Second Suns

by David Oliver Relin

  The previous year, after delicate negotiations with Chinese authorities, Ruit had been one of the first foreigners allowed to practice eye surgery in Tibet. He’d demonstrated his surgical technique in Lhasa City Hospital, and the results had so impressed the officials that they’d agreed to send their two most promising eye surgeons to learn alongside Ruit in Nepal.

  Dr. Olo and Dr. Kesang were eager students, but both had only two years of health sciences education after high school, followed by a single year of specialty training in treating eye diseases. Dr. Kesang had one additional specialty. An enormous man, he snored with more vigor than anyone Tabin had ever heard. When the doctors joined Ruit in the mess tent for breakfast the next morning, Tabin drank cup after cup of strong black tea, willing himself to wake fully up.

  But when it was his turn to sit at one of the two microscopes the team had placed side by side in the schoolhouse Tilganga’s staff had worked overnight to sterilize, his adrenaline more than made up for his lack of sleep. If operating at Tilganga had been a struggle, trying to remove the outsized cataracts of patients in a dimly lit schoolhouse, while balancing on an uncomfortable wooden stool, was more like torture for Tabin.

  “I kept looking over at Ruit, bent to his work, turning out a perfect surgery every seven minutes, and for one of the first times in my life I began to doubt my own abilities,” Tabin says. He averaged forty-five minutes to complete each surgery and often had to call Ruit over and ask for help with the most complicated cases. Ruit finished the surgeries quickly and silently, while Tabin waited for words of encouragement that never came.

  Tabin was amazed, as so many before him had been, by Ruit’s hands. “It was incredible,” Tabin says. “Every movement was graceful. It was like watching Michael Jordan steal a basketball and sprint down the court for an effortless breakaway dunk.” Tabin was also impressed by the elegant choreography of Ruit’s staff. “The moment we were done, a technician would cap and tape the eye, briskly help the patient off the table, and slot the next one into place. There was no time or motion wasted.” The first night, they worked until well after dark. And when they scrubbed out and walked together toward the mess table for dinner, Ruit had completed sixty surgeries to Tabin’s seven. As his adrenaline drained away, exhaustion had set in, and Tabin couldn’t recall any time in his life—in sport or in medicine—when he’d felt so thoroughly overmatched.

  He expected a simple meal, then another attempt at sleep. But Tabin was surprised to see that Ruit’s cooks had prepared a seven-course feast of vegetable and mutton curries, rice, and turnip salad, accompanied by freshly baked chapattis. “Like a wise general, Ruit knew he was pushing his troops hard and he had to keep them in top fighting condition,” Tabin says. He had resigned himself to the fact that Ruit would remain gruff and distant during their time together and decided that if friendship wasn’t possible, he would at least learn as much as he could from the finest surgeon he had ever seen.

  As Ruit washed down his second helping of mutton curry with a mug of Nepalese rum, Tabin noted the doctor’s transformation: Ruit shed his tense, tightly wound demeanor, and something appeared on his face that Tabin had rarely seen in the weeks they’d worked together: a smile. Twelve hours of surgery seemed not to have tired him at all. He filled Tabin’s mug with a generous splash of rum and asked who among the twenty seated under the first spray of stars was willing to commemorate a successful day’s work with a song. Singing was one of the few talents Tabin didn’t possess. But Dr. Olo had trained in classical Tibetan opera.

  Olo stood at the end of the long table, downed his mug of rum for courage, and opened his mouth. It was as if three separate people were singing at once. His voice was simultaneously sweet, guttural, and hypnotically rhythmic. Accompanied by brightening stars, he sang a ballad of conquest and betrayal, and the drinkers showed their appreciation by banging the plank table. When Olo was done, he passed the baton to Sonam, who sang Nepalese pop tunes with his achingly sweet voice. When the rum ran out, they switched to whiskey. And when the whiskey was finished, they drank raksi, the home-distilled rice liquor their hosts had provided.

  Near midnight, after most of the staff had stumbled off to bed, three doctors remained at the table, contemplating a problem. Kesang had passed out and lay by their feet, snoring. Ruit and Olo tried to raise him to a sitting position, but he weighed nearly two hundred pounds. They couldn’t move him. It was five hundred yards down a steep trail to the student barracks. “We’ll have to leave him here,” Ruit said. “He’s Tibetan—it won’t be the first time he’ll have slept rough.”

  “Mind if I try?” Tabin said. He squatted, gathered himself, and heaved Dr. Kesang up and over his shoulder. “I’ll put him in his bed.” Tabin stepped carefully down the dark trail, carrying Kesang’s dead weight as easily as he had hauled heavy packs of food, fuel, and rope during the years mountains had been his main ambition. He looked back over his shoulder at Ruit. “See you at breakfast?” Ruit didn’t reply. It was too dark to tell exactly what registered on the doctor’s face, but Tabin was fairly sure he saw a healthy dose of astonishment—and at least a grudging glimmer of approval.

  Three Shirts a Day

  Fill your bowl to the brim and it will spill.

  Keep sharpening your knife and it will blunt.

  Chase after money and your heart will never unclench.

  Care about other people’s approval and you will be their prisoner.

  Do your work, then step back. The only path to serenity.

  —Lao-tzu

  “Thirteen–two.” Tabin heard the score, but he still couldn’t believe it. The loss of the first set he had chalked up to a fluke. Ruit must play badminton regularly, Tabin thought; the soldiers at the gym on the police base near Swayambhunath Temple had all nodded to him and swung the gates open without suspicion, even though it was still dark when they’d arrived. But that didn’t explain the agony of this thrashing. He was still holding a racquet, after all. Swinging a racquet was something Tabin was so good at, he’d come prepared to muff a few shots and build camaraderie with Ruit. Now he was fighting for his life.

  Ruit’s eyes revealed nothing as he served with a quick flick of his wrist. Tabin lunged to his left and, with sheer athleticism alone, managed to get the face of his racquet on the shuttle just before it touched down in the farthest corner of the court. He lofted up a desperate, defensive shot. Ruit didn’t move his feet a millimeter. With the same blinding whip crack, he fired a smash that nicked the baseline to Tabin’s right.

  “Fourteen–two.”

  Tabin heard giggles from the policemen who’d stopped their exercise to watch. As he’d been losing the first two sets, there had at least been the distraction of a group of young men in the blue camouflage fatigues of Nepal’s police, grunting as they did their early-morning calisthenics. But they had cut their workout short to take seats on the sidelines of the court and enjoy the spectacle of the unathletic-looking Dr. Ruit showing a fit and cocky foreigner how relentlessly badminton could be played.

  “Game point,” Ruit said mildly, holding up the white shuttle for Tabin to see. If Tabin trusted his eyes, the last thirty minutes made no sense. Ruit stood on the opposite side of the court, his great, square head topping his equally broad body. He looked no more mobile than a boulder, and by the logic of someone who’d played tennis at Tabin’s level, he should have been a pushover. Yet Tabin couldn’t make him budge. Instead, Ruit controlled the center of the court with lightning flicks from his racquet, running Tabin from side to side until he was soaked with sweat. Tabin couldn’t recover quickly enough to hit a shot capable of moving Ruit more than a foot or two in any direction.

  Ruit wound up to serve, and Tabin anticipated a long drive deep to his left. He sidestepped neatly and prepared his backhand. But the shuttle floated lazily, clearing the net by no more than an inch, and died there, dropping like a bird shot from the sky. Tabin looked at the little white object lying on the court fifteen feet in front of him and
heard the laughter of the policemen echo throughout the gym. He hadn’t even taken a step in the right direction.

  “Match,” Ruit said.

  Tabin handed his borrowed racquet back to Ruit and gulped from a water bottle. “That was incredible,” he said, patting the back of Ruit’s clean white polo shirt, noting with annoyance that he hadn’t broken a sweat. “How long have you been playing?”

  “Oh, some years,” Ruit said, and Tabin was sure he detected restrained laughter just beneath the surface of the expressionless reply.

  If Tabin could get Ruit on a tennis court, he knew, the outcome would be radically different, but somehow that knowledge wasn’t satisfying. He wasn’t on his own ground. It was badminton, not tennis. Nepal, not America. Finicky, rather than first-rate microscopes. And massive, calcified cataracts, rather than the manageable variety he’d trained on in Australia. Still, Tabin wanted to succeed on this ground, on this man’s terms.

  After the eye camp at Jiri, Tabin had returned to Melbourne for six months and completed his fellowship with Hugh Taylor. Then he’d flown home to Chicago to visit his family and tell them what he’d seen Ruit’s hands perform. Tabin had acquired many mentors—at altitude as well as in operating rooms—but no one had ever challenged him the way Ruit had. Tabin burned to go back to Tilganga, felt that if he could only penetrate the guarded surface of this infuriatingly masterful man, his vague lifelong ambition to help others could finally be realized.

  Tabin hoped he’d made a positive enough impression at Jiri to convince Ruit to accept him as an apprentice. Carrying Dr. Kesang to bed might have opened Ruit’s eyes to Tabin’s usefulness on rugged trips to mountain communities, but it was his performance at the microscope that Tabin felt would be the deciding factor. He had sat beside Ruit during four twelve-hour days of surgery at Jiri, and he had worked as hard at improving his technique as he ever had at anything. By the fourth day, he’d shaved a few minutes off each operation and had interrupted Ruit less frequently to ask for help.

  He called Ruit from Chicago and pleaded his case, talking about how much he wanted to learn and how hard he was willing to work. The silence on the other end of the line was so pronounced that Tabin feared he’d been disconnected. Finally, he heard the doctor exhale. “Come along then,” Ruit said. “We’ll see if you can be of some use.”

  Tabin stuffed as much as he could fit into two large expedition bags and returned to Nepal with only his savings and two credit cards whose credit he was prepared to exhaust, determined to do whatever it took to earn Ruit’s trust.

  After his humbling on the badminton court, Tabin shared a ride to work with Ruit in Hilda. The Land Cruiser crept through the dense morning traffic, as motorcyclists with special steel roll cages welded around their engines to protect riders from frequent impacts sped past only inches on either side, ignoring lanes of traffic, slowing all large vehicles to a crawl.

  There was plenty of time to talk in the stagnant stream of traffic, so Tabin asked how he could be most helpful. “There’s lots of work to be done,” Ruit said. “And I have an idea how we might make use of your … energy. But you need more training. You should work with Dr. Reeta. She’s a wonderful surgeon. And much kindlier than me.”

  Ruit was conflicted about the hyperactive creature at his side, even now tapping his feet impatiently at the stalled traffic. “Geoff had shown me some iron at Jiri,” Ruit says. “But I still had doubts. I needed to know he was there—hundred percent—for the patients.”

  Rex Shore, who’d by then become Tilganga’s official driver, as well as its unofficial liaison with Kathmandu’s diplomatic community, knew how hard it could be for outsiders to penetrate Ruit’s protective shell. “Let’s be honest,” he says. “Ruit can be a cranky bugger. I always tell him he’s damned lucky he’s got a lady like Nanda in his life, to smooth over his difficulties in Kathmandu society. And he’s equally lucky to have Dr. Reeta on staff. Sanduk can be so damned impatient, always rushing forward, feeling his work is too important to be polite to people. Getting Ruit to go to a meeting or put in the kind of fifteen-minute appearances with officials that make this country go round takes a lot of arm-twisting, I can tell you. But Dr. Reeta is all patience and no ego. She holds the whole operation together.”

  Reeta Gurung grew up in the Annapurna range, west of Kathmandu. In 1993, she wrote to Ruit from England, where she’d completed her ophthalmic training, and explained that she understood exactly how radical a leap he’d made by operating in remote villages. She wrote that she’d also been born where resources were scarce, and she said she believed in his mission. When they met in Kathmandu, Ruit took to her immediately. With her Mongolian features and her matchless work ethic, she was, Ruit felt, a member of the same breed he belonged to: the underestimated.

  Reeta’s family came from Ghandruk, one of the last settlements before the base camp of Annapurna II. Ghandruk, like Olangchungola, had no school, so her family sent Reeta and her sister to boarding school in Kathmandu. Reeta’s father was a soldier employed by the Indian Army. The Gurung were renowned warriors and hired on with India as professional soldiers. As a teenager, Reeta was studying in Kathmandu when her father was killed in an exchange of artillery along the India-Pakistan border, where running battles for the disputed region of Kashmir were common. Reeta’s mother was widowed at the age of thirty, with a small pension from the army and three children to raise. After her husband’s death, she leased property the family owned in Nepal’s flatlands to growers who gave her a small portion of profits from crops, and she borrowed money to pay for her daughters’ education.

  “Why do you want to learn about me?” Reeta said, in the British-inflected English she’d acquired during her medical study abroad, waving away my notebook when I asked about her childhood. “My story is nothing special. If you want to write about a really impressive woman, write about my mother. I can’t emphasize how difficult it is to be a single woman in Nepal, even now. My mother was very courageous and fought for our futures like a wild animal. She let nothing stand in her way. My sister is a doctor too, a gynecologist who works much harder than me. Whatever we’ve achieved is because of our mother.”

  Sitting beside Reeta in Tilganga’s operating theater, Tabin watched her easily remove the kind of massive cataracts that had given him so much trouble since arriving in Nepal. Her hands lacked the balletic grace of Ruit’s every surgical movement, but they were rock steady, each gesture fast and efficient.

  Since training with Hollows, Ruit had been tirelessly making small improvements to his technique. Hollows had taught, for example, that after inserting an artificial lens, one should seal the wound with a single line of sutures and leave the stitches exposed to the air. One of Ruit’s many innovations was to tuck the sutures under a flap of tissue; because of this, his wounds healed faster and were less likely to leave the eye misshapen. Ruit had also taught himself, year after year, to carve progressively smaller tunnels in his patients’ eyes, scarcely wider than the cloudy cataracts that needed to come out.

  Fashioning such a minute escape hatch for a patient’s diseased lens was difficult to master. “Imagine using tiny, sharp tools, trying to coax a marble through a drinking straw without damaging the straw,” Tabin says. When Reeta asked Tabin to change places with her and operate on the next patient, he did his best to impress her. But the first incision with the point of his blade brought a grunt of disapproval. “Try not to jab at the patient like you’re killing a pig,” Reeta said. “Let your hand widen the wound gently.”

  Tabin pictured the way fencers held their foils as they sized up opponents—swaying gently side to side—and attempted to send that image to receptors in the fine muscles of his fingers, so that they enlarged the opening one delicate cut at a time.

  “Much better, Dr. Geoff,” Reeta said. “If you keep this up, you’ll hardly blind anybody!”

  After two weeks of training alongside Reeta, Tabin felt he’d reached a new level of proficiency. Ruit absented himself, t
rancelike, in each of his cases. But Reeta was encouraging, coaxing Tabin’s callused climbers’ hands to wield the cutting tools ever more gently. The enormous cataracts he addressed each morning through Tilganga’s microscopes had begun to feel not like outsized challenges to his dexterity but a normal, manageable condition he was able to cure. With so few doctors trained in Ruit’s technique and such an enormous backlog of blind patients in Nepal, Tabin hoped Ruit would soon consider him capable of traveling to eye clinics in the country’s mountains and, with the lessons he was learning at Tilganga, helping to teach more of the nation’s ophthalmologists modern skills. He hinted to Ruit how much he’d like to work someplace like Phaplu, where the fuse had been lit that had led him to a career in ophthalmology.

  As the days passed in the crowded capital, Tabin tried to fill his hours away from Tilganga with entertainment. Into the duffel bags he’d brought from Chicago, he’d stuffed tennis racquets, expeditiongrade outerwear, and a full rack of climbing gear. Tabin found a tennis partner, Krishna Ghale, who coached the national tennis team and worked as the resident pro at the American embassy’s tennis facility. They were perfectly matched, and Tabin looked forward to a long rivalry on the courts of Kathmandu. He planned to move from his guesthouse in Thamel to a spare room in the home of his summit partner Nima Tashi, whose extended family lived in a large house near the Pashupatinath compound, an easy walk to work at Tilganga.

  Thanks to Tabin, Nima Tashi’s ankles had healed well enough for him to rise to the top of his profession, as a climbing sirdar, the chief Sherpa on high-altitude expeditions. When he wasn’t working in the Khumbu, Nima Tashi and Tabin discussed mountains they might tackle together if Ruit posted Tabin to work at a higher altitude.