Okay, Uncle.  I'm going to take your case. For real this time. I think I am the best you have. And while I'm sorry for you that I am not a better person and a better healer, I'll do it. G.K. Chesterton said, "If a thing is worth doing, it is worth doing badly." I think that I might understand what that means. You're worth the risk of doing it badly.

I've brought you paper and pencils and even some charcoal today. I know you want to draw and paint and sculpt. I know you want to be the young man that you once were and I know that's impossible. I think that I will feel the same way when I come to the end of my life. But, I have hope that you can be the man that you are today, for however long that lasts. And I wish that when I reach the point where you are, somebody is willing to witness for me, to sit with me, to love me unconditionally and to make it a little less scary.

"Do you have something for my cough?"

You ask me this every time I visit and every time I tell you, I have something for your sleep. It will help a bit with the cough too, but it's not made for the cough.

I've answered this way from the beginning, from the point at which I took your case on. I've answered this way because you refused to go back to the hospital when we asked you to. But, in the beginning, I didn't know that the hospital told you there was nothing else they could do. In the beginning, I didn't know what the hospitals were like here. All I knew is that I couldn't be responsible for your case: Late stage emphysema, respiratory failure and an inability to breathe without an oxygen tank. I thought that there was a great answer out there for you. I thought you had access to better technology, like the kind of technology my family back home can access. I thought there would be somebody better for you than me. I couldn't offer you the wisp of smoke that is me when there was some solid, tangible foundation that I was imagining being available to you.

I am not good enough.

There's that thought again. It haunts me and in the last couple of weeks, it has hurt us both. I hear you saying it too: We both believe that about ourselves. How did that happen to us? I know it's not true about you so there is a good chance it's not true about me either.

What are we doing together, Uncle? Am I a healer? A doctor? Because right now, I don't know what that means. I sit with you on your bed. I hold your hand when you let me. I listen to your stories. Sometimes I give you acupuncture, sometimes codeine, but nothing I do lets you get off the tank and walk outside. Nothing I do will reverse the emphysema that is killing you. I can't get you out on your land, where you can watch your beautiful wife watering the bright green saag in the sunshine.

I said I couldn't help you because I've been trying to communicate to you that I couldn't take your case. I said that all I can do is monitor your vital signs because I haven't wanted the responsibility of your death. I haven't wanted to risk that responsibility for anyone on my team. This is what we decided that first night when we came to your emergency call. We decided that we did not have the resources to help you fight such an advanced disease. It's true. I have nothing in my toolbox to cure emphysema. So I've been clear with you about that from the beginning, even when it took so long for me to explain your disease to you because nobody ever did.

Today, I brought another practitioner with me. She was seeing you for the second time and she had her boundaries straight. When you asked for cough medicine, she told the interpreter, "Make sure he understands that we do not have medicine for his cough. We never will. He needs to understand that we will not ever be giving him a medicine for his cough."

Well, Uncle, that was just enough of a mirror to help me understand that something here just isn't quite right. So, I decided to go pray for some answers. I walked out to the cliff by the soccer field and found a temple. I rang the bell and walked around it clockwise. I rang it again and walked the circle again. I did this eight times, asking for help, ringing it louder and louder. Did anybody hear me?

I sat on the edge of the cliff, waiting for an answer. The mountains were covered in mist and I saw that any answer I was getting was just about as clear. A fog of confusion came over me, I started writing in my journal: Why can't we give him medicine for his cough? Am I a Western practitioner or a Chinese medicine physician?

Well Uncle, I've been confused here for a while. I've been checking blood pressures and looking for tuberculosis and trying to make sure that really sick people can get help if they need it. And because this is a bit different than I'm used to, I've been forgetting about the kind of doctor that I am. I've forgotten that I practice natural medicine and that I honor the body as an inherent part of this constantly changing ecosystem. I've said that here, in Nepal, I have to use medicine that works. What does "works" mean? What works for you, Uncle?

What is death, Uncle? How do we know when it's happening? At what point do we stop providing care? What is hope? Does hope have to disappear so that we can die? What do I do for you now? Am I an observer? Am I good enough to be with you right now? Do I have the courage to look into your eyes? Do I have the courage to stand up and take your case when no one else has done it or will do it?

I turned to go back home with nothing but questions in my book. No answer from a god or goddess. No answer from the earth or the mountains. Just a verification of my aloneness, of my lack of help. On the path, a woman held a carrot up while a dog jumped at it. He jumped and jumped and every time she raised the carrot above his reach. She had no intention of giving it to him but I could see that he trusted that she would. He even believed that he might like that carrot, perhaps imagining it to be a piece of meat. There's your answer, I heard in my brain.

I sat down on a pile of rocks. I feel so much pain and I don't know whose pain it is. Yours? Mine? The dogs? What do I do? I know I have everything I need for the answers. I am the one who gets in my own way.

Yesterday, our director told us, "I can't make you care. You either care or you don't. You can be the kind of practitioner that just pops in needles and charges for it as long as the patient will come back. You'll make money that way. Or, you can be the kind of practitioner who says, 'When you're under my care, I DO CARE. I care about you and I'm going to manage your case."

Well, Uncle, I do care about you. I really do. And I don't want to be holding carrots for you to jump at. I've got herbs at the clinic that I can give you for your cough. They won't make it go away and they won't cure your emphysema. But, when I give them to you, I think you will know that I care.

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