This photograph was taken during an early-morning run through the foothills of the Annapurna Himalayas in Tansen, Nepal. It is a rare scene – flowing “cloud waterfalls” cascading over the mountain ridge to form a “white lake” in the valley below. Halfway through my two-year term at Tansen Mission Hospital, I see these mountains not only as a Westerner would, in all their tourist-attractive glory, but also as a Nepali might: the source of intense hardship, as people here eek out a living in the unforgiving landscape. It is the story of families growing what nutrition they can on rugged terrace-farms that cling to these mountainsides. It is a story, now all too familiar, of sick men, women and children traveling endless distances across the steep terrain to seek medical care – often, too late.
Living in this land – learning its language, befriending its people, slowly grasping its nuanced culture – has been stretching in countless ways. It has taught me to see differently – the inevitable, humbling experience of life as a cultural outsider. It has presented me with more “unusual” cases in a single year than I might encounter in a lifetime of practicing medicine back home. It has opened up beautiful new relationships and deepened beautiful old ones. As anyone who’s undertaken similar adventures would attest, life abroad has given me untold space to grow – as a writer, as a family doctor, and as a fellow human.
Photo taken February 2014
Essay composed September 2014
I took this photo during my first winter here. It’s among my all-time favorite pictures of Nepal, and was exhibited with the brief essay above as part of a global health display at the FMEC Northeast Regional meeting in October 2014.
Exactly six months later, a series of earthquakes and aftershocks have acutely heightened my sense of ambivalence toward these mountains. With the ground beneath me no longer the stable bedrock it had always been, I still find myself startling every time a loud truck or tractor rattles along the rutted paths outside, or when a nursing colleague bumps the trolley on which I’m writing notes. It’s an instinctive bracing against the tremor that could escalate into our “next big one.” After all, there were more than 250 aftershocks in the first month alone. As it turns out, it’s never just one earthquake.
Having experienced firsthand — and for the first time in my life — its threatening capacity for violence, I’m aware of a changing relationship I share with the earth — a relationship that’s on shaky ground, if you will. (Sorry, bad one… bu-dum-bum-shing)
But in all seriousness, I and my friends here do actually feel a new, subtle sense of antagonism with the earth. Until April 25, my awareness of nature’s capacity for evil was purely cerebral, based on news of distant lands and people — tragic stories of typhoons and tornados, hurricanes and tsunamis, and (of course) other earthquakes. No longer merely benign, inanimate land beneath me, the earth now seems a living force, powerful and potentially harmful.
Considering, too, that these very mountains have created the massive logistical challenges aid workers face in their ongoing relief efforts post-earthquake, the essay above takes on even fresher poignancy. Please continue to keep the people of Nepal close in thought and prayer.