Tuesday and Wednesday Ongoings

Tuesday:
Nina and I spent all day working to get the machine ready to gather our arterial stiffness data for a project examining ARVs and their effects on blood flow. Stupid piece of crap...enough said.
After all day pulling out our hair at the clinic, I went home to cut 300 paper plates in half to make 600 masks for Day of the African Child and cut 600 nose notches. Thrilling.

Wednesday:
Nina and I worked all day at the clinic running the first round of testing with the women. We didn't have a translator, which made for an interesting revelation/confirmation. We have to place electrodes for an EKG on the women and measure the distance between the two pulse point we're using and the top EKG lead, then place a tonometer that gives us a reading of blood flow (velocity) at each point. Very Frankenstienish feeling. We were stuck in a tiny office with dim lighting that reminded me of horror film portrayals of mental institution...essentially, we were only missing the weird smells and the dripping water you see in every scene. My interactions with the women were completely different from what I had experienced every other day I was here. Medical sterilization at its best. I had to fight to keep the humanity I'm fond of in the room. At one point I was taking blood pressure measurements and Nina whipped out the tape measure and began taking the pulse point distance measurements. Immediately I felt uneasy, pulled my stethoscope out of my ears, took the cuff off and stood there staring into the eyes of the woman we were prodding. Instantly, I realized the uncomfortable feeling in the room...how very Tuskegee Institute. My mind flashed to the racist scientific experiments that measured head circumference, nose size and made bold, degrading, and downright ignorant statements to oppress those of African decent in our own country.

What bothered me the most, was that Nina didn't seem to notice. She continued measuring, continued rushing around both of us without lifting her head to really see the woman, without noticing the feeling of the room. I cannot conduct any work this way. I simply refuse. But in reestablishing that human connection with the woman, the tension was relieved with a smile and a touch--this is the importance of hand holding, of human contact.

It was in this instant that I understood a piece of Rwanda, and it's people, that I made a significant connection. The genocide started with systematic measurements that were used to divide people in to ethnic groups based on physical characteristics, many years before the 94 genocide. The Hutus and Tutsis were divided up long before the world turned its eyes to this tiny country (I still find it sad that my first education on Rwanda was through a mainstream movie, ten years after the devastation). Our behavior in the clinic that day was a parallel to that. Something that, clearly, I never intended, but seen too commonly in medicine and science in general. I strongly believe that this is not the inevitable fate of medicine. Not every interaction needs to be this way, so sterile, so mechanical, and I was happy to find that today I confirmed this idea in a smile. Again, it comes down to De Mello and his life changing idea of truly seeing people.

So, how do I do that in this experiment situation? I don't care if I look like the biggest nut alive, I talk to every patient. I use all the Kinyarwanda words I know. I'm awesome at miming. I show the women on myself where I will place leads. I show them every step on myself. I touch the tonometer to my skin and I watch their faces. I may be slower in getting done with each woman, but I will gladly sacrifice my time for maintaining the humanity and respect that these people have a right to. I am glad that I have figured out a way to connect again, in such a difficult setting. I extra glad I'm not a culturally incompetent moron, which was definitely the road I was heading down with this project.