what we do

I have hesitated to write about what goes on at Kalighat on a daily basis. I am not entirely sure why; there is nothing going on there that I'm afraid of, however, I think I hesitated to commit my thoughts and impressions publicly as I knew initial impressions never see a complete story.

It is Wednesday. We have volunteered for about ten mornings so far. Thursdays are off for all volunteers and we decided to go to a Protestant church this past Sunday: that left ten other mornings since we registered.

I have previously written about the regular routine: essentially we begin by making beds, doing laundry by hand or helping them brush their teeth (or tooth as is also quite common). After this there is a general hanging out with the ladies: colouring, nail painting, giving medicine, dressing wounds and physical therapy. We have break from 10:30-11 and at 11 it is lunch time and then bed. Throughout all of this there are ladies who need help going to the bathroom: either physically going to the room or having the bathroom brought to them. 

If I'm feeling social I'll head to help with laundry. That was on the first couple of days but I have not helped with laundry for the past week. (But, have no fear, there is an abundance of volunteers so there are more than enough hands helping out.) Instead, after I arrive I just plop myself down amidst the ladies sitting on their benches. Some of them holler at me in Bengali (I think) and I have no problem hollering right back. Some use aggressive hand gestures, and then so do I. The calm, demure residents often get a calm, demure Rachael in return or they'll get an excited one to try to liven things up a bit. I was told today by a Massi (an Indian lady who works in the home) that three ladies were fighting because of me...not entirely sure why as I thought I equally distributed attention. Regardless, it makes me laugh. I often have full-on conversations with the ladies. Do I know a lick of Bengali? Heck no. Do I play along and constantly translate? You betcha.They often speak to me with such passion that it is super fun to translate as we go. I even had a volunteer ask me this week where I learned Bengali. Boy do I have them fooled.

It is funny to sit with them as they take their daily medication. Some of them wait for it like it's candy, others try to hide it avoid taking it. Sometimes their mouths need to be pried open. All in a day's work, I suppose.

On her first day Teresa was recruited to work with Shanti, a 40 year old lady, on her physical therapy. The therapist is there on most days so he and Katherine have showed Teresa the daily routine. The hope is that Shanti can gain strength in her left side so maybe she can walk someday. We learned today that she was born with what she has and has never walked. This changed my hopefulness of the situation, but we'll still work with her. She reminds me of Adah from The Poisonwood Bible by Barbara Kingsolver as half of Shanti's body doesn't work. She does exercises where she uses her right arm and leg to life the other arm/leg so hopefully her brain remembers this pattern and, eventually, will move the left arm/leg on its own.

Physical therapy seems to be "our" thing - the therapist recruited me yesterday as we'll still be here for a while. He wanted to teach me the exercises for two other patients (one that Katherine has worked with during her time here, but her last day was today). He rifled through the instructions rapid-fire so I found myself slightly lost and forgetful today. He went over exercises, how to massage muscles etc...and pressure points. Whatever I couldn't remember, I made up based on the needs of the patient. I helped some around me make their exercises more effective ie holding their leg in a bit of a lower position so as to maximize the strength-building potential and minimizing the effects of gravity in the exercise. It has been interesting to dig deep into my Kinesiology days.

I also find myself being with patients as they get their wounds attended to. The stuff that goes on here in that regard is not for the faint of heart. The sisters take care of treating all the wounds: some days I am thankful for this and other days I wish I could be the one doing the actual care. I somehow always manage to be nearby. Many of the wounds here are bed sores/pressure ulcers gone terribly wrong. Let me tell you about some of them (queasy stomachs should stop here). When people with injuries first arrive, the Sisters clean out/remove/cut away all the dead skin and tissue. This is quite the task sometimes. On Saturday a lady with an infected food came in and so the Sister had to remove maggots, some deeply embedded. Sadly, when ladies first come in, maggot infested injuries are common. After they remove the dead flesh and tissue (honestly, it's a dark, deathly black) they use iodine and other things to clean it out, they'll pack the wound (if necessary) and re-bandage it. Rarely (if ever, I'm trying to be gracious) have I seen anaesthetic used. Again, I'm not in there cleaning the injuries out - the older sister is teaching the novice sister how to care for wounds - I'm chillin' with the patient but I'm observing everything and soaking it all up. It's biology in real life and it is simply fascinating. Here are some of the patients I've been around:

• one younger lady was bit by a dog on her left shin. The injury is now down to the shinbone and accompanying muscle and is a rectangle about a quarter of a regular piece of paper. It's just open and raw. When bandages (and, consequently, some flesh) is removed, she doesn't flinch.
• there is a diabetic lady whose right foot is disappearing quickly. She has only been here for a couple of days but I got to see the wound yesterday. Her second toe is just a bone; there is nothing left on it. She has a gaping wound on both the top and bottom of her foot. Although they aren't yet connected, it appears as though a complete hole is imminent. Her open wound on the bottom is open flesh from her toes to just before her heel.
• there are a number of patients with bed sores, but I'm only going to talk about two of them. First of all there is Maya Singh who has been here for about a week. She is a 'success' story I suppose, at least in terms of her spirit. When she joined us she was in excruciating pain (I gathered) and cried a lot. She did not exude much joy. She has gaping bed sores on her hip and lower back so sitting and laying is just plain painful so there is grace for no joy. Initially we saw some of the massi's treat her roughly, according to our standards, so Teresa and I have taken it upon ourselves to look out for Maya Singh whenever we are there. We will hoist her on to the bed to have her wounds treated and we'll gently lay her in her bed to sleep. Some of her wounds are healing well so, I would think, she is in less pain and this affects her overall demeanour. It's fun to see the change. When she was getting her wounds attended on Monday both Teresa and I were with her the whole time holding her hand and talking happily to her. At one point I said, "ice cream, rainbows, unicorns" and she repeated "unicorn". It made us laugh. She also likes to repeate her name, "Good morning, Maya Singh" with a response of: "Maya Singh. Maya Singh". We like her.
• now for another bed sore lady. To be Frank (yep, that's Teresa's gift to you), I do not expect her to be alive much longer. I'm surprised she's still here. Clearly she is a fighter. She seems younger and has extraordinarily huge bed sores - one in particular. She has gaping holes throughout her body: hip, heel (there is no heel), knee etc...but her lower back ceases to exist. I saw it yesterday and it is the width of my wrist to elbow, close to a palm print high and is inches deep. There is nothing left except a hole and even yesterday the made the hole bigger as they cut off newly black flesh. I am hoping that her nerves are just shot or they're giving her constant morphine (which, according to my research is NOT done here) because if she feels the pain from all these wounds she is more than a champ. Her feet are swollen and legs are sticks. Yesterday, in case her other wounds weren't enough, they began to address the one on her head which had previously been unattended. It is cases like this where the euthanasia debate can't be simplistically dismissed. In this country she can NOT have full healing. It is impossible for her body to repair that hole. At the very least she'd need a skin graft, which will not happen here. She is developing more sores regularly. So...I'm glad I'm not in charge.

Those are some of our stories. If you want generalities, Teresa and I interact with the patients. I daresay we try our best to treat them like humans. We talk with them, listen to them, and if they yell at us, we yell right back (yeah for our Greek and Italian cultural exposure!) Teresa has been immersed in, and on Friday I will begin, the physical therapy world. We are now well versed in the language of bed pans and we are go-to's to lift patients in and out of chairs and beds ("you strong, Auntie. You strong!")                              

I wouldn't call our days exciting but they are fun. I am not yet ready to measure impact or necessity or whether our actions are worthwhile but I am certain they are not detrimental. We will continue to plod along for (up to) another four weeks.