Second Suns

by David Oliver Relin

  On the operating table, Patali clutched my hand throughout the surgery on her left eye. Five minutes later, when I helped her sit up and repositioned her so her right eye faced Dr. Ruit, she was calm enough to release my hand. I stepped behind him, skirting the bucket now brimming with medical waste. Ruit had removed his hiking shoes, and his wide, bare foot lay on the pedal of the microscope, controlling fine focus. As he set to work on Patali’s second eye, I leaned forward to watch, my fingers resting lightly on his shoulder.

  “Don’t touch me!” he barked.

  I jumped back, accidentally kicking the microscope’s power cord out of the socket. “Daayviid,” Ruit said, his voice now low and sing-songy, the voice of someone calming a startled animal. “This lady would like to see out of both eyes, eventually. Do you think you might be good enough to plug my microscope back in?”

  On the roof of the temporary hospital, Ruit’s team had set up camp. Six tents were duct-taped to the concrete, lines of drying surgical scrubs hanging between them. Exhausted nurses and technicians sprawled on sleeping bags or darted inside to change into jeans and T-shirts. The esprit de corps of Ruit’s team was obvious, and I was struck by the confidence of the professional women, compared with the meekness of most of the female patients I’d met. At dinner, one particularly sassy scrub nurse wore a tight T-shirt that declared, in bold letters: SHUT YOUR MOUTH WHEN YOU TALK TO ME.

  I sat inside a low, open-ended mess tent across a camp table from Ruit, beside three Chinese Australian donors who’d come to determine what sort of investment they were getting for their money. I mopped the last of my dal and aloo gobi from a metal plate with my second freshly baked chapatti. Ruit swallowed his last bite and sighed contentedly. “It’s important,” he said, “to feed your army really, really well.”

  The crowns of eucalyptus trees rose just above the roofline of the building, stirring in the slight breeze. They flavored the dusk with herbal currents. Once it became fully dark, the cook’s assistant removed our plates and replaced them with candles, which lent the glowing interior of the tent substance, separated it from the dim evening air.

  The two North Korean surgeons were both named Kim, but they couldn’t have been more different. One was small, shy, and bespectacled. The other was strapping, outgoing, and as handsome as a soldier on a Soviet-realist propaganda poster. When I was introduced as an American journalist, they found an excuse to slip out, and returned a few minutes later properly equipped. They had each fastened a pin depicting Kim Jong Il, the “Dear Leader,” to their shirts.

  Ruit reviewed the day’s surgeries with them, drawing diagrams of the interior chamber of the eye on a page ripped from my notebook. He had performed forty-four perfect surgeries over the course of the afternoon. Between them, the Kims had struggled to complete seven. “The secret,” Ruit said, sketching the ideal wound construction, “is to go slowly, slowly, slowly until you’ve mastered the technique, you see. You’ll need to do about two hundred cases each before you really get the hang of it.”

  “How many cases have you done?” I asked. “More than two hundred, I imagine?”

  “Oh, a few more,” Ruit said, reaching for the bottle of rum he’d brought from Kathmandu.

  “By his own hand, more than eighty thousand,” said Nanda, the keeper of her husband’s flame. The scale of what Ruit had achieved and what he was attempting struck me then, for the first time. One man had already restored sight to the equivalent of a football stadium’s worth of people. Yet more than one hundred million people around the world who needed an ophthalmologist’s services were still waiting. Beneath us, sleeping on mats in a recovery room, were fifty-one people who, if all went well, could no longer be counted among that number tomorrow. And when the Kims returned to North Korea, they would bring Ruit’s technique with them and pass it on to their colleagues in one of the world’s most isolated places. He was seeding not only Nepal and North Korea but much of the poorest ground in Asia with enthusiastic young surgeons like Kim and Kim. It was visionary.

  Ruit poured a healthy splash of rum into each of our mugs, neatly quartered a bowl of limes with a sharp knife, and squeezed fresh juice into each of our drinks. Then he raised his mug. “What we do is hard,” he said, with something like glee. “If it was easy, someone else could do it.” Everyone sipped the citrusy rum, and we traded toasts in the half dozen languages of those assembled around the table. The Kims looked elated. The breeze picked up. Guttering candles threw sparks of light off our tin mugs, onto the canvas walls of the tent, and I felt something rare, something important, being kindled.

  Early the next morning Ruit looked fresh in a crisply ironed white polo shirt and black trekking pants. Though we’d had only a few hours of sleep, he practically skipped, clear-eyed, toward another long day of surgery.

  The fifty-one postoperative patients were gathered in a courtyard bordered by low stone walls, waiting with bandaged eyes, squatting on packed dirt with the same heartrending patience as the bus passengers stranded in the slow-moving Trishuli. Ruit conferred with his camp logistics manager, Khem Gurung, making sure the day’s new cases were properly organized. Khem was one of the dozens of younger, clean-cut medical technicians who cheerfully endured the hardships of traveling and working with Ruit.

  “I have to eat something and scrub in,” Ruit told me. “Stay and see these bandages come off. You might find it interesting.”

  The day had a peculiar yellow cast. Shafts of storm light broke through scudding clouds to pick out individual potato and turnip fields on the laboriously terraced hillsides, and made certain stands of scrub pine smolder like they were about to ignite.

  Patali had dressed for the occasion in a style befitting a master seamstress. She wore a crimson-colored silk blouse of her own design, and she had brushed her long black hair so thoroughly before tying it back with a matching silk ribbon that her silvered strands looked like reflections rather than evidence of age. Her husband waited outside the courtyard with the other family members, leaning anxiously over the stone wall. He murmured something reassuring, and her head tilted toward his voice like a plant tracking the sun’s passage.

  Ruit’s team didn’t wear uniforms. Most of the male staff favored polo shirts, like their leader. But what set them apart was their brisk efficiency, movements that must have been modeled on Ruit’s. Khem Gurung’s shirt was lime green, and his manner with patients mirrored Ruit’s almost exactly. Khem knelt to peel off the first patient’s bandages, then examined his eyes in the bright beam of a handheld slit lamp until he was satisfied the surgery had been a success. Thulo Bahadur blinked in the sunlight. Then he began to laugh.

  “How many fingers am I holding?” Khem asked.

  “Two,” Thulo said, waggling his head dismissively, as if insulted to be asked such a simple question. “Two fingers. I can see that perfectly well.” He looked across the courtyard, past the fifty other bandaged patients, toward the stand of eucalyptus; then his eyes focused on the battered cane he held clutched in both hands. He pulled himself up by it until he was standing and dropped the stick in the dirt by his bare feet like something unclean.

  Nurses followed Khem down the line of patients, handing out eyedrops and instructions for keeping the wounds clean until they healed. The two young brothers squatted, stunned and motionless, after their bandages came off. Then Birbahadur saw his mother, a worn-looking woman in a red head scarf and heavy brass earrings, waving outside the wall. He waved back at her shyly. She covered her mouth with both hands and burst into tears.

  I squatted in front of Patali with Khem. Ruit’s initials had been neatly printed on her bandages with a felt marker. Khem peeled both bandages down until the blue plastic cups that had covered her eyes were dangling from her cheekbones. Patali blinked and blinked and didn’t react at all. Her eyes were deeply bloodshot, and I feared the surgery had been a failure. Then her mouth widened into a grin at the vision kneeling before her; a sweaty, unshaven foreign journalist pointing a camera at you can’t
be the most inspiring thing to see at the moment you regain your sight. But she didn’t seem to mind.

  “If you can see clearly, why don’t you touch his nose,” Khem said.

  Patali reached out with her forefinger and placed it squarely on the tip of my nose. All three of us laughed when she found her mark. “Wait,” I said, scrambling over to her husband. I put out a hand and helped him over the wall. He squatted beside his wife and straightened his plain brown topi on his head. Patali studied his lined face.

  “So, how does he look?” I asked.

  “The same,” Patali said. “Still handsome.” Then she threw her thin arm over his solid shoulder. I watched Patali take in the world surgery had returned to her. I saw her gaze alight on a distant ridgeline, where a shaft of morning sun brushed the tips of terraced hills with a warm caramel color. They were only the dusty mid-hill ranges of Nepal, one of the poorest vistas the country could conjure, but she looked toward home as tenderly as Apa Sherpa had during our trek when we’d crested a ridge and he’d first sighted the distant summit of Everest. “Oh,” she said, leaning against her husband, smiling fully for the first time since the bandages came off, “Look at the hills! Do you see how they shine?”

  I watched Ruit’s staff perform a few dozen small miracles more. The oldest patients seemed the most overwhelmed by the gift of second sight. Their joy was sudden and unfiltered. One elderly man, wearing a white turban and a shabby suit coat that hung to his knees, danced circles around his walking staff, singing to himself, drawing protests from patients whose feet he was too entranced to avoid.

  All fifty-one of the previous afternoon’s surgeries had been successful, Khem explained when he finished his examinations. Kim and Kim’s patients had a bit more swelling and postoperative trauma, but for beginners their results were excellent, he said.

  I watched 114 new patients being led into the hospital for the second day of surgery, many hunched over and staggering as unsteadily as Patali had the previous afternoon. Patients streamed past them out of the compound, dozens of the formerly blind hiking away toward their homes, navigating the uneven dirt trails that radiated out from the temporary hospital without the aid of the relatives who accompanied them.

  Walking toward a rusted gate, I saw someone who looked like Patali. But this woman was standing straight up and striding confidently beside her husband. Her back hadn’t been bent by osteoporosis at all, I realized, but by her sense of helplessness, by the weight of blindness. The transformation was startling, almost more than I could reasonably believe one day after seeing her squatting timidly on the concrete floor of the hospital, waiting for surgery.

  I fumbled in my pockets for rupees, doing the math. Not enough. I scrounged through my camera bag, finding a thick wad of bills I’d saved for an emergency. I ran to the gate before she could begin the long walk home and pressed the money into her hands. “For a sewing machine,” I said, unable to meet Patali’s eyes.

  On the roof of the building, leaning against a railing, Sanduk Ruit was watching his patients. He stood with one arm over the shoulder of Serabla, who looked on proudly at her father’s handiwork. I pointed Ruit out to Patali, told her that the man on the roof was the one who had restored her sight. She bent low toward him, her hands clasped together in gratitude. “Thank you, Doctor dai,” she said, even though we were much too far away for Ruit to hear. “Thank you.” Then she took her husband’s arm and they walked together up a dirt trail that led toward a pine grove, his basket immeasurably lighter. I watched until they entered the shade and were swallowed by shadows.

  I looked up at the figure on top of the building, silhouetted against a borderless sky. Though his pitch had been full of self-promotion and bluster the night we’d had dinner, Tabin hadn’t overstated the importance of his work with Ruit. The man on the roof was still a mystery to me, but I wondered if there was a single person on earth doing more measurable good for others.

  The line had been cast in Salt Lake City and the hook set in the mid-hills. I had come to Nepal, lost one book on the trails of the Khumbu, and swerved, finding another. I felt the weight of the mostly empty notebook in my shirt pocket. “Well,” I thought, flipping it open to a clean, blank page, “well.”

  Here You Are

  The greatest country, the richest country, is not that which has the most capitalists, monopolists, immense grabbings, vast fortunes … but the land in which … wealth does not show such contrasts high and low, where all men have enough … and no man is made possessor beyond the sane and beautiful necessities.

  —Walt Whitman

  I sat beside Geoff Tabin as we hurtled down Interstate 80, toward Salt Lake City, in his cramped, sticky-surfaced Ford Escape hybrid. The floor was piled high with cans of used tennis balls, medical journals, crushed paper coffee cups, and nearly empty sports drink containers. Tabin was on the phone to Ghana, confirming the dates for an upcoming trip he’d arranged to train local surgeons and operate on five hundred cataract patients. We were traveling at nearly eighty miles an hour around sweeping curves down a rocky canyon, and he seemed oblivious to the double- and triple-length tractor-trailers passing inches from our side mirrors as he drifted in and out of our lane.

  He hung up and dialed Nepal. It was evening in Kathmandu, and he had to shout over the wind blast and the bad connection, trying to make himself understood to Ruit as they planned Tabin’s next trip. “What’s that? Ten! I can bring about ten fresh corneas!” Tabin said. “Today? The usual, trying not to blind anybody. Listen, we’ve got John Nkurikiye here from Rwanda. You remember I sent him to you last spring. Yes, I’ll certainly say hello. He’s very solid. I think John could be the person to really anchor eye care in Africa. Also, I’m talking with two ophthalmic technicians from Nigeria. I want to send them to you at Tilganga for a month or so.” Tabin looked crestfallen as he listened, for a moment, to an objection Ruit had apparently voiced. “Okay, you know I always trust your judgment. We’ll discuss it when I see you.” Tabin signed off with “Love to Nanda and the kids.”

  By the time he hung up we had descended several thousand feet and were approaching the hilly eastern suburbs of Salt Lake, where the sparkling, glass-and-steel John A. Moran Eye Center was located on the University of Utah campus. Traffic ahead of us had slowed, but Tabin seemed not to notice the river of brake lights as he typed a text message to a mountaineer buddy he hoped would join us that evening for dinner. He looked up from his phone just in time and jammed on the brakes, slapping his forearm protectively against my chest as we stopped a foot from the rear mud flaps of a cattle transport.

  “Hey, have you met Andrew McLean?” he asked. I would come to know this conversational lane change well, the lack of spaces in Tabin’s speech before he veered at freeway speed toward an apparently unrelated subject. “Technically, he may not be the best skier in the world, but he’ll ski lines no one else would think of touching. He’s really fun,” Tabin said. “Fun,” I soon learned, was the doctor’s highest compliment. “He should be there tonight. I’m thinking incredible, incredible steaks and my famous dirty martinis. Wait till you taste one. They’ll knock you out!”

  It was just after six in the morning.

  In the surgeons’ dressing room of the Moran, Tabin sniffed the armpits of the scrubs he’d worn earlier that morning while he’d attacked his home climbing gym, which peaked in difficulty on an overhanging pitch of 135 degrees. He’d started his workout long before I was awake, but I knew the angle of the slope because he’d given me a forced-march tour of the sprawling house where he and his family lived, on rangeland outside Park City, late the evening before. The only room where we’d lingered was his attic, where he’d pointed out the routes he’d set, the colorful resin holds that spread across the walls and ceiling like a peculiar formation of coral. Tabin told me that he tried to “get a quick burn” every morning and declared that his central philosophy in life was to keep that flame lit all day, to live every hour fully—or, as he put it precisely, to “keep the
fun-o-meter in the red.”

  He peeled off his scrubs and pulled a clean, folded pair from the stack of fresh hospital laundry. His gold wedding ring hung from a scarlet cord around his neck, a talisman he’d had blessed by the Dalai Lama. At five foot eight, Tabin didn’t have the long, wiry build common to many elite climbers. But you don’t reach the highest point on each continent, or make the first ascent of Everest’s Kangshung Face, without physical gifts. He had worked hard to sculpt and refine the modest material he’d been handed genetically. Even at fifty-two, Tabin had legs with the chiseled musculature of a bicycle racer’s, and his forearms were comically large. Popeye large. They ended at hard, callused hands, hands that seemed blunt instruments for the manipulation of delicate surgical tools.

  Dressed for surgery in scrubs and a sterile gown, Tabin walked so fast, trailed by his two ophthalmic residents and half a dozen medical students, that I had to jog to keep up. Shadowing Tabin and trying to answer questions he or any member of the hospital staff lobbed at them was a critical element of his trainees’ education.

  I fell into stride next to an African ophthalmologist on his way to watch Tabin perform cataract surgery. John Nkurikiye was a tall and handsome forty-four-year-old surgeon. He would have been imposing but for a cheerful spray of freckles across the bridge of his nose and eyes so wide open and optimistic they seemed to belong to a much younger man, not someone who had witnessed the worst of the Rwandan genocide.

  I introduced myself and, to make conversation while we tried to keep pace with Tabin, made the mistake of inquiring whether his family was Tutsi or Hutu. Nkurikiye stiffened. “You know, those are artificial categories the Europeans created for us,” he said. “We’ve had enough trouble because of those words. I prefer not to use them.”