March 4th, 2017 by Ashley Sweeney
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The drive back to Guwahati went smoothly. I caught my flight to Delhi and headed back to the YWCA for the night. My flight home was not until 9pm the next evening so one of the doctor’s sister-in-law took me around Delhi and we did some shopping. After cramming everything into my suitcases, I headed to the airport. There were no issues with any of my flights and I made it home safely after way too many hours of travelling.

I am so glad I had the opportunity to rotate with the physicians at BCH. While there, I saw patients with many medical conditions that I have not had the chance to see before and they taught me a lot.

I was also impressed by how cost-conscious the doctors were. It was not to a point that they were stingy or giving poor patient care but instead they were using sound clinical judgment to limit unnecessary tests wherever possible. I can’t honestly say I know how much the basic labs we get on hospitalized patients every day cost or how much a CT scan runs or how much an acute care visit to the PCP is; but they knew exactly how much that cost a patient. They also knew that running up these costs would keep the patient and family from eating or paying rent that month. This is something I think is important for physicians in the US to be aware of – especially with elders or families who live on a fixed income each month – because not infrequently we may be unaware of the true cost of healthcare to our patients.

March 1st, 2017 by Ashley Sweeney
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When I was on pediatrics, I got to witness the first administration of surfactant to a premature baby ever at BCH hospital. It was amazing to watch the pressures needed for ventilation drop once the baby received it.

In OB-GYN clinic, I saw grade 3 pelvic organ prolapse in a patient who unfortunately had had issues with it for years. The labor room was full all day and there were three births while I was on service.

On Saturday, I gave my presentation on interventional radiology to the staff with a focus on US-only based procedures. They are having a staff radiologist join later this year and were interested in hearing about low-resource interventions. I also made chocolate chip cookies for the other residents of the hostel (pictured below). I’ve never cooked in a microwave convection oven before but they turned out alright.

The last two days I was in “casualty” AKA the emergency department. There I saw a patient who had been bitten by a cobra! It seemed to me that the vast majority of patients who presented to the department were admitted. So many came in incredibly ill.

February 22nd, 2017 by Ashley Sweeney
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Orthopedics showed me more degloving injuries than I have ever seen in the rest of my training. Unfortunately many of them involved the patient’s hand which can be a devastating injury as it keeps them from working for a long time. The clinic was absolutely packed every day and all the patients seemed to love Dr. A.

On Saturday night, all the doctors got together for dinner and game night. My contribution was a stir-fry. We played things like charades and twenty questions. It was a lot of fun. Very early the next morning (I’m talking 4am early) one of the junior doctors and her friend and I left to go to Kaziranga National Park where we could ride an elephant in order to see the one-horned rhinocersus (which is a protected species). That was an unique experience!

The next two days I was on the medicine teams. The wards were always full and all the patients had family members with them. The doctors I worked with were conscious of how much every test and image they ordered cost and were particular about only ordering what was absolutely necessary in order to avoid undue financial burden for the patients. There was a patient with uremic encephalopathy whose case we discussed extensively to figure out what to do next as the patient’s family could not afford to move to a higher level of care.

February 15th, 2017 by Ashley Sweeney
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My second week started on radiology. Here the radiologist has to do the ultrasounds (as opposed to an ultrasound tech) and we did tons of them every day. I really enjoyed these days because I’m planning to go into radiology. Dr. P was good at teaching me about the findings we saw and about how to obtain the best images for diagnoses. I saw abdominal tuberculosis for the first time (and many more times after that).

On Sunday, we (one of the doctors and two of her friends and I) headed to the Kaziranga Orchid Park a couple hours away. The orchids weren’t quite in full bloom yet but the dalias were.

I spent one day in the ENT clinic. It’s a new specialty for the hospital and is a quickly-growing practice. I felt quite a few interesting thyroid nodules there.

The next day was travelling with the occupational therapy team. They travel to the community to provide in-clinic and in-home treatment for children with disabilities. We traveled to three homes where the OT staff taught everyone in the home how to help the child perform the strengthening exercises.

February 8th, 2017 by Ashley Sweeney
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The first morning in Tezpur I met my next door neighbor Dr. J who works in the medicine department. She helped me get oriented to the hostel and suggested several activities we could do over the course of the next few weeks together.

I started on surgery with Dr. S. It was so busy – I can’t imagine being the only general surgeon at the hospital. Every day were rounds, surgeries, minor procedures, clinic and rounds again. I also found the OR footwear to be most interesting.

The hospital still has a traditional set-up with a male ward and a female ward in each department and a few private rooms. During morning rounds, the doctor writes a prescription for the family of any supplies or medications needed for the day with the patient’s family then purchases and brings back to the patient’s bedside.

After a few days on surgery, I moved to the radiology department where Dr. P was visiting the hospital for a few weeks. He is planning to come work there full-time starting at the end of the year. When he’s not there, the patients have to go into town for ultrasound exams at a private radiology office. X-rays and CT imaging is obtained at the hospital and read by outside radiologists.

In the evenings, the other residents at the hostel (who all work at the hospital in some capacity) taught me how to play badminton. I’m quite awful at it.

February 3rd, 2017 by Ashley Sweeney
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I started my travels on January 29th and didn’t make it to my final destination until Feburary 2nd…granted a couple days in Delhi and Agra were thrown in there.

The flight from Dallas to Abu Dhabi was the longest I have ever been on. Fortunately, I had an empty seat next to me. On arrival to Delhi, all my luggage had made it (yay!) and I headed outside to wait for the driver to find me. Once he did, it was off to orientation at the EHA Central Office followed by some clothes shopping followed by a most sound night of sleep.

The next day I went to Agra to see the Taj Mahal and Red Fort. The Taj Mahal is beautiful and definitely worth a visit. The Red Fort is massive and has lots of interesting history.

The subsequent day I headed back to the airport for my flight to Guwahati. Arrival there was kind of scary because I did not know how I was supposed to find the driver who was meeting me. No matter though – I stuck out like a sore thumb and he quickly found me. After stopping at KFC (yes – you read that right!) and picking up some other hospital employees in Guwahati, we settled in for a five-hour drive to Tezpur.

I made to my final destination at last!

January 29th, 2017 by INMED
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Hello! My name is Ashley Sweeney. I am a medical student at the University of Missouri – Columbia, and I’m starting my INMED service-learning experience at Tezpur Hospital (Emmanuel Hospital Association) in India in beginning in January 2017