Wacky Wikipedia Entries - Bhutan's influence in Isabelle's homework

The​ ​Methane Powered Prayer Wheel ​is a hollow metal cylinder, covered in gleaming gold paint and engraved with buddhist writings. Traditionally the hollow space inside is filled with prayers delicately written on paper and rolled up under the graceful hands of monks. The beautiful prayer wheels are always spun clockwise, due to the common belief that spinning them counterclockwise will bring bad luck. Under the base of most large prayer wheels is a one inch thick wick that is lit every morning. As the top of the wick is burning, the bottom end is secured into a four by four foot glass box full of methane gas.

The gas is collected through small holes in the floor mats that monks meditate on for many hours. When a fart is released a silent vacuum under the pillow turns on and sucks the fart down into the glass box. As this large candle contraption operates, heat begins to rise from the flame and gradually starts to spin the large prayer wheel. The more farts that are released from the monks, the more gas the large candle has to burn on, therefore making the heat increase and the wheel spin faster. The purpose of this process is to maximize the number of prayers released in a day, and to allow human interaction with the delicate wheels to be limited.

Camera Dust ​is a fine multi-colored lens dust. Each individual speck of dust is a micro camera lens, designed to take nonstop photos. The artificially intelligent camera sorts through billions of photos every fifteen minutes and uploads them to your cloud if the camera considers it a “good” picture. Additional settings include setting the camera dust to only upload a specific number of photos a day, so as to not overwhelm the cloud. The dust is intended to be sprinkled over your head each morning and then can spread itself out around your surroundings in order to get a bird's eye view for the photo. The camera recognizes a 3D dimension of your body and therefore always stays within a 10 meter radius, following you throughout the day. When you are done with the dust, use the small magnet that comes with your purchase; hold it above your head and tap it three times. Tapping it will turn on the magnet and the scattered dust will immediately cling to its surface, allowing you to store it easily. To improve the ability of the camera dust you can like and dislike photos, as to help the camera better understand your sense of style.

A Yak-A-Corn​ is​ ​a large hairy mammal, resembling a unicorn-yak hybrid. The animal is most often found in the northern mountainous climate of Bhutan but as also been spotted in Tibet and small regions of Nepal. The Yak-A-Corn Ranges from 7-12 feet in length and 5-10 feet in height. It feeds on long buckwheat grain, along with the occasional small amount of cordricept; a small rare mushroom that grows from the brains of baby caterpillars. From 1756-1912 they were hunted for the ivory horn that grows on the mammal’s lower forehead. Not until 2001 was hunting this endangered species made illegal by the fourth king of Bhutan. Considered a sacred animal, they are permitted to enter temples and Dzongs. The ancient folktales of Bhutan also claim it is lucky to see a yak-a -corn and many citizens of Bhutan and Tibet still hold up the ritual of praying to these animals for long life and prosperity.

Video: Biking Vietnam - Cambodia.

Biking to Cambodia

There is this balance, this challenge to getting off the beaten path, to see and learn what life is like in another place without getting lost entirely and doing it as a family of four.  Twenty years ago I would hop on a bus and see where I landed, but as a family, it is all just a bit more complicated - each with our own needs and desires and just a lot more people in the mix.

We decided to try something different and hired a guide to help us bike from Ho Chi Minh Vietnam to Angkor Wat in Cambodia.  The hope of biking was to get off the beaten path and take in the sights, sounds and smells a different way while all getting some exercise.  There were lots of hesitations. How would Traverse's back do? Could we all handle the heat? None of us have been biking or training for this, could we jump on and do it?  It was also a lot more costly than just taking the bus on our own, but after our day with Chu, where the girls had a blast, and we saw the possibility of life on a bike in the Delta, we signed up.

And how was it you ask?  It was everything all at once.  It was inspiring, beautiful, hot, dry, funny, stressful, challenging, rewarding and both ever changing and always the same.  It was something we would have never been able to do on our own.

Most of the biking was on small trails or back roads where local kids would see us and come running through the fields shouting "Hello! Hello!" and grandmothers would do a 180 watching Lily bike down the path.  People would stop our guide to tell him there was a road nearby and they were sure we could get a ride - after all, we looked so tired and sweaty, why were we biking? He would tell them we wanted to and we were going 50-60 km a day and they looked like they didn't understand.

There were days so hot and dusty you could ring your clothes out from the sweat, and everything was covered with orange-brown dust of the delta.

There were rewarding moments like when Lily learned to bike without hands through the deserted back roads of Cambodia.  And there were the moments where tears came when she tried again later up a hill on pavement and took a hard tumble.

There were moments of awe and wonder as the water buffalo ate in the setting sun among the rice fields or the reflection of the hard work for salt farmers collecting the dryng sea water by hand.

There were moments of pure bliss watching the girls chat about life, peacefully talking together through the countryside and moments where I was counting every second until the end as my body ached and trying to hide my exhaustion and put on a happy face for a kid who was done but still had miles to go.

There were hidden temple in the woods, newborn puppies, run down monasteries and killing fields.

There was Karaoke at random houses, local kids sitting in our lap enjoying a laugh as their mother counted and cleaned snails for sale.  Often our guide would stop at some random home and ask if we could hang out and take a break, both puzzling and delighting some local family.

We all got sick at one point.  I have never passed out vomiting before, but now I know what that is like, but the trip must go on.  Zofran, Imodium, Ibuprofen, and band-aids were our best friends.

I let go of many rules.  One day Isabelle biked most of the day barefoot - who was I to say shoes would be better?  She knows the risks at this point. None of us had biking clothes - we made do with what we had, and the simplicity of it was freeing.

We got behind on most everything, work, school, the blog -  just taking a picture was a challenge as you bumped over the dried dirt road, dodging a dog, or pig, or kid, or chicken and the motto "you can do hard things" was repeated more times than I can count.

We didn't make any speed or distance records, but we saw, we experienced we lived those ten days fully.  As Traverse said regularly, we could not think of another place in the world where you could bike for so many days on flat, basically bike trails with kids and see and experience so much rich local culture.  This blog and these pictures are just the tip of the iceberg of our trip within our trip, biking to Cambodia.

So much of the biking in Vietnam was like this, basically scooter paths that work beautifully as bike paths connecting the towns.

Passing on the left through the rice field near town.

The size of the Mekong Delta was impressive. It was dry season, but for days, everywhere we looked there was water. It is this huge labyrinth of water and land producing incredible qualities of everything. Fish farms, coconut plantations, flower fields, mango and mangroves. Many of the town as connected by these bridges - everywhere.

It was fun to be on bikes after they were such a part of daily life for so many years in these parts.

And then you would stop, and look up, and be stunned by the beauty. This was in Cambodia and when our guide came to where we were standing waiting for the girls he told us these horrific stories of the history of war and genocide in this area. It was hard to balance it, with the intense beauty and calm before us.

All day - this, “Hello!” “Hello!” “Hello!” - there appeared to be a pure delight the children took in seeing us bike past. They did not ask for money or “pen, pen” as I had experienced in Nepal, just a friendly hello and they would scream in delight when you waved back. The gift of kindness was striking on this trip. I would see another mother, a grandmother who would look a little weary at us as we past, and if you smiled, you would be greeted back with an eat to ear grin - gifts of kindness exchanged, each of us a little lighter in our loads.

And sometimes you would think you were on your own, and then four heads would pop out of the water shouting “hello!” as they and the water buffalo cooled on during this part of the dry season.

I missed so much of this moment trying to bike and not run into everything, but all of a suddenly all of these kids came running out from the school, jumping off the grass piles saying “hello, hello” and giving the us all high fives as we biked past.

Towards the end of a long day, these kids full of smiles came out to say hello. They were near where we packed our bikes back in the van to “transfer” down the busy road to town so we got some more time to hang out with them (and actually get a picture). Always a smile.

Pretty soon the same kids were loosing their shyness and coming up to us. The little one in the white and purple loved Isabelle, pulling herself into Isabelle’s lap and holding on to her. As we pulled away, we all wanted to stay longer talking about what their life must be like and wishing we got to spend more time playing with them.

One day visiting a temple that we were biking past and trying banana root that is in season only for a short time each year, this little one sat down next to me and started talking up storm. When I offered her some banana root, she kept looking at me puzzled, but all smiles.

At a run down monastery that a few construction workers were repairing as we got our bikes ready this sweet family made their way out of the shadows watching everything we were doing. The little girl came up, we shared some of our snacks.

Once we crossed the Cambodian boarder we biked for a while through some dirt back roads and made our way to the ocean. It was such a beautiful surprise and off went our shoes as we headed in the water.

The beauty of the ocean life.

Low tide, fishing boats at sea and the end of the day for us all.

And then there was the food. Most of our meals were with locals at outdoor restaurants on the streets. This one full of fragrant flowers was part of this never ending stunning array of produce in this part of the world.

But to balance out all the veggies were the drinks - this one time we stopped and this women brought out these super sweet red drinks and spoon fulls of sugar to put in it for the kids . You can’t say no, so we just laughed at the craziness of the year and how many things we would “never” do at home, we just shrug as part of the experience.

Here with our guide in Vietnam enjoying a laugh, a journey an a shared meal over pots of charcoal at the tables.

This was our lunch spot anther day - near the second capital in Cambodia and the kings grave huge masses of hammocks and raised beds can be rented for your picnic. Near by is rows of food for sale, slated fish, turtles, frogs, freshwater shrimp fries and spicy mango salads. We hung out here for a few hours, enjoying taking it all in. the only foreigners in sight and delighted by the new experiences.

One option in the market - crabs with their meat pulled out, mixed with seasoning and replaced in the shell, to be then grilled and sold hot.

More biking in Cambodia - you never knew what you would see on the road.

Here are piles of fried tarantulas and silk worms for sale at a road side stand. Not for tourist, for locals in route.

On our way through Cambodia we visited a few museums, here is Isabelle at the National Historical museum reading about the history.

And little Lily going through the HUGE doors. The scale of the temples kept catching me off guard.

Live eels and frogs for sale. The frogs were all tied together by their waist so they all were jumping against each other - preventing any one of them from escaping.

And another small local temple, to be seen and experienced without the throngs of tourist we would later encounter.

The river is a way of life around here. Transporting a great load down this small canal.

The beauty of the morning markets.

I could have spent all day watching these women talk, smile and sell their goods. It actually reminded me a lot of Seattle’s pike street market, just bigger, few tourist and almost all on the ground.

Ginger and lemongrass dominated the smell of the vegetable market.

Across the way from the veggies was the meat and fish section - lets just say this part didn’t smell as good.

The Costco of Vietnam where you can get all your food wholesale.

Many of the families who sell on the river, live on their boats, traveling with the seasons and the market.

And then there were the salt fields near the boarder - mile after mile of drying salt.

Getting ready to collect another pile.

Collecting the salt to take it in and dry it again.

Raking another pile.

It seemed like in most towns you would see the town pig trying to find some place cool.

Another stop along the road - the famous Kampot Peppers of Cambodia. It was amazing to see the old paper farms, see how they are grown, sorted and dried. The place smelled amazing and learning the history of these berries was fascinating.

More markets - this time with grilled salted fish from the river.

You know when you need a break - there is always Karaoke - Isabelle and our guide showing us how it is done.

This was another temple where at the top you could purchase a bird to free.

Lily letting hers go. We thought we were getting one bird to let go - some how we got a whole cage of them to let go - there was always this sense you were missing some key detail of the conversation, but just went with it.

Last day of biking was through the temples of Angkor Wat. It was an incredible way to see the place because you got to see so much of it that is missed by the main tourist attractions. Like this little tunnel in the woods. Biking along the wall, resting in the showdowns of this ancient city that once was the largest in the world.

Ahh, rest at the end of long morning of more heat, sights and sounds.

Early reflections on the war

Vietnam.  Even the word stirs up many emotions and a wide range of responses.   When we put Vietnam on the list we got all sorts of questions like "I spent most of my young adult life avoiding that place, why would you ever choose to go?"  “Have the girls seen the Ken Burns documentary about the war?" And even blatant "why would you ever want to go there?" For some, even the idea of coming here seemed to represent a betrayal of either being a US citizen or to undermine their emotion surrounding the history between the US and this country on the other side of the world.    

Honestly, part the reason we chose to come here was that mixed emotion surrounding US history in Indochina.  That and the fact I fell in love with the idea of emergency medicine watching M.A.S.H re-runs at 2 am doing art projects in high school and college.

The girls are at this magic age.  They are open to the world, can think critically as they create their world views.  I wanted them to see the world, raw and up close. They know about the war. They have gone to the Vietnam memorial in Washington DC and found the names of half my dad's hockey team with him.   I also wanted them to know this place was more than a war, but, a place full of beauty, and kindness and so many kids smiling and waving "hello." As politics and policies have become so much more hostile and divided at home, I wanted them to not only know but believe one of my favorite quotes:  "it is hard to hate up close."

What I was not prepared for, however, was how much more it would affect me.  I texted a friend part way through the tunnels reaching out to someone else of the same generations trying to understand how to put all of these contradictory feelings and thoughts in the same bucket.   I found my eyes welling with tears at almost every corner and the "gun shooting range" at the tunnels, and I had to just a walk away, it was too much. And yet I was not drafted here; I didn't lose my friends to this war, I didn't experience this first hand in any way.  And I didn't live in the same area, still being affected by agent orange where my parents once hid underground for years like the tour guide's parents.

I think part of the reason for the intense emotion, was the intensity of the displays.  You went into the war museum, and there is a big sign saying "welcome to the museum on the War of American Aggression."  There is a rawness in talking about a war when it happened on your soil, a rawness we have been sheltered from in the United States.  A rawness in the photos, the US tanks in the middle of the city and in climbing through the tunnels where the Vietnamese lived and fought for years.

It is the same rawness struck me in in Croatia, how there should be three different words for war - war you fight with money and people who volunteer on another countries land, a war you fight in another land and draft soldiers and a whole other word for war when it is in your home, on your soil, among your people.   It was again a striking reminder of how blessed I have been knowing such peace and stability through my formative years.

As our year moves on, the memories and stories pile together; it is this intense sense of a desire for peace that strikes me again and again.  I am amazed at the resilience and forgiveness of the Vietnamese. I pull up facebook seeing friends "de-friend" each other because of policial difference and being here reminds me of how much nicer it is to see the similarities we all share than focusing on our differences and how easy it is to hate from afar, but how much stronger we are together.

There is the added intensity looking at this original iconic picture of the fear and horror of the war near the location it look place and your child about the same age. I kept checking in with the girls, to see if they were OK, how they were processing it all. They were reflective and thoughtful, but I realize more and more, the added vulnerability of having children and wanting them to be safe and protected with all of your heart adds an intensity to these places I don’t think they experience the same way.

The welcoming sign as you walk in - I learned of this war as the “Vietnam War” they learn of it as the “war of US Aggression.”

The whole court yard of the museum was filled with US tanks and helicopters, the size of which was impressive.

Coming out of a section of tunnel; it was hot, dark and claustrophobic - and there were occasional lights, air conditioning, no one was bombing us from above and we had a guide. I was a reminder of the power of the human sprit to survive, something I admire in my patients, in books and in these tunnels.

Our declaration of independence written next to pictures of war. A reminder of the values we set forth as a country. Values not to be forgotten.

Two things that always help me understand the world better, children and art. I was so grateful for the last room in the exhibit - full of children’s art, peace and hope.

Seeing the war through children’s eyes.

This picture captured my heart: the horror, the bombs, the missing parts, but despite that, the colors are vivid, it looks like there is a rainbow and the kid is still holding the hand of an adult. The wheelchair is almost like a rising sun finding beauty despite the distraction.

Powerful to read this on the New Year, 51 one years later .

There were many quotes on the walls of the museum that I don’t remember learning about when I learned about the war in school. Being here was to touch and feel the “other side of the story.”

“Yet we were wrong, terribly wrong. We owe it to future generations to explain why.”

— Robert McNamara

And this - so this. The joy of peace.

A Bhutanese Love Story - writings by Isabelle

Imagine a land forgotten by time, a land where houses dot the hillsides and mountains jet themselves upward, dipping their snowy heads in and out of the swirling storm of clouds floating just above. Bhutan, the name of this marvelous country nestled in the Himalayas, means “land of the thunder dragon”.

Jigme Khesar Namgyel Wangchuck is currently the fifth king of Bhutan. He rules his small modest himalayan kingdom with honor and pride. Jetsun Pema, his loving wife, stands proudly by his side. Jigme and Jetsun may come across as ordinary rulers, but the story of their love is not in the least bit ordinary. It’s a real life fairy tale, as enchanting as the magical country it took place in.

When the two lovers first met they were oblivious to the life they would one day lead. Jetsun was no older than the tender age of seven when she met the seventeen-year-old prince at a royal picnic. Jetsun was a typical Bhutanese girl, though her parents were well-known friends of the royal family. When they arrived at the picnic, Jetsun was overtaken by the stunningly handsome Jigme. Unlike the rest of her family, she was unaware that the fine boy she was staring at was the next heir to the throne. Snatching the prince by the arm, she innocently pulled her Romeo out of earshot and asked him to marry her. Jigme was stunned at first, but his surprise faded into amusement when he looked down at the little girl beaming with excitement. “Why do you want to marry me” he asked with some difficulty, feeling his cheeks turn pink. She simply replied in a cool voice, “because I like you.”

When Jigme was in his twenties and Jetsun was a teen they met three more times at royal events. Eventually a deep friendship began to develop and over the years turned more romantic. Jetsun, being so young when she had asked, nearly forgot about the marriage proposal. Little did she know the simple request had a significant place in the youthful prince’s heart. As the days, months, and years passed; Jigme recognized a strong love for Jetsun that one day lead to asking if she was still willing to be his bride. Jetsun, recalling her quite request at age seven, began laughing and announced that she would be honored to marry him.

On October 13, 2011, a huge celebration was held to honor their marriage. Jetsun wore the traditional Bhutanese ankle length skirt called a “kira.” This beautiful wedding skirt was made of raw silk, therefore taking many months to complete. King Jigme wore a “gho,” the male version of the traditional Bhutanese clothing. The gho closely resembles a robe, although the fabric only reaches your knees and is traditionally worn with black shoes and black knee-length socks. Jigme’s gho was yellow with delicately embroidered red flowers around the rim of the neck.

The wedding held much spiritual importance and many sacrifices of food and drink were made, blessing the couple with long life and happiness in their new relationship. During the wedding Jigme announced that even though his father had four wives, Jetsun would be his only wife and was irreplaceable in his heart.

In 2006 Jigme and Jetsun were honored with the gift of life and a baby boy was born to the royal couple. He was named Jigme after his father and will one day become the sixth great ruler of Bhutan. Jetsun and Jigme continue to live in happiness and their love for each other is still as strong as it was the day they first met. Jigme is very open about his love for Jetsun and often talks of his admiration for her at formal events. The couple is often seen holding hands in public and their happiness has made Bhutan an even more joyous country.

Every house, every restaurant has a picture of these two.

Getting out of town

As we got our feet under us in Ho Chi Minh, we slowly learned how to cross 6 lane roads packed full of motorbikes and eating on plastic stools in the street became the norm, but we wanted to start to branch out, learn more about the food, language and culture. Airbnb has "experiences" that we have looked at doing and tried one in Singapore but seemed perfect in Ho Chi Minh as it was hard to even know where to begin in this huge city.  
The first trip was a 4 hour street food tour on motorbikes.  Right on time, three delightful students showed up at our apartment and suddenly instead of fighting the motorbikes, we were one with them, part of the river of traffic navigating in and out of the mass of humanity.  Frog, mango salads, sweet beef, blended soup, lotus flower tea; the night was a colorful blend of flavors, places, and experiences. At one point Isabelle was drinking this sweet drink full of fruit and roots, seeds, seaweed, and other non-identifiable plants and she looked at me and said, "we have come along way, I use to have to know what I was putting in my mouth, I have no idea what any of this is, but it is good." Yes, we have my dear.
The next day we did a full day tour of the Mekong Delta via bike and kayak, partially to see if we wanted to commit to a long bike trip with the girls.  We chose a tour that touted "we don't go where tourist usually go" and he was right. It was a delightful day through the guide's village area, through canals on a kayak, floating markets and biking through towns on these little paths only suitable for walking, biking and motorbiking. It was such a different experience of the Ho Chi Minh and the surrounding Delta and the guide so great, we talked to him after the trip about setting up biking to Cambodia, which he agreed to do.  One thing I have really enjoyed about Airbnb is you can stay in places and do things without huge masses of tourist and in this case meet an amazing guide who dropped his other tours for the week and biked with us to Cambodia.
The last tour we did was a "sidecar to the Cu Chi tunnels and farming cooking class."  The sidecars were a traditional method of transportation in Vietnam before the population boom after the war and a fun way to see the countryside.  More about the tunnels in the next blog, but the cars paired with the cooking class was a totally different and again great way to get to know a different side of life and what really is in all that crazy food we were eating.
Slowly we are learning our way around this new country and a new culture.

little one on the street food tour - full of new adventures

boats full of fresh produce on the Mekong Delta

The sights, the sounds, the colors.. you never knew what you would see next. More fruit making its way to market.

selling coconuts on the river

Many of the boats would hang out the food they would sell so you would know what boat you wanted to go to. Here is the fruit boat selling pineapples, bananas and durian.

so many smiling faces commuting on the river

making another trip

houses along the river, we were here in the dry season, so the river was low, really showing how the houses are made.

life on the boat- making our way up the Mekong. The size and breath of this river was impressive.

My whole heart - sometimes I look at this through the camera to take a picture like this and and have to take just a deep breath and really believe, yes we are here, this is our year.

how cute they are.

so many smiles

growing in Alaska paid off as these two made their way up the river in a kayak navigating the kayak without a problem.

our boat driver, checking in on us and making sure we are all doing well.

getting a chance to drive up the river.

making a ferry crossing with our bikes

this is what the biking was like in the Delta, it was so lovely without cars, making our way through the country side - truly a great place to bike with kids.

this women came up to lily and kept saying “lovely, lovely” and kept rubbing her, and smiling. I have no idea what else what she was saying, but I have so loved these little connections as we moved along. Everyone took a liking to Lily surprise and delighted she was on a bike.

Iz and I ridding on the sidecar with our super smiling and lovely driver.

more sidecar fun

she rocked this little helmet and the side care

having fun

all smiles - her and our driver

this was lily’s dish that she made: beautifully done, full of flavor.

deep frying stuffed pumpkin flowers with seasoned meat, onions and garlic.

more time along the river

boats docked at low tide

A city of 9 million - landing in Ho Chi Minh

Landing in Vietnam was like being transported into the future after Bhutan. Twenty-four hours a day we were surrounded by the hum of humanity. We had rented an apartment for a week to regroup, reflect on our time in Bhutan and get ready for our next adventure. I realize this year the importance of transition, making the time and space to reflect, regroup and prepare for the next dive into a new world. We have started to build these transitions into our plans, and they have been critical for our sanity. They are also this weird half world as you let a new place sink in and as you processing the old.

Isabelle said 'mom it is weird how in a city of 9 million it feels like there is nothing to do, but if I were in a small place in the woods it would be like there was too much to do.' Clearly, they have grown up in Alaska, but it was striking how much more isolating and intimidating this huge city felt compared to Bhutan, our small islands in Croatia and Noraway and home. But soon we learned the streets, corner shops and places to go. Slowly the city started to show itself, and we were able to change gears into a new culture, new pace, and a new world.

Living it up when we first got to town. It was great to be high in the city when we first arrived to have a sense of place in the town.

Looking over the hum of 9 million. Such a different world than Bhutan.

We got to town it was the night before Tet, the celebration fo the New Year. The fireworks display was impressive.

When we first landed we kept pointing out the scooter: trees, doors, fill sized TVs, whole families. The use of space on a scooter in this country is impressive. Soon we realized this was a very normal and don’t even notice any more, but the first week it kept surprising and delighting us.

We signed up for a food tour around town one night to learn all we could about the city and the food. Totally different world on the back of a scooter compared to dodging them!

No problem the three of us on one.

The first day of Tet we walked around town, everyone was out in their finest, taking selfies and celebrating the year of the pig.

After leaving the snow and cold of Bhutan, landing in Vietnam as spring started was burst of colors and sensations.

Colors, smells and street food around every corner.

Street food everywhere!

Famous Banh Mi sandwiches around every corner.

Seafood anyone?

If there was not enough colors with the food, there was always the flowers to add to the beauty.

More Tet fun.

Coconut drink anyone?

There is a world wide obsession happening with these dogs and the girls were elated to see the trend continued in Vietnam.

Breaking free of the heat.

On the road again

Despite our best efforts, time would not hold still, and the day came to say goodbye.  The night before we left town we had a final lovely dinner with friends, Isabelle recovered from the flu and at least her eardrums burst before the flight (we all took turns getting nailed by illness in Bhutan). The day we left was frantic, half written thank you cards, long meaningful talks with friends as it felt like life's mysteries and challenges needed to be sorted out by this tribe of wise men before we were left to venture out on our own again.    The dogs got extra treats, clothes were left to be transported back to Colorado on this magical chain of connections that helps bring credits cards in and memorabilia back out of the country.  Last words of advice on the water heater or the frozen pipes were given to the doctor who had moved in with us the last few days and would be staying the rest of the month.  It all seemed too short.  We should be leaving more at the altar of our time here, but time rushed forward, projects were handed off, long hugs and beautiful flights.  Words were left unspoken and emotions were raw.  Tears slipped down my face as we drove away. 

Before we knew it time travel had happened and we landed in the clean and organized airport of Singapore, a perfect foil of Bhutan.  The Christmas decorations had been changed to Lunar New Years ones and the food and shopping possibilities were endless dizzying.  And then 24 hrs from that we landed in our 32 floor apartment building in Ho Chi Minh City Vietnam.  That night we fell asleep, not to sound of dog packs, but the hum of 9 million people getting ready for the new year.  We have no set plans.  We are getting our bearings again reflecting on what happen, getting caught up on life, and our blog and figuring out which direction to move in next.   May our  journey continue to take us apart and put us back together in new ways and may the kindess and acceptance of life we learned in Bhutan continue to ground us no mater where we land.

Head out on the beautiful morning. After 6 weeks here, I am still loving the monk’s selfies and this beautiful blend of the old and the new. Almost everyone got a selfie getting on this plane each treasuring the journey.

Leaving the land of the Thunder Dragon. It is also reportedly one more the more dangerous airports to fly in and out of. Compared to small flights in Alaska, it was no big deal, but still amazing to see Everest, grazing sheep and the clouds of India below as we banked left and right making our way out of the valley.

Our flight was early in the morning, coffee was had and again, the easy of traditional clothing and modern life made saline.

The layers of mountains, each filled with their own clouds, up above them the peaks sitting in the sun is one for the views we kept seeing over and over in our time in Bhutan and we got to see one last time as we left.

Culture shock landing back in Singapore and seeing all that had changed while we were away.

And like that we were in Vietnam reflecting on what just happened and what this all means.

A final weekend in Punakha

There was one weekend left in Bhutan, the weekend I had been looking forward to since we arrived.

Melanie and Shankar are two US trained emergency physicians who along with their spirited, beautiful kids Nora and Luka have moved semi-permanently to Bhutan.   They had come previously for 4 months, felt like it was a good fit and so came back on a two year plan. 

They were our grounding force for our time in Bhutan, also our ATM machine, running partners, local guides, translator, and for the last weekend, event planner.  Melanie had organized a weekend for a group of us with an easy that comes only by both knowing the area well and knowing kids.

As you can see from the pictures, there was no shortage of fun.  We headed to the famous town of Punakha, an almost tropic town north of Thiumphu but a noticeable 4000 feet lower.  We visited the temple of the divine madman who promoted the display of the phalluses has been taken to a whole new level with the boom in tourism.  We lounged in beautiful rooms, ate delicious food, talked for hours.  We visited the local Dzong, rafted the female river, watched migrating ducks from Tibet and joyful young monks strip off their robes to go swimming.  

But what this weekend more for me was a celebration of the people here.  Melanie and Shankar are the type of doctor am always striving to be -  kind, confident, humble and incredibly skilled.    Balancing life, politics, medicine, family and so much more, it is the hours spent reflecting on how you really teach, what it means to make a health care system work, or the fine balance in protecting your children while pushing them to grow to be independent, resilient adults that I will take away from my time in Bhutan. They were more than freinds, their kindness and support gave me the space to let go and jump subtly and profoundly shifting the way I see the world.   

We came on this year to see new places but again found it was the friendships that filled our hearts.

Isabelle made brownies in preparation for our adventure.

Our way over Doche La Pass with a large snow storm moving in.

Lily’s little foot fitting like a glass slipper into this gold foot print in the rock.

Sugar makes everything more fun.

Ok I think I just love potted plants

Working the rice fields in the middle of winter.

This boy and his chicken had us all entertained.

Punakha’s famous suspension bridge.

While Punakha clearly has more tourist than most places, it was lovely to see there was still space for those who live here.

Making the prayer wheel go round.

Headed back to work.

Helping make change.

Selling dried yak cheese- a cross between salt gum, mold and a rock. She was busting with smiles as we tried to figure out the cost.

Headed back in...

The party van. This huge beast of Melanie and Shankar’s got some major use during our adventure.

Ahh, high school and penis paintings.

In so much detail.

And a good time for more homeschooling sex ed. :-)

But instead each store these beautiful paintings were for sale.

And as always it was the people who caught our eye.

Making more for the upcoming tourist season.

And kids being crazy kids no matter what culture.

In middle school in Alaksa they have to carry a large object determined by the teacher if they get a hall pass for the bathroom. Isabelle didn’t think this would fly at her school for a hall pass.

Everywhere on the way to the temple.

All smiles all weekend.

I so love these little ones.

Reflecting on life.

The kids pack started to rove on their own, this time in search of food.

Huge wild poinsettias and prayer flags outside the home.

This is how I felt in Bhutan. Reflective, protected with new doors to go through.

I probably took 50 pictures of these. I loved the red flowers blooming in contast to the dead of winter.

Looking out

Rice patties resting for the winter

Duel prayer wheels

Love.

Separating out the rice and drying it for winter.

Pure will these two! So much fun.

Locals watching us from a bridge.

Boat 2 catching up.

You can just make out these beautiful brown birds from Tibet that I loved to watch.

Kids having a blast.

Monks running to the swimming hole.

Rafters and swimming monks.

Best buds after and advture together in the boat.

I love this one, Nora has so much to say, Shankar really listening.

The kids took the phone and we saw the way back though their eyes.

No fear!

Smile

Headed to the Dzong.

Everyone watching the small snake as they prepare to enter the Dzong and pay their respects.

Security helping the snake find a new home as a guide and monks look on.

Reflective moments

The beautiful, frightening, inspiring wheels of Bhutan’s Buddhism.

Fly.

Even the stairs were inspiring.

Like layers of insight, the doors to the Dzong kept going.

Reflecting on our time.

A beautiful views from the guesthouse we stayed in,

Life around Thimphu

Life around Thimphu was fun, chaotic and full of wonder.  Beautiful babies in colorful blankets tied to their parents backs in patterned tapestries.  Businessmen and women headed home from work in traditional clothing. Dog packs that roam the streets.  Markets full of local products and those from India. It was dirty, and safe and always full of stimulation.

Many of the days around Thimphu I was at work while Traverse and the kids explored.  What quickly happened however, was the kids created their own routine and Traverse his.  The kids jumped into life in Thimphu. The had the privilege of working at a cafe, taking orders, serving customers, and on down time petting the cat and having lengthy philosophical conversations with the owner's 10 year old boy about music likes and school routines.  They volunteered at an animal shelter, took art & dancing classes and became expert bakers in our toaster oven.

The highlight for them however was their fast friendship with three amazing girls.   Originally from the US they have been in Bhutan almost 10 years, being homeschooled by their physician mom while their physician dad works at health care reform in the county.   They went from awkward small talk to endless sleepovers. It became a joke that if Lily was still in their house after our plane left, they would think she was staying for good.  Their friendship was the easy kind of kindred souls who could get along for days on end with little to no tension, who could challenge each other on their budding philosophies about how the world works and their role in it all.   

There is no way in words to summarize all we did and saw for the six weeks around town, so here is a collection of pictures, of the few brief moments we would get out the phone and capture the reality of our home.

A local trail overlooking Thimphu and Isabelle taking it all in.

I love this picture Traverse took of a new park in Thimphu. There was never really anything that was rushed while we were here, always moving slowly, “oh la”, always with respect and reflection.

Lily helped capture this photo, as this was her happy place.

These dogs live by our apartment. The one to the far right is named Scuffles. The one next closest to Scuffles, is Ranger, Ranger always wants to come in the house, but we never let him. The black dog casting a shadow next to Ranger, is Luka. Luka is very shy and is very skinny. The dog behind Luka, who is black and white, that dogs name is Missy. (We named it Missy because it looks like our neighbors dog who’s name is Missy.) Missy always comes up to you to get attention, but she has hair loss so we never want to pet her. The gold dog next to Missy is named Charlie. Charlie is nice, but never eats the food you give him. The fluffy back and orange dog in the back is named Peter. Peter is lazy, and never wants to get up from where is laying, so when you walk up to him all he does is lift up his leg and waits for you to scratch his belly. Last but not least, the dog laying down on the box, who is brown and white, is Max. The reason its Max is because we thought she was a boy, but when we found out it was a girl, the name had stuck. Max is also the dog we let in the house at night. I try to give him dog food but she is to picky, she only drinks milk and eats dog food with warm grease on it.

Lily in her happy place.

Volunteering at the Animal Shelter as the girls could not get enough of the dog and there were always more than you could imagine.

Volunteering with friends at the animal shelter

More puppy time with friends.

I love this picture, they asked this women if she wanted to hold a puppy and she picked up this big dog.

Making dog food.

The Buddha above town where many hikes start.

Overlooking Thimphu.

Headed up the hill under more prayer flags.

Getting out and about.

Was the trail up here? Over there?

Big smiles and big hikes.

Love what these two bring to every adventure.

Off in their own world, talking about who knows what, always making me smile.

Trying to fit in, by wearing our Kira’s and tagos.

Dzong in Thimphu.

Local Market and shopping with the locals.

Ancient prayer wheels

Payer built in everywhere we look.

Not sure what this all means, but I kept thinking it was ancient emojis.

Layers of history.

Traditional arrows.

Getting produce from the local market.

People drying meet outside our house.

Yak cheese!!

This is the cat kali that lives in ambient cafe.

At ambaint cafe talking over life with the owner’s son and good friend by the time we left.

The girls did hip hop dance lessons.

Washing our laundry like the locals.

From Lily - “Look at this picture, look at it again. Do you see how many layers we have on in our bed!!’ This was our average clothing in the apartment most evenings.

A beautiful 5 mile run from the house: to the Buddha and home. Too bad it didn’t happen more often.

Local chorten where people walked daily in clockwise playful circles.

I saw my mom looking down from the gym at us as she finished off running on New Years eve - 2018 miles in 2018 with her friend back home. Yah!

A jungle of wires!! This is what living in Bhutan felt like, it worked, it was just not your conventional way of doing things and sometime sparked.

We did a cafe with our friends.

We put out a tip jar, and it looked like quite a lot, but when we counted it out it was only 56 cents each.

Haa Valley with Dawa

Most volunteers take off for the weekend, exploring the parts of the country we are allowed to explore. Interestingly Bhutan has divided itself into 20 different districts and where we could travel was pre-determined. We were allowed to travel to Has, Paro and Thimphu districts freely. We could obtain a permit to go to Punakha or Bumthang, everything else was off limits. We also quickly realized that it was winter, and the snow kept shutting the passes that connect us to almost everything besides Thimphu (the district we lived in) and Paro (the area we flew into). Haa is a rural community on the other side of the impressive Chele La Pass from Paro, at over 13,000 it is the highest road pass in Bhutan. The districts of Has was only open to tourist in 2002 and is one of the least visited regions in the country. Finally, it had not snowed for a week, and so the pass was open, and we decided to make a go for it.

The trip was a welcome change of pace and a chance to see much more rural Bhutan and 10+ hrs of driving and 2 days later we were grateful we went, grateful for our new friend and guide and glad to not be in a car again.

This monastery along the road was once a prison. When the death penalty was in place in the country, they would simply tie people up and push them off the cliff on the back side of the monastery. After Bhutan was untied and Buddhism became the predominate region, lethal punishment ended and this stunning location was turned into a monastery.

We were going to stop by the nunnery on the way up the pass, but the road was covered in snow, so we walked the rest of the way.

I love how small the world is - Suzanna is the daughter of my uncle and aunt’s good friend. She is in Bhutan for three years teaching at a school started by the King and it was a wonderful having lunch with her, leaning of all her stories. I felt like I was woven to the rest of my life while I was here. I was at a small advisory board meeting and 2 of the doctors there knew Melanie and Shankar who are here for 2 years. In our apartment we found a note from John and Ellien. Turns out it is the same Elline who was my pediatrician growing up, and John is my aunt’s good friend. One day while working in the ED, I find out “a guy from Utah is coming”. Turns out Scott Macintosh who runs the wildness medicine fellowship and was a fellow when I was resident in Utah was coming in town for a few days and Charlie who started the helicopter program is doing research with Ken Zafren who I have worked with back in Alaska. It was funny to be so far away, yet so connected all at the same time. One more way Bhutan quickly became home.

At the first chorten with Dawa. Dawa came recommended to us a diver with mad skills, good english an always willing to hep. This trip took us from acquaintances to fast friends. He drove with caution and skill. He knew us foreigners believe in seatbelts and want to use them. He both shared stories of Bhutans’s past and we discussed the hopes for its future. We learned words of dzongkha from him and saw sights we never would have seen on our own.

Making the way to Nunnery.

Following the girls.

Come on little one.

I could have put together a whole blog of pictures of these two. Traverse and Dawa quickly hit it off and often the two of them would be out front hiking, talking about who knows what I am sure enjoying the quiet and adult conversations.

As Lily and I came down the road we found this - you never know with these two.

Once we got to the top of Chele La Pass we ventured up towards a mediation hut. The wind was cold and blowing and the girls had not understood we were going for a hike, and I had not realized how late it would be but we finally had made it here, so we ventured up.

Our fearless leader looking at the setting sun wondering if we would make it before dark.

And as we climbed he put on layers and it got colder.

These two off again, leading the way into the clouds.

The final push to the summit in the final rays of light.

And at last, the meditation hut, well above 14,000 with the mountains falling away in all directions in the yellow glow of the setting sun.

Dawa, in his infinite kindness brought to the top warm sweet tea and crackers, fruit, nuts and cracked rice. I am not sure a cup of tea ever tasted so good. Dawa went above and beyond and saved the day. The kids inhaled the food. Isabelle like a wilted flower burst back to life jumping most of the way back down. I took it all in, the tea, the setting sun, the lessons we learn by pushing ourselves a little further outside of our comfort zone.

All smiles again with tea in her hand, food in her belly.

Pulling her arms out of her jacket to balance her self on the rocks on the way down as we scrambled to make it to the car without totally getting lost in the dark.

The back side of the mediation hut. A quick look an we all decided we were not ready for meditating in this cold hut for any amount of time, especially not the 3 years, 3 months and 3 days the Bhutanese monks mediate as the communication of their training.

Headed back down. These pictures never do the mountains justice, how each layer changes colors as the sun slowly slides lower reacting the light and brining each layer into focus before it slips below the horizon.

Dawa letting us know we missed the trail and me showing the girls where we took a wrong turn. Again, grateful for our guide.

Once again, despite our fears of the darkness, the moon was full ocean again, the sunset lated longer than expected and I have decided getting stuck high in the mountains in Bhutan at sunset is my favorite things. The oxygen requirement declining at altitude, the full tummies, the immense beauty of it all made the way down a breeze, full of warmth, light and love.

At then end of our hike was a curvy two hour drive down to the Haa Valley in the dark. Given the lack of tourism, the main places to stay in the Haa Valley were guest houses. The way down as I was trying to keep my stomach in I was envisioning a cold, dark home where we would be curdled around the fire and would try to make the bed work (much like our apartment at home) but what we walked into was pure luxury. A warm fire, hot water, beautiful warm beds and delcious food. The Soednam Zingkha Heritage with its handprinted walls in this forth generation home they clearly took amazing care of was pure luxury and a wonderful end to our day. Lily the next morning enjoying her tea after a warm shower the the handprinted walls behind her.

Isabelle in the mean time found a friend.

The girls were so happy, warm, feed, time to knit. The little beautiful details of this quiet valley and home were a welcome treat.

I think if she had her way, she would have liked to be picked up in a week and just sit in the sun and knit.

The fifth king stayed here about three years ago. He is known as the king of the people and traveled all around the country. This was his room, now locked and decorated. Again, the hand painted walls everywhere were wonderful.

On our way into breakfast, all of the beautiful additions at this home.

As we waited for the girls to go for a hike, this pack came down the road, full of goods.

The simplicity of Haa was a welcome change and stunningly beautiful mountains.

We explored the valley. Both India and Bhutan have military bases in the valley and this is basically where the road ends. Two passes over by foot and you are in Tibet. The tension between China and India and this little mountain country between the two is palpable. On our way home we walked though another 108 white prayer flags left to remember someone who has gone before. These flags have begun to feel like home, always present, always a reminder of the close dance between life and death.

On our way up.

On final stop on the way out of town - another beautiful monastery, full of dragons, prayer wheels and inside the fattest cat I have ever seen.

Sun touching the prayer wheels.

The whole monastery was in amazing shape and one of my favorite. Calm, beautiful, no one else really around tucked in the mountains it was peaceful and beautiful.

On our way home we got to see a lot more of traditional life in Bhutan. Indian workers making the road, wood being collected or hay for the cows. This women said we could take her picture but kept laughing and we told her she was so strong, she broke out into a huge smile. She seems the fitting end to a great weekend, one we wish we had more time to enjoy.

Going to Work

Bhutan had always been high on my list as a place to go, but honestly, I had been hesitant about doing any medical work this year and to be here as a US citizen, you need to either be volunteering or pay the large tourist fee. I was hesitant to work becuase as it is easy for me to say yes to work and this year was a chance to say no, so filling up the year with work felt counterproductive to accomplishing the goals we set forward as a family. The second reason was my hesitancy of international health projects in general. While working internationally before I saw both amazing, sustainable projects that were changing lives, and others that only served the egos of those who “volunteered” and may have done more harm than good. I was hesitant to make the wrong choice for the wrong reasons.

The opportunity in Bhutan seemed like the perfect balance, it was short and would allow my family to see a place we wanted to go and the project looked sustainable and well run. I wouldn’t be coming into “change” anything or “bring my skills” as much as I was as a member of well-coordinated fire line, doing my lifting and handing it off to the next volunteer while the Bhutanese created a health care system that would be best for them.

What I didn't count on was how much our family would embrace this time. How after six months we have had space and time to be together and being in one place for this time, and with me having work, it gave us all space to pursue our individual passions and interests. My dad always quoted his Minnesota relatives by staying “once you stop plowing the fields, you might as well be in the dirt,” and the meaning and purpose in my work hit me like a blast of fresh air.

I am still trying to unravel all the feelings and thoughts about my time in Bhutan. It is mixed with life, death, large personal career choices, friendship, and relationships. The people I meet, the stories I heard, the things I experienced were like a concentrated drink - meant to be diluted in a gallon of water but given to me at once. I can already feel life pulling the pieces apart, shedding light on the experience changing the colors and taste. Part of me wants to hold on to the whole things as tightly as I can, never leave, never let go, but the river flows and so must I, and thus I am left reflecting on what this all means.

This is the front of the new hospital, directly behind this sign is the emergency department - you can see the ambulances in the background. The adorable little guy on this sign is the 6th King (K6 for those of you in the know). On either side of him are K4 and K5. The fact Bhutan provides free, universal health care to its people is a significant source of pride for the country, and in general I was struck by the gratitude people had for the health care. My patients did not have any expectations for perfection, endless patients and gratitude for their Bhutanese doctors and for volunteers willing to come to spend time.

I was asked a few times near the time I was leaving what I thought of the care in Bhutan - if I would trust the ED for my family and friends. It is an interesting question and made me reflect on what is the same and what is different and what we all want in our health care.

In the end, people are people, they don’t want to be sick or die in any culture or community. People don’t understand how healthcare works anywhere in the world, and often we distrust what we don’t understand. We have never understood medicine and probably never fully will, just before it was one doctor or healer telling you what they knew. As humans, we are programmed to rely on relationships so we could trust this relationship for our health. But now our health care is made up for systems of care, systems that try to bring forth data and expertise to the problem at hand and systems are inherently flawed and harder as humans to trust. This is true in any community and your ability to trust the system, and therefore the care of your health depends on if you have a navigator of that system you trust, be it a primary care doctor, nurse, family member, friend or specialist who has gone the extra mile.

The system of care in Bhutan’s emergency department has a lot less fancy toys and less clean protocols than in the US. But in that space of less, the art of healing is no less. There are a lot more smiles, less blame for deviation and more conversations about care and what patients want. In a world of little to no malpractice less harmful and costly modalities like ultrasound have been allowed to grow and flourish in a way I could only dream of in the US. Appendicitis rarely got a CT, trauma cases that are stable, even with a positive FAST are allowed to heal without the CT as they likely will not need intervention anyway. We titrated peripheral pressors for a few days with a bedside look at the IVC without a central line. We femoral blocked hip fractures and let them get back in the car with family if they chose to drive back to India to have the surgery closer to home instead of opioids and an ambulance ride. The arrow in the aorta, the NSTEMI, metastatic cancer all got on a commercial flight to India instead of a $100,000 air medical transport who's risks again struck too close to home when we lost a crew back in Alaska just a few days ago.

But just like from the patients perspective of care being so reliant on the relationship, the care delivered in Bhutan comes from an intensely caring group of doctors and nurses.

The care is remarkable because of the nurse who calmly, on her own, bagged a patient that just arrived intubated as she troubleshoots the suction that is not working, the monitor who’s battery died and the donated vent machine which is different from the other three in the room without ever looking flustered or frustrated. Nurses who balance not only the needs of the usual demands of doctors in their department, or other departments and of the patients, but also the first responder students and a never-ending string of volunteer doctors like me who write medications the wrong way, never know the antibiotics at hand and need to be explained that “giddiness” means “dizziness.”

The care is remarkable because doctors who come in after a night shift or on their day off to hear a lecture and learn something new. Doctors who work with half staff to give each other breaks when their staffing is cut or let their female colleges go home one hour early to keep breastfeeding. Doctors who will come in and help on busy shift out of the kindness of their heart, and maybe the bribe of a beer or a dinner. Doctors who make a life-saving diagnosis by hearing an S3 gallop in triage or can diagnose and treat without labs or imaging available for hours.

So would I trust my loved ones with the care in this developing country? Absolutely. They had the necessary tools like gloves and clean needles and what they lacked they more than made up for in skill, dedication, and compassion.

K5 is known as the King of the People and the care I witness in the ED was really truly the care of the people and an honor to be a part of.

There is a gift in caring for those in need. A desire to see what is truly wrong and try to make it better and clarity that comes in stepping back in time. This old ECG machine reminded me of just that. These perfectly balanced little suction electrodes trying so carefully listen to the heart of the patient and translate that into something meaningful in the form of lines on a paper. It seemed a perfect metaphor for my time in Bhutan.

The pathology, oh the crazy pathology. They really don’t have HIPPA so I could probably actually share a lot, but a few of the cases and images are being written up for publication, and I don’t want to spoil the show. This one was in the papers, so I figured it was public - I love how they even have the patients face to help identify him.

It seemed like every week there was a different case that was good enough for the NEJM clinical images section. This guy got shot right through the arch of his aorta into his spine, after landing at multiple wrong “archery fires” to try and find him, the helicopter found him and brought him to us. He was amazingly stable, but the type of surgery he would need was only done in India, so a commercial air flight was arranged the following day- with him in the back. One of our doctors found this “follow” up in the Indian paper, and we were all relieved to see he was doing well.

There were so many like this, the women in VT who’s bedside echo showed a hydatid cyst the size of a grapefruit in her septum. The three-hour code of aconite (monkshood) poisoning. The rheumatic fever, the TB, the autoimmune diseases. The stokes were often hemorrhagic, and extensive and would wait in the ED for 2-3 days until a medicine bed was available. Sats in the 80’s were good, sats in the 40’s were sometimes the best you had before intubating. I was saved by the buggie for the first time in my career and now really know how good the tracheal rings can feel.

But when I think of all of my patients, there is one that comes to mind. This amazingly sweet 82-year-old woman in with pneumonia and hypoxia. She ended up staying 4 days in the ED waiting for a bed, and on the first day, she smiled this huge broken tooth grin. She, like all the patents in the department, was never in gowns (we don’t have them) so she sat in her traditional clothing, necklaces, and beads for the four days she was with us. Later that day I want to check on her, and she grabbed my white coat and just started talking. She smiled and nodded and kept talking, without me understanding a word. But I smiled back and bowed and held her hand until she was done and she gave me one more squeeze and off I went to the other patients. This same thing continued to happen for the next 4 days, always telling me some elaborate something, me never knowing what she was really saying and she was steadily improving. The team started to tease me about my favorite patent, and they were right, she made my day. On my last day before she went upstairs, she did something different, she kept holding her belly. I was worried. What had we missed? I pressed, and she was soft, did not seem tender, I could feel her aorta as she was very thin, but she looked good. So I did what we always do in the ED and don’t understand - got more data. I went and got the ultrasounds machine and looked all over - what was bothering her? I could find nothing wrong. Her liver, spleen, heart, gallbladder, aorta all seemed fine. I finally asked one of the students to help translate for me, what was I missing? Turns out that she was saying I am like one of her children to her (which would result in her holding her abdomen and smiling) and thanking me for listening. I laughed and thanked her for sharing her care and stories with me. She reminded me of how much more healing we sometimes do with holding a hand or sharing a smile. I then mentioned she was a little dry and keep drinking lots of water and she asked “so more alcohol, more tobacco, and more Doma?” I smiled and said, no just water and maybe tea and was glad I this time I had the translator and wondered what else I had nodded yes to before.

Every day I would walk out of the ED and past this sign. Turns out, the psychiatric ward was mainly an alcohol detox area where we could usually get patients a bed, but the proximity between the ED and this outpatient center was well planned. It was a good reminder to me of how every safety net will involve the vises of our society and that mental health, that like physical health can fail us all at some point in our lives.

I was asked to sit in on this ED redesign meeting. They are expanding the emergency department. This is the architecture and head of the department discussing issues such as emergency OR suits, the role of triage, ways to address boarding and flow issues. Many of the same challenges as when we looked at redoing ours emergency department. Some were different. TB patient needing UV light and fresh air, changes to VIP care, and unsure how far out we can build because they are still looking for the original building designs.

This was looking towards the emergency department every day. Ambulances ready to go, family and workers enjoying the sun.

I took this picture the last day we were in Thimphu. Fairly early on I began to realize that Bhutan and Alaska have a lot in common. Both have about 700,000 people, one major referral area and great challenging transports for patients. Both places have learned they have to learn from others, but ultimately figure out how to care for their unique patient populations.

There is no stable EMS system - EMR as they call it (Emergency Medical Responders). Just over a year ago BEAR was established, a helicopter service connecting the country in ways it had never been connected medically before through the passion and sheer willpower of a US doctor who spent over a year here. He is a "larger than life" character whose stories deserve a book of their own, one I hopes he writes soon.

But you can’t have a helicopter service and hospital without having medical ground transportation as well. This was recognized and EMR training class is well underway, but there were no protocols to go off of, no scope of practice. What would they carry on the ambulances? What should be taught? What was sustainable? How do you help without harming? How to do you make it culturally appropriate and functional?

These questions were being talked about by the Bhutanese nurses and doctors but also by the ICU doctor from Hawaii and the Melanie and Shankar, two US trained doctors now in Bhutan for 2 years working in the emergency department.

As the challenges in Bhutan came up, the more and more it seemed like the Alaska EMS protocols might fit this community better than more urban ones. I emailed the EMS director back at home who kindly shared the work of the Mat-Su Brough EMS with us, and so began my odyssey to create a draft set of protocols and procedures for Bhutan’s new EMR program.

This work was challenging, fun, and took way more time than I realized. How do you do ALCS if you can’t see the rhythm strip as you might only have an AED on board? How do you draft protocols that help and minimize the risk of hurting? How do you take this lifetime of learning and knowledge that still does not answer all of the questions and put them on a piece of paper for a protocol? As I frantically ran to print off 3 final drafts to leave in the department before we left town, it was gratifying to leave a tangible piece of me here, with a hope and a prayer that it is a seed from which the EMR system, and therefore more united emergency health care system can gown in Bhutan.

The education is a big part of the job of the doctors rotating through the emergency department. We also taught them what Jeopardy is - which I think was about as exciting as anything else. Much like practicing medicine in Alaksa, it was a fun challenge to take what you have learned or know and figure out how you would do the same things without the same resources.

The final day in the emergency department I had the best meal I have had in Bhutan. One of the nurses organized the party and everyone chipped in for a whole feast (note the large bottle of hot sauce). Homemade momos, chilies, lentils - I could have kept eating all day. I found a favorite part of every day in the department was lunch. The staff makes a great effort in breaking with each other, so everyone, nurses, doctors, techs all take the time to sit and eat together. There were two “shifts” so half of the department would eat for 15-20 min and then the other half would. You sometimes got called out for a code, or some other emergency, but really the in 45 minutes everyone had eaten and the sanity and comradely it brought to the ED was tangible. I never break to eat at home, just putting food in my mouth between reviewing charts and never with the rest of the staff, we think it will impact the flow of the department too much. But my experience here has made me question all of that, the chance to pause, to care for ourselves made me feel like I had so much more for others. I loved hearing the nurses stories about home, tips for cooking, mutual challenges and joys over raising kids, good days and bad days at work. Every day the department would make a huge thing of rice, and sweet milk tea and everyone would bring a dish to share. By doing this, every day everyone got to share a bit from everyone else. If you forgot food, no worries, the team would feed you and when you walked out that door, back to the crazy of work full of death, sickness and life, you knew you were surrounded by a team that was feed and who would have your back.

Sitting there amongst friends at this final farewell was bittersweet. It was a touching goodbye, but I felt as though I had gained so much more from them than I had given, it felt as though I should be the one making the lunch, but I also knew if I had, it wouldn’t have tasted so good.

When I think on back on what I want to take from this experience, I think of this mandala. The blue medicine Buddha in the middle - calm with a hand in the position of the future and holding the medicine of the present. It reminds me of my wise attending who in the middle of chaos would say, “Anne do what is right for the patient and remember the rest is noise.” This Buddha is focused on the patient, on healing, surrounded by the beauty and chaos and noise of sickness, emotion, systems of care and all that we bring to illness and health. I also love the clear space around the head, like a protective shield to think with clarity when it is needed most.

May I always strive for the clarity and compassion I have seen and experienced this past 6 weeks.

May I continue to learn from layers of our past and from those who understand and experience the world differently than I do.

May I continue to accept death as a part of life, but never lose hope in the power the body and mind to heal.

May I always continue to be amazed by the journey of medicine

May I be grateful for and learn from the honor of caring of another life.

May I always strive to give more than I take from my team that stands at my side.

May I find calm and clarity among the noise.

May I always do what is right for my patient.

May I always carry a piece of Bhutan with me.

And Like That She is 14

When we left for this year, I was nervous about what it would be like to take the girls away from school, friends and the things they love. After all, at 13/ 14 you are moving away from your family, spreading your own wings, not pinned to them for a year. Was she going to hate the year? Totally resent us for this? What would it really be like to spend this year away?

And here we are, halfway through and she is 14, and not one of us regrets taking the plunge. Isabelle has amazed us this year. Her easy go lucky approach to challenges, her mellow attitude, her willingness for adventure. She is kind and patient beyond reason, she is both mature and at the same time holds on to the kid inside. For every challenge we have thrown at her she has flown above the challenge. She is the equilibrium that keeps this family sane and at the same time the funny joker that throws us all off.

We have talked between us a bunch about how different it is to travel for a year rather than a year of trips over a longer time. The biggest thing is long enough to really walk away from everything, but as we celebrate this birthday, it reminded me it is also long enough to each celebrates a birthday, and to stop and reflect on how much we each have gained.

Morning breakfast selfie wishing this amazing kiddo a happy 14! Where did the time go?!?

Cinnamon roles have been a traditional birthday breakfast for the girls. Lily did an amazing job helping find the ingredients, making them with few baking supplies and bake them in the toaster oven.

Enjoying the fruits of her labor

Traverse found all of these fun birthday treats. This one was great, you light the top which melts wax and as the flame gets lower the whole lotus burst open, lighting the additional candles. The heat then spins the whole flower while a small battery inside, now connected to the circuit plays happy birthday. Not only did it provide a fun musical birthday, but was a fun science experiment as we took the thing apart trying to figure out how it works and to make it stop playing the music, and spinning.

While the morning was our family, the evening was a fun New Years bash filled with 2 birthdays, more food than we could eat and wonderful friends. It turns out that Krista, a wonderful woman from the US who has been living in Bhutan on and off for the last 10 years with her sweet family, also has a birthday on the same day as Isabelle. In her eternal generosity, they offered to have a birthday party / new years party at their house for all of us and other friends.

Here is the cake again after the we lit the amazing sparkler candles.

Lots of light - candles for Isabelle and Krista.

Doing her best to blow out the trick candles.

This. We could do a whole blog about just this cake. The Erbele girls are amazing cooks / bakers and dear friends to our girls. They made this amazing cake for Isabelle’s birthday. Double layered chocolate (the bottom brownie, the top chocolate cake) with starwberry filling covered in this amazing frosting. They put 14 trees around the outside for her birthday and made our two dogs on the top. They even made Luna in the snow and Nalu in the sun. For me, so much was summarized in this cake about this year. We left so much to go, but what we found is that we truly loved is still with us and our new friends, adventures and perspective only added light and love to those things we treasure the most.

Paro and the Girls

After our Christmas fun, Traverse and the girls stayed in and near Paro for a few days to see the sites while I headed back to work. This way Lily and Traverse could see Tiger’s Nest - or Taktsang Monastery, a must see in the country and they could see more of the history of Paro.

This pony / horse she made into her own unicorn. Seemed fitting to ride a unicorn to a flying tigers nest.

They made it back up the hill to Taktsang.

A beautiful place on the outside, stunning and enchanting on the inside.

The large Paro Dzong.

Classic construction, everywhere around the country.

Exploring the Paro bridge, where Buddha’s bowl is left in the “The Little Buddha”

stairs to hevan.

They will never tire of prayer wheels.

all the details.

another view of the Dzong.

embracing the old and the new.

One of the bucket list items the girls wanted to do this year was to ride a horse, so when the opportunity came to ride part way to Tiger’s nest they got their wish.

Making the way up the hill a whole new way.

The girls loved the horses, braiding the hair every chance they got.

Dad and girl adventure.

Little monasteries along the way.

Oh the little ones.

Winter beauty at the Paro Dzong.

Resting rice patties, crystal clear water, stunning mountains, this is Bhutan for us.

Birds about the Dzong

Such details.

clay and wood to the sky.

Thousands of years of climbing.

Christmas at the Sanctuary

We have been on the road now for 6 months, holidays have come and gone, but somehow Christmas stood out differently from the others. I think it was Lily. She had a count down on her computer, bought a Santa hat with her own money in Malaysia, and had Christmas songs playing for almost a month straight. It was clear the holiday meant a lot to her, but our family and friends would be far away, we would be in a new country and with our small bags, presents were really out of the question. We also wanted an experience. The girls would be volunteering the rest of the time they were in Bhutan, so we decided on an event. We saw an announcement for a Christmas discount at the newly created Bhutan Spirit Sanctuary - a stunningly beautiful all-inclusive resort and decided that would be their Christmas present this year.

Christmas Eve we arrived, greeted grandly to the sanctuary, built like a monastery overlooking a sacred valley outside of Paro. We were introduced to the philosophy of the sanctuary, a place of complete rest and wellbeing. After a splendid lunch, we had our appointments with the traditional medicine doctor (a part of the stay) as the girls were off playing with the local cats and dogs.

That evening, after a massage (again, all a part of your stay) we headed to family-style dinner with travelers from near and far where we were treated to the most delicious and elaborate Christmas dinner I have had to date. Turkey’s from Bangkok mulled wine, homemade egg nog and fully lit Yule Logs made the evening one we will never forget.

We decided it was such a gift to be in these places, we stayed all three days, taking in the peace, quiet and making the most of every moment. Pottery classes, meditation sessions, yoga, and back healing herbal baths filled our days, and the calm and peace were splendid.

The thing I will take home with me, however, is the feeling of Christmas morning. In our bathrobes next to a beautiful small tree, sipping tea and coffee, we opened a few small gifts and talked about the meaning of the season. How they are old enough now to understand the grace of giving without expectation of something in return, and that is the magic of the season. And with hugs and smiles, they both said in their own ways, how this was the favorite Christmas ever and I could not have agreed more. The gift of time as a family has been a priceless gift this year we have all treasured.

The best morning together as a family.

Welcome to Spirit Sanctuary.

We were lucky enough to share the holiday with Robin, another volunteer at the hospital who the girls took in as a member of the family. It was a treat to spend the time with him hear his stories of the Congo, kids and running. His kindness and generosity made the holiday even more special.

Lighting a butter lap as we entered and setting our intentions for our time there.

Every evening we would find these beautiful treats in our room.

After more fried rice than I have ever had, the artful and delicious food was welcomed by all.

Lily made the most of her time.

Yet again, getting help getting my evening Kira on.

Christmas eve in our Bhutanese finest.

The girls learning to play a traditional Bhutannes dart game that is really hard.

Learning the art of pottery at the Sanctuary.

Mom wanted in on the fun too.

Our beautiful little tree that lit up this winter season.

Total luxury.

Local Paro beer.

A little note in our rooms on the final day and good reminder for days to come.

Life as a circle - Bumdrek to Tigers Nest

I have this dream since I was 18. I had dropped out of college and went climbing in Nepal. That trip and the hours I spent writing in my journal helped shape who I am today. It was on those steep slopes in the Himalayas, marveling at the easy laugh and smile of Nepalese people that I dreamed one day I too would have kids, and I would take them high into the Himalayas. I wanted to share the beauty of the frosty sunrises, the sense of awe and peace that comes by being surrounded by fading prayer flags and the warmth that is felt from a cup of sweet milk tea shared among friends and strangers. I wanted the share with them the mysteries and power of these people and these places.

Then life came, medical school, kids, jobs and before I knew it, they were 13 and 10, and that dream still sat in my diary waiting to be filled.

We decided on this year we would not go back to any place we had been before, but the Himalaya and the mountains called to me. Bhutan, a land of mystery and suspense opened its doors, and suddenly that dream had a chance of becoming a reality.

It is winter in Bhutan so the trekking is limited and the one overnight trek we could do would not be open much longer, so I was eager to head to the mountains. Traverse’s back was still recovering from the flights, and Lily wanted to just be in a home for a bit, so Isabelle and I packed every warm piece of clothing we brought, added a pair of wool socks and other hats and headed off for the hills.

Two days and 754 pictures later I left like life had come full circle. Watching and sharing with Isabelle these mountains that captured my heart long ago, it was if those dreams I had sketched out long ago took shape and came to life in technicolor before my eyes. The weekend was magical.

We trekked to a high camp at 12,000 feet and then back down through Tigers’ nest monasteries. Much like my time in Nepal, it was not the destination, but the journey that left me in awe.

After reaching camp, we had the afternoon to climb through another monastery perched on the rock face to the top of a peak over 13,000 feet and a holy place of sky burials. The sky burial site is covered with prayer flags, as is the ridgeline. It was traditionally a place where bodies of those who had died, especially children, were taken so the birds could carry their bodies and the God of Compassion could carry their souls to the afterlife. While today bodies are not brought here, the remains of those who died and prayer flags are still carried to this holy site to speed their transition to the afterlife.

Sitting, fully enveloped by the fading prayer flags in the setting sun looking across Tibet and Bhutan and holding my daughter is a moment I will never forget. My sister and those who have gone with the God of Compassion before me felt as present as the stone I sat on, still warm from the sun in the rapidly cooling air.

Isabelle was a sight to behold. She was enthralled, taking hundreds of pictures, stopping to look at every amazing rock, doing handstands and jumping from one high point to the next. Her love for this place, for the trek, for the adventure was more than I could have hoped for. As any parent knows, watching the wonder of the world through your child’s eyes is even brighter than seeing it yourself.

As we started our way back to camp in the fading last rays of the sun, the great harvest full moon began to rise from the Tibetan plateau and the world transformed into a glistening black and white landscape of dreams.

That evening we ate a huge meal, shared stories and adventures and then braved the cold of our bed at 12,000 feet. As Isabelle and I struggled to get warm under pounds of blankets, holding close, our “mountain babies” (warm water bottles) our laughter could not be contained. I feel asleep that night filled with contentment and a sense of perfection of dream realized, of life completing a circle.

The following day was filled with Tigers Nest monastery, chanting monks, meeting others from Alaska, kids playing with prayer wheels and so much more. I listened, laughed and learned, but the day was like a dream, colors and sounds and stories that overflowed my cup of appreciation. All I could do was taken in as much as I could feeling gratitude for such a full and wondrous life. I knew in my heart these mountains, smiles, and stories, much like when I visited them before will carry and inspire me for years to come. Like the mandalas telling the stories of these people and the circles of life, my journey had come full circle making me whole.

This, all this. The love and the joy of an amazing world shared with those I love.

She enjoyed the ride up ;-). I on the other hand questioned if we would live to get to the start of the trial because of the ice on the road with bald tires around mountain switch backs.

I was truly surprised to see a bear in monastery at the start of our trail.

The beautiful “old man’s beard” growing on giant Rhododendron at 12,000 feet were incredible. I kept imaging what this place would look like in the spring when they were all in bloom. I turned around to find her embracing them moss and the moment.

With our tents for the night in the background, we followed the prayer flags up the mountain to an active monastery in the rocks.

The dance between nature and humans is something I have always loved about so many ancient cultures. Many of these monasteries are built into rock face, this one was built in this spot because reportedly a deity walked and left 10,000 foot prints in the rock.

Taking in the view. It was if the mountains, the air, and the monastery all held us there between earth and sky.

Making our way up from the monastery to the sky burial we were loving the sun, the view and the prayers left to be silently heard. Seeing this through her eyes (and hands) made the whole place brighter.

It was as if this world and the next were tied together by these prayer flags- sending hopes and dreams to the sky with each passing gust of wind.

This is in the center of a ring of prayer flags at the sky burial atop the highest mountain around. Each passing moment the light hit the flags differently as the world turned, the sun set and the full moon rose. The place was alive with wonder.

The sun slowly dipping behind the peaks lighting everything with a warm fiery red glow.

Looking towards Tibet and marveling at how they got these larger prayer flags up here and keep them up through the changing seasons.

She was all smiles.

And I kept taking pictures as a way to hold onto this moment forever.

As the sun dipped below the mountains, I said goodby again to my sister Mary and to all those who left the world too soon.

And as I said goodbye to one life, I embraced the life before me sending love to those not with us.

The moon is always hard to capture on a phone camera, but this one was so big she was able to embrace it like the sun.

Headed down in the rapidly fading light surrounded by stones, set on end to remember the dead.

This child has found her wings and I love watching her fly.

“Mom, we have to stop and get another picture, the rock is amazing, this place is amazing” We later learned it was holy rock, in the shape of a lotus and a place of special worship on the mountain side.

Looking towards Tibet at the rising moon.

Full of life. Full of wonder.

And I kept taking pictures.

And more pictures.

Even when the sun was down, and it was all blurry, there was magic…

And wonder…

And the fading light reminded me of what is really important in this world.

As we came into camp, the sun was long gone and the full moon yet again transformed this landscape.

Goodnight moon. Goodnight stars. Goodnight tent. Goodnight bed. Goodnight world. Thankful for today.

When morning came, we woke up before dawn and watched the sunrise. (I will post the video next) and came back to camp for an outside breakfast to take in the day.

Children like prayer flags, take your hopes and dreams into the future.

Visiting every monastery on our way.

Head in to another holy site. The attention to detail on these doors and entrances is lovely.

And more smiles.

As we descended down down we started to see Tiger’s Nest Monastery, the most famous monastery in Bhutan peached on this rock cliff.

High above - taking it all in.

As we came down into the Tiger’s Nest monastery, we started to come across all the people who had come from the bottom. This is probably the most visited site in all of Bhutan, and even during this “off season” there were an impressive number of people.

If I were to build a holy place it would be like this. Breathtakingly peached in this rock ledge - balanced with the world.

No pictures were aloud inside - which is probably good or this blog post would never get done. It is actually 8 different and stunning temples inside. We spent about 2 hrs touring the inside and I could have spent a week. One of highlights for me however was the “tigress nest” on the inside. You climb down a series of ladders into a crack in the rock from one of the temples. It is there that the tigress reportedly slept and you can go out on a ledge where she would take off - the world a thousand feet below the cliff face. Probably 75% of the people in the temple where Bhutanese paying respect. Kids clambered though the temples, people prostrated them selfs in front of deities, monks mediated as small groups of tours were told the intricate stories of how the second coming of Buddha flew here on a Tigress and meditated for 3 years, 3 months and 3 days.

More prayer wheels and flags on the way down. These prayer wheels, filled with flags are made out of plastic painted bottles.

At the end of the trail with the main monastery on the upper right in the cliff and the other smaller one on the left.

A journey I will never forget as dreams came to life and prayers answered.

A snow day for a birthday

Day 2, hospital paperwork, visas, kids projects, or maybe not…..  We woke up on the second day in Bhutan to snow, thick, white, beautiful snow.  Despite being at 7,800 feet this city rarely gets snow, and this was the first time in two years and it turns out that the first snowfall of the year is a national holiday.  What a beautiful tradition! It also happened to be my birthday.

I had been saying how it did not feel like my birthday because it was not cold, and there was no snow, so when the girls saw what was happening outside they jumped into our bed, full of excitement that I got my “birthday wish” and how fun it was.   As we really have no paper and can take very little with us, we curled in bed, each of them sending me their beautiful electronic cards and gave me the gift of a new pair of earring. We headed to the local cafe for breakfast and coffee.

The walk into town was an adventure.  Everyone was taking selfies and snowmen were appearing all across town.  We got to heart of Thimphu where a sole traffic cop normally is stationed directing traffic, but this day it stood deserted.  At first we were not sure what was going on, as 6 or 7 police were stopping taxis and collecting snow, then bam, a huge snowball hit me on the side of the leg.   Next thing we knew we were being pelted by snowballs. Turns out when it snows in Bhutan, everyone is fair game to be pelted. As we did errands throughout the day we got better at spotting who had the snowballs, how to hide and the umbrella came in useful as a defense weapon.  Everyone was grinning from ear to ear and the place was a sloppy, wet mess of fun.

Another snow tradition we learned about was people try to hide snowballs inside each others houses filled with a food.  If you find the snowball before it melts, the person who left it has to make that item for you and if it melts before you find it, you have to make that item for the other person.  So say you put some rice in a snowball, you then go and hide the snowball in someone else house, if they find the snowball before it melts, you have to make them rice.

That evening we had a lovely Indian dinner with two other volunteers who are in Bhutan, another ED doctor and an infectious disease doc.  It was a perfect birthday, full of family, friends, warmth, laughter, adventure and SNOW.

The following day we had planned to have the girls make cookies with three other girls of an expat American family who has been living here for 5 years, but the sun came out, the peaks were perfectly dusted with snow and so we headed to the Buddha on the hill and walked back to the house.  The Buddha outside Thimphu is an impressive site. Gold, striking, holding a lotus flower and impossibly large it looms above the valley like a guardian of the city. The inside temple is equally impressive filled with 108 smaller buddhas and gold everywhere you look (sorry no pictures allowed inside).   As the morning fog burned off the Buddha came and went until it stood cloud free, snow crusting the blue hair and painting its shoulders.

On the way back the girls made friends and by the time we were back they were all excited to make cookies.  Minutes stretched into hours which turned into a sleep over. The girls were beyond excited to have friends their age, bake in a real oven and paint on real paper.   Thankfully their new friends live close so we can plan more adventures.

Slowly we are getting settled in to our new routine.  I am getting the final paperwork finished at the hospital and have started to see and learn about the health system and pathology.  We have been here 5 days and the girls have jobs, friends, and our place is feeling like home. The community here in Thimphu has welcomed us with open arms but it is the smiling Bhutanese, dressed from head to toe in the most beautiful tapestries, eager to help and quick to laugh that is making Bhutan feel truly magical.

Bhutan National Day

We left for Bhutan in the early morning.  In the Singapore airport we went from security to security until the group of travelers became smaller and dressed in warmer and warmer clothes.  At last we loaded onto Druk Airlines - the official airline of Bhutan and the only airline I know if that that does not regularly use credit card but prefers money transfer.   After a brief stop in India, we landed in Paro Bhutan. The pilot warned us on the way in we would be close to the mountain sides but I was not expecting to see the details of a sheep grazing outside the 757 window with Everest towering in the distance.  Stepping off the plane felt like stepping into another world - cool, crisp, bright and beautiful with the sent of fires and spice hanging in the air.

We made our way through the airport and were greeted by the staff from the hospital, helping us into the jeep. For the next hour we snaked up the mountain side from Paro to the airport less capital Thimphu where we would be living for the next six weeks.  The drive brought back so many memories of Nepal for me and the love I have of the mountains and the people around the world who call them home.   We stopped and gazed at prayer flags and drank spring water from Tibet and the marveled at the beauty of the countryside. It was warm, lovely and pure bliss.

Our apartment was set up by the hospital and different volunteer doctors stay there.  Thimphu tends to be warm except November - January, so the solid concrete buildings have no central heating.  The apartment was dark, cold, and when the staff left we all looked at each other with no idea where we were in town, no internet or cell connection and scrambling to put on more layers.  It was a good reminder to me of how we have become so used to our phones and connectivity that even a brief break that was not planned can feel very disconcerting.

As we were reading through the paper manuals and seeing if we had saved anything to our phone we heard a knock at the door and smiling face of another volunteer - Robin welcomed us to Bhutan and asked if he could help.   Robin took us under his wing, and showed us all around. Within hours we had gone from needing survival basics like heat, to having money, groceries, phone cards for internet, the national dress and new friends.

The next day was the 111th National Day in Bhutan and we had been invited to the celebration.  It was smaller than previous years as the king was out visiting another part of the country, but we dressed in our Bhutanese best and headed down for a day of festivities.  On our way down both Traverse and I were “re-dressed” by incredibly kind locals. Traverse was stopped by a gentleman who looked at his robe and said “no all wrong” and started to undress his robe and re-tie the whole thing.   I had taken off my top to put another layer on and as I was trying to re-tie the Kira (skirt) 3 women came over and all together redressed me.

National day was about 4 hours of speeches, singing, performances, food, wine and was the perfect start to our stay in Bhutan. It ended with a big “conga line” style dance that was a mixture of laughter, left feet as we joined the fun.

Some how this is the first time this year I have really felt like we have traveled and left home, but by the end of our first 24 hours we were struck by the kindness, easy smile and beauty of Bhutan.

Tasting holy water from Tibet.

Prayer wheels hours after we landed as we get our bearings around town.

Bursting Bubbles in Penang Malaysia

One of the more interesting conversations I have loved having with the girls this year is this clash between what our expectations of the year was and what we have been experiencing.  Would it be hard, easy to get along all together, how different would the world feel. They are flexible and hard working, but we really have never taken then away from their comfortable environment for this long.  How would they deal with the heat? Time away from friends? Different foods and languages?

We all have different answers to these questions and it depends on the day and the mood for sure.  For me, I have been floored. They have been more flexible, loving and funny than I had expected. They have looked for ways to challenge themselves and at the end of Croatia they were both saying they were ready for something different, something new, something to “burst their bubble”

A few short weeks later in a street stall sweeting in Penang Malaysia eating chicken feet for breakfast, they looked at us and said “ok this is bursting my bubble”.

Penang is an island off the coast of Malaysia.  It has become a travelers destination, hosts a large community of pension retirees and a booming medical tourism industry.    It is cheaper than Singapore, better healthcare than Indonesia and benefits from the small history of shipping and cultural mingling with a vibrant blend of Indian, Chinese and Malay all mixed together.   Street food is ridiculously cheap, a huge lunch for all four of us was $4.30. Dinner at a nice restaurant ran us $20, the same price as a 90 min massage. It is hot, noisy, colorful and delicious. The people of Malaysia smile all the time and have been incredibly kind.   Huge Mosques sit next to Hindu temples and the blending sounds and incense leave us feeling like the US has nothing on Multiculturalism compared to here.

Everywhere you turn there is street art, some of it famous, but always gorgeous, surprising and wonderful.  Old buildings fill George Town and tell of its colonial history. Walking became an obstacle course of colors, sounds, motor bikes, bikes, grates, water ways, trash bins, sleeping people, food stalls and all other forms of humanity.  It is like the messy intense little sister of Singapore. Running was attempted twice but after aggressive iguanas, getting lost among trash dumps and temples, surprise cattle, two skinned knees and numerous near collisions with motor bikes, I opted for yoga and walking.

Short and intense, our time in Malaysia has been a warm, wonderful introduction to a form of traveling and living the girls have never seen.  They have embraced the change, eating anything and everything and making the most beautiful and wonderful observations I might not have noticed.  As we were sitting in a small Indian restaurant in little india, clearly the odd people out with everyone staring at us eating off of banana leaf plates, little one said “India reminds me of ravens, black as night and in love with shiny things.”  Traveling with them is like traveling with a new set of eyes, and it is wonderful.

Temples of Penang.

mmm chicken feet

Hindu Shrine

learning to expect the unexpected

Local spa where we enjoyed inexpensive massages.

Getting our first rabies shots in preparation for Bhutan

Our local corner. These metal signs are all around Penang and a fun way to share the cultural history.

Getting Ready for the King

Tomorrow we fly to Bhutan.

I am having a hard time believing I get to write these words. Bhutan has been a place on my mind since I first traveled to Nepal just after high school in 1997 and was a part of my focus of my Watson Fellowship when I was looking at the ‘impacts of tourism on culture and environment.” in 2000. As a Fellow in Nepal, Tibet, Antartica and Botswana my interest in Bhutan grew and now, many moons later we are about to take off.

I will be working while I am in Bhutan for HVO at the hospital. They have been amazing in helping with the logistics and yesterday sent us an invite to the National Day with The King. It looks like we will need to land, put our bags down and head over to buy the national dress for each of us. The girls and I will need a “ready-made half Kira (the skirt) and 'Tay-go’ - the jacket/blouse combination.” And Traverse will need “a Gho (and the white sleeves and collar that come with it) and black knee socks.” This plus a Zhechha Zherey, a traditional Bhutanese (usually wooden) bowl - you know, for snacks.

Our time in Bhutan is a place of two birthdays, the new year, Christmas and half way point of this adventure. It is also the only time I am working clinically, and the longest we will be in one house. It is a place we have more connections than anywhere else because of HVO, but have the hardest time researching online because of the limited tourism.

Here is to a new adventures, having life come full circle and what feels like a meaning transition point in our year. We are off to see the King.