Enter August: meditation on flying bone chips

I’m finishing up my third and final week at Aeyangwon Orthopedic Hospital.  I’m also entering my final month in Korea.  It’s been a wild ride, I haven’t updated my blog in most of the time I’ve been here but there’s no time like the present. 

      Needless to say much of my time here is too boring to relate.  It consisted of a lot of studying Korean, volunteering at Severance Hospital in Seoul, learning some Salsa and playing with some really good capoeira folks in Seoul. 

      But the past month has been a ripe orchard of food for thought.  In May I met a Japanese Buddhist monk on the streets of Seoul.  He was returning from his day at the Yonsei Language Institute where he was learning Korean. He was walking down the street chanting and beating his uchiwadaiko, a Japanese “fan-drum” that is held in one hand and beat with a stick. 

      I recognized him immediately as a Japanese monk and stopped him for a conversation.  Takimoto-san told me that he was in Kangwondo working on an herb garden at an NGO called the DMZ Peace-Life Valley.  I decided to come visit him if I had the opportunity, and in July I had the pleasure of spending 7 days there. 

      My stay there was largely affected by the torrential rains.  We had about 3 solid days of work and some days of intermittent work.  But it was just as well because I was reminded how hard it is to work on an organic farm.  The work was largely stoop labor, cutting grass with a scythe in the cornfields, pulling weeds, and transplanting sesame plants from one place to another.  After about an hour of cutting grass (not to mention in boot-sucking mud), the groin muscles and thighs are totally exhausted.  It made me think of the original capoeiristas, slaves and sharecroppers playing in rodas in their free-time between swinging a machete in the canefields.  It takes another kind of strength to play beyond ones limits, and it reminds us why they are legends and we, merely their followers. 

      Every morning at 5:30 and every evening at 8:00 Takimotosan and I would chant/pray for an hour.  Chanting is quite different from silent meditation.  For me, Chanting is mentally much easier but also somewhat frustrating because the mind tends to wander incessantly during chanting.  The drums reach a perfect synchronicity and everything else seems to disappear, but then the mind resurfaces in unexpected places and I ask myself “how long has my mind been wandering?”  In silent meditation the focus is on the breath, and time seems to stretch out much longer, but the wanderings of the mind are entirely apparent. 

I’m curious about the different mechanisms of the two types of meditation.  Silent meditation aims at reduction of sensory input: closed eyes, silent room, focus on the breath.  Mantric meditation infuses the practitioner with stimulus: drums, mantra, and open eyes (I usually don’t keep my eyes open because it’s too much of a distraction). 

Takimoto-san’s grandfather was an engineer working in Korea when he was taking prisoner by the Soviets at the end of WWII.  He has therefore dedicated himself to praying for peace on the Korean DMZ.  His goal is not to spread his sect of Buddhism, which is good because Japanese Buddhism is generally not taken seriously in Korea.  Many Koreans are aware of the tenets of Jodoshinshuu Buddhism which allow monks to marry, and they associate Japanese Buddhism with Sokka Gakkai, a politically engaged cult in Japan derived from Nichiren Buddhism.  There’s also the still-strong backlash to Japanese state Shinto being imposed on the Korean population during Japanese colonialism, with simultaneous suppression of indigenous Korean Buddhism. 

Takimoto-san’s situation reminds me of the distinction I often make between pilgrims and missionaries.  Pilgrims are people who travel to foreign lands in order to learn, while missionaries are people who travel to foreign lands in order to teach.  I like to think that there is a lot of pilgrim in the best missionaries, and that people can end up learning more than they bargained for while abroad.  But the mormons and so many others are proof that simply traveling abroad does not result in learning from said culture. 

After my stint on the DMZ, I came down to Yeosu in Jeollanamdo to stay at Aeyangwon, the hospital founded by RM Wilson.  I finish my stay here on Friday.  I’ve thankfully been kept fairly busy, and given a large comfortable house to myself.  The days are spent in the surgery room or at the assisted living facility which houses some 65 geriatric recovered Hansen’s disease patients. 

The assisted living facility, where I spend two days a week, is a home for those on government welfare who were disabled by Hansen’s disease.  I mostly spend my time there scrubbing floors, mowing lawns, pushing wheelchairs, and making chit-chat with the staff and residents.  There’s a feisty old woman from Taegu who is always yelling at me about how important it is to believe in Jesus and how my name is a colloquial term for the male member in Korean.  I have developed a good relationship with her in a short time, her birthday is this Sunday so I’m hoping to get her some flowers. 

The surgery room is in the main hospital.  It is one of the busiest orthopedic surgery units in Korea, conducting almost 4,000 surgeries last year.  Most of them are joint replacement surgeries, most commonly total knee replacements followed by hip replacement and Spinal Laminectomy and shoulder replacement.  I have also observed athroscopic knee surgery, knee fusion, vertebral fusion, leg amputation, and hand/foot fusion surgeries. 

It is a strange experience to first step into a surgery room.  Orthopedic surgery is essentially carpentry where the medium is bone rather than wood.  It is all hammers, saws, nails, screws, wrenches, chisels, drills, scaffolding and vices.  Yellow liquefied bone marrow is flying everywhere.  The scent of burning flesh due to the vein cauterizing/cutting utensil is heavy in the air.  It takes about 2 days to become 80% desensitized, but the amputation is still definitely a little bit creepy. 

Every med student must decide between surgery and internal medicine.  I’m not sure about which one is more appealing.  I tend to think that my strengths lie more to the side of internal medicine.  One of the turnoffs of internal medicine is the idea of doctor-as-deskjob.  There is little hands-on activity, its all assessments, diagnoses and prescriptions.  But I’ve come to see that surgery could potentially be an extremely boring field as well, if more lucrative.  Surgeons specialize in the same handful of surgeries and perform them over and over again… in korea’s case, as many as 50 of the same surgeries in a week.  This would give one the chance to master one’s craft, but it could also start to feel like a dull under-utilization of one’s mental resources.  Of course no two bodies are the same, there is always the possibility of the unexpected in surgery.  But in the case of knee replacement, the basic formula is essentially cut and dried.  An expert physician walks away from the table about 10 minutes after he first picks up the scalpel, and he doesn’t necessarily turn his conscious brain on in the interim.  I don’t mean to downplay the amount of effort it takes to achieve this mastery, but I’m curious about how it compares to other fields of medicine. 

Tomorrow is my last day in the surgery room.  During the first week I observed, and over the past two weeks I started assisting in surgery.  This means cutting sutures, holding suction, and holding the wound open while the doctor is cutting using claw/lever-like tools.  I also pull the pins out of the bones and remove the scaffolding and metal joints.  It’s a great challenge trying to memorize the order of the surgery so that I can do what needs to be done when it needs to be done.