Home Visits: Day 5 (Palode)

            Today, I made the 1.5 hour drive to Palode with Abbey, Jackie, and Mara, to work with Dr. Biacin and a team of nurses and volunteers from Pallium India. The day got off to a slow start when I woke up and was feeling pretty crappy, but lucky the Imodium kicked in just in time that I decided to go. We left our hotel at 7:45 am and followed another van with the Pallium team in it, and saw 8 or 9 patients throughout the day.

            The very first patient had undergone a leg amputation due to a vascular disease and diabetes. The man appeared to be in high spirits, and was laughing and carrying on with his son and neighbors that sat in on his appointment with us. He informed us, however, that he had applied for a disability pension from the government but was denied, leaving him without a stable income. One of the nurses explained to him that he has a right to know why he was denied under the “right to information” act or something to that effect, which I believe he was going to check into. I think that’s a testament to the fact that Pallium doesn’t just plug people full of meds and move on like sometimes happens elsewhere and even in the U.S, but takes it’s time with each patient to ensure well-rounded, holistic care.

            The next patient that stood out to me was a woman who had been diagnosed with cancer of the buccal mucosa (cheek), who was tearful when we entered and was very visibly in a lot of pain. She had undergone a partial mandibulectomy (had part of her lower jaw removed), and her tumor had grown and spread to both sides of her mouth. One one side, she appeared to have a blister or abscess of some kind which appeared to be infected, and on the other side, the tumor had broken through the skin and began to ooze. The woman had great difficulty talking, swallowing, and finding comfortable positions in bed which prevented pressure from being applied to her cheeks. The Pallium team prescribed her some pain medication to make her more comfortable, as well as an antibiotic to reduce the infection in her abscess. I can’t imagine living with something as painful as that must have been, but it was some consolation that she had a daughter that took very good care of her, and a small grandson to cheer her up.

            The next patient was an elderly man whose family was in the process of building a new house, and they were essentially living in a tent in the front of their new property while it was being build. Both of his legs were becoming gangrenous, and Dr. Biacin wanted to admit him to Pallium’s hospital for treatment, but the family refused because they were focused on building there house, and could not delay the process any more. Keep in mind, the family was physically building their own home, not a contractor or anything like that. Nonetheless, it was hard to see a family that didn’t understand the importance of getting their loved one medical treatment, despite encouragement from the Pallium team.

            The last patient that I won’t forget was a very elderly woman who lived alone in a small house in the forest. To be honest, I couldn’t even understand what her diagnosis was, but I don’t believe it was anything incredibly terminal. What really struck me was that she told us that her only son had gotten married 6 years ago and hadn’t come back to care for her ever since, which left her alone in a very remote house with no doors to fend for herself. The Pallium team had previously mentioned the option of selling her home and having her move into a home in the city, which she was somewhat open to. They made some phone calls today and discovered that it was her son who would have to take her to into the home and fill out the paperwork for various legal reasons, and she was convinced that he would never do this, because it would mean he likely wouldn’t get the money for her house and land. I was incredulous at the cruelty and selfishness of the situation, but attempted to refrain from passing judgment, as Dr. Raj had warned us that we must remember that we know very little of their backstory and family dynamics. The Pallium team then decided to call the police department and ask them to come out and assess the situation, as it could be considered abuse or neglect of a dependent person, in which case the woman could be taken to the nursing home and the need for the family to fill out legal paperwork could be overridden. I truly hope the police department arrives quickly and is able to help this woman out, because I can’t imagine living even one night in that home all alone when you can’t even get out of bed.

            After the home visits were through, we stopped at one of the volunteer’s family members’ restaurant for lunch, but I stuck to drinking water as I was beginning to feel pretty crummy again. The ride home thankfully went quickly, and I immediately went to bed to take a nap. I feel slightly better now, a few hours later, and am hopeful that I will have made an even bigger comeback when tomorrow morning rolls around so that I can be physically and mentally present for my final day of home visits. Until then, have a fabulous day, and thanks for reading!

The living quarters of the family in the process of building the new home.

This patient had used her clothes line to hang her IV.

The grandson of one of the patients. He was very playful and excited to see us!

Bidding our farewells.

Dr. Biacin examining a patient.

A rubber tree. The tree bark is cut around a portion of the trunk, and the sap (the thick white liquid) drains down into the cup. The sap is then mixed with a chemical similar to acetic acid and is layed in the sun to dry (see below).

Rubber sheets in the process of drying. The individual will then take the rubber to market and sell it for money.

Our team for the day!