You Get Used To
It
Target
publication: Harper’s Magazine
I went to Belize for two weeks in
December on a service-learning trip—service learning is a kill two birds with
one stone kind of deal: young adults (mostly college students) pay to go on a
trip for a brief period of time (typically 2-4 weeks) where they learn basic
skills associated with the medical profession, as well as perform acts of
service, like setting up free health-clinics in areas where medical assistance
would be unavailable usually.
I made the last deposit for the trip in
October, a month in which I was sure I would be attending medical school in the
future. The pitiful amount in my bank account was bearable because going on the
trip meant I would be further propelling myself down the path. The path otherwise
known as the go-to answer to give people (mostly peers and family members)
about your plans after graduating from college is also the justification for
your existence.
I mean your degree.... it is also the
justification for your degree.
Really, the path can be seen as a friendly societal reminder that if you don’t
have the next fifteen years after college planned out in a detailed manner,
something is wrong with you. Plainly, without the path or a path, your shit
is not together.
Well, November rolled around, and I
suddenly came to the conclusion that I had no desire to go to medical school. Not
only was my decision a slap to the path’s
face, but did I also mention the last deposit I made in October was
non-refundable?
It looked like I was stuck with a trip to
Belize. A trip that would either confirm or discredit my decision to abandon
the medical school path.
My timing in choosing to formally declare
myself an English major could have been a bit better—while in Belize, my major
often warranted the question, “So... why are you here then?” The seven other
people on the trip were die-hard pre-med students, all in Belize for the same
reason: the path. I assumed the
identity of the token Humanities kid, who of course forgot my blood pressure
cuff at home and had the most trouble stitching up a banana. I am forever
grateful that I can speak Spanish, or else I would have been completely useless
during triage. We split into pairs to do triage, and I always worked alongside
another volunteer who didn’t speak Spanish. My favorite partner was Allie, a
girl from Zachary, Louisiana. Allie seemed to live and breathe the phrase
“sweet as pie”, and her patience and easy laugh made me feel the least
alienated.
After triage, Doctor Yorleny, a Belizean
doctor who regularly volunteered her time to the service-learning program we
were participating in, would further examine the patients and prescribe
medicine. We had a makeshift pharmacy, which we stocked with donated medicine,
mostly consisting of vitamins and ibuprofen.
We used a community center building for
the last town’s clinic. It was the color of cornbread, somewhat dilapidated, and
about the size of a Wendy’s dining room. The “windows” had no glass; they were
simply cut out of the building, so kids would constantly call our attention
outside, asking for another toy or for more instructions on how to use the
toothbrush kit we gave them. It was during the last clinic that the case of a eight-year-old
boy named Alex made me feel the most estranged from the other volunteers.
Alex’s mother brought Alex to Allie
and me with the complaint of pain in his head. When I asked where the pain was,
¿Donde está el dolor?, Alex’s mom
tilted his chin down to reveal a lump on top of his head of about a 1-inch
diameter, sprinkled with tiny black dots. She explained that Alex had fallen
and cut his head two weeks prior to visiting our clinic, and the lump we were
seeing was where he had gotten stitches. Alex had been complaining of the pain
since he first got the stitches.
Allie and I called Dr. Yorleny over
to inspect Alex’s wound. After a ten-second glance, Dr. Yorleny calmly walked
away and grabbed a facemask and a pair of gloves. She might as well blown into
a bugle because as soon as the other volunteers saw her reach for a facemask,
they rounded up around Alex like he was the zoo’s newest exhibit.
Sensing the volunteers’ curiosity,
Dr. Yorleny explained, “There is a botfly in the wound. I must pop the wound in
order to remove it.” A week before, I had done a presentation for the group on
the human botfly, so no further explanation was needed. Everybody started
pushing each other out of the way in order to get closer to Alex. Someone said,
“This is so exciting!”.
I, on the other hand, felt like I
was going to puke. I was replaying the images I had researched of the botfly
and going over the mechanics of how it parasitizes its victims.
Basically, while Alex’s wound was open, a
botfly had managed to get its eggs inside of it, and the pain Alex was feeling
was the larvae growing and burrowing further into his skin. If not removed, the
botfly would feed off Alex’s blood for up to eight weeks, at which point, it
would drop out of the hole it had been using for oxygen and pupate. In a
free-clinic in a small town in Belize, the best way to remove a botfly is to pop
the wound like a pimple and hope the botfly is mature enough so none of its
segments break off and stay inside the wound.
Dr.
Yorleny asked Allie to put on a pair of gloves, and the chatter of the other
volunteers rose in anticipation. The cornbread colored walls seemed to be
tilting like the tops we had been handing out earlier to the kids, and I weakly
asked to no one in particular, “How can you be so excited when you know the
amount of pain he is about to experience?”
Katie,
the oldest volunteer of the group, responded, “Paula, it’s what’s best for him.
He can’t get better if we don’t do this now.”
In irritation, I
said, “Thanks Katie, I think I get the logistics of the healing process.”
She
said, “You seriously look like you’re going to vomit. Maybe you should go
outside.” She grabbed my hand, but I shook her off and told her I was fine. I
walked over to Alex and crouched down beside him. He was already crying so I rubbed
his back and told him how brave he was.
And
then Dr. Yorleny started to squeeze the wound.
With each pulse of
blood that spurted from his head, Alex’s scream sharpened to a new pitch of
pain, each pitch shrill enough to cut through any of our attempts at comforting
him. He writhed to the point where we needed three people to hold down his
seventy-pound body, sweated to the point where I could not tell if his face was
wet with tears or with perspiration, where I could not tell if the sweat on his
mother’s shirt was her own or from the face of her little boy.
After Alex’s wound
had been squeezed for ten minutes, it was found that the botfly was not mature
enough, and Dr. Yorleny could not entirely remove it. Alex would have to wait
another week or so and let it grow bigger inside of him. And then, he would
have to go through the same process. All over again.
Dr.
Yorleny thought the wound needed to breathe, so we left Alex’s head without a
bandage. She explained, “Now Alex, sometimes doctors need to do things that
hurt you to make you feel better. Okay?”
Alex
looked up at Dr. Yorleny, and his gaze gave away what was going on inside his
head. His brain was writing what had just happened into a memory he would keep
into old age. It would be one of his earliest memories of suffering.
Alex walked
outside and stood alone, keeping his distance from the other kids. I followed
him and crouched beside him, telling him again how brave he was, “Tú eres muy valiente”. Fruit flies were
gathering around the fresh blood on his head, and I tried to think of how much
better he would feel once the botfly was removed. But all I could focus on were
the swarming fruit flies. They reminded me of the way the volunteers had
swarmed Alex, and I felt sick to my stomach again.
When I walked back
into the clinic, Allie took me aside and said, “When I shadowed at the ER, the
first time I ever saw an abscess popped, I fainted. But it gets better, Paula,
I promise. You get used to it.”
I nodded and tried to smile for Allie. But
I knew she was wrong. It wasn’t the blood or the thought of the botfly feeding
off Alex that bothered me. It was the excitement among the volunteers that made
me feel weak.
It was the joy, rather than the pain,
that I would never able to get used to.
No matter how directed, how justifiable
the medical school path made my
education, made my life, Alex’s case confirmed that it was not the path for me.
