Que sera, sera...

Trip Start Oct 20, 2009
Trip End Nov 29, 2009

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Where I stayed
Wat Kampramong, Arokhayasan Hospice

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Friday, November 27, 2009

I'm typing this blog update from the most unlikely of places - the computer of Phra Paponpatchara Pibanpaknitee (AKA"Luang Ta," Thai for grandfather), the Buddhist monk who directs Wat Khomapramong and the hospice program here. He's traveling to Bangkok tonight and offered the use of his computer since I didn't bring my laptop with me. It feels a little strange sitting alone in his private residence using his computer but I am extremely grateful to him for his kindness.  (When I return to Khon Kaen tomorrow, I'll post the pics that go with this blog entry).

Yesterday morning, the van came to pick me up at the dorm at 7am. It was a different van than the ones I've ridden in before since coming to Thailand - not one of the KKU Faculty of Nursing vans. It turns out that KKU hired a private car service to take us to and from Sakon Nakhon - a special treat since it had a flat screen TV for watching movies. Hiroki, Wira (a PhD student at KKU). and I went in the van to the Pullman/Sofitel Raja Orchid to meet Dr. Kato (Dean from Fukuoka Prefectural University in Japan) and Dr. Je-Kan (monk and teacher at Fukuoka). After a few minutes in the hotel, we all piled into the van for our journey. 

Along the way, we talked about PhD programs in Japan, Thailand, and the U.S and how they are different and similar. We also talked about the difference between Buddhist prayers in Thailand and Japan, and Dr. Je-Kan showed up his prayer books in Japanese and did a few chants for us so that we could the way the chants use root sounds to create vibration. Juxtaposed against this very esoteric Buddhist discussion was our collective selection of a movie to watch in the van. The driver had a selection of violent movies from the US so there were few appropriate choices for our ride to a Buddhist temple with a Buddhist monk. Dr. Je-Kan led the movie-picking effort and chose S.W.A.T., a movie about the LAPD's SWAT team. The movie was still underway as we pulled onto a tree-lined path leading to the temple. Talk about cognitive dissonance - wow. We turned the movie off and drove through a series of winding paths into a wooded area. The van turned down another path and into a small parking area outside of what looked like a large courtyard building. As we got out of the van, we all noticed that this open-sided courtyard contained a TON of people, holding flowers and playing music. We walked up the the entrance of the courtyard, took our shoes off, and were stunned by the beauty that lay inside. A water fountain bubbled like a brook as music played all around us. A large gold Buddha was placed in the center of the courtyard, along with many other gold statues. Inexplicably, a group of older women were dressed like school children in jumpers, pigtails, and backpacks while holding baby bottles. To top off the look, some of them had painted their faces white. Another person wore a paper crown saying "Miss Kampramong." Everywhere I turned, there were people dressed up in various outfits. Everyone, without exception, was smiling and laughing. We were ushered over to the area where the ajaree (head monk) was sitting and we were shown to a series of wooden chairs and benches. Then, one by one, the people in the courtyard lined up and presented each of us with offerings of flowers.  Once everyone had given us flowers, the people in attendance put on a musical show for us. It turns out the women dressed as schoolgirls were in costume for their rendition of "Que Sera, Sera."  Before they sang their song, the ajaree introduced the musical numbers by letting us know the performers are all hospice patients or family members who live here. So when they sung "Que Sera, Sera," it took on a whole different level of significance. It wasn't just a song. These women (and everyone at the hospice) live by this philosophy.  I've never seen so much laughing and happiness. It was pretty stunning, actually....I didn't know what to make of it all at first.

After the welcome ceremony, we ate lunch in a basement dining area with Nong and Tom, two volunteers who are visiting from another province. When we arrived for lunch, I was in awe of the fact that two elderly women had been brought in from Bangkok just to cook for Dr. Je-Kan because he loves their cooking so much. The women are like grandmothers, cooking and feeding you until you're just about ready to pop. They cooked us rice and curry and sticky rice and noodles and some other things that I don't know the names of. That first meal yesterday was just a preview of the amazing food I would be served over the next two days. It's almost become a game to them, I think - let's see how much food we can stuff into the visitors. And I couldn't be happier. It's like living in the world's best Thai restaurant for a few days. 

After lunch, we walked over to the ajaree's residence (the same room where I am now typing this blog entry). Along the way, Tom demonstrated a sacred Buddha dance (similar to praise dancing) and it was breathtakingly beautiful. We continued on to the ajaree's residence where we took part in a traditional tea ceremony. After tea, Luang Ta called us all into his private office to show us some things on his computer. He showed us several Powerpoint presentations about the hospice, and then showed us a TV advertisement (for a life insurance company) with children with disabilities gleefully singing "Que sera, sera" while their sad looking mothers looked on. Dr. Kato (AKA "the dean") and I both got teary and were teased a bit for it but Luang Ta was on a roll and played it a second time. The song is very special to the folks at the temple, understandably so.

After we left Luang Ta's residence, we began making rounds to see the patients. But before I describe that process to you, I need to paint the picture for you of how things are laid out here on the hospice's campus.  Families live in small adobe houses clustered throughout the complex. There are also some wooden buildings housing groups of patients living in single rooms. At several points on the campus grounds, there are communal outdoor kitchens where families come together to cook and eat together with neighboring families.

The first patient we visited lives in a room at the end of a long saffron-colored wooden building. The patient - a women in her late 40's with breast cancer that had metastasized to her sinuses and brain - was suffering terribly from a migraine headache. She's not able to take narcotics and is attempting to control the pain caused by her growing tumors and multiple brain hemorrhages with meditation and Thai herbs. Dr. Je-Kan performed a healing ritual in which he sat behind the patient and held her while chanting but the patient was still moaning and writhing in pain. She was begging to see Luang Ta. The ajaree was summoned and arrived while we were with the patient. He squeezed her head while the family member of a neighboring patient stood on the woman's pelvis.While this was going on, I have to admit the Westerner in me was thinking to myself, why in the world aren't they giving this woman some drugs to ease the pain? She was suffering horribly and was clearly miserable. Imagine my surprise when 5 minutes into the ajaree's treatment, the woman's pain went away and she fell asleep. At that moment, I realized I had a lot to learn from the monk and volunteers here about how they manage symptoms. 

The next patient we saw was a young man in his late 40's, diagnoses just a week ago with liver cancer. He had not pursued surgery or chemo - he decided to enter hospice directly instead of pursue curative treatment. Later that night, I understood why. I'll tell you about that in a bit...

For the next few hours, we saw many of the patients currently here at the hospice. (20 patients and their families are currently in residence - last month, there were 40 but many died or went back home after a brief stay here).  At dusk, we sat with patients beside a small lake filled with lotus flowers and talked with them about their fears about dying while family members waved brooms to keep the scads of flying bugs off of us. The whole experience of visiting patients was surreal because it was so much life visiting dying patients in the U.S. and yet at the same time, it was totally different. Here, patients and their families live in complete community with one another. They cook together, eat together, attend morning/noon/nighttime prayers together, attend music therapy together, and attend exercise therapy together. Patients help one another, families support one another, and the entire community supports the monk that support them, even if they have nothing to give but a small bag of rice. Patients and families can live her for free but the ones who can pay are asked to contribute up to 7000 baht a month for their care (around $200 USD). Yet money is a non issue here, and most patients pay little to nothing for their care.

For the rest of my blog entry to make sense, you need to know that the Dean who is traveling with us was diagnosed with Stage 4 breast cancer last year, had surgery and 3 months of chemo, and then elected to stop treatment in favor of pursuing complementary and alternative therapies. She is a kind-hearted, brilliant woman who wanted to come to Wat Kampramong to learn traditional Thai herbal healing methods. Each type of cancer at Wat Kampramong is treated with a different mixture of herbs, and patients and families play a key role in preparing their own medicines each day.

After visiting patients, we ate another enormous meal and then attended nightly meditation with Dr. Je-Kan leading the evening's prayers. He chanted Japanese Buddhist prayers to a large group of patients and families and even though no one understood the words, no one needed to. The chants vibrate, kind of like a guitar string when you pluck it, and hearing the chants sort of turns you into the guitar string for a bit

After meditation, it was time for song therapy - a giant sing-along with hospice patients and their families. While we were all singing, the temple's dogs wandered through, stopping here and there for a pat on the head or a kind word. Once song therapy was over, the community sat to talk with one another and listen to Luang Ta speak to them. There was a long discussion about the Dean's herbs, specifically with regards to how she would carry them back to Japan, where she could purchase the huge terracotta pot needed to cook the herbs, etc. The ajaree gave her the bag of herbs and we looked at it together. It sort of looked like a bag filled with woodchips and potpourri but smelled bitter. While I was silently thanking my lucky stars that I don't have to drink this stuff, cups of what I thought was tea were handed out to everyone, myself included. The ajaree said a prayer (I assumed a tea-related prayer of some sort) and then we all were to drink our tea. Oh dear G-d, I cannot begin to tell you how bitter this HUGE cup of Thai herbal tea was. I politely took a sip and then put it down but was instructed by Dr. Je-Kan that I must gulp down the whole cup - we can't leave until everyone has drunk there cup of Thai herbs. Crap. Seriously, I kid you not when I tell you the stuff tasted like what I imagine battery acid tastes like....once it's gone sour. Yowza. I gulped it down and could literally feel my yucky-face muscles involuntarily contracting. It was that awful. The patients and families found this hilarious and laughed hysterically. (This must be the laughter therapy they had told us about). A patient handed me an orange tablet to help with the taste and I popped that thing in my mouth immediately and chewed it. If you're reading this and thinking to yourself that I'm an idiot, you sooooo don't understand how badly this drink tasted.  At that point, I didn't much care if the tablet she gave me was mescaline - as long as it took away the disgusting taste in my mouth, I was game. I'm pretty sure it was Vitamin C - whatever it was, it took away enough of the taste that I was able to make it through evening prayers without hurling.

After evening prayers, the volunteer M.D. from the community paid a visit to assess the new patients. He and the newly-diagnosed liver patient invited us to join them for the assessment so we went into an exam room for the interview and exam. The doctor spoke Thai to the patient and English to me while Hiroki translated everything into Japanese for the Dean. The gentleman was young and healthy looking yet had chosen to move into the hospice with his family. The doctor interviewed the patient and learned that the patient's cancer was discovered during a routine annual checkup because of elevated liver enzyme. The first ultrasound of the patient's liver was completely normal but 3 months later, it showed a 6 cm mass. A month after that, the mass had grown to 8cm and was now pressing on the patients organs painfully when he lay on his back. The doctor took him into another room and used ultrasound to evaluate his liver. Despite the poor resolution on the ultrasound screen, the doctor was clearly able to see the large mass as well as multiple mets. He spoke with the patient about both Western treatment options and Thai herbal methods and the patient was clear that he understands his cancer is incurable and he would like to receive hospice care

After assessing the new patient, we went to the herbal treatment room where ajaree and his helpers were preparing the Dean's herbal detoxification medications. They asked me if I wanted to detox as well and were quite persuasive but I said I was kind of fond of my toxins and wanted to hold on to them a bit longer 'til I'm in the U.S. They laughed and accepted my "no" as a no. Thank goodness - wait 'til I tell you want "detoxifying" entails......

We walked to the small but very new 2-room house where the three women (me, Wira, and the dean) would be staying. It was late - around 11:30pm - and it was the first time we had gotten to see where we'd be sleeping. We quickly got settled in and prepared for a short night's sleep. You see, detoxifying is a complex process that involves waking up at 5am, taking herbs, and then having diarrhea all day. Since I was in the same room as the dean, we'd all be waking up at 5am for both pragmatic and compassionate reasons. 

This morning, we woke up at 5am and the dean took her herbs and pills. She headed next door to Hiroki's house because she could have a toilet all to herself for the morning. I went into the bathroom in our house and was stunned to see a GIGANTIC scary spider on the toilet. I decided I didn't actually have to go that badly and opted for taking a quick shower instead. After showering (and finally scaring the spider away), I worked on making edits to the 3 Generation House proposal for Dean Eamporn. Around 6:30, I took a walk around the grounds and was greeted by several of the temple dogs. They were romping and playing and my favorite dog ran up to greet me, mouthing me accidentally on the wrist. He didn't break the skin or anything and he looked terribly sheepish after it happened. Poor pup - he has no idea how wild my dogs are back home! I called Grey and Kath to say a quick "happy thanksgiving" and was glad to her, via text message, that they had a fantastic time at Emil and Russ' for thanksgiving dinner. 

Around 7am, we all headed over for breakfast together. On our walk over to the dining area, the dean looked positively spent. She said the "detox" worked swiftly and powerfully but left her feeling exhausted. 

At breakfast, I experienced one of those language mix-ups that leaves a person a bit shocked. Wira was talking with us about food and mentioned that we would be having "gang bang" at dinner. Umm, excuse me?  Gang bang, she helpfully repeated, smiling. All sorts of alarm bells were going off in my head but I decided to gently persevere to figure out what exactly she was trying to tell me. Wira's English is very good so I gently told her that "gang bang" is something a bit impolite in America so could she please explain what she means when she says "gang bang." She asked me what it meant in America and I told her, then she started laughing hysterically and said "gang bang" is "red curry." She was very happy that I told her what the phrase means in English so that she won't ever offer Americans "gang bang" for dinner again. 

After the red curry/gang bang mix-up, we were in good spirits and laughing quite a bit. We walked over to the temple area together and when we walked in, my mouth dropped open. Wait until you see the pictures of the temple - it is stunning - and HUGE. We sat down for meditation, then afterwords we walked over to the back end of the temple where there were tables and chairs set up, along with a projection screen and a computer with Powerpoint. Dr. Je-Kan explained that they often have nursing conferences here because it's such a large space. As conference participants began filing in, Ajaree came up to us and asked Dr. Je-Kan, the dean, and I if we would please speak to the conference participants regarding end-of-life care in our respective countries. We gladly agreed and sat down in front of mics at the tables. The conference participants were here from Ubon Ratchatani Hospital and Udon Thani Hospital, with additional participants from Thamassat University Faculty of Medicine scheduled to arrive later tonight. Our presentations went on until lunchtime, and at the end, ajaree said excitedly that now this is an "international conference" since we have America, Japan, and Thailand represented. 

We walked over to the dining area and ate another huge lunch. (Notice a theme here? I must have gained 5 pounds in 2 days. But man oh man have I had fun doing it!!)

After lunch, we walked across the complex grounds to participate in the herb boiling ceremony. The ceremony consists of prayers, chants, meditation followed by fire-making, boiling, and straining of the herbal tea mixture. Each patient and family boils their own herbs because they believe in traditional Thai medicine that this gives the medicine more power. The ceremony was beautiful and I felt truly honored to have been invited to participate in it. The fires burned hot and smoky and Hiroki said it reminded him of his days as a Boy Scout. Throughout this entire process, the dean continued to dash to the bathroom periodically so by the time the ceremony was done (around 4pm), she was pretty worn out. We all walked back to our rooms "to take a rest," as they say in Thailand, and Hiroki, the dean, and I all fell fast asleep in our respective beds while Wira and Dr. Je-Kan drove into town to meet with a metal fabricator. Dr. Je-Kan is building a Goma Temple at the wat next month and needed to have some metal pieces made. Interestingly, Dr. Je-Kan performed what is believed to be the first Goma ceremony ever performed in Thailand several years ago). We slept until 5:15 or so, then walked together around the temple grounds and took pictures of the sunset, the Buddhas, the peacocks, and the geese. I also had a chance to see a sala tree in partial bloom. Wira explained to me that Buddha's mother gave birth under a sala tree. It blooms only once a year and is very beautiful.

Dinner was another feeding extravaganza and yes, we had gang bang. And it was fabulous! During dinner, we got into an intriguing discussion about gender in our respective countries and talked about machismo. Tom and Nong - both unique individuals in terms of their gender expression - contributed a great deal to the discussion and we had a great dialogue about what masculinity and femininity really mean.  After dinner, we relocated out bags to the main building where ajaree lives so that we won't have to walk very far in the dark to bring our bags to the van at 6am when we leave for Khon Kaen. We're sleeping on the 3rd floor of the building (but they call it the 2nd) on a row of hospital beds. 

After putting our bags down in our new rooms, we headed back downstairs for the evening's music therapy. After being in Thailand for 6 weeks, I've learned that no one gets out of signing, not matter what, so I've temporarily shed my shyness about singing in public.  So when they asked me to please lead our group of visitors in singing "Que Sera, Sera" to the patients and families, I was game. They gave me a print out of the words so it was actually kind of fun. Then it was musical solo time and we each had to sing a solo. Bet you can't guess what song I sung. Yup, you guessed it - that old Buddhist favorite, "Amazing Grace."  I love it that no one knows what the song is supposed to sound like here - plus, Thai people are so kind and accepting of everyone and never critical, so even if they think my singing is abyssmal, they'd never let me know.

Before the evening ended, the patients decided to turn the lights off and do some "dance therapy." We whirled about like dervishes, twirling and laughing and celebrating the day that each of us had been given. No one knows what tomorrow holds for any of us, but today, we all danced with wild abandon in thankfulness and celebration.  When I leave here tomorrow, I will take a piece of Wat Kampramon home with me in my heart. And I hope I never forget how liberating it feels to sing "que sera, sera" and really mean it.
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Ann Brandt on

I love to read your travel blog. Safe travel home.

Coffeguy76 on

I understand that "Amazing Grace" is now in the Thailand Top Ten Tunes thanks to a rather large Buddhist vote recently received! I know someone who is doing flips where she is - but with a big smile. Me too. Looking forward to early next week. Travel safe.

wira on

That's nice memory and I'm very happy when I read your lively record.
Stay in touch with you always.

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