Vulnerable

We got soaked on our ride home from San Gregorio today. Like most of the Guatemalans, we travel in the back of pickups. Sometimes we are blessed with a canvas tarp to keep us dry, but today the rain pelted us as we climbed back up the mountain from the small community we had visited. Our raincoats worked for awhile, but eventually they soaked through and the water found its way into our pockets and shoes. I got to thinking how we were pretty vulnerable out there today, which got me thinking about many of the patients we’ve met. Vulnerable to illness because of malnutrition and poverty. The difference between my vulnerability and theirs is that I chose to be here, to ride in the back of a pickup and do this work. Most of the people that are forced to visit traveling medical doctors who don’t speak their language don’t have a choice. Would you go to a physician who had only marginal understanding of your second language if you could choose to go to someone, anyone, else? I try to remember that while I explain the cause of an illness, or how to use a medication – I have chosen to be here, she has not. The power differential is palpable and the medicine and advice I gave aren’t that unlike a raincoat in the back of a pickup – it works for awhile, but eventually you may still get soaked.

I think we will spend our entire year here learning about vulnerability. I think we will learn that there are lots of causes of, lots of explanations for, and lots of plans to fix poverty. In the meantime we keep trying to reexamine the way we live, and try to see the connections between the choices we have the privilege to make and the vulnerability of our patients here.