Purpose

I've been feeling quite homesick. It's inevitable as I've haven't had a stable home since July. I'm thankful for my new Nepali friends as well as the other volunteer at the second clinic (first Ari and Lisa, now Bonnie), but I also appreciate the difficulty of being away from anywhere stable and the opportunity that that little hardship presents.

Clinic staff; goodbye party for Devi (with the scarves, flowers, and red tikka)

As humans, it is through trials that we are transformed. Many people feel this in small ways; they have a fight with a significant other that brings new understanding and deepens the relationship, or someone may struggle to learn a new concept and feel a sense of accomplishment once it is finally grasped. But how often do you peer into your own soul? When do you take time to think about your Purpose? Relationships (romantic and otherwise) may offer a reflection, but it is an altogether different experience to directly peer into your own depths.

Saru (midwife) and I visiting the tea garden

The truth is, I returned back to Nepal because of the emptiness and loneliness I felt when I was last here. At that time, I had spent my 21 years on this planet thinking about the ‘next step’ and waiting for my life to begin, which I referred to as ‘becoming a real adult’. First I have to graduate high school, then college, find a partner, get my career started, be financially stable….subconsciously I believed that achieving these steps would bring about stability, knowing, confidence, and happiness. It took the realization that I choose the wrong career when earning my bachelors degree to start to break that tenuous belief.

Tea flower

Maybe a trip to the other side of the world will clear my head and set me on the right track…

So I came to Nepal, not yet knowing what I was searching for. I learned that accepting uncertainty, instability, and impermanence were what it really means to be an ‘adult’. I suddenly realized that I had unwittingly become a ‘real’ adult’. First came elation, then came pain and loneliness. I understood that there are no series of achievements in life where everything becomes magically perfect. Signing a piece of paper; regardless of if it is for a business contract or a marriage does not automatically make that thing perfect and whole. Life is always challenging and always changing. Even when we are surrounded with people, we are still a discrete, separate unit and have to work to maintain our relationships and continuously strive for happiness.

View from the Chanauti (second) clinic

Even within my profound sense of emptiness I felt more alive than I had ever felt. No longer was I constantly distracted by the ‘next step’. I had stepped off of the prescribed path and was fumbling around in the dark with many more new questions than answers. But this new path felt more right. I had begun my search for my Purpose.

Sunrise in Bhotechaur (main clinic)

Through Chinese Medicine I learned more about the connectivity that exists where we sometimes feel separateness. The cosmos, the planet, and all living things are all interrelated. Humans (and maybe other living things) were given the gift of introspection, and so held a special place between Heaven and Earth with the potential of becoming a Sage (enlightened). The difficulty here existed in that these great teachings were delivered in a more-or-less standard modern teaching style, even with NCNM’s efforts to maintain a Classical approach. This standard model encourages that old ‘next step’ feeling, and leaves that dark, lonely, and oh-so-alive path overgrown with weeds.

View from Bhotechaur

I desired to again return to that path, and was drawn to Nepal where I had first discovered it. Of course, you don’t need to go anywhere to find what is inside yourself, but a complete change in everything familiar lends itself to introspection.

It’s difficult to feel that sense of Purpose and not have any prescribed way to achieve it. There’s no one to walk the path with you, for it is your path and yours alone. We all have teachers that help us along the way, or a friend that walks with us for a while, and if you are listening and watching you will find signs to point you in the right direction. And while I feel confident in my metaphors, I actually have no idea what I’m doing; but something propels me along nonetheless. So, there is the loneliness, the pain, and that amazing, brilliant, profound sense of being really alive.

Nepali Life and an Interesting Case...

Grandma and some kiddos,
mom in the background running the tea shop

Here's a little insight into daily life for all of you as well as a couple interesting cases for you interested Chinese Medicine folk!

Nepali style fire cook kitchen, with an inlaid blessing/prayer design

Life here is rough, so it's understandable that many of my patients look older than they are, and yet they continue their humble daily existence. Nepali people spend their day in the field wearing flipflops or going barefoot, hunched over or squatting down to dig up potatoes by hand or carrying giant bundles of grasses for miles. Their diet consists mainly of rice (which is inexpensive) and a small portion of SPICY vegetables or potatoes with a little bit of lentils. Once in awhile they enjoy a bit of chicken, or if they can afford a buffalo or a cow (buffaloes are more common) they can have a little milk in their tea--which has a TON of sugar. If they happen to attend a wedding (which lasts 2-3 days, see previous post!), they will eat buffalo or goat meat. Meals are often cooked over a fire, indoors, with no proper ventilation. I should mention that the Nepali government is preparing to set up legal guidelines to indoor ventilation, so people are slowly switching over to gas stoves! Electricity is unreliable, so there are no refrigerators and no central heating.

Nepali person carrying a load of grasses, wearing flipflops

The winter here is still pretty warm in the daytime- I often find myself stripping down to just a shirt and skirt with leggings (or the traditional kurta surwal), but nighttime is really quite chilly. Once the sun starts to set, I find myself putting on first one sweater, than a second, then my light coat, and finally wrapping up in a shawl, hat and gloves. After dinner (around 6-7) everyone disperses to get under their bed covers to read or maybe watch tv for a little bit. Rooms are shared; usually 3 single women and 3 single men to a room, or a married couple together in one room. I'm lucky enough to have my own room, though that means I don't have the benefit of body heat to keep the room at least a little warm. I have a hot water bottle for that!

Dipendra and I out for a morning walk before clinic opens

It's interesting to see life truly run by the elements. People wake up before daylight in order to be out in the fields by the time the sun is up. Laundry must be done in the morning so the sun can dry it during the day. You don't take a shower when it is a chilly day, or when you have a cold, or when you are menstruating, and only once a week for the first months (or the first few months) after having a baby. When it is dark, you go indoors and slow down.

The young bride from the previous post
 cutting up vegetables for a meal.
She now lives with her husband's family.

There is certainly a beauty to living by the elements, but it isn't without it's consequences. My patients suffer from a lot of joint pain, coughing, and a myriad of other disorders. I should mention that Nepali people are tough stock-there are many older village people with nothing but minor health complaints. Most of my patients come in complaining of knee pain and lower back pain. I also have several patients who have suffered from stroke, several of which are very young (one young man had a stroke at age 19). Many post menopausal women have uterus prolapse. No one seems all that concerned about their chronic cough (everyone seems to have one) unless it is disturbing their sleep. "Gastric" (acid reflux) is also the norm--due to the combination of ST/SP imbalance/xu and all that spicy food! For you Chinese Medicine folks, common diagnoses are LV and KD yin xu or LU and KD yin xu.

Another typical Nepali house with some farm animals out front

Despite all the hardships, life here is very good. The Nepali people are warm and friendly, and living among the mountains is an unforgettable experience. There certainly is a good reason why foreigners come back again and again; for the spiritual experiences with Buddhism, Hinduism or a blend of the two, for trekking, or for the culture. I'm very happy to be here and humbly offer my novice skills in healing and enjoy the benefits of gaining experience while enjoying Nepal!

Poisoning (?) Case

Patient: male, appears to be age 30-40

hx: alcoholism

Was found unconscious and brought to the clinic. It is suspected that he ate something poisonous, but no one has any proof that this happened, or any idea what the poisonous item might have been.

Patient is brought into the gynecological exam room (it had the only available bed). When I see the patient, he is unconscious but waving his arms and legs around at random and mumbling. The person who brought him in is attempting to constrain him.

Tx: prick and remove HT9 both sides, prick CV26

Patient responds to both HT9 pricks by shouting 'oooooowww!!' and opens his eyes wide. He then closes his eyes again, but is now no longer waving his arms or legs around. No response to CV26. He is still unconscious, but now calm.

Patient is carried from the gynecological exam room to the outdoors (not sure why). At this time he is still unconscious, but rolling a little bit left and right and spitting up foamy saliva.

Tx part two: Moxa at GV20, followed by needle prick towards the front DU20

No response to moxa. With needle prick, the patient becomes semi-conscious. He can not speak, but is coherently gesturing and trying to communicated something. He is propped up and assisted in drinking some water.

The village shaman arrives. At this time I feel that I can not do anything further, so I went back to seeing my patients. A few moments later, after the shaman burns something and chants words (that are not Nepali) the man stands up and walks away.

Breast Abscess

I treated this patient a few weeks ago, and since patients keep their records, this case is to the best of my memory.

Patient: female, appx age 19

hx: Birth of her child one month ago. Swelling and pain in her left breast began one week after birth.

Current: Patient's left breast is now red, hard, and swollen to 3x the size of her right breast. Aerola is red and crusted. She also has a mild fever.

Pulse: thin, rapid

Patient is strongly advised to go to the hospital. Her husband does not want her to go, presumably due to expense. We agree to treat her and ask that she come in first thing in the morning again tomorrow. If there is no change within 24 hours (tomorrow afternoon), she is very strongly advised to get on the bus to KTM and check into the hospital there (by tomorrow night).

Tx: bilateral: LI4, LI11, ST36. left side: GB21, GB43, SP21, ST18

Bleeding to left SI1

Ari, the other acupuncture volunteer, prescribed a huang lian based formula.

Unfortunately, this patient did not return the following morning. I can only hope that she either decided to go to the hospital, or that she was spontaneously cured after only one treatment.

Living the Dharma

Boudha stupa

5 years ago, I began planned a trip to China. Along the path of planning, somehow visiting Nepal became the main purpose of my trip, and visiting China became of much lesser importance. With little to no prior exposure to Buddhism, I decided to begin my trip with a one month Lam Rim course (introduction to the Buddha Dharma) at Kopan Monestary in the Kathmandu Valley of Nepal.

Young monks in front of the gompa at Kopan Monestary (meditation hall)

My stay there has had a profound impact on the course my life has taken, and yet at the time I decided that I took Buddhism "too seriously" to take refuge in the Buddha Dharma and to call myself a Buddhist. I did not want to make a commitment that I could not (or would not) keep. Since then the question of my spirituality faded into the background as I began my study of Chinese Medicine, which is deeply rooted in Daoism (as is Buddhism).

The view from Kopan Monestary

Now that my formal education in Chinese Medicine has ended, I have the time to contemplate the whole picture of my life. My practice of Chinese Medicine remains most important, I am constantly studying ways to better serve my patients (this is the Bodhisattva practice of Buddhism). But more and more I feel the draw to commit to a formal spiritual practice rather than just dabbling in this or that.

Boudha stupa watching over the city

I've begun re-examining Buddhism, which has again been playing a stronger role in my life this past year. Should I take Refuge? Am I Buddhist? By being Buddhist, am I refuting all the other spiritual paths that I believe to be true? I've always strongly held the belief that all the paths are just different ways up the same mountain (or as a kind gentleman phrased today, all are corners of the same bar of chocolate).

Monks hanging out at Kopan monestary

Daily Nepali life is immersed in a type of spiritualism that I have not seen in the US, or many other modern countries. Buddhism and Hinduism are fluid practices between each other, and I've even met Nepali Christians and Muslims! They truly practice, taking time out of their day to go to temple--and not at a prescribed time like Sunday Church. With that example, I find myself examining my daily life. As I am more familiar with Buddhism, I look to that example.

Butter lamps being lit as light offerings

In my understanding of Buddhism, to take Refuge in the Buddha Dharma (to "be" Buddhist) takes 3 vows: to take refuge in the Dharma, the Sangha, and Buddha. I feel the main purpose in this lifetime (and all my other lifetimes) is for spiritual development, which I do through serving my patients and studying from great spiritual teachers; this is the Dharma (Buddhist or otherwise). The Sangha are my Dharma brothers and sisters; other people who are seeking a deeper purpose to life. I already find myself seeking companions and advice from these like-minded people, though they may be from all different walks of life. Buddha is a name for the higher self; mine and that of all sentient beings. The universal consciousness and oneness.

Prayer flags flying in the breeze off of the stupa

And so, I have discovered that it doesn't matter if I "am" Buddhist or not, but what I am is a practitioner of the Dharma. I let go of my attachment to that particular label, and am just allowing myself to be as I am.