Raw Herring and Other Peace Corps Dangers

 

This past Friday, the New York Times ran two stories on the Peace Corps.

 

The first article I saw, Peace Corps Volunteers in Their Own Words by Michael Roston, is a collection of short first-person accounts from recent volunteers (more recent than my ten years out). Some wrote of overwhelmingly positive experiences; others wrote of the problems. One wrote of leaving her service early. In short, Roston’s article was a mix of positives and negatives.

The lead story in this collection is by Jonathan Halpern, a volunteer in the last group to work in Kazakhstan. His story, In A Place of True Need, tells of his determination to leave his mark on the people he worked and lived with. And it tells of his sudden departure when the Peace Corps program in Kazakhstan was shut down in 2011.

I was excited to hear his story; it was the first I’d read of that still mysterious time.

Jonathan ended his story with this:

Peace Corps did a terrible job of communicating the true situation to us, both during and at the conclusion of the program. But Peace Corps took care of us. Their medical and safety services were top notch. Peace Corps really got us in there. We were in a place of true need. I can say that Peace Corps provided volunteers with a true opportunity, and I took it.

 

Their medical and safely services were top notch. Jonathan’s experience mirrored mine in many ways and I’m hoping to line him up for a future guest blog post.

 

The second Times story painted a similar tale of miscommunication within a giant bureaucracy, but that was the only side it presented.  In Trail of Medical Missteps in a Peace Corps Death, Sheryl Gay Stolberg writes of the death of Nicholas Castle, a young volunteer in China who died from a gastrointestinal illness in 2013.

 

Because of these two stories, I’ve changed my plan for this week’s post, originally planned to coincide with the launch of my book.

 

First, I want to talk about what social psychologists call Defensive Attribution, of which there is a huge literature, and on which I wrote my master’s thesis thirty years ago.

Defensive Attribution is a fancy term for “blame.” It refers to the very human tendency to focus outward, defensively, for someone to blame in the face of a tragedy.  It’s not easy, when disaster strikes, to accept the reality of whatever the loss is. The grief can be overwhelming. Anger and blame, sometimes, can be useful tools, early stages in that process, serving as a bridge between that overwhelming sense of loss and despair and the acceptance that is required before one can move on.

 

Blame.  Sometimes it’s scapegoating.

We all do it from time to time.  The trick, I believe, is to recognize when we do it and to know that it doesn’t serve us well in the end.

 

I do it too. And this brief story is my steady reminder that I can still do it. 

I participated in a rowboat race one afternoon many years ago, one of many exercises during one of those leadership building workshops that were so popular in the 1980s. As the rower, I was blindfolded. My passenger had to tell me how to row so we could get to the other side. I was an experienced rower; I thought we could get there first and said so. But we came in last.

My boatswain would call out, “just gently to the left,” and we’d swing in a wide arc. That sort  of problem. When he’d tell me to just keep it straight, we’d list heavily to one side. When at last we reached the other side and I climbed out of my boat, I noticed one of the oarlocks was not in line with the other.

I ranted and raved for a bit, hoping to assuage my deep embarrassment at being really bad in this excercise. It obviously wasn’t my fault; here: I had defective equipment. No one seemed to care. No one sympathized.  I tell this story only to show how quickly we (aka I) jump to find an explanation that is comforting. I’m not really a bad rower; I had a defective boat. I had a handicap. 

But it turned out I didn’t.

It was only later, hours later, that I noticed nearly all the boats had crooked oarlocks. Yet no one else had complained.

That story has stayed with me for nearly thirty years and I use it from time to time to remind myself how much more palatable it is for me to see that the cause of (in this case) my embarrassment lies elsewhere. Surely not with me. How quickly I jumped to blaming something outside myself.

 

I thought of this story again as I read the sad story of Nicholas Castle and his death after a three month illness.

 

His death is tragic. I don’t want to minimize that for a minute.  And, if he were my son, I’d probably be first in line to want — to need — to point fingers too. The Peace Corps Medical Officers are only human. Humans do make mistakes. They are an easy target.

 

But, I believe  Trail of Medical Missteps in a Peace Corps Death told only one side of the story.  I’d like readers to know how common it is for volunteers to have a GI disturbance, how often we are ill, especially during our first year. It’s one of the risks we sign on for.  And, I’d like readers of the New York Times to keep these medical tragedies in perspective. It would help if the reporter went first.

First, a short Deleted Scene of my second illness, brought on by eating raw herring just one week into our arrival in Zhezkazgan, Kazakhstan.

My first illness was during training, after enjoying watermelon at my host brother’s birthday party.  I’ve not written of  that tale because, frankly, I have little memory of it. Both Woody and I were out for nearly a week with that one, sleeping nearly three days straight.

I had many illnesses, you know. Besides the tainted watermelon and the raw herring, which you’ll read about below, I had the worst head cold of my life, the worst case of laryngitis of my life, and a  period of weeks where I retched at the slightest hint of salt in my diet.

I am not sickly. And I was not unique. It is just that all Peace Corps volunteers get sick. At least everyone in my group of 40 + did. And not just once. The bugs I grew up with in New Jersey are not the same bugs you grew up with in California or Florida or Nebraska. And they are certainly not the same bugs that live in Central Asia.

We all lost weight too.  When my group of volunteers met in January of 2005 for our In-Service Training just four months after training ended, only one of our original forty-two trainees HAD NOT lost weight. Only one. And the weight we lost was not insignificant. It went from a ten pound minimum to nearly fifty (Woody).  I was right in the middle at twenty-five.

 

I say this only to show how easy it would be for a medical officer to see a volunteer with a GI disturbance and to assume that “in time” it would work itself out.  I can understand how the doctor in this case thought that. The other problems with the ambulance and the IV cause me more concern. In my post I want only to address how very common it is for Peace Corps volunteers to be sick.  GI distress is the norm, at least in the first six to nine months.

Here’s the promised Deleted Scene … 

 

That night, Soombat served raw herring for dinner, a welcome change from the usual boiled meat and potatoes we’d been eating.

I was thrilled. I’d relished herring in all forms ever since my mother served it pickled on crackers as a snack when I was a child.

My love of it bumped up even more during my first trip to Copenhagen where Woody and I had spent days hopping from one waterfront restaurant to another, eating whatever pickled herring creation they served; then in Holland the following year, I enjoyed it raw and whole. I couldn’t get enough of it.

But as Soombat placed the dish on the table, Woody excused himself and left, telling me in English that it smelled bad. I couldn’t smell a thing and wrote his departure off as his inner-curmudgeon surfacing again.

Then, I ate it with gusto. A lot of it.

 

In the early morning hours, I awoke to a gurgling in my bowels and rushed to the toilet to realize the raw herring had returned uninvited. Woody may have been right.

 

I grabbed my Kazakhstan Health Handbook 2004 and sat down on the edge of our bed to read it, the light from the sun streaming through our open window enough to light the page.

 

The table of contents alone was eight pages long and divided into four sections: Environmental Hazards and Precautions, Preventive Health Measures, Pain Management, and Specific Diseases and Therapy. This last one had two sections: “Gastrointestinal Disorders” and “Respiratory Infections.” I was getting closer. Then I flew off to the tiny toilet room again.

 

“If Mexico has its Montezuma’s revenge,” I declared to Woody, desperate to find some humor in the midst of my misery, “this is Genghis Khan’s.”

 

Returning, I picked up the book where I’d left off: Gastrointestinal Disorders. There I found four headings: diarrhea, gastritis, intestinal worms, and constipation. I quickly discounted the last one and, remembering what I’d heard during training, “All organisms that cause diarrhea have come from someone’s intestinal tract,” wondered which of the remaining three I’d prefer: simple diarrhea, gastritis, or an intestinal worm. It didn’t matter; I just wanted it to stop.

 

I began reading the  Diarrhea section, learning it was my “body’s natural method of ridding the bowel of something that doesn’t belong there” and that bacterial food poisoning is “self-limiting, since the bacteria do not continue to grow in the presence of normal intestinal flora.” Good news, I thought. This shouldn’t last too long.

Then, as I skimmed through the intestinal worms section, I read that eating raw herring in Kazakhstan was discouraged: it’s one way to get a tapeworm, the kind that grow “up to twelve feet in length.” Thwack. My earlier relief was gone in a flash. This was not why I’d joined the Peace Corps.

 

The idea that a tapeworm was growing inside of me took a firm hold. My Buddhist proclivities toward compassion for all life forms forgotten, I wanted only to kill it and get it out. But I needed Peace Corps to tell me how.
After my fourth visit to the toilet — four “episodes” in one hour was the official Peace Corps definition of real diarrhea —  I called the Peace Corps office in Almaty to report my condition. Victor, one of the Peace Corps’ two medical officers, advised me to take the Ciprofloxacin from our medical box and keep up my fluids. And, he added, I “probably” didn’t have a tapeworm.

That was good enough for me. I grabbed his acquittal and hung on tight.

My conversation with Victor may have set my mind to rest, but not my bowels. The herring would continue to haunt me, mercilessly, for another week. In all my fifty-six years, I’d never had diarrhea that attacked me so violently.

 

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The rest of the story can be found in this Deleted Scene from last year, when I went out for lunch with my new colleagues and taught them the English word for pa nos (diarrhea).

 

Another response to Ms. Stohlberg’s article is a letter to all volunteers from Peace Corps’ Director, Carrie Hessler-Radelet.  You can read it here.  

 

Risk. We all see it differently. What is risky and not doable for one, is risky and out of the question for someone else. Each of us perceives risk in our own way. And that is the part of the story that I thought was missing.

 

Had you read either of these NYTs stories? How did they strike you? How do they strike you now?  Does my explanation of  “defensive attribution” ring any bells?  I’d love to hear your story.