We had a busy day seeing a hospitalized patients including new consults.  There were a lot of pediatric cases of the usual variety, including shunt problems, myelomeningocoeles, trauma, etc.  There are quite a number of myelomeningocoeles in Nepal due primarily to folate deficiency.  Anthony learned a lot thanks to Sushil's fantastic teaching.  At the end of the day, we planned all of our surgeries for Thursday. Afterwards, Anthony and I met Marie for a tour of one of the best sights of Kathmandu:  Swyambunath.  This is a recognizable and important Buddhist stupa high on a hill overlooking Kathmandu Valley.  Some have nicknamed it the Monkey Temple because of the presence of so many monkeys running around.   I have posted several photos from Swyambunath including a beautiful prayer wheel inside a Tibetan temple next to the main stupa, and a couple Tibetan monks sitting outside the temple.  As you circumnavigate the stupa in a clockwise direction, there are a lot of copper smaller prayer wheels which contain the phrase "Om mani padme om."  These wheels are to be turned as you walk around the base of Swyambunath.  

Thomas Steffen, M.D., PhD, MBA arrives today and we are looking forward to seeing him.  He will help in the clinic on Friday when Sushil sees 40+ patients, and then assist in surgery next week.  Also on Friday, I will give a lecture on new techniques in spine surgery.  Next week, Thomas will give a lecture on either biomechanics or on Ranier Technologies' Cadisc.  


Richard Wohns