Presenting the certificates, tying it up with a red ribbon

The Final Exam

Yesterday was the final exam for the big Wednesday class, I made 75 copies of the exam but didn’t really expect everyone to attend.

73 showed up. There was load shedding when we arrived and the classroom was dark, later there was a buzz when the lights did go on.

I admit it was not a disciplined secure exam scene. To save money on photocopying I simply wrote the essay question on the whiteboard, to answer on the back of the ecg pages. There was a continual hum of whispering like a hives of bees.

They all passed. It was not a difficult final exam; I had made up my mind that the bottom line was whether they could correctly indentify VF or not (they all did).  I chose essay questions as a subtle form of tweaking the need to deliver the exact answer.

The Certificates

The other day I took home  the pile of certificates, printed in New Road on heavy supercalendared stock. Over the weekend I pre-signed and dated them, in preparation for the Big Day. They cost  forty rupees each, a princely sum by Nepali standards. Looking at them again a day or two ago, I realized that the certificates were all in black and white. So, on my way back from teaching the Kathmandu cohort, I made a quick stop at Pilgrim’s Books to buy a cheap rubber stamp and a red ink pad. Aha, a six-pointed star with an “OM” in the center, perfect! This design would mimic the one used by educational authorities in Nepal. Also, I knew that people would be particular about how to spell their name, and this would lead to wastage if I didn’t get it right, so I left the names blank until the day. When the time came I set up a sort of small production line. As each student approached they were told to print the name the way they wanted it to appear, and hand it to me. One student sat next to me and did the stamping, then handed me each certificate to add the name. I shook each person’s hand.

Predictably, one person in the class tried to distract me by proclaiming loudly that  it couldn’t be a proper certificate because there was only one signature. This same student had been one who argued over trivial issues earlier in the class. ( such as saying that a rhythm was not regular because the longest R-R interval was 78 beats per minute but the shortest was at 82 beats per minute therefore it couldn’t possibly count as regular).  It seems to me as though in any crowd in Nepal, there is always one such person who gets anxious if it isn’t “just so….”  I replied “but it’s mine, and my signature is worth five” but she continued. Oops, I’d given her a payoff. So she continued. So I said “give it back if you don’t like it. Go to the end of the line. Stop bothering me. Go.”

Lots of photos, I felt like FDR signing major legislation….

Anyway, lots of photos as usual. One subgroup gave me a Nepal t-shirt  and another gave me a new daypack. I called them all  together for one last “all hands in” exercise, a sort of benediction before I let them go.

Patan Hospital

Bijaya and Rajani  will come to help me at Patan Hospital Friday, so they stuck around so we could figure out what exactly we were doing.  This was great, because I have been trying to recruit the leaders of the class to take a bigger role in this training. In USA we would identify those with instructor potential and bring them along the same way. In international development it’s all about train-the-trainer. These two have been a delight to have in my class, always ready to explain to their classmates in Nepali what they just learned in English. They both work in ICU at one of the major hospitals, and I promised them they’d get to see Patan Hospital’s ICU (“you are my assistants, of course you need a tour!”)

There are others in the class who will also be really great in the instructor role but who were not able to re-arrange their schedules.

The Guest House

When I got home, the Koreans had gone somewhere but it looks like its only for a day or two, since they left a ten kg bag of kim chee in the refridgerator  and the TV room was locked, evidently their stuff is still there – they could have chosen a different room but now the TV is not available to me. I started to re-arrange my handouts and stuff to get ready for Patan Hospital, and the project ballooned into re-organizing my earthly possessions. Separating out the trash; re-piling the things that would go in the box; looking for my passport, AT & T sim card, the itinerary for the return flight home, sorting through the books that forgot to bring to LNC. There was a flash of recognition to see some old fashioned USA dollars and hold them in my hand again.  All my personal stuff got here in the day pack and the books came in cardboard boxes reinforced with packing tape. I need a new cardboard box in which to take home all the Wonders of the Orient…..

The Shakya Family Compound

Took a nap for a bit, after all I was just recuperating, and walked over to Bishnu Shakya’s house. Bishnu is a well known musician, and I own about five of his CDs. I had been meaning to get over there from the beginning, but time slipped away from me, and there was now important business to transact: I am bringing some stuff back to Honolulu from the Shakya family, to Bibin. Among other things, a bag of chiura.

In the meantime I talked with him and Bibin’s sister, told them about my project. We discussed Buddhist spirituality, and also the music business in Kathmandu. He is friends with Sudarshan Pariyar, the clarinet player,  and says next time, he will invite Sudarshan over to jam (Bishnu plays harmonium) so I can enjoy. I video’ed Bishnu playing a song he is composing – it’s now on YouTube…..

Soon we were called to the kitchen, where I was treated to a seven course DBT meal including chicken curry. Dessert was dahi (curd, a.k.a. yoghurt) my favorite. They also gave me a shot of home made raksi. Very potent stuff.  Had my head spinning and they told me it was one hundred percent alcohol… wow.


After the meal we returned to the living room, where I got the actual bag of stuff. Included is an old jelly jar with a particular Asian spice whose name I forget, looks like amber….. just the kind of sentimental items anybody might send to somebody living at a distance. They also gave me a “singing bell” and a small “dorje” (also known as a vajra if you are confused…). These are two commonly used meditational implements in Tibetan Buddhism, one in each hand. ( I guess “a bare-handed meditator is dangerous…”). I didn’t own these items til now – had resisted the urge to buy either one….. and voila. The bell has a nice tone and I may use it in my classes in lieu of the slide whistle. We’ll see.

Came home and slept pretty well…… today’s plan is to chill, rest up and recuperate. Going to dinner with some friends in Thamel ( my first evening venture to Thamel all summer). Today is 72/78….


About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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