As I placed my feet onto the red-eye flight to Lima, Peru I instantly felt a rush of emotions that had been building up in my stubborn self for several months. From the discussions of packing to the safety concerns from my family, it was not until my long flight that I started to consider what I had gotten myself into. The next 24 hours of travel that involved several plane transfers, unsafe cars, donkeys, and wagons proved to become a microcosm of the adventures I had voluntarily placed myself in for the next few months.
As a health education coordinator working for Sacred Valley Health in Ollantaytambo, Peru, it was my responsibility to develop and train community health workers (promotoras) in 7 surrounding communities. With little knowledge about the communities, I found my first day hiking 8 hours with a Peruvian nurse to quickly learn about my main areas of focus. Let me say that hiking over 14,000 ft. passes and extreme conversation barriers leaves a lot of time to think, and a lot of time to complain about your aching legs. In fact, the majority of my time in Peru was spent in solitude trekking across the mountains, riding donkeys across the passes, or more commonly hitchhiking in the back of an animal truck just praying to get back to my village. Everyday I left my home in Ollantaytambo, never knowing what danger I may face, or if I would make it down the mountain alone. If I wasn’t hiking or up working in one of my communities, my time was spent in my own village. This often included hour-long meals eating guinea pig, being chased by rabid dogs, or more simply just living out underneath the beauty of the stars. With zero electricity, I didn’t have any modern conveniences such as a hot shower, running toilet, or even a normal sleeping arrangement for several months. Despite the hardships that I faced, these were the three best months of my life, and I am yearning for the moment that I can return.
I believe that my personal discovery of the field of medical anthropology, though occurring relatively late in my time at university, has nonetheless been one of the most influential aspects of the liberal arts education that I attained at UNC. And though the readings from my med anth classes reached far and wide in content, one text in particular from a class with Professor Rivkin-Fish continues to stand out with rippling effects in my life: …And a Time to Die. How American Hospitals Shape the End of Life by Sharon Kaufman.
Kaufman’s book grapples with a topic that is by its very nature innumerable shades of grey in every respect. How do we think about death? How do we think about others’, our own, as a concept, or as an acute reality? How are specific ways of dying created and promoted in the American hospital setting? What sociocultural, political, and economic factors play into creating these paths and guiding (or forcing) people along them? How much of the decision process do you want responsibility for, or do you think you should be responsible for, in another’s death? In your own? How do you want to die? When? Where? Why do people think they can ultimately have a real choice when it comes to these questions? I hadn’t honestly thought in depth about many of these ideas before coming in contact with Kaufman’s book. My major take away from the text: death is an invaluable discussion to have with friends and family during life and any time is the right time. In respect to life and death, I personally believe that ignoring the inevitability of the later can truly detriment one’s experience of the former.
I took my first medical anthropology course during the spring semester of my freshman year. I realized I was hooked to the field in the middle of a lecture in Professor Rivkin-Fish’s Comparative Healing Systems class. As I recall, we were discussing an anthropological explanation of the transition from the era of midwifery prevalence to the rise of obstetrics and gynecology as a male-dominated, biomedical “profession.” Previously, I had been drawn to the natural sciences and their steadfast faith in the scientific-method, evidence-based research and the like. Fortunately, my first medical anthropology class – and the many that ensued – opened my eyes and my mind to the extremely complex nature of human beings and the way the world works in general. Though we may like to view the world as regimented, consistent and predictable; this is rarely the case. I continued to learn this lesson throughout my college career and have carried it with me into what many call “the real world.”
1. How did the idea for this project come about?
It was a question of being in the right place at the right time. I was brought on to the project after the initial investigators, who were two professors of sociology at UCLA, had developed this idea to study the impact of newborn screening in the clinic. They had learned that newborn screening was in this new phase of development where the state had just rolled out screening tests for a large number of disorders. They were really interested in doing something around the idea of medical uncertainty and this seemed like a perfect target for exploring some of those ideas, because it was really unclear what the impact of screening asymptomatic children for such a large number of disorders was going to be. At the time that this was getting off the ground, I was a graduate student. I was working on my dissertation research and I started out working on the newborn screening project as a research assistant. Over time, one of the investigators got busy with other projects, and I ended up taking on a bigger role, and working more closely with Stefan Timmermans, who co-authored the book with me.