The Shambhala Odyssey

CHAPTER 1 - A cup of Clarity: An Unexpected Encounter

As the sun dipped below the jagged peaks of the Himalayas, casting a golden glow over the bustling city of Kathmandu, I was sitting alone in my hostel room with a warm cup of tea in my hand. It was cold as the winter was about to start. In spite of being a tropical islander, I had well adapted to the cold climate of Kathmandu over the last couple of years and a steaming cup of Ceylon tea I had brought from home often became a comforting companion. The room was mostly dark, except for the light coming from the heater.

The hostel was neighboured by one of the biggest hospitals in the valley, the Kathmandu Medical College Teaching Hospital and it was one of the busiest areas in the city. I finished my cup of tea and got up stretching like a bow. After having a glance at the pile of books, iPad and faint remnants of the day's study I sighed and thought "I guess I'm done for the day".

I stepped out of the room and ascended to the terrace. You could still see the strip of the majestic Himalayan range in the far north. Staring at those snow-capped peaks was something I could do all day long. Since the day I arrived in Nepal, these mountains never ceased to captivate me. There was always something about them. Along with the little surge of serotonin and endorphins in my brain, I felt as if they were trying to communicate something - something that not everyone might deserve to know. Eventually, I'd find myself caught in that very present moment, gazing at the mountains until something noteworthy occurred to divert my attention. This time, it was someone placing a hand on my shoulder. I jolted and turned back, only to find my batchmate, Saurav.

"What's up, mate? enjoying the view?" he asked in his usual pretentious English accent. I nodded. Saurav Adhikari was a true-blue patriotic Nepali. A smart, thin and outgoing young man with a solid grasp of history and politics and he evinced a sense of wisdom most of the time he spoke. He was in fact our class representative and I could not imagine anyone better for that position.

After a bit of tittle-tattle, we went to have dinner, and soon after, I called it a night. The next morning, my sleep was interrupted by the loud slam of a door. Some blockhead had hastily closed the shared bathroom door, shattering the peaceful quietude. I reached for my phone groggily, cursing under my breath when I realized I forgot to set the alarm. Time wasn't in my favour; I had a mere 20 minutes to get ready. Being late on the first day of my psychiatry posting was not an option. I jumped out of the bed and started to get ready. After putting on the white coat and snatching the stethoscope on my table I ran to the hospital. When I reached the psychiatry ward, I was already five minutes late. "Come on in fast!" urged the professor. "I'll let it slide this time since it's your first day, but everyone needs to be on time from tomorrow," she added. "Wow, Nadun, what a way to kick off the first day," I mused.

After a short briefing on the learning objectives for our psychiatry postings and the art of the psychiatric history taking we were asked to go around the ward and find ourselves a patient for practice. She encouraged the students to start with comparatively less complex cases-those involving alcohol dependency or general anxiety disorder. As I moved through the ward, it seemed like everyone else had already chosen a patient. The consequences of being late once again dawned on me.

I walked up to the patient board in the ward and gave it a quick scan. The diagnoses were coded using the ICD (International Classification of Diseases) system, a coding system we weren't familiar with. I pulled out my iPad, downloaded the ICD classification, and started comparing. The mental disorders are designated with the letter F and are categorized in numbers from F01 to F99. As I scanned through, I noticed that my colleagues had already chosen several cases, including Major Depressive Disorder (F32), Generalized Anxiety Disorder (F41.1), and alcohol dependence (F10.2). 

Among the list, there was one intriguing code that stood out: F29, an unfamiliar and unusual diagnosis. It read, "Unspecified non-organic psychotic disorder." It was the bed number 13. I started having second thoughts. This is obviously going to be a tough one for me and I wouldn't go anywhere with this. Looking around the ward, my peers were already deep into scribbling down the patient's life story. "Well, I guess I've got no other choice," I muttered to myself, throwing caution to the wind, and headed over to bed number 13.

"Namaste!" I greeted the patient. Dressed like he was ready for a casual stroll in the park, the guy seemed anything but what his diagnosis suggested. He appeared to be in his late 60s, with a Mongoloid ethnicity and his eyes twinkled with a warmth that contradicted the whole psychiatric ward scene. He had this simple, pleasant smile that made him look like someone's friendly uncle rather than a patient with an "Unspecified non-organic psychotic disorder." Seriously, who would've thought?

"Namaste," he replied with a simple smile. His demeanour was calm and composed, not what I had anticipated given the initial diagnosis. I introduced myself as Nadun, a medical student on my psychiatry rotation, and explained that I was there to learn about his experiences.

As we delved into the conversation, I navigated the questions with a mix of English and my best attempt at Nepali. Surprisingly, he responded in a mix of both as well, understanding the need for clarity in our communication. "You are not Nepali I suppose. I don't think you are Indian either" He said. "Actually, I'm from Sri Lanka " I replied. "Well, you speak Nepali surprisingly well for a foreigner," he remarked. It was a familiar compliment that often followed the revelation of my non-Nepali background. The more we talked, the more I was impressed by this man and the more I was curious to know what was actually wrong with him. His name was Karma Lama, a 67-year-old retired archaeologist originally from Simikot, currently residing in Kathmandu with his daughter's family.

I was finally done with the patient's particulars, and I carried on with the presenting complaint. "Okay sir, could you please tell me what brought you to the hospital?" His expression didn't change at all, and he managed to hold his usual pleasant smile. "Actually, my daughter and her husband think I'm delusional. And they wanted me to get checked. So here I am," he said.

"Delusional? Why would they think so?" I questioned. His smile grew. "Because I told them that I finally found Shambhala."

"Shambhala? What on earth is Shambhala?"