by Nadine Seide Gonzalez
Retired yellow school buses are shipped to Haiti and sold into forced labor. You’ll find them lined up at crowded bus stations, crammed with passengers, four adults to a seat, kids on their laps and baskets stuffed with red feather hens at their feet.
Early one morning in the late nineties, I boarded one such bus for a three-hour trip from Port-au-Prince to Gonaïves to begin a medical residency at the local hospital. Over the following year I’d make that trip numerous times, staring out the window at the changing landscape: beaches, mountains, fields, and long stretches of hard brown dirt. But on that first day, as the driver raced recklessly along narrow unpaved roads, I withdrew into myself and blocked out the world.
Up until then, my life was in Port-au-Prince. Everything beyond was foreign territory. I was ten when my family moved from New York to Haiti. My father, a practicing physician, walked out on what most would call a comfortable life – a decision based on nostalgia, not common sense. A decade later, when I was preparing to leave, he urged me to stay, follow in his footsteps and attend his alma mater, the state-run medical school. Of all my siblings, I resembled him the most. Perhaps he saw himself in me, thought I could carry on his legacy. But my dreams were not limited to an embattled Caribbean nation. The rural residency year was meant to be my last in Haiti. My focus was to return to the US and catch up with the rest of the world. But the bus was like a time machine, taking me back ages.
Gonaïves is a hard place. The coastal city is plain, flat, and coarse with sea salt. The people are not particularly welcoming. Mosquitoes abound. That was my assessment at the time, anyway. I had only chosen it for its proximity to the capital. But even if it had been a seaside paradise, I would have still dreaded spending an entire year there.
I arrived at Gonaïves, a newly minted MD. Credentials aside, I wasn’t prepared for my assignment. Six years of study and I didn’t feel like a doctor. In my mind, the doctor in the family would always be my father. The first time I was called “doc,” I almost looked around for him. Still, I’d studied and trained and passed all the required tests. I expected to do some good, if no harm. With the bar set so low, how could I fail? But fail I did.
Things did not start well. I had a hard time connecting with the people I was meant to serve. Part of it was my fault. I was in my late-twenties, but I looked like a child. I imagine my patients took one glance at my tiny frame in the lab coats my mother had starched and pressed, compared me to the male doctor I’d replaced, and thought to themselves: “Nan kisa nou pran la?” (“What fresh hell is this?”)
There was also the matter of my chronic tardiness. Slow weekends in the country held zero appeal to me. The plan was to take the five a.m. bus from Delmas, my neighborhood in Port-au-Prince, and arrive at Gonaïves by eight. Gridlock traffic made that schedule impossible to keep. So on Mondays, the busiest day of the week, I’d show up late. When I walked past the clinic’s overflowing waiting area, my patients greeted me with cold silence and dirty looks.
And as I met with them, I began to understand the science-based advice I was trained to give wasn’t what they were seeking.
Gonaïves was reputed to be a hotbed of vodou activity. Terrified, my mother had equipped me with a zombie repeller kit consisting of a Bible, a rosary, an amulet of the Virgin Mary, and a small flask of holy water imported from Lourdes. In Port-au-Prince, discussions of vodou were cultural, not spiritual. Its iconography characterized our art and its rhythms influenced the popular music of the day. If the nation couldn’t shed the stereotype, it might as well embrace it. In Gonaïves, the practice wasn’t theoretical or metaphorical; it shaped daily life. Some nights, deep in the darkness, the city hummed with drums and chants. The sounds reached me in my dorm room above the hospital.
If it were all chanting and drumming it wouldn’t be so bad, but their beliefs seeped into the clinic. The first time a patient refused to let me start an IV or draw blood, I was puzzled. The nurse tipped me off: the healer who’d referred the patient to me had advised against it. Any perforation of the skin would undo whatever he’d done. My role in this health care system was limited. I could use my stethoscope and blood pressure cuff. Nothing else.
Not that I had much more. The clinic was a room with a desk and an exam table. The ER was a larger room with a few cots and IV stands. Lab tests were limited. There were no specialty clinics to speak of.The faithful worshiped at many altars. A young mother of three kids had severe anemia and complained of weakness. I wrote her a prescription for iron supplements – and birth control. She shyly declined. Her pastor wouldn’t approve. Children were gifts from God, she assured me. “Is your pastor going to help feed these kids?” I asked. She conceded that I had a point and accepted the prescription. I doubted she took a single pill.
Children were everywhere. I watched them running barefoot on the side of the road all those long trips back and forth to the capital. What kind of future did they have? It was the age of Internet cafés. And yet in their world, a man wasting away from AIDS was widely believed to be under a death spell. Their neighborhoods had dozens of churches and very few schools. Their fate was left in the hands of the Almighty or a chorus of other gods.
And when I stepped off the bus, exhausted, coated in sweat and dust, I worried about my own future. I was practicing a watered-down version of medicine that yielded to religion.
With a growing sense of panic, I began applying to grad schools in Florida. Before the end of the year, I was accepted to a public health program.
Only then could I finally relax. Gonaïves and its strangeness no longer frightened me. In the evenings after work, I’d take walks to the waterfront. At night I’d sleep peacefully to the beat of the drums. I used my time on the bus to sketch the landscape, rendering the countryside in rough pencil strokes. Finally, I began to connect with my patients. With so few resources, what choice did they have except to knock on all doors in search for answers?
One day, an elderly woman came to the clinic wanting only for me to prescribe a pill to keep her hands from shaking. The signs of Parkinson’s disease were obvious, but I did not have the tools to properly diagnose or treat it. “I want to thread a needle again,” she told me. She felt useless. And so did I.
The woman left, resigned to her fate. And I had a better understanding of mine: I couldn’t heal her. Even with all the advances of modern medicine at hand, I likely still couldn’t heal her. The most I could do was listen and hold her hand steady. The rest was up to the gods, the Almighty and all the others.