Better Late Than Never

We, the little troupe of American students, are taking a tour of Nepal to check out what’s there. In fact, we are under strict instructions to just observe for much of the time we are here. So if all we are allowed to do is come in, look around, and then leave, how are we anything more than tourists? Sure, we gave a few plates of food to the homeless, we heard the stories of some people who have been working in Nepal in various ministries, but it’s hard to choose a place where we really made a lasting impact. Nepal will go on as it was before we arrived. So I ask again, how are we anything more than glorified tourists?

Well, one way we can go beyond tourism is right here, in simple reflections on our time in Nepal. That will help determine what exactly we take home with us, and will help us to be able to follow through in the future in such a way that this experience is more meaningful. As far as what we bring home, it’s easy for tourists to come back with some simple observations. For example, they might notice the beautiful mountains or the crazy traffic. They could see lots of Hindu or Buddhist symbols, and notice a lot of friendly people in a more community-oriented culture. But Nepal is a lot more than that.

While these observations in themselves are not wrong, the act of going beyond tourism must necessarily go beyond these simple statements. These observations are things you can come away with after being in Nepal for 48 hours, or probably even less. So what difference does it make being here for 4 weeks in a course on medical missions?

I’d propose that there is in fact a distinct advantage to being in a country for more time than a quick tour, and with a focus besides sight-seeing: extra time allows you to finish examining the other country from your native perspective, and actually begin to examine your own country (and yourself) from a foreign standpoint. I suggest that this is the point at which we can go beyond tourism. So, to continue, what can Nepal teach us about us in the US?

To focus on the medical aspect first, I think we can learn that in some cases, American medicine can do too much. I found in the Nepali hospital that in a number of situations, there is a sense of relief and peace in being able to say that there is nothing more to be done. It is time for the patient to go home and be with family for the end. In America, our tendency is to test our patients to death, and try out new and expensive treatments that can wear out the patient, all for only marginal improvements to the outcomes. In the meantime, we can bankrupt the patient’s family with massive medical bills because we couldn’t let go. With the amount of testing we do, and the uniqueness of every human body, testing abnormalities are bound to happen even when they don’t indicate anything being wrong. But under the threat of lawsuit, we continue our testing, maybe even chasing ghost illnesses, all at the patients’ (or taxpayers’) expense. It could be time for us to figure out when to expect a little bit less of Western medicine. Or we can at least ensure that the patient and family honestly know what the outcome of significant interventions might hold so they can make an informed decision on their own treatment. We don’t yet have a medical cure for death, so maybe the best medicine is just a little bit more quality time with family and friends, rather than a few more months as a medical experiment.

Something else I have come to appreciate about medicine in Nepal is the attention the doctors give to their patients’ financial well-being. There’s not much point to leaving the hospital physically healthy if, when you get home, you don’t even have money to eat. The doctors here in Nepal, from what I’ve seen, are always balancing effective treatment with its cost, being sure to find the least expensive way to give the patient quality treatment. This is not to say that no American doctors are also considerate of their patients’ finances. I have had personal experience with doctors that have demonstrated such concern, but it is always healthy to remember that good medicine should care for the whole person. This includes a consideration of their economic well-being.

A final lesson that I think Nepal teaches me about America, and about myself, involves the importance of people. The increased value that Nepal (among many other nations around the world) places on people and social connection is something that the US can certainly learn from. In fact, it could even make us healthier. The US tends to be a pretty lonely place, which might stem from the fact we have a cultural emphasis on hard work and productivity, often at the expense of social connection and friendship. Now to argue for the more Nepali approach in a very American way, research has shown that social connection carries tangible health benefits. Friendship is a great drug- it can carry some side effects of vulnerability and even occasional heartbreak, but it brings broad benefits that make the risk worth it. For example, psychology focused “rat park” experiments suggest that social interaction could play a role in preventing or treating addiction. The “nun study” on Alzheimer’s also highlights the centrality of social networks in developing a sort of psychological resilience against disease. This particular study suggests that social connection is a key factor in tolerating the histopathology (brain tissue patterns) of Alzheimer’s without experiencing the related psychopathological symptoms (forgetfulness, progressive cognitive deficits). My scope here is obviously limited, but I believe the principle holds true through many situations– quality friendships are beneficial to our health. So, would you rather give all your extra time to your job, or spend that time at coffee developing or maintaining a friendship that could improve and/or prolong your life? Would it be better to go to bed on time every night, or sacrifice a little sleep to be with people you care about? Science is saying the health benefits are there, we just have to take advantage.

Considering the limits on time and on my own mind, I couldn’t possibly write everything here. There is much more that I’ve learned from Nepal than just what is expressed above; these are just some select takeaways that I have thus far. Now to end, I’d like to give one suggestion: if you want to ask us about Nepal when we are back, it means a lot if you are willing to hear more than a two statement response. What we are experiencing here can’t be truly communicated in a couple comments and photo captions. So if you want to hear about it, let us know! We can meet for coffee, or I think I speak for any of us in saying a dinner invitation is always welcome. (I’m looking at all the parents and grandparents, aunts and uncles, 1st/2nd/3rd cousins, or even a family of a sister-in-law that live in West Michigan and care about us enough to read our blog) We’ll trade our stories for a meal any time. Thanks!

 

 

P.S.

All these observations, like any coin, have two sides. I assure you that I have thought about both sides of the coin, and I am not just trying to be hyper critical of the US (i.e. medical experiments are part of advancing modern medicine, and thus are not just negative things). I am simply writing in such a way that I focus on the side of the coin that I feel to be more often neglected.

3 thoughts on “Better Late Than Never”

  1. Thank you for this Jacob! I like a lot of what you had to say in this reflection and I’d like to share a book recommendation. Being Mortal by Atul Gwande talks about the struggle for patients, families and health care providers in deciding when enough is enough in regards to treatment. I highly recommend anyone in or considering a health care profession to read it. In fact, I encourage ANYONE to read it as it pushes the reader to think about our own mortality and our last days and what we want that to look and feel like no matter our age. Again – thanks for your reflections!

  2. The Reed’s look forward to hearing about your time in Nepal 🙂
    Great blog, thankful your mom sent the link!
    Let us know when you can come for dinner!!!!

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