Second Suns

by David Oliver Relin

  Krishna Thapa wasn’t hard to find: All I had to do was walk toward the flames. He left his assistants to tend the embers of a traveler on the wheel of samsara and shook my hand warmly. He wore clean white homespun clothing and was as small as Ruit had described, with a radiance in his light brown eyes that I attributed to the thirty years he’d spent launching the departed toward their next life. Thapa said he hadn’t received any donated tissue for days. Next to a funeral pyre two other Chhetri were building around the shrouded body of a young woman, Thapa unlocked a metal gate set into a stone wall and showed me the room where Tilganga’s technicians would harvest the next set of corneas a grieving family agreed to donate.

  It was warm inside, and constructed like a miniature operating room, with tan marble tile and a steel gurney for the patients. The door facing the river was warm to the touch when I helped Thapa shove it closed, and its base was imperfectly sealed, so that we stood among gray drifts of human ash. I turned to face the small man. “Do you enjoy your work?” I asked.

  “Oh yes!” Thapa said. “We are able to be of great benefit to the dead. And now, thanks to Dr. Ruit, I’m able to make a small contribution to the living.”

  I could hear the whoosh of flames beyond the door as the funeral pyre was lit, and the room became steadily warmer as we spoke. “Do you fear dying?”

  “Not at all,” Thapa said. “I know what an ordinary thing it is to move on to other forms.”

  “So would you like to be cremated here?”

  “Oh yes,” Thapa said enthusiastically. “That is my fondest hope. This is my home.”

  Thapa was so hospitable that I asked the indelicate question I’d been too embarrassed to put to him at first: “Working so closely with so many of the dead, are you ever afraid of ghosts?” Thapa’s face curled up in a sneer, dismissing what I presumed he considered a foolish question. He was right to be offended, I realized. Just because he worked in a setting that seemed macabre to an outsider, why should I assume he’d be superstitious?

  He fingered the collection of beads, amulets, and fetishes on leather thongs that hung in the hollow of his throat, including a slim metal cylinder containing ashes from the funeral pyre of King Birendra. “I’m not afraid the ghosts at all,” he said, lifting the charms toward me to display their power. “I have very, very strong protections.”

  Thapa gave me a souvenir, a set of the small, clear plastic disks, the size of press-on fingernails, that he places over the wounds where the dead’s corneas have been excised, so that their bodies appear intact to their families. Then we pushed the hot, heavy door open together.

  While her parents clung to each other and watched, flames licked out of the young woman’s mouth, and as the clarified butter trickled down her cheeks, it dripped burning drops onto the kindling piled beneath her body. “Do you know how she died?” I asked.

  “The leukemia,” Thapa said, tsk-tsking. “Terrible. She was so young.”

  I couldn’t take my eyes off the flames. They leapt from the base of the burning pyre toward one of her hands, which had fallen free of the shroud. The young woman’s nails were painted the same glossy pink as Kiran Kumari’s had been while I watched Alan Crandall cure her. I stared until the flames reached them and the polished nails ignited, flaring hotter than the surrounding flesh. Then I walked past Thapa’s colleagues, who were sweeping the still-glowing embers of other departed souls into the Bagmati, crossed the river, and returned to the land of the living.

  Tabin was amped up to attempt a procedure so cutting-edge it had never been tried at Tilganga: With a keratoprosthesis, an experimental artificial cornea he’d brought from Utah, he would try to repair a shrapnel-scarred eye by combining it with donated human tissue. While Tabin briefed Reeta on the technique, I sat in Tilganga’s waiting room, speaking with his patient, a thirty-two-year-old man, through an interpreter. His Maoist comrade and minder, a skinny teenager wearing camouflage pants and a black ski cap, tried to look more menacing than he appeared.

  “How were you injured?” I asked.

  “I prepared a bomb,” the patient said, “which I intended to fling at a police post. But it detonated in my hand while I was in the motion of throwing.”

  The man wore sunglasses. He removed them with the stumps of his arms, which had been amputated just below his elbows. His face was scarred from blast wounds, and the socket of his left eye was empty. His right eye appeared intact, if heavily traumatized.

  “Do you regret what you did?”

  His teenage minder interrupted before he could answer: “He is a martyr injured fighting corruption, fighting to set his people free. He can’t work, so now the party is feeding him.”

  “Yes,” I said, then turned my attention back to the patient. “But do you think it was worth it, losing your hands and eyes fighting for the cause?”

  Though he was wearing comically oversized plaid pajama bottoms with the blue surgical smock the hospital staff had tied onto him, the man carried himself with quiet dignity. “Though I’ve lost my hands and my eyes, the citizens of my country have lost much more than that,” he said. “We have many resources, but they’ve been stolen by the few. People are still hungry. They have no clothes. They lack education. I have three daughters. If they, and all the children of Nepal, achieve universal literacy, if the revolution is fulfilled, then I’ll be happy about my sacrifice.”

  The surgery seemed gruelingly complex. Moving more patiently than I had imagined he could, Tabin sewed donated corneal tissue to the patient’s traumatized eye, delicately carved a round crater at its center, and, with Reeta murmuring her support, snapped the clear circular keratoprosthesis into a titanium ring that would hold it centered over his patient’s pupil, succeeding in reconstructing the man’s eye. “I wonder if that’s the first artificial cornea transplant ever done in Asia?” Tabin said, elated, after two hours of surgery.

  The intricacies of the procedure were lost on Tabin’s patient. The man was happy simply to see anything again, to be able to make out forms a day after the surgery. Twenty-four hours later, after Tabin had flown home for Thanksgiving, the man was already seeing well enough to count fingers across the length of an examination room. During the next day, as his eyesight steadily improved, the fervor of his revolutionary rhetoric diminished. He didn’t speak about stolen resources or his glorious martyrdom the last time I talked to him before he returned to Hetauda. “What I want most,” he said, staring at me steadily with his one working eye, “is to see the faces of my daughters. And to tell them that education, not violence, is the path I hope for them to follow.”

  I planned to head home soon after Tabin had, but Ruit approached me during my last day in Nepal. “Some people are holding a ceremony for me next week,” he said. “It’s silly, really, lot of noise and pomp. But you might find it interesting.” The ceremony, I learned from Nanda, was in fact a formal affair commemorating Ruit’s career. It would be held in a recently restored palace in the royal city of Patan, which was being opened for the occasion. I emailed my travel agent and arranged to miss Thanksgiving with my family.

  Almost from the moment I pushed Send on my computer, I was leveled by a bout of fever. We’d been eating wild boar, left over from the inauguration of Hetauda’s hospital, for days. Whether that was the cause of my illness or not, the huge bristly hog heads that drifted in and out of my fever dreams for the next five days argued that it was. And those plaintive notes from the singing bowls formed the soundtrack to my illness, ringing in my ears like a case of tinnitus, like a wailing child who won’t be calmed, like a never-ending test of my brain’s Emergency Broadcast System, though I knew in my more lucid moments I was too far from Swayambhunath to hear them.

  By the evening of the ceremony I was well enough to travel to Patan. I rode beside Ruit, who wore a sober new gray suit for the occasion. Nanda was turned out in a long, pale blue blouse embroidered with white flowers. Sagar, at university in Pokhara, remained at school, as his father surely would have, studyi
ng for his exams. The teenage Serabla and Satenla, abstaining from the formality of their elders, wore sweatshirts and jeans.

  Before urban sprawl, Patan had once been separate from Kathmandu, and its Durbar, or Palace, Square, was one of the architectural wonders of Nepal. We parked beside the Krishna Mandir, a masterpiece of Newari craftsmanship. Its concoction of filigreed pavilions tapered four stories high, like a wedding cake sculpted of stone. Ruit climbed out into a throng of reporters and cameramen from Nepal’s major television networks, who jammed their lenses so close, as the head of the welcoming committee pressed a thumbprint of red tikka paste to Ruit’s forehead, that I feared they’d smear his symbolic third eye.

  We were led past burning urns of clarified butter and through low brass doors into what had been the royal palace when Patan was a competing city-state. The building had been converted into a museum, and this was its first function since its restoration. After the Ruit women were shown to their places, every one of the hundreds of seats in the courtyard was filled. Ruit and Sonam were led to a low couch on an elevated stage by a welcoming committee of women in red and gold saris. They draped father and son with white silk katas. And Sonam and Sanduk tried not to laugh as the women slipped a traditional checkered cotton topi on Sonam but struggled to make a small matching hat balance on top of Ruit’s oversized head; he took pity, pulled it off, and jammed it into his jacket pocket.

  I paced the perimeter of the courtyard, taking pictures, gathering evidence of the day of vindication Ruit had worried would never come. We were in the neighborhood where Nanda had been raised, at the epicenter of the elite Newari world. Here, the heart of Kathmandu society had rejected Ruit’s marriage to one of their own and dismissed his medical career until his work proved so visionary he could no longer be ignored.

  An elite member of the Nepal Ophthalmic Society—an organization that had once denounced Ruit as irresponsible for operating in rural areas—presented him with a carved wood plaque so enormous it could fill most of a wall in the Ruits’ new living room. The writer Jagdish Ghimire, the chairman of Tilganga’s board, was due to speak next. He had recently survived a bout with cancer, but only after Tabin’s protégé Matt Oliva used his connections to arrange a bone-marrow transplant for him in Bangkok. His speech was brief and emotionally charged. “I would argue,” Ghimire said, “that the founding of Tilganga, and the construction of its world-class lens laboratory, is a historic development for Nepal on par with the recent transformation of our nation into a democratic republic.”

  The guests included many of the country’s most famous writers, poets, musicians, and progressive politicians, several of whom took the opportunity to speak. But Ruit and the Tilganga staff said little. Sitting quietly in the last row, I saw Reeta Gurung, Nabin Rai, and Rabindra Shrestha, the core of the team that had launched Tilganga fourteen years earlier and had demonstrated the excellence Nepalese could achieve when they burnished their intelligence and refused, as Ruit had taught them, to be treated like children of a lesser god.

  There was almost too much to look at in the courtyard of the former palace. There were jeweled and silk-swathed dancers, performing the elaborately choreographed specialties of each of Nepal’s major ethnic groups, and pairs of men stuffed into hairy yak costumes, stamping across the stage between performances. But my eyes kept returning to a stationary spot in the swirling complexity of the hours-long ceremony: the face of Sonam Ruit. While Sanduk had to periodically leap up off the couch to accept one award after another and mumble a few words of thanks to former foes after they made lengthy speeches praising him, Sonam sat quietly by his side, beaming with a look of Buddha-like contentment. I couldn’t understand the droning speeches in Nepali, but I could read Sonam’s face clearly. The fifteen days of trekking to place his seven-year-old son in school; the equal distance over treacherous passes he’d traveled to return home; the abandonment of his ancestral village and his struggle to reinvent himself as a shopkeeper; the flight during wartime to the strange new world of the capital; the shunning by Nanda’s family and much of Kathmandu society—it had all been worth it, this humble man was surely thinking, because it had all been part of the fate written on the surviving members of the Ruit family’s foreheads, the inescapable karma that had delivered them all to this unforgettable day.

  Eye Contact

  At that first sight of the town I felt that living among such people might change a man for the better. It had done me some good already, I could tell. And I wanted to do something for them—my desire for this was something fierce. “At least,” I thought, “if I were a doctor, I would operate on Willatale’s eye.” Oh yes, I know what cataract operations are, and I had no intention of trying. But I felt singularly ashamed of not being a doctor—or maybe it was shame at coming all this way and then having so little to contribute. All the ingenuity and development and coordination that it takes to bring a fellow so quickly and so deep into the African interior! And then—he is the wrong fellow! Thus I had once again the conviction that I filled a place in existence which should be filled properly by someone else.

  —Saul Bellow, Henderson the Rain King

  Quiha Zonal Hospital was a plain, prefabricated building. It sat on the dusty plateau above the city of Mekele, along a wide, well-paved road the Italians constructed before World War II, when they tried, and failed, to colonize Ethiopia. Most days, the building blended into the landscape of sun-bleached thornbushes and dishwater-colored hills. But when we arrived in early 2009, the hospital, obscured by a crush of bodies, looked more like I imagine it had in the mid-1980s, when it was hastily built, by other Italians with better motives, to treat the victims of Ethiopia’s famine, a catastrophe that killed more than a million.

  Tabin’s goal was to restore sight to as many as eight hundred people. In the days before our arrival, patients began traveling by bus, by donkey cart, and on foot to reach the hospital. By 8:00 A.M. on January 10, it was already uncomfortably hot, and more than four hundred people ribboned the perimeter of the hospital, squeezed into every sliver of available shade. We’d arrived in northern Ethiopia on a predawn flight from Addis Ababa, but any notion of sticking to our original plan—checking in to a hotel, showering, and leisurely fortifying ourselves with coffee—evaporated when Tabin made eye contact with the few of his patients who were still able to see. “We’ve got to … get to work,” he said, and I could hear the expectations of hundreds of blind Ethiopians in his voice. Without Ruit by his side to organize and fine-tune the process, the fun-loving Tabin I’d often traveled with was nowhere in sight.

  That spring I sat next to Tabin’s parents in San Francisco’s Ritz-Carlton Hotel, in a ballroom filled with men in well-tailored suits and elegantly turned-out society women, while their son received an award from the Dalai Lama, who was suffering from a cold. He had selected Tabin as one of his Unsung Heroes of Compassion, and before he’d presented the awards, he’d given a short speech. His Holiness’s hoarse voice made the audience lean forward, hanging on his every word. “Don’t pray to a god and ask him to do things,” he told them. “Illogical! You should do it. ‘Compassion’ is an empty word unless it’s put into action.”

  The writer Isabelle Allende read out the names of the honorees. Each of the orphanage builders, microcredit lenders, and housers of the homeless briskly shook the Dalai Lama’s hand or bowed briefly and returned to their table. But when Geoff Tabin’s time came, he took both of the Dalai Lama’s hands in his and spoke quietly into his ear for two solid minutes. When he returned to the table and sat beside his parents, their faces shining proudly, I asked him what he’d said.

  “I said, ‘Now that you’ve become such a chick magnet, do you regret your choice to spend your life as a monk?’ ”

  “Come on.”

  “No, I said, ‘It’s a shame that my partner Sanduk Ruit couldn’t be here to share this award with me.’ I told His Holiness that everything I’ve achieved, I’ve achieved because of my partnership with Ruit. I said that he
deserves the award at least as much as me, and that it would have been more meaningful to have him honored by my side.”

  Tabin’s mother, Johanna, listened attentively, her sharp intelligence fully intact at eighty-three. She seemed more proud of her son’s humility than of the award he’d received. The Dalai Lama concluded the ceremony by warning the winners not to rest on their laurels but to continue exemplifying compassion in action: “If after you receive this, then relax, wrong!”

  Tabin didn’t need to worry. Relaxation wasn’t in the irradiated DNA he’d inherited. He continued to recruit talented young doctors and was thrilled when he convinced a dedicated corneal specialist named Matt Oliva to join the HCP. Years earlier, Tabin had arranged for Oliva, currently a surgeon practicing in southern Oregon, to get advanced training at the All India Institute and do a fellowship with Hugh Taylor in Melbourne. Since 1998, when he’d first watched Ruit and Tabin in action at a surgical outreach in Kalimpong, Matt had been operating with them in the field, and he was beginning to lead his own HCP-sponsored cataract camps in Africa. “After I saw the speed, grace, and economy of their surgical system,” Oliva says, “I realized they’d found the solution for third-world blindness. I told them I was in, all the way in.”

  “Most doctors are risk-averse overachievers,” Tabin says. “Matt wasn’t one of those. As a researcher for Johns Hopkins, he traveled all over Kenya and Tanzania, conducting the best survey of blindness ever done in East Africa. He’s also become a specialist in creating eye banks, which has been incredibly helpful as the HCP continues to grow. Since Matt joined us, he’s been willing to go wherever and do whatever it takes.”