Best Review of The Sacrament of the Goddess so far – a “page turner” for summer 2014

I have been sending out copies of the book to gather pre-publication reviews. The date approaches – May 1st.

Here is the best of the early reviews, from Goodreads


Justin Acklin rated it 5 of 5 stars

I read a pre-release manuscript of this delightful genre-spanning title. First a little background. The author is an RN/Nursing Teacher who goes to Nepal regularly to teach nursing. He has written a non-fiction book of his adventures called “The Hospital at the End of the World,” a fantastic book itself. As such he has experienced extensive immersion in the Nepali medical field as well as the culture of the country
I read a pre-release manuscript of this delightful genre-spanning title. First a little background. The author is an RN/Nursing Teacher who goes to Nepal regularly to teach nursing. He has written a non-fiction book of his adventures called “The Hospital at the End of the World,” a fantastic book itself. As such he has experienced extensive immersion in the Nepali medical field as well as the culture of the country.

This is all reflected in “The Sacrament of the Goddess”. However, unlike his previous work, this is historical fiction – but even to say that is pigeon-holing it. On its surface it is the story of a young medical resident going abroad to practice medicine in a third-world country. This description doesn’t do it justice; there are multiple layers to the plotline, each of which could almost be placed it into their own genre. It has technically accurate medical and surgical descriptions and events. The history is thoroughly researched as evidenced by the way the main characters become inadvertently embroiled in Nepal’s recent Maoist civil war. The battle scenes are based on actual battles and described in thorough and accurate detail, so much so this particular plotline could almost be war history, not historical fiction. There are moments of intense action and drama where I literally couldn’t put the manuscript down for page after page. And it’s also a romance, complete with erotic scenes. These are beautifully written, and normally I detest romantic/erotic writing, but it’s written so tastefully that I was enraptured. The standard love-lost-found trope weaves the common thread through it all, but is done with such subtle elegance and finesse that it does not feel at all clichéd.The characters are intriguingly developed and we think we understand what motivates them – but more and more is revealed as the plot becomes more complex, and we discover there are deep undercurrents that the protagonist is not aware of until some surprising twists near the end.

This book is so well crafted, researched, and based on real experiences that it’s one of those books where you finish it and realize that the entire story could actually have taken place – that this *could* be non-fiction. I was left very satisfied and eagerly anticipating where this talented author will focus his attentions next.


The book is available on Amazon.

Naturally I am flattered.

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CCNEPal 2014 is counting down the days

Quick summary

I bought my ticket for the 2014 trip. I leave from USA May 24th and I arrive in KTM May 26th at 0830. The plan is to continue teaching critical care nursing skills.

I have been working to set this up. This year I finished writing my second book, The Sacrament of the Goddess, and I am pleased to report it will be officially published May 1st.  I have been working on the publicity for the book.

In the meantime, I am activating all the contacts I made on previous trips to Nepal. I will offer my training to as many nurses as I can. I am willing to travel outside the Kathmandu Valley. Wherever you are, please know that if you want the training in a location near you, I will come there if you can find a place to hold the class and thirty people to take it.  start thinking about it now. Talk it over with your in-charge. then send me an email

Thirty four days until I am back in Nepal. Let’s work together to save lives.




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An insider’s view of my writing process…..

My daughter has her own blog titled “Maine – The Way Life Turned Out” and she used her platform to proclaim to the world her opinion of my book.

very objective of course!

click here. and why not subscribe to her blog?


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for all medical volunteers to Nepal, March 1st 2014

Just a quick note. this week I was contacted by the leaders of a group bringing medical students to Nepal. (not their first time).

I was happy to help them – providing links to my YouTube channel etc – but also to help them make contacts from among my list.

If any other group or individual makes a query, my policy is to help in any way I can.

feel free to contact me

Are you trekking?

Many doctors or nurses come to Nepal to do one of the classic treks – long distance hikes with a guide and porters. They wonder how to make use of their health care background. My advice? If this is your first time to Nepal it’s hard to find a role. Spend time reaching out and learning. The hospitality of Nepali people is legendary. Ask them to show you their health post or hospital  and tell you what they do.

Used textbooks?

Tip: before you leave home, slip one used medical or nursing textbook in your luggage. Find a school of nursing or a hospital and donate it to their library. This is a more lasting way to make a difference than, say, handing out toothbrushes.

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About the Nepali Diaspora and nurses going abroad


First, a definition. A Diaspora is a scattering about of a group of people. Most commonly used in reference to the Jews ( the Israelites) who were forcibly uprooted from their homeland. Wikipedia has a fine essay on the meanings and nuances of diaspora for those with a sociological bent. I can’t improve on it, the best I can do is to point toward it.

In December 2013, MyRepublika published the following article.

KATHMANDU, Dec 13: More than 450 thousand people enter the labour market every year in Nepal.

Nearly 1,500 people leave the country for foreign employment every day.

The number of youths going on foreign employment by taking labour permit has reached 3 million 21 thousand 302 as of November 15, and of them, 91 thousand 308 are women, according to the Ministry of Labour and Employment.

The Ministry of Labour and Employment is marking the International Day of Migrants 2013 by organising various programmes throughout this week.

At a programme here today, the Ministry informed the media that programmes like screening of documentaries, interaction, community awareness, art and photo exhibition, blood donation, morning procession, street play, booklet publication etc would be organised in Kathmandu and other places on the occasion.

Secretary at the ministry Suresh Man Shrestha argued that Nepal figures as the country where a large section of the population has migrated in proportion to the total population of the country.

Shrestha said that this number includes people who have gone abroad without taking labour permit, those people who have gone to India for seasonal work, those who have gone to Europe and the U.S. and other countries for higher studies and in connection with business and the Nepalis who have gone abroad for temporary residence.

December 18 is observed as the International Day of Migrants every year and Nepal has been marking the Day since 2000.

The United Nations had passed the Convention on Protection of the Rights of Migrant Workers and their Family Members on December 18, 1990

Two numbers jump out.

First, it’s 400,000 per year.

Next it’s 90% male.

The total population of the country is about 26 million, and if 3 million or more are away, this is at least twelve per cent of the country.

Now, it is not entirely a bad thing since all these migrants are sending money home. it is no coincidence that there is a Western Union office on every street. I am not sure there is accurate data regarding how much money comes to Nepal via this route.

Nursing as a route out of Nepal?

For nurses, there are definite implications. First, many women study nursing so they can join their (future) husband in whichever foreign country he may reside. The numbers above focus on the people who left the country but when there is such gender imbalance in those who leave, it means that a disproportionate number of women are left behind in Nepal. Also, nursing is seen as a means by which a woman can generate an income for remittance purposes. The country of the Philipines has long been known as a place where women study nursing to get out of the country; Nepal is following that model, whether it is official policy or no.

There is a problem. Not all the programs in Nepal meet international standards, and the nurse finds out they need to re-do their education in order to get a foreign nursing job. And, there is not enough reliable information out there to guide them. so sometimes this means that the person goes abroad and their gamble does not pay off. and they are too ashamed to share this with the people back home.

Every young person totals up their individual situation and decides whether they can personally get ahead or not, and whether it might be better for them to go abroad.

There are so many issues rolled up into this phenomenon, that to describe all the ins and outs would take fifty pages.

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The Future of PCL nursing education route in Nepal

Update: after only two hours, this post got 120 views. I can see that people are interested. If you go to the right, click on “subscribe to this blog.” Go ahead. You know you want to!

There are two present controversies in Nepal regarding nursing education. (okay, there’s probably more, but this is what I want to focus on today).

background: I have taught nursing at a PCL-level program, one of the best in the country. I have visited many schools of nursing and I have also taught my program of critical care nursing to about 700 nurses, from all levels of program. I have a Nepali RN license.

PCL nursing needs to be phased out

The first controversy is whether to continue PCL nursing education.  This is the basic education for a nurse in Nepal. after completing SLC at age sixteen, a young woman goes to a three-year program usually sponsored by a hospital. Any hospital of any size can start a PCL nursing school. The faculty do not need to be very experienced. The main reason the hospitals want these programs is because the students provide free labor to run the hospital.

The drawbacks of this approach are: because there is no “plus two” requirement for admission, if the nurse wishes to go abroad to work, they need to start their nursing education all over again.

Next, these programs emphasize “functional nursing” and the accomplishment of tasks, but do not emphasize the thinking and problem-solving skills needed by nurses when more complicated care in needed.

Third,  when the hospital is small, it can’t afford a basic library, and there are not enough patients to provide a well-rounded exposure to the care of sick people. Many of these schools are not accredited.

For these reasons, mero vicarma is that PCL should be phased out. Nursing candidates absolutely need “Plus Two” before they start.

It should be noted that the Nursing Council has attempted to limit the number of new schools, but has been over-ruled by political entities.  This is intimidating and makes it difficult for Nepali leaders to speak out for fear of losing their jobs. To me, this interference with professional standards is not a good thing. Also, I have heard that one of the major hospitals in Kathmandu (which offers both PCL, B Sc and BN nursing tracks ) tried to phase out PCL education, and there was an “andolan” protesting this decision. ( it did not receive much attention in the press, I was told of this second-hand). The protesters were short-sighted in my view. Why should they protest a raising in standards? they need to know the truth: that PCL graduates are at a tremendous disadvantage in the job market, both in Nepal and abroad. A Nepali PCL graduate who does not have plus two, will never get an RN license in USA unless they re-do their entire education.

Scope of multiple educational tracks

The next problem is the overlapping scope of educational track. This one is a bit more difficult to understand at first. Here is what happens – a staff nurse job is posted, and the nurses who apply will have either a PCL, BN or B Sc degree. They are expected to do the same kind of work regardless of their educational background.  It is because the system has not changed.

This is actually similar to what happens in USA, where we have nurses with Associate Degrees and Bachelor’s Degrees. These days, many USA hospitals are instituting policy to only hire nurses with a BSc.

I am told that when B Sc and BN nursing levels were first developed, these persons were always hired into an in-charge role. Now, my opinion is, even if we phase out the PCL level nurse, we still need to have people in staff nurse roles, and so a new BSc nurse should still start out as a staff nurse in a hospital. That is how it works in USA.

The difference is in the way the nurse carries out their job. A PCL nurse is trained to do the best of “functional nursing” that can be done. A B Sc nurse is taught to think differently about the unique needs of their patient and to apply a higher level of critical thinking. The hospitals with more B Sc nurses will be moving away from just ” functional nursing.”

A related issue is that the new B Sc programs do not offer as much clinical practice time, and the people who hire the nurses do not think they have enough experience. The B Sc programs have learning laboratories, and I think that as they become more experienced with use of the learning laboratory, this aspect will improve.

What do you think?

I know that that there will be people who disagree, and I also know that many people don’t even want to discuss this because it divides the nurses who ought to be more united. I invite feedback from every reader. Please make a comment. If you are not comfortable with making a public comment, send it to me via email and I will publish it after removing your name.

PS if you are not sure about what I mean when I say “functional nursing” you may wish to read up on it before you comment.

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Kindle book version of first book, The Hospital at the End of the World

my first book is now available in a Kindle edition.


click here to find it.

When the Sacrament of the Goddess is published, we will definitely have an e-book edition from the git-go. I am flirting with the idea of having an audio book of The Sacrament of the Goddess, from the very beginning.

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