RUTHFULLY YOURS

Call it providential intervention or just the wisdom of a Chinese fortune cookie, but whatever the impetus, Dr. Richard Moss embarked on a journey to the Third World that he elucidates in his masterful book titled A Surgeon’s Odyssey — a book that deserves a space on everyone’s nightstand.

Moss, a son of the Bronx, was “exposed to most of the common pathologies of the inner city.” But he beat the odds when after 14 years of grueling study and training, he embarked on a journey that led him to Thailand, Nepal, India, and Bangladesh.  While working as a cancer surgeon from 1987-1990 he sought to ameliorate the suffering of people who lived under “extraordinarily horrifying circumstances.”

As a Board Certified Head and Neck Surgeon, Moss brought his skills to these people –many who had “unimaginable diseases at advanced stages and amidst tragic human suffering.”  This volunteer stint was not for the fainthearted, as he documents the heartbreak he saw at every stage of his time working in the various countries. But the words of the fortune cookie were “Do not forsake your dream for material security,” and thus he began a journey that led him to “help the neglected and diseased” as well as “understand healing, its essence, and embrace it as something sacred.”

He admires the respect accorded him as dictated by Thai custom.  He explains the quintessential Thai greeting of “wai” and how it underscores the importance of showing respect.  He learns to understand the nuances of the Thai language where “depending on the tone” of one’s voice, a word could mean either “beautiful” or “bad luck.”  He soaks in the nuances of a culture where even the act of walking reflects a smooth “never hurrying” approach, quite the opposite of the hustle and bustle of his New York City upbringing.  He comes to view this contemplative walking as a “form of meditation helping to ward off the assault of modern life.”

A congenial people, Thais also have a formal process which is carefully structured by which members of the opposite sex get to know one another.  This traditional culture is another of the many new things Moss would encounter during his stay.  He considers the “interplay of culture and healing” and becomes more aware of the contrast between the American expectation of prompt diagnosis, treatment, and cure juxtaposed against the Buddhist belief founded on the “notion of suffering, impermanence and non-self influence.”  How, he wonders, could the two ideas merge in medicine?

Known as Ajarn Moss, Ajarn being a respectful title given to teachers and professors, Dr. Moss learns that tuberculosis is endemic in Thailand so he wears a mask and gloves for every patient he treats.  One of the first things he notices is that Thai medical facilities cannot afford to use disposable items as is done in America but that does not stop the Thais from attempting to maintain sterility. Thus, rubber gloves are reused after sterilizing, but as a result, they are stiff and often rip apart.

Before long, Moss’ “lofty goals” of healing are put to many a severe test. His first patient is a 20-year-old whose cancer is so advanced that the tumor has fully consumed the young man’s tongue.  It is unnerving to the young physician to realize that early diagnosis and treatment could have helped this young man — but this is the Third World where options are very limited.

He brings his upbringing as a Jewish man to bear as he immerses himself in the East.  It is his “noble venture, [his] Kiddush or sanctification” and he would embrace it fully.  But little does he know that whatever hardships he had encountered as a youth in the Bronx could not come close to the urban nightmares that await him.

He soon learns that CT scans are not standard practice in Thailand.  The tools that are basic in American medical care are simply not available in this land of exquisite beauty.  The patients Moss sees have “hopeless, absolutely hopeless” medical situations. In America, treatment options are extensive; in Thailand, treatment options are too expensive.  Rationing is a necessary evil.  Thus, advanced disease is prevalent.

The contradictions of life in Thailand are stark. Along with the magnificent Buddhist temples and clear gestures of honor and deference, there is a never-ending sex trade whereby the “brothels — more like sex factories” act as magnets for raging hormones.  The sacred and the profane coexist side by side.

Nonetheless, imbued with a “sense of duty, discipline and honor,” Moss learns to appreciate how Thai patients “remain unperturbed in the face of utterly devastating medical news.”  He also comes to realize that for the Thai individual, showing any emotion is “among the worst things he can do” because he will “lose face.”  Another quality that absorbs Moss’ interest is “mai pen rai” which is the remarkable friendliness and assistance of people in caring for their very sick family members.

He also learns that a Thai person will never allow a person to die in the hospital unless it cannot be avoided because of the ingrained belief that to transport a dead body would disturb the spirit or the ghost of that individual and it might bring bad luck.  Angry ghosts are to be feared.

But the above is only a taste of the journey Dr. Moss vividly describes as he recounts his time in the cities of Bangkok, Kuala Lumpur, Jakarta, Bali, Singapore, Bangkok, Bodhgaya, Goa, Dhaka, and Calcutta, to name only a few.

Indeed, this is A Surgeon’s Odyssey — a pilgrimage that is well worth the read from a man who has also lovingly written Matilda’s Triumph, a book about the fierce determination of his single mother to raise her six sons.

Dr. Richard Moss is a man who appears unafraid to tackle what most would avert their eyes from.  It is about a spiritual quest that merges culture, philosophy and religious beliefs with the ultimate goal of helping other human beings.

It is about life and death and the shocking, gruesome, triumphant and tragic aspects of each.