Buttertea at Sunrise (20 page)

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being awoken by painful spasms. I imagine Yeshey, Choden and her mother, how they spend the long nights in the ward, three women sharing a narrow hospital bed.

Our daily sessions, the hard work and her rewarding improvements all help to connect me through a special bond with this determined young woman. I feel excited for Choden, and I am proud of her success. Soon she will be independently mobile. A few more weeks and she should be able to go home with the help of a walker or crutches.

After years of handicap, she will be able to live an almost normal life in her village.

Nevertheless, the tremendous effort that Choden has to bring forth is exhausting, and a few times a week, she misses her treatment because she is feeling feverish or too tired.

On one such occasion, I ask Pema to come to the ward and help me with translations. We find Choden sitting on her bed, playing with her daughter, looking happy and relaxed.

Confused, I ask why she is not coming to physio. With a shy smile, Choden replies that her urinary infection is under control, and she will be going home. I cannot believe my ears. Surely, Pema misunderstood. Choden cannot possibly be giving up. No, she cannot quit; not now, not after making such remarkable progress, not with our goal in graspable reach!

I look around me but the curious stares from the other beds offer no suggestions. Bewildered I ask Pema to confirm. Again, I get the same answer. They will be leaving here tomorrow. Pema points at the neatly packed bag with Choden’s belongings. Her husband is already on his way to pick them up. Incredulous, I realise that somehow the news of Choden’s upcoming departure bypassed me. On enquiring with the doctors, my worst fears materialise.

Choden has already been discharged.

Nervously rocking on the chair behind the desk of my treatment room, I debate what could be done to change 153

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the course of events. Choden is not ready to go, not yet.

Finally, I speak to the DMO and plead to keep Choden for a couple more weeks, at least until she has practised walking outside of the parallel bars. The DMO agrees.

With a sigh of relief, I hurry along the yellow corridors to share the good news with Choden, but my joyous message is greeted by a long face. Choden’s mother insists that they have to leave anyway.

I do not understand. Again, I ask Pema to find out what the hurry is. Certainly, after all this work and effort, Choden will not throw everything out the window just because she no longer wants to stay here. Impatiently I wait for the answer. My confidence reappears as I listen to the quiet discussion in Sharchhopkha. It was all a misunderstanding, and in a minute, I can plan the next week of treatment for my determined young patient. However, after what seems like hours of talk, I find out that there is a different reason.

It is harvest time, and Choden’s mother cannot afford to look after her daughter at the hospital any longer. She needs to go home and bring in the crops. Choden has to go with her.

Unbelieving, I weigh the facts. I cannot argue with a family’s livelihood, and it is true; in Mongar, a patient like Choden cannot stay in the hospital without an attendant.

Many personal tasks, such as using the bathroom, Choden could never do alone. She needs someone to stay beside her at all times, especially during the night. The nurses do not perform such support roles here. Someone from outside has to look after the patient.

I feel trapped in the system but refuse to relinquish our goal. So close to success, so close to independence, it seems ridiculous to throw in the towel now. I discuss with Pema the possibility of finding a woman in town who would like to earn some extra money and be Choden’s attendant for a few weeks. The idea seems promising, and I take my 154

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new proposal to the hospital’s administration. They agree in principle but interject that there is no budget for such a service. Another obstacle, but this one will not stump me. How much can it cost? The average monthly wage for the wardboys is 700 Ng, less than thirty Canadian dollars. Without much hesitation, I offer to pay whatever is necessary, but although my proposal is accepted, I meet a few raised eyebrows.

Ignoring the sideways glances of whoever deems it their business to frown at this foreigner throwing around her salary, I lay out my plan to Choden. I am exhilarated at the possibility, and eagerly expect an equally excited Choden.

Not so. After another lengthy discussion with her mother, Choden informs me that she will go home. Why exactly I will never know. Whether she feels uncomfortable at the thought of a stranger helping her with her personal affairs, or whether she is convinced that we will not find anyone, I refuse to believe that her walking matters so little that she is unwilling to overcome a few minor obstacles.

Still, in the end, I look at her gentle but set smile, and I know that I have lost her. She promises to come back in one month, after the harvest, but now, she needs to go home. I think about her long journey, about how miserable the ward must look to her after weeks of boredom in an overcrowded room abounding with disease. Still I try my best to convince her. I beseech her and beg her to stay, but at the end of the day, I have to accept her decision.

With a heavy heart, I wish her a safe journey and wave goodbye the next morning. The empty parallel bars stare at me from the exercise room. Now there is no one to breathe life into them, they no longer give hope or support.

Through the whims of farming law, they have been cast off and labelled useless. Deep down I know that Choden will not come back in one month, and probably not thereafter.

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All I can do is pray that she will continue to improve at home.

Without Choden’s daily treatments, I now focus my

attention with renewed energy on my other problem child, Lhamo. Her right leg is making slow yet steady progress, but I am still racking my brains over the immovable left knee.

‘These villagers are tough, don’t worry about it,’ was the advice from the surgeon after he discovered that he himself would not be able to reap any praise for an ingenious operation. ‘There is nothing that can be done,’ was the final most unhelpful diagnosis from the other doctors. I am frustrated by such passive comments. Lhamo is only thirteen; there MUST be something that can be done.

At the hospital in Thimphu, North American orthopaedic surgeons volunteer for one-month rotations. I decide to send Lhamo’s X-rays for a consultation. Finally a glimmer of hope.

‘We can try,’ the surgeon says on the other end of the telephone, ‘but we would have to fuse the knee completely.

She will not be able to move it again.’

I weigh the consequences. Lhamo can always sit with a straight leg, but she cannot stand with it bent.

‘The operation will be difficult. We would have to cut into the knee, and I am worried about the arteries and nerves. They might be damaged in the process. You would have to think about it carefully.’

I do think about it, and the enormous responsibility of my position weighs heavily. But I believe that even if the worst came to the worst, and they would have to amputate, Lhamo would be better off with an artificial limb than with the crooked knee she has now. I am all for trying – but Lhamo refuses.

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She is scared. Scared to the point that she comes wailing into the physio room one day, repeatedly yelling that no one will cut off her leg. I sit beside her and put my arm around her shoulder. I try to explain that the doctors are not just going to ‘cut off her leg’, but Lhamo will not listen. Even her mother shakes her head in silent refusal. No operation for Lhamo.

Afresh every day, I remark on the issue, and every time I run into the same brick wall. Lhamo’s participation in physio dwindles, and more often than not, I have to summon her to come and complete her exercises. Then, one morning on rounds, I make the connection.

In the bed beside Lhamo lays a shrivelled old Abi with diabetes. Due to a gangrenous leg that could not be saved, this Abi had to have a below-the-knee amputation. It was the only thing to do, and Abi is lucky to have survived the operation. She comes to me for exercising the stiff knee, and I try to teach her family how to wrap the stump.

Lhamo, of course, sees her all day long, and must assume that any leg operation means cutting the leg off, a thought which would terrify anyone.

Having discovered the culprit of her fear, I assume that now I will be able to clarify the misunderstanding. I spend hours explaining the operation of a fusion to Lhamo and her mother. The answer is still a vehement NO.

In a desperate attempt to motivate Lhamo, I introduce her to the parallel bars. At first, my mission ends in disaster, with a crying and sulking Lhamo who complains about everything from foot cramps to sore palms. She seems dead set on sabotaging my efforts.

One morning, when all the doctors are on rounds and I am sitting at my desk discussing a few cases with Pema, Lhamo rolls her wheelchair to the open window. Her cheeky smirk greets me before she sticks her head through the opening. Reassuring herself that the air is clear of 157

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unwanted listeners, she waves her mother over. Like a conspirator, Lhamo’s mother starts whispering with Pema.

‘
If
they did the surgery, when would they do it?’

I explain that we would have to wait until September when the next American surgeon arrives in Thimphu.

‘How long would Lhamo have to stay there?’

‘Maybe a month, maybe two, depending on her

recovery.’

Lhamo’s mother decides to come inside the room for further privacy and, without looking at us, mumbles something to Pema. Somehow I can feel that whatever is being said has the utmost influence on Lhamo’s future.

Finally Pema turns to me and translates.

‘They cannot go Thimphu. There is no money to pay

accommodation and food.’

I sigh in relief. A surmountable hurdle. Pema and I agree that there is no problem. I will find enough money to feed them until they return to Mongar.

With that promise, the way is cleared. Lhamo’s mother does not doubt my sincerity for a second, and does not bother to ask how much I will give them. I must have proven trustworthy and now they will put their fate into my hands. They will go to Thimphu.

As if touched by a magic wand, Lhamo’s attitude changes dramatically. She pushes herself without needing a reminder. Pema makes a list of all her exercises, and every day adds a few repetitions. Lhamo keeps up. Defying death and disaster, she throws herself between the parallel bars until honest exhaustion forces her to stop. Her strength increases in leaps and bounds, and every day she looks healthier and happier. After a few weeks, we prepare the next vehicle to take her to Thimphu.

Too soon, shortly after Lhamo’s departure, the day arrives for Pema to say goodbye – and I feel as if my own departure 158

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date has been set. My teaching job, which is supposed to be the basis of my work, is essentially cut off. Both Lhamo and Choden are gone. What will be my role over the next few months?

Above all, I will miss Pema. Her unruffled, calm presence has become my lifeline to communication with the hospital staff. Her smile has cheered us through the rain and fleas of the monsoon, and her resourcefulness has bridged many a day without electricity. No doubt, my real challenge in Mongar is about to begin.

‘Good luck!’ I whisper to my friend who is standing with Nima and Karma in front of the post office, waiting for the bus to Samdruk Jongkhar.

‘Don’t worry!’ Pema repeats and shifts Nima on her hips.

The boy is in the best of spirits, happily drooling on Pema’s kira and spreading his dribble with his mechanical wiping motions around his mouth and evenly over Pema’s toego.

‘Bye Nima!’ I wave. Nima gurgles and looks past me towards the mountains. Suddenly his little hand extends in my direction but then pulls back to once again spread saliva over himself and his mother.

‘It’s good that you are going,’ I can hear myself say aloud.

Pema nods. Her smile brightens and affectionately she wipes Nima’s fingers on her handkerchief.

‘Take care of Dr. Bikul,’ she grins.

I make a face at her, but silently promise to do just that.

‘Bye bye! My thoughts will be with you!’ With a heavy lump in my throat, I wave as the overloaded bus finally pulls out of Mongar bazaar.

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Chortens and

Prayer Flags

A hot day is drawing to an end. The warm air feels sluggish, but a touch of coolness is just beginning to set heavy dew on the ground. In front of me, a