A Winter in India

As we are looking back on our months here, there was one day that sort of epitomized the way things go. This was actually back in January. The Health Attaché at the American Embassy had set up some appointments for us to meet with various people in Delhi. They scheduled two appointments in one day, the first at 10 in the morning, the second at 2 in the afternoon. Figuring that each appointment would be no more than an hour, this in the U.S. would seem like more than enough time to do both. Even though they were at two different institutions, both places were in the southern end of Delhi. But as the day transpired, it felt more and more like one of those children’s books, where you turn the page and a folded cutout pops up with a new picture.

So here’s the story:

We arrived by taxi for the first appointment, at AIIMS (All India Institute of Medical Sciences). This is a huge, sprawling research and teaching hospital; we were headed to the Cardiology Department and the signs pointed to the Cardiology Building over on one side of the campus.

(Turn the page of the storybook. Up pops a picture of a different building)

The first building turned out to be the Cardiology Clinic. The Cardiology offices were in another building, also called the Cardiology Building, back near where we started. Each part of these roadways was packed with vehicles and people, so getting turned around took some time. We had to walk to the correct building, leaving the driver who went off to park (taxis in India can be rented in four or eight-hour blocks and the drivers wait for you). We walked past lines and lines of people standing or squatting outside on the sidewalks waiting to get into the various clinics. So with all this we were a bit late by American standards, but still early by Indian time (10:15).

(Turn the page. Up pops a picture of a group of office people looking confused by our arrival)

Not an auspicious sign. They scurried around and unlocked a huge padlock on an office door. We were ushered in, offered tea, and then everyone disappeared and there we sat. Maybe 20 minutes later a doctor appeared and asked who we were. “Ordinary” staff people here will never question the likes of us (even though in this case they did speak English). So while we sat, the staff people had sent for someone of a rank appropriate to ours, who was hauled away from who-knows-where to find out who we were. He called the doctor we were supposed to meet. Turned out he had not been informed of the appointment and was at a different office. But if we would just wait, he would have the second doctor call over to the dental part of AIIMS and get us an appointment right then with them, and we could do that and then join him for a working lunch. The math wasn’t really adding up for how there would be enough time for all of that. But when we told him we had a 2 PM appointment and could easily reschedule this one, we were assured that it was “no problem.”

(Turn the page of the storybook, and up pops a picture of the Dental Department)

So off we go the Department of Dental Research and Education, where the Director, Dr. Naseem Shah, met us. She had very graciously dropped everything she was doing to meet with us. We had a wonderful visit with her and learned a lot about the Indian plan for public health dentistry, which she had been in charge of developing.

(Turn the page, and up pops a picture of multitudes of sick people)

Suddenly we are pushing through the jam-packed hallways that serve as the waiting room of the Ear, Nose and Throat Clinic, on our way from Dr. Shah’s office to the Dental clinics. People are standing, squatting and even lying down, some on stretchers and some on the floor and she is clearing a path that we squeeze through.

(Turn the page, and up pops a picture of a well-equipped dental clinic)

The dental clinics are a post-graduate teaching facility, where students are working towards Master’s degrees and specialties in orthodontics, endodontics or prosthodontics. Dr. Shah was apologizing because they are in the process of building a new building. (In fact, the task she had been taken away from to entertain us, was the picking out of the equipment for this new facility. No one here would ever say they were too busy to entertain “important” visitors; greeting visitors is seen as an obligation). The old clinical space is very cramped but functional. This was another instance where our American standards of patient confidentiality were challenged. Dr. Shah went from chair to chair asking the student what they were working on, and the student told us about the case, as if it were a model, not a person, whose full-mouth reconstruction or twisted teeth were being discussed. The patients didn’t seem to mind, but we felt very intrusive. We waded back through the ENT “waiting room” to Dr, Shah’s office, had another cup of tea, made arrangements to come back at a later date to give lectures, and then…

(Turn the page of the storybook, and up pops someone to take us back to the Cardiology office.)

There we were met by the second doctor who was assigned to bring us to this working lunch, which turned out to be somewhere across town. That meant we had to find our driver, so that our driver could follow the doctor to this other place. By some miracle, when we got down to the sidewalk, there was our driver! These guys seem to have a sixth sense about where to wait so that they will see us when we pop up out of nowhere. Rather than all of us going with our driver, the doctor told our driver to get our car from the carpark, while we walked to a different carpark to get the doctor’s car, and then join up.

(Turn the page of the storybook, and up pops another driver)

Turns out the doctor doesn’t drive his own car either, so out of nowhere another driver appeared and we all walked to the doctor’s car, with the doctor apologizing for making us walk that distance (200 yards). The doctor’s driver spends the day floating around in the parking lot awaiting whatever the doctor needs to be driven to.

(Turn the page, and up pops a picture of an empty driveway)

When we arrived at the meeting spot, our driver was nowhere to be seen. We waited with traffic swirling around us, but still he didn’t come. So we called the taxi company on our cell phone and they called him on his cell phone, and he said he had gotten stuck behind a construction crane that was blocking the entire road.

(Turn the page of the storybook, and up pops our driver)

But he was in a different car! He had somehow borrowed the car of some other taxi driver who wasn’t stuck behind the crane, and came to get us. The doctor went off with our driver, and we went with the doctor’s driver. We leave AIIMS and get out onto the major road, a divided highway. It is probably 1:30 by this point, so from the car I call the 2 PM appointment and say we aren’t coming. (Such a change in plans seemed no surprise to him, and we agreed to reschedule. How did people negotiate all of these constantly shifting plans before there were cell phones?)

(Turn the page, and up pops a picture of three lanes of traffic that are ALL making a U-turn!)

As I am on the phone I look up and realize that wherever we are going is in the other direction but the only way to get there from here is to go left, bang a u-ey and go right.

(Turn the page, and see a picture of those little wooden people bobbling around in a Fisher-Price toy bus)

After heading back up the other way a ways, we turn off into a residential area, and bounce through narrow streets and after ten minutes or so arrive at a house that turns out to be the research offices of the cardiologist. The reason we were meeting with this cardiologist was because he (Dr. Srinath Reddy) and the American Embassy Attaché (Dr. Altaf Lal) have been working on a joint project to start schools of public health here in India. Surprisingly, despite a plan on paper for getting health care out to the villages, there have never been any schools of public health here. There are Community Health programs that do some of what Public Health does, but these new schools will be more comprehensive. It is a large initiative that will actually be announced by Prime Minister Mohoman Singh on March 28, and the first two of five schools will open within a year. So we were included in an already scheduled lunch with Dr. Reddy plus an epidemiologist from the London School of Hygiene and Tropical Diseases, and a person from MacKenzie, a large consultant firm here that is pro bono helping set up a foundation to support these schools.

(Turn the page and up pops a picture of our driver, in our original taxi)

While we were in our meeting, our driver had gone back to AIIMS, returned the borrowed car, found our car, and escaped from behind the crane. There he was waiting for us like it was just another day at the office. He took us back to 55 Babar Road with our heads spinning.

And so on a day where we had two scheduled appointments, by the end of the day we have indeed had two appointments, but not the ones we had anticipated. The mental flexibility required of us to get through time-shifting days like this is exhausting. And we wonder if it isn’t equally exhausting to our hosts. People too numerous to count have been inconvenienced on our behalf, yet everyone is very gracious and acts like they have only been waiting to host our visit. We keep forgetting that in their eyes we are People of Importance. This happens to us over and over, even for appointments that haven’t been made by the U.S. Embassy.

Just another day in India.