where mothers who don’t know better or who struggle to breastfeed dilute milk in the same way). One way of addressing this is by dazzling mum with science – so there are charts back home showing the main components of breast milk versus cow’s milk, and so illustrating the “Breast is Best” message. One of these was in the neonatal ward (sweetly called “Nursery” here), and alongside “Human” and “Cow” was “Buffalo”.
It is less good than cow, in case you were considering it. Bye for now.
I’m afraid that Hallowe’en isn’t celebrated here, and as gynaecology is less easy to write delicately about than obstetrics, instead I’m going to tell you all about the food. As most of you know, India’s reputation is both very good – chicken tikka masala is Britain’s favourite food - and very bad – everyone who comes here gets the shits. Although Tamil Nadu, where Vellore is, has slightly different food to what the British palette is used to – which is more Northern / Bengali cuisine – it’s been much more good than bad. I must at this point congratulate Padman, who’s also on the graduate medical course with me, for being the only one of us to get the runs. His family are from Jaffna in Northern Sri Lanka and so he’s Tamil and basically a native, so he must have thought he’d be pretty safe, particularly when he was coming here with Tom Pollak, who’s not only pale-skinned, but also managed to get typhoid while in India over the summer. Alas not – Pad had the runs for the whole of his first week. As he himself put it: bit embarrassing when the gora’s absolutely fine. Given that he also arranged for the two to go to Mangalore when they wanted to go to Bangalore, a mere eight hours away by train, it’s also possible Padman is lying about his heritage.
However, tempting fate, the four of us in Vellore have been fine. Breakfast has been the biggest culture shock, perhaps because you’re that little bit more vulnerable at that time of day. For most of the first week we tackled either idly or poori masala. Idly are steamed rice dumplings served with a little pot of very liquid vegetable curry which we’ve affectionately dubbed ‘pond water’ because of the close resemblance of the two. Happily it tastes fine, although picking up rice dumplings at 7am with your fingers, dipping them in curry, and then getting them to your mouth without dripping pond water down your shirt takes some getting used to. Poori masala is a thicker vegetable curry with some quite oily, thin, savoury wholemeal pancakes. That these two dishes feature on the breakfast menu tells you several important things about Tamil food:
(1) It’s vegetarian.
(2) Its major components are fat and starch in various forms and invariably fried.
(3) Cutlery is not routine (as toilet paper isn’t either, it’s important not to use your left hand to eat with).
(4) Every meal, from breakfast on, is curry.
We eat breakfast without exception in the YWCA canteen at the hospital. For those of you who’re confused by this, I should explain that CMC, standing as it does for Christian Medical College, is quite a religious place, although only occasionally overtly so. Although there are morning prayers on the days there are ward rounds, no one has yet sat us down for Earnest Conversations, nor asked if we Believe or are Going To Hell. On the upside, the college is studded with plaques bearing bible quotations, and many are also written on the top of ward whiteboards; although “If God is with us, who can be against us?” may not be to everyone’s tastes (and as Ben pointed out, the obvious answer is “Satan”), it’s a lot better than “You don’t have to be crazy to work here, but it helps!!!”. Some are a little bizarre – the bins have the biblical-sounding “wealth through waste” and “health is wealth”, which leads to the baffling conclusion that waste is health – one for those who believe in the constitutional power of a glass of urine, perhaps. Best of all is the incinerator tower, which bears the legend “God’s presence will go with you in spirit”. There are also lots of great pictures of the missionary doctors who set the place up, chief amongst whom is Ida S Scudder. Her family have, as one plaque not unreasonably trumpets, dedicated 1,047 years of life to CMC Vellore. The library in which I’m typing is named for Gertrude Dodd, a plumpish lady whose photo, which hangs over the door, makes her look sallow and sunken-eyed but somehow also matronly, sort of like a vegan zombie. While praying over the incision you’ve just closed, as a lovely doctor from the Labour Room does, is perhaps taking things too far, it’s actually a very tolerant and cohesive place. Granted, I was unsure what to make of one nurse with a <bindi being called Sister Sebastian Ignatius, but even if she isn’t Hindu, a lot of the patients are that or Muslim and get treated identically to the Christian ones. The main advantage of the place’s religious leanings, however, is unquestionably the canteen, which while serves excellent food cheaply – and of course, being a good Christian establishment, beef biriyani makes the menu most days.
Breakfast, however, was a battle at first, particularly for Charlotte, who reached curry saturation point earlier than the rest of us, and Toyin, who had to battle with the coffee not giving her the necessary fix because of its contamination. All of us have had problems on this front due to the unusual nature of tea and coffee in Southern India. Tea is not Darjeeling, nor Assam, nor Ceylon – instead it’s some unidentifiable black stuff boiled in what looks like a metal sock and immersed in hot milk. To this mix is added (unpredictably) cardamom and (predictably) about an equal weight of sugar. Despite the skin which invariably forms on it as it cools, it’s fine – but I was hoping for real tea, and instead I’m getting something closer to a boiled cardamom milkshake. Toyin and Charlotte have now persuaded the canteen, which is a small-scale model in production-line efficiency, to make them black coffee specially in the mornings, and our favourite chef indulges the gora by bringing it over. We’ve also regressed from idly and poori masala to “egg fry” and toast, although Ben and I occasionally brave the porridge (equal parts hot milk and sugar, with either semolina- or spaghetti-like stuff in) or the pongal (like kedgeree without the fish and with the curry).
After that, though, there’s pretty much nothing but curry, with the main difference between lunch and dinner the availability of biriyani at lunch. This is a healthy portion of spiced rice with bits of meat in (chicken as well as beef, and allegedly mutton, although they never have it when I order it despite there being plenty of goats around), and a yoghurt-and-chopped-onion raitha. In addition, lunch offers the mysterious “chicken cass roll” – see if you can guess what that is before I tell you. The other options with rice are a “veg meal”, which is four or five little pots of pond water, rice, and a poppadum, or something western-sounding on rotation (“lemon chicken rice” one day, “tomato chicken rice” the next) which is curry variant. All the little pots, including the “chicken fry” and “beef fry” which are delicious, focus on the fried fat part of the diet – they are swimming in oil. When starch isn’t supplied by rice, it comes as some sort of bread – not naan, but rather chapathi (doughy fried flatbread), parotta (moister, thicker dough in spirals), or uthappam (thick dough often with red onions or something fried into it). These all come with a pot of vegetarian fat of some description.
This leads neatly on to pudding, which covers the other staple of the Tamil Nadu diet – sugar. Their attitude to pudding is, to quote Ben, “pretty much spot on. If you’re gonna have pudding, make it very sweet and have a little bit of it, d’you know what I mean?” Some of them are similar to the porridge only with nuts in, some (gobi) are a dough ball in a little pot of syrup, some (“pine apple cream”) are basically milk, sugar, and fruit juice, some (“pineapple upside down”, “caramel custard”) are english puddings. I love them, particularly as they make the tea taste less sweet.
That leaves only snacks, which you can perhaps guess about: samosas (vegetable or chicken wrapped in butter, albeit in the form of filo pastry), egg puffs (eggs and filo pastry), strange things which can all too easily be bought as doughnuts but which are actually tasteless deep-fried suet with bits of spice in and are the only bad thing I’ve eaten so far. Sweet snacks are cakes (sponge with sugar icing), genuine doughnuts, biscuits (quite like shortbread), or a sort of fudge made from ghee (clarified butter), sugar, and occasionally nuts and topped with more sugar. You can also get fruit, thank god – but a pineapple costs 35 rupees (~40p) where ghee fudge costs 5 rupees (~12p), so small wonder everyone here’s diabetic. I’d give myself at least another couple of months.
As Ben discovered recently, however, you can get gora food in the canteen. He had noticed the excitement of the chefs as they served his chicken cass roll up – half a roast chicken, and some cold potato and carrot slop. It took Toyin to point out as he and I wondered where the roll was that it was chicken casserole. I’ll leave you with a final example of how deep the differences run. All over the world, you try to persuade new mothers to breastfeed, as it’s better for the baby every which way. This runs into problems in the developed world, where mothers may be on medication which makes it unsafe, or just feel they’ve better things to do with their time, or they may not produce enough milk. In the developing world, corporations like Nestlé prey on very high infant mortality rates by aggressively and utterly dishonestly marketing bottle formula as “safer”. This means not only that the baby’s immune system does not get the benefit of breast milk, but that formula is often made with contaminated water; this directly causes about 1.5 million infant deaths per year according to UNICEF figures. If you can do without that kitkat… In India, the problem is rather different – the mother-in-law often believes baby will be stronger if they’re fed on diluted cow’s milk (the same problem exists in the UK where mothers who don’t know better or who struggle to breastfeed dilute milk in the same way). One way of addressing this is by dazzling mum with science – so there are charts back home showing the main components of breast milk versus cow’s milk, and so illustrating the “Breast is Best” message. One of these was in the neonatal ward (sweetly called “Nursery” here), and alongside “Human” and “Cow” was “Buffalo”.
It is less good than cow, in case you were considering it. Bye for now.
Subscribe to:
Posts (Atom)