From the Hospital Bed

Sitting on the stool next to the bed and sleeping on the bed itself are two completely different perspectives in life. I have been in the hospital one too many times, mostly to attend to the sick, sitting on the tall uncomfortable stool.

For a change in perspective, I have always wanted to look at life from the hospital bed once, like taking a vacation from life, but without much pain. I wanted to lie there without a worry in the world. I wanted to take along my laptop and edit my stories, write blogs and contemplate over life.

I know a time will come when I am there on the hospital bed never to return home, to wait for the ultimate end, in pain, without hope, and with only past to look back on. But like a trial run, right now, from the middle of my life and I wanted to do a midlife review when there's still hope, time and energy, so that I could change the way I live the gap between this first review and the final review of my life on earth.

There I was on the hospital bed without any pain and feeling a bit amused. I had an overdue surgery from years ago and this time I had my vacation to finally dare it. When I was admitted I carried my beddings and walked in. The security guard asked if I had a new admission. I said yes. Where? Here! Even he was amused.

My son Jigme, who was supposed to attend to me looked like a patient. He finished few packets of chips before collapsing on the next bed. The nurses were confused every time they came on rounds. In the morning he was the last person to rise. It was kind of a trial run for him too...

It was from 10 pm that things stopped being amusing because I was to start fasting. They started feeding me from my veins. I was experiencing all these for the first time; sleeping on hospital bed, getting an IV, fasting... thank god I had good experience as an attendant to understand whatever was going on. But I couldn't help wonder how a man could be fed from a pinhole on the skin, while throughout our lives we ran after satisfying our expandable mouth.

And the heartbreaking irony was seeing your friends and family come and fill your bedside with loads of edibles when all you could do was to switch your gaze between the IV bottle and the riches on the bedside table.

But to my disappointment I couldn't even open my laptop. It was going to look very rude not to be in pain when rest of your roommates were. It was going to look like another office day. Besides the inspiration you would have while siting on the stool won't come when you were lying on the bed. And soon my mouth parched for a sip of water. I knew if I stayed awake any longer I would land up drinking something and that would result in termination of my surgery. So there went my romantic ideas of writing on the hospital bed.

Next morning I was made to wear the green gown that showed my back to the world. I had to be very careful because my daughter was following me mischievously and I could trust her to embarrass me. I was like a curious science student wanting to see how things worked inside the operation theatre. But before long I was put to deep sleep, literally dead for the time being.

I was handed back to my family after three hours and the moment I heard their voices I made a subconscious attempt to show them Thumbs Up. I could feel them dragging my bed on a rough surface. It was hours later that I could ask for water but my wife would only wet my lips with few drops. I could feel my nostrils loaded and nose plastered. My daughter and niece found me like their cartoon character Oggy.

There after I could see people coming and going like in dreams and all I was thinking about was when would they remove the packing from my nostrils. I didn't want to remain awake and feel suffocated. I went on sleeping. Nurses came often to give me doses of medicine, which I didn't need a day ago. I was officially ill now. I needed support to sit up. I wished if I could pee in my bed. It's then I realised the real difference between sitting on the stool and lying on the bed.

After what seemed like ages, which was actually the next day, my nostrils were cleared but there was another hard plastic support which had to stay for another few days. I was discharged after that and here am I enjoying my third day of rest. My wife, sister and brother in-law are pampering me like a little child.

My nose hasn't resumed its job yet, my spine and neck are aching and I can't swallow solid food easily. But I hope these are prices I am paying for a better nose. I asked for it.

As for the bigger question on reflecting on life I realised that I don't need a hospital bed to take vacation from life. This one trial run is enough to make me realise that whatever I have to do must be rushed before I reach the hospital bed because the world in there has its own problem to solve.

P:S: Knowing it was a simple surgery I didn't want to bother anybody but many of you showed up and I must tell you it feels so good to see people when you are on hospital bed. I will always remember this. 

Blessing

It was the October I never want to remember, the october that suddenly took away a beloved family member. My mother inlaw was a simple lady who has lived her life well. She must be the only mother inlaw who didn't complain even once in all these years we have lived together. Even heavens don't know the true fairness. She was a blessing I always cherish. And to her soul I promise that I will always love her daughter, take care of her daughter, and protect her from the world of harm, and that she can peacefully go and find her path to the next life that awaits her.  

In her last hours, when medical science didn't have anything to do, when everything was left to god, and when in between doctors and gods my mother inlaw's life slipping away I watched that screen endlessly and counted my blessings. 

The monitor shows the heart rate, the oxygen level, the blood pressure, the pulse rate, the body temperature... Whenever numbers changed badly and when ever the alarm on the machine went off I called sisters and doctors for help, I pretended to be the strongest and stood by the sick, but I was also reading the faces of people there. Even though my mother inlaw showed good signs of recovery after suffering from stroke, the hospital was preparing us for the worst. My wife cried and begged for her mother's life but after sometime I understood that the hospital has seen too many deaths to be bothered by one dying lady who is occupying their bed in ICU. 

That long painful night I stood by her bed listening to the deafening beep of the machines, suffocating rhythm of the ventilator, and watching the numbers on the screen change now and then, I realized how blessed we are every minute of our lives.
There are hundreds of things that could go wrong inside our body without warning; heart could stop, kidney could fail, blood pressure could fall or rise, temperature could shoot or drop, brain could die, all so suddenly but the fact that we are standing and breathing is a blessing- having our heart beats between 80-100 is a blessing, having our BP close to 120/80 is blessing, regular passing of urine is blessing, having body temperature around 36* is blessing, even being able to breath on our own is a blessing- but these are blessing we don't acknowledge and appreciate until one day one of these begins to misbehave in ourselves or in someone we care. I have seen all of the failing in my beloved mother inlaw to understand how blessed I am and how blessed all of you are despite life's little problems. You are blessed. 

Lunch for Dr.Lotay and Team

Dr.Lotay's team began their voluntary surgical camp in Bajothang on 4th Nov 2013. The next day my wife underwent the surgery. During my two days in the hospital I have witnessed the finest human qualities and absolute sacrifice. He ran from one end of the hospital to another with bright smile on his face, between two surgeries he sees 10 to 20 patients, still there are people waiting to take chances on his way to the OT. He shows no sign of disgust, he rather walks them to the bench and ask them to wait there until he finishes his next case. This continues from 8 in the morning to late into the night. In the following day the team spent over 18 hrs straight, completing record 32 cases in a day, and calling it a day only at 5AM in the morning.

Dr.Lotay doing his last surgery in Bajothang on 13th Nov.

 I was so proud to see my school mate and adopted sister Nime Chunda in the team. She always had that caring nature in her and this time she has found the right team to work with. She hides her shy smile behind the mask and deals with hundreds of patients with consistent softness. I offered to bring her meals but she declined saying she eats with the team in the hospital itself and that's when I learned that they were eating at the hospital mess. I know the food there isn't so bad but for the team that's doing so much I felt it would be an honour to offer them good meals.

I made a casual post on Facebook about offering lunch to the team and suddenly I received a message from a Bhutanese living in New York. Ugay Wangmo supports various causes in Bhutan and this time she asked me to offer lunch to the team and has sent me Nu.10,000. I was so motivated that I offered to serve them lunch throughout their stay here. Even my school and my friends promised their help. By 10th Nov morning my wife recovered enough to help me and together we worked on menu for 13 member team and over 6 helpers. We ordered the lunch from the best hotel in the town.

It's interesting to observe that the team has no set lunch break, they run for lunch in twos and threes as they get time and rush back. Dr.Lotay himself had less than 20 mins to finish his lunch before the next case was ready. But I love it so much when he looked at his menu and commented: "Someone must have told you that I love fish." Yes he loves fish. He was so pleased to see my wife standing and working. Later in the evening when we went to serve them tea and momo, he took my wife in front of the crowd of anxious people and said, "See, there is nothing to worry about. She had her surgery and now she can even work, she is our cook." She was made to show her healing wounds.

Patients consult Dr.Lotay during the Lunch Break

That night they went on till 5AM in the morning to complete 32 cases. After few hours of rest on 11th Nov they conducted 80 endoscopy and still managed to work on seven surgeries which took them till 2:30 AM, this morning. During the lunch I expected to see everybody exhausted but not surprisingly they were full of energy. They were relaxed and had little more time to spare. They say that jokes keep them awake and give them energy but at the end it's the passion that drives them to extremes.

I got a call from a young entrepreneur, Chencho Dorji who wants to help me in offering lunch to the team and he contributed the additional amount of Nu.2000 for yesterday's lunch. For tomorrow a close friend of mine, and an inspiring young leader has offered his hand. He said said, his is not rich but he can do so much for Dr.Lotay. He will send me Nu.5000. He chose to be unnamed. At the end I may have to contribute only a small amount but experience of doing it is an honour for my family and all thanks to three of you.

The following is a poem that has inspired Dr.Lotay and I hope it does the same to all of us. Thanks Tshewang Rabgay for sharing it.

Do it Anyway

People are often unreasonable, irrational, and self-centered. 
Forgive them anyway.

If you are kind, people may accuse you of selfish, ulterior motives. 
Be kind anyway.

If you are successful, you will win some unfaithful friends and some genuine enemies. 
Succeed anyway.

If you are honest and sincere people may deceive you. 
Be honest and sincere anyway.

What you spend years creating, others could destroy overnight. 
Create anyway.

If you find serenity and happiness, some may be jealous. 
Be happy anyway.

The good you do today, will often be forgotten. 
Do good anyway.

Give the best you have, and it will never be enough. 
Give your best anyway.

In the final analysis, it is between you and God. 
It was never between you and them anyway.

~Mother Teresa

Three Medical Discoveries

Some of the greatest scientific discoveries were accidental, coincidence or unexpected therefore trust me on the following three personal discoveries I have made over the years. But don't ask me about the scientific logics behind my theories because I was never in good terms with science subjects since high school.

1. Kezang used to have a strange skin disease. The moment she exposes her skin in sun it begins to itch and she would scratch until her arms and neck swell and turn red. She would then have fever and sleeplessly painful night. This disease kept her indoor most of the time and when we had to go out she had to wear full sleeve shirts.

Safi

We showed it to the best of dermatologist in the country, and one of them even gave her a ointment he personally ordered from abroad. But it didn't help. Finally it was concluded that she was allergic to sun, and only remedy was to avoid it. Can you imagine a life like that?
One day she had some tummy problem and a friend recommended SAFI. It's herbal syrup meant to purify blood. God knows how this would help tummy problem, however she tried it obediently for a week. I don't know if it oked her tummy but the next time she went out in sun she was surprised that her skin didn't itch. We tried staying in the sun for a longer time and still she was fine. We brainstormed for hours to find what helped her and it was finally the herbal syrup. We tested it again to confirm and now it's almost two years and she is fine. But she always keeps a bottle of safi handy.

2. It's rather a funny discovery, and I hope the company doesn't sue me. Dabur Red tooth paste is also herbal and gives out very good aroma of familiar herbs. The red color and the roughness in the paste really make us feel that it can whiten our teeth, often it appears to do its job well. It became popular when I was in college and I believed in it strongly.

Dabur Red

One day my sinus got infected and it became really bad. It was always bad in the morning. My nose was always on the run and it didn't need reasons to block the air passage. Soon smelly discharge started coming out and I thought my head was rotting inside. I took tonnes of medications. It took me over five years to finally get rid of the disease with a set of medicine from Taiwan.
In last few years with my good nose I had discovered that when I brush with Dabur red toothpaste my nose suddenly becomes itchy, it runs and sneezes and I could feel the sensation I had when I first fell ill. I tried it again and confirmed that this toothpaste has something in it that is not good for nose.
Later I talked with many people who had bad nose and many of them were Dabur Red fans, I suggested them to change the toothpaste and I received good feedback. But if you have strong nose please keep using the toothpaste because I don't want to be sued by the company.

3. Silagee is a local mineral extracted from some sort of soil/rock found in Dawakha in Paro Dzongkhag. People drink solution of Silagee for various disease but what amazed me was how it cured ulcer in my brother in-law's mouth and throat. By now you must be wondering how many sick people I have in my family but that's the reason why you should believe me, because only the sick knows what helps best. lol.
My brother in-law's mouth ulcer is really ugly, it begins in his throat and covers his tongue and even the lips. When he falls sick he can't even talk well let alone eating. Hospitals helped him recover but it kept relapsing until one of my aunties gave me a bottle of silagee. He tried it and believe me it worked magic. He was fine until last time when he ran out of stock. He called me up to find where he could get this medicine from.
I called my aunty and found out that a lady called Aum Gyem sells it from her home somewhere behind Changlam Square in Thimphu and I was given her phone number (it's 17636459, in case you need). I went there and called her and she made the delivery. The small bottle shown in the picture costs Nu.700, but it's worth the cost I tell you.

Silagee

***Disclaimer: The above three discoveries are not to be treated as absolute facts because firstly it was based on an ordinary man's knowledge, who failed in science in school, and secondly human bodies are different in many ways and what worked on us may not necessarily work on you. But because the products are herbal there is no harm in trying if you have similar diseases.

Little Boy-The Victim of Fails

Kezang went to hospital this morning and was calling me and telling in deep anxious voice that my friend's child was hospitalized. I had heard the news of a young boy being attacked by pack of stray dogs in Khotokha about a week ago. The boy had gone beyond the fence to play when the pack of dogs attacked him. He was rescued by a monk who was passing by. And that boy happens to be my friend Damchoe's three year old son, who is now nursed back to health at Bajothang Hospital. It took 84 stitches on his head, back and arms to close his wounds. The boy is doing well now.

The repaired scalp 

The Dog Issue:

However, it's time we pay serious attention to stray dogs. Some half hearted dog rehabilitation attempts have separated dogs from human population and now many dog-compounds are shut down. Homeless and hungry the abandoned dogs are now roaming forest and villages attacking cattles. And this year alone we have reports of two incidences where humans were attacked- one was in Haa last months and the other my friend's boy. What measures can be taken to reduce the risk of dogs attacking humans? Who should be taking care of this issue? How long should we wait until we start taking action?

Drug Shortage Issue:

Another problem that surfaced today was the shortage of Anti Rabies Vaccine (ARV), which is a must take vaccine for dog bitten victims. Even a smallest wound from dog bite requires this injection and in this case the little boy was bitten by around seven dogs and literally peeled off from head to back. Unfortunately ARV ran out of stock. Tencholing didn't have it, Thimphu only has enough for their patients and was waiting for the new stock to arrive in two weeks. My friends was asked to find it on his own. Medical Shops are handicapped by new policy. 

It was boy's luck that Punakha Hospital had some doses left. He was taken to Punakha for the first dose but there is no guarantee if there will be any left when he goes for the second dose, which is on 17th May. I took the issue to Twitter and I was inspired by the support and concern shown by fellow Bhutanese. Some even offered to send from Delhi and another from Gelephug. Thank you to all the people who answered to my tweets this morning.

In such time we must awake to the reality that something in the system is not going good. Such emergency medications should be readily available in every corner of the country. I am hopeful this concern will be considered seriously by whoever is responsible. And if it's very difficult to pave through tedious Bhutanese procedures then why not allow private pharmacies to sell them?

Simple Rules Bhutanese Break Every Day

More than often we see people smoking in a room where there is 'No Smoking' written in bold, a car parked right on the 'No Parking' space, people talking aloud in the area where it's clearly written 'Silence Please', pile of rubbish around the sign that reads 'Do Not Litter' and worst of all there is no 'Do Not Spit' place without thick bloody read doma spit. Can't we read these simple words? Forgive the people who can can't read, but what about the literate folks who are often the ones breaking these simple rules.

Bulls don't get it! We do.

During my week long stay in JDWNRH I have been an observer to many conflict between sick attendants and G4S guards, sick attendants and nurses, and visitors and G4S. In all these fights I saw how our people find themselves at right after breaking numerous hospital norms. First they come when it's not visiting hour, and when G4S guards stop them they pick up fights. Inside 'one patient one attendant' rule is broken, and when nurses remind them they find the nurse bitchy. When the patient is in agony people crowd over it and won't let nurses do their job, nurse grow furious and shout at them to leave some space for air, and then these people counter. After visiting hour is over, no visitor leaves, not until the G4S boys come around thrice to chase them off. It's not a happy ending either. There is a big dinning room in the hospital and people eat and throw their waste in the space where clothes are meant to be dried.Wash basins are filled with food waste, when there is a separate dustbin to dispose leftover food.
I didn't see a space for problem if at all we could follow the simple rules written all over in Dzongkha and English both. Have I been perfect? No, I arrived late but I greeted the guards with apology and if they asked me to wait I would wait. My visitors left late too and they were shouted at by G4S but I have gone close to them and explained and apologized. But I have spent the rest of time entertaining the sick, clean the toilet, and at one time I have self appointed myself to investigate on a person who was smoking in the ward toilet. I failed to find him but nurses have flashed the message that if he is caught both the smoker and his patient will be kicked out of the hospital.
These people working at hospital at strange hours taking care of our people have their own family sleeping without them at home, and they get their hands in our shit and blood, which our own people won't do. Some of our folks won't even visit us at the hospital because they believe in 'Dhrip'(bad energy that comes with birthing and dying), and I say nurse and doctors would have died of that then. Hospitals are our gateway to the world and exit from the world and these people are the ones who help us at these critical hours.
I wish to send my deepest gratitude to the people working in Thimphu hospital and hospitals across the country for doing the dirty job for us and still tolerating our unending demands. I also pay respect to their frustrations,(after all there is a human inside those angels as well) which many great nurses have brought under their control. I also hope that those unreasonable, biased and arrogant people also change themselves so that one day everybody looks at hospital as a place of worship.

Mothers Suffering Silently

Today my mother in-law is undergoing a surgery to remove her uterus, and our joy is beyond our anxiety because we are finally removing a part of her body that has bothered her for years and couldn't share with anyone. The womb that has brought my wife and her two siblings to this world has threatened to take her own live had we not known it before it became too late.
Her uterus had prolapsed and had been hanging out through her vagina for years but because of the nature of the disease she has hidden from everyone, even from her daughter. It was during the melom chembo in Haa that her son's sister inlaw sighted it when they toileting outside. She inform my brother inlaw, who in turn took her to the doctor.
This is a common risk among elderly women who give birth at home without the assistant of medical staff, meaning many of our village mothers could be suffering silently. The woman on the next bed is awaiting the same surgery, and shockingly she has hidden the disease for 25 years.
These two ladies are lucky that theirs didn't turn into cancer, which has high probability. But not many will be lucky like them, there for I urge all daughters and educated women to check on your mothers and other elderly women in your family for any secret disease such as this if they are hiding. Your one action in time could save their lives and free them from their worse discomfort. I visited my sister last evening and asked her to check our mother though I have asked her myself without hesitation. She says she doesn't have it but I still want my sister to verify. Please verify your mothers.

To all the friends on Twitter who sent in your wishes, thank you very much, your prayers are very important for us at this hour.


Update 8th Spet 2012: 
There are various causes to this sort of disease and not just unassisted birthing. One woman who underwent the same surgery the next day had left copper T inside for 12 years. It nearly took her life. But all stories in JDWNRH this time had happy ending but not many will be so lucky if they are late in seeking medical help. Therefore please take this issue seriously and do whatever is possible within your capacity to help free women around you from such disease.
My mother in-law is doing great at home now, she is recovering very fast. Thanks for all the support and prayers during our hard times. We will "Never forget the people who help you in your difficult times"

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Location:JDWNRH Thimphu

Florence Nightingale in Punakha Hospital: Golden Gift from Burma

That wasn't my first encounter with rude nurses, I have seen enough of them before. But after coming to Bajothang everything changed. I shared intimate relationship with people in our hospital. They have their children studying in my school and some of them studied here themselves, that made all the difference and I was soon pampered. It made me think that all the rude nurses have either changed or have disappeared.
But last four days gave me the chance to wake up from my fairy tale and see the unchanged reality and untamed nurses. My mother in-law had her womb prolapsed  and was due to undergo a surgery to remove it. But an ulcer somewhere on her cervix needs to be healed first. She needs dressing and packing on daily basis and I could think of no place better than Bajo.
I was waiting outside the hospital and my wife was taking forever. When she finally came out she was almost crying. She said the surgeon would pay any attention, though she presented all the document from Thimphu. The Dressing room nurses send her to ward, and ward nurses send her back. She had to walk the length of hospital several times with her sick mother. She could finally get it done at the ward, though they kept mentioning that it wasn't their job. We thought things are settled but the same ordeal continued the next day and the next. I then understood how ordinary patients are struggling everyday. I noticed that there were many new faces and sadly wondered why do we have to know each other to receive good treatment when their only job is the nurse the sick. On the fourth day the nurse who knew how to do packing wouldn't look at us. She was free but angry with us. She directed two first-timers to deal with it and despite their best effort they landed up bleeding my mother in-law.
That's what took us to Punakha Hospital. The gynecologist there wasn't a Bhutanese either but the moment we saw her it felt like we were breathing fresh air after a long time. She is a Burmese and speaks soft English. It was afternoon when we met her but she was full of energy and smile, something very new to us. That morning she had conducted two Cesareans and if there is anyone who has to be tired and frustrated it's her but she was ready for more. That makes Punakha Hospital the safest place for giving birth.
She took in my mother in-law and educated my wife on all aspects of the problem, which was when my wife got to understand the disease for the first time. The Burmese then instructed my wife to come with plastic bangle - the one we used to on our wrist in high school- so that she could device a way to hold up the womb in its place, by which not only infection could be prevented but also quicken the natural healing of the ulcer. Seeing my wife confused, the lady came out of her chamber and check every visitors' hand, laughing and apologizing, to find a sample and she succeeded. She took my mother in-law in and used the ring.

Florence Nightingale

In Bhutan we are never used to so much attention and care, unless we are related or connected or special. And the Burmese changed my mindset all together; we don't have to be special to be cared for. She knows we come there to seek her help and she helps with whole her heart. I always thought Florence Nightingale was fairy tale character but she made me believe that it's possible to have such people. She herself is a living Florence Nightingale, a golden gift from Burma.
She is the second woman I know from Burma, first one being Aung San Suu Kyi, whom I honour so much for doing their job so well. Thank you so much for coming to Bhutan.

Aung San Suu Kyi, only lady I knew from Burma until I met Ms. Swe Swe

Update 8th August 2012: The kind lady from Burma is Ms. Swe Swe. Her contract with Bhutan will end this year. I only wish if our health ministry could request her to stay for some more year. She is an extraordinarily dedicated expert who has attained greatness beyond rudeness and frustration at work. Please Stay.

I Question the Medical Judgement

When my cousin brother was diagnosed with tuberculosis about twenty years ago, his parents didn't give a second thought and started the long treatment. About five months into the treatment they discovered that the little boy wasn't suffering from tuberculosis. His parents were only thankful that it wasn't TB. Five months of heavy dose didn't matter to them. As years went by the ill effect of heavy doses of wrong drugs showed on his physical features and his mental efficiency.
That was a long time ago and everything was forgiven and forgotten even though my brother is still paying the price each day for error in medical judgement some people made. Over the time everything changed and technology came into hospitals to reduce human errors. But machines are just tools and its the human at the end who has to pass the judgement.
Over the years I was shocked at the number of rumors I heard of people being wrongly diagnosed with TB, and some paying the price with their lives. Advancement of human resources and technology seemed to have made no difference to Bhutan. May be all the rumors I heard are wrong, therefore I may be wrong too if not for what happened early this month.

Photo from  fabulousnurses.com, edited by author   

My nine year old sister was diagnosed with TB from Jigme Dorji Wangchuk National Referral Hospital. She had some swelling below her chin after a long toothache and after series of checkup it was confirmed that it's lymph node tuberculosis called Scrofula. My mother was asking me if they could begin her treatment. I am not a doctor, I am but a loving brother, I don't want to risk my sister. I rushed to Thimphu and found out that all the test reports were negative including the biopsy, which I found from Google as a crucial test. Wikipedia tells me that she should have symptoms such as " fever, chills, malaise and weight loss. As the lesion progresses, skin becomes adhered to the mass and may rupture, forming a sinus and an open wound." but she has none of these except the medical judgement of doctor. I trust the big hospital, I trust the big doctor, but on what basis should I trust this judgement?
I brought my little sister with me and took her to Wangdue Hospital, where I explained my fear and showed the reports to the renowned medical specialist. He checked her neck thoroughly, studied all the reports, took a fresh x-ray and declared that it's NOT tuberculosis. He prescribed her antibiotic for five days after which the swelling subsided.
Now I question the Judgement of that doctor who wanted to fill my sister's stomach with loads of drugs. I even fear that all the rumors I ever heard are true but they all landed nowhere because we Bhutanese are so forgiving. No doctor was ever taken to court for their mistake because we forgive, and because we forgive they take for granted.