Life-affirmative Threshold

A common question I am asked upon my return home is, “how was Nepal?” Usually my answer is, “It was great, but intense.” It is impossible to sum up this experience in a casual conversation.

I suppose a better way to describe my time here would be to offer examples of profound moments and daily observations I've experienced.

The set up:

Daily activities are roughly the same. The town starts to rustle with noise around 5am, this is when Auntie wakes to start cooking our breakfast. Our neighbor's tea shop opens and I can hear someone hocking up copious amounts of phlegm, sounding similar to gagging followed by the sound of spitting. Chickens are released to scavenge for scraps the dogs haven't eaten from the road; their chicks chirping incessantly. Dogs bark randomly, at any hour of the day. I can smell the fire someone has started either to cook breakfast or burn trash. The odor permeates my room, it is a smell unique to Nepal. The area smells of car exhaust, dust, livestock, burning plastic, boiled milk, butchered animals, curry and incense; each odor alternating dominance at any moment.

Numerous times throughout the day a man pushing a rusty metal 4-wheel cart similar to an oversized wagon delivers goods. It is filled with firewood, propane tanks, 50 kilo bags of animal feed or rice. Sometimes he gets stuck on a rock in the road and struggles with the momentum of the cart, which inevitably comes to a halt. The man is small and muscular, he uses his right shoulder propped against the handle of the cart to push it. I always stop to watch him and struggle to stop myself from helping him push it down the road, not that I think I would be of much help. Modernity takes a back seat to methods perfected through routine and time.

A brahman comes begging for alms in the morning. Auntie gives him 5 rupees, no questions asked, no blessing in return. Offering him money is just what you do when he calls to you from the gate. He waits until someone makes an offering before moving on. Everyone donates, even the Christians.

A large group of Indian workers saunter past on their way to a construction site in the jail down the street from our house, tongue-gaping stares in our direction.

The street isn't busy with vehicles, but there is a steady stream of foot traffic passing. Everyone stares at us. Some say Nani to me in reference to the dog we've adopted. She's famous on the street here and the kids play with her before and after school. She's been included by the local pack of dogs on the street, but if she wanders too far outside her turf, she's attacked. Nani plays with a slightly older puppy on a regular basis. They wrestle, battle over found toys (mostly disregarded shoes, scraps of cloth and the occasional sock) and chase each other sprinting down the road, Nani always trailing behind given her small nature.

Everything is washed at the local spigot across the street. Laundry is hand scrubbed with a bar of soap and brush, put on the clothes line near by and covered in a thin layer of dust by the time it's dry. Dirt is everywhere. Cleanliness is a futile effort. All dishes are metal, hand washed and put to dry on the ground in the sun. It is such a contrast from the almost sterile conditions I was taught to maintain at home.

I am surrounded by the foothills of the worlds tallest mountains. Last night I walked over to a cliff overlooking a drying riverbed. The mist covering the tops of these hills created a scene from a painting I remember in the recesses of my mind. A lone Nepali walked through the rocks below on his way home and I felt an acute awareness to the size of the world. This ant-sized man, the large riverbed, these giant hills and me; all coexisting. I felt transported to another era.

The clinic, patients, volunteers:

The clinic is a five-minute walk away from the house. We've seen several cases of suspected TB. Many have tested positive with the skin test and all the cases we've seen are extra pulmonary, meaning either on the skin, in the bone or lymph system. The skin test has a high prevalence of false-positive results and can pop up positive if you have been in close contact with an infected person. The prominence of TB is alarming, but most of the patients who have been diagnosed have suffered with a mysterious ailment for several years and are happy to hear a confirmed diagnosis. At least TB is treatable, although there was an antibiotic resistant type discovered in India...

This year I haven't had the clinic experience I had last year. I am overseeing the volunteers who are in the clinic daily. I am around to offer another perspective to practitioners when they are stuck with a patient. I'm here to help with other details, but I miss treating patients and having the interactions with the locals and interpreters. I feel like an outsider and participant, a dichotomy difficult to blend. I came with the intention that this trip isn't about me and my experience, but it is impossible to come here and not have transformation. For me, it has been much more subtle and introspective, my entire being hasn't been jolted like it was last year and I am grateful for that. I don't know what type of leader I would be if I were dealing with too much of my own shit and unable to be present with the group when they need me. It has been a pleasure to witness the practitioners work through their doubts, acknowledge their limitations and learn so much about themselves and this medicine. I am sad the clinic is closing in a few days. Things are winding down and an air of melancholy lingers. I find myself equally ready to depart and unprepared to leave, as is generally the case when I travel.

Death:

I recently witnessed the the final breaths of a dying patient. I've never been so near someone about to transition. The fear in his eyes haunts my memory.

Last year we went to the Pashupatinath Temple, where the funeral ghats in Kathamadu are located. I'd never seen bodies burning. The experience was profound for me; death, right out in the open for anyone to see. Wailing women crying, ceremonial head shaving of the son when a father passes, smoke drifting by as I inhale, water carrying the ashes to the Ganges and me bearing witness to it. Traditions for death are sacred. Hindus wear all white for a year after the death of a family member. Bodies are burned within 24-hours and in some ethnic groups widows are unable to remarry, especially if they have children. Up until the 1970s it was common for widows to throw themselves on their husbands funeral ghats and burn right along with him.

I want to gain a better understanding of my relationship with death, but thus far, it still scares me. I realize there is no way of knowing when death will come, for myself or those most important to me. I try my best to embrace opportunities and celebrate each moment as if it were my last. Sometimes I find myself too wrapped up in the mundane and forget life's fleeting nature, coming to Nepal reminds me how precious it is and I look forward to returning home to my loved ones.