‘When The Dust Settles’ — Two Weeks Photographing A Medical Mission In Nepal

There are travels that add stories to your repertoire, travels that offer glimpses of beauty, and travels that are just fun as hell. Then there are travels that leave you feeling like your heart is beating outside of your chest, like you’ve discovered a brand new piece of the world and have allowed yourself to become wholly and entirely vulnerable to it. These are the trips that change everything and leave you staring out the window on the ride home — dazed, not quite ready to process, and incapable of doing anything other than shaking your head in disbelief.


The dust takes a long time to settle, and when it does you can never quite go back to being the same person you were before. For me, Nepal was this sort of trip. It made me reevaluate everything, it shook me up, it left an indelible imprint on my life.

The Nepal adventure began a month and a half ago, with a phone call from my dad’s cousin.

“Parker! How you doing, man?”

“Really well, Tom. How are—”

“You wanna go to Nepal next week?”

As it turns out, cousin Tom — a Florida-based cardiologist — was teaming up with a group called Cardiostart International for a two-week medical mission abroad. He wanted me to come along to document the trip and pass along photos to the organization.

Naturally, I had a few questions — but there wasn’t much time for minutiae. Tom has never been one to obsess over details (except, I assume, when he’s operating on people’s hearts). It was my Ocean’s 11 moment: “Are you in or are you out?”

“I’m in,” I said.

The flights were booked that day and two weeks later I was sitting next to Tom on a flight to Nepal, attempting to work while he watched three Dwayne Johnson movies in a row. As he finished San Andreas, nine hours into our 18-hour journey, he took off his headphones and watched the credits scroll. “Shit…that was a bad idea.”

I grinned, assuming that he was dissing The Rock, before it dawned on me: We were traveling to the site of a massive earthquake, which had claimed over 9,000 lives just eight months earlier — San Andreas had just supplied graphic visuals for Tom’s imagination.

We arrived in Kathmandu late at night. As our taxi driver wove through the streets, he explained his country’s current situation. The Nepalese people, he told us, are rattled. They had to deal with two back-to-back earthquakes—one in April and another in May—that measured magnitudes above 7.8 on the Richter Scale while simultaneously facing an ongoing fuel shortage.

At that point, the fuel shortage was on its 52nd day. All cooking was done with wood, and heating anything was a chore. Public transport and taxis were a rarity while the few fueled busses were filled so far beyond capacity that dozens would pile up on top of the vehicles.

Looking out the taxi window, I saw lines of busses and trucks sitting at a standstill, their drivers asleep inside. It dawned on me that they were waiting in line, queued up at gas stations that might not even open the next day. When I asked our driver about this he shrugged it off. The wait had recently been as much as a week, the current wait — three days — felt like a breeze.

We rested in Kathmandu for two days before heading an hour south to Dhulikhel, a small-ish town in the mountains with a view of the Himalayas. It would be the base of our operation for the next 14 days. As we rumbled through the mountains, our driver commented on how great it was to have open roads. Without fuel there are no cars, and without cars there is no traffic. He loved that he was free to race along the winding mountain passes. Tom and I forced ourselves to nod in agreement, while gripping the edges of our seat cushions with white knuckles.

When we arrived in Dhulikhel, we were introduced to the team of doctors and nurses working with CardioStart. Tom greeted some as old friends, while others got a handshake and a more formal introduction. It was late for everyone and we decided to call it a night — with hopes of waking up to a clear view of the mountains.

The next morning, we packed up and walked in a clump toward the hospital. The views weren’t quite as brilliant as we’d hoped; the Himalayas stood behind a dense curtain of grey. We discovered that this was partly weather induced, but mostly due to smog and smoke. The fuel shortage was forcing everyone to burn wood, which took a toll on visibility.

Over the next two weeks, I got comfortable in Dhulikhel. The oldest buildings in town had somehow survived the quakes. Hand-carved wood adorned every facade standing strong through the current state of things.

Dhulikhel is a city just off the backpacker’s trail, but it still finds a place on a fair number of tourist itineraries. In the streets, kids would run up to us and ask for chocolate, then bounce along chatting about American hip hop. I tried to push Tribe and Biggie, but they weren’t having it.

Word in Dhulikhel is that the new Big Sean album is all anyone needs to care about.

Although the town was our home, the hospital was the hub of activity. Dhulikhel Hospital is a privately funded, non-profit, non-governmental institution. As someone who knows very little about the Nepalese medical system, I found its size and functionality to be awe-inspiring.

There, our team and the local physicians spent their hours running echocardiograms, diagnosing heart conditions, performing surgeries, and setting recovery plans. After a few days, I became comfortable with terms like tricuspid valve, systolic pressure, tricuspid leaflets, pulmonary valve gradient, end-diastolic pressure, and mitral stenosis. I remained in the dark as to what these words meant, but I quickly learned to differentiate the good news from the bad.

I sat in silence as doctors discussed each patient’s echo scan. Doctors from California, Oklahoma, Florida, Pakistan, Brazil, the U.K., and Nepal all sat together, as if they’d been lifelong co-workers — quickly rattling through the type of consequential and ethical questions that would have stopped me cold for weeks.

“Do they need surgery?”
“Does it make sense to save them?”
“How long will they live if we do?
“How long will they live if we don’t?”

They discussed each patient with both clarity and compassion. Even without knowing shit about medicine, I could tell when a certain patient made a big impact. Like the 10-year-old girl who walked for three days through the mountains to arrive at the hospital, only to learn that she had three cardiac abnormalities. According to the team of doctors, most people couldn’t walk up a flight of stairs with one.

To a room crowded with 12 of his colleagues, Tom uttered, “This is the healthiest person I’ve ever sent to surgery.”

With limited time in-country, the team needed to use each second wisely. Some of the patients were immediately approved for surgery. They’d be scanned on a Wednesday evening and led into the operating theater the next morning. Others were deemed beyond help, like the 52-year-old woman with heart disease who refused to give up cigarettes and liquor.

These are the realities of medical missions like this — she made her choice, and the doctors made theirs. The door opened and another patient was ushered in.

A descendant of the first sherpa to climb Everest was wheeled into the operating room. An American cardiovascular perfusionist—a specialist who uses a heart-lung machine to monitor the patient—said to me, “This is a long way from the ladies back in Oklahoma who get their hair and makeup done before surgery.”

The doctors quickly became a seamless team. They commended one another and shared techniques. Egos were left at the door and patient care was paramount. After surgery, patients were handed off to Nepalese and American nurses who also worked side-by-side, graciously, beautifully, despite language barriers and cultural differences.

Before I could blink, it was all over. I’d watched patients come in off the street and leave a few days later, healthier than they’d been in years.

On the flight back, there were fewer Dwayne Johnson movies and less talking. I sat quietly and wrestled with the experience, trying to wrap my head around it. For a non doctor, being so close to life and death is a shock to the system.

I reflected on the dozens of people I’d met, smiling in the face of heart conditions, earthquakes, and fuel shortages. I thought about good people getting through dismal situations, together. I thought about how all dust eventually settles, how the smoke will clear in time. Then, the mountains are revealed again and an ancient world is made new — the same, but also forever changed.