Ram Kairam MD
524 Pelham Manor Road
Pelham Manor, N.Y. 10803

Dear friends, 

I have just returned from an excellent trip to Andhra Pradesh (in the context of developments at AMC/KGH). As indicated in my last communication I was able bring along with me Dr. John Coffey, chairman of the Department of Emergency Medicine at Bronx-Lebanon Hospital Center, where I also work. He and I met with Dr. I.V.Rao (“Venkatesh”-batch of 1965), who is the current Director of Medical Services for AP. We found in him an excellent listener to our proposal to develop a full pledged “US Style“ Department of Emergency Medicine at AMC, including the creation of a PG program in about 3 to 4 years. Venkatesh promised to call the leadership in Vizag in advance of our arrival there and lead them towards orchestrating the details of the proposal. 

The next day, Dr. Coffey and I met with the senior management of EMRI - (Emergency Management and research Institute) located on the outskirts of Hyderabad city. 

http://www.thehindubusinessline.com/2005/08/16/stories/2005081601131300.htm

http://www.siliconvalley.com/mld/siliconvalley/16104670.htm 

We met with a large group of EMTs and the physician leaders, inspected an ACLS ambulance and watched the operations of the command center handling state wide fire, police and medical emergency calls. The EMRI leadership was very encouraging of our proposal for Vizag and we were very happy to see that this important infra structure organization essential for EM had come a long way since its birth only one year earlier!

Unfortunately, a serious incident had occurred the same night I arrived in Vishakaputnam three days later. The entire physician and PG staff went on strike. KGH’s 1000+ beds were emptied within hours. I.V Rao himself had to fly in from Hyderabad to calm the population and professionals. Our formal lectures were cancelled but we were able to meet the academic leadership on the 3rd night in a late evening conference. Beyond the initial skepticism and cynicism, we managed to convince those in attendance that they were looking at an opportunity to convert the usual traumatology focused Casualty Department into a full service Emergency Department. There was general acceptance of the idea but we were left with the impression that much administrative work needs to be accomplished before a few junior faculty could be attracted to move to a fledgling department of EM.

I also managed to tell the current principal and several of the professors and head of departments present, that we (program directors in the USA interviewing residency candidates from AP medical schools) have been hearing that AMC has dropped from the #1 to #4 or #5 in ranking!! Whatever has been happening to the academic programs in AMC or clinical services at KGH, I pointed that the deterioration in the facilities in the men’s and ladies’ hostels, the decline of cultural activities, the discontinuation of activities such as Ebden Memorial Cricket Tournament, the loss of Men’s Hostel Day and Ladies’ Hostel Day etc, helped to destroy the ambiance and the excitement of being a student at AMC. I met the principal, two days later I received a pleasant surprise that he had already managed to convince the professors and the civil asst Surgeons to reinvigorate the cultural and civic life of the institution and received substantial pledges from them to restart the Ebden Cricket Tournament!

I then visited the central AMC library and found that all 14 Electronic Library stations were in use. The electronic access library and the PG reading room in Bhavanagar Ward and the new S. Balaparameswara Rao Memorial reading room and the electronic library in the Neurosurgery Department were in active use. Members of AMCANA should be happy and proud that we have contributed to these projects which directly benefit the undergraduates and the PG students.

The remainder of my trip consisted of inspecting the facilities of AMC Ladies Hostel & proposing a substantial upgrading of rest rooms, showers, a reading room and a sports room. The building in the back part of the hostel had not been used for many years and was in substantial state of disrepair. I discussed with Drs. Muralikrishna and Pedaveerraju a substantial upgrade of this structure to create a sports room, lounge, internet access room (to be funded by AMCANA). They promised to send a formal proposal from a building contractor. The Principal in the meantime managed to get permission from the Municipal corporation to run an extra water line to support the new facilities!!!

Overall, I left Visakhapatnam reassured that several, if not all of the AMCANA proposals will bear fruit. I promised to return in the third week of January during which two class reunions are scheduled, batches of 67 and 66.

During my January trip I hope to raise discussions on a project which is very close to my heart-the development of a curriculum on bio-ethics, to include issues such as informed consent, death with dignity awareness and training, end of life and bereavement counseling. From my experience of dealing with graduates of AP medical schools in residency programs in New York and reading health care related news from Andhra regularly on the internet I have come to notice a disturbing lack of sensitivity in these matters. This may turn out to be a more difficult task to accomplish but I hope to feel out the senior leaders and explore how we can contribute.

Respectfully submitted,

Rammohan Rao Kairam