SURGEON’S DIARY: Surprise meeting with medical friend on a visit to Kathmandu 

Marie and I, with our two children, made a nostalgic visit to Kathmandu to see Nepal and the Himalayas at a close range. ILLUSTRATION | JOHN NYAGAH

What you need to know:

  • At the end of our week-long sightseeing, I realised that I had a spare day in Kathmandu.
  • By then, like a smoker who misses his ubiquitous cigarette from between his fingers, my hand was missing the scalpel.
  • Marie with her feminine intuition noticed that I was suffering from withdrawal symptoms and suggested that I visit a hospital.

The fact that I could not do any mountaineering did not diminish my fascination with mountains. While in Nairobi, I have often been to Mount Kenya Safari Lodge and Treetops just to see the highest mountain in Kenya. Marie and I stayed in Kilaguni Lodge when it opened in the early sixties and watched the highest mountain in our continent of Africa, Kilimanjaro, with as much awe as we did the elephants at the salt-lick right in front of the lounge.

We have been to Kilaguni many times since, both to see wildlife and Kilimanjaro, with snow gleaming on its summit. Further afield, when I was a medical student at Grant Medical College in Mumbai, I followed with great interest the climb of Mount Everest by Edmund Hillary from New Zealand and Sherpa Tenzing Norgay of Nepal and its conquest on 29th May, 1953, to coincide with coronation of Queen Elizabeth.

Edmund Hillary was knighted for his timely feat. When asked what motivated him to climb and conquer the summit at 29,035 feet above sea level, he nonchalantly replied, “Because it was there!”

HOLIDAY TRIP

Many years later Marie and I, with our two children, made a nostalgic visit to Kathmandu to see Nepal and the Himalayas at a close range. The capital city is like a dent in the roof of the world, a scenic valley surrounded by snow-capped mountains, with the horizon bending to kiss their peaks. At ground level it is a city of palaces and temples, stupas and prayer wheels, rich Ranas and monks wearing saffron-coloured robes and religious fervour flourishing side by side with squalor, poverty and drug-peddling.

We did the usual tourist circuit by visiting Buddhist temples with richly carved wooden doors, with Buddha sitting inside in majestic repose and a thousand butter lamps burning around him and surrounded by Lamas with their shining tonsures.

We took the Angel’s flight, which perilously flew us between the Himalayan peaks, reminding us of a similar flight we had taken in Zimbabwe to see Victoria Falls and Zambezi River from above. We also visited Fishtail Lodge, the most popular tourist Nepalese attraction outside Kathmandu.

Apparently, we followed Prince Charles who had stayed the night before in the suite we occupied during our stay. Marie being British vainly looked for any royal mementos he might have left behind.

At the end of our week-long sightseeing, I realised that I had a spare day in Kathmandu. By then, like a smoker who misses his ubiquitous cigarette from between his fingers, my hand was missing the scalpel. Marie with her feminine intuition noticed that I was suffering from withdrawal symptoms and suggested that I visit a hospital.

“The children and I will go shopping,” she added to assure me that she would occupy herself. So I asked my taxi driver. “Is there a hospital nearby? I am a doctor and would like to visit one tomorrow since I have a free day.”

“The government hospital is 15 minutes away by taxi.” He replied. “When would you like me to pick you up?”

“Nine please.”

So at nine sharp, he was waiting for me in the hotel car-park. As I sat in the front besides him, he thrust what looked like an album in my lap, saying, “I was a bit shy to tell you in front of your memsaab yesterday but there are other tourist attractions in this city. They are experts in the erotic art and I have obtained an album of their photographs for your perusal.”

“I would rather visit a hospital.” I replied pushing the album aside.

“I beg you to look at and if you like a face and figure, I can book her for your next visit,” he said.

Convinced that he was incorrigible, I casually looked at the photographs until we arrived at the hospital. I went into the CEO’s office and used my charm with the secretary to let me see him, which happened to be a her.

LOOKS FAMILIAR

She condescended to send my business card to her inside when a visitor came out.

After a few minutes, an attractive Nepalese woman came out of her office holding my card. She studied it for a few minutes and asked,” How can I help?”

“As my card says, I am a surgeon from Kenya, on holiday here and wondered if I could see the type of surgical pathology you see here,” I replied.

She went back inside her office bidding me to follow her. She picked up her phone and dialled a number. After a short conversation in Nepalese, which I didn’t understand, she held the receiver and said. “It is an operating day for Dr Narayan and he would be happy if you joined him in the theatre.”

“Beggars can’t be choosers,” I replied, “The operating list will give me an idea of what is surgically common here.”

She whispered something in the receiver and put it down, saying to me: “I will take you to the operating room.” The surgeon was starting on a case of cancer tongue and said to me. “Biopsy has proved the lesion to be malignant and I intend to do left hemi-glossectomy since it is early malignancy confined to the left border with no palpable sub-mental glands.” He meant removal of the left half of the tongue and the glands he was referring to were below the chin.

As he was dealing with the usually bloody procedure, I was busy watching the anaesthetist because he had caught my eye. Despite the surgical mask he was wearing and the beard he had grown, his penetrating blue eyes gave him away. They proved to be the windows of his heart. It took me a little time to place him because we had met almost 30 years ago when I was a surgical registrar in Banbury training to be a surgeon and he held the same rank in anaesthesia, preparing for his fellowship in the speciality of his choice.

It was all a hush-hush affair but when it broke out, the consequences for him were lethal and served as a warning for me not to ever get out of the confines of medical ethics and never to forget the Hippocratic Oath we had sworn to on qualifying as a doctor.

There were a few more operations after hemi-glossectomy, which I watched, and after the operating session, as we changed in the surgeon’s room, I had a good look at the anaesthetist, which stirred my memory but I could not place him. Like a roulette ball in the casino, it was rolling all over the board but did not settle in a slot. In deference to my wishes, Dr Narayan took me to the wards to see the surgical cases in his wards.

There were cases similar to what I see in Nairobi and yet others pathognomonic of Nepal. At about five in the evening, Dr Narayan looked at his watch and asked me “Have you any transport and where is it meeting you?”

“My taxi dropped me outside the CEO’s office and I asked him to meet me there,” I said.

“That’s a long way from here and I better ask Dr O’Donoghue to take you there,” Dr. Narayan replied, and dialled a number from the ward.

CONFESSION

Five minutes later, in walked the anaesthetist ready to escort me. I thanked my surgical colleague and left in the company of Dr O’Donoghue. It was a long walk among the well laid-out garden and I took my opportunity. “I take it, with that name, you are from Ireland.” As he nodded in agreement, I popped the essential question. “Did you ever work in Banbury?”

Hearing that question, he came out clean. “Yes. You were a surgical registrar and I was your counterpart in the department of anaesthesia. As you remember, I became very fond of chloroform and started inhaling the gas. In time, it stopped giving me the “high” and I went over to heroin and pethidine because I could lay my hands on it easily in the hospital.

“Of course, I was caught because pethidine ampoules went missing from the anaesthesia trolley and then from drug cupboards in the wards. As for obtaining heroine from the black market, it ruined me financially and sometimes I was high when I was anaesthetising patients, and surgeons complained so the hospital set up a committee to investigate me quietly and ultimately caught me red-handed. They complained to the General Medical Council who barred me from practising anaesthesia for two years and deregistered me.”

As I was listening intently to his candid confession, he continued: “After two years my practising rights were restored and I got a job in the hospital. But it was difficult to ignore the stealthy glances from my colleagues and nurses in the theatre. I gave up the job and decided to apply for jobs abroad to get away from it all.”

“Did the fact that Kathmandu is the capital of drug peddling have any bearing on the choice you made to come here?” I asked.

“I suppose,” he replied, “unconsciously yes, but there was an opening for an anaesthetist in Kathmandu, so I took the job.”

Then he added, “God knows that they don’t need any drugs here, their religion and the ruling Ranas have given them enough dope to last a few generations.”

By then we had reached the CEO’s office where my taxi was waiting for me. I bid Dr O’Donoghue goodbye and went back to my hotel where Marie and the children were back from their shopping spree.