The Kangshung Face has often had that kind of effect on a climber contemplating it from below. In 1921, after becoming the first foreign mountaineer to receive permission from the Thirteenth Dalai Lama to attempt Everest from the Tibetan side, the Englishman George Mallory—famous for answering “Because it’s there” when asked why he wanted to climb Everest—arrived to survey the Kangshung Face. “Other men, less wise, might attempt this way if they would, but, emphatically, it was not for us,” he recorded in his journal, before dying during his attempt to climb Everest from the Nepalese side.
Rising after an understandably sleepless night, Tabin gulped strong coffee and assessed the situation. The team had broken into factions, arguing about which route to attempt. Roskelley’s faction wanted to entirely avoid the Kangshung Face, which he considered too avalanche-prone, and try a different route along a ridge to their north. The other group, led by the Colorado climber George Lowe, pushed for a route straight up the five-thousand-foot buttress of vertical rock and ice that stood between base camp and easier climbing on upper snow ridges. Lou Reichardt ignored the controversy and led by example, carrying heavy double loads to the high camps they’d established, doing the hard, tedious work of caching supplies partway up the mountain so the team could prepare for whatever probes the climbers made toward the summit.
“I was shocked to see my heroes bickering and confused about how to proceed,” Tabin says. “If Sir Edmund Hillary had altitude sickness and an elite mountaineer like John Roskelley felt that the conditions on the Kangshung Face made it too dangerous to climb, I wondered what business I had being here. Base camp, at seventeen thousand feet, was as high as I’d ever been.”
A week later, Roskelley made an impassioned plea to his friend Kim Momb. “Come off the mountain if you want to live,” he radioed while Momb was fixing ropes high on the Kangshung Face. “I owe it to your family to bring you home alive!” Momb and Roskelley left the next day.
Tabin, who’d had a week to acclimate, tried to put the drama out of his mind. “I realized what a privilege it was to be in that place, and I thought I might never make it back, so let’s see if I can do this.” He was feeling strong enough to try to help the remaining climbers push a route farther up the center of the Kangshung Face. “I was amazed by the climbing they’d already accomplished,” Tabin says. “I’d never done anything that difficult.” Tabin pushed upward, helping to carry loads and fix ropes, nearly to the top of the buttress, gratified to learn that he was capable of tough technical climbing at Himalayan altitude.
Arguments and injuries drove most of the team away. Six weeks after base camp had been set up, there were only four climbers willing to continue: Reichardt, Lowe, Tabin, and the team doctor, Dan Reid, a diminutive cardiac surgeon who favored kilts and had a frenetic energy rivaling Tabin’s. They took inventory of their options. They had no Sherpas to support them, and only limited supplies remained. According to Tabin, Reid half-jokingly suggested that they all sign a “death pact” and make a frantic dash for the summit, agreeing that if anyone became sick or injured on the way up, the others would abandon him. “I stared at ‘Death-Pact Dan,’ ” Tabin says, “and realized the expedition was over.”
The Problem of Her Eyes
Only our eyes had met. The lips had still not spoken. The days that we’re apart, I know not where she has gone. The sun crowns the snow peak. The lowland lies in darkness. I tune my mind to her. I lay my pillow down, pointing my head toward where I hope she’ll be. I wish my soul would run, to wherever she has gone.
—Nepalese poet Madhav Ghimire, “Aaja Bholi,” as translated by Dr. Singha Basnyat
There was the problem of her eyes. Eyes were rarely a problem for Ruit nowadays. He could diagnose a youthful cataract from across an examination room, before a patient even sat down at his slit lamp. Astigmatisms, abrasions, the telltale pressure bulge of glaucoma—all these Ruit could detect with almost mystical insight, faster and more accurately than any of his peers. But her eyes were a problem he couldn’t solve.
Her name was Nanda. Nothing had passed between them but the proper synchronicity of a surgeon and an excellent scrub nurse. She’d anticipate the instrument he’d need, and just as he’d turn to ask for it, there it would be, in her slim, steady hand. Her dark eyes, framed in the narrow band between her surgical mask and cap, were wide, and clear, and calm. When he turned from a patient on his operating table in the Nepal Eye Hospital and looked into them, searching for a spark, any indication that she felt the way he did, he found nothing but professional attentiveness. And that made him anything but calm.
Of course he’d made the usual inquiries. What he’d learned was daunting. She was Newari, a daughter of the original residents of Kathmandu, masters of wood carving and stonemasonry who had built the cultural heart of the capital. The temples and palaces of central Kathmandu, Patan, and Bhaktapur were her heritage, as surely as the boulderscape of Olangchungola was his. Her father was not wealthy, but she had been born into an upper stratum of class-conscious Kathmandu society. An even more formidable obstacle than caste stood between Ruit and his aspirations: Her family was Hindu.
He finished his case, and as Nanda waited for him to lean back on his stool so she could bandage the patient’s eye, Ruit hunched forward, staring into space, summoning his courage. He’d already asked her to have tea with him, somewhere away from the hospital, several times, and each time she’d rebuffed him with a simple “no thank you,” her eyes as unreadable as ever.
“Thik cha?” she asked. “All is well, Dr. Ruit?”
“Please, Nanda. Please. Won’t you go out someplace with me when we’re finished here?”
She lowered her lashes modestly, and he took her silence for assent.
What was happening to him? Where was his focus? For more than a decade since Yang La’s death, he had hewed to the path that had been revealed to him. There had been a few diversions. At King George he’d joined the basketball team. And though he stood only five foot seven, he played “pivot,” as the center position was known locally, because he was broad and powerful enough to bull his way toward the basket against taller players. He had dated a bit, without much emotional consequence. There might have been a bit too much whiskey in Delhi, at the All India Institute, the country’s top medical school, where he’d been accepted, after blazing through King George, to specialize in ophthalmology, too many late nights drunkenly speculating about the future with his classmates. But Ruit understood that, in Asia, raw knowledge without the social connections to put it to use would lead nowhere. So he’d added a few rupees to the hat passed to purchase local spirits.
Despite the occasional bleary morning after, he became all business at All India. The school had the finest facilities in a nation of nearly a billion souls, and he was drawn to the new technologies on offer in their well-equipped research labs, especially the emerging field of microsurgery. After graduating from King George Medical College with his general medical degree, he’d been assigned as a medical officer on a team of cartographers mapping Nepal’s northern border. He kept the surveyors safe from altitude sickness and treated their sprained ankles, strained limbs, and other minor ailments. Ruit spent months trekking from Everest eastward to Sikkim, to villages that reminded him more and more of home as he approached the upper Tamor River. And he did what he could with his limited medical kit for local people wherever they camped, far from the resources of the capital. What he discovered shocked and enraged him.
“I found all manner of malnutrition and infectious disease, of course,” Ruit says. But what amazed him was the staggering extent of preventable blindness he’d taken for granted as a boy. “It was everywhere! In every village I’d find people blinded by cataracts living like animals, actually worse than animals, because even dzo are taken out for fresh air and can rely on being fed. But these people, thousands and thousands of them, were stranded in the darkness of their huts. I asked people why they didn’t seek treatment. They talked about the distanc
e to hospitals. But really the essential was this: resignation to fate. They said, ‘Your hair grows white, your eyes grow white, and then you die.’ I knew this was nonsense, that when you’ve lost your vision in such steep places like the mountains of Nepal, blindness takes away ninety percent of the meaning of life. I knew cataract surgery could give them their humanity back.”
By the time Ruit reached Olangchungola, he was dismayed to see how impoverished it had become. A third of the houses had been washed away by floods. New roads from Kathmandu to Lhasa had slowed the busy stream of trade between the people of the Tamor valley and Tibet to a trickle. It seemed there was no one left in the village but destitute people.
As he trekked away from the community his father had worked so hard to help him escape, he felt a detailed vision of his future coming into focus. Every complex sort of medical care was needed by those who lived at the margins of Nepalese society. But restoring sight was relatively simple. He spun the prayer wheels flanking the central lane of Olangchungola as he set out, perhaps for the last time, away from the place where he’d been born. He injured both arms and survived, chanting the pujas his father had taught him, asking for the blessings of Guru Rinpoche and of the spirits of the earth and air, preparing for the climb forming clearly in his head, no matter how steep.
In Delhi, at All India, Ruit lived and breathed the study of ophthalmology. He haunted the laboratory where the rhesus monkeys he used to hone his surgical techniques were kept. “I would be there so often, at such oddly hours, that I’d have to give the night watchman some baksheesh, a few rupees or cigarettes, to let me in,” he says.
The microsurgical treatment of cataract disease was a far more subtle and technically challenging way to cure blindness than the crude technique still common in the developing world during the 1980s. But Ruit was determined to master it. Learning to operate under a microscope was difficult. He had to move his hands very slowly and delicately, but magnified by the lenses, subtle movements appeared jerky and exaggerated. Reconciling his brain to deal with this disjunction took patience and repetition.
Ruit’s research required that he blind dozens of living creatures, monkeys who could look up at him with such moist, humanlike eyes that his hands shook, at first, before he began to operate. “I knew how my dad would feel about me causing these animals suffering,” Ruit says, “particularly a creature like a monkey that we venerate in our culture. But I’d become different. I’d feel troubled at first, but as soon as I picked up my instruments, I thought about nothing else but improving my technique.”
The distance he’d traveled from the Buddhist certainties of his boyhood could now be measured in lives taken, not only miles trekked through mountains. Despite Sonam’s solemn request that he eat only large animals, life in a British-style boarding school had swept away such distinctions. He had come to eat unthinkingly, to fuel his studies. But he’d never forgotten Sonam’s advice to remember that he was Walung. He carried that knowledge always, near his belly, like the silver bird-shaped belt buckle his mother still wore.
And now he’d just asked a Hindu woman to tea.
They strolled through Durbar Square. Around them, the carnival atmosphere of the old city center whirled. Emaciated sadhus marched by in loincloths, clutching their trident staffs as tightly as the vows they’d made to renounce the material world. Holy wanderers squatted on the terraces of multitiered temples, chanting praise to Lord Shiva, or snoring as they sprawled on warm paving stones, inches from the bare feet of street children who darted between them, playing tag or untangling kite string by winding it around temple pillars carved with acrobatic images of erotic couplings. Tikka-paste and marigold vendors held out their wares, admonishing passersby to consider parting with a measly rupee or two, so their karma could benefit from the draping of a statue of Krishna with flowers or the smearing of a stone god’s forehead with a daub of crimson.
Ruit walked on in awkward silence, his tongue stilled by a city that hadn’t seemed as foreign, as fundamentally Hindu to him, since he’d arrived as a teenager fresh from the mountains. He was aware of the way men’s eyes followed Nanda, who looked even lovelier out of hospital scrubs than he had imagined. And he felt their eyes on him, too, calculating what a Tibetan type was doing beside this beautiful Newari woman in a pale blue sari that rippled like water as she walked. Ruit realized that his plan to lead Nanda to a table at a sidewalk tea shop would expose her to more of this scrutiny, so he pushed open the door of the first sanctuary he spotted, a dim, narrow Chinese restaurant he wasn’t sure he could afford, because it catered to tourists. It was too early for dinner, and he was relieved to see that they were the only customers.
At first, as they sipped sugary black tea and picked at a plate of fried vegetable rolls, Ruit talked in jolts and starts. But he detected a flicker of warmth in Nanda’s eyes, now that they were alone, and this encouraged him. Suddenly, the plans he’d been nurturing for the future came pouring out. He explained that when he’d graduated at the top of his class from the All India Institute, he’d had his choice of lucrative jobs in Europe and America, that there had even been an offer to serve as physician to the sultan of Oman, with a cook, a home, and a driver of his own. Instead, he’d made a promise, not only to the memory of Yang La but to the underserved majority of the Nepalese people, and, he told Nanda, he intended to keep it.
Turning down profitable work like the job in Oman meant that Ruit lived in a bachelor’s studio apartment near the Nepal Eye Hospital, where he’d been hired in 1985, and his junior surgeon’s salary left him just enough to put out plates of biscuits and brew large, weak pots of tea for the staff who often gathered at his apartment in the evening to discuss the country’s political dysfunction. The subject they circled back to frequently was their frustration with Nepal’s medical caste system, in which few but members of the royal family and other VIPs received high-quality care.
Ruit told Nanda that he’d urged his colleagues to adopt microsurgery for removing cataracts, and that they recognized his skills and ambition but the established surgeons clung to their expertise: the older procedure called “intracapsular” surgery. The process involved filleting a patient’s eyeball nearly in half, extracting the diseased lens whole, sewing the eye back together, and prescribing glasses with thick lenses that the patient would then have to wear for the rest of his or her life. Recovery from such an invasive surgery required that patients spend a week flat on their backs, their heads immobilized between sandbags so their wounds wouldn’t burst.
Intracapsular surgery, he said, left patients with, at best, a narrow tunnel of vision, which was nearly useless to people trying to navigate steep mountain trails. And he confided to Nanda that when he’d argued, at a tense meeting with senior staff, that it was the hospital’s duty to send medical teams to rural areas, to treat patients who weren’t able to travel to Kathmandu or pay surgical fees, he was reminded of his junior status in the institutional hierarchy and bluntly instructed to stop making waves.
The waiter asked if they wanted to order more food. Ruit declined, with the air, he hoped, not of someone who couldn’t afford another overpriced dish but of a man too busy to be interrupted. Nanda hadn’t said much, but he felt sure she was listening carefully.
“Have you had enough to eat?” Ruit asked, and Nanda nodded. He let his mind swim from these shallow conversational depths toward the solid shore of the question he really wanted to ask.
Sitting cozily in a booth beside her, in a quiet tea shop he had managed to find on Kanthi Path that offered shelter from prying eyes, Ruit asked Nanda to marry him for the first time. The moment felt right. But after he gathered the courage to propose, she seemed not to have heard his question. So he repeated it. Nanda flatly refused, saying that the communities they came from were too different for it to work.
The second time, Ruit brought her back to the Chinese restaurant near Durbar Square where they’d gone on their first date. He ordered tea, a plate of egg rolls, and an extr
avagant dish of Hakka noodles and tried again. This time she fended him off, laughing, as if he’d just told a mildly amusing joke.
“I began to feel really desperate,” Ruit says. “Nanda was beautiful, and I know I’m not so handsome, but I felt sure we were right for each other. I could see she had a very straight character. When you fall in love, you like everything about your darling—her hairstyle, the way she walks. The way she works. I felt I could watch Nanda work forever. I wanted to give her time and let the feeling come from her side. I tried to throw myself at my own work even harder, but I worried, when I had lonely time to myself, that all the love was coming from my side only, and she might marry some other joker.”
One morning, after Ruit’s third and fourth unsuccessful attempts to change Nanda’s mind about marriage, he was dispatched, as one of the Nepal Eye Hospital’s junior surgeons, to pick up an important foreign doctor at the airport.
Since Ruit’s return to Nepal from the All India Institute, foreign doctors had been his lifeline to advances in cataract surgery. The Dutch doctor Jan Kok was a frequent visitor to Nepal and brought Ruit news of advances in artificial intraocular lenses. Dick Litwin, a bearded Berkeley ophthalmologist who looked more like one of the backpackers who wandered the Thamel District in a hash haze than a leading-edge eye surgeon, performed one of the first IOL implantations Ruit ever witnessed. “In the mid-eighties,” Litwin says, “lens design was changing so fast that perfectly good year-old IOLs were being thrown away in America. So I cultivated lens salesmen and brought duffel bags of obsolete but perfectly good IOLs to Nepal.”
Litwin remembers teaching IOL implantation surgery to junior staff at the Nepal Eye Hospital. “When I walked in the OR, all the surgeons stepped away from their tables and asked, very obsequiously, ‘Dr. Litwin, will you finish my case?’ All except one.” So Litwin bent over to watch Ruit struggling, then succeeding at implanting an artificial lens. “I was struck by both his determination and his skill, so I invited him to lunch.”
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