Fieldwork’s Hard Reality is in the Soft Stuff: Part 1: Health
I came to Trinidad armed with a suitcase and a backpack, ready to plunge myself into THE FIELD. I was going to own it. I was confident Trinidad was for my taking. Beware, you feisty, carnivalesque woman. I was coming with energy to match.
The three and a half years leading up to January 2016 were spent huddled over theory books with perspiration accumulating in my brown armpits as I gave qualifying exams, taught my first class of squirming 19-year-olds, and presented at conferences that reminded me again and again of how tremulous my voice sounded behind a microphone. But there was a higher purpose to graduate school groveling. I was preparing for fieldwork, for data collection. I was cajoling my brain to renew some of that grey matter lost to puffs on many a forgotten night, all for the grand pursuit of knowledge in THE FIELD. I did the mandatory course on ethnographic methods, I read and practiced how to ask the “right” questions, iterate on them, sniff out the breadcrumbs, and chart a course to victory.
My economics training discovered a love-hate relationship with anthropological methods, like a bull with a matador’s flag. Research design, sampling methods, population size, my brain was buzzing with order and categories. The field researcher was being forged in steel.
My technical training continued via Skype, emails, and phone calls. I wanted to add a third site, also add gender as a new variable. One committee member coaxed me to ease up. Go with the flow, she said. Perhaps she noticed the paradox that in the most humanistic of scientific disciplines (a.k.a anthropology) (said Alfred Kroeber), I was getting caught up in the hard stuff. Isn’t that what fieldwork is about, anyway?
July 2016. My month so far was coming along nicely. I was on schedule – I was stratifying my research sample (i.e. getting participants with certain characteristics I wanted), collecting good data, writing up my reports, huffing and puffing to T-25, and basically feeling like the steel-forged researcher I had set out to be. Till I started developing some redness in my eye. Out came the contact lenses. A day later, it was hurting enough for me to make a trip to the hospital. Thankfully, I knew someone well connected who told me which door to knock on. Registration done, half an hour later, an ophthalmologist was seeing me.
The doc wasn’t sure why the eye was red. Three days later, acute sensitivity to light. Back to the ophthal clinic. Another doctor this time. I’m put on steroids, antibiotics, and antiviral treatment. The bastard was going to be bombarded with whatever they’d got. Two weeks later, some improvement but I’m not a very happy patient. There is a white spot on my cornea at this point. Week three. I start developing blurry vision. The drug experimentation continues. Week four. The doctors discuss writing a paper on my eye. At this point, I am flipping out. What the fuck is going on? Should I get a second opinion in the capital city? Should I get a second opinion in another public hospital? Should I return to the US? At this point, I write to my advisor and get her up to speed. I tell her of an upcoming trip to California that would now probably double up as a second consult. The steel-forged researcher was actually flesh and bones.
Advisor’s response: Get to California ASAP! Messing with your health is not good.
I am writing this blog on the plane to L.A. I am nervous as hell. Is my blurred vision permanent? Did I wait too long? Should I have gone straight to Port of Spain (the capital city)? And then the annoying anthropologist rears her irritating, politically-sensitive head. Do you not trust rural doctors? Was it not reasonable to wait a few weeks, to put your fate in the hands of the local doctors as everyone else without a U.S. visa does? I don’t have the answers to these questions. I don’t know if I waited too long. I will know soon.
In the meanwhile, what I do know is that I was thoroughly unprepared for health emergencies in the field. I have health, dental and vision insurance in the US. I even signed up for emergency medical repatriation to the US in the event of life-threatening illness. I was a steel-forged researcher, with my armory of international insurance papers, online medical records, and a travel-size medical kit stowed away in my red suitcase. That’s all well and good. But what happens when you are in THE FIELD and it’s not a life-threatening emergency (or you don’t know that yet) and you need medical assistance? Where do you go? How long do you wait? Who do you contact? How do you prepare?
Going through the experience now, this is what I would tell a young, naïve researcher who thinks she’s made of steel when she enters THE FIELD:
- If you are doing home-stays, share contact details with your spouse/sibling/advisor/anyone else who is “your person” in your home country, and vice versa. It is absolutely paramount that someone somewhere always knows how to reach you or your family in case of medical emergencies.
- Make friends with a local doctor and/or nurse. Even if you meet a doctor in passing, strike up a conversation and take her contact details. Be honest about why you’d like the information, and that you’re a visitor in the country. Even if the person doesn’t have “connections”, she would be better placed to tell you where to go for assistance than you would probably figure out yourself. I am grateful for the people who have guided me in Trinidad.
- If you can get copies of your medical records from visiting a local hospital in THE FIELD, get them by hook or by crook. At the hospital I was being treated, medical records are not digitized and can take two weeks to process, which in my case would be too late. Nothing like having a full medical history to show to the doc in your home country when you return.
- When the medical prognosis involves a big scientific word, don’t just let the doctor write it in your file. Ask her to spell it out so you can write it down and look it up. Google searches should be taken with a pinch of salt, but I like to stay informed of what the doctors think is going on, especially when I am in a foreign country. I also asked one doctor to take a picture of my eye as he saw it in the machine. It’s actually easy to do and pretty painless. Think of all this as accumulating your own medical history.
- This is one from the experience vault of my academic advisor – don’t wear contact lenses in the field. The doctors who treated me in Trinidad second that advice.
- I am not practicing what I preach here but I have to keep reminding myself that treatment often entails experimentation. I am being harsh on the doctors who have treated me so far – Why don’t they know? Why is treatment taking so long? I hope to god my eye isn’t permanently damaged but should I be blaming the doctors for trying different approaches to tame this beast? Would I feel the same way if doctors in the US were experimenting and seemed to be getting nowhere? My brain yearns to be reasonable but right now, I can’t wait for the blasted second opinion.
- Which brings me to – GET THAT BLASTED SECOND OPINION. I should have done this sooner. I had four doctors look at my eye. But they all belonged to one hospital, feeding off of each other. For the four weeks I was being treated, I gave an ophthalmologist friend in the US (yes, I have one of those as well) a running commentary of my condition and the doctors’ prognoses. But there is only that much she could say or confirm without seeing my eye through the machine herself. I should have gotten a local second opinion sooner, even just for peace of mind.
I have often joked to my husband that I have the immunity of a cow (considered a sturdy, reliable animal in Indian mythology and culture). I can count on my fingers how many times I have had a cold, I am not allergic to any medication, and do just fine eating anything that doesn’t bite back. My eye issue is a harsh reality check of never overestimating good health, especially when travelling abroad. Currently, the winning hypothesis is that I have an amoeba infection that caused a hyper-sensitive reaction from my immune system. How did I get the amoeba, if it is that? Probably a perfect storm condition created by washing my eyes with unclean water (I don’t know the source of the water) combined with wearing contact lenses and being exposed to dust and street grit to add to the inflammation.
Preparing for the field is so much more than the technical know-how of collecting data. That’s the hard stuff. It’s the stuff the economic buff in me can handle. I get it. The method, the process. It’s the uncontrollable, unpredictability of everyday life – the “soft stuff” – that seems to have slipped through the cracks of my fieldwork expectations. Health is one of them. Food and emotions are the others. But those are for another post.
Right now, I’m still making peace with the fact that the immunity of a cow was probably brought down by an amoeba.
[Postscript: On Oct 23rd, 2016 I completed almost three months of steroid treatment to curb my infection. Despite numerous followups, including three in the U.S., doctors in both countries were unable to accurately diagnose the infection. The silver lining is that with the bombardment of treatments I received, something hit the jackpot. I was advised to curb my stress levels – environmental and emotional – as it appears whatever I had was an auto-immune reaction triggered most likely by stress and a weak immunity system. My eyesight is back to normal although I’m staying off contact lenses till I complete fieldwork in December.]