From Red Fort We met up once again with our driver BP, who was by far one of the most trustworthy people we had ever met. It’s like he had an internal bat radar to detect when we needed him and would instantly pull up. He also told us about the important rules of driving in Delhi: good breaks, good horn, good luck. Once we were safely ensconced in the van, we took a short trip to visit the grave of Gandi, which is one of the most well maintained places I have ever seen. In a city that is so often surrounded by or buried under filth and refuse, every at Gandhis grave is immaculate, and it is clear he is still as revered as a great leader in death as he was in life.

From the Tomb of one famous Indian to that of another, our next stop was the tomb of Humayun, the second Mughal emperor

The first example of a “paradise” or persian burial garden on the indian subcontinent, it not only set the stage for succeeding Mughal emperors to create royal Mausoleums, but also served as a model for the Taj Mahal, built by the fourth mughal emperor Shah Jahan

Imagine that this was made of marble instead of sandstone, and voila! instant wonder of the world.

We approached the entrance with some trepidation, seeing as how Indians have mixed/confused views on holy objects and religious imagery. Sound rascist?

Think again. Apparently this is a blessing or affirmation of life and positivity, at least until it is rotated 45 degrees, which gives the now infamous german logo.

Also, this is probably not a rabbi. But I digress. There we were entering the steps to the final resting place of Humayun

Hmm. Seems like he was down with the Jews after all.

The cenotaph of the second Mughal emperor

And our silhouetted adventurers pause for a moment to bask in the wonder of the things they have seen thus far, before setting off to one of their most dangerous sites yet: The Qutb Complex!

Yes, amidst the still stand columns, and a host of booby traps, the Qutb Minar, or victory tower can be espied. It is this structure, the tallest brick minaret in the world, that gives the complex its name

Filled with miles of columns, graves, arches, and archeaological accomplishments, we stood there unsure of what to do first…

Short Round was having a grand time admiring the architecture, until he set off a hidden trap from which we had to flee

luckily, years out of use, the trap had rusted and all we ended up running from was a few confused locals

A brief dash through another archway

dodging a few more snares along the way using only our wits

and bypassing the resting sites of those who had come before, we finally arrived at Qutb al Minar

This erection (as our guide referred to it) Thrusts into the sky at an impressive 239 ft (72.5 meters metric world!) and was built by three different rulers, not too mention struck by lighting twice. One can only admire the workmanship of such a towering erection

Or, you know, make a phallic joke. Whatever.

This stubby little fella was eventually supposed to compete with and even outstrip the qutb minar, but it remains an unfinished erection, incomplete because the sultan who ordered it built blew his wad of cash and materials too early, leaving it standing forever impotent and powerless in view of its more successful counterpart. Miss Crystal therefore took pity on this tower and rewarded its desperate efforts by posing in front so you could all ooh and ahh at this cyclopean endeavor.

Having finished our sightseeing, we journeyed around to the flea markets, a tea store where we purchased darjeeling (the champagne of teas) and dinner with some friends of friends before finally bedding down, awaiting the morning to continue our journey out of Delhi and onward to Rajastan, land of princes, pachyderms and our next destination.

The group finally all together, we met our local guide Tarun and set off for our first destination, Jama Masjid

Jama Masjid is the principal mosque of Old Delhi in India. Commissioned by the Mughal Emperor Shah Jahan, builder of the Taj Mahal,in the year 1644 CE and completed in the year 1658 AD, it is the largest and best-known mosque in India. Being A Mosque, you are not allowed to wear shorts, or be a Short Round

at least not without covering up in holy mumuus. Once past the entry gate the mosque comes into view.

Jama Masjid is a reference to the weekly Friday noon congregation prayers of Muslims, Jummah, which are usually done at a mosque, the “congregational mosque” or “jāmi’ masjid”. The courtyard of the mosque can hold up to twenty-five thousand worshippers. or three times that many pigeons

Muslim Architecture does not allow representations of any living creatures, that being the sole province of God. Instead elaborate geometrical designs fill the walls, offering worshipers a focus while they contemplate and pray

We took the opportunity to indulge in a bit of contemplation of our own before heading on a brief rickshaw ride through the streets of old delhi to nearby Red Fort aka Lal Qil’ah

Lal Qilah is a 17th century fort complex constructed by the Mughal emperor Shah Jahan  in the walled city of Old Delhi that served as the residence of the royal family. It also served as the capital of the Mughals until 1857, when Mughal emperor Bahadur Shah Zafar was exiled by the British Indian government. We entered this elegant complex through the hilariously named Whore Gate

Probably does not mean what you think it does.

Red Fort is so named because of the red sandstone which makes it up. It is filled with intricate inlaid and carved designs of flowers, which demonstrate the influence of Hindu architecture, which shows gods in everything on the muslim architecture, which strictly forbids representations of living things

Above is Diwan-I-Am, the hall of public audience, where the shah would hear resolve the peoples problems, in what I can only assume was a hilarious Dr Seuss-like fashion based on the name of the hall. You Shall not have your neighbors land, from this country you are banned, you shall not take your goat or cow, you must leave here, must leave right now!

I have no idea what this structure was originally used for, but damn did it look epic. Off in the background to the right you can see the barracks used by the emperors military, and then when the British took over, used as their military barracks, meaning this fort was in use long past its expected prime, though now it is overun by tourists and wildlife

Ch-ch-ch-chip and Dale!

Of course, surrounded by all this cool stuff, some of the locals begin to take it for granted and just stare at passerby. LIKE A BOSS.

Next Post: Humayuns Tomb and Qutb complex!

-Indiana J

Greetings All!

Indiana Josh and his trusty sidekick Short Round, accompanied by longtime fellow adventurers Dr Han and Miss Crystal recently returned from their yearly trip exploring yet another continent. This year, our intrepid band of thrill-seekers decided to explore the exotic experiences of Northern India, and search the mysterious heights, and brave the worst lows of bordering Nepal. Stuffed with the usual Danger, Despair and Deeds of Derring-Do, the following journal entries and their accompanying photos will hopefully make you laugh, cry, and keep you at the edge of your seat while you read the latest epic

INDIANA JOSH AND THE TEMPLES OF DOOM

Day 1: 16 Mar 2012

Have Just arrived in India, another third world bastion of developing culture, industry, and yes, aromas.

The Crowds are palpable, a post apocalyptic throng of poverty stricken zombies searching for change instead of brains. Brains they have aplenty, as they must to survive from day to day, but not a street goes by but is populated by working stiffs in one form or another

First order of business then, is to find some means of conveyance to get to our hotel. We learn quickly that there are three rules to good driving in India

1. Good Breaks
2. Good Horn
3. Good Luck

Suddenly, New York Cabbies make a lot more sense as we are whisked away in what can only be described by Dr Han as “like playing a video game for two hours with MY LIFE”. Traffic moves at a steady 30km per hour, but it does so by whisking in and out of lanes that clearly exist only in the minds of the drivers as any extraneous material such as painted road lines, traffic signals, and pedestrians are simply ignored.

One moment our cab is driving down the left side of the road (thanks a lot Britain!) only for the cabby to decide he doesnt like his current position so he abruptly honks his horn to let other drivers around him know he is about to attempt manslaughter of his fares, then cuts across 4 lanes of traffic (in a 2 lane road no less), driving briefly against the flow of traffic toward several oncoming cars, only to duck back in to a lane somewhere in an intersection, all while sipping his chai and answering a text. Everyone hear drives like this, and after the initial terror, the car rides become a blur

By the end of the trip, we all agree that No racing game or driving simulator in the world will ever match up, and the previously loved Indiana Jones ride at Disneyland is now less thrilling than a trip to the Mall.

After settling in at our hotel, The Shangri La, an undiscovered paradise indeed, we briefly search the surroundings for some type of sustenance

Knowing the dangers of getting the dreaded Delhi Belly from street vendors, Indiana Josh gets in touch with local contacts, their information obtained from an associate stateside

The modern, ultra hip decor of the punjabi restaurant belies its humble surroundings, and a delicious meal is had with new friends

From Left: Miss Crystal, Dr Han, Indiana Josh, Mansi, Pavan, and Siddharth

Bellies full, we return to our hotel to await the fourth member of the party set to arrive tomorrow, when the adventure will truly begin

Welcome, my friends, to India.

TO BE CONTINUED…

Currently on vacation in India, and in two days have learned the following 1. If you can drive in India, you can drive anywhere. Corollary-new york cabbies now make sense 2. People do not automatically burst into song and dance, but a few well placed rupees can easily fix that 3. You dont know what pollution is until you sneeze black boogers. Literally, coal black. Just breathing here is a pack a week habit 4. No matter what you say about your tolerance for spicy food, indian people wont believe you 5. Dont drink the water. IMPORTANT COROLLARY: ice counts as water. Anyway, short round, ward, nakochan and I are off on a two week blitz through bollywood and beyond with photo posts to eventually folow…until then, namaste Dr J

I am backlogged up the wazoo with post ideas, so I am going to vomit one or two out and then hopefully blog em as I think em:

1) Histories

If you ever wondered why the doctor presses you to give more specific information, it’s because we don’t want our dictations to sound like this:

Mr. Smith is an old man with pain everywhere for an amount of time he won’t tell me. He rates his pain as “okay” out of 10, can’t describe it, and says it is associated with a funny feeling in his legs. He takes a medication for the pain that starts with the letter R. He is not sure of the dose. He went to an emergency room somewhere for the pain a while ago and they took X-rays and gave him a shot of some kind, which didn’t help. He had an MRI ordered by some doctor. He doesn’t have the MRI or report, but he thinks it showed a disc

This is how every one of my histories starts, and most of the doctor training is learning how to guide your questioning and direct the pain into something more like this

Mr Smith is an 70 year old gentleman with a history of lower lumbar pain for>5 years as a result of a slipped disc from a skiing injury taken with his grandchildren in 2004. Recently after falling at home, he has noted increased pain sharp in nature radiating down to his legs bilaterally. This feels similar to his exacerbations of his herniated disc in the past, and he went to an ER 1 month ago where imaging confirmed herniation, for which he was evaluated by ortho and given norco until follow up with spine surgery

See the difference? That’s 3 years of training right there. btw mr smith is entirely fictional

2)Ethics

I cant believe this actually happened. Via FB message and then chat no less from someone I havent seen since my highschool reunion but is on my friends list because, internet.

“Hey, I know we haven’t talked in a while, but I just thought I’d call to catch up.”
“Oh. Okay. Great. What’s up?”
“I don’t know. Not much. You’re still doing the whole doctor thing, right?”
“Yep. Third year of residency. Almost done.”
“Great. So you already have a medical license and everything.”
“Yes. That is something I have. 
“Yeah, yeah. So, I was just thinking, you wouldn’t happen to be able to prescribe me some Ambien, would you? I’ve been having a lot of trouble sleeping.”
“Uh, you should talk to your regular doctor about that.”
“I don’t really have one. I just thought this might be easier.”
“Easier, maybe. But I really can’t. I’m not your doctor.”
“I don’t really have insurance anymore.”
“Free clinics…”
“Come on, what kind of doctors are working at free clinics?”
“Doctors like me. Residents. I think it’d be fine, especially if you’re not working and can wait for a couple hours in a waiting room.”
“Ugh. That sounds terrible. What if I pay you– not like you’re selling drugs or anything like that, but if I’d have to pay a doctor anyway, I may as well pay a friend what I’d pay.”
“Not from me you won’t.”
“Come on. Be a friend?”
“Not a cool thing to want me to do, I promise.”
“Oh, well. Figured I’d try. See you around?”

I mean, really? We dont talk for years and then you hit me up as a dealer? I though I would be further into my career before that started happening

3) Fun

Oh clinic Patients, how I have missed you

“If I use the nicotine patch and the contraceptive patch, do they cancel each other out?”
“No.”
“What if I get them confused?”
“Don’t.”
“If my boyfriend uses condoms while I’m using the patch, do they cancel each other out?”
“No.”
“My friend has some kind of ring she uses as birth control. Can I get that even if I don’t know my ring size?”
*facepalm*

my schizophrenic patient is telling me she doesn’t want to take her very much necessary medication, because she doesn’t like how it looks.
“If you don’t take the medicine, you’re crazy.”
[long, awkward silence]
“I didn’t mean it like that.”
“No, it’s okay, I am crazy. I know I’m crazy.”
“You’re not crazy, you have an actual illness. I didn’t mean to call you crazy. The medication is important.”
“Well, if you think I’m taking it, you’re crazy.”

Really these should all be separate posts, but it’s just easier to stuff it into a super special post for you guys and then try and get back on track with multiple mini posts as they occur. Thank you, that will be all

-Dr J

Usually as part of a mental status exam, I ask patients who the President of the country is. If they don’t know that, it’s pretty bad. It’s kind of annoying when a patient refuses to answer on account of not liking the President.

This was my favorite response to that question:

“An asshole.”

And now some comics

I Talk a lot about what it’s like being a resident on here, and even more about the hospital behind the scenes that you dont see. 

But that got me thinking, what is it like behind the scenes as a patient? I spend a ton of time in the hospital and yet I am rarely sick enough to require it. But some patients seem to really enjoy their hospital experience while others remain miserable the whole way through. So what are some steps you and your loved ones can do to improve your hospital stay?

1. Bring something to do: a laptop, a book, a crossword puzzle. You are going to be left alone in your room a lot, and believe me counting the cracks in the ceiling gets old quick

2.Bring your own pillow. just trust me on this one. Comfort and sanitary issues of hospital pillows aside, the best thing you can do when you are sick is rest, the best way to rest is on a comfy pillow

3. Have an accurate and updated med list. If you are older than 50, you should have one of these on you at all times…especially in this electronic age, your doctor may only have a list of every medication you have ever been on, not just what you are taking now

4.Write down all your questions early.  Your doctor will only come to your room  once a day  (because they only get paid by Medicare to come once in a day) and any unanswered questions will have to wait until the following day.

Do you feel weird when your doctor is the same age as you?

There is always a slight amount of awkwardness on my part when I have patients my age in clinic. Not something I feel when patient are 5 years my junior, or 20 years my senior. A brief eye opening moment, of there but for the grace go I. Two 30 year olds walking into a room, one accepting the absolute authority of the other.

It doesnt affect my care, my treatment, or anything I do, but I guess I just have more a sense of awkwardness. If i were in their position, would I accept me as a doctor? Who is this guy to tell me how to live my life?

With our older patients, my fellow residents and I act like we know what it’s like to have to take 10 pills a day, or how easy it should be to lose weight and cant understand why patients aren’t following our instructions. With our younger patients, we have crossed the line into adulthood, joining the vast cabal of “grown-up” knowledge giving us our authority and right to tell them to have safe sex, stop smoking and the like.

WHen someone walks into the room who is my age, I always feel like I have been caught in the act. As though they are gonna call me out and be like, well you had everyone fooled for a while, but time to give up the game. Cmon, lets go grab a beer or something and you can tell me how this whole doctor thing worked out.

I wonder, will I ever settle comfortably into the white coat?

Things at work seemed to have settled back into a routine for now. Few interesting patients here and there, but I am still am not quite up to sharing stories and experiences yet. That said, one of the reasons I continue to maintain this site at all is to communicate, to learn, to teach, and just to have fun. It’s strange how I go through waves of activites. Some months I will write everyday, others I wont look at the computer, instead doing yoga, or playing video games until I simply get bored and return to one of my other hobbies for a while. I think however that it is time I start trying to write more again, because I miss all you guys and gals. We communicate only through comments and messages, with the rare exception of some of you who I have been fortunate enough to meet in real life, but that makes you no less a friend, and in some ways, you all still know me better than your real world counterparts, because I have the illusion of anonymity here.

Enough drama. On to something fun, (YAY! SCIENCE!) : the following is an excerpt from a BJU article about a lecture given in the 80′s on treatment for erectile dysfunction, long before the day and age of viagra and spam mail about penile enlargement.

http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2005.05797.x/full