Coffee in hand, I stroll downstairs into the Vajra Barahi Health Clinic’s waiting room to prepare for my morning. Before the clinic bustles into life, I have the privilege of traveling out to a nearby Newari village and treating Asa Maya, a sweet, elderly woman, who recently had a stroke. I have been hearing about her and the strong commitment of her family from my colleagues for months. I consider it an honor that I get to continue her care.
I take another sip of coffee and gather up my travel acupuncture kit. Today, I am bringing my blood pressure cuff, stethoscope, since the weather turned significantly cold this week. We want to monitor her lungs closely for any signs of an upper respiratory infection. In this weather, a common cold could quickly turn into pneumonia in an elderly patient that has limited mobility.
By 8:30am my interpreter, Tsering arrives to lead me to the Newari village where Asa Maya lives. The village is only a ten minute walk from Chapagaon and Tsering leads me through the winding streets, hills, and fields to Asa Maya’s home. As soon as we enter the Newari village, the feeling of being in a foreign land intensifies. They buildings are striking brick and mortars with decorative wrought iron window bars. Outside nearly every home is a two story tall pyramid of drying corn on stilts. Women sit in small groups, spinning yak wool into yarn. Chickens, goats, and water buffalo lounge in the small areas in front of each house. Ducks wiggle their tails while crossing the street.
We turn down a small side street and enter one of the homes. In a small room only big enough for two people to sit next to each other, we find Asa Maya and her husband. He gently moves her affected leg back and forth above a ceramic basin of warm coals.
He smiles a wide, welcoming grin when we arrive. He explains that it has been much more difficult to keep Maria warm the past few days. He removes the coal basin to create enough room for Tsering and me to kneel. A moment later, their daughter arrives and trades places with him. ‘Namaste.’ We exchange greetings.
“My name is Lindsey. Stephanie (the practitioner) is one of my dear friends in the United States. We went to school together. She told me all about your case and you are very dear to her.” Both Asa Maya and her daughter light up.
It is clear how much the family has changed their lives to help Maria regain her health, and the strong bond of love that exists between each family member.
The last few days Asa Maya’s stomach has not felt well. She is having difficulty eating, but they are very concerned about her ability to walk. She had started walking again with the help of a staff and her daughter to lean on during December. I had to explain to her family that before we keep attempting to improve her walking, we need to get Maria eating again. She will not regain strength without food. Most of the morning is spent assessing this new condition and reviewing the treatment plan for Maria with her family. Her husband or daughter sit by her side at all times. They massage her legs and arms multiple times a day. As they ask me about diet, herbal medicine, and her other home care suggestions, the unwavering bond of love is quite clear. It is a bond that I will see repeated throughout the day at the Vajra Varahi Clinic, in various families bringing loved ones to the clinic.
I tell Asa Maya’s family that I will be paying home visits three days a week with my roommate covering the other two. Tsering and I head back to the clinic.
The clinic is well under way when we return. My colleagues are bustling back and forth, grabbing formulas and clinic supplies. I take a deep breath, don my white jacket, and prepare to feel overwhelmed as Tsering gathers up three patients to bring to my clinic room. They sit in a semi-circle and Tsering guides me from patient to patient. We launch into introductions and figuring out the right care needed by each patient for the day. Within the first hour, I had to refer out a patient for further assessment before doing acupuncture. Her husband stood by her side during the entire interview, deeply concerned. Other patients came in with all of their children. Sisters and aunts stood outside the clinic room window, peering in occasionally with moral support. The deep commitment of family permeated my first clinical experience Nepal, and leaves more for me to ponder in the coming days.
My first day ended up being a special blend of similar muskuloskeletal pain cases, interspersed with more complicated cases, including a Bell’s Palsy case. I had to delve deep into my memory for orthopedic examinations and was grateful that I reviewed the signs of various infections and pathologies in the respiratory system the night before. I listened to lungs, heart valves, taught patients to say the word ’99’ in English, in order to listen for hyper or hypo-resonance in each lobe of the lung. I gathered up medications lists to review. By the end of the day, I felt in a happy daze.