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Each night after the surgery team finished, the cook, fourteen-year-old Madhab, served a feast of dal bhat and vegetable dishes. Jay and I took our shoes off and entered one of the rooms in the clinic. The seven Nepalis and a few local workers sat on blankets on the floor. Madhab offered Jay and me the only two chairs in the room. Then he offered us a heaping plate of food, cooked from fresh ingredients. There were not enough spoons to go around, but Jay and I each received one. Jay always finished a heaping plateful. I gobbled down more than I had wanted, too. Madhab was liberal with the turmeric, an assertive, burnt-orange Eastern spice that is a cousin to the ginger root. After a week of the twice-a-day dal bhat meal, I was sure that the rice was better here.

One night I noticed that Anita, the nurse, did not take a plate right away. I asked her why, and she explained that she fasted every Thursday in honor of Lord Shiva, one of the major Hindu gods. She would eat in just a few more minutes, when it was completely dark outside, she assured me. I marveled at her dedication to her values and to her religion under such stressful, tiring conditions.

Jay and I left right after dinner, following Nepali custom. After a while, we heard the medical team happily singing local folk songs, accompanied by a makeshift pot and pan percussion section.

One afternoon, I watched Madhab cook up some of the dishes. Everywhere I turned, the Nepalis accomplished so much with so few resources. Madhab was a master at managing with one kerosene stove, a few pots, and a little bit of water, which normally had to be hauled in buckets from an outside well to this room. Everything was done on the floor, which was kept spotless. We had fun comparing Nepali and English names for spices with only a handful of common words between us. I carefully watched his unmeasured portions and took notes in hopes of replicating the dishes at home.

On the fifth day of camp, it rained steadily and cooled things down. The patients bundled up in their coats and blankets. Jay wore a down jacket under his scrubs to keep himself warm in the OT. On the sixth day, the road washed out. No busses or any other traffic passed through the town. We couldn’t have left Sandikharka that day if we had wanted to. That morning, it continued to rain. Stuck in my little room, I watched the walls weep with moisture. There was no escaping the wet, piercing cold. I felt the damp cold through my three layers of clothes, down to my skin.

When I returned to the surgery line, I found eight-year-old Putala, barefoot and shivering on the cold concrete floor. Goosebumps covered the part of her arms that her sweater didn’t cover. She squinted with her left eye and tried to keep it closed to keep the tears from streaming down her face. Three weeks before on the school playground, she was chipping stones while playing, and a sharp fragment flew into her eye. She stopped going to her third grade class because she could no longer read comfortably.

Putala, through Bishnu’s translations, told me she was not afraid of the surgery. Bishnu said she was lying. I told him to tell her that she was brave.

Putala was led inside and asked to lie on a bench. She was still shivering when the assistant put a blanket over her. After a few moments, Putala felt her own warmth trapped under the blanket and stopped shivering.

This year, the Red Cross donated the use of about ten blankets to the camp. In prior years, the patients came into the operating room shivering so hard that Jay was afraid for their discomfort and that the patients’ shaking would adversely affect the surgery result. He even brought his big thick down sleeping bag into the OT to cover the patients while they were having surgery.

“A little luxury never hurt anyone,” he commented.

The smell of kerosene permeated the OT. The burner stayed lit all day to sterilize the instruments between cases. Jay developed a sore throat from the fumes, and many of the patients coughed while they were in surgery. But it was too cold to keep the door open to air out the fumes.

Narayan prepared the local anesthetic for Putala’s eye. While Americans would be put to sleep, the Nepalis, even the children, were awake for the entire operation. He numbed the surface of her eye with drops and waited a few minutes. Then he injected a needle behind her eye. Eight-year-old Putala held her breath, stiffened up, and bore the pain. She did not even whimper during the fiercely painful injection. I winced and looked away, then shook my head in awe as I thought about how a spoiled American child, or even I, would have handled the same situation.

Narayan was really skilled at anesthetizing patients. Jay never experienced any problems with any of the patients’ anesthesia and marveled at Narayan’s record. Of course, in his ten-year career, Narayan has had a chance to exercise his skills about 30,000 times – more than most American anesthesiologists have a chance to perform in a lifetime.

Narayan applied a weight to Putala’s eye to soften it for surgery. She lay on the bench for a few more minutes, then was guided onto the operating table. No time was wasted changing table drapes in between patients. Putala was tense and breathing hard.

Anita, the nurse, said in Nepali to her, “Relax! Why are you breathing like that?” Putala relaxed a little.

Jay fidgeted on the stool. His back was killing him after days of standing in the same pose and working under such precise conditions. He worked on Putala’s eye. It was not the normal cataract operation that he was used to, but he was able to remove the fragment and obtain a successful result. “Ramro cha!” he said to Putala as he finished. She relaxed a little more.

As the anesthetic wore off, the pain set in for Putala. No painkillers were prescribed for the patients. She had a hard night the first night after surgery, but nothing was as painful as that fluid being shot into her eye by the anesthetic needle. In the classic Nepali fashion, Putala was stoic about the pain and admitted to only a little when I talked to her the next morning during rounds. The Nepalis just didn’t seem to let little things like that get in their way of happiness and zeal for living, I reasoned.

The next day, Putala was sitting next to a new friend, fourteen-year-old Harikala, who developed an early cataract and had it removed by Jay. The two were talking girl-talk and laughing as they looked out at the clouds that enveloped the mountains and the hospital itself. Putala had a lot of reading to catch up on at school, she was telling Harikala.

Finally, the last night of camp arrived. Parajuli reported the final tallies to Jay. Parajuli had treated 1,655 patients in the five days of the clinic. Jay had performed 129 surgeries, far more in seven days than some Dallas ophthalmologists do in a year. In Jay’s six years of camp, this year’s number of cases was a record. I had never seen a group of people anywhere in the world that worked as hard and accomplished as much as Jay and the employees of the Lumbini Rana-Ambika Eye Hospital that week in Sandikharka.

Out of all of the cases, I asked Jay if he had a favorite patient over the years.

“Oh yes,” he remembered. “A few years ago, one man, acting as a human ambulance, brought his mother in a basket on his back. The journey took three days for the man and his mother. His mother was deaf, mute, and blind. Neither knew if the operation would help or not. The woman had the surgery, and all of the other patients were rooting for her. The day after surgery, an assistant took off her patch. She could not talk, so we could not communicate with her like we could with the other patients. She just sat there. We were all waiting for a sign of success, a sign that she could see. Then slowly, she started tracing the letters on her hospital chart with her fingers. It was her ingenious way of demonstrating to everyone that she could now see.” His voice was full of awe and pride. “Then the whole room cheered, quite uncharacteristic for the unassuming Nepali people. It was just about enough to bring tears to my eyes.”

The Nepalis’ families in Bhairahawa were getting worried about their relatives who were so far away from home and who had been at camp two days longer than planned. Parajuli had a wife and three daughters in Bhairahawa. He had missed seeing his older daughter, Nawadita, perform in a ballet while he was away. Finally, in the afternoon, the rain cleared up, and it looked like the roads would dry up enough for us to leave on time tomorrow.

On the last night, Jay and I wandered outside to look at the stars. With the clouds gone and so few lights, the Milky Way could be seen clearly. Orion was visible, and Jay pointed out Antares. While we were surveying the sky, I told Jay some of the more poignant stories of the patients I had met. When I finished the personal stories of Dil Ram, Sita, Gangi, and Putala, he said, “Thank you. After all these years, I never knew how much of a personal difference we were making. Maybe we are.”

“Look up,” I said with a smile, realizing Jay had said that phrase hundreds of times this week as he examined patients. “The stars are glittering in the sky. Maybe you’ll see a shooting star. Your patients, the ones who were blind last week, can now see these same stars for the first time in a long time,” I said.

“Yes,” Jay said, a big satisfied grin on his face. “Yes, they can.”