“Into the woods to journey’s end…”

Intro: With the advent of the digital age, and the ever-increasing availability and exchange of information on a global scale, one might presume that regional and national culture would be disappearing in favor of world-wide homogenization. The pressures of globalization are exerted especially forcefully in airports given the high volume of passengers exchanging culture and, probably most importantly, supplying demand for global wares on a local level. Have airports, as an early indicator for the broader population they service, succumbed to these pressures? Is Chennai significantly different than Chicago? Dubuque from Delhi? Or will I find the salty aroma of Chili’s ToGo and the calm pleasures of Hudson News the world over?

Methods: I began a prospective cross-sectional cohort study, n=1, to study whether regional and national identity has persevered or perished in airports on three continents. My project encompassed 4 flights across 3 continents on 3 different carriers. My point of embarkation was Detroit, MI, USA (Detroit Metro) from which I traveled Chicago, IL, USA (O’Hare Int’l). Next was Chicago to Brussels, Belgium (Brussels Airport) aboard American Airlines. From Brussels I continued to Chennai, Tamil Nadu, India (Chennai Int’l) with Jet Airways, before connecting to Hyderabad, Andhra Pradesh, India (Rajiv Gandhi) on SpiceJet. Variables to be observed included (but not restricted to): regional food and design influences, overall “cuteness,” crowd control, security protocol, baggage claim, and facilities available to the “economy” traveler.

Results: Flight times to arrive at the various airports as well as the amount of time spent at each site is depicted in Table 1.

Table 1	Detroit	Chicago	Brussels	Chennai	Hyderabad
Time on site	2:00	4:30	2:30	9:00	trace
Flight time	—	1:10	7:30	9:30	0:55

Detroit/Chicago: Both American airports and very similar, familiar. Detroit security was a tad sluggish given the relatively low volume. Same old routine – shoes off, belt off, watch off, bags down, computer out, reverse. As expected the plane arriving from O’Hare was late, so the returning flight from Detroit to Chicago was delayed. Chicago was, as always, very busy. Hudson News – check. $8 Turkey sandwich with white bread – check.

Brussels: The trans-atlantic journey on board the AA 777 was actually much more pleasant than I expected, and as it turns out, the 777 is a pretty sweet ride. Smooth landing, smooth take-off, plenty of leg room and a braised beef for dinner that was actually respectable (although the AM croissant did not fare as well during the journey).

Upon arriving in Brussels I was graced by a vision of the ideal European airport. We landed on a serene pasture amongst lush rolling hills draped in a delicate fog. The airport is a testament to efficiency of design. It is quite large, but never betrays its size except to those whose gates happen to be at the end of the terminals. Lines move quickly, the exterior is simple and minimizes the industrial clutter of most airport terminals while the inside is sleek, minimal, appointed with conveniences like international outlets, and impeccably clean. The security personnel were all friendly and fluent in English, and possessed the air of professionals, as if those who did not have a PhD in security screenings need not apply. Even the more detailed screenings, often a humiliating and frustrating experience in the US as one has to slowly, awkwardly remove clothing items and inconspicuous piercings before a crowd of onlookers while the baggage handler tears through a duffle bag before suspiciously eyeing (and eventually discarding) a 4.1 oz bottle of saline solution, is more enjoyable in Brussels. Take out all the contents of my bag? I’d be happy to. You want me to place a few drops of visine into my hand? Gladly – hell, I’ll drink it if you want. There’s none of the rush, none of the pressure, and none of the air of misdirected aspersion synonymous with the TSA-USA.

The Europeans, presumably Belgians, within the airport also fit well into the aesthetic schema. Everyone appeared well cared-for, with a normal BMI, and effortless style that was layered but not fussy, comfortable but not sloppy. Of course all this style comes at a price. My solo purchase in Brussels, nestled amongst the pastry and Toblerone, was a small bottle of water for 3.20 euros ($5-ish). For a moment, as I was waiting at the gate during my brief layover and surrounded by such lovely circumstances, I contemplated abandoning my plans and taking off into the Belgian beyond. But then I remembered that at 3.20 euros a piece, the glamorous life would have to wait. On to Chennai!

(to be continued in the next volume)

Frantic but excited

I am no stranger to India, as most of you know. But this time it feels a little different, for one thing I am not afraid of getting Hepatitis A (confirmed past exposure, immune for life!) and I will be taking malaria pills. This time I have a different perspective and a lot to learn. See you all there

Cle to Hyd

I think the team is slowly gathering in India one by one but fortunately I get to travel with 3 sharp girls -we leave tomorrow 11:25 and arrive at Hyderabad 11:15 pm local time Saturday with a little layover in Philly and Frankfurt

There’s a nice mix of people and backgrounds going so it’ll be nice to have the different viewpoints of all our experiences- It’ll be really interesting to see the different presentations of all these diseases that I wasnt 100% convinced existed when learning about them..

One of the other specific things I’ll be interested at looking for is the Hyderabad IT and pharmaceutical industries- I always though Bangalore was the silicon valley of India but apparently the development centers for many fortune 500 IT companies have blown up in Hyderabad

Well, most of the packing is done and the agenda is set- only thing now is to figure out how to kill all that time over the next 2 days…

Leaving on a jet plane…

I can’t believe it’s already time to go to India.  I’ve been running around like a crazy person all week trying to get everything together.  Ready or not, the plane is leaving tomorrow morning!  I’m glad that Puja, Christina, and Waqas are traveling with me.

I’m very excited to see India–I’ve never been so far from home before!  Even though I’ve been reading about the country a lot in the last several months, it’s still quite a blank canvas for me.  The words and food are still unfamiliar to me–I continue to refer to Indian food by the color as in, “Can I have some more orange chicken and green stuff?”  I’ve asked Puja the name of the outfit I’m wearing to the wedding about a thousand times!

I’m anticipating that the poverty is going to be heartbreaking and difficult to see.  I’m excited about the diseases that we are going to encounter there (which my family thinks is crazy..).  I can’t wait to put a “face” to the diseases I’ve been reading about.  This experience is going to be very helpful for my future career.

26 hours and counting…better get going on the to do list!

The Last Minute

This is it I guess. I’ll be leaving tomorrow afternoon to drive to Ann Arbor before departing from the Detroit airport Thursday. Since finishing up my last rotation I feel like I’ve been doing 1000 things all at once yet still getting nothing done! Picking up last minute items, figuring out how to use the camera I’m taking with me, and trying to get some things pulled together for residency applications which, of course, open the day after I get back from India! (Oh yeah and trying to figure what residency I’m even going to do!) Somehow in the midst of everything my date of departure snuck up out of nowhere. I’ve been planning some form of this trip for so long that it’s sort of unbelievable it’s actually here.

I have been and continue to be very very excited for this trip. This is definitely the most exotic location I’ve ever visited, and I feel so fortunate for the opportunity to be there for a whole month. However, only in the past few days have other reservations crept into the back of my mind. Generally I’m very flexible in terms of my surroundings – I can go with the flow, and I’m pretty happy wherever I go. But what if it’s too different there? Will I love it, or wish I was back home? Have I packed enough? Too much (is there such a thing!)? Am I going to stick out as a 6 foot white guy everywhere I go? Will I be able to feed my caffeine addiction sufficiently? Can I seriously not eat fresh vegetables for a month?

But the food… Perhaps the only thing I’m more excited about than the prospect of seeing (and perhaps being surrounded by) monkeys is the fact that I get to eat delicious regional foods for a whole month. I couldn’t be more excited! Enteritis be damned. Bring it on!

Tomorrow is the BIG day…

It is the night before I leave for India.  Ayrel and I have used wonderful Gina’s comprehensive list of things to take as a guide in packing.  I feel a mix of excitement, fear, happiness, and nervousness all at the same time and I can’t seem to focus on any one thing.  A violent Bruce Willis movie playing in the background isn’t helping the nervousness.  I can’t believe I was originally going to travel to India by myself.  I’m so glad Dr. Yadavalli is travelling over there with me.  I already miss Ayrel and the dogs and they’re right in front of me.  I’m used to travelling with her all the time.  This is the first international trip I’ve taken without her in years.
I feel as though my first year of medical school has prepared me for so much yet so little.  I plan on taking my stethoscope but I don’t even think I’ll be comfortable using it.  I feel so skill-less, even after so much schooling.  It’s always times like these where I wonder when I’ll ever feel competent enough to treat patients.
I plan on reading the book ‘Three Cups of Tea’ during the trip.  I also plan on shooting plenty of video with my camcorder for a lecture Dr. Yadavalli and I plan on giving when I return.  My digital camera’s memory card will hold one thousand images and Ayrel wants me to fill it up so I will do my best.
I am so excited to eat the food.  I’m not going to eat meat for the entire trip because I want to see if I can do it.  Ayrel said she’s going to try the same while I’m gone.  We are weighing ourselves before I depart and will compare when I come back.  Today I weigh 177.2 lbs.  BMI 26.1.  We will see how much weight I lose on this vegetarian diet.  Well, I have nothing else to blog about.  I can’t wait for tomorrow.

And so it begins…

The team is assembled…and growing. The agenda is slowly coming together. I should probably buy my ticket at some point, but CIT3 is underway!

This time, we will stay in Hyderabad for the full 3 weeks. We have our 4 IM residents – Puja, Christina, Nora and Waqas – and the two of us ID attendings (I am pleased to report that Shobha has decided to become a regular). We also have The Others:

Nicole is a faculty member in the Department of Bioethics at Case. We are planning a two-week course for undergrads for next summer, and Nicole is coming to check out the CIT scene. I am excited to have her perspective, since a big part of CIT involves issues of healthcare disparities and justice, and she is well-positioned to discuss these.  Ben is a first year med student at Case. He and I are planning a global health curriculum for medical students and residents, and he is coming to see firsthand one type of global health field experience. Finally, Nick is a fourth year student who was going to India anyway and I roped into joining us. This is the largest, most diverse CIT group yet, and we are in the midst of the biweekly seminar series that prepares us for the trip. The trip is slated for the month of August.

I am excited.