A Personal Journey of Questioning Medicine

Since I was 11 years old, when I was hospitalised in Brunei after injuring my leg while playing on a metal swing, I have never been fond of taking medication. I used to refuse medication, and the nurses would sometimes pinch my nose to force my mouth open and place the medicine inside. At the time, I was completely bedridden, with a plaster cast extending up to my waist.

After about six months, the plaster was removed, and a shorter cast was placed from my thigh downward. I could then move around in a wheelchair and even go to the toilet independently. I began pretending to be a compliant and obedient child in front of the nurses and took the medication when they gave it to me. After a few days, once they trusted me enough to hand me the medicine, I would take it to the toilet and throw it into the pan instead. Even as a child, I had a strong instinctive resistance to taking medication, and that experience has stayed with me.

Interestingly, my childhood experience in hospital also shaped my career. The kindness and care I received from some of the nurses inspired me, at the age of 13, to decide that I wanted to become a nurse. I pursued my education accordingly and became a registered nurse in 1995. However, during my nursing studies, I came to believe strongly that prevention is better than cure. This led me away from a long-term clinical career and towards community-based work.

My early experience with medication therefore left me with a lasting reservation about taking medicines unless they are genuinely necessary, for example, to prevent or treat serious infection or inflammation. I have always been interested in hearing evidence-based perspectives from medical professionals and experts, particularly their critical views on pharmaceutical drugs and the commercial systems through which they are developed, tested and marketed in the name of treatment and cure.

That is why discovering Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families, written by psychiatrist Dr. Peter Breggin, was an eye-opening experience for me. The publisher states:

“This is the first book to establish guidelines and to assist prescribers and therapists in withdrawing their patients from psychiatric drugs, including those patients with long-term exposure to antipsychotic drugs, benzodiazepines, stimulants, antidepressants, and mood stabilizers. It describes a method developed by the author throughout years of clinical experience, consultations with experienced colleagues, and scientific research. Based on a person-centered collaborative approach, with patients as partners, this method builds on a cooperative and empathic team effort involving prescribers, therapists, patients, and their families or support network.

The author, known for such books as Talking Back to Prozac, Toxic Psychiatry, and Medication Madness, is a lifelong reformer and scientist in mental health whose work has brought about significant change in psychiatric practice. This book provides critical information about when to consider psychiatric drug reduction or withdrawal, and how to accomplish it as safely, expeditiously, and comfortably as possible. It offers the theoretical framework underlying this approach along with extensive scientific information, practical advice, and illustrative case studies that will assist practitioners in multiple ways, including in how to:

• Recognize common and sometimes overlooked adverse drug effects that may require withdrawal.
• Treat emergencies during drug therapy and during withdrawal.
• Determine the first drugs to withdraw during multi-drug therapy.
• Distinguish between withdrawal reactions, newly occurring emotional problems, and recurrence of premedication issues.
• Estimate the length of withdrawal.”

Likewise, American physician Charles L. Whitfield, who specializes in helping survivors of childhood trauma with their recovery and in treating addictions, including alcoholism and related disorders, reviews the book, stating:
'As a physician who specializes in addiction medicine and drug withdrawal and written widely on them, I recommend Dr. Breggin's book to every health professional who deals with anyone taking psychiatric drugs. He gives highly useful information and reasons for stopping or avoiding them. It's an excellent one-stop source of information about psychiatric drug effects and withdrawal. Prescribers, therapists, patients, and families will benefit from this guidebook.'

“Gradually, as more and more of our needs are met, we discover a crucial truth: that we are the most influential, effective and powerful person who can help us get what we need. The more we realize this, the more we can seek out, ask for and actually realize our needs. As we do so, our Child Within begins to awaken and eventually to flourish, grow and create.”
― Charles L. Whitfield, Healing the Child Within: Discovery and Recovery for Adult Children of Dysfunctional Families (Book)

How Language Reflects Social and Racial Prejudices Against Nepal’s Indigenous Peoples

The case of “Bhote” and the language of othering. 

Words are not always offensive by origin. A word may simply describe a place, community, culture or identity. But when repeatedly used to belittle, stereotype or exclude people, it can acquire a deeply derogatory meaning. As Sushant Nepali argues in his discussion of language and prejudice against Madhesh, words such as “Bhaiya,” “Dhoti” and “Madheshi” become offensive when they are used as instruments of humiliation rather than as neutral descriptions [1]. 

“Bhote” is one such contested word in Nepal. 

The term derives from Bhot/Bod, historically referring to the trans-Himalayan or Tibetan region. In itself, therefore, it is not inherently an insult. Yet in Nepali social usage, particularly when directed at Indigenous highland peoples, it has often acquired a racialised and derogatory meaning.

Anthropological and historical accounts document its use as a broad label for peoples associated with Tibetan culture and appearance, while Jonathan Samuels specifically examines the rejection of the “B-word” among Tamang activists as part of a wider assertion of ethnic identity [2]. 

 The problem is not simply a word. It is the hierarchy behind the word. Nepal's history provides important context. The Mulukī Ain of 1854 legally organised the country's diverse population into a hierarchical caste order. Historical documentation identifies categories of “enslavable alcohol-drinking” groups and includes Bhoṭe (Tāmāṅg, Śherpā) in an illustrative discussion, while also noting that Tamangs and Sherpas do not accept being called Bhoṭe [3]. This history matters because social prejudice does not disappear simply because discriminatory laws are repealed. 

Legal equality can arrive long before social equality. The legacy is visible in personal experiences. Dorje Gurung has written about growing up ashamed of being identified as a Bhote and about his family's adoption of Nepali names and surnames to avoid discrimination. He describes the negative stereotypes attached to the term and the pressure to conceal his Tibetan heritage [4]. 

The prejudice has also appeared in much more brutal forms. Reporting on the 2014 Dho-Tarap violence in Dolpo documented allegations that police used “Bhote” as a derogatory term against local highlanders and questioned their belonging to Nepal. The same report described police violence, including deaths, injuries and arrests [5]. Nor is this history confined to the high Himalaya. 

Deepak Thapa has documented the structural discrimination experienced by Tamangs, including their historical exclusion from opportunities such as service in the British Indian Army and the exploitation of Tamang labour for the benefit of Kathmandu's ruling elite. His central message remains remarkably simple: “The country is yours as well” [6]. 

This is why language matters. 

Calling someone Bhote is not automatically racist in every context. The term appears in geographical and historical names, and some people may use it as a self-identification. Context, intention, relationship and self-identification matter. What is unacceptable is using the word to suggest that an Indigenous person is backward, uncivilised, foreign, inferior or somehow less Nepali. That distinction is crucial. 

Nepal's Indigenous peoples do not need to prove their Nepali-ness. Tamang, Sherpa, Gurung, Thakali, Rai, Limbu, Magar and other Indigenous identities are not obstacles to being Nepali; they are part of what Nepal is. The challenge, therefore, is not merely to replace one word with another. It is to dismantle the prejudice that gives a word its power to humiliate. 

 The South Asia State of Minorities Report 2024 continues to document the marginalisation of ethnic and linguistic minorities in Nepal, including the exclusion of Indigenous languages from public discourse and the persistence of social and cultural prejudice [7]. 

Language can be a mirror of prejudice—or a tool for dismantling it. 

Nepal has changed its laws. It must now change the social meanings attached to its words. A citizen should never have to hide their name, language, face, culture or ancestry to be treated as fully Nepali.

Nepal belongs equally to all its peoples. 

References 

1. Nepali, S. (2023). How language reflects social and racial prejudices against Madhesh. myRepublica, 22 May 2023.2.

2. Samuels, J. (2018). Banishment of the B-word: Interpreting ethnic and religious revival among the Tamang people of Nepal. European Bulletin of Himalayan Research, 52, 17–45. 

3. Khatiwoda, R., Cubelic, S., & Michaels, A. (eds.) (2021). The Mulukī Ain of 1854: Nepal’s First Legal Code. Heidelberg University Publishing. 

4. Gurung, D. (2017). Oh, What’s in A Name? Personal account of ethnic identity and discrimination in Nepal. 

5. Gurung, P. D. (2017). Police brutality in the Himalaya. The Record Nepal, 11 August 2017. 

6. Thapa, D. (2015). The country is yours. The Kathmandu Post, 2 July 2015. 

7. South Asia Collective (2024). South Asia State of Minorities Report 2024: Economic, Political and Social Participation and Representation of Minorities.