Disaster Strikes: Nepal Hospital

A week before my dad's arrival in Nepal, I went to a Newar festival in my didi's uncle's village. Crowded with people jostling to move out of the way as teams of twenty boys and men sped back and forth through the streets bearing the heavy statues of Hindu deities, I think I crossed paths with someone who had pneumonia, and that they coughed as I passed by.

I awoke the next morning in my apartment with a slight pain in my chest, but ignored it and got ready with my didi (who had spent the night) to go back to Bungamati and say goodbye to another didi's younger brother who had gotten his visa to go to America to study medicine. I felt worse and worse during the twenty minute bus ride, shaking with chills more and more - by the time we got to Bungamati, they had to bring me upstairs and put me in bed. I had a fever and a strange pain in my chest, and I felt delirious. I felt even worse that I was interrupting a very important time for a family to say goodbye to their son/brother/uncle and send him to the airport. Already an intern in a hospital, he took a look at me and worried I might have malaria. I wished him good luck in the US, and then my didi went to find a taxi to take me back to Kathmandu to the doctor's office.

The strange pains in my chest grew worse and worse, and the doctor sent me for a chest X-ray, which showed the beginnings of a pneumonia infection in my lung. He prescribed antibiotics and painkiller pills, and gave me a shot of morphine for the pain... You all who have ever seen me around needles know how bad the pain must have been for me to volunteer for a shot... I fainted as we waited for a taxi outside the doctor's office.

Back at my apartment, my didis put me to bed and I slept for a short while, they made me some soup, but I was sick on my bed and the floor... and in so much pain I could only roll back and forth. On top of this, the power went out, and I can only think how awful it must have been to try to take care of me that night, moving me to another bed (it didn't matter where I was, my whole body ached) and spoon-feeding me water and trying to make me take a pain pill whenever I woke up (which was often). The next morning we went straight back to the doctor's office in my landlord's car - I had been crying too loud for anyone not to notice and he volunteered to help.

The doctor checked the percentage of oxygen in my blood and found it very low, 84 I think, enough that he immediately called for an ambulance to take me to the hospital, gave me another shot of morphine which did very little, and a shot of strong antibiotics. My Nepali language teacher came to the doctor's office as well, she had called in the morning and knew what was going on. Dr. Johnny called the Fulbright director as well, who met us at the hospital. I can't quite explain how painful it was to breath - it was as though there was a knife planted inside my lung that my own body was slicing me down on every time I took a breath. The medical term for this is pleurisy, the inflammation of the pleural lining of the lung cavity. The ambulance ride was a blur, and the Nepal version of an emergency room was disturbing for me - many beds close together and a lot of other people in pain and seeing me in pain. The doctors didn't know what was wrong with me at first, took another X-Ray and an EKG of my heart (since I was complaining of chest pain). They gave me more morphine but as they gave it to them I told them it was no use, they had given me some before and it didn't make a difference. I wasn't feeling too positive, if you know what I mean. Didn't have too much patience for the doctors and nurses poking me and looking at me. Throughout the experience I had just begun, my pain took a higher priority to my personal commitment to cultural sensitivity - though, ironically, my experience in hospitals was perhaps one of my best lessons in Nepali culture.

Mike, the Fulbright director, arranged for me to have a private room in the hospital, and I waited for news of my X-Ray results. They kept giving me morphine and bright green antibiotics through an old-fashioned IV system. The toilet was across the hall and I demanded a toilet seat I could sit down on - no way to squat when it hurt to just move. I was just hoping and hoping that I would be better in time to go meet my dad at the airport, or at least to be able to show him some of Nepal. My didi phoned my other Nepali family and told them what was going on, and my aamaa came to see me as well. This was the first meeting of my Newar and Chhetri families, in the hospital. The doctors came after the Xray the next day, when I was feeling in somewhat less pain but still sick, to tell me that my lung cavity was filling with fluid and that they would need to take it out.

The big needle in the back thing was just about my worst nightmare. They had to suck out the fluid that was in my lung, and that was the easiest way... but they didn't give me enough local anesthetic, and I was crying from fear, so it was a horrible experience. My aamaa and my daai where there, and I was embarrassed that they had to see me crying. Everything about it was horrible.

There were two American doctors who had been doing rounds, and I complained to one of them about how painful that had been... so when the next XRay showed that the fluid was back, an American doctor, the head of the hospital, came to take the fluid out. This time he let me lay on my side, gave me anesthetic and a lot more morphine, and it wasn't so bad. I hoped and hoped and hoped that I would just get better in time for my dad, but I didn't improve and Mike went to pick up my dad at the airport. I got some help to wash my hair so I wouldn't look as awful when my dad saw me the first time for 7 months. I think I still looked pretty bad, but it was reallllllly nice to have him be there, and to be able to have my Nepalese families take a break from taking care of me. (At least one person had to be with me at all times, because the nursing profession in Nepal doesn't involve bathroom assistance, and they just don't have anyone to bring you food or give you something if you need it).

My dad's first experience in Nepal must have been pretty horrendous, his daughter in the hospital and all he saw were the crazy roads and lots of people all over. Even though my spirits were down, I still wanted him to meet my Nepali family and be able to translate everything for them. After my dad arrived, though, the doctor came to tell us that the second try at removing the fluid had failed again, and that they would have to use a chest tube. This was an even worse idea than the big needle. A tube is like the biggest possible needle imaginable, only bendy.

WARNING: THOSE WHO DON'T LIKE GORE, SKIP TO NEXT PARAGRAPH
A chest tube insertion is not considered an operation, and can be done in the hospital room. However, it is a difficult procedure because the doctor has to force the tube into the chest cavity, and there is some pretty tough tissue surrounding the ribs and lungs. I lay on my side and my dad held my hand, and I was pretty much scared out of my wits, and the doctor put one knee up on the bed so he could get enough leverage to poke the tube through. It was a horrible horrible feeling and I yelled. The pressure from the fluid trapped in my lung forced its way up and sprayed everywhere - it was a good thing my dad was wearing glasses. The doctor clamped the tube so they could control when they let the fluid out. I wasn't getting enough oxygen ever so I had to have the little oxygen thingy that sticks up your nose, which makes you look really sick and in the hospital. They came back to let out more fluid late that night, and it was one of the worst pain moments, as the tube had messed with a nerve and caused a pain to shoot right up into the inside of my shoulder joint. They opened that tube clamp and it was like on Princess Bride when they have Wesley strapped to the torture machine. I was given morphine (I was being given morphine intermittently throughout the entire time really, it became like a little friend) but I was delirious and going in and out of consciousness, especially when they had to come and take an Xray, lifting me up to slide the panel behind me...

Meanwhile, there were people coming to visit me continously. It was like a party in some ways actually, and a party in my honor really. It wasn't good in the sense that I didn' t get to rest as much as I should, and had to use energy to speak Nepali and explain things. But it was good in the sense that I felt very cared for, and I liked that my dad got to at least meet my family. The tube drainings were so bad, and my oxygen level so low, that the doctor put me in the Intensive Care Unit. I HATED THE ICU. The nurses there are used to dealing with unconscious people, I think, so they right off the bat threatened to use a catheter, for going to the bathroom... For those who think I'm a pushover (ok ok, you're right, I am) I was extremely outgoing in asserting my opinion that time, no catheter for me! They also instisted on giving me the antibiotics undiluted - the nurses in my ward had gotten so tired of me whining and crying that they mixed the antibiotics with saline before putting it into an IV drip. That green stuff going into my arm felt like a bunch of fire ants on parade. I hated it. And I hated the IV, which had to be moved around every couple of days because it would hurt too much, and I was running out of easy veins. The ICU nurses would wake me up in the middle of the night just to take my temperature. There were alarms continuously going off and keeping me from sleeping. My dad couldn't stay with me all the time, as there wasn't room for a second cot. Kamal called from the US and I couldn't talk to him because there was no phone. Finally after much pleading the doctor allowed me to go back to my regular room.

The Xrays improved so they took the tube out and allowed me to leave the hospital. I developed a weird burping problem, where I would have burping attacks. Mike invited my dad and I to come stay at his house for a while, and since I was worried about my dad having to go out to get food etc to bring back to my apt, I said yes. It was nice to stay there but I still felt sick and my dad really wanted to rest. The followup Xray showed that the fluid had come back, as much as ever before, and that I would need another tube. I was so disappointed when I heard this, I didn't know what to do. My dad and I went to ask for advice from my first doctor, who thought my idea of going to Thailand would work out ok. He was going to Thailand in two days anyways, and said it would be easy for me and my dad to come at the same time, so he could escort me to the emergency room there. I had to have a second tube inserted before I left, but they put me under with some twilight anesthetic this time, after they finally found a vein to use (it took them ten minutes). This meant I was awake but don't remember the procedure. The doctor said I complained about the pain and then mumbled for the rest of the time. Sounds about right.

I cried when I had to say goodbye to my families as we left the hospital. I was happy to go to Thailand but very sad to not have them with me anymore. I had my dad though so I was doing fine.

Ambassador James F. Moriarty and me. Would have been good photo if not for piece of hair covering eye. He's way, way taller than Nepalese people. 

Encounters: Arranged Marriages, and, more recently, the Ambassador's house

Hi everyone – yes, I’m still here, alive and kicking! Not kicking too hard though, since basically any movement “makes the dust fly,” a translation of how they say it in Nepali. The freak wind storms have subsided for the most part, so there’s a bit of dust on the roads. I bought a handkerchief to breath through whenever a car goes by as I’m walking on the road. To counteract this nuisance, the weather is nice and warm, all the flowers are blooming, and some new kinds of birds have migrated in. Maybe other people knew this already, but I was shocked to find out that not only is there a real cuckoo bird, but that it also makes exactly the same noise as its clock buddy! They have funny tails that stick up vertically.

Other news: I’m getting ready for my dad to come visit, he’s coming in about a week to stay for two weeks. One possible activity will be going to Pokhara for Cheena’s wedding (Kamal’s little sister). If we do go, that will be my third wedding so far, and fourth wedding reception. I don’t know how I missed going to any weddings the last time I was here – they seem to happen every other minute. As promised, a long time ago, here are the photos of my didi’s wedding. I’ll try to give some obvious description so that you all will get a sense of what goes on over here. Marriage here is traditionally arranged – this is a norm rather than an exception, and in fact the type of marriage system we tend to think of in the US is referred to as ‘love marriage’ here. There are a lot of mixed feelings on love marriages, and mixed ones on arranged marriage as well. I personally have had a really difficult time coming to terms with these cultural differences – the idea of marrying someone you’ve never met or have maybe met just a couple times, a woman’s family being expected to provide a dowry, the grief involved with suddenly moving from the house you grew up in into your husband’s parent’s house. I have found that certain romantic ideals have been lurking in my brain that I didn’t even realize were there until now – they come from movies and tv, and books too. Though I thought I would be better prepared by having read about the marriage system here, I didn’t realize that I would be having my own internal battle over whether or not it is appropriate to allow myself to feel sorry for my sisters here, about their being nervous and afraid and stressed about marriage. I think I’ve decided that it is worth examining from where all these thoughts are arising, but not to allow myself to get too swamped down and stressed out – the system of arranged marriage has been going on for thousands of years, here and everywhere, and on top of that the US system doesn’t really seem to deserve any glowing praise either.

The marriage ceremony is a form of puja, religious worship. It is a long puja, and in Chhetri families they perform it outside, around a mandala drawn on a red mud/cow dung surface. Two Bahun (Brahman) priests came to officiate the ceremony by reading all of the Sanskrit prayers and directing everyone what to do next. The ceremonies involve (in as simple terms as I can) exchanging rings, giving a special wreath of grasses and flowers, many circlings of the mandala, the washing of the bride and groom’s feet by the bride’s family (and drinking of said foot-water), the giving of special treats by the groom’s wedding party (the wedding takes place at the bride’s house), and lots and lots of puja and Sanskrit prayers (read by the priests). The red wedding sari is a symbol of marriage – after her wedding a woman may wear red saris and must wear red dye in the part of her hair, glass bangles, and a special type of bead necklace. This has the same meaning as the wedding band on the ring finger. The groom’s wedding party comes along with a brass band that plays traditional Nepali songs as well as theme songs from hit Hindi movies. There is some dancing but in general the majority of dancing takes place back at the groom’s house (the mother and other non-sister women stay home and perform special rituals supposedly timed with the wedding ritual, and later on while awaiting the arrival of the new bride one or two women dress in men’s clothing and cajole the other women into dancing). At the end of the day at the bride’s house, the bride is taken away; her and the groom get into the waiting and decorated car and leave – but by the time this takes place basically every person on the bride’s side is crying. I knew that there would be crying but it is particularly affecting, for the bride’s immediate family is really wailing, the brothers and everything. In America we have a somewhat private idea of grief, but here it is supposed to be a sort of spectacle, and everyone around rushes to watch the crying family members.

I recently also attended a reception in honor of the Fulbright program held by the United States Ambassador to Nepal, James F. Moriarty. Everyone dressed up pretty fancy, and I had a suit made for the occasion, so here I get to show it off. Everyone had drinks and stood around talking, which was nice because I hadn’t seen some people since the India conference. Later on all the Fulbright people headed over to a restaurant for dinner. The night went smoothly except for the two dogs which were allowed to roam around the room freely.

I’ll be posting more photos later this week, my mom sent me a great package with the photos we took while she was here. I hope everyone is enjoying springtime over there. I’ll be back soon! (Sort of).

The 'jagya,' mandala and ceremonial wedding area, along with all of the dyes, foods, oils, and water necessary for performing the marriage later. At this point a few guests have arrived. Specific cuttings of different sorts of trees and bamboo must be set into the ground around the edges of the mandala.  

Yours truly, with sister (bride), aunts, cousins, and sister's friends. This is upstairs in my didi's room, before her descent to the ceremony.  

Bride in red sari, having the wreath of flowers/grasses tied around her. Groom in traditional 'dhaka' cloth dress and 'topi' head covering. That is my family's house in the background. 

This is everyone's favorite photo from the wedding. 

Another shot of my beautiful sister. 

Bride (sister) and groom. For the groom's family a wedding is a festive, happy occasion; for the bride's it is somber and depressing. They asked me whether I liked Nepali weddings afterwards and I answered honestly, not really. Planning the event is very stressful for the family, and the entire experience is emotionally draining. If it weren't, though, that would mean something is lacking in the feelings of the family toward the daughter - it is only appropriate for everyone to cry.  

I like this photo because it shows a different angle of their traditonal wedding clothing, as well as a little glimpse of the colorful tent that was erected behind the house, where all of the food was served to the guests buffet-style. One of the more curious rituals of the day: the groom ties a white sheet around the bride's waist and follows her around the mandala.  

A close up of the hands at the time of the foot-washing. If you look carefully (click on the photo to see it larger) you can see the design of mahendi (temporary henna tattoo) that my sister's friend drew on her hand the night before. Both of their hands are red from all the puja, red powder (abir).  

The bride's family members wash the feet and hands of the bride and groom, splash some of the foot water into their own mouth, and give tikaa (red paste on forehead) blessing. 

One priest reads the scripture while the other officiates the ritual. 

Sitting at the ritual mandala. Note the hand-made leaf bowl. I just like the artistic effect of the smoke.  

Another photo with the smoke. The Hindu god of fire is Agni.  

Receiving a blessing from her younger brother. 

Guests on their way to another wedding, this is from the roof/terrace of my family's house. Note haystacks.