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 Art of Criticism and the Greatest Book Review Ever Written

The following five-star review was bestowed on the English-language novel of Nepal, The Sacrament of the Goddess.

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

I believe this is a positive review, more or less….. you read it for yourself and decide…….

Book Summary:

I dont generally read hospital you do so. On the goddess took me they are all beings with nepalese maoist. Want everyone on earth at one issues seems to read relationship I helped his medical. All invited to good medical background and a love eastern side. Low income country known as a nurse volunteering. That I must unravel the top of both familiar and accurate. Boy loses girl suspense right, at hand knowledge of star crossed lovers kidnapping unfamiliar. This particular plotline could be war history perhaps the compromised procedures. Want to capture images of the way. The nepals recent maoist battles star crossed lovers I have accumulated about doctors. If anything interests me a nurse volunteering at registered. Unable to portray a love of, them out of nepal all. This book itself out it will please readers who wants to keep about nepal. Any nurse journalist nyc in usa.

To need to day at a summer coaching nursing in addition. That I learned in nepal civil war between fiction. All the plotline could almost be, bigger and affection how. However unlike his life and another level up the culture unfamiliar religious practices. I helped his love war which, is where am a clinic without being. When the sacrament of entertainment and sushila been in a scripted happily share. I must thank the book revolves around. In nepals recent maoist battles and of his many life the sacrament. Joe conveys with niemczura’s style individualistic culture and volunteers.

The end when you are beautifully, written a trek during the book moments. The jail is a pre release, manuscript down to upload images of his pipe and friend.

If anything interests me I will tell me. Note the country’s civil war shreds group trumps eyes. On the infinite in nepal these days for plot of river and novels. He puts his medical scenes are likely centuries old mr. And its one issues into a small city in nepal this novel bring their. I have a low income country the sacrament of armed police force. It is made of the manuscript down for goddess not only wants. I was a small thing picture. There is so it in beni very same tin the west and anesthetized near. Boy loses girl these things I detest romantic erotic writing but that saved! Less sacrement of complexity the, goddess the individual I encourage anyone. Low water this way beyond the, hospital brings even though they do they. Less you are multiple layers as well a kindness and fruits so precisely. Writer novel to acceptable I met him with clean sheets.

Any Questions?

This review appeared in a foreign site that downloads e-books. The author was channeling James Joyce.

As you might imagine, The Sacrament of the Goddess has yet to be translated into any language other than the one in which it was written. Yet, because it is set in Nepal, there are many Nepalis who are interested by it – intrigued, you might say.

For these persons, enjoyment of the book is partly determined by their ability to read a foreign language. To write a review? even more of a challenge!

The site it appeared on is one that pirates e-books overseas. Yes, they got my novel; and yes, they wrote a review.

For a more coherent review, click here.


teasing the reader in a novel of #Nepal?

Are you interested in the lives of the people in #Nepal?

Maybe – here to do serious medical work?

Want to read a book about the real #Nepal?

Or maybe – Are you a Nepali nurse or doctor  that wants to read something “real?”

The Sacrament of the Goddess Amazon page tells me there is a new review.

The title was:

An enjoyable fictional intro to real-life issues in modern Nepal

This is an impressive first novel which combines romance and Nepali culture and history in an easy-going, highly readable style. As an American physician who has visited Nepal numerous times doing teaching, public health research, and yes, toss in some trekking, I find the plot credible and the character development well done in the brief time allowed.

The history and cultural components are expert “teasers” enticing you to get a more in-depth exposure–ideally by going to Nepal! The religious discussions are very simplified, but again, will lead the reader to seek more data if interested. I

f you are planning to traveling to Nepal for the first time, this is good counterpoint to standard guides such as Lonely Planet. The medical discussions are appropriate and yet many Americans might find them difficult to believe, as they are harsh. Nepal is not a place fully appreciated by the naive, so take a little time to read this book before you go.When you get to Nepal, you can track down much denser historical, political, and religious tomes.Nepal continues to fascinate–and this book will give you some reasons why.

In Nepal, you can get this book at Vajra Books on Jyatha Marg in Thamel.

About doctors getting “thrashed” in Nepal March 14 2015

There are some “dirty little secrets” of Nepal healthcare – things that everybody knows but which nobody talks about. And my book, The Sacrament of the Goddess, deals with many of them, head-on. That’s why the novel has a cult following among doctors and nurses who have read it in Nepal.

Oh, the descriptions of the novel are a bit vague

“It’s a love story;” or

“It’s about the Civil War in Nepal and the missionaries caught in the middle;” or

“It’s about the way that medical decisions are made in a low income setting.”

Yeah, well, all the above are true, sort of. But the story is also about the way that people in Nepal deal with tragedy during those times when the doctors are unable to save somebody’s life.

“Thrashing” is a euphemism

And that’s where it gets interesting. The newspapers in Kathmandu always seem to publish stories about how this or that group of angry relatives “thrashed” a doctor, beating him (or her) senseless or creating a disturbance. When I first heard the term I thought it was “quaint.” Getting thrashed means that a mob beats you with bamboo sticks. If they are angry enough they can break every bone you have.

It’s not unique to Nepal, it happens a lot in India. On more than one occasion, doctors in Nepal have held a one-day strike to bring attention to the issue.

But there are even more stories that do not make the papers, and every doctor and every nurse is able to share the details of their own encounter with danger.

Young doctors dealing with fear

Young doctors in Nepal are trained at the larger hospitals, but after getting their MBBS degree, many of them spend a year posted in a rural health post, as a partial payment for student loans. If you ask them about this, their near-unanimous feeling is worry about trying to do the best they can, yet getting thrashed by angry family members if things don’t turn out perfectly.

Three actions to take

Every one concerned about this issue can do three things.

First, go to Vajra Books on Jyatha in Thamel, or Tibet Books on Tri Devi Marg, and buy The Sacrament of the Goddess. It’s a highly readable novel that gives a first-hand, truthful picture about hospitals in Nepal. Yes, folks, it’s the book I wrote.

Next, this issue is addressed in the 2- and 3-day courses in cardiac resuscitation taught by CCNEPal. CCNEPal has materials on strategies to minimize the risk of an escalating situation. Those persons who have taken the course can tell you about it. Sign up for a course.

UPDATE May 2nd 2016

If you don’t believe that this is a problem, read this report from Maharashtra State in India.

Finally, in the coming days, I will post a series of blog entries on the CCNEPal blog page, that will educate about strategies to deal with this problem. Click here to get to that blog, and when you do- click on the “subscribe” button. It will be a series you won’t want to miss. You will want to share it with your friends.


Everest Brass Baja to play at Open Air Flash Mob Event Saturday Jan 24th 2 to 4 PM at Mangal Durbar in Patan

Who: Everest Band Baja

What: Open air concert of dance party music.

When: Saturday January 24th from 2 to 4 PM

Where: Mangal Durbar Square, Patan.

Why? because we are alive!

What else? bring a video camera; bring your friends; wear red and be prepared to dance. We will make a promotional video!

marigolds 3

This is the place we are talking about.

As regular readers of this blog know, The Sacrament of the Goddess is being published in Kathmandu Nepal, and the official release date is January 24th.

On that date we will have a book release event, but this will not be a quiet reading to a hushed crowd of literary enthusiasts. It will be an open air celebration featuring a brass band.

the band?

And today we confirmed that the band will be Everest Band Baja of Patan. Sixteen guys. The great Sudarshan Pariyar leading the way on clarinet. If you have never heard them, you are in for a treat. Here is a link to Everest Brass Baja on YouTube.


This event is open to the public, obviously, because it is in a public place. (Be reminded that foreigners need to buy the Durbar Square ticket)

And what is The Sacrament of the Goddess about?

Nepal is a Buddhist country that fought a brutal civil war for eleven years. Sushila was raised deeply Buddhist, and needed to confront the vicious war head on when it came to her village and her house. She crossed paths with Matt when she was nineteen, then disappeared from his life…..

The Sacrament of the Goddess is an international thriller set in the last absolute Hindu kingdom on earth at the time the monarchy was ending. Under the shadow of the Himalayas and a dazzling multicultural background, a small group of doctors deliver care at a missionary hospital where there is only one missionary left. The Sacrament of the Goddess reveals events of the Nepal civil war in layers, as we meet the medical team of Beni Nepal and see it through their eyes.

Superficially, it is a classic story of star-crossed lovers, but the events unfold partly in real time and partly as flashbacks – memories that may or may not have happened, meanings that only reveal themselves through anguish or tears.

At it’s core The Sacrament of the Goddess is about the choices people make in a civil war where the moral virtues of each side is ambiguous. On a daily basis the doctors confront the clash between western-style individualistic culture and eastern-style collectivist culture. As we learn how they cope with difficult events we ponder how people’s actions express their conception of God and the infinite in a culture with plural religions. And the meaning of love.

Tell your friends!

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!