Don't Hate The Player, Hate The Game

The weekend in Dehli was just for fun. A few days ago I arrived in Chandigarh to get down to business. My mom and I took the Shatabdi Express, the newest and fastest AC train available, to get there. It was a tough ride- pretty smooth and all, but within the first 10 minutes I discovered I had to go pee. Little did I know this innocent call of nature would cause me to almost flip my shit. To my surprise, the toilet was a squatting, not a sitting, toilet, but I rolled with it anyway. I know how to aim, I thought. Then there were 3 different buttons to press for it to flush, apparently they kept dying and had to be replaced. But I eventually figured that out too. The really tough part was when I was all done and had to get out. I couldn't open the door. It was the kind of door that you had to pull in to open and push out to allow it to spread out and close. I tried and tried to pull it hard enough for it to open, trying to stay calm. After about three minutes, the claustrophobia started to kick in. Somehow, miraculously, I managed to open the door within the next minute. Another 30 seconds stuck in there and I might've started to cry. Now that would have been really embarrassing, not good for my street cred at all.

On a more serious note, I found it rather hard to ride in the air conditioning, devour the breakfast that was served to me, and sip on my little carton of mango juice while the view outside was largely a long string of slums, of hardship and poverty, of people planting and plowing with only their manpower to aid them. It really sunk in that the gap between the rich and the poor in India was in fact a gaping, bottomless pit. Like I said, it was a tough ride.

...

Most of you vaguely know that I'm here to do thesis research, and that's about it. In more detail, I'm working with a couple of dermatologists at the Post Graduate Institute of Medical Education and Research (PGIMER or just PGI for short) to recruit patients for an ethnographic study that will hopefully be the basis of my thesis in medical anthropology and health policy. My research revolves around vitiligo (aka leukoderma aka safed daag aka phulveri), which is a skin condition characterized by a loss of pigment, or basically an appearance white spots onthe skin, which I have myself. Vitiligo is often reduced to a cosmetic condition, and the psychological, emotional, and social health of patients is largely ignored. My research will focus on the lived experience of a handful of Punjabi women with the skin condition, and explore if and how vitiligo is gendered in the context of socially accepted ideals of beauty, normality, and marriage customs. I’ll also be interviewing patients’ family members to get an outside perspective on the condition and learn more about the social stigma surrounding it. In addition, I hope to interview some doctors/hospital administrators to investigate if there is a health policy component to the condition, like a glaring inequality in access to treatment.

But enough of the academic speak. My first day at PGI had mixed results. An autorickshaw took me to Nehru Hospital on campus, and the first thing I thought was, this is rather mediocre-looking (the picture on the right is the New OPD, which is where I actually do my research). Then on my way in, there were sick people (you're probably thinking no shit, it's a hospital), but they were everywhere- not just inside, but outside as well, which made me kind of sad. Then as I got closer to the dermatology unit I went into Christina Yang mode and started to get really excited about the rawness of the medicine conducted there.

I arrived at the office of the dermatologist I had been in touch with. He was exactly as his profile picture had captured him, except he smiled underneath his large mustache when I came in. He was on the phone explaining how to treat some toe infection involving a lot of puss, so I decided to make myself at home and jump into anthropologist mode, taking notes on the ethnographic space. I looked up at his whiteboard, and the first thing I scribbled down was the William Osler quote he had written there. "The practice of medicine is an art, not a trade; a calling, not a business." Brilliant. I looked to his desk and found a little calendar of daily words of wisdom. That day's quote was that all things are difficult before they are easy. Then I recalled all of his groundbreaking research and published articles on vitiligo treatments. I grinned and thought to myself, I want to be just like him when I grow up. He left for a brief while to tend to a patient, while I did some more snooping and note-taking. At one point, the power went out (a common occurrence here, only Americans freak out about it), and I sat there thinking, hmm, it will be a little odd if he finds me sitting here alone, in the dark, or worse, if someone else comes looking for him and finds me sitting here alone, in the dark. Luckily the power was back within a few minutes and I acted like it didn’t phase me.

Next stop was his boss’s office. He wasn’t nearly as cool. Unforch, he's the one I work with on a daily basis. I went into his office, and gave him a bag of pistachio nuts and almonds and shit in a gift bag (you'll only get this if you're Indian), to which he said, "Oh, you shouldn't have!" and proceeded to half-place and half-throw it aside. "So what is your research about again? If you don’t mind me asking, are you taking some treatment for yourself? So you’re not an actual doctor?” I was a bit annoyed (didn’t you read the email I sent you hella months ago foolio?), but I began to explain. I was cut off somewhere in the middle when his cell phone rang and he quickly said something bossy to the person on the other end in Punjabi. I continued, in English, because he was thoroughly unimpressed by my Punjabi, something to which I took great offense. Two minutes later his regular phone rang. It was then that I noticed this scared looking guy sitting in the corner of the room. Throughout my visit to the office, my boss (if you will) barked orders at him. Poor guy. Grow a backbone for god’s sake. Sort of reminded me of Peter Pettigrew- not to extend the metaphor to his boss and put him on the level of Lord Voldemort (yeah, I said it) or anything.

At the end of our convo, I smiled and thanked Mr. Boss profusely, because I knew he expected it. I was a little annoyed at myself for mimicking the behavior of his backbone-less intern or whoever he was, but oh well. The man must be brilliant or something, because he is the head of the dermatology department. And I probably don’t know him well enough to judge him, but I respect the kind of doctors who don’t just treat the biological component of an illness, but who choose to take a more comprehensive approach and treat the patient, the person as a whole, because there is usually so much more to it. When treating a patient with vitiligo, if all a dermatologist sees are white spots, they aren’t much better than any other person on the street who chooses to stop and stare or ask inquisitive questions laced with judgment. Skin conditions are unique, and such dermatologists are only putting band-aids on wounds that are much deeper and require much more healing and attention than most patients get. This practice is in no way unique to India, though. Nearly every American dermatologist and every curious American passerby I've met has had the same mindset. So maybe I shouldn’t hate the player, I should hate the game. Better yet, maybe I’ll try and change the game.