Tuesday, December 13, 2011

Back Home

I can't believe I am back. After a 5.5hr flight, 6hr transit, 14hr transatlantic flight, 1hr waiting on line to go through customs, and a 2hr drive , I am finally home. Everything looks "new and shiny" but feels old at the same time, comforting with a rosy glow. I noticed things I never did before, appreciated things I used to take for granted. I am ecstatic just to take a long hot shower and curl up in my warm comfy bed.

I'm sure I will face some re-entry shock re-adjusting to life here but if Nepal has taught me anything, it is to breathe, relax and take things one at a time as they come. I'll handle the rest after I tackle this jet lag.

Monday, December 5, 2011


Back on the road Friday morning, finally reached Lumbini, the birthplace of Buddha. Lots of countries have built their own Buddhist temples on this sacred ground.

Before calling it a day, we drove to the Nepal-India border to check out the Sonauli Bazaar.


Going outside of Kathmandu never ceases to humble me. Even though the Lumbini compound is beautiful (with the help of foreign aid), the areas around it are very poor.

Saturday morning, we woke up at 5am to head home in the densest fog I've ever seen. It was like traveling into nothingness. Shadows of men walking and riding bicycles were all that could be seen. The rickshaws weren't out yet but we saw a few ox carts.

This was rural farmlands, but the roads were thousands of times better than city roads - "Nepal's highway." This is the same route that is used to ship goods from India to Kathmandu. 

The sun finally rose. I chuckled to myself as I saw a chicken rush to cross the road before we passed.
This is my 6th time traveling this mountain road. It's still beautiful but now staring at the rapids, all I think about is Bernoulli's law, playing out physics and bio problems in my head. Science is beautiful. I have had an incredible time on this international co-op and while I will miss Nepal, I think I am ready to get back to school and finish up my last semester. I could not be more excited to start medical school and the next chapter of my life.

Thursday, December 1, 2011

some bad luck

Ever had an incredibly unlucky day, where just about everything seemed to go wrong? Today was one of those days.

I didn’t sleep well so packing in the morning was no fun, rushed to take a cold shower and get ready. Being my clumsy self, I fell UP the stairs. We were leaving for Lumbini today and I didn’t want to be late. I scarfed down some food and threw my things in the car. At my aunt’s house, we waited for the driver and finally headed out around noon. If you ever want to go somewhere decently far away, leave early in the morning.

We got stuck in the normal traffic jam in Kathmandu so it took a while to get out of the city. We picked up some speed for about an hour until we hit another jam. It seemed pretty normal; it’s usually stop and go, especially if a car broke down or there was an accident – traffic bottleneck because the roads are narrow. Twenty minutes pass by and we’ve only moved a few inches so the driver goes to see what’s going on… Turns out there was a political protest blocking the road. The government had just captured the leader of a youth communist group and protesters would not allow anyone to pass the road block until he was set free. This was the main road out of Kathmandu so it was a big deal. We were towards the front of the line, if we had left even 15min earlier, we would have passed through no problem. So here we were for two hours until the police came by to sort things out.
Back on the road not even a half hour and a tire blows out. Someone threw a long nail on to the road and it punctured our tire – good thing we have a spare… the driver quickly changed the spare and we were back on our way. We drove slowly, looking for places that would repair the tire on the way. We must have stopped at a dozen places before we got it fixed. 

Not too long afterwards, we get a second flat tire, only this time it was getting dark and we didn’t have the right lug for the job. Thankfully we were not too far away from the next town, my cousin walked to the nearest shop to ask for help and the rest of us had some tea and waited.

Deflated upon our bad luck and nightfall, we decided to stay in the nearest city a few kilometers away instead of driving all the way to Lumbini. It’s not safe to travel at night.

Thursday, November 24, 2011

Thanksgiving, Nepali-style

Okay so Thanksgiving is kind of an American-only thing, no one else really feasts on behalf of Native American and pilgrims. The Nepalese don’t need an excuse to feast on amazing food, we do that everyday :)

Nevertheless, having grown up in the U.S., I have American holidays engrained into me so I couldn’t forget the third Thursday of November.

The only problem is that no one else celebrates it here (also, there are no turkeys here).

So instead, I spent this Thanksgiving on top of a mountain, picnicking with my family while watching the sun set in the Himalayas.

Nagarkot is the highest peak around the valley at an elevation of 2,195 meters.  The 360 degree mountain view is breathtaking. It really can’t get more perfect than this.

I have so much to give thanks for. Even just this trip itself - sometimes I still can’t believe that I got this incredible opportunity. I have been talking about this trip for years and I’m finally here. I’m so thankful for the support of my wonderful family and friends, my alma mater, my professors and advisers, my mentors, and my scholarship donor. I really would be nowhere without you. 

Thank you.

Wednesday, November 23, 2011

Thursday, November 17, 2011

the team

Finally got over that wretched illness and got back to work. I started at a private hospital on Sunday

–inpatient rounds and outpatient clinic in the morning, and the operation theatre in the afternoons.
The doctors  have been spectacular and it is pretty amazing to see them in action (read more about one of the consultant surgeons) . It is thrilling to think that I’ll one day be in their shoes.

I get to see patients all the way through from the initial consultation to post-op follow-ups. Being at a private clinic, the doctors have a lot more time to explain EVERYTHING to me - everything from how to read an x-ray and explaining diagnoses/diseases/treatments to showing me step by step several surgical procedures, how to manage anesthesiology, pre/post-op procedures.

kidney stones
after removal
As a sidenote, after seeing mini-Percutaneous Nephrolithotomy (MPCNL – kidney stone removal) and laparoscopic surgery…. 

I asked one of the doctors what we’re doing today, and he replied with treasure hunting. Kidney stones really do look like gold on a video feed, and the electrohydraulic gun used to break large stones into smaller pieces sounds like a paintball gun, to top it off, the forceps used to grab the pieces out looks like a giant claw game
Of course that is an immensely simplified way of looking at a difficult technique, but still… I’m now completely convinced surgeons have to be really good at video games :) and also can confirm the well known fact that anesthesiologists are multi-tasking geniuses.

some of the team relaxing before getting started for the day
The doctors, PAs, nurses, interns, and other staff are a tightly knit, highly cohesive AND incredibly welcoming group. They’re professional, fun, friendly, easy-going, and amazing at what they do. As we sat in the lounge chatting and joking around, waiting for the next case, one of the doctors said to me, “You know it’s always like this, day or night, we spend most of our time here; these are my friends, my family, my coworkers, my team.”

Described it perfectly.
I want that.

Wednesday, November 2, 2011

Home Sick, not to be confused with homesick.

I know I’m on the path to becoming a doctor but I still hate going to the doctor’s. After over a week of a sore throat and cough during the holidays, I was still holding strong. Until last night when I was abruptly woken up at 3am by an unbearably dry sore throat, cough, fever, and racing heart beat. I’m cranky when I don’t get sleep so off I went to make this go away.

The doc ordered a typical 5 day course of antibiotics

Day 1 – I feel worse, can barely talk without wanting to somehow shove ice down my throat to soothe it. This is going to be fun.

Probably the worst part is that this means I can’t work. I’m in the minority that actually hates calling in sick. Staying home is like admitting defeat. Part of me feels like I’m lying, screaming “Yeah you can work, you wimp, you’re just making excuses.” Will my boss think the same? Am I really not able to work today? Can I possibly work from home? …and you can see where this cycle goes. 
Short story, I’m a workaholic, I hate giving up when I could be doing something.

However, this is a whole different story. This week I was supposed to start in adult oncology. There is absolutely no way I’d set foot inside that door. Even if I put on a mask, viewed from afar, and took all precautions, it just doesn’t feel right. I came here to volunteer and learn, staying at home does nothing for me but even the slight risk of spreading an infection to a patient or health care team member far outweighs any benefit. Not just because this is a developing country, I recall feeling the same when calling in sick while volunteering at Brigham & Women’s Hospital in Boston. The workaholic in me caves when I realize it compromises the cost-benefit ratio. All those hours spent on CITI certifications has reinforced that nagging feeling of my conscience. If it was office paper work or school work, it would be different. If I were an essential member of the team, if it wasn’t a high risk immunocompromised patient population, if this wasn’t a third world country with high rates of infection, maybe I’d give it a second thought…? Probably not, but either way, right now, it’s just not happening. My conscience is pretty clear on that. 

Here comes five days in sweats, slurping piping hot chicken soup, endlessly gargling salt water, aimlessly trying to pass time.