Since then, I have taken trips to India every few years. Some of them have been timed before or after key milestones (before or after college, medical school, residency, etc.).

My visits as a teenager and adult have resulted in deeper emotional connections with relatives. It is my goal to bridge the cultural divide, though it is becoming narrower all the time due to the advent of television, more access to Western images (even in the tiniest villages) and increasing presence of Western technology.

I relish my grandparents’ stories about the “old days” and about my parents when they were little. Together we enjoy humorous remarks — I declare that “an expandable stomach is helpful” alluding to the unbelievable hospitality and endless offering of food by loving relatives and friends, and describing the experience of Indian traffic: “The only sane way to travel in India is to keep your head turned to the rear window. Be glad that you have made it this far. Keeping your head turned to the front is for the bungee jumper who doesn’t mind seeing the cow, goat, auto, lorry, bus converge right in front ….” 

I remember one trip, while I was in medical student in America, I visited a medical school in India. I was trying my best keep my saree up, amidst a room full of eager Indian medical students listening to a brilliant, but intimidating pediatric professor discuss cases on the inpatient ward. As we made our rounds, we came across an 8 year-old boy. He was really lanky with big dark eyes. He had a heart murmur and was being treated for rheumatic heart disease. I never saw a case of rheumatic fever in my residency here in America. Now, when I perform a Rapid Strep test and treat a child for Streptococcal pharyngitis, I often think about that child and how fortunate we are here in America to have better awareness and access to tests and treatments that can prevent such severe illness.

Another patient we saw in the outpatient setting was quite a dramatic case. The parents of this 5 year old boy said that as the day progressed, they had to carry their child and his eyelids became droopy because of weakness. They had been carrying him like this for years, and could not get a diagnosis or treatment. The professor instantly arranged for a “tensilon” test, in which edrophonium is administered, and voila! The boy’s eyelids just opened up! His diagnosis: myasthenia gravis, an autoimmune neuromuscular disorder. Again, I realized that in India there were patients who presented with diagnoses that I would only read about in my American textbooks, What a shame that this little boy had suffered for so long because good pediatric and subspecialty care is hard to find.

In more recent years, with the advent of the digital camera, I have been chronicling my Indian vacations through a digital photo diary made possible through the wonders of the internet. I also reflect on cross cultural pediatric issues, especially in the context of my earlier general practice in the heart of Silicon Valley, where there is a large Indian population, many of whom are computer engineers.

My summer vacations in India helped me have greater understanding of their cultural attitudes toward illness, the diet and customs, and the social and historical context of their influx to this area. Even just last summer in India, I noted that many of my cousins and their children were studying computer science. There has been an amazing increase in the number of engineering colleges with graduates near my parents’ villages, headed to Silicon Valley or increasingly, to companies in the “tech” cities right in India, like Bangalore.

I now understand the meaning of the word “culture shock”. There are so many differences and sights to process. It can be overwhelming and confusing. For example, the poverty, sanitation issues, contrasts between rich and poor, social pressures (e.g. dowry system), large population, different methods for bringing about a marriage, the technology boom, and increasing “Western influence”. I believe age appropriate conversations with children at the end of cross-cultural trips, combined with journaling (in cyberspace, these days!), art work, poetry, and photography, may help second-generation Indian-American children process these enriching experiences. There may be questions about identity, which I must have been thinking about in a journal entry after college: “I am an American first, and although India wields a big influence in my life, my home will always be in America.” It is important to help children figure out what their heritage means to their lives here in America.

As you can see, the Indian summer vacation has influenced my life through all my ages and stages. And, I had a case of déjà vu the other day, when I saw a 1 year-old patient who had just returned from a summer trip to India, her head shaved. I wonder what stories she will tell in the summer vacations to come.

If you have your own stories, I’d love to hear them. Please feel free to share them here!