Summer reading for #Globalsurgery

The Sacrament of the Goddess is a great “beach read” for persons who want to be transported to an exotic time ( in the recent past) and place (on the far side of the planet from Boston).

It’s a way to learn the boots-on-the-ground of #Globalhealth and #globalsurgery without wading through a textbook. The story of working in a remote hospital in the Himalaya is told through the eyes of an international crew of medical volunteers working with a team of Nepali and Indian doctors.

Doing surgery is hard enough and it is not the usual experience to be around sick people every day. Taking your skills and offering them to people of another country during a civil war will take the challenge to a new level. Soon you are thinking about commitment, courage and sacrifice in a different way.

This book is available on Amazon.




the Andolan in The Sacrament of the Goddess, August 16 2015 – updated

Update #3 August 25th – I wrote a longer piece on a different blog in USA, you are invited to read that one. please share.

Update #2 latest report says 17 police and three protesters killed in Kailali. Army deployed to the region.

August 23rd update: the news from Nepal is not good. In Kailali (an area of Terai) the police arrived to break up a protest and the protesters used weapons to kill police members ( differing reports – possibly five, possibly seven. One is too many). This has escalated as the days have gone on. Let’s all send good karma to Nepal and hope they can find ways to de-escalate. The best way is to engage in the political process, which includes listening to the demands and adjusting. There is no shame in compromise and dialogue!

My novel, The Sacrament of the Goddess, is the only novel that features an “andolan” as a main event; how it got started and how it affected the people swept up in it. The way that Nepalis conduct their lives as members of one group or another, is a fascinating subject and you can’t figure out Nepali life unless you have a handle on this idea. This appears at every level, not just the political. For example, in Kathmandu a pedestrian was killed crossing the street near Tri-Chandra College and the other students thrashed the driver and set his micro-bus on fire.

Life mimics art?

As of August 16th, 2015, Nepal is having political instability. There are pro-monarchy demonstrations calling for restoration of a Hindu state in the capital; a curfew in the west as people in Jumla demonstrate against the proposed boundaries of the six-province model; demonstrations in the east as Madhesh activists protest a draft constitution that does not recognize the people of the Terai; an outcry on the internet about #citizenshipthroughmothers; and now, a nationwide bandh of Maoists, which led to a counterprotest – people are tired of bandhs. Oh, and did I omit the injured protesters in Surkhet, fired upon by police? the families wish them to be declared “martyrs” and are seeking compensation.

The RPP was holding small demonstrations all year but people said they were a fringe group. The are pro-monarchy, and want to bring an end to all Christian prosyletising in Nepal. This is a recipe for further trouble.

The RPP was holding small demonstrations all year but people said they were a fringe group. The are pro-monarchy, and want to bring an end to all Christian prosyletising in Nepal. This is a recipe for further trouble.

All this because the Constituent Assembly finally took action and put something on paper. For much of the time the political reporting was limited to gossip about the top leaders of Nepal but little else. Now, there is something on paper and people can react to that.

The odd part is that it was spurred on by the earthquake. Everyone could see the need to actually do something, to get a functioning government, so that Nepal could recover. Before long, everyone will long for the “good old days” when the Constituent Assembly did nothing.

This is not good for tourism

To recover from the earthquake, Nepal needs to show the international community that travel is safe and a vacation in Nepal can be “fun.” None of these events can be construed as “fun,” this is not attracting tourists to Nepal. As a foreigner, I am usually circumspect as to comments about the host country I love. But – could anything be more obvious? The vast majority of the country is unhappy with the way things are going.

The Sacrament of the Goddess

I wrote the novel to explore the way that collective culture shows itself in Nepal. Specifically, there is a long-running problem in the health sector. If a patient dies, the survivors act out their grief through collective anger, and often the doctor gets thrashed, or the hospital gets vandalized by a mob of one size or another. This too, is not good for tourism.

There are ways out of this spiral.

Violence is not the answer

Written in 2014 to explore the aspects of Nepali culture that go beyond the temples and trinkets. The day-to-day life in Nepal is not easy. You can get this book at Vajra Books on Jyatha in Thamel, or Tibet Books. Or Amazon

Written in 2014 to explore the aspects of Nepali culture that go beyond the temples and trinkets. The day-to-day life in Nepal is not easy. You can get this book at Vajra Books on Jyatha in Thamel, or Tibet Books. Or Amazon

Despite the Hindu nationalists, Nepal is also a Buddhist country – birthplace of Buddha. This too is a paradox. How can Buddhists be so angry? In the meantime, the novel has been praised for it’s depiction of Nepali culture and the way that hospitals operate in this Himalayan country. Time to look at the message regarding ways to re-channel the energy being wasted on protests, into something productive…… You can buy the novel in Kathmandu

Review of my novel The Sacrament of the Goddess by a Nepali RN

The Sacrament of the Goddess is now available on Amazon. You can read the first five chapters on the Kindle site, and decide.

Pre-Publication reviews

In prep for this I sent a number of spiral-bound copies of the draft in pdf to people who might review it. The feedback is beginning to appear.

This book will be of interest to people in Nepal, or who want to learn about the fascinating and wonderful culture of that magical country. Here is a thoughtful review by a friends of mine. Binu is a Nepali citizen and a Registered Nurse in that country.  I would humbly say that she “Gets it”

from  Goodreads

I feel lucky to get pre-publication copy of the book The Sacrament of the Goddess written by Joe Niemczura. I am not fond of reading books but I do read something sometime and if anything interests me I go deep into it. I must say The Sacrament of the Goddess is the book, which created my interest as I start to flip pages of it.

The book is about an American guy Matt who loved a Nepali woman Shushila. He goes to medical school, then comes back to look for his love and volunteers in hospital of Nepal. It is also about a Nepali girl who went through tough time in a relationship. It depicts war between maoist and governmental army of Nepal so clearly.

I am a Nepali reader and I thought in spite of being foreigner, writer knows more about our situation than me. And he presented everything so precisely. When the guy came back to Nepal and volunteer in hospital; episodes of burn victim, emergency cesarean, mushroom poisoning, malaria, and of course, violence against hospital staff are well pictured. It shows Nepali community and cultural aspects also. There are many other characters besides hero and heroine and writer did totally fair with all of them with their roles. Book is about, What happens with hero and heroine and with their love?

I am not finding one right word to say what is the book as a whole, because it’s a love story with tragedy, there is a war and there is a kindness and lots of problems with their solutions. In fact the book is a complete package of entertainment and emotions. And I must mention that it has suspense right up to the last page. As a whole I recommend this book for all those readers who want to read a “GOOD READ”.

I have been tweeting about it, if you are on Twitter, look for @CCNEPal2013

The Sacrament of the Goddess on the web

We are counting down to May

The book will be released in May, and you are all invited to the launch party in Charlottesville Virginia on May 10th. Q. Why Charlottesville?  A. Why not!

what is it about?

ummm, lots of interlocking themes. the experience of working in health care in Nepal can not be boiled down to just one small thing. It’s about hospitals; the civil war; the culture of Nepal; love and belonging; collectivist culture vs individualist culture; the legacy of colonialism; death and eternity.


An early reviewer noted that it fits about ten genres. It’s a thriller but it’s also a love story but it’s also a historical novel of the Nepal Civil War and it’s got a lot of ethnography in there.

The book is to be found on the web…

nowadays you need to have a social networking presence. so-o-o-o,



(note: we are running a free book giveaway contest on Goodreads. add your name and you may win a copy. hooray!)

Amazon: it’s on Amazon, now that the cover design is finished. (it’s a gorgeous cover, by the way….)  click here and you can find a way to  pre-order the book.

Going to the beach this summer? this will be the number one beach read for summer 2014.

YouTube: I have a YouTube channel, but I have not video’ed something for that site, yet. hmmm….. maybe I should….


What about Nepal? it’s a book about Nepal, will it be available there?

we will specifically have a second book launch in Kathmandu, sometime in June or July. This is not finalized yet. The Kathmandu edition will be priced in such a way as to make it affordable in Nepal.

learning and growing as a writer Dec 28 2013 part 3

being a medical person working overseas is not what you think it is.

So the first parts of this blog mini-series dealt with the idea of my first book, and the limitations when a person starts out to write in the long form. Also the idea of how to get motivated to start another book when you know what you went through the first time. Oh, and the idea that it takes so long and there is no guarantee that you will finish or have anything useful at the end – did I tell you about that part?

“Write the book you want to read, the one you cannot find.”
―     Carol Shields

The above is also attributed to Toni Morrison. There are variations, but you get the idea.  When I was first going to Nepal, to work at a hospital run by missionaries, I tried to read up on what to expect, but I was not satisfied.  (I made a listmania on Amazon, go there if you want a bunch of book reports.) And since I have returned, I still think that way.

The problems

If the book is written by a Christian missionary, there seems to be an unwritten convention that it has to be relentlessly upbeat. Which means that it will never tell about the challenges and failures directly.

Too many Biblical references to wade through. Sometimes this genre is full of Biblical references, and this slows you down. It also gives you the idea that Missionaries mainly pray all day.

on the other side of the pendulum, research articles don’t cut it either. Here is a problem: most people who want to go overseas need funding. so they make a research proposal on some tropical disease, and when they return that is what gets published. But what they really learned was more practical: how to live in a foreign culture; how to deal with the everyday medical problems of people in a low income country ( i.e., poverty); how to be a member of a small team doing intense work. But the academic writing process does not allow any of this to be told. All references to the interpersonal nature of the experience are relentlessly edited. Often by somebody who has not actually done a similar thing themselves.  So – this is not the one-stop shopping source of information either.

conflict  is not good. Not often written about, because it requires critical reflection. The person writing the memoir has to preserve their self-image, even though not everything goes well.

Colonialism and neo-colonialism

I think every book on the topic of cross-cultural exchange in health care needs to address issues of colonialism and neo-colonialism – also known as western patrimony. In real life, any person who goes overseas must overcome the idea of their innate superiority  because of being born in the USA or UK.  In USA we love the myth of the Lone Ranger as the hero. ( think of Lawrence of Arabia or Indiana Jones. these are good examples of the genre. The-white-guy-is-the-hero. And we perpetuate this. In 2013 there was a media controversy when somebody tried to claim the Jesus was a white guy.

hint: Jesus of Nazareth was not a white guy. He did not speak English. But His message is what was important, not the color of His skin.

I think every book on this topic can be analyzed by this standard. There is a spectrum. Oh, it’s easy to have a hero in an adventure story; but most of the time that is when you are clearly in the realm of fiction.

Is there something wrong with allowing Hindus and Buddhists to be who they are?

Trying to spread Christianity has gone hand-in-hand with colonialism for centuries.  I’m not saying we should completely pull out of the low income countries of the world – far from it. But I think everyone needs to get hip on the issues. Read some of the classic books – The Wretched of the Earth or The Pedagogy of the Oppressed – to get some idea of what you are getting into. Do more than just read up on diagnosis of tropical disease!

back on track –

I could go on this tangent for a bit, but let’s get back on track. If you are  a medical person ( doctor, nurse, therapist) you will be going on the experience to provide medical expertise. How is that experience different from what you do in USA or UK? that’s what I wanted to write about.

So the idea is to have characters the reader can identify with. and that is what I tried to do with The Sacrament of the Goddess.

I need to move along, I will edit this later. and add to it.

learning and growing as a writer dec 24 2013, part 2

continued from part one yesterday

To sum up yesterday, quite a bit of the motivation for writing my first book was – therapy.  after the first summer in Nepal I was trying to process the experience and I just couldn’t. so I began to write. the first prerequisite of writing at book length is – to have something to say.

To actually write the book was a learning process. I learned the second prerequisite of writing a book – you have to know how to write! I think there is the non-writer’s dismissal of the writer – of course I could do that if I wanted! all I need is the time! and I started off with that same lack of understanding. I learned a lot during that process.  by the end of writing, I was done – the fire to write was quenched. I felt I had said what needed saying. I didn’t think I would do that again.

then again, after 2007, I didn’t think I would return to Nepal again either. but I did go back in 2008, partly to answer some questions I had – was it really like that? did things really work that way? was my 2007 experience there real, or some sort of dream?  in 2008, the answer to these questions was yes. within 36 hours of arrival, I had picked up where I left off, I was doing the same activities I had been doing when I left in 2007, as if the intervening eight months was just a long weekend.

2008 was the summer I was meant to have in 2007. People were friendly; I knew what to expect; I had taken a burn course in Honolulu and was more prepared for the burn unit. probably if this had been somehow transposed into the first summer, I would have never written The Hospital at the End of the World.


And similarly with 2008, I returned in 2009. fast forward to 2012.

My trip in 2011 was different inasmuch as I felt I had more to offer than just helping out at the nursing school in Tansen. I think TNS is one of the top nursing schools in Nepal, I really do. But I wanted to work on critical care skills and to reach a wider audience, so that meant working out of Kathmandu, the biggest population center.  I started this blog then. made new friends and shared my knowledge with 190 nurses. I travelled outside KTM valley to offer my course, and every day I talked with people about hospital care in Nepal. I didn’t know it then, but I was gathering material for my next book.

available on Amazon. In Kathmandu you can get this at Vajra Books on Jyatha Marg in Thamel, or Tibetan Books on Tri Devi Marg.

available on Amazon. In Kathmandu you can get this at Vajra Books on Jyatha Marg in Thamel, or Tibetan Books on Tri Devi Marg.

It took awhile to get motivated to write. That’s the first step – having the desire to embark on a long quest with no certain end in sight. In fall 2012, though, I was willing.

Why a novel? why fiction?

This time around, I made a series of decisions. The first was to write fiction as opposed to nonfiction. There has to be more to a book than simply a series of war stories. we need a story arc, with a plot and a climax, in order to keep the reader’s interest. this was the first. I knew that my level of background info about Nepal was inexhaustible – by this time I had spent five years studying it and living there.  And I wanted to educate and inform the reader about issues of health care in low income countries. There are many examples of books where the setting of the book is important. The reader stays with the story because of the plot and characters, and can’t help but learn about the setting. so -it would be a “historical novel” – that’s the genre.  Furthermore, from the very beginning I knew what the climax of the book would be.

Oh, and I decided not to have the “page 42 problem” in the second book.   Finally I had a better idea of who the ideal reader would  be.

I also knew a lot more about the writing process, the “craft” of producing something people wanted to read. And so  – I started to write The Sacrament of the Goddess.

tomorrow -part three!

Nov 30 – finishing a manuscript about Nepal

final polishing

Today, I “finished” the manuscript for which this blog is titled. I am sending it to a retired newspaper copy editor for the purpose of finding all punctuation/spelling/spellcheck/trackchange errors.

It’s like running a marathon

Some statistics:

92,290 words. that’s the final count. I think I may have banged out 400,000 words, then edited out 308,000 to get to the remaining ones worth keeping.

seventeen months. okay, I did not write for three months while I was in Nepal. But I was researching the context, every day while there.

Innumerable revisions. twenty-four “beta readers.”  Did the way it was interpreted by the test-readers imply that what I meant to say was what actually conveyed on the page? was it believable?

writing a love story. not to be underestimated. passion, los of innocence, betrayal, joy, fulfillment, jealousy, despair. all this and more.

Dozens of methodical pass-throughs for “craft” – eliminating passive sentences and the like.

find every “-ing” word. find split infinitives. kill your darlings. write a synopsis and use it to analyze propulsion of the story arc.

solve POV problems.

travel back and forth through space and time.

write dialogue.

scintillating dialogue!

Apply Checkov’s Rule.

Apply Elmore Leonard’s rules.

character-by-character, find three-dimensional challenges for them.

and more!

trips to FedEx to get a hardcopy for purposes of keeping track.

hundreds of cups of Starbucks coffee. black. no room needed. Now I have a Gold Card.

Research part one. all kinds of odd things – the battle of Beni during the civil war of Nepal; slogans and songs used by Maoists. Nepali culture including courtship and wedding customs; Buddhism, along with spiritual practices of “Vajrayanic” Buddhists; and the deepest recesses of the human heart. Buddhist epigrams.

Research part two. medical stuff, such as “what is a Finochietto?”  and  the truth behind some of the things I was told during various events, such as mushroom poisoning and meningococcal meningitis.

a professional editor. who made two complete pass-throughs and helped ensure that the thing had a purpose and direction.

The final product?

The final product ought to give the reader a glimpse into the mind of people they would not be able to interact with otherwise.  In a place they are unlikely ever to visit. during events that I pray they will never personally experience.

Where to go from here

From here, my plan is to find the widest audience possible, and that means trying to find an agent and a publisher. I will begin sending out agent queries December 10th.