August 23-24th – That’s A Wrap!

On Wednesday we were back in our old stomping grounds, the teleconference room at AIG (thanks to IT guy Sushil for letting us take over his room for a week).  There were a few more junior and senior endoscopists as well as some technicians that we were still hoping to interview, so we armed ourselves with some samosas from the hospital café and posted up in the teleconference room to continue performing our study at AIG.  Luckily, we were able to catch Dr. Mohan Ramchandani and Dr. Rajesh Gupta as well as one of the senior technicians to perform the study.  We had great conversations with each of them and got some invaluable advice to guide the future of our projects so we were happy to head back to the hotel at the end of the day.  Since we left AIG a little later that day we got caught in a bit of Hyderabadi traffic but, luckily, the diverse and ever-present car horns on the roads of India still leave Emma in fits of laughter (though probably confusing to our Uber drivers) so it was an enjoyable ride back.  We rounded out the evening at the delicious Mainland China where we prepped ourselves for our last day of the study.

As Thursday was the last day available for our usability study, we had to rally the troops to make it the most productive and successful day yet! Since we still had a few doctors left at AIG who wanted to take part in the study, and had left Pune on Tuesday knowing there were more stakeholders who wished they had been able to participate, we decided to split up the team to cover all of our bases. For that reason, we sent Conor and Regina back to Pune to interview the last few physicians at Deenanath Mangeshkar Hospital, while Jess, Jake, and Emma stayed behind at AIG to cover the last few physicians there.

To start out by speaking about Pune, we’d returned because we’d been invited by Dr. Bapaye to spend some more time with him on our usability study as well as been offered to perform the study with three other ERCP fellows that Dr. Bapaye is training.  It was an extremely productive day at DMH filled with frantic notetaking as we were able to interview five more endoscopists and two nurses.  In addition, we got to sip some filter coffee and watch a game of cricket in the conference room with some endoscopists in between cases (we think we’re finally starting to understand the rules of cricket, score that century!)

Meanwhile, Jess, Jake, and Emma remained in Hyderabad for their final day of interviews at AIG. The Hyderabad team sought to find a meeting time with the last few physicians that had not performed our usability study, as well as talk to a few more technicians about our solution concepts. We also finally had the chance to discuss the process by which reusable products (e.g. sphincterotomes, guidewires, etc.) were sterilized between procedures. We were fortunate to begin our day with Dr. Rajeev Shandil, a visiting physician from New Delhi. Receiving insight from another experienced physician who works at a lower volume specialty center in a different geographical location than AIG was a valuable addition to diversify the viewpoints on our concepts as we reach the end of our trip. Dr. Shandil provided key counterpoints and validations to complement the unique feedback provided by the unique patient volume and business model adopted by AIG.

We were able to interview our final physician directly after Dr. Shandil before moving on to our time with technicians in the afternoon. After interviewing a tech on solution concepts, we added some additional questions that had been developed in response to our time in India. We have gained an increased understanding as to the importance (in reality, nigh on a requirement) placed on the reusability of tools used in the operating room, and therefore the necessity of any solutions embodiments that we develop to fit these needs.

After asking about the sterilization process that technicians follow to clean tools between procedures, we arranged to see the sterilization process firsthand. We were taken up a few floors to a large piece of equipment, an ethylene oxide sterilization chamber, where a nurse explained the 8 hour process by which she adjusts conditions within the chamber to appropriately sterilize equipment placed in the machine. Key metrics and details such as pressure, temperature, and timing will allow us to subject our future embodiments to equivalent tests back in the US. As a result, we can return in the future knowing that what we present to physicians can stand up to the same cleaning and reuse standards expected of the Indian endoscopic environment.

We finished our day where our time at AIG began: in the operating room. A few final follow-up questions for Dr. Rakesh and witnessing some pre-sterilization cleaning of tools by techs post-procedure brought our time at AIG to a productive close. A few final pictures with technicians eager to capture the memory, a grateful thank you to Sushil for allowing us to use his office space for our interviews, and a heartfelt goodbye to Suresh as we entered the Uber to return to the hotel made for a sincere conclusion to this leg of our study in India.

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Overall, we are proud of the information that we have gathered and enthused by some of the insights that we have gained. While certain overarching themes and major takeaways are already apparent, we have several hours of audio and pages upon pages of notes to process upon our return to the States. Before Anant left on Wednesday to return to the US we were already discussing the techniques learned in our coursework this summer and how we intend to apply them to the information gained during this study in order to analyze what we have learned. We look forward to beginning the prototyping process in the fall, shaped by the insights gained from our time spent in India over the past several weeks.

Yet, before we return to the states, the team has decided to remain in India for a few extra days in order to relax and celebrate our hard work. We will be enjoying the countryside of Kerala, and Indian state famous for its rural nature, expansive tea agriculture, and stunning mountainous terrain. Stay tuned for one final picture-based blog post where we share the sights and sites of our last few days in India. Here is a sneak peak of the team on our first day of relaxation, celebrating a usability study well done!

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August 21-22nd – New Week, New Hospitals!

One of the most important parts of our study in India is getting diversity in our feedback. For that reason, this week was not only focused on wrapping up our studies at AIG, but also on travelling to other centers to talk to doctors from inherently different backgrounds. Our first stop on Monday was spent at the Sai Vani Specialty Hospital, located about half an hour away in Hyderabad. Sai Vani, like AIG, features a specialty in gastroenterological disorders and, with regards to ERCPs, has a lot of patients who have been referred from other hospitals that were unable to perform the procedure, or performed the procedure and were unsuccessful. While we were only scheduled to talk to one ERCPist that day, we were fortunate enough in our timing to get to speak to another experienced endoscopist who was just stopping by for the day and happened to be free! Our scheduled endoscopists, Dr. Sreenivas, was very insightful as we went through our study and demonstration with him, as he provided feedback that was in a few senses different from that which we had been receiving from AIG. Below is a quick snap we were able to take with Dr. Sreenivas before we headed out!

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We were hoping to go back to AIG for the remainder of the day to continue talking to stakeholders there, however we discovered that we would not be able to make it there because the Vice President of India was there visiting and speaking to Dr. Reddy. While we would have loved to crash the party and see the vice president strolling through the halls of AIG, we decided it best to call it a day and prepare for our upcoming trip the next day to Pune!

On Tuesday morning, we got up bright and early to head to the airport. We arrived and headed straight to the security line, where Conor had an interesting time trying to explain our model to airport security! Luckily for all of us, he was able to make it through after showing the officers that it was harmless. With that taken care of, we waited for our flight and we were quickly off to Pune. Once we arrived, we hopped in ubers to head to our destination: Deenanath Mangeshkar Hospital, or DMH. After 45 minutes of driving and enjoying the local scenery we arrived and got straight to business. We got our visitors badges and went to the Shivanand Desai Center for Digestive Disorders where we would be conducting our interviews. After setting up our model in the conference room, we were ready for a lot of interviews as we tried to fit in as many as possible before we had to leave to catch our flight back to Hyderabad.

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We first met with Dr. Amol Bapaye, a senior endoscopist, and one of our most valuable stakeholders ath DMH. Afterwards, we had a constant stream of back to back meetings with physicians, technicians, and fellows for four hours in order to get as much information as we could in such a short time. Even then, we still weren’t able to speak with everyone there who wanted to participate before we had to scurry out to make our late night flight from Mumbai (several hours away). The drive to Mumbai was scenic and beautiful and provided a much needed time to relax after a long day of interviews. We arrived at the Mumbai airport for our flights and flew back to Hyderabad, ending an extremely busy, but very productive, day trip.

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August 16th-20th: Usability Studies at AIG Begin!

The 16th was our final day to review our newly refined usability study with our India contacts Suresh and Anil, as well as Clinvue representative Anant and our very own Dr. Acharya. After adding some finishing touches based on their feedback, we headed to a nice dinner out at Khan Saab. We all ate our weight in family style spicy meats and paneer, then after we were nice and full and decidedly near explosion point, we decided adding dessert on top of it would be a great idea and ordered several desserts for the table, including a flaming gulab jamun. I can guarantee you we have never slept better.

The next day, on the 17th, we kicked off our usability study at AIG with a bang! It was a whirlwind of a day, as we had several straight hours of doctors coming in for their interviews without any breaks. We rounded out four usability interviews that day: one senior physicians, two new fellows, and a senior technician. The senior physician was Dr. Sundeep, who we had met the Friday before. He is a doctor who greatly enjoys the technical side of these projects, so we were able to jump right into our solution concepts and talk details! Overall it was a very insightful conversation. One of the new fellows was from this area and the other was visiting from Italy to complete his fellowship. They both had just a few months of attempting cannulation under their belt, so it was very interesting to hear their challenges as new ERCPists, especially since those learning how to perform ERCPs are our project’s target. The senior technician, Dr. Srinivas provided invaluable insights, as we discovered shortly after arriving that in India it is primarily the technician that controls the accessories during ERCPs. He even brought props as demonstrations to help us get an idea of the hand motions and touch/feel sensations he uses to control the guidewire.

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To avoid an overly lengthy blog post, suffice to say that the next two days (the 18th and 19th) were equally as exciting and valuable. We were able to talk to some of AIG’s very influential endoscopists, such as Dr. Tandon, one of the senior-most ERCPists, and Dr. Rao, one of the co-founders of AIG. Both of them were very excited to see our solution concepts, and were also eager to provide their expert opinion on our ideas, leading to some very interesting and productive conversations. Beyond the endoscopists that we were able to speak to, we also had the chance to speak to a pre-op nurse, who takes care of the outpatients before they head in for their ERCP. She was able to help us gain a fuller understanding of what the patient experiences from when they walk in to when they are anesthetized, as well as an understanding of the nurse’s role in the process.

By the end of the day on the 19th we had now completed full usability interviews for 11 endoscopists (4 of whom are trainees and 7 of whom are more experienced ranging from early career to senior-most physicians), 1 technician, and 1 pre-op nurse. We have, across these days, learned a lot more about both the reception of our solution concepts, as well as general information about the Indian healthcare system.

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After a long, difficult half-week of constant interviews, we were happy to enjoy an evening of great dinner at Paradise Biryani followed by a relaxing day off on Sunday! Stay tuned for the continuation of our usability study next week, when we will move to some other hospitals in Hyderabad and Pune.

August 12-15th: Long Weekend + Independence Day!

The first three days of our long weekend were mostly devoted to working on our study– we kept a healthy balance of experiencing Hyderabad while also working hard on refining our usability study based on the information we had learned the week before. Our work sessions involved spending a lot of our time with all five of us packed onto Emma’s king sized bed typing away and discussing ERCP related things. In the evenings, we would explore various restaurants (like Paradise Biryani) and revisiting our favorite mall.

The real fun started on the 15th, which is India’s Independence Day, where the country celebrates its liberation from the United Kingdom in 1947. The Partition, which refers to when British India was divided into India and Pakistan over religious majority lines, is also jointly separated on this day. So overall – August 15th is an important day for India! We decided that this was the day to go out and see everything we could possibly see in Hyderabad, so we signed up for a tour of all of the major sites. The day was packed full starting at 7:30am and not winding down until 7:30pm.

We started out at the Birla Mandir, a Hindu temple belonging to the affluent Birla family of Rajasthan. Sadly for the purposes of this blog post, no phones or cameras are allowed near the temple, so we have no photos. However, rest assured that it is truly breathtaking, constructed entirely of white marble, and filled with numerous shrines of Hindu gods and goddesses. To enter the temple, everyone had to remove their shoes and walk in barefoot, as a means of respect for the deities worshipped within. It was an immersive experience climbing the steps to each shrine and seeing everyone individually stop and pray, leaving offerings and reciting the names of each god or goddess. After a lot of climbing, we reached the top of the temple and were greeted with a stunning view of all the entire city, as the temple itself sits upon a very (very) large hill. After taking the view, we descended to retrieve our shoes and head to the next destination.

Next on the agenda was the Nizam Museum, which is located within the Purani Haveli palace. The Nizam’s were the rulers of the Hyderabadi state beginning after the collapse of the Mughal Empire in 1724, until 1948 when it was forced to join the Indian Union (now India). The Nizam’s were once the richest people in the world, so it should come as no surprise that the items found in the museum, all possessions of the family, were exquisite. Again, sadly, photos were prohibited inside the museum so this blog will see none of the Nizam’s possessions. We did get a picture of our crew outside of the gates of the museum, though!

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The next stop was the highly anticipated Charminar, known as the gateway to Hyderabad. It is an archway that serves both as a monument and an Islamic mosque. We were able to climb up inside of the building through a steep, tight, winding staircase (which proved to be quite the workout for us), in order to see views of the surrounding city on each side. Finally, we were able to take pictures of the beautiful architecture and capture some memories, so you will find some photos below.

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We thought we had seen the peak of beautiful Middle Eastern architecture at the Birla Mandir and the Charminar, but we weren’t prepared for the sites of our next stop: the Chowmahalla Palace. The palace is actually a grouping of 4 separate palaces, all originally inhabited by, you guessed it, the Nizams of Hyderabad. For this portion of the trip, I think pictures will speak louder than words, so in an effort not to have to read the words “beautiful” and “stunning” a hundred times, see the (few) photos I was able to sneak in below!

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After our adventures at the Chowmahalla Palace, our next stop was the Salar Jung Museum. In all honestly, we spent most of our time there waiting in the food court area for our long awaited lunch! But we did get to spend a small amount of time walking around and seeing art from a wide variety of Middle Eastern and Asian cultures. Of particular fascination was the ivory room, where a wide array of sculptures, idols, and even board games had been created from ivory alone. Our team faced the internal moral struggle of seeing some of the most beautiful, intricate art we had every seen, while knowing the sad reality of where it had come from. Right as we were to head to our next destination, we walked past a large auditorium of very intrigued people staring at three tiny screens in the front of the room. We quickly realized that they were watching live footage from the Red Fort in Delhi, where the prime minister was to raise the Indian flag in commemoration of Independence Day, as is custom. Suddenly bells began to ring and the flag was raised, eliciting lively celebration from all of the people in the auditorium.

With that excitement, we headed forward to our next destination: the zoo. This was the controversy of the day, as the tour was supposed to include a trip to Hyderabad’s most famous and popular destination, the Golkanda fort, but it was closed for Independence day, so the logical replacement in the tour was a local zoo. Nevertheless, we embraced our children-within and enjoyed walking around to see all of the majestic creatures of the world from exotic cats to hippos and peacocks. We made some new friends on this adventure too, as one group of women from our tour stopped the tour to get a group picture with the girls of our team. They were all so excited and thankful that we took the picture with them that they gave us all “I ❤ India” pins, which we proudly wore for the rest of the day.

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We finished up the day getting to shop at a local bazaar, where we found much food, clothing, and accessories to explore! After a long day of walking, climbing, and seeing beautiful sites, we retreated to the hotel to relax and enjoy the rest of Independence day!

 

August 10th-11th: Clinical Immersion, cont.

On Thursday, we returned to AIG to continue our immersion and learn more about ERCP in India. It was Dr. Rakesh’s day in the ERCP room, so we reintroduced ourselves and settled in to watch several more procedures. As we observed, we were able to split up to speak with technicians, fellows in training, and anesthesiologist in order to gain even more insight. This was a very valuable day, as we were able to speak about a lot of the more detailed questions regarding workflow that happen behind the scenes. After a couple hours and many, many procedures we left to debrief on the day and fill each other in on what we learned.

Thursday night was also Mohit’s last night with us. We decided to head to the mall nearby for shopping and food. After a little bit of exploring the racks of beautiful clothing, we headed to the food court to see what we could find. On Mohit’s recommendation, Jess and Conor tried out “Frankie’s”, which are seasoned chicken or paneer wrapped in savory wrap-like bread. Unfortunately, it proved to be a little bit too spicy for Jess, and no one was surprised. For dinner, we decided to branch out of our American comfort zone and try a great local spot, which I believe they call Burger King. All jokes aside, this wasn’t your typical Burger King – the Indian version has lots of vegetarian and spicy options, and of course did not include the typical beef burger. We each tried a variety of chicken or mutton sandwiches with varying levels of spices. After dinner, we went to Cream Stone – very similar to Cold Stone creamery – and got some delicious desserts involving tiramisu and Ferrero Rocher to finish the night.

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On Friday, we went back to AIG with new questions to ask as we watched more procedures. This time we were with Dr. Sundeep, who had acted as a sort of mentor for last year’s team. We filled him in about the progress of our project and were fortunate to receive some guidance from him regarding our study, which we would be able to run through with him next week. After all of our observations for the week, we were ready for the 4-day weekend (thanks, Independence Day!). We needed some time to relax, but more importantly to synthesize all of our insights from our three immersion days to make our usability study better. Before Mohit left, we took a quick walk over the train tracks to get a bite to eat and see the lake we had been looking at from afar in our rooms. Mohit then took off to catch his plane, and we decided to take it easy and order in some room service after a long week of traveling and observing.

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Aug 9th, 2017: Asian Institute of Gastroenterology

Today marked our first day at the Asian Institute of Gastroenterology, or AIG. Our plans for the day involved observing as many ERCP procedures as possible to get an understanding of how Indian hospitals operate, with specific regards to the procedure. We would be watching these procedures with Dr. Mohan, a senior endoscopist. We hoped to be able to talk casually with these physicians and perhaps technicians as they became free in the OR, but our primary intention for the day was just to watch and learn.

We met Suresh and Anil, our contacts for AIG, in the hotel lobby and ubered over. As soon as we stepped out of the uber, we could see that people were overflowing from the building, and waiting outside on the streets. We walked in through an old metal detector, and were presented with the most crowded hospital lobby we had ever seen, with hardly enough room to walk through without running into people. We walked down a narrow hallway to the right, entering a waiting room with people lined up in fifteen or so rows, sitting in chairs shoulder to shoulder waiting for their turn. There was only a narrow path to walk through to get past these rows, and this path was filled with people standing around and even sitting on the ground. With a bit of effort, we made it through and passed through a set of doors to a clean hallway. On the left was the door to the office of Dr. Nageshwar Reddy, the “godfather” of the ERCP procedure. Several other dull blue doors lined the walls, without indication of their purpose. Finally, at the end, we were led into a room with a label of “VIP Lounge”. We would wait here for further guidance as to our plans for the day.

We were soon guided to the OR to begin observing. Upon entering, we saw that the room was already very full, with at least 12 staff in the room: the attending physician, several fellows and residents, a senior technician, several junior technicians, an anesthesiologist, and an administrative patient coordinator, who was running in and out delivering the patient medical history as they arrived. Further, there was a patient on the bed being scoped, while two other patients lay on gurneys asleep under anesthesia having completed their procedures. We would learn that this was the way patient flow works at AIG, all part of an amazing process that allows for over 40 or 50 ERCPs completed in one day. In order to make it all work, it requires that patients complete the first stage of their post-ERCP recovery in the OR while the next few patients are operated on. This acts as an example of the many striking differences we saw between Indian and American facilities.

We were able to speak with Dr. Mohan as planned, while he watched his fellows performing the procedures largely from afar. However, the whirlwind of adaptability began as we were approached by many that we were not anticipating getting to meet that day. After three patients had been seen and what seemed like hours, we emerged from the OR to discover we had only been in there for about 25 minutes. It was a session self-described as “drinking straight out of the water hose”. We had just begun to catch our breaths and debrief about what we had just seen when Suresh appeared in the door, telling us to quickly come with him, as he had just caught Dr. Nageshwar Reddy who had agreed, graciously, to give us 5-10 minutes to chat with him about our project. Yes, thirty minutes into our AIG experience and we were about to meet the grandfather of ERCP procedures. Gulp. Though we were, of course, nervous, the meeting went well and we were thankful that he was able to give us his time and his insights on the directions we are taking with our project. We rounded out the day with a visit to introduce ourselves to Dr. Rakesh, another senior endoscopist, who we would be spending more time with tomorrow in the OR.

Overall the day was tough, but we learned a lot about the way things work in the hospital setting. Nothing is predictable and we have to be prepared for anything!

Today was not only important because it was our first day at AIG, but also because it was our very own Mohit’s birthday. To celebrate 23 trips around the sun and “one more year closer to death”, as Mohit puts it, we headed to dinner at Barbeque Nation. If you want an idea of that experience, think endless meat skewers on a conveyor belt headed straight for your face.  One hour and many tears shed over spicy shrimp later, we were waddling back to an Uber to call it an early night.

Aug 8th, 2017: Boston Scientific Visit

Today we had the incredible opportunity to spend the day at The Boston Scientific India Headquarters in Gurgaon. We arrived in the morning at the Bestech Business Tower and went up to the second floor to meet our host for the day, an R&D Engineer. We started off with a brief presentation of our project and the progress made so far for several Bos Sci representatives in the Endo R&D and the marketing team. Then we were taken on a tour of the R&D labs, where we had the opportunity to see the equipment they use as well as gaining some insights into some of their up and coming projects. We then headed back to the conference room for a few presentations by engineers regarding their ongoing R&D projects, with particular emphasis on the pathway that these projects are taking from needs finding and ideation to prototyping and usability studies. Since our own project is focusing on the usability and prototyping portion of product development, we were very fortunate to have had the chance to hear engineers talk about this process for products that they are actively working on, and dig deeper into aspects of those projects that apply to what we are doing. We then headed to lunch that Boston Scientific had provided, complete with butter chicken, dal makhana, naan, and gulab jamun for dessert (the butter chicken was definitely ordered because we asked for food that was “less spicy”).

After lunch, we got a presentation from the marketing team on the landscape of the Indian market for medical devices, and how Boston Scientific fits into this market. This was a particularly helpful part of the day for us, as we were hoping to learn a lot more about the differences in the device landscape. We ended the day having answered all of the questions we had hoped to have answered, and having learned far more than we had even anticipated! We were incredibly lucky to have the opportunity to make connections with these representatives, show them our project, and get their feedback.

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With a successful day behind us, we hopped back in the cars and headed to the airport to catch our flight to Hyderabad. We arrived at the Park Hotel and, after marveling at its beauty, promptly went to bed to get a full night’s sleep before our first visit to AIG the next day.

August 6-7, 2017: Agra and New Delhi

Before our work begins at Boston Scientific India Headquarters on the 8th, we have the opportunity to be tourists for a few days! So when we woke up on the morning of the 6th we were all tired, but excited for the day ahead. We headed downstairs for breakfast to find the most elaborate spread of food our eyes had ever beheld. On the left a full array of traditional Indian breakfast cuisine, and to the left, an equally impressive selection of American breakfast items. We toured the Indian side with Mohit, as he pointed out to us which items would be too spicy for us, and we filled up our plates. Several rounds of refills later, and we were all feeling rather large, but very happy, and ready for the day.

We then hopped in the taxis for our 4-hour ride to Agra, where we were to later see the Taj Mahal. On the way there, we were able to see from our car some more rural Indian communities that were rather different than that of the high-rise filled Gurgaon. Mud huts lined the streets, and men, women, and children alike could be seen sitting on the ground, passing time, their bright clothing contrasting against their earthy surroundings. Animals were also abundant; wild dogs, pigs, and monkeys walked side by side with humans, who were unphased by their presence. Cows freely roamed the streets, and elicited utmost attention and respect from all drivers.

About half an hour before reaching Agra, it began to rain. It was originally our plan to visit the Taj Mahal immediately when we reached Agra, but the rain resulted in some last-minute plan changes and we rerouted ourselves towards a guesthouse. It ended up taking over an hour to reach the guesthouse because rain, it turns out, causes dramatic traffic problems in India as the streets quickly flood. We reached the guest house, only to discover that the rain had knocked out the power there. The kind owners brought us inside and welcomed us into a dark room to wait as they went outside in the downpour to fix the generator.

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A bit later, the lights came on, and the owners came in to offer us coffee and water. He advised that the rain would likely slow soon, and that we should go ahead to the Taj Mahal to see it before it closed for the evening. With that recommendation, we hopped back in the car and took off for the Taj Mahal. Upon arriving, we parked and took a small buggy to the entrance. A bit of walking later, we rounded the corner to see the breathtaking view of the Taj Mahal in the distance. In the misty clouds from the rainstorm, it looked almost dreamlike its perfection. After a few moments of taking in its beauty, we did as tourists do and began taking pictures.

As we walked around the periphery of the palace, and moved through the inside to see the (stand in) tombs of the royalty, Mohit recounted to us the history of how the Taj Mahal came to be. Right as we were finishing up, it began to rain again and we made our way back to our car, dodging vendors selling Taj Mahal snow globes and, more strangely, leather whips.

It was now dinner time, so we headed to a restaurant which served traditional northern Indian cuisine, meeting Jake’s friend Devashish when we arrived. We ordered family-style Tandoori chicken and mutton, as well as large quantities of naan. The food was delicious, but definitely more spicy than we had experienced so far! While Mohit, Regina, Conor, Jake and his friend fared well, Jess and Emma cried many a tear. Luckily, a quick order of a lassi later (self-dubbed at this point as the spice antidote) and all was well.

That night, we drove back to the Taj Mahal for a special night viewing; Mohit’s friend had helped us obtain the tickets several days prior. Sadly, the clouds from the storm kept the moon from illuminating the Taj Mahal, but it was still a sight to behold. It was a bit ominous, sitting dark in the distance only barely visible, with not but one light illuminated in its center. The distant sound of the Islamic call to prayer could be heard echoing through the air. All together it almost made one feel as though they were there on a hot summer’s night many years ago.

After this, we headed back to the cars and began the several hour-long journey home, during which most of us passed out from jetlag and exhaustion from a long day.

The next day, we all woke up early in anticipation of the delicious breakfast awaiting us again. We then set out for New Delhi, which was about a 45 minute drive away from our hotel. We noticed while driving that the roads were packed with people in more traditional and colorful Indian clothing, and Mohit told us that this was because it was because today was Raksha Bandhan, the festival celebrating the bond between brothers and sisters. On this day, a sister will tie a bracelet around their brother’s wrist to signify the renewal of their bond.

We arrived in New Delhi, where the scenery more closely resembled an American city than we had seen before, with high rises with highways crossing over one another. We arrived at the first destination of the day, the Lotus temple, a Bahai house of worship. Unfortunately, it was closed so we could only see it from afar, but it was still beautiful!

We grabbed popsicles from a street vendor and hopped back into the car to go to the next destination: Dilli Haat, an outdoor food and crafts bazaar. There, we were able to observe many vendors selling their intricate crafts, from scarves and saris to handmade Madhubani-Mithila paintings, jewelry, and small statues of various Hindu deities made of marble, wood, and paper mache. About an hour after arriving, a downpour set in, sending us running for shelter underneath cover from one of the food vendors. We camped out for an hour or so before the rain lessened and we made our last purchases and headed back to the car, soaked but happy. Because of the downpour, we decided to head back to the hotel to change into dry clothes instead of going to the other sites we had planned to see that day.

That night after getting dry, we headed out to get a nice dinner at Parikrama, a restaurant at the top of a tall high rise building, which rotates so that you can see a full panorama view of Delhi while you eat. We ordered some mild butter chicken and kebabs, both delicious. We were not full after this, but instead of paying full price for more food at the restaurant, we left and Mohit brought us to one of his favorite restaurants, Nizam’s. There we gorged ourselves on chicken and mutton kebabs and headed back to the hotel feeling quite fat and happy. We finished the night at the hotel by finishing up preparations for heading to the Boston Scientific India Headquarters the next day.

Aug 05, 2017: A Crash Course in Indian Transportation

We have arrived in India! After an eventful traveling stint involving some unplanned planes, trains, and automobiles, we touched down at the New Delhi International Airport at 9:35pm, local time. Once we de-boarded, we groggily tried our luck at the ATMs and headed to the taxis that were to take us to our hotel in Gurgaon. The moment we stepped outside, our lungs constricted, filling with the hot, dense, characteristically Indian, evening air. Within a minute of walking, every one of us was drenched with sweat, appearing as though we had just emerged from a swim by the time we arrived at the taxis several minutes later.

We quickly loaded our suitcases into the taxi and jumped inside, greeted instantly with the refreshing flow of cool air from the AC. Relieved as our sweat began to evaporate, we all started to relax. The relaxation, however, was short-lived, as the taxi driver sped out of the garage and onto the road, narrowly missing collision with several other cars and motorcycles. It was at this time that we learned that this is the constant state of driving on Indian roads: no lanes, no rules, no space between cars. When the roads opened up on the highway and became ~10 lanes wide, it was reminiscent of a go-carting experience, where each driver could choose their own path, not restrained to lanes, maneuvering in whatever means necessary to pass the drivers in front of them. When the roads constricted to what, in America standards, would qualify as two lanes, we thought perhaps that the traffic would become slightly more standardized. It did not. It became quickly apparent that the desired mode of traveling was straddling one of the lines on the road, instead of fitting one’s car into any of the lanes. Other cars would then lay on their horns as they careened through the tiny opening between our car and the cement divider several feet away. It quickly became apparent that the car horn in India is used as a means of saying “ready or not, here I come” so that you can navigate through these small spaces. A wise man once said that two solid objects cannot occupy the same place at the same time; I have never spent more time thinking about this quote.

When we finally reached our hotel in Gurgaon, we thanked our lucky stars to still be alive, and made our way inside. This, too, was not easy feat, as hotel security required a complete conveyer belt scan of all of our bags as though we were at an airport. With our bags scanned and approved, we walked inside, checked in, and made it up to our rooms to hit the hay [see our excitement to be going up the elevator in the accompanying picture]. However, we ended up finding ourselves a bit wired from travel, and instead of tiredness came hunger. Luckily for us, the hotel offered a late night snack menu, and we rapidly descended upon a platter of chicken nuggets and samosas: a healthy combination of American and Indian nourishment. Food comas quickly set in, and we all promptly passed out to get a full night’s sleep.