I arrive on schedule at Shamshabad and am met by our driver for the next two weeks. He has the same name as my old driver from my previous trips. I ponder this as we make the one hour trip to my uncle’s place in Secunderabad. On the way, I observe the architectural marvels of Hyderabad.
Upon arrival to my family’s home, I access the internet and realize that I have a meeting in a few hours. I have stationed two students here for the summer. One, Mounica, is a rising second year medical student. The second, Sameera, is getting her MPH at BU. They have been working primarily at Nireekshana, an NGO that works in HIV. They are expecting me after lunch in order to provide me with a report of their activities. I am feeling spectacular despite the arduous journey and 4 hour layover in Mumbai, and am more than ready to tackle some actual work. Mounica assures me that I will start feeling sleepy at 1pm. She takes me for an amateur, clearly. I scoff and say I will see her shortly.
I head off with the driver at noon, anticipating a long drive through lunchtime traffic. By 12:30 I cannot keep my eyes open for more than 3-4 seconds at a time and by the time we eventually make it to Narayanaguda and find the entrance to Nireekshana I am sleeping soundly. I get out and greet Mounica, who is waiting at the door, with extra enthusiasm to show that I am nothing if not awake and alert, and maybe even hypervigilant. We go inside, and I see my friend Dr. Ravi Barigala, a US-trained ID doc who is the only ID specialist in the organization.
Ravi has been kind enough to take Mounica and Sameera under his wing, and arrange for them to work on some educational projects that will be described separately. He takes me in to see a couple of patients with him. One has longstanding bilateral lower extremity edema that has become superinfected. Another has a paronychia that has been present on the order of weeks – treated only with courses of antibiotics since the patient has been unable to find someone who will do a minor procedure for her. There is some suspicion that this has to do with her HIV status, but it is not clear. Ravi actually removed the nail and drained the finger a week previously with good results. Since he has returned to India, he has found himself doing many such procedures, much to his surprise.
I get the update from my students, am told a few times that I look exhausted, and take my leave to go home and get some rest. It has been a good first day. Some project work, some patients, and catching up with a friend. I am excited to be back.