The night before Langtang

It is Wednesday evening and I am back in Kathmandu.  We leave early in the morning for a long drive up for our Langtang trekking adventure (here).  This morning the other girls in Kogate met us in Bhimphedi and we took a sumo drive into Kathmandu.  We all look a little rough and needing some time off.  Upon arrival at our hotel at the Earthhouse, I went shopping for some last minute needs for colder temps.  It is still quite warm in Bhimphedi, so I am looking forward to some change in weather and some mountains.  I had a hot shower today and was able to sit on a western toilet.  That was really something special.  We went to dinner together and I decided to take off by myself afterwards to grab a late night Jameson (or two) at a lovely cafe nearby playing some light jazz and type this blog.  There is only the waiter and a couple off in the distance.  It is bliss.  Kathmandu is quite filled with tourists when 3 weeks ago we were the only other Westerners about it seemed.  Supposedly when we come back here in November before we leave it will be prime trekking season and there will be even more folks about.  I feel a bit more comfortable here in the city this time around.  A bit less overwhelmed perhaps.  I mean we have been in rural Nepal the past couple of weeks, squatting and washing our clothes in a bucket, so anything slightly resembling a touch of comfort is welcome right now.  

Here is a random picture of our beloved peanut butter.  

Now look closely and you will see the cover is a bunch of cows eating what seems to be grilled cheese or cheese sandwiches of some sort.  Now I don't know why this picture might be the best descriptive label for peanut butter, but there you go.  We have one boiled egg, peanut butter and honey with Sel roti (here) every morning for breakfast.  Nepali donuts... yum.  

It was decided that the 3 current practitioners stay in Kogate and the 3 of us currently in Bhimphedi stay put after our trek for patient continuity.  While initially annoyed, I realized the importance of it and the fact is we do have our own things going on already, different personalities, etc...  I am sad to not get a bit closer with the others or have the experience and slightly more peaceful environment out there, but I am thankful for Anna, Patty, our interpreters and of course our house mom, Krishna, who already has sewed us clothes and takes great care of us!  I know we all have challenges, and this is the way it played out and at this point just wanting to go with the flow, whether out of exhaustion or just not wanting to deal with additional stress.  We are starting to recognize patients on the streets now in town and follow up visits seem to be finding much relief for many.  It does seem more welcoming there, but we all have been awful homesick lately.  Perhaps this is what happens 3 weeks in.  It is almost that we are dragging ourselves into the clinic each day,  still seeing 60-plus patients between the three of us, working out of boxes and looks like we will not be moving into the building we first thought, which means we have to wander down the road for a bathroom when we need it, if we find the time for a bathroom break during our busy day.  We have been coming home exhausted.  Andrew wants us to head to Kogate each weekend, which requires us packing, getting on a packed bus both ways.  It basically is just a good amount of transit which makes things a bit more physically challenging for us considering we still are getting about 5 to 6 hours sleep each night.  Of course there is the option of walking back and forth and last weekend Anna and I decided we would rather walk than bus there.  It is no lie when I say the walk there is straight up... 3000 feet elevation gain.  We started at 2PM and realized at 3 or so we were walking the wrong way so we backtracked.  We thought we might make it there by 8PM.  We were told there would be short cuts that delete some switchbacks, but we were a little weary and just wanted to follow the road.  Low on water and overall energy, I was hurting. Eating mostly rice and carbs and not too much protein really showed.  All of the sudden while taking a break against a rock, one of our interpreters jumped out and said 'hey!, we saw you from way up high and that you made the wrong turn".  By this time it was getting dark and he was walking us the rest of the way.  But the shortcut was straight up, and I mean switchback straight up.  It took us about 40 minutes just going straight up this cliff with leeches falling on us and the most huffing and puffing I have ever done.  We met the director and other interpreter at the top, and they said we still had another hour to go.  If we had missed that shortcut, we would not have made it to Kogate until 12AM.  Needless to say we made it back in the rain and dark. I had one big leech on my back and a couple in my shoes, but that was basically it.  We stayed two nights in Kogate and took the bus back Sunday morning... an early morning packed bus ride and straight into clinic to treat patients.  Eat, sleep and treat.  That never changes. That is what YOU payed good money for, all you donors!

There is no question we are all working very hard out here and how necessary this break is for all of us. I am looking forward to enjoying some incredible views and fresh air while giving myself an attitude adjustment.  We come back to only 3.5 more weeks to try and get our patients better as well as preparing a case study which I really want to strive hard to accomplish and do well at.  I have a few patients in mind... stroke victim, amenorrhea patient trying to become pregnant, and a dupuytrens case.  I had a break through on Monday I feel.  It was the day when I was feeling quite ill with a throat infection, tooth ache and possible ear infection, but I realized I was excited to see my patients, and truly invested on them getting better.  We have been told this is the hardest year for ARP, and most challenging for opening a new clinic and I wish it was a bit easier, but I think that day finally kicked something into gear for me, like this is it.  This is what it is.  Your back is going to hurt, you are going to eat a lot of carbs and less protein, there is going to be early morning wake up calls, that cow might wander back into the clinic room again, the internet is never going to happen, the electricity will continue to go off and on and you might pee on your leg when you go to the bathroom in the middle of the night, and that's OK.  I want to come back from the trek and do my best, get some yoga in, learn how to make Raksi (here), soak in all I can and bring back all of these things I am experiencing into my practice and share all I can with my loved ones so that I may be a better person.  It is pretty simple when you think about it.  Just be kind and not an asshole.

So not the most illuminating entry this time.  Blame it on the Jameson(s) if you will, but I know it is important to keep sharing my thoughts and not to sugar coat this.  Life is hard here. People carry 50 pounds of grain on their freaking heads. 

I am off to see some fucking mountains.  Picard out.

Third World Problems

Patty and I arrived in Bhimphedi last Sunday  (Sept 22^nd) via a 3-hour bus ride packed to the brim with passengers and burlap sacks of various grains and vegetables from Kogate and surrounding villages.  The bus is the only way between the two places unless you walk (which we plan to do both ways at least once) or by car/motorbike.  The road is essentially a series of tight turns with switchbacks and loose gravel along with jaw clenching drop offs brushed with beautiful green hills full of vegetation and glimpses of streams.  The bus stops every now and then to load more people and cargo, and by the end of the trip, the bus has people hanging off the sides just to get to their destination.  The driver plays Nepali pop music as loud as he can over the speakers and while I admit though blaring at times, has been quite enjoyable and helps the trip go by a little faster, be a tad more comfortable and a little less jolting on the head. 

Bhimphedi is very hot and humid.  The weather is just now starting to change towards cooler air, but there is still a good amount of rain.  We hear Kogate has been getting poured on daily… so goes the tail end of monsoon season.  Terry, Haley and Alyssa are currently back in Kogate and we hear the leeches are in full effect and that their electricity is limited with all the rain.  Neither of our camps have Internet.  The three of us here in Bhimphedi have been getting bits and bops of a signal, mainly in the morning but are barely able to check or send emails.  We suspect when we return from the Langtang trek that both destinations will be cooler and drier and perhaps a bit more organized. 

It has been an interesting time here. Bhimphedi has shown to be challenging on many fronts.  We were supposed to arrive and walk right into clinic to treat patients, but we were told that there were political hang-ups that still needed to be worked out so the building was not available due to said politics.  Tsering has constantly been traveling to the nearby city, Hetauda to deal with papers and gently massage the officials in charge of allowing our project to use the health building here, which we still have not moved into as of now.  We have been using a community yoga room with a side room attached.  We walk down the road for a bathroom and back to the house every day for lunch.  The first day of clinic was pretty chaotic and exhausting.  We were and still are working out of boxes, while our interpreters are wearing multiple hats trying to schedule patients for follow ups and coordinating all the new patients.  Patty and I have been seeing 20 people per day and coming home just completely beat.  We essentially have been treating people, eating and sleeping (well sleeping as much as we can).  I wake at 4:30 AM every morning to the sound of really extroverted roosters and music coming from the community room and then the rest of the neighborhood begins waking up and banging around, doing chores, burning their trash or shouting across the way to each other (Nepali telephone).  I think I slept about 4 hours a night for the first week.  It is much different from Kogate.  Bhimphedi is a very busy town, with not many places to escape to or have a moment of silence.  One evening while walking home, we found ourselves trying to pass in front of a pack of wild dogs growling at us.  We turned around and started running fairly quickly the other way.  We found a boy to help walk us past the pack, but I was certain they could smell our fear.  Needless to say we survived and later laughed at the series of events unfolding around us.  The house in which we stay seems to always be filled with construction workers, neighbors, the local jailer from the prison down the road or friends that the house Mom, Krishna hosts.  We go outside to use the bathroom and cold shower and stay in our room for the most part after clinic and dinner.  I definitely seem to be struggling with finding a little peace and acknowledge that this is one of the hardest parts about being here…  the lack of privacy, peace and quiet.  The one benefit to Bhimphedi is that there are no leeches, but huge spiders.  The house mom does a good job of keeping things tidy, but we had quite a scream when Patty noticed one walking across my bed one night.  The squat toilets continue to vex me.  It is a skill to try and squat without wetting yourself and making sure your business goes down the drain.  Hygiene is not a priority here of course so you have to make sure you have proper form and supplies before heading into the toilet and doing your best to keep things clean. 

On an upswing and as exhausting as it is right now, treating patients has been great and I am ecstatic to be keeping up with my skills.  I find myself reading before bed when I find some energy and never thought that a month after graduation that I would be reviewing TCM patterns and point actions along with herbal formulas, but our patients have been interesting as well as challenging, and we desire good responses from out treatments.  We have become needling machines and now have some follow up patients that we are starting to recognize.  We even begin joking with them and are learning a few Nepali words.  Everyone here drinks too much milk tea (yum) and not enough water and seem to have knee pain.  I told my interpreter to tell my patient in an amusing way that the reason everyone suffers from knee pain is because they squat so much for the toilet.  After translating that, the room busted out with laughter and I said that even I have knee pain from squatting and I have only been here 2 weeks!  Just think about it.

As far as patient cases go though, we are seeing quite a bit of wind damp bi syndrome.  We also see more than enough of stomach pain (gastritis, burning pain).  Folks are bringing in their medical records for us to look at which has been beneficial and challenging to make some sense of.  I am amazed how many people are on birth control and then hear complaints of lower abdomen pain.  I question the hospitals and health care here.  It seems they just throw medication at them, and many have no idea what they are taking it for or why.  It is perplexing, but grateful that I can even prescribe antibiotics to make sure many of them are on the right track.  I am seeing results.  Several people are coming back with decreased pain or even full resolution of their initial complaint which makes me feel great considering we spend about 20 minutes total with each of them in one day.  I have been increasing my warming needle and estim protocols along with prescribing herbs, but for the most part it is a quick intake, tongue and pulse, needling and moving on to the next patient.  At least people are getting some acupuncture, and they all seem thankful… as chaotic a scene it is here.  At many points throughout the day, you just have to laugh even though you want to scream or can’t handle the tough and ridiculous conditions anymore.  It does turn comical at some point… complete surrealism. 

All and all this week seems to be better than last; we have another practitioner out here now, Anna as well as another interpreter and receptionist.  It really is helpful, but just means we can see more patients, so still the same number for us individually if not more.  We have about 70 + patients booked per day for the three of us.  We certainly are here for work and I am just doing my best to stay healthy and have some reserves left.  We are feeling a little tired as well as a little low at times and while the food is tasty, a heaping serving of rice at every meal does not bode well for those with anemia.  We do our best to ask what we need nutritionally and seem to be sustaining, it is just a big amount of carbs.  I am thankful for my beef jerky that I brought from home.  Tonight was a much-needed night of lighthearted conversation outside on the porch with Bibek and Krishna along with some other neighbors.  We ate outside and had some rakshi (fermented yumminess) and shared pictures of our boyfriends around the table.  Clearly we are starting to miss some comforts of home.  We are looking forward to the trek next week during Dashain (here) for a much needed break and I look forward to returning to Kogate afterwards to experience the patients there and finish off my time in that environment.  Until then, I continue to be flexible and open to what happens next, laughing and trying to keep myself sane with the third world swirling around me just like the ashes of our burning bathroom, bodily-fluid-soaked trash we ignited tonight after dinner on the side of the street.  What would you do for a Klondike bar?  

Leeches and Lions and Squat Toilets... oh my!

Thursday morning we had breakfast in Kathmandu and piled into a jeep headed out of the city towards Kogate.  Another truck in front of us was loaded with our bags and tied down with a tarp followed in front.  We were excited to escape the city and the pollution just to see a little greenery and of course begin our clinical third world journey.  Though we were not looking forward to the bumpy ride ahead that we were warned about.  It wasn't too long before we were heading up and down passes witnessing some breathtaking views.  There were many close calls with oncoming traffic, but all and all I was impressed with the roads.  They were bad of course, but not horrific.  The terrifying part was the tight turns and the unknown of what car was around the next curve that we might crash into.    

We stopped at the top of a pass for some tea while we waited for our truck with the bags to catch up.  I caught a glimpse of a peak of a mountain from our view, but still too much haze and clouds to see it in its full glory.  I know that time is coming.  Since we are practicing in a different region, we won’t have the views as previous practitioners, but for me that works out fine.  It will make the upcoming trek worth it even more as well as my Everest day trip.  There was a sign posted on the side of the restaurant that was translated for us... "Come see famous white doctors".  We were ecstatic... we were famous!! 

About three hours in we were all becoming a little loopy and yawning, perhaps from elevation gain?  Our driver was getting a kick out of 7 female girls screaming and bopping of heads.  He eventually put on some Nepali music to further set the mood for our journey to our new clinic.  I recognized and appreciated that we were going to uncharted regions for ARP, setting up entirely new 3 separate clinics, and as the hours went by we knew we were really going "way the F*** out there".  We came to a standstill when we noticed the truck in front of us stalled.  The drivers poured water over the engine so that it could cool down.  Soon we were on our way again, but it wasn't too long until we came across it again, but this time we noticed it wasn't going to make it up the hill.  Our driver jumped out to assist, while we stayed in the car.  Suddenly our car slid back suddenly and again we screamed like a bunch of little girls.  Another jolt backwards and I opened the door and jumped out abandoning ship.  Looking back, that was cowardly but quite amusing to us all now. Not as funny as the driver sticking a rock behind the tire, the same rocks we were rolling over.  Did he really think that would help from keeping our jeep from sliding back further?  They started pushing the truck and eventually after getting a running start we were all back on the road.  

Soon we started heading into the clouds and began noticing beautiful foliage and vegetation except for stinging nettles, though it makes a fine tasty soup.  We made it to Bhimphedi and passed through town quickly and traveled on a one-lane bridge to continue on to Kogate where we eventually were greeted with a beautiful waterfall, reminiscent of Avalanche Lake at Glacier Park in Montana or even Multnomah Falls in Oregon.  I didn’t know what to expect, but I was envisioning something similar and was just in awe.  I secretly held back some tears just from being overwhelmed with the experience and maybe perhaps realizing just how secluded we really were going to be for the next 7 weeks.   After a long 5.5 hours or so, we arrived and descended into the village and were greeted with children and the interpreters with a Khata and beautiful marigolds with jasmine.

We walked right into the building and into the common area where food awaited us.  We didn't have lunch so we were excited to meet our cook, Zhambu and taste our first preparation from him.  It wasn't soon until we were warned that there were leeches crawling on the ground.  Holy shit... leeches.  Seriously?  Andrew stood up and shook one out of his shirt, a nice big fat one.  We kept looking around on the floor and checking our legs and sure enough I had one on my knee.  Ugh.  I pulled it off with a napkin and just sat there a bit shocked.  Well, it is what it is.  At least I got my first one out of the way. It is the very end of monsoon season and the rain still comes, so we suspect another 2 weeks of leeches.  Let's hope for the best.  We sorted our rooms and I immediately took out the sage stick I made and brought from Oregon and smudged our rooms, the entire building, even the toilet and myself.  No running water, just a hole in the ground to squat in and two buckets to wash our hands and face.  I knew this was going to be rough, but man I was hoping for just a tad more comforts.  Andrew mentioned that previous practitioners had indoor plumbing, western toilets, marble floors and perhaps better food.  One can be envious of hearing this or turn it around and feel pretty invincible for roughing it and being a part of opening brand new clinics in an entirely new region. This is a raw and completely new experience for us compared to past practitioners.  Needless to say many kinks need to be worked out and we have to be flexible.  There is something to be said about needing to use the bathroom three times a night, when you have to watch for spiders and leeches and squat in a smelly pit.  My stream aim has improved since the first night, but still needs work.  I will never ever complain about camping again.  Never.  

The next day was a busy one, sorting through all the supplies and organizing what needed to go where.  We sterilized all that we needed to upstairs on the roof with bleach and dried in the sun.   Later in the afternoon we met our interpreters.  Two of which have been with ARP for a few years, but the rest were completely new and a little terrified as were we.  We paired up and talked so we could introduce each other.  I met with Sumanmager, a 23 year old whose hobbies include meeting new friends and visiting new places.  He wants to be a social worker and is single and enjoys his freedom!  He was born in Kogate and was very nervous talking to us, saying it was his first time meeting Westerners.  I reassured him saying I was equally, if not more nervous because it was our first time too.  We soon had role-play sessions where one interpreter would act as a patient, the other an interpreter and then us as the practitioner.  We soon learned just how difficult this was going to be with the language barrier.  Asking more than one question at a time is useless and difficult.  We have to retrain ourselves to go slow, rephrase questions and hope we have some clarity into what exactly is going on with the patient.  We shared our expectations of each other which was really eye opening.  Later after dinner we talked about lancing boils and how this will be one of many common cases coming into the clinics.  Andrew graphically told us how to lance, cup and drain the boil going at least 1 to 1.5 inches deep to make sure we hit it right, or we will just cause more pain.  Have a cup ready for the pus and blood and glove up.  We went over pharmaceuticals and all of us just sat there with deer in the headlights after realizing that we are going to be prescribing western meds.  We write a prescription for antibiotics and the patients can go to the local health post.  We have herbs and basic first aid supplies; Tylenol, Benadryl, etc.… but need to think what is best for the patient.  We truly our doctors out here, primary if only care provider to these people.  Again overwhelmed, we have to just keep our wits about us and do the best we can.  We also had a class on safety and realized that all our education about tuberculosis, HIV and hepatitis and needle sticks came to this point.  Trying to stay safe, healthy, watch for leeches, crazy spiders, lice, beware of hiking or going out after dark for tigers, not catching contagious diseases or whatever else.... it really is a lot to process.  Other people are on an island or in Europe and I chose to have my limits pushed in a poverty stricken country prone to communicable diseases after graduation.  The uncommon in the common world. 

Breakfast this morning was enjoyable; corn flakes and crepe-type pancakes with peanut butter and honey.  I decided to splurge and have one of my starbucks instant coffee packs I packed.  There is only so much Nescafé and milk tea one can have, although the milk tea is simply delicious.  During breakfast Andrew treated one of the interpreters for a leech bite that had become inflamed and caused some swelling.  We ground up some Huang Lian Jie Du Tang for a footbath and Andrew tried to bleed the area a bit.  Some tears of discomfort came, but she seemed fine afterwards.  We sent her home with some Benadryl and hope she will be better for the next day.

We spend the rest of the afternoon sorting needles and herbs, deciding what was going to go to Bhimphedi and who was going to go for the first week of rotation and opening.  Patty was assigned team leader and will be staying there permanently so that there may be come consistency in patient care and I offered to come out for the first week and help.  We already have 40 on the books.  We are certainly nervous.  It will be chaotic, especially with brand new interpreters and whatever might get lost in translation.  Our evenings will be filled with researching our cases of the day and preparing our class to teach.  I suspect we will be exhausted.  We finally had the sun shower set up on the roof so I bravely went for it.  Not a fan of cold showers, but I'll be damned if I get a boil.  No sun, so no warm water.  It is what it is.  I felt myself becoming slightly agitated with the continuous swatting of flies, the looking for leeches every other minute, the shrieks of others who find them on their bodies and no electricity or bouts of it here and there, but I know things will continue to improve and that this is all building character and a true part of the experience.  I am trying to be more in the present and not worry about my pet sitter and cat at home, or licensing process, or how my practice will go when I get home.  I do wish I had enough money when I return to go and sit on an island and sip cocktails even for just a few days in the sun, but this journey will lead right into working when I get home and that is welcomed and needed.  There is beauty in this hard work and intense conditions.  I am fortunate to have this experience to serve people as a doctor and have such an impact on their lives.  The lesson to learn is endurance, patience, compassion, trust, and so many more that I have yet to realize.  

Kathmandu > Bhimphedi & Kogate

It is Thursday morning and we leave Kathmandu after breakfast for the clinics.  A supposedly very bumpy 5 hour jeep ride awaits us.  We have only been here since Monday, but it feels like a couple of weeks.  Funny how traveling can do that to you.

Today we had a wonderful person names Anil who is an artist here in Kathmandu.  He led us on an hour walk to the Monkey Temple aka Swayambhunath which included a plethora of stairs to the top.  We were huffing and puffing and were happy for the training for the LangTang trek later on next month.  The sun was out in full force and already at 9AM I was over the heat, but we had some cool breezes here and there.  I decided today after a significant headache overnight to wear my mask.  We are walking through dusty streets, past trash, dodging motor bikes and cars, chickens, dogs, merchants and the air quality is just rough.  The hot weather made it hard to breathe with them on, but it was needed.   I saw a peak of a mountain in the distance but the haze was still too dense to see anything else but some hills that were pretty impressive.  

When we made our way up to the temple we were greeted with more monkeys.  A really spectacular view though down to the valley and prayer flags galore.  We walked left around the top of the temple and spun the prayer wheels lining the walls.  I pulled away from the group as I noticed these beautiful panoramic canvasses hanging that depicted mountain ranges and looked for the artist.  I was happy to talk with him a bit and even take a picture of him.   I haggled (or negotiated) a lower price which is what you do here in Nepal (always negotiate down), and bought a beautiful oil painting from him for a gift and was happy to buy from local artists.

After another 40 minute walk, we made our way to Swayambhu Environmental Park (here) and took a little time to rest and look at the huge Buddha deities in front of us.  There was some construction going on one, but still a sight to see.  Interestingly enough the construction scaffolding was put together with bamboo and we questioned the integrity of the frame.  Our guide for the day then took us to a wonderful rooftop restaurant overlooking Durbar square, where we had a superb lunch and Haley and I even split a coca cola.  Was that the best thing ever!  Following lunch we head downstairs to Anil's gallery where he generously took the time to show and talk to us with great detail about Thonka art.  Check out the link (here).  It reminded me of Iconography and I shared with him along our walk earlier that my mother was an Iconographer and how intricate the detailing and egg tempura technique were along with the gold leaf.  I personally felt much correlation between the two religions in regards to their artwork.  It was highly impressive and I felt he could have his own gallery in Soho.  He just returned from an exhibition in Shanghai which proved to be successful so I am hoping to hear more good news for him.

After lunch Andrew took us through the square where folds were gathering for a festival taking place the next day (the Kumari festival explanation).

When we made it back to Thamel and we were exhausted, but needed to go shopping for last minute items for the clinic.  We then had dinner at a great little cafe where I spotted a bottle of Jameson and was thrilled to have a drink before we head back to the hotel to pack up and get an early start to head out towards Kogate.

Though I am still adjusting, it is proving to be more and more interesting.  We really do not know what to expect and I have learned to just go with the flow.  For the first time in a while I do not have to tour manage.  As I observe Andrew the past few days making arrangements, talking to people on his phone and checking the clock, I smile with delight and admire him taking care of us, but even more so that I don't need to worry about the next thing to be coordinated.  That in itself has been a treat.

I will be excited to publish my next entry and share how things are going out there.  No expectations and an open mind.  That seems to be the wisest thing I have said in a long time.  Oh Nepal, don't make me all soft and woo woo.  

Jet lag at its finest

Well here we are.  Made it to Nepal about 7 hours ago and here I am sitting in the hotel lounge listening to some Howlin' Wolf playing in the background.  I think that sets to mood just fine to type up a quick entry.  I am tired, that is no lie.  My ankles are swollen like sausages, but so it goes when flying internationally.  I watched a total of 5 movies throughout my flights and lord how I love that Tylenol PM.

As we descended through the clouds to land in Kathmandu, it finally hit me that I was going to be here for two months.  Not long at all of course, but still... long.  What have I gotten myself into?  All I needed to do for the bus ride to the hotel was close my eyes and I would be transported to New York, with the incredible amount of horn honking.  A polite honking though, just to let you know they are right next to you.  It was a bit of a tense ride, but more in awe than anything.  So many people in the streets, on bikes, vehicles along with just randomness mixed with so many other elements.

We were met at the airport by Andrew from the ARP and some lovely people to help with our bags and shuttle us over and help with us to our rooms.  A very quaint one awaited us and all I wanted to do was lay down before anything else.  A quick rinse and we were off to dinner.  The team altogether.  4 practitioners from Oregon, 1 from Canada and 1 from Australia. We wandered around the streets for just a bit, enough to learn how not to get run over in the streets by motorbikes and such, or how to gently and kindly turn down a merchant who is so eagerly wanting to make that sale. There is so many wonderful things to buy here, I was to overwhelmed to even attempt while struggling with jet lag and my initial introduction.  We at least attained a feel for what to expect.  Crowded like Mexico City, but so incredibly different and beautiful in the most chaotic of ways.

We have a couple days here in Kathmandu then head South for 4 or 5 bumpy hours and see what awaits us at the Bhimphedi and Kogate clinics that we are opening up on Sunday.  We have a few days of training and preparation to take care of, but I am very eager to start meeting and treating people.  it is surreal to be here though and I cannot wait to see what lies ahead.

Check one, two... is this thing on?

It has been a long time since I have published an entry for my blog... about two years actually.  I remember being so dedicated in my mind that I was going to write every week, or at least every month, well surely once a quarter would suffice.  How wrong I was.  I read through all my entries tonight, laughing at the younger, naive Joy.  I find it amazing how much my mind has shifted, how my thoughts, goals and desires have transitioned, and the incredible people who have come into my life the past few years.

I graduated just under a week ago and leaving for Nepal in 8 short days on September 14th.  What?  How did this all happen?  Am I really doing this?  I sit drinking a glass of wine staring at 3 x 50lb bags full of medical supplies I am shuttling over wondering when I am actually going to pack and what exactly am I going to pack?  I still have a week. Procrastination at its finest.

I acknowledge this entry is not going to be very exciting or long, but I realized the importance of resurrecting the blog not only to document my impending adventure overseas with the Acupuncture Relief Project, but to help fill the void I have been missing with writing and sharing my thoughts as ridiculous they may be.  It will be important for me to keep up with blogging for my practice and hey, all the kids really ARE doing it.

I implore you to read my past entries as some of them really are quite amusing, but keeping in mind that was the younger Joy writing (because I am SO old now).  I never thought I would be sitting here tonight NOT working Music Fest NW, but preparing to leave the country to volunteer my time with such virgin Acupuncture skills that I have, to help the less fortunate for two months in rural Nepal.  There is no doubt that this is going to be quite the adventure.  Do keep an eye out for future entries and I shall do my best not to let too much time lapse before the next one.

"Mellow is the man
Who knows what he's been missing
Many, many men
Can't see the open road"

Over The Hills and Far Away - Led Zeppelin

Symphonupuncture?

I picked up the trumpet in 8th grade. Back in high school, I played trumpet all four years in marching and symphonic band. I was lucky enough to take lessons from a first chair trumpeter in the Houston Symphony. It was quite an experience and in hindsight, I was incredibly lucky for those lessons. I recall him being extremely proud of me for perfecting a solo for one specific performance. Amisher, spit valve, chromatic scale... all these memories. The first song we learned in high school for marching band season was Day Tripper (he loved the Beatles). Our director was incredibly cool and quite jolly looking, but stern with keeping the beat. I picked up the guitar and taught myself in my later teens and stayed with piano, an instrument I started learning at a very young age. Piano... missing Saturday morning cartoons for years and years. Hating the long drive to Mrs. Cote's house and the practicing... oh the practicing. My sister of course being older than me was more talented, and I a tad more jealous. She would not even share some of her music with me for some time... as if she did not want me learning those songs. Moonlight Sonata was hers, Minute Waltz was mine. Fur Elise was fair game. Nadia would wake up, sleepwalk and play the piano, our mother reminds us from time to time. Interesting and freakish.

Last night, I went to go to see the Oregon Symphony perform Mozart's Jupiter. I really did not want to miss this performance. The Arlene Schnitzer Hall itself is worth visiting, but this was quite an experience. I arrived in time to quickly drink a 10.00 glass of wine and made my way to the upper balcony. A few open seats, and quite a few attending solo like myself, but otherwise fairly full.

My Mother would take my sister and I every year to see the Nutcracker back in Houston. It was a tradition and of course better appreciated now than then. I recognized these memories last night and was truly touched by the performance. I don't know if it is my experience of tour managing and the biz that has burned me out of listening and being excited about new music, but a symphony is big stuff! This was real music. Real intricate, complicated music.... and I just don't hear it now. Watching all the sections last night though, the strings, the brass, the percussion, just brought some excitement back. How some players express more than others with their body language, the conductor truly getting off on it all. So many instruments I still would love to learn (the cello especially), but already learning German, Chinese Medicine, maintaining exercise routine and beginning a running clinic, painting, piano, social life, sleep... well the time is not there clearly. Albeit, there is no excuse for not attending more performances as opposed to meeting those who would rather see a crap band (or subpar mediocre band that sounds like everyone else) and drink beer. I am getting old.

I had random thoughts of trying to sneak backstage just for kicks. I ponder just how easy it would be for me. Then I thought about my plan for Rockupuncture and wanting to treat my old clients and new ones in the music business, and how I could treat these players! That is more people per stage and talk about violinists having neck tension and those lower backs from sitting? So perhaps I should also by the domain name, 'Symphonupuncture'? It just does not have the same ring to it.

I realized I needed last night. The stress and intensity and constant bombardment of tests with school, the potential opportunity of working next year whilst in school, the holidays coming up, money woes and exactly how I am going to launch my practice when I graduate. Where am I going to go? Technically after this quarter, I will be halfway through the program and that is scary and exciting at the same time. Time is flying, things are making sense as far as understanding the medicine. I am becoming a practitioner and will have over 100,000 smackers in student loans and that does not even include the Doctoral program (if I pursue that afterwards). Fantastic sensationalism. Reality. So being able to escape and listen to the sounds of Mozart allowed a few hours to just be and appreciate that somewhere out there, I still do really love everything about music.

'Leaves are fallin' all around, time I was on my way
Thanks to you, I'm much obliged for such a pleasant stay
but now its time for me to go, the autumn moon lights my way...'


Ramble On - Led Zeppelin