by Ali Gripper
them make- believe stories.
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Every evening when he came home from work, Ruit would
scoop them up, give them both a big hug, pat Serabla on the
head, then sit down with them, and ask them about their day.
After dinner, they would watch television, or play Carrom
Board, a billiard- style board game played throughout Asia.
Returning from an eye camp or a conference abroad, Ruit’s
smile would be even wider. ‘He would be like a big glowing
mountain when he walked back in after being away for a
week or so,’ Serabla recalls.
Nanda would cook his favourite curry or roast dinner
and the children would follow him around the apartment,
peppering him with questions about the trip. What had he
eaten? What were the people like? Where had he stayed?
He’d always bring them back gifts—cars and train sets for
Sagar, and dolls and soft toys for Serabla, and, later, Satenla.
For many years, while they were living in such cramped
confines, the young family would treat themselves to a
weekend at Hattiban, a picturesque mountain resort about
an hour out of Kathmandu. Ruit and Nanda would sit on the
lawn under the trees, enjoying curries for lunch, taking in
the view of the Himalayas, and watching the children play on
the swings and slides. They all loved the sunshine and space.
Saturday afternoon was the one afternoon of the week
when Ruit did not work. It was completely quarantined for
his family. Work colleagues might be invited to their flat,
but it would always be a noisy family affair, with everyone’s children invited. They’d scream with laughter chasing each
other, playing hide and seek and tag.
Ruit would often bring the children to Pullahari monas-
tery when he worked there, too. They would play with the
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young 4th Jamgon Kongtrul, the reincarnation of Ruit’s guru,
the 3rd Jamgon Kongtrul. It was a treat to run wild and free
in the garden of tropical flowers, perched high on a ridge
above Kathmandu.
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10
Second chances
What many people don’t realise is how cripplingly lonely life for a blind person can be in a country as poor as Nepal. Like everyone else, the blind yearn to be useful, for people to talk to them, to be part of the ebb and flow of village life. It’s usually easy to find the blind when you arrive at a village.
They are the ones who are hunched over, their faces etched
with worry, staring vacantly at the ground or the floor in
front of them. It doesn’t take long for depression or mental
illness to set in, especially those who are left alone for many hours of the day.
Just ask Kamisar Tamang, a woman Ruit met at one of his
eye camps. Accompanying the surgeon on the trip was Aus-
tralian journalist Catherine Marciniak whose documentary
A Himalayan Vision, 1991, captured the grim psychological effects of being trapped in darkness for years.
More than two decades later, Marciniak still recalls how
shocked she was when she interviewed Tamang outside her
small stone hut in the mountain village of Trishuli.
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‘There is often this romantic vision of the blind being looked after by their extended family. Tamang’s family had given her enough food to survive, but the harsh reality of subsistence
farming is that every member of the family needed to pull
their weight. Tamang was incredibly lonely and depressed.
She had been blind for years, and lived in an isolated little hut high above the village, and had pretty much been abandoned
by her family and friends. No one visited her. Life went on in the village without her.’
As Tamang sat forlornly on her doorstep in her patched
clothes and bare feet, she admitted to the filmmaker that she wanted to die. At first, she explained, when her husband left for Kathmandu to work for months at a time, one of her
sisters- in- law would visit her every day. But, gradually, the visits grew more and more scarce. No-one visited her.
‘She used to be nice to me, but now that I’m blind, she tells me how useless I am,’ Tamang said, her face cast downward
as the camera rolled. The documentary shows Tamang’s utter
helplessness and dependency on others; her life had literally shrunk to the four walls of her small house, and she was
unable to work and take part in village life. She grieved for her old life. Her independence. Her old self.
‘For eight months, I haven’t been able to move anywhere.
I’ve had to stay around the house. I’m blind and I can’t do
anything. I haven’t got any money, and I haven’t got anyone
to do things for me. One day I was very hungry and thirsty,
I tried to get something but I couldn’t walk around. So, I just sat and cried. I cried all day.’
At night, Tamang dreamed of being able to see again.
She dreamed she was free to enjoy all the things she used
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to when she could see clearly. She dreamed she was walking
on the slopes of the mountain in the sunshine, and standing
among the trees she loved. Each time she woke, the reality
that she could not see the world anymore was a crushing
disappointment.
Like many people who live in remote areas of Nepal,
Tamang’s suffering was compounded by the belief that her
blindness was a curse, a karmic retribution for something she’d done wrong in the past.
‘Why is this happening to me?’ she said. ‘I haven’t done
anything bad in my life. I haven’t been greedy. Now I just feel like crying. The local spiritual leader had told me that some bad people in the village had put a curse on me. They told me to kill a chicken, so last year I gave him 21 chickens and also some goats.’
Tamang’s life was finally lifted out of the darkness after
she was brought into a field surgery Ruit’s team had set up on the dirt floor of the nearby village schoolhouse. The surgeon examined her eyes, which had been ruined by cataracts, and
told her husband that if he could bring her to the Nepal Eye
Hospital in Kathmandu, his wife would be able to see quite
well again. Tamang was terrified. Rumours still circulated
in rural villages that eye doctors sometimes removed their
patient’s entire eyeball, but something about Ruit must have
convinced her otherwise.
Kamisar Tamang was a proud, determined person, and she
wanted her life back. She was sturdy. And independent. She
took a deep breath and started planning her trip to Kath-
mandu with her husband. ‘I just want to get my eyes fixed.
When I come back I want to farm my land,’ she said.
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/>
Marciniak, like the rest of the film crew, was moved by the
sight of Ruit restoring sight to as many people as he could each day at the camp. In her diary, she wrote: ‘Like a scene from an epic biblical movie, over a thousand people came down from
the surrounding mountains, the blind led or carried by family and friends, expecting miracles. And, the miracle of modern
medicine is what Dr Ruit and his team delivered, over and
over again.’
Meanwhile, Tamang’s journey into the light was about
to begin. Her husband gently strapped her bird- like frame
into a large basket on his back, and took her to Kathmandu.
After tying his wife in tightly with rope, he clambered down
the rocky mountain paths for about 50 kilometres to the bus
station and then caught the bus into the big city. Tamang was so nervous when she arrived at the Nepal Eye Hospital that
she vomited in the courtyard. Ruit immediately calmed her
down by telling her she would not feel any pain, and that he
was going to give her ‘in- built spectacles’—a layman’s term
for intraocular lenses.
As usual, Ruit listened to romantic Nepalese and Indian
music in the background as he worked. (At first, he would
listen via a small radio, then later through his iPod). One
of his favourites was the Nepalese singer Narayan Gopal.
‘I always operate to music. Always. It soothes me. And it
creates a nice atmosphere in the theatre.’
And, as always, he was barefoot, allowing him complete
control of the pedal under the table that pulls focus on his
microscope. ‘Barefoot is always so much better. You have such a better feel. It’s much more tactile.’ He operates barefoot no matter where he goes, even at medical conferences, and when
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abroad. ‘At first people used to raise their eyebrows, but now they know it is my way and no-one questions it,’ he says.
By this stage, Ruit had built up his stamina to the point
where he could sit at his surgeon’s table, doing one operation after the other, without a break, stopping neither for a drink nor a snack or even to go to the bathroom, for more than
seven hours a day.
Turning up to the operating theatre day after day and
tackling an enormous case load had not only refined his
technique—fine- tuning ‘the system’, as he called it—but it
had built his endurance.
What is he thinking about when he’s operating? ‘Mainly
I’m doing a form of meditation, where I clear my mind and
give the person lying in front of me my all. I give my total
concentration to the patient before me. All I’m thinking about is how much I want their life to benefit from the time I spend working on them. Everything else just falls away. I can’t think of anywhere else I’d like to be when I’m working, because I
have built up a great team and a great system that makes me
look forward to work. Going to work remains a joy, and then
a great family means I look forward to going back home.
‘Most of the time I get into a rhythm, and I feel comfort-
able and calm. There are not many things that distract me.
Once in a while, if I’ve got a very serious pressing personal problem—for instance, if someone in my family is going
through difficulties—a thought might enter my head.’ So,
what does he do when that happens? His mental toughness
kicks in. ‘I close my eyes and don’t think about it. I don’t go there until I’ve finished my work for the day. There are no
distractions.’
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During operations like the one he did on Tamang, he says,
he is ‘looking at much more than the vision of one eye. It’s
more of a lifesaving procedure. The magnitude of what I’m
doing makes me extra careful. Every operation is an enormous
opportunity to change a person’s life.’
Ruit talked to Tamang as he operated on her. ‘I like to talk
to my patients as I go. I tell them that everything is fine. That they don’t need to worry. There’s going to be no pain and it’s going to turn out very well. I think of how I would like to be treated if it was me lying on the table. I know I would not
like to hear a lot of people making a lot of noise in the background. So, I ask my staff around me to keep the discussions
to a minimum. Then I usually give the patients a little touch on the head and after I’ve finished the operation I tell them I’ve finished and that everything went well. I think partly it’s because I was a patient myself as a boy. I remember how
frightened and alone I felt. Sometimes, when I’m doing big
numbers, it’s not absolutely possible to talk for very long, but I do always try.’
The next day, Ruit gently unwound Tamang’s bandages
and began to show her the world again. She simply could
not contain her joy when Ruit brought her husband to her
and said, ‘Do you know who this is?’ She opened her eyes
slowly, and held onto Ruit’s elbow as if to steady herself. Her husband tenderly brushed her hair off her face and said, ‘Can you see me?’ Her smile lit up the room. As her line of sight
expanded, Ruit pointed outside to the banana trees. ‘Can you
see out the window?’ he asked her. ‘What kind of trees are
they? Can you see the other side of the village?’
Ruit’s grin was as wide as Tamang’s. He started giggling
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along with her as she realised the enormity of what had just
happened.
‘One of the great things I have earned over a period of time
is the faith of my patients. It is my biggest treasure, besides my family. A beggar on the street, or a farmer from the mountains, won’t come to sacrifice an eye just like that for surgery without asking around about me. They would check me out
through word of mouth. All I know is that so many people
have unparalleled faith in me. I really think this is a treasure that I’m going to keep for a long time until I die. It’s this faith that comes even from beggars that motivates me. Faith is very important.’
Tamang started laughing with the nurses, especially when
Ruit told her she could throw away her walking stick. One
of the first things she wanted to do once her eyes had begun
adjusting to the light was to go shopping. She browsed through the nearby market the next day, gazing at the richly hued
scarves and shawls on display. She chose a green cardigan and began her journey back to her village, this time unaided, with her husband by her side.
Sadly, it was not to be the homecoming she’d fanta-
sised about. Tamang had been completely excluded from
her village’s activities for years and had lost contact with
neighbours, and it showed in the lack of response when she
returned. She talked bitterly about the way she’d been treated by them when she was blind, and declared she wanted to
return to Kathmandu.
‘Because that’s where people have been kind to me,’ she
said. ‘My parents weren’t as kind as the Nepali doctor who
made my eyes [work]. I pray to the gods to watch over him.’
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11
The Wild West
Ruit and his team tried to be as discreet as they could, but
word soon spread about the miraculous results he was achiev-
ing at his cataract camps. In Nepal, they started calling Ruit
‘The mad doctor curing blind people in the mountains’. The
camps, they said, were ‘The Wild West of eye surgery’. In
the West, some eye doctors scathingly dubbed Ruit’s practice
as ‘litigation- free surgery’, implying that he was using the Nepalese people to experiment on for his new technique.
Ruit and his team were, by definition, true outlaws,
performing advanced surgery without any form of regulation
or a clinical trial. But by 1990, a groundswell of support for Ruit’s work had begun to strengthen and grow. The eminent
American surgeon Alan Robin, an associate professor at John
Hopkins University in Baltimore, who had been donating
corneas and intraocular lenses to Ruit for years, began docu-
menting the remarkable results of his field work.
The Archives of Ophthalmology (today known as JAMA Ophthalmology), the magazine of the prestigious American 117
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Medical Association, published an article by Professor
Robin showing that the long- term results of lens implan-
tation in rural Nepal were just as good as those in Western
hospitals. The article put Ruit on the map—and it created
a furore.
‘What I wrote,’ recalls Robin, ‘was that Ruit was achieving
the same sort of results in remote camps with the most basic
equipment as patients could expect to receive at Harvard or
John Hopkins Hospital in the US.’ He still has some of the
letters fired off to the editor saying that what he’d written was total rubbish, and that Ruit must be fabricating the
data. A lot of people simply could not accept that a Nepalese surgeon with minimal resources was achieving such extraordinary results in one of the poorest countries in the world.
Professor Robin wasn’t the only American expert to begin
championing Ruit’s work. In 1995, another well-