To The Bitter End and Back Again

The day of Thursday began by ending like any other night. The power went out at midnight and as the day officially began I rolled over in bed and decided to go to sleep. I thought about getting up and drinking another liter of water but decided against it. It didn’t take too long into the day before things started going wrong. Once the lights went out, the two mosquitoes that hide under the bed in daylight came out and started harassing me. I pulled the blanket over my head and went to sleep. At 2am I woke up and felt awful. I was shivering cold under two blankets and I was beginning to sweat. I figured that there was nothing to be done until morning so I didn’t get up, instead I went back to sleep. This repeated a few times through the night until it reached around 8am. Thinking that I was a little dehydrated and that could be the source of the problem, I decided to re-hydrate and if that didn’t work, I would go to see a doctor. Feeling dizzy, weak, and out of breath, I got the one liter water bottle on the other side of the room and then returned to my bed where I drank it slowly with some vitamins. Feeling no better, I repeated the same process again lurching across the room and back. After the second liter sized bottle of water was gone and nothing had changed, I knew that something was very wrong. My first thoughts were that I had dengue fever, even though there are no mosquito born diseases in the Kathmandu Valley.

Grabbing my laptop bag I hoisted it over my shoulder with most of the effort I had available. I left my room and headed for the front desk. The same as leaving any other day, I gave the reception desk my laptop bag and key. This time I showed them an international number and told them that I needed to dial it. It was my insurance carrier. On the phone, they said that seeing a doctor did not need any pre-certification. That was only needed for being admitted to a hospital. I rested my head on the front desk of the hotel and the man asked if I was tired. I responded that I was sick and something was wrong. I asked him if Patan Hospital was close, already knowing that the answer was yes. Also, knowing that there were no taxis near the hotel entrance I asked if he could have one of the hotel staff walk with me to the hospital. He looked confused at first from the strange request but then got someone to walk with me. As we headed out of the hotel and down the streets, I was having trouble keeping up with my escort. He was walking at the ordinary Nepali pace, which was normally painfully slow for me. As we rounded the corner I expected the hospital to be right there, instead it was further down the road a distance that seemed like eternity. I thought about needing to stop at the ATM but decided not to because of my exhaustion. We walked to the check-in for the emergency ward and I filled out my admission sheet. As the woman processed it, I rested my heard on the counter, barely able to hold myself up. She gave the sheet to me and pointed into the emergency ward.

With my blank pink medical chart in hand, I walked into a busy emergency ward full of beds and patients. Uncertain where to go, I walked past the waiting area into the treatment area. There was no definite line separating the two. I saw one western looking doctor and I locked eyes with him as I struggled to stay standing. A shorter local doctor passed in front of me and I made eye contact with her, looking for anyone to help me. She told me that I needed to put my chart in the bin on the wall and a doctor would come help me. I did just that and since the bench for waiting was full, I leaned on the wall, a little too afraid to sit on the unclean ground. The western looking doctor came and took the chart, then led me to an inclined bed around the corner where I sat down. He started to take my blood pressure as part of a routine check. As the blood pressure cuff tightened around my arm, it started to fall asleep, tingling everywhere below the cuff. I told him that my arm was going numb and that this was not normal for me. A nurse came by and took my temperature and another doctor took my blood oxygen levels, all as he redid the blood pressure measurement to make sure he had the right number. After a few other quick tests, the western doctor told me that I had a fever of 104 and my blood pressure was 80 over 60. I repeated back to him “80 over 60” and said that it was not good. Something he knew already. I told him that my arm was still numb and that it wasn’t coming back to life even after he removed the cuff. Answering some questions, I gave the two answers usually ruling out stomach problems, no vomiting and no diarrhea. Helping me up, he said that depending on how the further diagnosis went I may want to transfer to a western hospital or I may need to fly to Bangkok. My eyes widened when he said Bangkok and I realized that I may be in more trouble than I was used to. He continued to help me as we walked over to one of the emergency ward beds. Each bed was only a few feet from the next with no separator in the crowded one-room emergency ward. Lying down on the bed, I looked up at the whitewashed concrete ceiling above me. It had a visible layer of dust from where one of the many fans in the room blew air over it.

I asked the western doctor where he was from and he said he was from Britain. He asked if I had a friend that I could call. My left arm completely immobile on the bed, I used my right arm to point to my left pocket and I asked him if he would take the phone out of my pocket. He did so and then placed the phone in my right hand. Lifting my head off of the bed, I looked at the phone and pushed the button for the address book. When I tried to make the call, the phone fell out of my hand and onto my chest. I put my head back on the bed and looked up at the ceiling again. Now my right hand was starting to malfunction and I felt a little more scared. I asked the doctor if he would dial the first number in the address book, labeled “Albert”. Albert was a semi-retired American architect I had met through Rotary and he was my best friend in Kathmandu. The doctor told Albert where I was and then gave me the phone. My fingers becoming useless, I cupped it in my hand and held it to my ear. I told Albert that I didn’t know what was going on, but something was very wrong with me. The doctor talked to Albert for a short while and then hung up the phone. He told me that Albert was coming and would be there in about 30 minutes, it might as well have been forever to me at that point. I asked the doctor why my arm wasn’t coming back to life since the blood pressure test. He responded that he wasn’t a doctor yet, just a medical student. I responded by saying that I didn’t care. I saw the look of surprise on his face at the response he didn’t expect to get.
My phone rang again and I managed to answer it and cup it to my ear, only dropping it once along the way. It was Seema, a friend and local Nepali woman my age that Albert had introduced me to a while ago. I told her the same thing I told Albert and she said that she would visit after she got off work. At this point it was still 10am in the morning so I told her that I would call and keep her updated of any changes. I had the western medical student put the phone back in my pocket as he asked if I had money to pay for the emergency ward services. I pointed to my other pocket and told him my Nepali money was in there. I told him that it was probably not enough but I had some American money and that Albert could pay for anything when he arrived. I told him that I would have no trouble affording the cost of the medical services. He told me that the hospital would only take the Nepali money and he left with the small amount of cash I had.

The British medical student returned and put my money back in my pocket. He said that the money wasn’t enough but he had paid my emergency room bill for now, the USD equivalent was $35. Another local doctor came by and joined the medical student. I noticed that his coat said “Resident” on it. He had helped do some earlier tests on me and he began to take my blood pressure on my right arm as I lied on the emergency ward bed. Again, my arm started to tingle and it didn’t stop when he removed the cuff and repeated the same numbers, 80 over 60. He then left to go get another machine. While he was gone my right arm continued to tingle. Suddenly, both of my hands froze solid and rigid in an awkward position that a person would never make intentionally. They started to hurt in this position as they were fixed solidly and awkwardly out of my control. My right arm still barely awake, I lifted up my right hand and asked the British medical student why my hands were doing this. He responded that he didn’t know. I put my hand back down and within a few seconds my right arm was gone. I couldn’t move either arm and the tingling feeling was starting to move across my chest. The resident doctor returned with what I assumed to be an EKG, and he also brought a nurse with him.

As the tingling across my chest was getting worse and worse, I started to roll my head back and forth on the bed. I was the only part of my upper body I could still move. I said, but in actuality probably yelled, “This is bad. I’ve never felt like this before… …This is really bad. I’ve never felt this bad before”

The resident doctor replied, “Please calm down. Things will be much better in 5 to 10 minutes. Please calm down Sir.”

“OK. I’ll calm down.” I replied while relaxing everything in my body I could. My hands stayed firmly locked in their awkward position despite my will. The British medical student asked the resident doctor why my hands were acting that way. The resident doctor responded that I was probably going into shock. He then lifted up my shirt and started placing multiple sensors on my chest. He slid down my socks and placed a clamp on each ankle. He put his hand slightly above my wrist, expecting me to lift my wrist into his hand so he could put the clamp on it. I looked him in the eyes and told him that I could move my arms. With that, he picked up my wrist and put the clamp on it, and then the next one. As he looked at the machine all I could think of was the end of my life. At the same time the tingling numbness in my chest was getting worse. For the first time ever I saw the possible end in the near future and I definitely wanted to live. I didn’t want to live for myself though. I could only think about my father and mother, grandmother, and sisters and brothers and how sad they would be if I never came back from Nepal. Mostly I thought about how devastated my mother would be if I died in a Kathmandu emergency ward. I looked up at the ceiling and prayed, ‘God please don’t let this ceiling be the last thing I ever see… …and if it’s not too much to ask, I’d like to keep my hands too.’ I stared at the ceiling some more until I was brought back to reality by the doctor removing the sensors from my chest and the nurse inserting an IV into my arm. Even though I couldn’t move my arm, apparently I could still barely feel pain through it. I looked up at the IV bottle as a constant stream passed through the drip system. I’d never seen and IV move so fast. I imagined that if it moved any faster, a whirlpool would form in the bottle. In less than a few minutes the bottle was done and it was replaced by a second, and a few minutes later a third. As the drip went on, life slowly returned to my chest and then spread down to my arms and my hands. The resident doctor was right. In 5 to 10 minutes things were much better.

About 15 minutes later Albert arrived. He asked how I was doing and I told him that I was doing much better compared to about a half hour ago. My Nepali-only speaking escort from the hotel stepped forward and waved in a way to ask his leave of us. I nodded, not even realizing that he had stayed there the whole time. I told Albert the story and then lifted my hand into the air, touching each finger to my thumb. I reiterated that I was much better. Using his phone, we called Seema to let her know that things were much better and that I would be alright. I talked to Albert and made sure that he paid both the Hospital and the British medical student, especially the British medical student. I didn’t want his kindness to be punished by negligence. Thinking that this may be just a case of dehydration, Albert and I started to plan where we would have dinner together. I lied on the bed for several hours waiting for all of the tests and the x-ray to come back. When they did, the doctors said that they wanted to admit me because I showed signs of an infection that they couldn’t determine the origin of. Postponing dinner, Albert and I agreed that I should be admitted. The only room available was half of a double room in the private ward of the hospital. A situation that turned out for the best in the end, but that’s another set of stories to be told.

The stories not told also include A LOT of help from Albert and Seema. I am especially thankful for all of their help throughout everything. That is one nice thing about hanging around the Rotary circle. You meet a lot of genuinely great people who are willing to help you when you need it the most.

Just for anyone who is concerned about my health. After 5 days of in-patient service I was released from the hospital today with my last 4 cipro pills in-hand. I am feeling much better. The final diagnosis had to be made after I had recovered. Many tests were done with each one coming back negative. Two days before I was discharged I had a malaria test because the doctors still weren’t sure what I was suffering from. According to them, it was apparently one heck of a case of dysentery. Although I must admit that its strange that I had no vomiting, little diarrhea, and all negative stool samples. I don’t think I’ll ever be certain, but things are much better now and I am thankful for that. I’m also glad that I decided to go see a doctor so quickly. From the first signs of symptoms, it was less than 8 hours until I was going into shock.

Multiple Points of View

It’s about one month into my scholarship year I am in an unexpected position. I have received my student visa, the start date of school has been postponed 2 weeks, and my on-campus housing is undergoing maintenance. I am staying in an inexpensive local hotel, but I don’t quite have the feeling of living here. I still have the feeling of visiting. It’s hard to feel a sense of residence when staying in a hotel. I have decided not to leave the area on more vacation-like activities, so that I can keep up to date on the status of my dorm room. I have visited many of the popular sites in Kathmandu and have exhausted the tourist feeling as well. With lots of time on my hands before school starts I have been able to relax, and also get back in touch with the world events I couldn’t keep up with while living in Houston, working 60 hour weeks, and volunteering on weekends. I could always get headlines, but I never had the time to see news reports from multiple outlets in an attempt to understand what was really happening.

One such event that drew attention around the world was the recent “satellite” launch from North Korea. At the end of venturing out and about each day, I could expect to come back to the hotel and watch the television news awaiting the launch. The suspense grew each day since the only news was that there was no launch today, maybe it would be tomorrow. After a few days of waiting, the launch took place and all the news agencies scrambled to report anything they could on the story. With plenty of time on my hands, and a beautiful array of worldwide news agencies broadcasting on regional satellite TV here, I decided to see what I could learn about this news story. As it turned out, I learned more about the news organizations, their countries of origin, and their respective people and cultures more than anything else.

The first television news I turned to was the trusted USA mogul, CNN. Although, here I get the international CNN broadcast instead of the domestic one shown in the USA. It’s actually quite humorous since they employ many people with British accents, possibly in an attempt to combat the domination of BBC World News on the international market. As expected, they were reporting on the developments of the North Korea launch. As I watched the dialog between anchor and reporter, the dynamic became repetitive and very tiresome. Every other sentence switched off from the current news to mention old news on North Korea and how CNN was the first to break that previous story. Then another sentence of the current event followed by more old events and a mention that the reporter speaking now was the one who gave the exclusive of that older report in 2003. Again they made another short statement of the present situation followed by CNN tooting its own horn. Then another small fact followed by the reporter giving some of her resume. After five minutes, all I knew was that North Korea had launched a rocket, and for some reason I wanted to hire the reporter to a full time position.

Only one channel over was BBC World News, the overpowering force in international television and radio news services. Once I changed the channel, the resume harping stopped. BBC was giving the news in a concise factual manner. One statement after another, they clearly stated the few facts that they knew. Next they continued on to the developments in the story that they expected to see in the near future. The report was surprisingly brief, condensed by only talking about the facts on the current event. While this was effective, it left something lacking. Throughout the report there was the air of both indifference and self importance from each person speaking. It seemed clear that I was listening to people who would never be affected by North Korea developing military technology. More importantly I was listening to people who knew that it didn’t endanger their lives or livelihoods in any way. Quite the contrary, North Korea brazenly defying multinational sentiments on weapons proliferation is what ensured that their livelihoods as news reporters would be sustained for quite some time. I decided to find a newscast that came from people with a greater stake in the news story.

Fortunately, I had already been very adventurous with the remote control and I knew the channel for NHK World, the English language world broadcast from Japan. Immediately I saw the anchor for their news program with the most serious look on his face. In his heavily accented English he delivered the top story with a stone cold grave demeanor. After going over the facts that all news organizations were reporting, he made it a point to clearly state that as the rocket passed over Japan, no debris fell on Japan and no Japanese citizens were harmed. Next, the news organization went to a one-on-one interview with a visiting expert on satellite launching rockets. The interview was very concise and there were no jokes or smiles exchanged as the interviewing journalist and local expert went over the details they were there to share. There was no question that this was a serious matter to everyone in the newsroom and each person took this world news development with the utmost importance. The newscasters weren’t excited that this gave them something to fill airtime with or that reporting this story would add to their personal resume. For them it was not a world news development, it was an unfolding plot that had the potential to harm them, their friends, and their families. Watching this broadcast, I was aware of how important this story was to the people of Japan. There was only one group of people I could think of who had more at stake in this development than the Japanese.

Again, my tastes in multicultural TV paid off as I already knew the channel for ARIRANG, the English language Korean world broadcast. Of course, I am referring to a South Korean world broadcast. Normally ARIRANG broadcasts the news in English. In fact, I could hear faintly in the background the sound of the anchors and journalists reporting on the launch in English. I couldn’t make out what they were saying because over their low volume English was a very loud dubbing of Korean. I continued to watch as the report continued entirely in loudly dubbed Korean. It seemed clear that it had been dubbed over in the language that was guaranteed to be understood by every South Korean citizen around the world. With the loud volume of the dubbing, it seemed evident that even a hearing impaired senior citizen of South Korea could understand the broadcast. In addition, they had more North Korean national TV footage than any other news service. It seemed safe to assume that the airwaves containing the footage reached South Korea on a daily basis. I left the TV on as I read the newspaper in my hotel room, waiting to see if the broadcast would return to the normal English. After an hour there was still no change. They were reporting the news as seriously as anyone could and in the language that every South Korean, young and old, could understand. Once again it was clear that these people had a significant stake in this news story. I was a little disappointed that I couldn’t understand what they were saying, to try and further grasp just how serious they were.

I came to Nepal in the hopes that cultural exchange would be a large part of my scholarship year. On this day I didn’t interact with Nepali people any more than any other day. By tourist standards I led a dull day that would be shunned as being worthless. I went to the grocery store, ate in a restaurant, read the newspaper, and watched TV. I didn’t see any historical monuments, visit any artisan shops, or climb any mountains. In fact, it was watching television today that was the cultural exchange. I started at my own culture, continued to a familiar culture, and then ventured further east to get to the heart of the top story of the day. The real story was the people whose lives were in the balance of this military proliferation. The actions and demeanor of the reporters and news agencies in Japan and South Korea were more telling than any facts, charts, sound bytes, or video clips.

A Familiar Image – Namaste and Jay Mashea

The traditional greeting of Nepal is to place your hands together in a prayer-like posture and say, “Namaste”. This greeting is not just ‘Hi’ or ‘Hello’ but a blessing given to the other person. This is not an archaic Hindu blessing reserved only for formal usage, it is used in everyday life. When entering a home or a shop, passing the security guard at the hotel gates, or walking into a restaurant, this greeting is used as a part of modern day life across the Kathmandu Valley. The exception is the local Christians who have replaced the phrase with “Jay Mashea” or ‘Praise the Lord’ as it translates. At one point I was in a sauna and the local young men there asked my religion in their broken English. They easily understood when I put my hands together and said, “Jay Mashea”. One of the five added that he was “Jay Mashea” too. As expected, there are many other cultural nuances far removed from Latin derived languages and Judeo-Christian culture. Touring the city with a local friend, she openly admits that she does not know the meaning of all the symbolism, the names of all the gods, or the purpose of every festival. She says that there is so much to know it is difficult to keep up with it all.

Friday was an official Nepali holiday. I had planned to visit the school and get a closer look at the dorm building, but an American Ex-Pat friend called me in the morning and told me it was a holiday and that I couldn’t get anything done that day. I agreed to meet him in the afternoon to visit a home expo featuring lots of the current technology in Nepal. Technology that could easily be used in an Engineers Without Borders style community development project. Instead of going to the school, I relaxed until I met a local friend to look at an artisan shop she was planning to export goods from. Unfortunately, when I met her we found out that the shop would be closed until I had to be at the home expo. We decided to put off going to the shop and instead we visited her Aunt’s house, where some of her relatives were celebrating the holiday.

Arriving at the house, there were many Namaste greetings to go around. This holiday, like many others, has people gathering in a home and cooking and eating together. For a few days after the holiday everyone continues the rounds, eating at multiple houses and making sure that everyone invited to eat at their house is everyone whose home they were invited to. I had explained to my friend before entering that I had just eaten a large meal and was very full. This way she could explain to the family in Nepali right away so no one would offer me food and no one would be offended if I declined. In the home I drank several cups of milk tea, the family not offering food, knowing that I had just eaten. After a short while, the mother came up to me and offered me a single hard boiled egg. My friend told me in English that the egg was a symbol of respect. I gladly accepted and ate the egg, not so full that I would consider turning down the gesture. After more tea, we left the house. I headed to the trade expo and my friend headed to the artisan shop.

At the trade expo I found lots of good information for the community development minded engineer. For the inquisitive browser, displays of potable water piping systems included information on pressure ratings and costs. Also available were technical and cost information at the displays of jet and centrifugal water pumps. I cruised from one booth to the next scraping together all the project related information I could. A full understanding of what was for sale would have to wait until later that night. My off hand engineering frame of reference does not include kilograms per cubic centimeter pressure ratings and cubic meter per hour flow rates. Not just in units but also in product lines, I felt a little out of place when comparing to the things I was used to seeing at a home expo. From air conditioning to water heating, every product line is vastly different in Nepal. After getting everything I could, I returned home to rest.

On Sunday, I visited Patan Durbar Square with a local friend. We went into the museum there for a free Buddhist art showing, but in order to get into the area I had to pay for the tourist ticket. We looked over the Buddhist art for a short while and then I walked my friend to her bus for her return home. Standing outside the square, I decided to walk back in and enjoy the privileges of the tourist ticket. I cruised around a little, but finally decided to join some other Nepali’s sitting on the edge of the Krishna Mandir temple. I chose not to go in, because there was a sign at the doorway saying ‘Only Hindus may enter. Photography and leather goods prohibited inside.’ I sat on the ledge with about 10 other locals, admiring the view of the buildings in the square. Looking up, I saw something that I hadn’t noticed while walking around. In front of two of the temples were statues on top of 30 foot stand alone columns. Their height removed them from the view of the casual stroller below.

In front of the temple where I was sitting was a column with a semi-familiar figure. Overhearing an English speaker’s guide below, I heard that it was an image of Garud paying respects to Krishna’s temple. It didn’t quite match the stereotypical image I would recognize. Even so, with its eyes still open and only kneeling on one knee, it looked like an angel preparing to pray. In reality the statue conveyed something along the lines of ‘Namaste’ but I couldn’t help but smile as I thought of an angel saying “Jay Mashea”. In a place where everything is different, I had accidentally stumbled across an image of something that was intriguingly similar.