"Sister, problem? No problem!"

Trip Start May 28, 2010
Trip End Aug 02, 2010

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Where I stayed
Kalika Community Hospital

Flag of Nepal  ,
Thursday, July 8, 2010

I don't know how to start this blog post. I haven't updated things in a while, because I have been busy since June 27th. I showed Mom and Dad around the city on their first day...they were pretty tired and a little frazzled.

Day One

On Tuesday morning, we got a bus to Kalikasthan. The bus was local...full to bursting with people and dirty and uncomfortable. I thought it would be ok though...we didn't break down and the road was passable. Mom and Dad were not fans though. After 6 hours, we made it to Kalikasthan. We were dropped off at a little row of shops in what appeared to be the middle of nowhere. We were directed down the hill towards the hospital and arrived to find a building with no patients and few medical supplies. The homestay had fallen through so we were going to live in the hospital for our stay. They got us some rooms on the second floor, and then we headed downstairs to see what the hospital had.

It was pretty empty. More shelves than supplies, and more rooms than they needed. But it was spacious and clean. The first floor had a big hall with a reception desk, behind which was a set of shelves containing medicines - both traditional and Aryuvedic. Off of the main room were smaller rooms...a doctor's office, an OB room, a lab, and a few rooms with beds for patients.

We soon discovered the best thing about the hospital...the tea. They had a lady who cooked and cleaned for the doctors and nurses and volunteers. About four times a day, they served us a little cup of masala tea...hot, with milk and sugar. Real milk. Yumm. I miss it already.

We went for a walk around the town, and soon felt like VIPs. Our entourage consisted of an English teacher, a Nepali doctor working at the hospital, the parliament representative for the Rasuwa district, and a scattering of other people that joined the walk for brief periods and chatted with our Nepali guides. Towards the end of our walk, we were taken to a little restaurant and treated to omelets, cookies, and tea.

A little portable ultrasound machine was at the hospital, but the doctor there didn't know how to use it. Dad did...and decided to give the Nepali doctor a lesson in ultrasound. But of course, it's hard to teach someone ultrasound without someone to ultrasound on. So...I was laid down on a bed and given an ultrasound. Bonnie Garvens will appreciate this...I geeked out. I got to see my heart, and liver, and kidneys. I appear to have healthy insides. Hooray!

After a good dinner, our first day in Kalikasthan ended.

Day Two

The second day was excellent for my bucket list. I got to see a birth. So cool. A lady in labor walked in right after breakfast. A few hours later, she delivered a baby girl. I was super happy. And I don't feel as scarred as I thought I would. I think I can do that someday. So that's good.

Then I went to a school down the hill to hang out with the English teacher we met the day before. His English was ok...a bit rough, but he could communicate alright. Another English teacher was a little bit more fluent. We had some good conversation in between classes. I went to four classes...the students sat in concrete classrooms with tiny wooden benches. The windows and doors were made of iron bars and the doors all opened to the playground, so it was noisy. I asked them questions, then we read stories in English, and then the students asked me questions. The last was the most fun. In the highest class, the questions deviated from "What is your name?" and "How old are you?" to more humorous things...."Are you married?" Through the English teacher, I was told that I looked very beautiful in my Nepali clothing. I had worn my kurta that day.

I got to eat a snack with the teachers in their equivalent of a cafeteria....a hut with a packed dirt floor and more tiny benches. The cooking lady made the food on a clay oven with a wood fire on the dirt floor. It was tasty though...a doughy mashed grain thing, curry, and some tea.

The drive home was fun too...we hitched a ride with a truck carrying gravel. Me and two teachers packed into the cab of this monster truck and rode uphill. One of the teachers hopped out along the way to buy a chicken...and then he handed it to one of the boys riding in the back of the truck and we continued on. I think at one point, the boy dropped the chicken and had to jump off to go fetch it. We arrived back in the village and I was invited to have some tea...yes...lots of tea....and I agreed. Then I was walked back to the hospital. A most excellent day.

The next day I got my MCAT scores via a phone call to a friend at the volunteer house in Kathmandu. I did well! Improved my score over last time by 4 points. But the improvement didn't come in the Physical Science or Biological Science sections, really....it was in Verbal Reasoning. Apparently I am a champ at reasoning verbally...whatever that means. =) I will credit my religion courses.

The Trek

We began with a Jeep ride to a town called Syaphrubesi. We had planned on taking the bus, but Mom and Dad were not fans of our bus ride to Kalikasthan and they rented us a Jeep. The driver didn't speak much English but he was very nice. Whenever we went over a really bumpy section he would look back at mom and say, "Sister, problem? No problem." Mom was not happy though. Apparently she has a problem with cliffs.

We got stuck on the road for a few hours while we waited for some people to build a road around a truck with a broken axle. They just piled rocks and dirt on the cliff side of the road until it held, and then we were able to drive around it. A much heavier bus went through first...so we were pretty sure we could make it. And we did.

We got hiking at 4 and went for 3 fast hours until we reached the little town of Bamboo. It was right on the side of the monsoon-full river...very loud. The beds were comfy though and we slept well, after our bucket showers by candlelight. That bucket shower was one of the coolest shower experiences ever. You stood in a little room with a rock wall on one side, a door on the other, and the other two sides made of rough planks. The floor was stone. You dipped a little pail in the bucket and dumped steaming hot water over yourself...and proceeded to go about your showering as usual. All by candlelight.

The next day we hiked about 7 miles uphill to a town called Langtang. On the walk, we had some good discussions about my big art vs. medicine decision. I'm feeling a little better about medicine. Still some more thinking to do, but I am leaning that way. If I do medicine, I will have the freedom to pursue art when I retire or even during my practice, depending on the field I go into. Art doesn't offer that freedom in reverse.

One perk of being a doctor is the unofficial international doctor's club. Mom and Dad were acquainted via telephone with a Dr. Mipsang Lama, who was working in Kathmandu but had a house in Langtang. We got to stay at his house for free. There was a married couple working there...a 24-year old woman and a 35-year old man (I think that's what he said). They were incredibly nice, and fed us well.

Mom and Dad got to do some doctoring in Langtang. When we arrived, Dad was led off to see a woman who was sick. It turned out that she had an infection in the glands around her neck, causing her throat to become so swollen that she could not swallow. Dad gave her some of our antibiotic pills, crushed up in water, but she could not swallow them very well. She'd been sick for 2 weeks, and was 24 years old with a 1-month old baby.

Dad came back to the house and raided the doctor's medical supply, jumping through an open window to get into the locked room. He found some stronger antibiotic that he could inject, and some morphine. Mom and I accompanied him on the return to her home. She was resting in a small room in a house on two beds pushed together...several older women sat with her. Her husband, a young man who spoke some English, sat nearby. Men and children peered in the doorway as Mom and Dad examined her. Then we cleared the room with the exception of her worried husband, and gave her three injections...two of antibiotic and one of morphine. Two doctors speaking no Nepali explaining to a man with rudimentary English that his wife needed two injections in her rear was interesting. There was gesturing.

Dad returned later that night to check on her, and her condition had improved. But she still was not well enough to swallow food or much water, and she was too weak to make the 11 mile trek down the mountain. It was decided that a helicopter should be called. They had tried to call it before my parents arrived, but the cloudy weather prevented the chopper from making it up the pass. It costs about 2,000 US dollars for a helicopter ride, much more than any of the people on the mountain make in a year. But it was necessary, or she would probably die. My parents had extended her survival for a little while with the antibiotic, but she needed more care, especially IV fluid, and possibly a procedure to drain the abscesses around her neck. They hoped the helicopter could make it the following morning. 

The next day we got up early, before the helicopter arrived, and hiked to a village called Kyanjin Gompa, at 3860 meters. We left our bags at the doctors house, so it was an easy walk. We arrived and found the house of Dr. Mipsang's mother. She was caring for two children of the couple working at Dr. Mipsang's house in Langtang. The oldest child, 8 years old, was at school down the mountain. (Yeah...the lady at the house had her first baby at 16, when her husband was 27, if I heard correctly....a little different than home.) The two girls were adorable though, and very happy to draw with me in their raggedy notebook. When we left Langtang the next day, my parents decided to sponsor the girls' educations. It costs about 100 dollars or so a year...a lot of money to the mountain people. Dr. Mipsang's mother fed us an amazing breakfast...roti, a tibetan flatbread that we dipped in honey, and omelets with yak-cheese. Mmm.

When we got back, we discovered that the lady had been successfully flown out. Mom and Dad discussed what had happened...and decided that the cause of the issue was strep throat. I had no idea that you could die of strep throat. She had just had a baby, which may have decreased her immune system's responses...but still. Dying of strep throat. It makes you really thankful for our medical system at home.

Last Day of the Trek

Whitis family style, we hiked 11 miles to get back to Syaphrubesi. It took 8 hours. We waited 30 minutes for our driver to show up, and then headed down the rough road to Kalikasthan. It went well for a while (according to me and dad's standards...mom hated every minute of it)...and then we were informed of a landslide ahead. We drove into a group of other vehicles...jeeps, buses, and trucks. Everyone was waiting for the landslide to clear. We had some tea, and then drove up to the landslide. Dad and the driver hopped out to look at it. A giant boulder...the size of a small house, had rolled into the road. A backhoe was working on it intermittently...it would work for a little while, then drive off. The assortment of Nepali drivers would then bargain with the operator to keep working. He wanted money.

Eventually, we decided to drive back 30 minutes to a town called Dunche with a guest house. We had to clarify some things...the gates to the town closed at 8:00 PM, and it was already 7:30. We didn't want to be rushing on the bad road in the dark, either. Our friendly parliament member was called...and he called the gate and had the army waiting for us to open it. Connections are handy. We started down the road...and then the driver stopped. He had something in his eye. Dad had us find a flashlight and some tweezers. It was a leech. On his lower eyelid.

I thought mom was going to die.

We got it out...and then continued up the road once the driver could see. We arrived in Dunche, had a wonderful dinner, and then went to bed. We slept well, once again. It's hard not to sleep well when you walk 11 miles.

Back to Kalikasthan

We woke up early, had breakfast, then drove back to the landslide. Still not clear. We got on a bus on the other side of the landslide...but Mom really did not want to ride the bus. So she used the mom veto and we walked back to Kalika...we were given estimates of 1 hour to 5 hours. It took us about 4. Not too bad. Another 11 miles. We arrived in Kalikasthan and Dad got back to doctoring. The hospital was busy! There was a girl with jaundice and dehydration, an old man with COPD, another old man with a heart attack, and a lady with a shoulder dislocation. She had dislocated it a month previously. Crazy.

Dad and a doctor working there attempted everything they could to put the joint back together. But her shoulder had become so inflexible that it was very difficult. First they injected her joint with a pain-blocking drug and tried to relocate it...but it was still too painful for her. Then they tried knocking her out with a few drugs...Valium, Ketamine, and some other drug. They tried again to relocate it, but the joint was still too stiff, even with her mostly unconscious. They had to give up. It was sad.

Back to Kathmandu

We bought bus tickets, thinking that our Jeep wasn't going to make it through. But he did! We canceled the bus ride and loaded our things into the Jeep. Dad offered the lady with the dislocated shoulder a ride to Kathmandu...and after much deliberation and a few phone calls, she, her husband, and their adorable little boy piled into the Jeep with us. We set off down the hill. It had to be the most painful thing in that woman's life...with the exception of Dad trying to relocate her shoulder the night before. Every bump made her grimace. She was sitting in between Mom and I at the start...she had her injured shoulder on Mom's knees, and she held onto my hand or my knees to keep herself as still as possible on the bumpy road.

After a long trip, we arrived back in Kathmandu. We gave the family money for the surgery and saw them off to the hospital, paid our driver, and then went back to our houses for some hot showers. We went out for dinner...got some tasty Italian food and beer. We then wandered around Thamel for a while and shopped. Finally, we headed back and called it a night!


Today Mom and Dad are at the Indian Embassy getting their visas approved to fly back through India. Then they are coming back here and we are going to head to Patan, a suburb of sorts, for some shopping. Tonight we are hoping to meet our doctor friend, Mipsang Lama, and go out to dinner. Mom and Dad's flight leaves tomorrow at noon or so I think.

Two more weeks for me here, and then I'm off to Germany for a week before heading home. It's all gone by so fast!
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