A Pole and a Mexican Practice Thai in Nepal

This week I expanded my work at Vajra Varahi Clinic: teaching. My assignment in Nepal is not limited to providing massage to the residents of Chapagoan, but to also train the English-Nepali translators in anatomy and bodywork. The plan is that after I leave for my next assignment at Namo Buddha the translators here will be able to sustain the care I’ve been giving.

Monday and Thursday I work with my sister, Manesha; Tuesday and Wednesday my partner is Prajal; and Friday I work with my brother, Satyamohan. This past week the schedule allowed for a formal lesson from 9am to 12:30pm and then we accept patients after lunch from 1:00 to 5:00. Prajal and Satyamohan have some previous training in anatomy where Manesha is new to the world of bodywork. It has been a tough week…not because they can’t handle it, but because they are so motivated and intelligent – I have to be on my game.  I’m really happy that they are also very patient with me.

The sessions have been going splendidly. This first week we spent much of our time learning the parts of the body, the systems of anatomy, directions, and finally movement. After our marathon sessions we were able to put our knowledge to the test on actual patients. Starting this week we are going to change things up a bit to maximize our study time and patient face time. Rather than splitting the day in two, we are going to see patients all day and cover pathology, dysfunction, movement, and treatment while working with patients. My massage section of Vajra Varahi will become a sort of make-shift teaching clinic.

Interestingly, we were given an unexpected day off on Wednesday. An organization of young communists called for a national strike in Nepal. Most shops, busses/ micro’s, schools, health facilities were shut down because of it. We all were able to make the most of it. Joel, a Thai Buddhist and over-all cool guy, is the project manager of a shrine being built just behind the temple and clinic. Because of the work stoppage he had about an hour in is busy schedule to receive some Thai work from me. It was totally my humble pleasure and honor.

Later that night I cooked dinner: we have a cook that comes in and provides lunch, but we are responsible for breakfast and dinner. Breakfast is a sort of free-for-all. I get up at about 5:30 to the horns of the monastery next door and sit with a cup of coffee reading and preparing my lesson for the day. The rest of the staff (Marcela, Mac, Lee, and Ben) filter-in throughout the morning. By 8:00 we’re all usually sitting around the table sharing our experiences of dealing with the midnight barking dogs and our valiant fight against the ear-buzzing mosquitoes. We each take a turn preparing dinner on the 2-burner propane stove, usually with candle light (often there’s no power in the evening). Even though there is no refrigeration, only two burners, and using fresh vegetables locally purchased that day – every dinner we’ve had has been a glorious experience. After dinner Wednesday, I was able to once again practice Thai – this time with Marcela: hence the title of this blog – A Pole and a Mexican Practice Thai in Nepal.

With no television, night-life, or electricity we all end the evening together. Ahhhh, maybe that’s the way it should be – everywhere. We all sit around the table, usually well into the night, playing cards, and exchanging stories and experiences before retiring to our respective rooms to start the battle against the noises and annoyances of the night.

Before we all take-off for Lela’s (a local kitchen next door) to meet Satyamohan for dinner, let me share with you my Sunday. After doing some reading this morning and chatting with Ben and Ariela (an acupuncturist who came to visit from Boudha) I decided to take a little trek. At first it was just going to be a short walk in the woods that lie next door to the temple, but I found a little path. The path led straight down and opened up to an amazing view of wheat fields. Following a little foot path I continued to walk greeting farmers with Namaste and enjoying a light sprinkle of rain. An older gentleman who I caught up with started to chat with me.

I continued to walk when I came upon fields and fields of piles of bricks, brick huts, kilns, and people carrying their handmade red blocks from one location to another.  It was an amazing site to see and experience walking among the rows of huts while dodging mules carrying heavy loads of bricks. After about an hour I decided that maybe I should turn around and try to figure out my way back home. It being Sunday, getting lost was no big deal. Fortunately, there was a red-tailed dragonfly that led me most of the way home. Just in time for lunch.

Later that afternoon, Joel suggested that since the water levels are low in the holding tanks on the roof it may be a good opportunity to clean them out. Without hesitation, Lee jumped on the project. I don’t think that Lee has ever turned down an opportunity to help us all out. He’s a marvelous chap, even though he’s from Birmingham. After sometime I decided to head up to the roof to see how Lee and Mac were doing on this new project. Lee was inside one of the tanks dredging out the silt and handing the buckets to Mac who then dumped the dirty water off the roof. I jumped up and into the other water tank and lent a hand. It turned into a friendly competition between a Brit and an American to see who could get the inside of the water tank cleaner. In the end his was cleaner, but I’m positive that mine was dirtier to start and needed much more scrubbing.

The rain is pouring, the lightning is flashing, the thunder is roaring and I’m off to dinner at Lela’s.

Peace and Love.

Namaste.

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Pictures will follow later in the week.

My Parents Must be Proud to Have a Son Who’s a Doctor

“Doctor Joe, you have another patient to see you.” I never get tired of hearing this phrase from Prajawl, the front desk attendant. Wearing my white lab coat and a smile on my face, I walk out of my treatment room to the front desk with my interpreter, Ritesh, Maneesha, or Satyamohan.

“Namaste,” with my hands clasped together I give a short bow to my new patient who returns with the same bow and “Namaste”. We escort her to a back room - before we enter she takes off her shoes as a sign of respect for my space – I prefer to think of it as our space.

The three of us sit at a small table where I first read the patient’s chart and try to get an idea of what type of physical issues my client has been troubled with and the treatments she has received.

“How is your back feeling today?”

Although I’m speaking through a translator, it’s important that I talk to my patient and maintain eye contact with her. Neither a person’s nationality nor culture change the fact that being heard and understood are prime signs of respect.

“Doctor, my back hurts.”

“Could you please show me where it hurts?” I ask.

She moves her hands to the lower right part of her back but slightly over the crest of her hip.

“I’ve had massage and acupuncture before but I’ve been working in the fields and the pain has come back. Doctor, can you please help me?”

The trust, faith, hope, and uncertainty in her eyes meet mine and I immediately feel a sense of humility. Here I am a rich foreigner from a wealthy country who has at his fingertips some of the best healthcare in the world, who has running water and 24/7 electricity, who’s notions of farming all arrive from television, books, and riding rural roads on my bike and her eyes are begging me for compassion and relief from her pain. It’s with a complete humble heart that I nod my head and tell her that I will do my best to help.

Treat the patient not the issue.

It’s so easy to get lost in the daily grind back home: massage after massage treating clients who have succumb to the stress of daily life. Here I can’t do that. Every treatment session, usually 45-60 minutes long and up to 8 per day, I have to give all my attention and dig deep to remember all that I have been taught and learned.

With a deep breath, I place my hands on her back and remember the advice of Paul Fowler, one of my Thai instructors, Love, not technique. There is no other way and no massage technique as healing and as powerful as love. I’m learning that with love, compassion, and a conscious breath comes healing. Listening with my hands I start to palpate her back through her clothes (although my patients are on a massage table-except for their feet, are completely clothed) and find a hypertonic QL.

“Dukksha?” I ask using the Nepali word for pain.

In a groan she replies, “Dukksha.”

Throughout the session of compressions, friction, and stretches I mumble “ramro, ramro” – good good, as she breathes and I feel the tissue release its stubborn tension.

Helping her to sit-up on the table, “How does your back feel?” 

“It feels much more relaxed, dhanyabaad – thank you.”

 “When should I come back?”

We go over some simple stretches and the preferred way of rising from a chair and using one’s legs rather than back when reaching for the ground.

“Give it a week and if the pain comes back, please come back to see me – dhanyabaad.”

We exchange Namaste’s and Maneesha, my interpreter for the day, escorts her to the front desk as I sit down to write my notes on her chart.

“Doctor Joe, do you have time to see a monk from the gompa?”

With a humble heart, “Of course, please send him back to see me.”

With love...

Namaste.

Note: I apologize for the slow response to emails. We only have internet access when the power is on and often the power is on while I’m working in the clinic.

Prologue - NAMASTE

Sunday, April 17, 2011, 21:30

After over thirty hours of travel, two hours of customs in Kathmandu airport, and an hour thrill ride in a cab I finally arrived at my location: Vajra Varahi Healthcare Clinic at Vajra Varahi Gompa in Chapagoan, Nepal. When they opened the large gates of the gompa (Buddhist monastery) to allow for the cab, I knew that I arrived at my location and at my new station in life.

Marcella, the clinic manager, was the first person to greet me. After a warm exchange of Namastes she showed me around the building and led me to my living quarters – my new home. Within an hour Macferson, her husband Lee, and Ben arrived. The new clinic team has been assembled: two acupuncturists and a massage therapist.

During and after dinner we were given our orientation: clinic procedures, working with the translators, case loads and scheduling, meal schedule, expectations, and load shedding. Load shedding is an interesting Nepali concept of power delivery. To ensure that the country receives adequate electricity the government has scheduled black outs. Chapagoan, for example, receives about eight hours of electricity a day. Usually we get two four hour blocks of scheduled power. Each day the times are different and the schedule isn’t always accurate.

After an evening of talking, sharing our experiences, and exchanging wide-eyed amazement we all retired to our respective rooms: Macferson and Lee to theirs, Ben and I to ours. After some brief chatting we both decided to turn in for the night. Incredibly, as my heavy eyes began to close, the wildlife (all the stray dogs) awoke. It turned into a night of tossing and turning to the serenade of barking and howling. Ahhhh…glorious.

Saturday morning at breakfast we all decided to head into Boudha with Marcella as our guide. The trip would take about ninety minutes and three busses. Public transportation in the Kathmandu Valley is an adventure. Busses, mini-busses, and tuk tuks make random stops along the road. A barker hangs on the side of the packed vehicle and scans for possible riders. He yells out the destination and when someone shows interest he bangs on the side to let the driver know to come to a stop – or at least slow down enough to let people jump on. This, my friends, is a far cry from the CTA…much more exciting.

Boudha is a spiritual center of Nepal. It is the home of the Great Stupa. Travellers and pilgrims come here to walk around the stupa three times, pray, burn offerings, and heal karma. The mass of humanity is incredible. As a special treat, Marcella suggested that we pay a visit to the White Gompa and offer kata scarves as offerings to Chokling Rinpoche, Chokyi Nima Rinpoche, and our benefactor Phakchok Rinpoche for blessings. This was done during a Drupchen, a nine day holy observance of non-stop mantra chanting. We reverently entered the gompa, walked alongside the left (clockwise) to the back of the altar and then we each presented our katas to the respective rinpochet. Each blessed us and presented us with a book and herbal medicine. Before our departure we were stopped by one of the monks and invited to a back room for an audience with Phakchok Rinpoche.

For over an hour Phakchok Rinpoche talked to us over tea about his experience as a Lama, Buddhist philosophy/theology and his thoughts of and experiences in America. As well, we had a candid and very cordial conversation with him about our lives, experiences as healthcare/body-worker practitioners, our relationships, and expectations. Phakchok Rinpoche shared with me his painful experience with Thai massage. I promised him that when I’m honored to have him on my mat, we will by-pass discomfort and win him back to the honored practice of Nuad Boran.



The following morning we had breakfast at Saturday Café which overlooked the Great Stupa, did some grocery shopping and headed back to Chapagoan. Sunday, the first day of the Nepali work week meant that the streets and all of the busses would be crowded. Our first two connections went without much drama. The third leg of our adventure was a bit more challenging. One packed bus after another passed without stopping. After waiting for almost an hour and no luck, we decided to walk the several kilometers home. Soon after we started walking, like a chariot from heaven, a packed bus pulled over and invited us aboard – on the roof. We scampered up the back of the bus and found places on the roof among other fellow Nepali travellers. Before we reached our destination the driver pulled over and ordered all of us off of the roof. Apparently, it’s against Kathmandu traffic laws to ride the roof of vehicles – blahhhh.

The night is now getting late and we start working in the clinic bright and early tomorrow morning. I still have to pick up my laundry that’s drying outside, do some studying, reading and prepare for a new experience – new life.

Namaste…