Road to Manjushree

June 29, 2008 5:28 AM

Sometimes doing “good” is difficult, but the feeling that you get when you accomplish it is indescribable. It is the same feeling that you get when you win something, fall in love, or any other thing that brings pleasure. However, the “good” deed must fit the true definition of good. Good is when you constructively interact w1ith another person or thing to help fulfill or serve the purpose of that other person or thing so that they may evolve into God.

This time when wanting to do well, it was hard; my goal was to volunteer to provide medical care to orphans in remote regions of India. How I arrived at the orphanage was just as interesting as the measures that I accomplished when I helped the little ones.

Preparation to Leave

In order to go on this adventure, I gave up much, sometimes wondering if it was the right thing to do. By going on the mission, I used up not only all my remaining days of vacation, but I was also over and would have to pay back the time. I would also have to work all remaining holidays, all the weekends in the two adjacent months and most difficult of all spend the time on the trip during Thanksgiving, away from my family. I was reluctant to leave my family again, leave my loving wife, three young children, not to mention the team I coached, and the weekend class that I taught. I am so grateful that there were other volunteers who stepped in for me.

Although we were going to a remote region of the world, where we would be cold, not have ready access to heat, hot water, and toilets and presumably had to sleep in a tent, I knew that I had something to offer that the orphans desperately needed. I did want to bring my wife and children; however, she did not feel that it was safe, nor did my wife believe that they could put up with the conditions. Well, even though it was a struggle, most events unfolded in my favor, allowing me to venture out.

It is often said that the road we take is more important and as rewarding as reaching the destination. Furthermore, the lessons that we learn on the journey are usually the main teaching points of the experience, and so this began the road to Manjushree.

Being a doctor

I was lucky to be a doctor. Although I was a neurosurgeon and practiced technicalogically advanced medicine and surgery, I was also an osteopathic physician where I had advanced training in primary care medicine throughout my medical school training- and first year of residency. As a matter of fact, you can say that my neurosurgical practice of not only the most advanced intensive care medicine but daily exposure to the most common ailments of our society such as back pain, headaches, stroke and its causes of hypertension, diabetes and obesity further provided me with the diagnostic training that I needed to accomplish the task. The other resource that I unknowingly was going to India with was the knowledge that you obtain just from living in the United /states.

What we took for granted

We take for granted many things, one being our hygiene and the customs that we learned as children to wash our hands, brush our teeth and the procedures to use the toilet. These customs, although second nature for most developed cultures, are not the customs of all. The customs of our times have also led us into difficulties, and it may be that by embracing some of the customs or other societies our own struggles diminish. As with all cultures Americans want. We, as do others, want peace in our family, want happiness for our family, and want to survive. We also share other wants with other societies such as the want for leisure time, and the want to be healthy. Most societies and the people within societies want these things, but then the wants and the extension of those wants start to diverge. Some people in other societies may want still more. They may want more food, more money, more authority, more standing in society and more “power”. “Power” is a relative term used mostly by Western societies. Some think power is money, political position, authority, the accumulation of material, or other terms from a developed society. However, the true meaning of power is your circle of influence, your ability to use your resources to accomplish something. That circle of influence only depends upon your established interactions with people. Therefore, the true definition of power does not depend upon material objects, but constructive interactions with other people or things. This definition although, not expressed seems to be innate in other cultures, and starting to retreat from the United States and therefore affects their wants. People all over the world want, hover not all people crave, and not all people feel entitled. These are the lessons that I learned. These are the lessons that I believe can help society and restore healthcare in the United States and abroad.

Journey begins

Our journey began from Los Angeles aboard a jumbo jet. In a short amount of time, during the six months before our departure, the organizers of our adventure labored to obtain supplies from other charitable organizations. They raised funds with activism and obtained an entire shipping container full of medical supplies from organizations. Also, prior to leaving it was decided that we would be sleeping in the shipping containers and when not shivering in our dreams, we would use the shelter to see patients. At that point, sleeping in an enclosed large shipping container seemed better than sleeping in tents.  We accepted the inconveniences because we knew we had a duty to perform and we knew the conditions, although dramatically different than our domestic conditions were still better than the conditions, we would cause by displacing the children from the Orphanage or using their supplies.  We knew it would be cooler than Los Angeles, that we would use out-houses, and have limited electricity.  We also hoped that there would be some kind of “hotel” in town where we could stay once or twice a week, get meals, call our families back home, use the toilets, and bathe.

Why Manjushree?

We were going to Tawang, India, a remote mountainous region in Northeast India on the disputed border with China, near Bhutan. The Manjushree Vidypith Orphanage sat at about 10,000 feet in the Himalaya Mountains. Since the region is in a nationally disputed area, special government permission was needed to go to the region. This is in addition to a passport and visa. The connection to the orphanage was made by happenstance, as is many events in our life. Neither the physician who initiated this trip, Doctor Natalie, nor I sought out Manjushree. A friend of Dr. Natalie was lost in an airport in Gauhati, India. She was stranded there without her ride to Tawang. She saw a Monk, Lama Sir Thupten and thought he was her Monk, her ride to get` to Tawang, India. He in fact was going away from Tawang, India to another city in India. However, she was desperate, and Lama Sir hired a car and took her back to the remote town that he had just left. This was a random act of kindness, a good act indeed. During the two-day trip Lama Sir naturally discussed his life in Tawang, India. Lama Sir told the lady that he was a Buddhist Monk, who started an orphanage in Tawang, India. Lama Sir talked about the tale of raising funds by knocking on the doors of people in India, by appealing to his leader the Dalai Lama, and by constant work to accomplish his goal. He knew that to help these children he had to work hard, he had to put in long hours, travel distances, make sacrifices, all while being a Monk, all without any resources, except his power to do good. Lama Sir raised funds, bought land and a very small building and then took in seven children. However, this was only the beginning for him. He lived in an agricultural region, a region with little connection to others, a region the government needed to keep closed for security.

The region did not receive much influence from neighboring Indian states. The people of the region were of Tibetan descent, different from the Hindus of India. The people spoke Monpa, in addition to the declared national language, Hindi. However, although Hindi is the national language there are many languages spoken, most if not all, unable to communicate with the next.  In essence, the community was independent from most of India, was required to use limited resources, needed to gather knowledge and technology by their own means, and although in one region, were still different from one another but bound by a common set of goals to survive, be happy, and be at peace.

Meeting in LA

In Los Angeles International Airport the group met for the first time; each person had known only Dr. Natalie. Her husband, Paul, an attorney, accompanied Natalie. I was unsure of whom I would be meeting, and we were all unsure of the qualifications that each was bringing on the expedition. I was introduced to another physician, Dr. Becky, who was a family practice resident that I had met earlier in the year at an education meeting. She was accompanied by her fiancée Bryan. There was a dental hygienist, Trish, a neonatal nurse Marni, a photographer Fran who went by her Yoga name, Saporim, and a couple who would be the film crew. I had previously thought there would be fourteen doctors as part of a twenty-person crew; I wonder what had changed. I also was curious about the role the non-healthcare providers would play, and sad that my wife and family were not accompanying me. The situation was not unlike our daily events- we have an idea of how our life should go and we make general plans but, as we would soon learn, life changes sometimes for the better and sometimes not. I asked questions as much as tolerated, however the answers were not available. I simply had to deal with what I had at the time- a sense of our mission and the goal to help others.

After the introductions I noticed the luggage; it was everywhere. There were ten of us but mountains of crates, duffle bags, metal boxes, suitcases, and even what looked like a silver casket. I assumed that some of the medical supplies, the medication and examination equipment we needed for daily use were staying close to us to ensure security and sterility. I had some room in my three suitcases and accepted eight empty water filtration bottles; I did not consider them as coming from strangers. The airlines created a separate area for the cargo, and us, however the average overseas passenger could not tell. We were strewn about within the canyons of luggage, talking, and bonding, never sizing up to another-, which was unusual for medical specialists.  As a matter of fact, or of culture, although I had been engaged in the grips of conversation for only ten minutes people broke out snacks from their smaller hiking packs. I suppose food is a manner of camaraderie, sharing what little one had to make others welcome. In the United States you still see the custom in large families of strong heritage. It was as though we had gone over to someone’s house for a Sunday afternoon, where despite the lack of accommodations and the hectic atmosphere outside, we were still standing in the main walkway of the international terminal; there was something that made you welcome and at ease. We stayed in our area, breaking bread, laughing and talking while the airlines prepared to make arrangements for the group. There were passengers who stood behind our waiting place. They were not interacting, not noticing our comfortable gathering. Instead, they fumbled through their paperwork, glanced at their watches a time or two and took several deep breaths. I am not sure how long each stood there but as soon as I noticed each one, I meandered through the mountains and communicated that we were not moving and that another line would be faster. Sometimes they stared at me with a blank expression prompting me to speak more with gestures. One time I even caught myself speaking slower and yes, louder, as I tried to show them the direction to begin their journey.  Eventually they would leave, without coming into the gathering, without at least having some food- at least we tried.

At the time that we laughed and talked about matters, different from the expedition, different from the polite introductions you encounter when you make a mandatory visit for work, or your spouse, Dr. Natalie was slowly moving our equipment closer to the check in window- Paul, her husband, the lawyer was beyond her site at our end of the canyon. I hiked over to Dr. Natalie to help- she said she would do it. I had known Dr. Natalie for years; we were directors at different hospitals, but she was the chairman of our education consortium, and I was the chair elect. We had worked well together, sharing common ideas and strategies, dependently accomplishing a great deal during her tenure. As she now began, with one hand to move one piece of the pile at a time to the window, while holding the documents she had gathered from us in the other hand, I had to help. We brought each piece to the counter. She had some assistance from two big baggage handlers, lifting and placing the load onto the scales- most pieces exceeding the weight limit, no piece near the size of a carry-on. I was motioned to set away as the silver coffin was lugged and thumped onto the metal scales. The agent looked with concern. She said it could not go. Dr. Natalie immediately responded that it had been cleared ahead of time and quickly thrust the documents into view. The ticket agent instantly reverberated that she would get the supervisor. Again, I had to step back. I returned to the laughing and talking- there was no singing and no campfire, but I expected it soon. At some point I looked over my shoulder and noticed Dr. Natalie walking along side three carts piled 8-10 feet high being pushed by six men and guided by my diminutive friend- she had accomplished another task against rather large odds.

In about ten minutes she came back to us to distribute our boarding passes, passports and new instructions that we would stay together, go through security, and go to the gate for Taipei, Tawain our 14-hour flight and connection to Delhi, India. From that moment on, we were bound, and time became muddled, almost meaningless.

We crossed the international dateline and arrived in Taipei, Tawain- the date two days after we left. Although we had an hour before boarding the next leg of the journey, Debra, who wanted to go by her Yoga name, Padmini, started the interviews. Our adventure was being documented, filmed by professionals- other friends of Dr. Natalie’s. First Trish was sequestered, taken to an appropriate backdrop and questioned for ten minutes. Next it was my turn. I anticipated that it would be fun, different, and something to take up time when waiting in airports, between patients and when everything else had been on hold. I was fitted for the microphone; we walked to one place and then another settling on the sign to Delhi, India in the background. At first the wireless microphone signal was not perceived in Joel’s camera.  Batteries were changed first in the box that was hidden under my shirt, then in the receiver and then in the camera. I kept saying, “check” and “sound check” and then all matters of things- trying to be funny. I was not getting through in either format. At different times, between the cues to say, “Check” I was instructed to not talk. Joel thought it was one piece of equipment, and Debra was telling him it was another, you could tell they were a couple. Finally, after adjusting the microphone up and down my chest, plugging and re-plugging cords; we were ready. I was first asked to say my name, and then what I did for a living – two relatively simple questions, a trick used by any prosecutor to obtain a false sense of security. Then I was asked to describe the lessons that I expect to learn from the people of Tawang. I felt as if I was trust into the scene from the 1974 Python Pictures, Ltd, Monty Python and the Holy Grail, where in order to cross the Bridge of Death (now into India) I needed to answer this third question and tell the kind Yoga instructor the airspeed velocity of an unladen Sparrow.

We were going to one of the remote regions of India, a place was their little connection with the rest of India, let alone the world. I saw pictures at the internet site of the Tawang, India region, I know that I could not learn the language because most retailers did not have Monpa language tapes, I have read about India and even talked to natives about the trip, but even they did not know about Tawang, India. Even my cell phone carrier who could provide service in Delhi, India did not have Tawang, India on a map.

As I stopped to ponder the question, I thought about my three young children, about our family vacations, about our monthly road trips where they ask invariably “Are we there yet?” and about Friday Family night and contrasted that to the Orphanage in Tawang, India. I remembered that each day when they wake up, I ask them to name their goals. They recite be happy, have fun, learn a lot, make the world a better place, read and write, build things and teach. When we sit together almost every night and have dinner I ask them about their day, about what they had learned in school, about their times at sports practice and music practice and about their plans for tomorrow. We talk about the places we had been around the world and the different places that we had lived- but I was going to an Orphanage. It was common to my children about what they expect to learn from a new experience, but they did not have to put it onto tape for a documentary. It was not that I did not have an answer; I was able to board the plane across the jet bridge.

Arrival in Delhi

It was the afternoon when we arrived in Delhi, India, when we helped transfer the luggage with the army of transporters, and boarded the bus for the hotel, making Delhi traffic the first experience with the region. The streets of Delhi, India relate a remarkable story. There were no tour guides or stories from my comrades, just the sights, sounds, and smells of the city. Studying each street, the anthology of vehicles, the people in the vehicles, the cadre of buildings, the people as they lay, sat, or walked along, and the animals told the tale of this metropolis. The streets crowded with cars moved like a Manhattan sidewalk during rush hour. In general, cars remained close to their side of the guideway. However, just as people when people are walking with the crowd stop to read, cross rows of people to get into a store, walk 5-10 across, move to the opposite curb to walk faster, or remember someplace else they need to be and turn around, so do the vehicles on the streets of Delhi. The traffic maneuvers could be made anytime by large trucks, American cars, three-wheeled Autorickshaws, people or even groups of people riding one bicycle, men pulling delivery carts where burden of wood planks, iron rebar, or vegetables protrude ten feet out either side, or by animals such as cows, elephants, and camels. There are expressways through Delhi, however the elevated guides for traffic are no different from the other streets, and although it appeared that at times the expressways were the preferred choice for pedestrians providing more room for their stroll.

The streets echoed with sounds, mostly the beeping of vehicles as if they were the instruments warming up just prior to the concert. The beeps were different than in America where mostly it is a warning to not perform an unacceptable maneuver again. Here, and throughout our travels in India it was a form of communication. It was sounded to signal that one car was going to pass another by charging head on into the oncoming whord of vehicles and by the vehicle being passed, acknowledging the stunt, possibly providing the condolences to the far away families of the daredevils or as a means of encouragement as they made their last stand against the charging Indians. Then there was the response. The oncoming traffic politely signals that the risk taker is seen. However, if the intruders’ presence remained too long, as opposed to too close which appeared to never be a concern, there would be the delivery of longer repetitions of noise leading to the final vibratory acoustical insult should the invader not obtain acquiescence from the fellow traveler permitting the vehicle to join back into the ranks of the column. The columns never matched the suggested line designations on the pavement. However, if the feat was successful and it was almost way, when the marauder joined the column, they signaled thanks to all around and all around signaled back the welcome back into the formation. The slow speed of the columns not only allowed this deadly dance it also encouraged it, building bravery, possibly a right of passage in India.

As we continued to be swept along in our column toward our hotel, in between the quick hesitations and jolts ahead, I played my role as tourist, taking pictures of the cultures and traditions, all new to me. Although many pictures were blurry because of my inability to coordinate the shutter release and bus’s choreography in the column, the pictures were hazed due to my through-the-window photography technique. I opened the bus window and instantly recognized the smell of diesel, burning wood, and smoke from all things exhausted which not only filled the air, blocking the sun but covered your skin with an oily goo and stung your eyes with drops of acid. I quickly closed the window attempting to prevent the gases from quickly moving from their higher concentration outside into the relatively clear air in the bus. As I sheepishly settled back into my seat, most passengers unknowingly responded to my activity with coughs and throat clearing, acknowledging that I could have put their health at risk.

On the street the social hodgepodge of pre-industrial age and 20th Century technology was apparent. While elephants and camels were still used as beast of burden for wealthy villagers, and the well to do upper class drove Mercedes and Lincoln Continentals, the poor slept at the side of the road oblivious to the current bustle of activity. The bus meandered through areas of stucco large houses situated directly across from shantytowns constructed of cardboard and tin huts. In the windows of ten story cramped cement apartment buildings, next to the makeshift shelters, elderly people and children, not dreaming about past times, and not hoping to gain the marvels of progress played on the balconies, hung clothes out to dry or tended to their crops. There were areas where children played stickball, soccer, and cricket in the dirt areas of the tin hut towns, and all seemed pleased. Maybe they had thought about more time to play, or more food to eat, or an appliance to make washing easier but it was not apparent. It did not appear that they had cravings for wealth or sat staring wondering why they did not receive what they should be entitled to have.

Also at the side of the road were examples of how although readily available, technology was not the dominant way of life. Cars were stranded every few miles, pushed off the paved street onto the dirt sidewalk. The trunks were open and people, in fine clothes tinkered with German engines or home design multicolor wiring strewn together with duct tape. Eventually, with the help of passers-by or prior to the gathering, the vehicles would start running as evidenced by the thick blue smoke coughing out of the tail pipe. Crowds were everywhere, and they were busy. India is slightly bigger than one-third of the United States but has almost four times the people at 1.13 billion. Many of the inhabitants of Delhi probably did not have much leisure time, having to plant supplemental small patches of crops, fixed their small simple cars, pushed single loads of construction materials over miles and swept the dirt at the side of the road. Sweeping dirt was pervasive. Usually elderly people, however there were also women of all ages who bent over to use two feet long brooms, in what seemed like an endless impossible task to move dust from an area into the air, temporarily providing a surface that could be seen. People performed all tasks, usually without machinery. Scores of men in silk shirts diligently worked on 2 story buildings. Men poured one bag of cement at a time into a two-foot piles in which another man poured a container of water that he had carried over from a larger container. Sometimes one of the men would prepare the mixture other times another would go to that pile after just completing the previous. Then one of the men would carry as much as possible to the wall for incorporation. Rebar protruded from the walls and floors like whiskers on the elderly that men would constantly tie. At the same time there were women at the site using picks or sledgehammers to remove a portion of the wall that presumably was not structurally sound. People were the power that held India together, each taking responsibility for their own actions, each working as part of the larger fabric of mankind interacting to construct. Even when portions of the structure were unsound the people removed those parts so that new material could be utilized. There was no apparent arguing about the infinite construction; there was no arguing about sweeping dust into the air only to have it settle back down. The sweepers were apparent almost every mile of street.  Two-story construction in all phases, even those without recent activity permeated the landscape. People were the resource of India. Technology was available, procedures for mass production existed, and products to improve efficiency could be found but none were utilized in mass. Her people, working together to keep any job going, held India together.

After one hour of driving, our bus settled at the hotel in downtown Delhi, not far from the airport.  The driver and his three helpers, who sat up front behind the glass partition in an eight-foot by eight-foot wooden paneled room, hurried to unload the undercarriage of the bus. The passengers unloaded the remaining armada stacked upon the once empty seats. The luggage was transferred to the unending line of bellman. Our first chore in the hotel lobby was to identify each parcel of luggage as Dr. Natalie collected our passports, registered us in the hotel and distributed the room assignments. We were told to be back down in the lobby in three hours for dinner. When I was given the room key, I was told my roommate was Mr. Dan.

Mr. Dan traveled to Delhi from New York, where he worked as the editor of a financial magazine, and because of his friendship with Debra, his genuine kindness and belief in goodness, obtained the largest proportion of funding for this medical mission from his publisher. Mr. Dan, as became apparent later that day, was also a considerably accomplished photographer, blog writer, and humanitarian. Mr. Dan’s inclusion on the trip was a bonus for all of us. Not only did he report firsthand knowledge to his publisher, but he also brought a different cultural viewpoint. He had moved from London seven years ago, retaining his British Passport, British accent, and British historical view of India and the world. Although Great Britain is our closest political and cultural ally, the British opinion is different, and Mr. Dan’s perspective was welcome and necessary.

Sharing opinions about issues brings individuals, groups, and even nations together, and we were on this adventure because of our corresponding humanitarian belief. Similarities allow an idea to flourish, a group to build members and a need to be met. However, differences among the individuals are also required for growth. Our world continues to be better and stronger because there are differences. In a collective where there are differences, changes are usually made to overcome stalemates. Furthermore, when things are not going well and the differences in opinion are reflected upon often methods to overcome obstacles become apparent. Although changes may result in a reversal of progress, more often than not advancements are made. It is up to the individuals, groups or nations to approach differences in ways that the result is a constructive interaction in which all parties benefit. Sometimes the ideas that will advance all sides are not initially known, when that occurs a small step forward while planning for the next step will still lead to progress. Although India is not a leader on many technological roads, the intermixing of technology and “older ways” ensures that India’s small steps will guarantee that the nation continues to move into the future. Mr. Dan pointed out that the mixing of old ways and new technology occurs in Great Britain as well. There, urban areas are often land-locked prohibiting large open areas, large roads to maneuver upon, and large buildings. Yet, within the spaces available Great Britain uses technology to maximize efficiency, leisure activities, and abilities to make further advancements.

Mr. Dan used the opportunity of a clean room to take a shower while Dr. Becky, Bryan and I had a similar idea to go into the heart of the city. We walked out into the thick haze of nighttime Delhi, being met by the sounds that we had grown accustomed to and the smells that identified where we were. We walked four long blocks, darting between smog-cloaked vehicles to arrive at the marketplace. As we would later discover, most of the downtown area was a marketplace. Consumed by the merchants, we soon realized how incredibly similar the world was to where everyone was trying to sell something. On the streets of Delhi everything was for sale and children, adults and octogenarians sold it. We were looking for products unique to India that we could legally take back to our loved ones in the United States. Only by completely ignoring the peddlers, while watching out of the corner of your eye for any item that might be interesting could you move ahead. We saw unidentifiable fried foods, colorful fruits and vegetables, silk shirts, open toed shoes, every type of cloth and clothing, sculptures of all shapes and sizes, paintings of deities and Elvis, ivory carved into objects of pleasure or for pleasure, jewelry crafted of rubies and jade, cadres of incense, teas of the regions, and all manner of electronics. The market came to life at any moment there was a space larger than four feet. At that time, individuals would occupy the cherished ground and begin to thrust their wage-earning ways onto the unsuspecting pedestrians. Chum hit the water when one-person broke stride signaling more peddlers to fit into the four-foot space than college students cramming into a Hummer. As the mob grew into the street, the vehicles became outnumbered and dwarfed in mass forcing an orchestral warm-up that usually thinned the crowd forcing it back onto the sidewalk or side street. This growing and thinning of the crowd occurred as if the people were waves moving to the shore only to retreat as the tide of people waxed and waned.

Not only did the market spring up on sidewalks and side streets, but there were also small wooden huts where merchants stood behind wooden counters to larger areas where one had to enter a door to appreciate the wares. No matter where the merchants’ trophies were found, in the store, on the street or in their coat, the prices were lower than found in any bargain store in America. And yet, the mere idea that we were willing to make a purchase prompted us to search for even better buys. As we pushed ahead 100 more feet we were met with another type of entrepreneur. Young men came up to us, describing magical wealth that was found in a six-story mall only blocks away. At first, we dismissed the foreign intrusion into our quests, wondering at first whether would be whisked off to a ship container bound for some other part of the world. After many boys came up to us, we heard the complete sales pitch that we could receive a ride in an Autorickshaw to the mall for a mere ten rupees. It was 38 rupees to the dollar, so we offered three rupees to take all three of us to the mall for shopping. The boy lookout convinced the Autorickshaw driver to accept the offer.

An Autorickshaw, the three wheeled covered green and yellow scooter is three feet wide, and five feet long and now carried five people on a nighttime pilgrimage through India in search of treasure. In one mile we arrived in a quieter sector of downtown Delhi, in front of a six-story building 150 feet across, where police guarded the front door that we were about to enter.  Through the gilded doors we climbed six stairs and were met by our buying guide. He inquired as to our interest, and suggested silk shirts, shoes, cloth and clothing, sculptures, paintings, ivory carved objects, and jewelry. When we suggested rugs, we were escorted down to the lower level where a man on three young men greeted us, ushered us to a lavish crimson couch, offered us sweet tea, and told us it would only take 30 minutes to review a selection of fine silk rugs. We told the man, as he sat down on the floor next to us that we had only five minutes. Dr. Becky mentioned that she would like to see a four-foot by six-foot rug. Waving his hands, the young men started the procession of rugs, each being unfolded with a snap before us. With each rug came the request for comment about the color, design, and sheen. After twenty or more rugs that now covered half the floor of the great rug hall, came the haggling. The once curator said three hundred dollars. Dr. Becky immediately replied no, that is unreasonable. He said two forty, Dr. Becky said one hundred. I smiled as the second demonstration began. Dr. Becky asked to see a smaller rug such as three by five, small enough to carry on the plane. The boys snapped down twenty more rugs of different designs woven from another palette of colors. Dr. Becky said fifty, the salesman said one fifty. After several more exchanges Dr. Becky said we would be back, eventually the man came down to 120 as we walked up the stairs. We next headed to the sculpture department. The salesmen that lined our path were less forceful than the merchants on the street, but not by much. We were the only people in the department store, which gave us a wonderful opportunity to see the works of art. The sculpture room, amongst many objects contained mauve and plum marble elephants caved one inside another for a total of three. We were told it was carved out of a single stone, not just placed inside another. The price at ninety rupees or under three dollars convinced me to purchase the museum artifacts on the return trip through Delhi, since my luggage was stuffed with much needed medical supplies. Our journey took us through other areas of the store where we were greeted, attended to by one or more people, who offered us comforts so that we could view their wares in leisure. Dr. Becky bought several items. I enjoyed the show. As we left the bazaar another Autorickshaw was parked in front, we asked the price back to our hotel and were told one hundred rupees. We decided to walk back to meet the group for dinner.

We walked as a group out into the streets of Delhi toward the restaurant. Some of the same peddlers accosted us. I was interested to see how capitalistic they were, or were they simply attached to some merchant who let them sell his merchandise for two rupees a night. Our group was offered a package of three handkerchiefs for one hundred rupees, clearly over-priced based upon other merchandise on the street and in the department store. For the first five minutes I told the pests, “No”- but they continued to march along with us. The handkerchief gang coalesced into 5-10 children. Finally, I stopped and asked if they spoke English, several shook their heads, “Yes”. I motioned to them to gather around and then asked who would take ninety rupees. Suddenly there was silence, and then one boy said he would. I asked who would take sixty another said he would. I asked who would take less, one raised his hand. I suggested forty; they stopped and turned to an approving adult who had joined the crowd. The boy waved acknowledging forty rupees and received the same- and he was allowed to keep the handkerchiefs as a reward for his capitalistic efforts.

In the restaurant we met one of our many benefactors, Colonel Lamar. As a member of the Indian army and great humanitarian, he was able to make arrangements for the shipping container filled with medical supplies to be delivered to Tawang, India, in the state of Arunachal Pradesh. Tawang, India is bordered on the north by Tibet, Bhutan on the southwest and China on the east. It is well known in romantic Indian literature as the place where King Bhishmaka founded his kingdom and Lord Krishna married. It is also an area with disputed boundaries, a political powder keg stabilized checkpoints, bunkers and the omnipresent Indian army. In 1914 the British Empire, without formal consent from China, established the McMahon Line as the boundary between India and Tibet and where Tibet could remain an independent pacifist state until 1950-51when 20,000 Chinese troops occupied its land. Since that time the Chinese also claim rule over Tawang, India and the state of Arunachal Pradesh because this region is blessed enough to also contain the Tibetan religion and monasteries- and China believes it owns all things Tibetan. The Chinese continue to make border crossings in an attempt to establish territorial domination and for this reason the state of Arunachal Pradesh maintains a large contingent of the Indian army, only equal to the men stationed in Kashmir, India. To this day, despite Chinese attempts, Arunachal Pradesh remains secure, both militarily and culturally. The border crossings into Arunachal Pradesh from within India are gated. Even when crossing from Assam, the Indian state just south, all Indians must obtain special permission. So, for foreigners, with mountains of luggage and shipping containers big enough to conceal tanks, an ally was needed. Colonel Lamar and his family enjoyed dinner with our group who with the addition of AyJay grew to its maximal traveling size, fifteen. AyJay was the soundman that had worked on many pictures in Bollywood, the Indian film capital that rivals Hollywood. He, as was Colonel Lamar, was kind and compassionate, personable and hospitable. His family also accompanied him on this last dinner before once again, embarking on a long journey in a quest to help others learn about the many diverse and important Indian regions and cultures.

The dinner with our companions now numbering 25, occupied the entire upper floor of the traditional Indian restaurant, where our table stretches unbroken from one wall to another. I sat between Mr. Dan, and our cameraman Joel, Debra sat across from me with Dr. Becky and Bryan. Joel was a professional cameraman and directed film as well. He had been influential in many historical documentaries, and historical movies. Debra, our director had recently completed work on multiple reality television shows and was in the process of editing a short film. Both Debra and Joel had practiced Yoga and Buddhism, were fascinated by Tibet, and volunteered their time to make this journey. They related their fanciful expectations of our expedition, their genuine desire to help our brethren in Tawang, their ambition to document a unique and culturally significant part of our world, and to work together, with each other. Not only had they not worked together, but they were also only minimally acquainted with each other through Dr. Natalie. Although their roles on our voyage were arranged for Debra to be the director and Joel as cameraman, their backgrounds directing the dichotomous scenes from reality TV and historical documentaries would bend the Buddhist light just as if there was a black hole. Joel and Debra possessed mutual experiences and qualifications, hope and general beliefs- more than enough to overcome any financial or personal hardships needed to accompany the physicians and spread love and healthcare around the world. Yet, as with professionals and experts in any field, the pattern of mowing the grass remained as paramount as the pasture itself.

We are a civilization that organizes individuals into groups, often for the sake of security and efficiency such as the sailor who mops the floors of aircraft carriers so that gas and oil does not prevent the commander from moving to the strategic planning theater or the aircraft exhaust setting fire to the deck. However, when diversity places people into categories for more personal matters for slight differences, outsiders are created. We may be a member of a country, a state, a city, and religion but we are also members of a political party, a social class, an organization, and a belief. When such divisions are set, small differences of opinion become labeled with “their” burden, that of an interloper’s, a foreigner’s, and a stranger’s- the unknown, and a mechanism for conflict. Although, it is innate that differences that are overcome make us stronger, small disturbances such as a dew drop falling from a leaf onto the mirrored lake disrupt the reflected sky; small differences of opinion disrupt our reflection of our world. Debra and Joel were of the same cloth, they like the rest of us in our section of the banquet, discussed ordering the same food. It started when each ordered the same Mulligatawny soup. Then we asked each other their preferences, when that was the same, we asked which meals we would prefer to share. Instantly there was a chorus as if the conductor gave a tap with the wand to sing Row, Row, Row Your Boat in Hindi. The request for the delicacies harmonized from our now watering mouths- Raita, Dal Tadka, Baigan Bharta, Aloo Gobhi, Palak Paneer, Nann, and if giving his solo song Bryan said, “Murg Masala”, the only non-vegetarian dish. We laughed knowing that this feast, which we expected to be our last means of sustenance until we returned to New Delhi, would be a memory that we could cherish when our stomachs started to grumble from the lack of food or inability to keep it in. Joel and Debra were integral patches of this magnificent quilt that was traveling to Manjushree; in any other circumstance where they were not separated into supervisor and supervise their seams would have been transparent.

During dinner we took turns introducing ourselves to the crowd, each saying who we were, where we were from, what we were going to do, and to our surprise what we were expecting on the journey. Colonel Lamar stepped out to use the cell phone just as we started, relieving the near silence that fell over the crowd. Trish and I continued to talk probably because we were well prepared, as that was part of our on-camera interview. I believe the last question added was a prompt for others to ponder before their interviews that would take place. The laughing and enjoyment quickly returned to the previous levels of excitement, unaware that Colonel Lamar had returned. After Dr. Natalie regained our attention the comfortable introductions resumed, abided by the additional time. The additional hours quickly dissolved into the night, none of us cognoscente that our bodies had been awake and traveling for over thirty hours. AyJay’s well behaved young children, with their new fidgeting were the first to signal that the hour was late and that they wanted to go to their home in New Delhi. This contagious action spread to the Lamars and then quickly along the banquet counter, reminding all that our journey in India will continue early in the morning. So, we thanked Dr. Natalie for the dinner and our guests for their help and camaraderie and made our way into the streets of New Delhi. The young boys selling handkerchiefs were no longer waiting outside the restraint, presumably having found someone to pay 100 rupees. The street was still alive, the horn section still practicing playing in harmony, and the engulfing smoke that permeated our flesh still signaling that civilization was all around. We made it to our rooms, where I used my cell phone to call my family and tell them, as they were awaking, that I was finally going to sleep.

To Gauhati

Although the alarm clock was there waiting one minute more to sound, we woke up without its assistance, filled with anticipation, eager to see and encounter the day’s offerings. Immediately outside our window was a field hockey stadium, in fact our building was one of its walls. People were already practicing, using a ball and curved stick shooting against a reluctant goalie that appeared to want sleep more than to be the object of attack. There was a ball of light in the sky just making its way over the skyscraper tops of downtown New Delhi. It was doing its best to light up the city through an opaque tan Plexiglas sheet covering the mighty town capital of India, seat of the Mughal Empire and home to thirteen million inhabitants. We showered and brought our contribution to the mountain of luggage that we would again build in the lobby before it was moved to the bus. When we met, we Dr. Natalie told us, to our surprise, that again we would be fed. The hotel provided a complimentary continental breakfast, that they said was available because we had asked. We took our ticket downstairs to an expansive restaurant, sparsely populated at this early time by other guests. The buffet was extensive served in brightly polished silver warmers covering every inch of the 50 feet of the brilliantly covered and skirted red and golden tabletops. Sampling food from every one of India’s 28 states was no small feat in the thirty minutes that we had before the bus would dart through traffic toward the airport, but we accomplished what we set out to do and boarded the busses, again with full stomachs that would have to last us two weeks. The ride to the Indira Gandhi International Airport, a different airport in New Delhi from where we had arrived, generated more pictures of the delightful and now seemingly familiar culture of one of the most visited cities in India. As we disembarked with our train of luggage, our bus operator shepherded us through the crowd in front of the military guarded entrance of the airport in a manner slightly more forceful than a tour guide would lead his group through a crowded museum. Once inside, we were led to the x-ray security machine where we would place luggage from anyone in our group and pick it up thirty feet away on the other end where, and with a new tag placed around the handle we would take it to the ticket counter for delivery to the plane. While waiting to place luggage on the conveyor belt Dr. Natalie garnished our passports and brought them up to the counter with the tickets that she cherished, and which never left her possession- until she presented them to the agent. Again, there was discussion regarding the large metal case but after minutes of persuasion several skycaps hoisted it onto the conveyor belt, which overloaded only slowed for seconds before resuming its journey into wherever the luggage was going. As we headed over to gate security, Dr. Natalie told us that last night at dinner Colonel Lamar’s phone call was to inform us that the large shipping container of medical supplies, which left Los Angeles weeks before us, had not yet arrived in Kolkata, India. She informed us that she had already contacted Lama Sir from Manjushree Vidhyapith Orphanage and made other living arrangements. She also assured us that we had brought along enough medical supplies with more being available in Tezpur, India, the largest city on the road to Tawang, India.

The short four-hour one-stop flight provided a panoramic overview of the Indian landscape as it changed from lush green jungles to the snow capped and mist blanketed 29,035-foot Mount Everest regally poised above the plane’s wing.

From Gauhati

Landing at Gauhati, back into India’s green valley, our group was greeted outside the small terminal, by Lama Sir, a military contingent the size often seen surrounding the President in a foreign country, and an immense crowd of people who bestowed around our necks Katags of sheer white nine-foot cloth containing precious symbols. Many of the waiting people accompanied Lama Sir but many more were drawn to our group out of curiosity. The attraction was the magnetic Lama Sir, the film crew dangling boom microphones over our heads with waist held movie cameras leading the way through the crowd and our new companions from Kolkata, India. They were four young men, pediatric residents, who made the adventure to learn more about the mysterious regions of their country and the magical lure of American medicine. They had finished their medical school training, served as house officers, and were now residents in varying years of their pediatric residency. Dr. Natalie had originally contacted their medical college faculty to see who might be interested in serving at an outreach clinic. Over many phones call, e-mails, and the disparity of time being thirteen hours difference, she finally found the “Kolkata Boys” as they would be affectionately remembered. They also toiled to make the journey. Although they were happy to take a break from seeing 250 patients a day, they had to give up their vacation, work extra hours and provide extra call coverage during the time before their departure in order to make up for the time they would serve their country at Manjushree. The physicians from Kolkata were young, by our standards, dressed in suits and brightly colored silk shirts, as if they were at a formal dinner. They appeared bewildered, unsure of the circumstances to which they had committed. With them was not only more luggage but the precious vaccines we hoped to use to inoculate the school children and teachers. After the introduction of our “Kolkata Boys” Drs. Sourav, Joydeep, Neeraj and Subhajit, we began loading the four Sumos, large multi-utility-vehicles the size of Hummers meant to carry nine adults each. Just as I turned to help the drivers pile the mounds of supplies on top and inside the vehicles, I noticed Natalie looking up to the sky with her eyes closed. The sun radiated off her long golden hair as if she was an angel sent to help the less fortunate. It was heaven- sharing its energy, filling her with the strength needed to start the road trip to Manjushree.

Debra, the director and Joel our cameraman were magicians who imparted a life to each bag caught on film. Using angles, lighting, movement, and close-ups the luggage developed stories associated with their contents, with their owner, and still others with the bag’s destination. Spliced in between epic takes of baggage footage were repetitive commentaries from Lama Sir and numerous others from Dr. Natalie. At first the comments were spontaneous, but as another camera angle was required, or because too many horns bellowed in the background, another shot was mandated, the spontaneity became lost and so was the original heart felt warmth. The extra minutes of filming and re-filming were no burden but a welcome new experience and a cherished memento of the adventure. Our Sumo, with the third row filled with suitcases and a spare driver, formed the new bounds of friendship between Trish, Dr. Becky, Bryan, the other driver, and me as we drove away from Guahati’s terminal and into the tropical jungle. After minutes on the two-lane road, passing walkers lightly dressed in silks, the perspiration signaled that our long sleeve thermal shirts, heavy jeans, and boots were utilized a day earlier than needed. The street was less crowded than New Delhi, although being more crowded was not a possibility. Guahati did possess the customary and omnipresent cow and goat that were out for a stroll and unconscious of both traffic regulations and flow. The passengers took pictures- and then the camera crew took footage, the first roll traveling toward the sacred animals, the next roll adjacent to the sacred animals, and then the third roll of film driving away from the sacred animals- Holy Cow.

As we relaxed watching the filming, we were given a unique opportunity to learn about other customs in the area. Large open back trucks, labeled “Public Carrier” were packed like sardine cans, tight with standing commuters inching their way to work while trains of three-wheeled bicycles whisked the more fortunate around traffic to their destinations. Our mission was to get to Manjushree, and after traveling four days we continued slowing and deliberately toward our goal. We did not have to look far to see unique experiences in the daily life of others, even the retakes were exciting. Each moment and every mile of road provided an opportunity to learn, an occasion to enjoy, and an instant to cherish. Gauhati’s cityscape mirrored New Delhi in many regards, similar colors of people and clothes, familiar sounds of traffic and machinery, but a different feel to the air. It was not heavy with oil or stinging with diesel but light and fragrant with vanilla and sandalwood. Greenery, untarnished by soot was abundant filling the empty spaces between makeshift dwellings of tin and cloth. There were banana trees, swaying palms, and forests of tall broad leaf grasses blanketing the rolling hills and crested plains. As we drove out of the small village, we saw families with many small children playing in the yards of the one room grass thatched houses. They played with sticks and balls, dolls and clothes. They played imaginary games of tag, hide and seek, and kick the can. Their laughter quieted only with the occasional hit or disagreement, quickly resuming as if the instance never took place. The children played as all children do, anywhere and everywhere in the world without regard to clothes, electronics, fancy toys, or store-bought items. As we drove up the road people waved to us happy to see visitors, or just happy to be.

The next four hours melted away as daylight became night. The sites were new and fascinating when seen, but darkness only allowed our minds to drift off to sleep, occasionally stirred by the driver’s sharp correction. We felt comfortable with our experienced chauffeur, even though immediately in front of Trish, the windshield was struck by the head of an unknown passenger. Maybe our dreams were of unknown roads, which probably was the basis for our collective jolt awake as we drove off the pavement up to the rest stop. When the diesels went silent the mass exodus from the Sumos immediately formed a conga line formed toward the toilets. Suddenly the rhythm was broken when the facilities were discovered. Our only experience with toilets had been in the hotel and on board the plane. We now stared through a plywood opening into a six-by-six-foot room opened to the sky who’s only distinguishing feature was a hole in the ground. As if some custom was being preserved, the plywood campground structures displayed a sign for women on the first structure and one for men on the second. Those adventurers that gave the best dance performance united with nature, while those who had not needed too much water in the tropical atmosphere decided to wait until familiar facilities were available. Our group’s arrival at the rest stop seemed to trigger the appearance of the lights, which came on slowly at first. Every source of light in this remote public house was a compact fluorescent bulb. The roof was tin, the side walls were single sheets of plywood and there were no other walls along the front and back sides of the plain concrete floor. The proprietors, thrilled to see our group and their friend Lama Sir, quickly set the tables bringing numerous bottles of water, Chiai and Indian sweet tea, plates, napkins and silverware. As the cable TV went off, others began to cook. Soon we were sitting again at a long table put together to accommodate all of us, including the drivers. Our contingent had grown, now there were twenty-four to eat the delicious fried vegetable patties dressed in spices and ketchup. The electricity only went off twice while we sat, sang songs and talked about how intriguing our adventure had been. We were halfway around the world from our homes in the United States, we had been traveling for 54 hours and we already had an encyclopedia of stories to tell, that had been documented by our film crew with commentary from Lama Sir and Dr. Natalie.  Once we had eaten more than we could hold, Dr. Natalie paid the bill, and we headed back to our Sumos.

The next four hours along the 10-foot narrow superhighway passed in the blink of an eye. As we entered the vehicle our eyes closed and opened for the next time when we stopped at the Government Guest House on the outskirts of Tezpur, India in the state of Assam. As if in a dream state, we unloaded the cargo piled in and upon the vehicles. I know that Mr. Dan’s and my luggage went into the room we were assigned on the first floor. Although we unloaded the rest, I could not say where all of them were stored for the next few hours until morning. We were told to meet in eight hours for breakfast, fully packed and ready to leave. We were also instructed to take advantage of hot water for cleaning. As I dragged my suitcases into the room and put them next to the bed, Mr. Dan happily said that he had to go shoot an interview with Dr. Natalie. There were no keys to the room and no doorknobs; there was a latch on the outside and another on the inside that allowed the door to stay closed. There was a bathroom in the room with a flush toilet, no shower or tub, just water spigots on the wall. Under the spigots rested an eight-inch spider, undisturbed by the glare of the four compact fluorescent lights momentarily switched on. I retired to the bedroom, put on sweatpants and got under the sheet for the night’s rest- until there was a knock on our door. Trish was assigned to inform our group that dinner was ready. Being sometime after midnight, and the fact that we were going to eat breakfast soon, I respectfully declined. However, Trish told me that “They” had cooked dinner especially for us and we could not refuse. I dragged myself out of bed and along the short path to the pallor. The others were coming along from each room in the Guest House, doors closing, feet shuffling, bodies hunched over, greeting each other with one to two word often incomprehensible sounds as if it was the night of the living dead gathering for a feast. In the dining area was a twelve-foot decorated table covered with rice, flat bread, green beans, lentils, okra, cauliflower, baked whole fish, turnips, yams, salad, and five different types of juices- guava, kiwi, lychee, orange and grapefruit. After feasting we talked all the while waiting for our crew and stars to return. We went to sleep while the monstrous lights from Joel`s silvery container lit the inside of the second story.

When I awoke in the morning the exhausted Mr. Dan was in his sleeping bag under a Mosquito net completely enclosing his set of bunk beds. I felt refreshed and warm in the plain room. Although we were in the state of Assam, this was the Arunachal Pradesh Government Guest House reserved for traveling dignitaries of the state, I assume as they travel along the only means to get to and from their home. There were no other airports, rivers or routes of transportation, only the road. The room was brightly lit as the sun came through the two floral curtains covering windows. The floor was covered in linoleum, there was one sitting chair, and a television connected to cable. I went to the water room, said good morning to our furry room mate who had not moved off the wall and used the toilet. I brought along toilet paper and diaper wipes which I kept in my fanny pack along with my camera, satellite phone, computer, cell phone, nutrition bars, passport and money. My last shower and first in India were only the morning before in New Delhi, so I decided to skip a thorough body cleaning especially since I was unsure how to perform that most basic function. Instead, I used diaper wipes, brushed my teeth and applied deodorant. I was sure that not using the hot water from the spigots would also be to the liking of the eight-legged guest who maybe out of custom moved down and away from the spigots about three feet- just enough room to allow the human guests to use the water without himself getting wet.

When I returned to the bedroom Mr. Dan was gone. I changed my undergarments, put on the same wool-lined jeans and the same thermal undershirt, new socks, and my hiking boots. I quickly packed my bags and found electric outlets to charge my phones. Then habitually, I turned on the television without a remote control- although I looked for one for more than a minute. I search the channels looking for news. More than half of the selections were in English, the rest in Hindi and other languages. There were 70 channels of a variety found throughout the world- movies, American and native sitcoms, religious and spiritual stations, reality shows, cartoons, infomercials, and news channels. I shut it off after five minutes of channel surfing and went outside to explore the region. In the yard was Mr. Dan who had walked into town and taken photographs. Although the editor of a magazine, he seemed to be a fine photographer as well. On his very fancy, studio quality, digital camera he displayed some of his recently acquired illustrious scenes. Also in the garden was Lama Sir who had been up for hours, completed his meditation, and also returned from walking to town.

Lama Sir, the respectful title, was born Thupten Phuntsok, the middle son protege, or scion, of Shri Sonam Wangchu, in Dharma Gang Village in the Tawang district of Arunachal Pradesh, India. As the middle son it was his honor to move to the monastery when he was eight years old, one year before his mother’s death. He became a Buddhist Monk, traveled the region to study wisdom, morality and meditation, and then taught in the Tawang Public school until he founded the Manjushree Vidyapith Orphanage in October 1998. Lama Sir was just under six-foot tall, weighed 110 pounds and donned plain crimson and gold robes and a “number one” short hair cut. People were absorbed by his soft spoken, mild demeanor, as he drew your thoughts into an atmosphere of the Right path. As we spoke in the garden, he told me of the supply trips he makes twice a month from Manjushree to Tezpur- a two-day trip in Sumos.  There were no other venues for supplies, as Tawang, a town of 37,000, only had the bare necessities. It was unusual to hear that there was no consolidation of economy, no distribution centers, and no union of services that could supply the state of Arunachal Pradesh. As we strolled in the warm sunshine of the garden, I shared a story of my family’s walk down into the Havasupai Indian reservation in the Grand Canyon. At the end of the eight hours walk in 100 plus temperatures, sat a secluded canyon village, with a general store, small shops, simple homes, and large satellite dishes. The next morning, after the long reinvigorating sleep, as we started our quest to explore the lush green canyon caves, aquamarine pools, and velvet canyon walls decorated with Anasazi petroglyphs, we noticed a refrigerator being delivered to the back doorstep of a house by a large army helicopter. It turned out that this remote village had daily helicopter service for the residents that included mail and grocery delivery. I asked Lama Sir if such a service was available for Tawang?

A companion came by and reminded us that we had thirty minutes before breakfast and an hour before we had to return to the vehicles for the two-day journey to Tawang. Lama Sir and I parted ways as he wished to wash before the ride and I, driven by the rising warm sun and slightly humid conditions which bath the vegetation with energy, wished to walk into town to explore the unknown. But first I hoped was to call my family and learn about their daily activities- did my daughter do well at cheer practice; were the boys playing ball; how did school go; and was my wife tired from transporting the precious cargo all over the city. My cell phone no longer worked, so it became the point in time to start communication in short relevant bursts, utilizing the satellite phone at $2.40 per minute. As with most new chores, I went through step by step, making choices, going down a path only to realize it was wrong. After two or three attempts, remembering the thoughtful encouragement of my wife, I decided to get the instruction booklet, hidden deep in my waist bag. I sat for some minutes, before getting up for town after the connection was made. As I talked, I realized that I could not move more than 100 feet or so before the signal became garbled. That opportunity gave me a chance to sit down on top of a two-foot square rock perched two feet above the ground, right in front of a cow. The cow just stood there, looking at me as I looked at her. She was chewing her cud, lowing, and enjoying her exalted status. The village seemed quite familiar, one story five room homes with screened front doors, windows, picket fences surrounding the 50-foot front yards, and electricity and cable television lines going to the roof lines. I was in any town in the USA, half-way around the world talking on a satellite phone during the early morning to my family in the evening. Many structures were the same in Tezpur as they were at home. As I finished the telephonic visit, talking to each one, I began to walk in the direction pointed out by Mr. Dan and Lama Sir.

The dark-skinned people looked inquisitively at me, as if I was an alien from another planet, not just a fair skin male from another country. Their eyes, furrowed brow and lack of expression demonstrated their reservation, their questioning of my reason for being in their village. At first their look pierced my skin, almost provoking a reflexive barrier, a thought of, “What are you looking at?” But that is not what happened. Instead, I said, “Good morning” and smiled. Their demeanor instantly changed, a smile covered their face, a beam of light connected our souls, and they responded with, “Good morning”. Often, we would draw closer, talk about where the group and I were from and the medical mission we were on. This meeting occurred time and again, making the walk into town slightly longer but more enjoyable. Over the next twenty minutes I wove through the asphalt semi-paved roads that passed along a myriad of homes. Some had running water, many did not. I passed several community water spigots where families performed the morning washing of their bodies and clothes. I passed children dressed in school uniforms and others aboard a bicycle driven by a parent or slightly older sibling. Many of the houses doubled as early morning roadside stores, selling rice, spices, bakery goods, and soda, with accompanying bags of potato chips. The sun continued to conquer its domination over darkness, and along with its rise went the temperature and humidity. I was dressed in flannel jeans and a thermal shirt, which only acted to soak up my own humidity. This and the fact that another 30 minutes of fascination had passed alerted me to walk back to the guest house which had inconveniently now moved to the other side of the village. I turned and walked to familiar surroundings, the water-well where families gathered to wash their bodies, dishes and clothes, the now closed three-foot by three-foot hut that sold water, the two-room public school where over fifty uniformed clad children gathered, and the one-story, ten-foot by ten-foot electronic store that offered plasma screen televisions and DVD players for sale. I thought I could take a short cut by turning left along a street before the one I had actually walked down before; it should have cut the journey in half. The road was not much different than the dirt and grass way I had been on. I noticed it was just before a large field that I had walked around earlier; but began to lead me more toward the left. I followed the road, beyond a small turn to the right that appeared to be through someone’s yard. As I approached steps descending into a remote part of the village, I remembered that the Guest House was on the edge of town, away from all other dwellings, near a big cat animal preserve. I walked down the one foot-wide uneven, highly weather stone steps that seemed to descend into darkness. After 150 feet and the loss of the sky, I decided the best course was the one I had traveled before. So, I went quickly to the top and the other path I had seen. Of course, this time I should have gone where I had been, where I knew it was safe and a road that would have allowed me to finish close to the proper time and not make others wait too long. However, this smaller less traveled road seems to produce an opportunity to finish quicker, possibly before the others began to wonder, before they would have to wait to eat. So, I turned along the path to the right, between two small farms, which lead to a pleasant man attending a small garden. How are you doing? he said in English. Where are you trying to go? I answered the Government Guest House. Go back along the path and go-left pass the cell phone tower and left again. The path you are on only goes into another farm with a high fence. He then asked about our group and the Lama Sir. I thanked him for the guidance.

It is not always easy to know which path to choose, the familiar, the less traveled, the long and sure or the short-cut, the one with the quickest return. Opportunities to learn, chances to make improvements are always available but the results are never sure. However, it is important to know when to choose, when the decision you make, even when made with good intentions, if fail will not lead to too much hardship and too much despair. Making decisions is relatively easy as long as the consequences are acceptable to others and you, as long as the risks, benefits and alternatives are understood.

I returned to the Guest House within twenty degrees of leaving, knowing that I had over-dressed for the walk and wondering whether I had over dressed again for the day. The group, with the exception of the film crew, Lama Sir and Dr. Natalie, were in the parlor waiting for breakfast. There was chicken stew, breaded vegetables, and fish made from the previous night`s dinner`s. There were also the usual green beans, lentils, rice and juices in addition to two-to-three other delectable and colorful vegetables. After we finished, the first journey began.

As mentioned from my article in the California DO magazine, 2008, Arunachal Pradesh, India is bordered on the north by Tibet, Bhutan on the southwest, China on the east, and Assam, India on the south, all separating the region politically and culturally. The people were able to receive some healthcare through Tibetan Shamans and visiting physicians. There is no national healthcare except for tuberculosis treatment, and there is no health insurance, requiring each visit, test and treatment to be paid out of pocket by the impoverished people. All of this resulted in no significant medical treatment for the vast majority of the entire state. When it became known that visiting physicians were coming to the region, the governor of Arunachal Pradesh asked to have us treat his people during the state fair. People journeyed from all over the region, sometimes walking sixty miles to be seen. Most of the people, by far were women aged 20-40, but there were infants, as well as some elderly men and women. They presented with a myriad of signs and symptoms, from elderly people wondering why their vision was getting blurry or their ability to hear faint sounds in the distance was decreasing to brain tumors, myocardial infarctions and endemic tuberculosis. We were able to discuss the reasons behind their health problems, give them prescriptions for medications which they could buy in town, or prescriptions for test to be done at the local TB hospital so that appropriate treatment or referral to Assam, India could be made.

Most individuals, children and adults alike suffered from upper and lower gastrointestinal problems, the majority of the time for years. It was because of the foods they ate, the lack of vitamins, and of course the poor hygiene, passing on diseases to entire families and villages. The treatments were similar, drinking water, eating green vegetables, and taking medications to treat H. Pylori or parasites.

In addition to gastrointestinal diseases (GI), the conditions of chronic manual labor needed to be treated. We discussed posture, lifting, Osteopathic Manipulative Therapy and prescriptions of anti-inflammatory when appropriate. However, the most unexpected disease found was hypertension. During the two days at the State Fair, we saw over 700 people. Each patient’s vitals were taken, including height and weight. The patient’s habitus was 5-10% underweight, and other than GI signs and symptoms, they were healthy young females 67%, average age 35.2 years. Their diet was rice and meat, occasional yams, and very infrequently vegetables. They only occasionally drank fluids. The average systolic blood pressure for women over 21 years old was 168 and diastolic was 101. Each one was counseled and given medication according to the American Heart Association Standards.

The men’s blood pressure from this group, as well as from the over 300 Monks at the Monastery who received healthcare was not elevated. The Monks major symptoms were again gastrointestinal and musculoskeletal problems related to prayer. Many had low back pain, hip pain and knee pain because of hours in limited positions, which they refused to change. They did not perform manual labor. Once again, they were counseled, shown exercises and stretching maneuvers, told to drink fluids and given an anti-inflammatory when appropriate.

We, as do others, wish for peace, happiness, and survival of our families. We also share other wants with other societies, such as the want for leisure time, and the want to be healthy. Each one of us can make a beneficial change as we establish interactions with people throughout the world. As we share this goodness and we teach others to do the same, to be comfortable with helping others to fulfill their purpose, we will have peace, individually and globally. So, we venture forward on a road, throughout the world and throughout life, hoping to improve and empower health through our human touch.