Tanzania

In Tanzania, the patients arrive at the IR clinic early in the morning and take a number, just like customers at the deli counter. They wait outside on hard wooden benches in the torrid heat and patiently await their turn, hoping that they won’t have to re-queue the following day in the event they don’t get seen today. When they finally come in, they are stoic and respectful, listening intently and trying to understand the incomprehensible: they have a terminal disease, or, worse yet, their loved one, their spouse, their parent, or their child does. The scene is made even more disorienting because of the incredibly beautiful and mesmerizingly colorful clothing they wear. In those awkward moments, I retreat into a task-oriented mode, hoping that the small achievement of external biliary diversion, for example, will attenuate the risk of life-threatening sepsis, as well as distract them from the bigger, more ominous picture.

I can also burrow into the safe haven of a unbridgeable communication gap. I can descend into this abyss where I can shrug my shoulders and avoid the need to sit, to be, to be there, to talk about this terrible situation. I don’t know if the stoicism is a cultural trait in eastern Africa or if it is simply the manifestation of not understanding the incomprehensible. I just excuse myself to go start another case and distract my attention away from where it truly needs to be. My last excuse is the temporary nature of my two-week position at this hospital- I can only do what I can do with my hands; I just don’t have the mandate to be as engaged. 

At least, that’s what I keep telling myself as I cast my eyes downward, a little bit ashamed for my inadequacies and lack of any plausible excuses.