The Pilgrimage

Two months ago, I flew to the north of India for my elective posting in Apex Hospital Pvt Ltd. With state of the art facilities and a wide array of specialties, Apex Hospital was supposedly the best Hospital in Jaipur.

Image from Apex Hospital website

For the following few weeks, I was attached to the orthopedics department with the privilege of observing the many orthopedics problem which plague the Indian population. The cases seen were more or less similar to the ones seen in Malaysian with the only difference being that diseases that are almost eradicated and rarely seen in Malaysia are still very at large in India. For instance, tuberculosis (TB). 

Such a vast amount of the population is infected that various presentations are seen instead of the normal pulmonary symptoms. Poor management and even poorer compliance has resulted in the birth of a strain of the bacteria known as the Totally Drug-Resistance TB which makes treatment of TB an enormous hassle.

Most of my time was spent either shadowing the doctors or assisting in the Operating Theatre. With my vast vocabulary of Hindi and an even vaster English vocabulary of majority of the patients, communication between the patients and me involved many blank stares and confuse expressions. With all the hindi being spoken, it did feel a little like in a Bollywood movie. At times, I half expected everyone to drop everything and start dancing and singing. 


Of all the cases I saw in India, one that really left an impression was this particular case:

An elderly Indian woman came to the emergency department with a grossly distended abdomen. The swelling has been there for almost 2 weeks and 1 day ago she developed severe debilitating pain in the abdomen. The pain was so severe that she couldn't eat and drink nor could she defecate or pass flatus. She even had trouble breathing and moving without feeling crippling pain. 

After a series of investigations, the doctors diagnosed her with a strangulated umbilical hernia. Which means part of her intestines or in this case a large part of her intestines has protruded through the umbilical opening in the abdominal muscles and has been strangulated by the small opening causing the intestines to necrose and decay. If you notice the dark patches on her abdomen, those are signs that the intestines have started to turn gangrene. 

Back in Malaysia, this situation would have been an emergency! The patient would have been sent with all haste to the operating theatre and an emergency surgery would have been done to try save the patient's life. The patient wouldn't have survived the night without the surgery and even with the surgery, the patient only had a 50% survival rate. 

But what happened was after the doctors explained the situation to the patient and the family members and strongly advised for an immediate surgery, the family members decided to hold an annual grand meeting. 

So after the minutes of the previous annual grand meeting was read and the proper greetings were given, the debate on the best course of action to take started. And after hours and hours of debating they finally came up with a verdict...

They decided not to do the surgery and instead wanted to seek for alternative medicine or more specifically they wanted to bring the patient for a pilgrimage in hopes that God or some other higher power would grant them mercy and heal the patient. 

And that did not make sense to me at all! I mean, the pathology of her condition is crystal clear and the treatment even clearer. Why would one decided not to do the surgery and put one's life in the hands of some unknown deity??

I was extremely curious at what this pilgrimage was all about and wanted to see what kind of pilgrimage was this where terminally ill patients would rather go for the pilgrimage than seek proper treatment. 

I asked around and got to know that the pilgrimage was to a Holy Lake high up in the mountains found extremely north of India. And thus I packed my bags and headed north, extremely north.

I rode buses when they were available, hitched hike when there was none. For days I travelled across unfamiliar lands, meeting people of foreign cultures and eating what I could carry in my bag. In this fashion, I arrived at the foot of the mountain where the Holy Lake was said to be found. 

Braving the cold, the desolation and the exhaustion, I followed the footsteps of the strangulated hernia patient up the mountain. 

Carrying all my photography gear (camera, lenses, flash, light stands, soft box, umbrellas), tents, sleeping bags, warm clothing, books and food, my bag weighed at least 25kg. I kind of realised I over packed when the weight of my bag fractured both my clavicles, dislocated my shoulders and herniated my intervertebral disc. 

So lugging all that weight for days, I painstakingly made my way all the way to the Holy Lake, which was high up in the mountains where the air is thin and cold.

The thing that strikes you the most when you arrive at this holy alpine lake is not the beauty, not the cold nor is it the exhaustion. Don't get me wrong; it is breathtakingly beautiful and freezing cold! But the thing that strikes you the most is the silence. A heavy cloud of silence, so quiet that you not only hear your every heartbeat but you hear right down to the cellular level. Every single ATP being produced by your mitochondria is clearly heard... 

And it was in this blanket of silence when I finally understood why the herniated patient chose to come for this pilgrimage instead of undergoing the surgery.

The destination itself wasn't the main point of the pilgrimage nor was getting healed any part of purpose of the trip. Instead the journey to the Holy Lake was what made the whole pilgrimage what it was. Many a days were spent walking high up in the mountains, above the clouds and living off the land. 

They hunt with the mystical eagle hunters, drink from cold mountain springs and sleep under the stars. 

And when they arrived at the Holy Lake, they can finally die in peace after savouring pristine unspoilt beauty of nature, the very best this world has to offer. And through this experience, they have truly lived at least once before they pass on from this world. 
What better way to leave this world?

If I were terminally ill, I would make the same choice. I would rather travel one last time and witness unparalleled beauty instead of lying on the operating table with the probability of dying and the last thing I see would be the doctor's face.

What will your choice be?