International Rotation: Part #1: A Dream comes true...

Initially this post would sound like bordering on the verge of flattery but nonetheless has to begin with me thanking a very important person i.e. Dr. Anne L Glowinski (hereafter mentioned to as Dr. G ) my program director who made this dream come true. I will tell you how this germ was born. The origin of this story is somewhere in Fall of 2010 when I was interviewing for my child and adolescent psychiatry fellowship programs. During my interviews I came to know of a concept called an international child psychiatry rotation at the Yale Child Study Center. I did not choose to be a part of that prorgam, but then I could not take this thing off my mind as I started my fellowship here at Wash-U. I was very curious to know How psychiatry is practiced in other parts of the world if at all. I say "if at all" because I was born in India, where an adult could be seen by a psychiatrist only if they were having a full blown psychiatric or manic break, or were depressed to the verge of killing themselves. Outside of the above mentioned if you were not a bollywood star/starlet, you could suffer for the rest of your lives but would not go to a psychiatrist as you don't want the society at large to think you are "crazy". So if that is the state of adult mental health (adults: who by the way can make their own decisions) it can be safely assumed that India and child psychiatry is almost an antithetical construct. Then I moved to the US to pursue child psychiatry as my career which (to be precise Johns Hopkins in Baltimore, MD) is the mother-land of child psychiatry. Here I was and now having experienced the two facets of the coin.  

I approached Dr. G at the beginning of my first year of fellowship. I told her that I was interested in pursuing an International child psychiatry rotation. She is an amazing person and has taught me how the questions are not if something can be done, but that "it can be" and it's just a matter of finding the right resources. As a result when I asked her that I wanted to do an International child psychiatry rotation she did not say that if it can or cannot be done, she just said "tell me what do we need to do to make this happen". So the goal was to identify a place that was somewhere between two worlds which I knew. I was very keen on going to South america. Lima was the identified place, and UPCH  was the university http://www.upch.edu.pe/portal/index.php. First step was to establish some connections with UPCH, which happens to have an international student department which is well organized and well functioning since the last 2 or more decades. See the Picture (one at the start and this one below) with all the pins indicating the countries/cities from which various medical students and residents have come to UPCH. I put the first pin on the map representing St. Louis

Dream came true, and UPCH provided me with an invitation letter. Dr. G again was gracious to give me an extra week of educational leave, and hence the two week rotation was finalized. Then came the problem of being an Indian citizen, which warranted that I have a Visa from the Peru embassy. It was a long (read very long) process because of various logistic issues. Sometimes the people who are on either side of the red tape realize that a red tape is actually entangling and complicating the stream of communication between the two parties. But we still need it, though we don't know why. Like Nietzsche has said about traditional societies or crude people "There is a species of customs, the intent of which appears to be custom as such: fastidious and at bottom useless ordinances...". So the custom I was facing was a personal interview in which there will be no communication, but the documents which were sent over previously will be seen and a stamp applied on my passport. Here it was me a resident wondering if he will be able to ever reach Peru and the very kind people from the Peruvian Consulate in Chicago http://www.consuladoperu.com/consulados/index.php?consulado=CHICAGO. Entangled in this red tape things got stretched to the very last moment and I had a to go to Chicago on the very last day to have a personal interview. February 15th was a very chilly morning in Chiagoland.. The interview was a formality, more so with my limited espanol skills, and the officers English. We chit chatted with each other for about 10 seconds, he gave me the best wishes, and wished me a great flight ahead. Finally I was able to embark on the dream plane flying from St. Louis to Miami. Waited for about 6 hours at the Miami Airport and by midnight I was ready to see psychiatry in a different context and culture. All excited, but really tired I dozed off as soon as the plane left Miami. There is a lot to be told which I will be narrating in the next few days......

How an international rotation changes a perspective is amazing. The amount of things you learn wont fit into a paragraph, but I will try over in a few paragraphs over the next several days discussing psychiatry in a different part of the globe: how similar and how different?

Till later

Pallav