Week 3: Mussoorie

Howdy once again friends:

My remaining days have been action-packed here in India with a lot of traveling. After Rishikesh I headed back into the upper foothills to Mussoorie for a short work week with some great folks. As I mentioned earlier, Mussoorie is a touristy "hill station" but on the backside of the hill from the tourists and busy malls and markets there is a peaceful little community called Landour, which is where the hospital is located.

Landour Community Hospital (difficult to get a proper photo b/c it's on a steep incline)

My digs at Landour was a converted hospital room just across from the OR, which meant I got to see all the late night emergent operations :-)

Landour Community Hospital was built 75 years ago by British missionaries so the architecture of the hospital has a colonial charm including wood-framed windows and an epic hardwood staircase in the center of the three story building. The hospital is affiliated with Emmanuel Hospital Alliance, which is an organization who's mission involves fixing and rebuilding a lot of the old, run-down missionary hospitals throughout India. The hospital serves the town of Mussoorie-Landour as well as the surrounding village communities.

The hospital runs on the German system of health care and involves "smart cards" - actual cards that patients carry with them - so that patients under a certain level of poverty and pregnant women get free care and the remaining patients pay fixed rates. I had a look at the price list of services and most labs were between 50 and 100 rupees ($1.00 - $2.50). An echo-cardiogram costs 1500 rupees ($30). It's easy for myself and westerners to look at these prices and believe that everyone in India should be able to afford these prices but you must keep in mind that an entire family could live comfortably for months on 1500 rupees. Most meals in India are under 50 rupees (you can eat VERY well for 50 rupees, or 1 dollar); in fact, with some clever financial maneuvering you could very well feed an entire family for 50 rupees.

The hospital staff is diverse and includes Indians, Americans, and New Zealanders so it was really great to work with physicians with experience in the western world as well as India (and also to have some conversations in English and talk about March Madness). There is a general surgeon (Dr. Uttam), a pediatrician (Dr. Jakob), a general practitioner (Dr. Joe Weaver), a Ob/Gyn (Dr. Sima Weaver), and an orthopedic surgeon (Dr. Alex). There were even a few other medical students: Natalie, a PGY1 from Memphis and Eddy and MS3 from Leeds, UK. The professional and collegial atmosphere at Landour is incredible and it is clear that physician and staff satisfaction and quality of life is very high. The physicians are recruited by Catholic Charities so that all physicians are Catholic and the nursing staff are all nuns. Each day begins with a short prayer mass at 8:00am. Then all the physicians round at the same time so that if problems or questions arise there is instant consultation between physicians ans nursing staff.

The hospital census and clinic was a little slow during my few short days at Landour but I was able to scrub into and experience a few surgeries, including several cesarean sections, lateral sphincterotomies, and some really cool orthopedic cases. I was amazed at the technology in the ORs of Landour, including orthoscopic arthoplasty (ACL repair done with minimally invasive techniques and video scopes). The techniques were identical to what I saw on my surgery rotations in America with the exception of higher technology like optic fiber wiring and high definition screens.

Dr. Alex and his colleague repair an ACL.

Minimally invasive.

The hospital and clinical experience at Landour was excellent but the true highlight of the week was the nature and peacefulness of the hills behind the hospital. The network of trails and viewpoints from above the hospital were unreal! It was like a whole new world: there were maintained trails, garbage cans with inspirational green quotes, and - get this - "no honking" signs! Whaaat!? I learned that these changes are due to the fact that there is a world-famous boarding school - Woodstock School - also nestled in the hill by the hospital and that the international staff at the school have made this green sanctuary their own over the past 50 years. I was told that from the highest point of the hills (appx 7,000 ft) there are great views of the Garwhal Himalayas on clear days. I awoke every morning at 5:30 am in hopes that the sky would be clear but had no such luck but I did capture some pretty great shots none the less.

I had to depart Landour a bit early to start my trip east into the high Himalayas. Will write another post soon detailing that trip - hope everyone is doing well back home - I'm getting excited to return :-)

Indeed.

Trails above Landour

7000 ft. sub alpine forest

My hiking partner Natalie. It was great having some American companionship.

Mussoorie-Landour by dawn.

Sunrise through the forest.

Didn't get to see snow-peaked mountain tops but this made up for it!