Sick in Sevagram

(The following is a description of events during my two week observational period of healthcare practices in India)

The patient was sitting in a chair in the doctor’s office. He was a young male, who had fallen ill and made it to Sevagram’s MGIMS hospital in order to receive treatment. The doctor grabbed his arm and asked, “Do you have a fever?”, feeling his wrist to perform her own assessment. He nodded affirmatively as she verbally confirmed, “Yes, you seem a little bit feverish.”

The patient also reported a headache but no chills or other severe symptoms. He had been lethargic for the past 1-2 days and had a suppressed appetite. After some bed rest, he had developed a fever and went to a friend, also a doctor, to see what care he should seek out. Here in Sevagram, in the district of Maharashtra, malaria is a huge concern and one initial symptom is fever; meaning that any fever is always assumed to be malaria and tested as such. The patient’s friend immediately called up a practicing doctor in the area to ensure a prompt appointment to get his blood tested. Twenty minutes later, the patient was already being evaluated.

Here in India, it is quite common to call up a doctor you know and walk into their office to receive treatment. In contrast, patients from rural areas may travel from up to 15km away to be seen (after waiting sometimes 6 hours) by some of the most talented and skilled specialists in the region. Luckily, this patient had a personal connection and was able to receive prompt care, something taken for granted in the United States thanks to the 2000 emergency departments located throughout the country.

The doctor explained to the patient that she wanted to run some blood tests for malaria and dengue fever. She reassured the patient, “I don’t think it’s malaria, but we will do blood tests to confirm. It will only take 30 minutes.” The nurse then entered the room with the same kind of kit seen in blood labs throughout the US. She tied the rubber tourniquet around his arm, asked him to make a fist, and inserted the needle into his left arm, just opposite the elbow. No hesitation, no struggle, no “let’s try again because that vein is bad”. Pretty high quality healthcare. Twenty seconds later she had the vial filled with 5mL of blood, withdrew the needle, and handed him an alcohol-soaked white cotton ball to keep pressure on the punctured skin. Simple. Quick. Safe. How much more can you ask for in this region where income per capita is about $1700 per year?

For those that may not have realized yet, the patient experience described above was my own. While the blood was being tested in the pathology lab (which usually closes at 5pm but stayed open to run my sample), I went with my fellow CBID classmates to the referring doctor’s home for a traditional Indian dinner. Two ibuprofen and an hour of rest in a guest room with the AC on full power had done wonders for me and my fever. As I woke up and ate what remained of dinner, the doctor informed me that the lab had called: tests came back negative for both dengue fever and malaria. Just a quick hesitation on my part in understanding what she meant before she added, “you are all good.”

Between that news and biting into some fresh Naan bread (prepared specifically at my request two days prior), I finally felt the best I had in days. My appetite slowly returned as I made my way through most of the Indian dishes that sat in front of me. During the rest of the dinner conversation, she shared stories of her past. There were stories about reflection such as working in Saudi Arabia compared to India, stories about family involving her mother and how she relates to her daughters today, and also plenty of laughs and smiles spread around the table. Not sure I could have asked for a better night or place to spend my recovery.

Being sick is never a fun experience but there is something to be said about my opportunity to explore health care in a “non-traditional” way. My classmates would joke before leaving Baltimore about trying to feign illness to discover how patients are treated and assessed but my acting skills were not even necessary during this visit. I would like to extend a special thanks to Dr. Poonam at MGIMS and her staff of nurses and pathologists for taking care of me in my time of need. I will always remember the wonderful care and attention they gave me while I was sick in Sevagram.