AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. August 2001, Volume 3, Number 8.

Out of Africa

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"You Gotta Keep a Sense of Humor"

A Peace Corps physician working in Eastern Africa relates in his latest online journal entry some humorous anecdotes about his experiences there.

Robert C. Davidson, MD, MPH

Finally, the pathologist arrived and we proceeded into the autopsy room. Because there was an ongoing police investigation into this death, 4 detectives and 2 police photographers accompanied us—too many people for the small autopsy room. The pathologist whispered in my ear, "Don't worry, they won't last long." He then chuckled and nodded for his assistant to begin. Sure enough, in a scene right out of the old television series about Dr. Quincy, medical examiner, one by one they began covering their mouths and quickly exiting the room. Soon there were only the 3 of us left. This significantly reduced the tension in the room, and I had the opportunity to talk with the pathologist about his work in Africa. He had a great sense of humor, and I realized this was his way of coping with his gruesome job. That evening, as I reflected on the day, I realized how important humor was to me in the way I dealt with the stress of the job and living in Africa. I decided to share some of the humorous things I have encountered so far in hopes that it will bring a chuckle to the readers and lighten their stress a bit.

As I exited the plane on my initial arrival in Nairobi, I was of course a bit anxious. It was about 10:00 at night, and I was scheduled to be met by a driver. As in any airport, taxi drivers, people wanting to carry my luggage, and others offering to obtain whatever I wanted, immediately accosted me. In the midst of this jumble of bodies, a voice with heavily accented English asked if I was here with the corpse. No, I replied, I was not here with the corpse. Off he went to look for someone else he was to meet. I was finally able to get across to the group that I did not want any of their services or products. I did not see anyone, however, who looked like my driver. I began formulating plans to change some money into shillings and figure out where I could spend the night. The same man came back and asked again if I was here with the corpse. Again, my reply was no. As he started away from me, I heard, "Well someone got to be here for the peace corpse." I suddenly realized that the pronunciation of corps was different in Swahili, and I was indeed here for the corpse.

The differences in English have led to several other humorous events. Early in my tour, I went to one of the major hospitals we use for volunteers. As I was given the grand tour, I was repeatedly introduced to Sister this and Sister that. I remarked to the Peace Corps nurse who was with me that I did not realize this was a church-run hospital. No, this was a private hospital she replied. Why then, I asked naively, were all the nurses nuns. When she recovered from her laugh, she began my education in British medical jargon. Nurses are called sister and charge nurses are matrons. When I asked to see the emergency room, she looked perplexed until it dawned on her that I meant the casualty ward. But the best was yet to come. I was caring for a young volunteer with a pilonidal cyst that needed surgery. I arranged with our surgeon to do this in the outpatient surgery. I then told the volunteer to be ready, as she was booked into the theatre at 10 a.m. the next day. She got this frightened "no way" look on her face until I realized that she thought she was going to be on stage for a large audience with her bare posterior displayed for all.

Some of our best laughs have been with the workmen hired in Nairobi for various jobs. I am sure there are some very skilled workers in Kenya, but we do not seem to get them. We live in a lovely 40-year-old colonial home. It has lots of character, but, like all older homes, it has lots of problems. For instance, the roof. It seems to have a roving roof leak. After each rain, we dutifully call the landlord with the news that, yes, the roof leaks again. He sends out his trusty work foreman who inspects the house and proudly states that the roof leaks. He will schedule the men to fix it. The next day, a worker arrives to patch the inside ceiling plaster and repaint the ceiling. I try to suggest gently that he might want to fix the roof first. No, he is the painter. Another man will fix the roof. Of course it rains before the roof fixer has a chance to come. Back comes the painter with his plaster and paint. Again I suggest that the roof be fixed first. He ignores this advice and again repairs the ceiling. My wife reminds me that he gets paid to fix the ceiling and if it keeps leaking, he gets more work. Finally, the roof man comes. He proceeds to cut off some branches from trees in the area to make a ladder of sorts. After a period of loud noises on the roof, he exclaims that the roof leaks. He will come back later to fix it. In the meantime, it rains again. My wife bakes some cookies for the painter-plasterer. At last count, we have had the roof man 4 times and the plaster man 7 times. Yesterday, we had a heavy rain and of course had to get out the buckets to catch the drips through the ceiling. Actually, we are looking forward to the upcoming visit by the kindly painter- plasterer.

Perhaps the best story is the saga of the paper truck. A large truck was loaded with paper to be taken to the recycling plant. The paper was piled way too high, making the truck top heavy. As it started up the hill on a busy street near our house, it hit a deep pothole and the axle broke. It was already leaning heavily to one side with the weight of too much paper. The workers decided to try to repair the axle on site. They jacked the truck up and set it on rocks so they could work on the axle, then enlisted about 10 men to hook ropes to the uphill side of the truck and pull on them to keep it from tipping over down the hill. Meanwhile, frustrated drivers were making new pathways over adjacent lawns and winding through the men holding the ropes. We were enjoying watching this spectacle when it began to rain. Of course the paper was not covered and began acting like a sponge soaking up the rainwater. This made the truck even more top heavy and it soon began to tip. Their answer was to get more ropes and men to counterbalance the load. The crew grew to about 20 and might have worked if the rain had only gone to the paper. However, the clay dirt road soon became a slippery mud bath. I do not think even the best of the Hollywood comedy writers could have envisioned this scene. As the day progressed, the paper continued to get heavier, the truck tipped more, the road became more slippery, and we were now up to about 30 men with ropes. Finally, the law of gravity won out and the truck slowly began to tip. As the workers and rope men realized what was happening, they all abandoned their posts and ran uphill. As if in a slow motion film, the truck slowly tipped over and began its roll down the side of the hill. The next day, another truck arrived and the paper was hand carried up the hill to be carted away to the recycle mill. The new truck swayed from side to side with too much wet paper raising its center of gravity.

When the strain and frustration of living and working in Africa (or anywhere) begins to get your down. "You gotta laugh." Those are my words of advice for the month.

Daktari Bob, [AKA Robert C. Davidson MD, MPH]

Robert Davidson, MD, MPH, is professor in the Department of Family and Community Medicine at University of California, Davis, where his interests include both rural health and the organization and financing of health care systems. In the past few years, he has served as both the director of Rural Health and earlier as the medical director of Managed Care for the UC Davis Health System. What follows is an on-line journal of his odyssey in the US Peace Corps as the area Medical Officer in Eastern Africa.

The views expressed are those of the author and do not represent the opinions of the Peace Corps or the United States Government.

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.