The Barefoot Surgeon
Page 14
the dust swirled around them, forcing them to tie cloths over their mouths to protect them from the grit. The harsh sun
meant they also had to wear sunglasses against the glare.
It was three days’ ride. There were no trees or grass. The
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barren landscape was strewn with animal skulls and bones.
Eagles soared and kites whistled eerily overhead. No-one said a word as they clip- clopped slowly along the edges of the
canyon under a dark brooding sky; a sobering silence had
descended as they realised just how arduous the journey was
going to be.
‘Mustang was a personal turning point for me,’ Ruit says.
‘I realised there’s a limit to how far you should go to reach patients, and that I really needed to stop taking unnecessary risks. I felt a terrible sense of responsibility taking my team into such a dangerous place. I wondered what the hell I was
doing. I was scared of flying, of riding horses, and heights, and here I was dealing with all three at once. Panic ran through
me every time my horse’s hooves came close to the edge.’
On their first day, as they wound their way past giant
cairns of stones, carved with the Buddhist blessing Om Mani Padme Hum, Ruit silently said his prayers. He knew any misstep could be potentially fatal. He was about to find out
later that afternoon when his packhorse stumbled and he was
thrown off, tumbling down the slope, head over heels, so
many times that he lost track of which way was up and which
way was down. He plummeted about twenty metres and his
horse landed right on top of him. He was bruised, scratched
and disorientated when he got up, but, luckily, his fall onto a gradual terraced slope meant there were no broken bones.
‘As I dusted myself off, I realised how lucky I’d been.
I could so easily have been thrown off the cliff into the gorge below, rather than against the wall of the stone terrace.’
When the party had reached 13,000 feet later that day,
Litwin started suffering from altitude sickness. His lips turned 129
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blue, and he felt light- headed. ‘Altitude sickness is terrible when you get it; your brain can swell up and you can actually see bleeding in the back of the eye as the optic nerve swells.
You get a bad headache and nausea. It’s one of the occupa-
tional hazards of our work,’ Ruit says.
Then it was head nurse Beena Sharma’s turn. Suffering
from vertigo, almost involuntarily, her feet refused to carry her around the bend of some of the narrow paths, if she so
much as peeked down into the steep gorge below. ‘I’ve never
been so frightened in all my life,’ she recalls. ‘I’d follow Dr Ruit anywhere on earth, but on that day I just couldn’t seem to go on.’ Sharma had to turn back, with the aid of a guide.
The journey was like travelling back into another century,
and Michael Amendolia took reel after reel of photographs
of the patients they encountered. Using his favourite Leica
and Nikon cameras, he was electrified by what he called
‘biblical’ scenes unfolding in front of him. Ruit had first met Amendolia in Hanoi, Vietnam, in 1992, when he was training
surgeons on behalf of Fred Hollows. The photographer had
been sent by an Australian newspaper to document the story
in Hanoi. Ruit was impressed with his world- class photo-
graphs and unassuming nature. ‘I loved his passion for his
craft, and his gentle smile. I knew right from the start we
would work together for a long time.’
Many of the locals at Tsarang spoke Tibetan. The men wore
rough coats made out of goatskins and fur hats. Their faces
were weather- beaten, almost black. Their body odour was so
strong that Ruit and his team could smell them coming from
afar. The women wore traditional tunics of blue, red, green
and yellow stripes, and their hair in long braids. The children 130
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came out to stare at them curiously. Most made a living as
subsistence farmers and life centred around the fire; as there were almost no trees, they collected yak dung as fuel instead.
Ruit was used to improvising, but the next town they
operated in, Tsarang, took his ability to make- do to new
heights. Their horse handler acted as the interpreter.
Without Sharma as his usual nurse, Ruit had to rely on
his camp leader, Nabin Rai. ‘I had to keep slapping his hand
because he was doing the wrong thing all the time,’ Ruit recalls.
The operating table had one leg missing, so Les Douglas
and his brother John, being salt-
of-
the-
earth Australian
country blokes, set out to see if someone could split a tree for them. The whole place was so barren, they probably found
the only tree. As there were no nails, John used wire and
twine that he’d packed at the last minute at his sheep and
wheat farm in Australia.
Despite the hardship, Ruit was in his element. He treated
225 people and performed 55 intraocular lens implants on
the trip. ‘I loved every moment of it,’ recalls Ruit. ‘The terrain is so rugged, that, without sight, their world had shrunk to
their home, and often just their bed. These patients were
absolutely ecstatic to have their sight back.’
The king of Mustang, who came down to meet Ruit at
Tsarang on his white stallion, bearing a 22- calibre rifle, was so impressed with Ruit’s work that he invited the team to
lunch at his castle in Lo Mantang, the medieval walled city a few hours ride to the north.
Les Douglas remembers the trip as if it was yesterday.
‘I don’t think anything in our wildest imaginations could have prepared us for this city. We had to keep pinching ourselves.
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A group of riders came out to greet us, with great Tibetan
horns blowing. They were very rugged, with Mongolian-
looking faces. We were right on the border of Tibet, so they
were literally close cousins to the Tibetans. They rode with us to the city’s huge wooden doors. We tied our horses up and
were led inside. The whole thing felt like a dream.’
On a tour of the king’s castle, after being offered thick yak butter tea, they were greeted with huge Tibetan mastiff dogs on the top floor. They lunged at Ruit and his team, snarling and straining from their chains. Everyone turned pale at the thought of one of them breaking free and mauling them to death.
In Mustang, Ruit and his team witnessed the ancient
phenomena of a sky burial. The king’s lama took them to
watch the corpse of a 70- year- old monk, who had died the
night before, being cut up and fed to the vultures.
Watching it left Les Douglas thunderstruck. ‘When the
smaller vultures were finished, the lama’s assistants crushed the monk’s bones up, mixed them with yak butter, and demol-ished the whole corpse except for the skull. Then, all of a
sudden, these birds got all fidgety and flew away, and this
enormous black vulture circled slowly down and finished off
the mon
k’s corpse. It was one of the most amazing things
I’ve ever seen in my life. The whole trip with its spectacular windswept red and orange cliffs, and eagles soaring above,
and shepherds in goatskins making their way toward the
camp gave us an insight into what Tibet was probably like
before the Chinese occupation,’ Douglas says. ‘It really was
untouched, like some sort of lost Shangri- la.
‘The whole trip was fraught with danger. Ruit almost died,
Dick Litwin had shocking altitude sickness, Beena had to
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turn back because of vertigo. The challenges just seemed to
bring out the best in Ruit. He was scared of flying, scared of heights, scared of horses, but he overcame all his fears to be able to cure blind people.’
On their trek home, staying in a goat herder’s hut for the
night, they witnessed the most euphoric reactions by patients.
They were warming their bellies with lentil soup and local
beer, when, all of a sudden, the door flew open and in came
three imposing, wild- looking goat herders. They had long
hair, grimy goat and wolf skins as coats, and their body odour overpowered the room.
One of them walked toward Ruit, hugged him tightly,
lifted him right off the ground, and carried him around and
around the room, dancing a jig. Ruit was so shocked he was
speechless. He had operated on the goat herder’s mother the
day before and now she could see with perfect vision. It was
the first time the mother had been able to see her son for more than a decade.
Their elation evaporated on the way home, however, which
proved as dangerous as the rest of the trip.
Ruit had saved several lives outside the operating theatre,
and one of them was Les Douglas’s on the return journey.
Douglas dismounted from his horse to look at the view and
failed to see another packhorse bolting toward him from
behind. Ruit, ahead on the road, could clearly see the horse
running and shouted out. Just in the nick of time, Douglas
took a step back from the edge, narrowly avoiding toppling
into the steep gorge below.
Douglas’s eyes gleam as he recounts the time in 1999 that
Ruit also revived his wife Una’s son (by her first marriage).
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Zac, who had been put into a controlled coma after contract-
ing encephalitis, was fifteen years old at the time and the
couple were beside themselves with terror. The doctors in
Canberra, Australia, where they were living, had told them
there was a risk of brain damage.
When Ruit arrived at the airport and heard the news, he
hardly said hello. He just said, ‘Where’s Una?’ and then said he wanted to go to the hospital where Zac was straight away.
He hugged Una, and just sat down next to Zac and held
his hand.
‘I don’t really know how or why it happened,’ recalls Ruit.
‘But next thing I knew, I was saying to [Douglas and Una]
that Zac was going to be all right. Maybe it was my patients.
All the patients I had worked on, hundreds and thousands of
them. Something of their energy came and took my hand and
it went into Zac’s system.’
Zac wasn’t supposed to wake up that day, but, the next thing
everyone knew, he was awake, and soon feeling well. Douglas
and Una were overjoyed. They still regard it as one of the most powerful moments in their lives. ‘It still makes our hair stand on end whenever Una and I think about it,’ Douglas says.
When Ruit and his party arrived back in Kathmandu, they
were sporting beards and had not washed for two weeks. The
red dust of Mustang had permeated their clothes, hair, food
supplies, cameras and suitcases. He almost kissed the floor
when he walked back into his apartment.
‘I remember the relief that flooded my body when I saw
Nanda and Sagar and Sera’s faces. I realised how valuable my
life was. I vowed from then on to take better care of myself
and my team.’
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There were to be fewer life- threatening treks on Tibetan
packhorses, and fewer flights into the world’s most dangerous airports. He had a hospital to finish. Thousands of patients’
sight to restore. Children to raise. His life was too precious to take risks like that again.
Professor Alan Robin was incredulous about the hard-
ships Ruit and his team were prepared to face to reach their
patients.
‘Everybody has probably met two or maybe three people
who have changed their lives, and Ruit was one of those for
me. I can’t think of anyone who faced such problems with
infrastructure, politics and geography and yet who did so
much to cure the blind.
‘Ruit reminded me of Steve Jobs in the sense that he refused
to accept the status quo, the system that was already there,
and instead listened to the people and decided what they
really needed, then provided it for them.’
He likes to compare Ruit’s work with the work done
by India’s Aravind Hospital, which also restores sight to
hundreds of thousands every year for free. Even the most
remote rural areas in India have electricity, roads, buses,
and, today, patients who have mobile phones. In Nepal, by
contrast, the roads were almost non- existent; even today,
there are power cuts throughout the day and many villages
where there is no telephone system at all, let alone mobile
phone reception.
And there was Ruit, helping blind people to see with the
worst of equipment, for no cost.
To steady her nerves when he was away, Nanda would go
in the early morning to light butter lamps at the feet of the 135
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three large Buddhas at Swayambhunath, Kathmandu’s most
famous temple. She went early, before dawn, when it was
filled with devotees performing their prostrations, and saying prayers on wooden prayer beads or malas.
Despite her own misgivings that Ruit was sometimes in
physical danger, and a long way from home, and especially
before the introduction of mobile phones, Nanda remained
supportive.
‘It must have been really hard for her, not knowing
if I was okay or not,’ Ruit says. ‘There were weeks when
there was absolutely no way we could communicate. I knew
she was worried. Sometimes she would say quietly to me,
“Enough is enough.” But she never stopped me going.’
‘I would just light the butter lamps and remember him,’
Nanda says. I would pray that all the operations would be
going well. And that he would return home safely to us.
I knew he would always come back.’
Another person who prayed for Ruit’s work was the Dalai
Lama.
In 1990, Ruit received an invitation to meet His Holiness
the greatest accolade.
As his career flourished, Ruit’s faith in the dharma, the
teachings of the Buddha, deepened. The 3rd Jamgon Kongtrul,
in particular, had empowered Ruit’s work by reassuring him
that restoring sight was just as important as chanting mantras and saying prayers.
‘A few teachers told me very clearly that my work is the
work of Avelokitasvara [the Buddhist god of compassion],’
Ruit says.
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That thought, however, did not stop Ruit being completely
in awe of His Holiness. Ruit took his parents with him on the trip, and visited the sacred hot springs of Sikkim, renowned
for their medicinal value, as well as the famous Bodhi tree
where Gautama Buddha obtained enlightenment.
On their way to His Holiness’s office, they noticed Holly-
wood actor Richard Gere listening to the teachings. Ruit’s
nerves grew as His Holiness’s secretary invited him and his
parents into the inner sanctum.
‘As a religious and spiritual leader, he really is such an
inspiration. I have great reverence for his teachings, the way he lives, and the way he inspires so many people. He influences so many people with his positive thinking. As soon as
he enters the room, you realise there is a definite presence, an aura,’ Ruit recalls. His parents, in a natural expression of devotion, began prostrating.
Their scheduled five minutes turned into a 30-
minute
audience. His Holiness’s personal assistant tried to finish
the interview twice, but the Dalai Lama was fascinated by
the technical details of eye surgery, and how it transforms the patients’ lives. Ruit told him that the state- of- the- art surgery needed to be taken to as many places as possible, to reach as many patients as possible, and that he needed to train as many doctors as he could. ‘That’s a very good idea. Exactly! Good
impact! You should definitely do that,’ His Holiness replied, giggling.
Ruit then bowed to him, and said, ‘Please bless me, Your
Holiness.’
He said, ‘You already have my blessing.’ He reached out
and held Ruit’s hands. He’d never felt hands so soft. He felt 137
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as if he was soaring, and something had drained out of him,