About Time

When I was living in England time felt mostly linear. It was a flowing river of minutes hours and days from here to there (wherever there was). Occasionally a long stretch at work or a complicated shift pattern (especially one involving nights) would warp it somewhat, telescoping from one island of relative freedom (be it weekend or holiday) to another. I would be busy caught up in something and the little raft signifying my concept of “now” would rush along the river, days passing without me realising.

Here in India my already slightly vague concept of time has been shaken significantly. Having heard and read other westerner’s experiences in India this is by no means an unusual experience. India rushes along from day to day, week to week with sun rising and setting, moons wax and wane like any other country but time itself does not seem to be as firmly set as other places, particularly in comparison to the U.K. It does not run from A to B.

Some people explain this Indian concept of time as cyclical. When you consider the widespread Hindu belief if reincarnation you can understand why time might go in circles. From birth through childhood to the point in adulthood when you have your own children, then old age and grandchildren, then death and ultimately rebirth, forever looping around into infinity.

To our tribal population, even more than most Indians, time is an abstract concept. A very practical example of this is if you ask the age of a tribal patient. At best you get a general answer which you can almost guarantee is a guess. The woman glances around at her young children and pronounces herself 25, or the girl who has just got married tells you she is 19 (although she looks about 15). More often you just get a blank stare as though you were asking “what is the square root of 47?” age to them is entirely irrelevant. Traditionally birthdays are not celebrated, or even known about. Although there is no shortage of calendars to follow here with the western, the Tamil and the Malayalam months running at different times they really don’t care much for dates. So you might ask a mother when her baby was born and rather than getting a day and month she will say “just after the neighbour had her baby” or “before the last rainy season”. Very often I will be trying to ascertain the duration of a patient’s symptoms and stumble into trouble with the timings. I ask a patient with fever how many days he has had it and he answers “night time”. At first I thought it was my rather dubious linguistic skills but even the doctors who are fluent seem to find it difficult to pin down time periods.

I must admit in some ways this relaxed attitude to time can be quite appealing. So here are a couple of interesting things which have happened recently and I haven’t placed them in any particular time order.

So here is something I found interesting while at work. A visiting paediatric surgeon came to do a day’s surgery at the hospital. Unfortunately as staff levels are low I was needed in the outpatient’s clinic for much of the day but luckily I got to sneak down and watch a bit of the action. There was one young boy having a small lump excised from the corner of his eyelid. At first when examined in clinic this was thought to be a dermoid cyst (a benign lump usually containing skin cells) but at the time of operation it was not behaving like a dermoid would and the surgeon said that in his opinion it was likely to be a cyst due to a parasite infection. Perhaps not everyone’s idea of something exciting but I thought it was cool. Being here has really made me realise how interesting infectious disease is, especially all the tropical stuff. At the moment our small hospital is just developing a microbiology lab. It's going to be really great when it is up and rumming properly and I feel like it will make such a huge difference to our antimicrobial prescribing practice.

Now for something completely different, here is something I got up to outside of work. Our friend at work who just got married finally came back from his honeymoon. Of course we were all very excited to see him and meet his lovely new wife, so there have been lots of lovely dinner parties! This for me means lots of exciting opportunities to eat lovely food while chatting with friends. For one of the parties we made a pudding which one of my friends adapted from a magazine clipping. We took a large amount of fruit and liquidised it to a pulp (mango and banana because they are in season) added equal quantities of cream and milk powder, enough sugar to make it sweet and some milk to get a good consistency then put it all in the fridge to chill. Once it was really cold we topped it off with pomegranate seeds and chopped almonds, it was really great.

So this is a really long letter and I hope you are not too bored. Thinking of you all at home obviously and missing you and wishing you well. I will write again soon perhaps if there is some good fruit at home you could try an adaptation of the recipe, when I get home I want to make something similar but put it into the ice cream maker, I bet that would be awesome.

Lots of love

A x

p.s. here is a photo I took in Cochin a while ago of a nice tree, I know its not recent but I like it and as we are talking about a lack of concept of time I thought it was a good opportunity to sneak in a less up to date pic.