27 June 2011

Learning language

The following is slightly modified from a recent graduate admissions essay. (The first paragraph, alone, was posted in December). It may be a cop-out to post something I've already written - and, quite differently from everything else I write here - this one is highly edited and revised. With help.
This, however, is the manifest - and I wanted to explain what the connections are, for me, between the disparate interests. It's like writing poetry - once I've written a poem about something, describing that (event, feeling, person) in other words and sentences falls short. It isn't exactly, not quite, what I mean. Hence the quoting-of-self that happens. Inevitably. This, I imagine, must happen to all writers. So, rather than expound upon what's already been written:

***

It starts when I enter the room. How many words can my patient speak without needing
air? Is she leaning forward to breathe? Are her fingers clubbed? My stethoscope hangs without weight. My hand is on her shoulder now. My eyes close. “Breathe,” I say. “Relax.” And I am listening to the inside of her body. It’s telling me things my patient knows but lacks vocabulary to describe. It is my privilege to explicate this poem.
            I was born speaking two languages, and, as a bilingual child, French and English were imprinted in entwined synapses. I do not always know which language I am speaking. If I read a book in English that takes place in France, I “remember” the dialogue in French. I transpose. In this way, I have learned that translations are only approximations. I connect most with those who speak both my languages because that allows me to use the most precise word possible.
            I speak two languages. From my early years in school, I was drawn to science because of its inherent beauty and creativity. I decided to pursue biology the first time I looked into a dish of pond water under a microscope and discovered an entire invisible world. I spent late hours in the lab, peering at 400x magnifications of cells I had stained green for mitochondria and red for nuclei in a 12-hour painstaking process. I would forget to count and simply stare.
Cacao field, Mvangan

As I explored poetry and science in parallel, organic chemistry flattened molecules into boxy lattices. I couldn’t see their relationship to even the scientific study of life. At the same time, I wrote a paper on Sharon Olds’s “I Go Back to May 1937.” First look, second look, I loved the poem. As I delved deeper, I discovered the structure – the tendons, ligaments, and fascia – subtle scaffold for this exquisite organism.
I see the body as a poem to learn, but early medical training spends years on anatomy, physiology, and pathology. It’s like learning to read and write poetry by counting epics in syllables. Every two beats must be an iamb. But the iamb echoes the meter of the healthy, human heart. Exactly.

The poet is better at listening. The doctor is better at discerning what to listen for. Dr. Rafael Campo’s Desire to Heal circumscribed the locus where I want to exist: narratives of illness, stories of medicine, exploring the palimpsest of the body. Diseases are stories that have been written over and over through history, and yet they continue to engage us in the same basic plot. I had the opportunity to work with Dr. Campo both as a writing workshop teacher and in his medical practice. My first steps in clinical medicine were alongside a poet. I started learning the practice of medicine by listening and asking for stories.


Batoke, near Limbe, Cameroun 
I find the narratives of medicine everywhere. In AIDS in Anthropological Perspectives, a college course, I read the history of AIDS from the first descriptions of a strange epidemic in San Francisco and New York to the scientific papers, anthropological dissertations, national statistics, and the poetry and fiction by those infected and affected by the virus. Here altogether was public health, literature, medicine, global health, and an opportunity to work with underserved populations. In college, I volunteered in AIDS outreach and activism. In Cameroon, as a Peace Corps Volunteer, I directed a rural health district’s HIV programs, trained HIV counselors and counseled patients, worked with high school students, and wrote curriculum. In Kenya, I did public health research on HIV. As a medical student, I work in HIV clinics. I am reading the literature as I learn to write it. Every connotation and different cultural metaphor is critical to my understanding. And this is just one disease.
HIV poster in Migori District, Kenya
When I was a community health volunteer in Francophone Cameroon, no one understood me for a few weeks. I was technically speaking the same language as they were, but African French is a more oral language than French-French, with different and mutable vocabulary. The natural storytellers I worked alongside and who became my close friends were raised in a poetic culture of call-and-response. To be an effective volunteer in my village and in the larger health district, I had to re-learn to speak my first language. Words, though, weren’t enough. In Cameroon, people also communicate with clicks from the back of the throat. These clicks mean assent, empathy, “I am listening,” “I am here with you.” They express more in a single sound than can any combination of words. Every language requires the tongue, larynx, and jaws to move in varying configurations while air expelled from the lungs charts a slightly different course. It was difficult, as an adult, to learn to shape a sound I had never made before and could not write down. I spent many hours practicing in order to be able to say what I was learning to hear. Back in the United States, I find that I want to use the clicks just like I want to use French while speaking English. Having to communicate without access to my full range of languages is challenging and, at times, feels stilted and stifling.


in Madagascar (sign in Malagasy)
 I have spent three years formally learning to read poems of the body. I turn now to MFA programs to learn to write them. I want to be equally a physician and a writer, so before I continue a clinical education that will not allow deviation from a strict path for many years, I feel it is time to explore poetry as rigorously as I have medicine. Scientists are just beginning to study human history through mitochondrial DNA. Living in contemporary poetry, I want to study literature’s attachment to the earth.
In my career, I plan to work as a physician in global public health, and as a writer. I will continue to explore experiences of the body across cultures and demographics, working with underserved and under-heard people. The poets writing about AIDS in the 1980s had no small part in raising awareness of the epidemic. Writers lent humanity and narrative to disease, working in concert with and giving imperative to the medical fight for progress. Theirs was a revolutionary act, in showing that even the ill body, ravaged with disease, could be worth loving – and thus – human.




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