T minus 3 days

Hello all,

Last week in Xining and things are winding down at the hospital. I think we are all ready to finish by now. The rotation has been a mind-opening experience, and is something few foreigners have been able to do in the past. We have been challenged and frustrated but will come away with a great appreciation for another culture and the way in which its medical system has existed and survived for literally thousdands of years.

That said, we have kind of hit a wall in the past two weeks in terms of learning. The number one issue, as I've said many times before, is the language barrier and the fact that we are limited to asking very superficial questions. That is essentially a deal breaker when it comes to understanding the incredible complexity of Tibetan Medicine. Our hosts have been wonderful and can sense our frustration (they must feel it as well). We don't look forward to lectures because they can be very hard to follow and our morning clinical rounds have become a bit stale. One of the doctors we were rounding with has left and so we see patients with a non English-speaking Tibetan doctor and our untrained (medically at least) translator. So you can imagine a lot gets lost in translation.

Another issue that has come up relates to this hospital in particular and the current state of Tibetan medicine overall. The system is in flux right now, at least in urban areas, as it tries to combine both Western and Tibetan knowledge. However, the outcome is less than the sum of its parts. A lot of the Tibetan doctors are not truly practicing pure TM. At the same time, they are prescribing Western medicine without truly understanding the why and how of it all. Xrays are ordered, labs are sent off, but from what our host says (The "Don") they only have a basic understanding of the results and what they mean. The outcome is a mishmash of both systems and the whole thing seems a bit slapped together. We witnessed a team of Western and Tibetan doctors admit a patient (which means seeing him/her for the first time and is traditionally the most thorough and exhaustive encounter between doctor and patient) and it was far from the holistic method I had anticipated/expected. The whole thing lasted less than five minutes and it didnt seem like any of the pure TM techniques we learned about were coming into play. I dont judge any of the doctors, because I cant imagine what its like to straddle two divergent systems of thought, but it was disenchanting nonetheless. (then again, I have had many such moments working in Boston this past year).

At the end of the day, I would do this over again. I think the program needs to make some changes, but its only in its second year, and that's to be expected. Outside of the hospital we have had some awesome experiences on our incredible day and overnight trips. This weekend we went to Repkong (Tongren in Chinese), which is almost 100% Tibetan and is the home of three beautiful monasteries. It is also the origin of all of the best Tibetan thangkas (traditional Tibetan religious artwork, describing it would not do it justice). In fact, the worlds largest thangka was made there and is over 600m long (all hand-painted in extreme detail). In many Tibetan and Chinese cities, people gather at night to dance in the main square. In Repkong, there is only one tiny square, and we joined in on the traditional Tibetan circle dancing. The dance is beautiful and everyone seems to know the moves (except us). We caused quite a scene...(see upcoming pics). All the kids were following us, making fun and laughing. It was hilarious.

The next day (Sunday) we left for another overnight trip to the mountains to collect herbs. The highlight however was the fact that the "Don" finagled his way into having us stay inside a monastery. Apparently this rarely happens, especially for women. We were greeted incredibly warmly and two monks in particular gave up their little home for the night for us to sleep in (not the best night of sleep but a very small price to pay). The monastery sits in a little valley surrounded by amazing holy mountains, and fields of canola (bright yellow). We climbed one of the peaks to get a good view and realized we were higher than some of the clouds! The monks were about our age (23) and were our guides/official hosts for the night. They hung out with us in our room till we slept, laughing with us, even though they spoke practically no English. At one point they pulled out these elementary English-Tibetan lesson books and we taught each other words for a while (I know this sounds lame, but honestly it was one of the best nights I have had in a long time). They exuded warmth and love and we all felt incredibly at peace around them. It really was a palpabe sensation coming from the entire monastery. Walking around in the early morning, all we could hear was chanting coming from each little house. All of our senses were engaged, with the bautiful view and the crisp air...In the morning they prepared for us a traditional Tibetan meal called Tsampa (take a bowl, fill it with Yak butter and Yak cheese pellets, then melt down with hot water. Then add Barley flower and using your fingers, mash it up until it has the consistency of dough. Serve and enjoy!. It isnt horrible, but the Yak cheese adds an unpleasant after taste. It is also as hard as a rock). Soon it was time to go and we all regretfully hopped into the van and wished we could stay another day. It was really one of the highlights of the entire trip (see pics soon).

The program finishes this Friday. The plan, as it stands, is to head for Lhasa (capital of Tibet) with Katie on Saturday night on a 24hr train ride (if we get our visas in time). We'll spend a few days in Lhasa and then head to Everest base camp, which is a 6 day trip there and back (stopping a lots of little towns on the way). After that, we are flying together to Xi'an to see the terracotta warrios and then to Shanghai. Altogether about three weeks of travelling. I'm really excited!!!

Hope to hear from all of you soon and make sure to check out the photos that will be posted soon.

Peace and love,
Tyler