The extraordinary chronicle of two doctors “bringing light to those in darkness” (Time)—the “miracle workers” whose story is featured on 60 Minutes The publisher will donate a portion of its proceeds on the sale of this book to the Himalayan Cataract Project.Second Suns is the unforgettable true story of two very different doctors with a common mission: to rid the world of preventable blindness. Dr. Geoffrey Tabin was the high-achieving “bad boy” of his class at Harvard Medical School. Dr. Sanduk Ruit grew up in a remote village in the Himalayas, where cataract blindness—easily curable in modern hospitals—amounts to an epidemic. Together, they pioneered a new surgical method, by which they have helped restore sight to over 4 million people—all for about $20 per operation. #1 New York Times–bestselling author David Oliver Relin brings the doctors’ work to vivid life through poignant portraits of their patients, from old men who can once again walk treacherous mountain trails, to children who can finally see their mothers’ faces. The Himalayan Cataract Project is changing the world—one pair of eyes at a time.
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About the Author
Journalist David Oliver Relin (1962–2012) was a recipient of the Kiriyama Prize and a James A. Michener Fellowship. He coauthored the #1 New York Times bestseller Three Cups of Tea.
Paul Farmer is the UN Deputy Special Envoy for Haiti and Chair of the Department of Global Health and Social Medicine at Harvard Medical School. He is also Chief of the Division of Global Health Equity at Boston’s Brigham and Women’s Hospital, and cofounder of Partners In Health. Among his numerous awards and honors is the John D. and Catherine T. MacArthur Foundation’s “genius award.”
Read an Excerpt
This world is blinded by darkness. Few can see. . . . Become a lamp unto yourself. —from the last teaching of Siddhartha Gautama, the Buddha
There is the Nepal of myth, the ice-and-rock realm of Mount Everest, the roof of the world. Then there is the country where most Nepalese actually live. I was still unfamiliar with that other, more earthly, Nepal when I first came to the Khumbu.
I had hiked up to the village of Thame, at twelve thousand feet, with Apa Sherpa. He stood a wiry five foot three and weighed perhaps 120 pounds. Apa’s hair was cropped close, and his head was a thing of beauty—smooth and sun-browned like an exotic nut. Looking at him, you’d never guess he was one of the world’s greatest athletes. But by the age of fifty, Apa had climbed to the top of Everest twenty times; no one had ever stood on the sharp peak of the earth’s highest point more often.
Apa had invited me to Thame to meet his family and gather material about his career in the mountains, hoping that I would write a book about him. I was intrigued, not simply because of his high-altitude achievements but because, unlike many publicity-seeking Western mountaineers, Apa, like most Sherpas, climbed not for glory but to feed his family. He had also dedicated his most recent expeditions to raising money for the schools that surrounded the mountain his people know as Chomolungma, Goddess Mother of the World, and to raising awareness of the toll that global warming was taking on the Khumbu’s receding glaciers.
By the time I arrived, the five-room school Sir Edmund Hillary had built in Apa’s village was planning to lay off two of its teachers because of funding shortages, which would force the older students to walk six hours each day if they wanted to continue attending classes. And the lower portion of Thame had recently been washed away when a lake of glacial meltwater overran its rim and thundered through the valley where Apa had been raised. His family’s home had been spared. So had the house next door, which belonged to the family of Tenzing Norgay, the first person to step onto the summit of Everest, alongside Hillary, in 1953.
Apa Sherpa had taken advantage of his prominence as a mountaineer to move his family from Nepal to suburban Salt Lake City, where his three children could count on a quality education. But his American dream hadn’t panned out as he’d expected; Apa’s attempt to create a line of outdoor clothing had crash-landed shortly after its launch. When he emailed me to introduce himself, he was working in a metal shop, stamping out road signs for Utah’s highways. Apa wasn’t bitter. He described his achievements on Everest with such matter-of-fact modesty that I agreed to accompany him to Nepal on his next expedition.
As the stone and ice immensities of the Himalaya thrust into view around every twist in the trail, Apa led me over swaying suspension bridges and up steep rock staircases with effortless grace. And as we traveled together, he proved to be one of the kindest people I’d ever met. Whenever my breathing became ragged, he’d put a hand on my shoulder. “Slowly, slowly,” he’d say, guiding me to a seat on the nearest stone wall or to a bench at a tea house, where he’d pretend that he, too, was anxious to rest.
At altitude, the air was beautifully crisp, the peaks fairy-tale white. The sky draped over the low stone homes of Thame was the unblemished blue of tourist brochures. Each morning I’d wake to the gentle alarm of yak bells. Cocooned in my warm sleeping bag, I’d open my eyes, peer through puffs of my breath, and watch wood smoke from breakfast fires drift across low stone walls that divided pastures from potato fields. On one side, shaggy black pack animals foraged for grass shoots with delicate lips. On the other, slender plants angled toward the sun, pale green with new growth.
I interviewed Apa’s elderly mother as she spun her prayer wheel and kept my tin mug of butter tea topped up. I also spoke with Apa’s climbing partners, brothers, aunts, uncles, and cousins. I was so enchanted by Thame that I lingered there for several days, resisting the conclusion that was becoming as clear to me as the air above the village: that writing a book about a man climbing the same mountain twenty times, even the world’s highest mountain, even for admirable reasons, was not something I could do well.
Apa was preparing for another attempt on Everest, and though I protested that I could find my way back down the trail to the airstrip at Lukla, where I planned to catch a small plane to Kathmandu, he insisted on accompanying me for the three-day trek. His middle-aged sister-in-law served as our porter, carrying, by a strap balanced across her broad forehead, the expedition bag I could barely lift. And with each step closer to the world of cities, with each foot of altitude lost, I felt more acutely how lucky I had been to get a glimpse into the life of this gentle man, and how much I regretted failing him.
Apa left me at Lukla. I promised that when he returned from Everest, we’d hold a fund-raiser together for the Thame School, which we managed to do a few months later. And I delayed telling him about my pessimistic view of the book’s future. I didn’t want him carrying that disappointment on his way back to the top of the world.
I spent a day sitting on a foggy airstrip, feeling like I’d been cast out of a kind of paradise, waiting for a window to open in the weather so a Yeti Airlines propeller plane could land. Dreadlocked European trekkers lounged against their backpacks, smoking hash or playing hacky sack on the empty runway, killing the hours. Sheets of fog blew by like possibilities, blanketing all of us in gloom, or opening narrow boreholes that revealed the snowfields of the high peaks, hinting at and then denying the splendor that surrounded us. The runway tilted steeply downhill, and everything felt out of balance. Though I was looking up, whenever I got a glimpse of clear sky I felt I was staring down into the ice-blue depths of a glacier.
The sight of those mountains made me think of a promise I’d made to another climber.
I’d met Dr. Geoffrey Tabin late one night the previous winter, in Utah. He approached me in the ballroom of the Cliff Lodge, at the Snowbird ski resort, after I’d given a lecture. Tabin waited until the crowd thinned out. Then he pounced. He told me about his considerable achievements as a climber, which included scaling the Seven Summits, the highest points on each continent. Before inviting me to dinner the following evening, he spoke of his current passion, working with a Nepalese surgeon named Sanduk Ruit to cure blindness in the developing world. Tabin was as tenacious and outgoing as Apa was modest and reserved. I agreed to join him for a meal only because he made it nearly impossible to say no.
We met for Mexican food the next night in Salt Lake City, where Tabin works, when he isn’t overseas, as director of the International Ophthalmology Division at the University of Utah’s Moran Eye Center. Or, rather, I watched as the bundle of nervous energy that is Geoff Tabin ticked in his seat like a time bomb and told implausible stories that turned out to be true—he really had been part of a group of adrenaline addicts at Oxford University who invented bungee jumping—while inhaling all his food and half of mine.
“A lot of climbers get all weird and competitive,” Tabin said, his voice high-pitched, his cheeks bulging with carne asada. “I try to take the golden retriever approach to life. Try to be friendly to everyone. You get more done that way.” I could see, even then, that he was more terrier than retriever. Tabin is compact, thickly muscled, and has a habit, once he gets something in his teeth, of not letting go. We spoke of my upcoming trip to Nepal with Apa, and he urged me to look in on his partner in Kathmandu if I had a few hours free. He said proudly that Tilganga, the eye hospital Dr. Ruit had built, was the finest medical facility in Nepal, an assembly line turning out minor miracles of healing. He assured me I’d find Ruit fascinating, if a little intimidating. Tabin’s enthusiasm was infectious, but I couldn’t escape the sensation that I was becoming lodged in the terrier’s teeth.
On the airstrip, I waited seven hours with no sign of an arriving plane. Lukla is one of the world’s most dangerous airports, and closures can last for days. Six months after I left, in similar weather, a Yeti Airlines Twin Otter crash-landed just short of the runway, killing two crew members and all sixteen passengers. Toward dusk, I was losing hope when a chartered helicopter touched down to pick up United Nations staff, and I was able to buy my way onboard.
We flew low, beneath the clouds, tracing the contours of the land. For me, Nepal was Kathmandu and a collection of snow peaks. But as we floated slowly down toward the capital, I saw that the barren, brick-colored hills in between were densely populated. Every slope, no matter its pitch, seemed to have been stripped of trees for cooking fires and sculpted into terraced fields. I observed small figures, bent to their labors, working to draw nourishment from depleted soil. Far below, rust-colored runoff from eroded hillsides pooled like blood where it met what had once been unspoiled mountain streams, staining them with evidence of overpopulation.
With my head leaning against the helicopter’s scuffed window, I felt deflated, as the book I’d come halfway around the world hoping to write receded into the fog like the high peaks of the Himalaya. Dipping beneath storm clouds, we passed over the hill dwellers so closely that I could see our rotor blast ruffle their mud-spattered clothes. But they rarely looked up at us, and I had a peculiar sense of disconnection—that the six of us gliding over their heads in our aluminum capsule were living not only in a different world but in a different century.
Sullenly, I watched the poverty of the mid-hills slide past my window. The thatched huts fastened by pillars of felled trees to denuded hilltops, the men hacking terraces from the dirt with hoes, the women carrying water up from fouled streams that trickled an hour’s hike beneath their homes, the underfed cattle and skinny dogs—all of it scrolled by like a documentary I didn’t want to see. I couldn’t know then how much of the next three years I’d be spending in that landscape, that the brick-red soil of the mid-hills would seep into my clothing and flesh and stain the way I saw not only Nepal but the world.
The air down at four thousand feet felt hot and wet. With each breath I was aware of dense vegetal decay. Despite its powerful engine, our Land Cruiser crept along, averaging only twenty miles an hour on the road from Kathmandu to Rasuwa. The drive had looked like a simple matter on the map I’d studied before setting out. But after hours of crawling first through maddening city traffic, then up a switchback road that climbed out of the smog-filled bowl of the Kathmandu Valley, we were still only beginning our journey, on a long, grinding descent to the Trishuli River.
Our driver, La La, and his young assistant took turns twisting every knob and dial on the dashboard. They had yet to master the operation of the air conditioner, so the windows were open to the scent of manure baking on the steep, terraced fields, and rotting plant matter where the jungle had not yet been slashed and burned. “This vehicle is brand-new,” La La said cheerfully. “Only fifteen days, actually. A lot of the controls is unknown!”
I was sitting in the backseat, next to Sanduk Ruit. Up front, Ruit’s wife, Nanda, leaned her forearms on the windowsill, her blue sari bright against the brown hillsides. Next to her sat one of their daughters. At seventeen, Serabla clearly asserted her status as a modern, emancipated woman. She wore Levi’s, running shoes, and a track jacket.
“Not a bad way to travel, eh, Mommy,” Ruit said to Nanda, who nodded dreamily. The white Land Cruiser had been a gift from a Chinese Australian donor, and Ruit was clearly delighted by it. “When we began these remote surgical camps, we used to ride on the tops of buses with all our cases of gear, isn’t it?”
Each blind turn down the mountain road took me farther from the wood-fired pizza and glass of wine at an Italian restaurant I’d been anticipating in the capital, a small reward I’d been promising myself to dilute the taste of my failed trip to the Khumbu. But when I met Ruit, at Tilganga, he was preparing to leave immediately for a rural area, to perform free cataract surgeries, and, impulsively, he invited me along. I had no sense of Tilganga’s merits as a hospital yet, and didn’t have a handle on Ruit either, but Tabin had been right about at least one thing: Sanduk Ruit was intimidating. He held his large, craggy head high over his barrel chest, and a thatch of thick black hair sat on top of his scalp like a heavy woolen hat. And though he was affectionate with his wife and daughter, he spoke to me gruffly. In brief sentences. Without meeting my eyes.
Ruit was treating our conversation like an interview, so I took out my notepad and conducted one. “We’ll be operating for three days,” he explained. “With luck, we’ll see two hundred cases.”
“Why are we going to Rasuwa?”
“Because there are blind people there,” Ruit said, without a trace of humor.
“But why Rasuwa particularly?” I asked, trying to keep the frustration from my voice.
Ruit exhaled, his eyelids lowered, indicating the effort it took to answer such an obvious question, and then he began to lecture. Rasuwa was one of the poorest regions of Nepal. The Tamang people who lived there were mostly subsistence farmers. Their lands were set unprofitably apart from the commercial center of Kathmandu, to the south, and the tourist magnet of the Khumbu, to the east. Ruit said he had conducted half a dozen free surgical camps in the area and still he was just draining an ocean of need, one teaspoon at a time. “The Tamang of Rasuwa are the most downtrodden people on earth,” he said. “Also the most deserving.”
Table of Contents
Foreword Paul Farmer v
Chapter 1 See You 3
Chapter 2 Wound Construction 12
Chapter 3 Here You Are 26
Chapter 4 Burn the Day 34
Chapter 5 Down from the Moon 47
Chapter 6 Stones on Your Chest 61
Chapter 7 Daylight in the Dark 71
Chapter 8 A Bit of Sport 90
Chapter 9 The Problem of Her Eyes 103
Chapter 10 The Eighth Summit 118
Chapter 11 If You Can Dream 133
Chapter 12 Stream of Sesame Seeds 152
Chapter 13 The Most Eyes on Earth 167
Chapter 14 Three Shirts a Day 176
Chapter 15 The Wave Is Water 190
Chapter 16 Rock Meets Bone 203
Chapter 17 Sir Is Willing 216
Chapter 18 Load Shedding 228
Chapter 19 Burn the Old House Down 245
Chapter 20 Ravishing Beautiful Flowers 259
Chapter 21 Clear Vision for Life 277
Chapter 22 The Singing Bowls of Swayambhunath 287
Chapter 23 Eye Contact 307
Chapter 24 The Road Is Coming 326
Chapter 25 This Is Rwanda 346
Chapter 26 Hands, Eyes, Heart 372
Chapter 27 The Winter Trail 385
Afterword Dr. Geoffrey Tabin 408
Author's Note 415
Reader's Guide 418