Arabian nights

In addition to our nursing studies in and around Manipal, this month in India is also an opportunity to explore the local - and not so local - attractions of a country that none of us besides Elissa have ever visited before, and probably will never have to chance to visit again. We only have a couple of weekends remaining here, already earmarked for ambitious trips farther afield, to Mysore (to see the Mysore Palace) and Delhi/Agra (to see the Taj Mahal). On weeknights, though, we will sometimes have the opportunity to venture out on smaller off-campus excursions. Our first such adventure was to the seaside town of Malpe, located just west of Manipal on the Arabian Sea.

You may remember from an earlier post that Manipal University specifically prohibits students from swimming in the ocean, which according to Elissa has little to do with the water quality and more to do with the fact that, by and large, Indians don't know how to swim. In the recent past, some high-profile drownings have occurred after university students ventured into the water, prompting the school to take a firm stance against beach outings. Of course, there's no way to actually enforce what students do away from campus, so we departed about an hour before sunset and summoned two cabs to drive us the half hour to Malpe.

The taxi journey was, per usual, a fear-filled joyride through the manic traffic patterns we now know to be typical of all Indian roads. At first it appeared that the car had no seat belts, but after some rummaging between the cushions Cody discovered that they had simply been tucked deeply out of view; as she struggled to extricate them the driver turned around and said "no problem, no problem," making a dismissive motion with his hand. Ignoring him, we defiantly clicked the belts into place. There may not be much we can do to ensure our own safety on these treacherous roads, but I've seen enough of the hospital system to know that I'd like to avoid a trip to the ER - or as they call it here, with unsettling nuance, "Casualty."

We had been riding for about fifteen minutes when we saw the dog. He was ahead of us in the lane, clearly hit but not yet dead, all four paws kicking skyward in a panic as he lay belly-up on the pavement. "I can't look at that," Cody murmured, turning her head away. The car swerved right in a wide arc and I made one fleeting glance backwards, hoping the dog would flip over and run away, but he seemed fixed in place. Motorists and pedestrians gave a wide berth; no one, certainly, would venture into the busy street to assist or dispatch a dying stray. Uneasy smalltalk in the car resumed. I tipped my head back to keep the tears welling in my eyes from spilling down my face.

It was, I suppose, inevitable that I would witness a scene like this, given the sheer number of animals on the streets and the reckless operation of motor vehicles. As the driver slowed to a stop and deposited us at the entrance to the beach, I wondered if the dog had succumbed to his injuries, or if he had been hit again, or if he was still in the same spot, suffering, writhing in pain. Unbidden, a quotation printed in the Visa section of my passport came back to me.  Later, at home, I flipped to the page and confirmed the wording of the excerpt I'd read and reread in every boring airport queue and baggage claim and College Bus ride that led up to this moment: "We send thanks to all the Animal life in the world. They have many things to teach us as people. We are glad they are still here and we hope it will always be so."

I thought about the dog as we regrouped on the beach, walked down to the water's edge and stared toward Boston and the sunset, sunk our feet into the warm, pale green water and took photos in the surf. I thought about it as yet another random Indian woman asked permission to pose with some members of our group, as people often seem to do here when they spot the unusual sight of so many white girls wearing kurtas. I thought about it as Shira traced "MGH IHP 2016" into the tawny sand and Elissa snapped a picture of the seven of us, smiling. I thought about the way I'd never stop thinking about it, and how I've never been good at letting go of the things that haunt me, and how that might not be the best quality one can have in a job where every day has the potential to bring some fresh tragedy through the clinic door. I thought about helplessness.

I don't know that I'll ever look at the photos from this otherwise picturesque night on the Arabian Sea and not recall the upsetting drive that brought us there, but when I'm being honest with myself, I don't want to. When people back home ask me what India is like, I'll tell the truth - that it's both inspiring and unpardonable, hard to look at and hard to look away from, a country striving to realize its potential but still steeped in its old problems. I'll say I've already learned more than I thought possible in one short week here, and that I'm privileged to have three more to go. I'll say that I've met brilliant, genuine, welcoming clinicians and top-tier researchers who are advancing the practice of medicine year by year, study by study, with far fewer resources at their disposal than what we in the United States take for granted. And I'll say that it's been hard to reconcile this country's obvious desire for high quality healthcare with the cultural impediments that push that goal just out of reach. I'll say that I've seen troubling disregard for sterile technique, and malnutrition worse than any hunger I will ever know, and inpatient conditions reminiscent of a Crimean War hospital prior to the arrival of Florence Nightingale. I'll say that here, like everywhere, you choose what you take home with you, and that some parts of this trip have been incredible, and some parts have been unbearable, but here we all are, bearing it.

I'll say that I'll never forget a day I spent here. And I'll mean it.