Second Suns

by David Oliver Relin

  Most of the official obituaries running in the press praised Koirala as a statesman who’d hastened the demise of Nepal’s monarchy, brokered a peace agreement with the Maoists, and led Nepal’s march toward democracy. Ruit, like many other Nepalese, saw things differently. To him, Koirala was a formerly idealistic politician who’d become far too comfortable in his role as kingpin of the nepotistic clique that ensured power never strayed too far from Kathmandu’s elite.

  The coalition of Koirala supporters in the new Nepalese government had thwarted the efforts of Maoist prime minister Prachanda to integrate his former soldiers into Nepal’s military, forcing him out of office in protest just days after he’d cut the ribbon of the new Tilganga Institute. And with his resignation, Ruit feared, went much of the country’s hope for corruption-free leadership and rapid improvement in the lives of Nepal’s poor. “Koirala had a chance to change everything,” Ruit whispered to me, “to steer this country up. But instead he drove it down.”

  We were standing in the lobby of my hotel while bellmen dragged my hastily packed bags toward the door, and Ruit and I tore ourselves away from the televised images of riots that had replaced the funeral procession. We were about to set out on the trip I’d convinced him to take to his homeland in the country’s far northeast. But with the sudden power vacuum, ugly street demonstrations were breaking out. Maoists were threatening violence and general strikes, and Ruit wanted me to stay at his home for a few days, where I’d be safer until we left Kathmandu.

  I spent the morning organizing my trekking gear in Sagar’s vacant bedroom, then hiked up the 365 stairs to Swayambhunath, where visitors walked clockwise, spinning the prayer wheels that circled the golden stupa to send their wishes fluttering out above the city’s smog. I spun the wheels, too, praying for the ability to keep up with Ruit and Tabin on the trek over rough terrain we had planned. I’d injured my Achilles tendon just before leaving for Nepal, and though I’d wrapped my ankle in an Ace bandage and the pain seemed manageable, I didn’t know how fast or how far I’d be able to walk.

  After I returned to the Ruit home, a wave of jet lag swept over me. When I woke it was dark. I padded down the carpeted hallway and peered into the living room. It was mid-March and frigid in the house. Ruit, Nanda, Serabla, and Satenla were curled up together under a heavy quilt, wearing fleece coats and wool ski hats, leaning comfortably against one another and watching Koirala’s cremation on TV, like a family warming itself by a campfire.

  The Ruits had left their one-room apartment without heat or air-conditioning behind, but even though they had both settled in their luxurious new home by Swayambhunath, they weren’t yet comfortable with the extravagance of turning a dial and heating such a large space when they had insulated clothes and body heat to ward off the chill.

  Koirala, who’d died of respiratory failure at age eighty-five, was burning on the same exclusive upstream bier where the assassinated royal family had turned to ash. The flames leaping from his mouth seemed to shoot higher than those of the other bodies I’d seen burning at Pashupatinath. Perhaps the grade of clarified butter in his mouth burned hotter than most. Or maybe his departing spirit, so used to dominating Nepal’s political conversation, was still straining to be heard, as the tiny white-clad figure of Krishna Thapa stood by, stoking the fire.

  While I stared at the flames, I mourned a different loss; I thought of the news Khem Gurung had given me that morning. I’d just learned that Patali Nepali, the seamstress whose sight I’d seen returned the first time I’d watched Ruit work, had died. Patali had endured for a good six months after her operation, Khem told me, able to sew, support herself, and gaze at the faces of her family, before complications from the asthma she’d suffered from for years killed her. It was a harsh reminder that though restoring sight could be transformative, it couldn’t eliminate all the factors that could destroy you in a poor country like Nepal.

  Before we left on our trek, eighty-three-year-old Sonam Ruit asked us to wait in the foyer and dragged himself upstairs to his shrine room to fetch something he considered crucial for our journey. He returned, wheezing, and unwrapped a bolt of marigold-colored silk containing an antique bronze vajra. Chanting a puja for us, he placed white silk katas around our necks, then touched Sanduk’s forehead, and mine, with the divine thunderbolt he’d carried for the half a century since he’d last seen Olangchungola.

  “You know how dangerous those trails are,” he told his son. “This will keep you safe.”

  The machete was wielded expertly. It hit the target again and again with a firm thunk, thunk, thunk, severing the limb into equal-sized portions. Ruit bought a bundle and handed a piece to his daughter Satenla. She began gnawing the sugarcane while the old Tamang woman at the end of the Mulghat Bridge wrapped the rest in newspaper.

  I looked down over the rusted iron railing. By the bank of the Tamor, two men held a water buffalo’s head upright by its nose ring while a third sharpened a long curving kukri against a wet river rock, then slashed it casually across the buffalo’s throat. Blood pumped out of the dying animal’s carotid artery in rhythm with its heartbeat, fountaining foamy pink into a bowl the executioner held, until the spurting slowed, stopped, and the buffalo’s front legs collapsed into the water. Then the butchering began.

  Each year, during the fall Dashain festival, Nepalese, propitiating their many gods, but especially the goddess Durga, destroyer of evil, conduct the world’s most extensive ritualistic slaughter of animals. As many as half a million buffalo, goats, ducks, roosters, and pigeons are sacrificed to ensure luck for the coming year. The killings cause an outcry from the country’s more outspoken Buddhist leaders, who suggest that if celebrants need to cut something up, they should substitute pumpkins. Year after year, the slaughter continues. We were traveling in March, during Little Dashain, altogether a much smaller affair. Still, on our drive to eastern Nepal, we’d passed sheets painted to resemble ornate Hindu temples dedicated to Durga erected on wooden frameworks in many small villages, and enough blood running in the gutters to make me glad I’d missed the main event.

  We’d planned to drop off specialized surgical equipment at an eye hospital in the town of Janakpur, but Ruit, his ear pressed to his mobile phone, monitored the rioting along the route. He told Manbhadur to hold the White Elephant to an easterly course and give Janakpur a wide berth. “The Maoists are getting grumbly down there,” he said.

  We drove up a recently paved road into the hills, following the Tamor for a time, the river of Ruit’s childhood, through foliage dried by drought, to Dhankuta, the town where Sonam had washed up when war and flooding had chased his family down from the heights of Olangchungola. Ruit was concerned that visiting the site of his family’s saddest history might be too much for his youngest daughter. “Satenla’s the most sensitive of my children,” Ruit told me. “She’s always been the most upset when I’m away working. She calls me every day and needs to know what I’ve had for lunch, what the weather’s like, and how hard we’re working. So now that she’s thirteen I told her it was time to see all of this for herself.”

  Satenla, plugged in to her iPod, wasn’t listening. But when we passed through Dhankuta and stopped on Hile’s humble main street, in front of a row of tin-roofed shophouses, Ruit told his daughter to take out her earphones. We climbed out to have a closer look. “This is where we lived, Sat,” he said, indicating a house indistinguishable from the others. It had a small hand-painted sign hanging out front that read, WELCOME TO FANCY SHOP, but it looked no fancier than its neighbors, all of which sold nearly identical stock: Chinese acrylic sweaters, toiletries, phone cards, and dust-covered bags of potato chips in flavors tailored to the subcontinent, like prawn curry and mutton masala.

  With her long hair spilling over the shoulders of her silver Nike windbreaker and her spotless white skateboarder shoes planted cautiously on Hile’s muddy road, Satenla looked at the shop like a tourist eying an ancient ruin, a relic from a history that wasn’t hers. Ruit explained t
o his daughter that before a road came all the way to their home, he had to take a bus from college in Kathmandu to a trailhead in Dharan, sleep overnight on sacks of grain in a warehouse owned by his father’s friend, then hike over two ranges of hills, setting out before breakfast and arriving, with luck, long after dinner. “What do you think, Sat?” Ruit asked. “Could you do a hike like that?”

  Instead of answering, Satenla took out a pink diary she’d bought for the trip. On the title page she’d written, carefully, in English calligraphy, “Love is a bond between the hands, the eyes, and the heart.” She scrawled a few notes; then, at Ruit’s request, father and daughter posed while I took a photo of them with Ruit’s camera. Another teenage girl tended shop, cracking seeds in her teeth as she stared enviously at the clean clothes of the city folk. I thought of Ruit’s young sister Yang La spending her last days in this place, lying on a cot behind the counter, coughing into a bloody cloth, and rousing herself to a sitting position whenever a customer wanted to buy something.

  Ruit was clearly on edge after visiting the home he hadn’t been able to reach for the funeral while he took his exams. He was as turned in on himself as I’d ever seen him, his eyes focused not on the colonial-style bungalow where we began unpacking but back toward a time when he’d been a student, powerless to save his sister.

  A fleet of sleek black SUVs pulled up outside, disgorging a group of politicians in business suits who were threatening to use their clout to bump us from our rooms. Ruit ran up a long flight of stone stairs and stepped between the guesthouse manager and the leader of the group. “Are you telling me these parasites are trying to take our rooms?” he shouted. “We’ve come here to cure people, and who are they? Politicians? What have they done for the people? Nothing! Now tell them to climb back into their cars and be on their way.”

  The chastened politicians slid back into their vehicles and rolled down the road while we waited for Tabin. He was due that evening, flying in at the last minute after celebrating the wedding of his eldest daughter, Livia. Tabin also had to leave earlier than Ruit wanted, to give a speech at the annual meeting of the American Society of Cataract and Refractive Surgery, where Alan Crandall was due to be sworn in as president. Immediately after that, Tabin planned to fly to the Caribbean and meet with U.S. general Lie-Ping Chang. General Chang had asked Tabin to critique the American military’s humanitarian medical outreach around the world and help recast it in the model of the HCP. He wanted Tabin to advise him how to build permanent centers of excellence and train local medical professionals, rather than just docking hospital ships for a few weeks at the world’s neediest ports and sailing away to leave patients behind with their problems and complications. Tabin blithely added the meeting to his lengthy to-do list and moved on to planning his next six or seven trips to Asia and Africa.

  He drove up just before dark, a few hours after we arrived, with an American donor who wanted to see the HCP work he supported up close, lucky to have flown and missed the two-day drive that had brought us to Pakhribas, the town fifteen minutes farther into the hills than Dhankuta, where we planned to operate in a middle school. Tabin also arrived without his luggage, which had vanished somewhere between San Francisco and Kathmandu.

  Tabin had spent the few hours he had in the capital running between the homes of his former Sherpa climbing partners, borrowing gear for our trek. He arrived with no waterproof clothing and none of his specialized surgical tools, only the foam Crocs clogs he wore during surgery and a pair of borrowed approach shoes a size too small, which smelled so pungently of foot rot that I asked him to leave them outside the door of the tiny room we shared.

  “Well,” Tabin said cheerfully, unzipping his borrowed duffel bag and spreading the rank, unwashed gear he’d gathered on his single bed, a foot away from mine. “I may not have any of the clothes I need for our trek, or the tools I need for surgery, but at least the shoes I have to walk in for weeks smell like a steaming pile of buffalo shit!”

  The group gathered for dinner that night in the drab concrete commissary of the district department of forestry, across the road from our guesthouse. Ruit and Gurung had typed up complex itineraries, which they passed out while we waited for our lentils and rice. They had reserved three days for surgery in Pakhribas, then charted the distance we would march for three days toward the upper Tamor River and a surgical camp we planned to conduct at Sinwa, a small town at the confluence of two river valleys.

  I took out my topographical map and traced the route. It looked like three exceptionally hard days of hiking to Sinwa, double the length of the stages most trekkers would attempt, then another three long days, after the surgery was finished, to climb up and visit Ruit’s birthplace in Olangchungola before retracing our steps. If nothing went wrong—and in Nepal something almost always did—we’d be gone for at least two more weeks. “I already told you, Sanduk. I can’t stay that long,” Tabin said. “I have to be back in Boston for a speech.” I added that with the condition of my ankle I didn’t think I could make it all the way to Olangchungola either, but I was determined to reach Sinwa so I could watch Ruit and Sanduk treat the people of the region where Ruit was born.

  Ruit’s face reddened. He scraped his chair back, stood, and began shouting. “David! Khem and I have worked on this plan for months so you could see everything! And Geoff, you know, you can be very, very difficult to work with! Lot of people wouldn’t bother and they’d be done with you!” I’d heard about these flare-ups from Tabin but had never seen one firsthand. I coughed and looked away. Tabin blinked rapidly, the only sign that he’d heard what Ruit had said, and sipped mildly at his milk tea. The rest of the meal passed in silence.

  Later, in our room, reading by the light of our headlamps during the inevitable load shedding, Tabin said, “Sorry about that. He gets that way sometimes.”

  “How do you deal with it? It looks like you let it roll right off you.”

  “Not always. One time we were staying in a guesthouse way out in western Tibet. I went for a hike the morning before surgery that I guess was too long for Ruit’s taste. I ran into my room to change into scrubs, and when I tried to leave I found it had been padlocked from the outside and the team was gone until late that evening. I had no toilet in my room and no food. It didn’t roll off me then. Ruit tends to make a point in a way you’ll remember.”

  I realized how much I’d come to value Ruit’s praise, and how crushing it could feel to be the target of his condemnation. “So you’ve learned to accept it?” I said. “I feel too upset to sleep, and he hardly said anything to me.”

  “I guess I have,” Tabin said. “Maybe that’s why I’ve lasted so long as Ruit’s partner. I try to look for the kernel of truth in his criticism. I do tend to overschedule. But I try not to let others define how I see myself. I want to measure myself against the best. That’s why I always play top young tennis players. And that’s why I’m willing to put up with the occasional dressing-down from Sanduk. A lot of high-powered medical types wouldn’t. I see myself as someone who can get things done. But Ruit’s the genius behind everything we do. He’s the best. The best surgeon and the best person I’ve ever met. I try to measure myself against that.”

  On a small stainless steel table behind Ruit’s surgical stool, Ajeev Thapa had set up and calibrated a prototype of the portable phacoemulsification machine Ruit had chosen after extensive testing. It was manufactured by Oertli, a Swiss company that had come closest to meeting his requirements. The device was slightly larger than a briefcase, pale yellow with a sturdy handle on top for easy transport, and rugged enough, Ruit hoped, to accompany him on his travels. The cutting tools Ruit had planned to drop at the hospital in Janakpur, before receiving reports of grumbly Maoists, were nearly identical to the blades in Tabin’s lost luggage, so by a lucky accident, both surgeons were well equipped to work.

  That afternoon, in a classroom of the Pakhribas school that Tilganga’s staff had converted into an operating theater, Ruit tested his new machine
’s capabilities on the cataracts of his patients, and Tabin operated manually. Despite Tilganga’s advance team having papered the district with pamphlets and advertised on the radio, only 125 patients showed up for surgery. Tabin seemed bored, for the first time in my experience, by his work.

  “I haven’t seen a mature cataract all day,” he said. “These cases are a piece of cake. We’ve done such a good job over the years that we’ve cured most of the serious cases in the populated parts of Nepal, and now we’re just catching the others before they become too bad.”

  Tabin’s boredom seemed cause for celebration. What was a more tangible sign of success than a shortage of blind people in a country that had once swarmed with them? “It’s strange,” he said, closing up a patient’s wound. “I expected turning around preventable blindness in the Himalaya to take a lifetime. That’s why we called ourselves the Himalayan Cataract Project. But we’re getting close and it’s only been about fifteen years. Now, when I work in Africa, I get the feeling I used to when we were first starting out.” Many people would happily hang their life on such an achievement. But it couldn’t be bad for the blind of Africa to have an unstoppable force like Tabin turning his attention toward them.

  At first, when I’d started traveling with Ruit and Tabin, I’d asked them to point out blind people, so I could be sure to interview them. They’d seemed amused by the naïveté of the question. “Just look for the people who wave their arms and stumble when they have to walk,” they’d told me, “or the ones who hunch over as they sit.” In many of the places we’d visited, those matching that description had numbered in the hundreds.