What's Going on?
Marvin Gaye's buttery voice lilts between my ears.
What is going on?
As I suppose is typical for most people, in most lives, at most times, my ability to suitably answer the question varies tremendously depending on which of the infinite sectors of life it's directed at.
Let's start easy.
No. 1: Update on K, the wonderful tall monk
Sonam, K and I returned to the TB hospital the day after our first attempt was foiled by Gai Jatra. We waited quite a while, saw a Nepali movie on television in a waiting room full of masked and coughing people. Eventually K's name was called and we headed back to a small room to consult with a pulmonologist. He was clearly overworked, but I was very impressed with the time he took with us, patiently, or sometimes not so patiently, but still answering all of my questions and detailing his thoughts and plan of action. The good news: DNA amplified sputum smears, much more sensitive than the ones done here in Boudha, confirmed that K does not have TB. Cultures in 8 weeks will provide further confirmation, but it's safe to proceed with the assumption that he is clear in that regard. The chest x-ray, on the other hand, was concerning. We had a second xray at the hospital, along with bloodwork, and K was diagnosed with a secondary lung infection. More importantly, it was noted that his blood sugar, supposed to be controlled with drugs, was far too high. This is probably affecting his susceptibility to infection, as well as the metabolism of the antibiotics, and certainly has something to do with the leg and foot pain he's been complaining about. The great news is that this can be regulated. We came back to the clinic and have spend the rest of the week consulting with doctors here. K is now on tranexamic acid and the bleeding has stopped; he will come to the clinic Sunday for a diabetes management course including dietary strategies and foot care and his meds will be adjusted according to follow up blood work in the next week. He's on a new antibiotic for the secondary infection, and we'll start supporting with acupuncture and herbs next week as well. I wouldn't call him 'cured,' but definitely on the up and up.
He's made me think a lot about the importance of a primary care provider. There have been a lot of good physicians attending to K and doing their best to evaluate and help him, but each in their own segmental role. His problems are reparable, but in order to identify and address them, it is necessary for someone to take responsibility for K, as a whole patient and whole package of unique human physiology. Health care systems, whether in America, Nepal, or on the moon, will always be inadequate if they fail to acknowledge the importance of the primary care provider.
No. 2: Strikes in Nepal
Apparently transportation strikes are a pretty frequent occurrence in Nepal. We had one last week, and another yesterday.
It's sort of amazing. The usually shockingly chaotic roads are emptied. It would almost seem peaceful, if one could forget about the political chaos behind it. Anyway, it's kind of weird. I just heard that the strike is off for today, but the whole situation is unresolved. I hope that talks can proceed without violence, either physically or politically, and meanwhile, I hope that the businesses and transportation systems civil society depends on are able to function. It's strange to just wake up in the morning and find you're stuck.
Which brings me to No. 3: The Dissolution of Everyday Life as I Know It, not to be dramatic or anything
The neat little life I thought I had back in the states is sort of dissolving. Truly, dissolution seems to me an apt description. I have this image of the way a solid object actually dissolves: at first the solid just kind of sits in the liquid, and then maybe some bubbling starts, or the liquid starts to change colors, and suddenly you realize there's something going on. Before you know it, the change is fully under way, picking up speed, and there's fizz and everything's transforming, and it's all sort of neat to look at, but it's also just chaos, and it's hard to envision what you'll be left with when it's all over. I am trying though. I am holding on to this image of what remains when the reaction is complete: something altogether new and whole, again still and calm, just unmistakably different from what you began with.
I reiterate what I have said, over and over, and over again.
Life is good. But sometimes I worry that 'good' sounds constructed, like some imagined and imposed and altogether pleasant little framework to stretch one's experience to fit so that you can bask inside of it. This is not what I mean. Life is real only in so far as one dwells within it, steps outside his or her framework and surrenders him or her self to the endless interplay of elements beyond his or her scope of control. And so I add, if you are really seeing it, if you are really asking yourself what's going on, life is good, but it is also never, ever boring.
: )
What is going on?
As I suppose is typical for most people, in most lives, at most times, my ability to suitably answer the question varies tremendously depending on which of the infinite sectors of life it's directed at.
Let's start easy.
No. 1: Update on K, the wonderful tall monk
Sonam, K and I returned to the TB hospital the day after our first attempt was foiled by Gai Jatra. We waited quite a while, saw a Nepali movie on television in a waiting room full of masked and coughing people. Eventually K's name was called and we headed back to a small room to consult with a pulmonologist. He was clearly overworked, but I was very impressed with the time he took with us, patiently, or sometimes not so patiently, but still answering all of my questions and detailing his thoughts and plan of action. The good news: DNA amplified sputum smears, much more sensitive than the ones done here in Boudha, confirmed that K does not have TB. Cultures in 8 weeks will provide further confirmation, but it's safe to proceed with the assumption that he is clear in that regard. The chest x-ray, on the other hand, was concerning. We had a second xray at the hospital, along with bloodwork, and K was diagnosed with a secondary lung infection. More importantly, it was noted that his blood sugar, supposed to be controlled with drugs, was far too high. This is probably affecting his susceptibility to infection, as well as the metabolism of the antibiotics, and certainly has something to do with the leg and foot pain he's been complaining about. The great news is that this can be regulated. We came back to the clinic and have spend the rest of the week consulting with doctors here. K is now on tranexamic acid and the bleeding has stopped; he will come to the clinic Sunday for a diabetes management course including dietary strategies and foot care and his meds will be adjusted according to follow up blood work in the next week. He's on a new antibiotic for the secondary infection, and we'll start supporting with acupuncture and herbs next week as well. I wouldn't call him 'cured,' but definitely on the up and up.
He's made me think a lot about the importance of a primary care provider. There have been a lot of good physicians attending to K and doing their best to evaluate and help him, but each in their own segmental role. His problems are reparable, but in order to identify and address them, it is necessary for someone to take responsibility for K, as a whole patient and whole package of unique human physiology. Health care systems, whether in America, Nepal, or on the moon, will always be inadequate if they fail to acknowledge the importance of the primary care provider.
No. 2: Strikes in Nepal
Apparently transportation strikes are a pretty frequent occurrence in Nepal. We had one last week, and another yesterday.
It's sort of amazing. The usually shockingly chaotic roads are emptied. It would almost seem peaceful, if one could forget about the political chaos behind it. Anyway, it's kind of weird. I just heard that the strike is off for today, but the whole situation is unresolved. I hope that talks can proceed without violence, either physically or politically, and meanwhile, I hope that the businesses and transportation systems civil society depends on are able to function. It's strange to just wake up in the morning and find you're stuck.
Which brings me to No. 3: The Dissolution of Everyday Life as I Know It, not to be dramatic or anything
The neat little life I thought I had back in the states is sort of dissolving. Truly, dissolution seems to me an apt description. I have this image of the way a solid object actually dissolves: at first the solid just kind of sits in the liquid, and then maybe some bubbling starts, or the liquid starts to change colors, and suddenly you realize there's something going on. Before you know it, the change is fully under way, picking up speed, and there's fizz and everything's transforming, and it's all sort of neat to look at, but it's also just chaos, and it's hard to envision what you'll be left with when it's all over. I am trying though. I am holding on to this image of what remains when the reaction is complete: something altogether new and whole, again still and calm, just unmistakably different from what you began with.
I reiterate what I have said, over and over, and over again.
Life is good. But sometimes I worry that 'good' sounds constructed, like some imagined and imposed and altogether pleasant little framework to stretch one's experience to fit so that you can bask inside of it. This is not what I mean. Life is real only in so far as one dwells within it, steps outside his or her framework and surrenders him or her self to the endless interplay of elements beyond his or her scope of control. And so I add, if you are really seeing it, if you are really asking yourself what's going on, life is good, but it is also never, ever boring.
: )
posted by bella.calamitas at 5:56 PM
