This is the third (and most recent) of my email dispatches from Nigeria, copied and pasted below. In the interests of full disclosure, I cut out a significant chunk of this email where I explain the work I’m doing in Nigeria. If any of you (few, maybe nonexistent) readers are interested in international health and want more details, feel free to email me (or comment below).
It’s been too long, I know. And so much has transpired. I’ll try to keep it short, but of course, I’ll fail spectacularly.
On child slavery
Let’s just say that diplomacy did not work. In numerous conversations, I tried to urge my roommate to be kinder and more patient with this 11-year old girl Bidemi. But the abuse escalated. It was admittedly naïve of me to think I could change someone’s behavior with a few empathetic words. I discovered this when my roommate got angry at me for giving this girl my food flask one morning. Bidemi had not been fed breakfast in several days and was never given lunch, unlike my roommate’s two daughters. Apparently she was being “punished” for some trivial infraction. After this followed several temperamental meltdowns and disturbingly passive-aggressive behavior on my roommate’s part, and I found myself intervening constantly to protect Bidemi from the onslaught of daily beatings, unreasonable workload, and criticism. As it turns out, the only thing that did work in curbing my roommate’s behavior was the fear of exposure. I finally got into an argument with her where I told her outright that I was considering reporting her to my boss, and that her behavior constituted abuse. I pleaded with her to send Bidemi home. She started to be much nicer to Bidemi after that whenever I was around. Unfortunately, some other events transpired (e.g., her using my fondness for Bidemi to obtain money from me under false pretenses, her spreading malicious gossip about me in the office, her failure to tell me that one of our office coworkers and her child was moving into our apartment until I woke up one day to the sound of them moving in). I had had enough, and I finally told my boss everything. He was shocked and ordered my roommate to send Bidemi back to her family. A few weeks ago, to my great relief, she finally did. She didn’t tell me in advance that she would do so (probably deliberately), and I never got a chance to say goodbye to Bidemi. Luckily, I had managed to sneak Bidemi my mobile phone number without my roommate’s knowledge. I am so glad I did, because I got a call from Bidemi two weeks ago, happier than she’s ever been now that she’s back with her family. I also managed to send her some gifts, for which her parents secretly came to thank me in person yesterday, telling me that Bidemi has told them the whole story of her ordeal and that she talks about me all the time fondly.
My boss is also looking for new accommodations for me, but as of now, I am still living with my roommate. Our interactions are civil and polite but has none of the friendly rapport that it had at the beginning. Despite everything, she has begged me to stay in the apartment (for self-interested reasons, I suspect, and not because she particularly wants me around).
There is a lot more to this saga, and a lot of details have been left out, especially with regard to money. But I honestly have no energy to go into it all. Suffice it to say I have a better understanding of “evil.” Not to label my roommate as “evil,” as nothing is ever that black-and-white. But I understand now that when most people do bad things, it arises from a loss of perspective and not a gleeful joy from doing bad things. My roommate argued that she was not “abusive,” that it was kind of her to take in another family’s child and pay her school fees, that in Nigeria, children were commonly subjected to corporal punishment, and that Bidemi deserved to be beaten for not knowing how to do the simplest things, like covering the pot when warming soup or not hanging wet laundry properly. She felt completely justified in her actions and was shocked when I (and other colleagues) admonished her for her cruelty. I bet Hitler or Pol Pot or Stalin would react similarly.
This situation has made me realize that I’m a hell of a lot tougher and more capable at dealing with difficult situations than I give myself credit for. It also pinpointed for me my fatal weakness: my being drawn to vulnerability and my willingness to fight for the underdog. With regard to the situation with Bidemi, one coworker said to me, “Why can’t you just live your own life and ignore what’s going on in the rest of the house?” My supervisor said in a similar vein, “Be careful not to get so attached. You can’t save the world, no matter how hard you try.” Still, I’m glad that there is a happy ending to this story. Even if I accomplish nothing else while I’m here, I will always take comfort in having helped this girl get reunited with her family (which may have happened on its own eventually, but at least I speeded up the process).
On clinical distance
I have had thoughtful email conversations with Laura A about clinical distance, about the fear of losing our ability to empathize when we step back from a situation. When I arrived, I had expected that my first significant international experience would be more observational in nature, a chance to learn about health and development but from an clinical distance that would preserve my objectivity. I believed that my “foreign” status meant that I would always be an outsider and regarded with polite disinterest and disregard by the community. Instead, I’ve become rather involved without quite intending to. I’m the only foreigner around (though there are a couple of Americans who have recently visited for 1- or 2-week stretches), and I live and work with Nigerians. As a result, I’ve gotten numerous comments on how well I’ve “integrated” into Nigerian society, that I’m so “free and comfortably myself.” I do feel like I’ve been welcomed into this community with open arms, and my gregariousness and willingness to tease my coworkers seems to have endeared me to them. And yet, that lack of clinical distance also means that I’ve become entangled in the messiness of human society. It means that I’m forced to intervene in situations like Bidemi’s, have my home situation be the topic of office gossip once my boss is made aware, have my clothes criticized openly by strangers (“You should wear more colors”). It means that people make inappropriate requests for money, take advantage of my ignorance, and plead their needs. The importance of clinical distance becomes apparent to me after Bidemi’s situation is finally resolved, and I realize just how emotionally drained and exhausted I am. I crave clinical distance right now. I feel like I’m that “oyibo” (white person) who came to Nigeria to stir up trouble, no matter how much people reassure me that I did the right thing. I have this desire to live by myself for a while and be left to my own devices to recover, with only a few friends around me.
Perhaps that’s why emergency medicine might be the right fit for me. I can deal with crisis situations, but I need to protect myself from my own tendency to get too attached, which gyn-onc or peds critical care will not allow me to do.
