Home Visits: Day 6 (Muttacadu)

            Today, I traveled to Muttacadu with Aparna, a Pallium doctor, and a Pallium nurse for our final day of home visits in India. It was a bitter-sweet day because I must admit, I’m getting rather homesick as we approach the end of our 3 weeks here, but at the same time, our time here went very quickly and I’ll be sad to leave.

            Our first patient was a younger man with encephalitis. The house was too small for Aparna and I to step into so we watched the chickens as the doctor did the visit. However, when we were leaving, the mother of the patient brought an ulcer on her foot to our attention, that she said hadn’t been healing. When she showed it to us, I couldn’t believe she wasn’t showing more signs of pain. The ulcer was massive, covering almost the entire ball of her foot, and was so deep that you could see her bone. I have no idea how she was still walking on it. Aparna and I were in disbelief. She followed us to the van where they gave her a bandage and some medications, which I believe were antibiotics, to prevent the ulcer from becoming infected and hopefully helping it to heal.

            The next patient that stood out to me was a very elderly woman who was bed ridden due to both old age as well as a cancer that had metastasized to her lungs and her liver. I could immediately tell that she was very near the end of her life, as she appeared to be in delirium as she uttered inaudible, broken phrases among her labored breathing. She no longer responded to her name when called upon, nor to any sort of auditory stimulus. The doctor told us that she had huge pressure ulcers on her back and bottom, the largest of which measuring 15x15 cm. She pointed out the numerous flies that were flying specifically around the patient, and later informed us that she believed that the flies had laid eggs in her pressure ulcers, and that she expects to find maggots (fly larvae) in the ulcers during her next home visit (if the patient lived that long). She would then have to remove the maggots, one by one, and rewrap the ulcers, hoping that the flies wouldn’t be able to find a way inside of the bandages again to lay more eggs. My heart sank at this news, both out of sympathy for the patient as well as frustration that she had no choice but to remain in this environment, which was so inhibitory to her comfort and well being.
            In conclusion, I am very fortunate to have been given this opportunity to go into people's homes in a foreign country to gain a new perspective into the world of palliative care, healthcare, and life in general. In my reflections, I had one dilemma that I could not shake, but I'll go into that more later. For now, here's some pictures from our day in Muttacadu. Thanks for reading!

One of the chickens decided he wanted in on the doctor's visit, so he strolled right into the home of the patient.

Aparna and I discovered this grave in the backyard of one of the patients. We asked the doctor why they would bury someone in their backyard, and she explained that the patient's father was buried there, and that this was a fairly common practice for people who cannot afford to be buried in a cemetery.

Jackfruits growing in a tree along the path into the patient's home.

One of the children I gave a Hawkeye bead necklace to.

Two grandchildren of a patient who were happy to be decked out in Hawkeye spirit with a beaded necklace and a tiger hawk tattoo to support Team Iowa.