a tapestry

It's a small city - and country (and world). The other day at the clinic, a new TB patient - a one-armed, skinny, elderly gentleman - called me over to where he was sitting and demanded to know what I was doing. I explained my research to him and after a few minutes of conversation, he relaxed and began to smile. Just yesterday, while sitting with a friend at an outdoor cafe in the Zona Colonial (a world away from the community where I do research, in every sense), a beggar approached us, asking for spare change. My friend, a Dominican well-accustomed to this, waved him away, but when I looked at the beggar, I realized with shock that it was the same patient who had questioned me a week before. He recognized me, too, and, after greeting me, began to personalize his entreaty, telling us how he had tuberculosis, children to feed, and had lost his arm in an accident. I gave him some money and he thanked me and wished me well.

No matter how much time I spend here, it's always a shock to realize how small the world is, a phenomenon that's epitomized on this tiny island. There are coincidences with fellow U.S. Americans - like running into a guy I met two years ago again, or meeting someone whose father and mine happened to work in the same laboratory at Yale 15 years ago - and other sorts of coincidences. My participants and friends at the clinic are the people who, in a neighborhood just a guagua ride away, drive public transportation, pick up trash in parks where I go to hang out, and clean the houses of the wealthier Dominicans I know. But in the clinic, they are patients, participants, and friends. Half the people I talk to have a daughter or a cousin who looks "exactly" like me. One of them, a man I refer to as my Dominican dad, had his "identical" daughter call me the other day to see how I was doing when I hadn't shown up to do fieldwork for several days.

And then how do you tell people who begin to look out for you, who start to care about you, that you're leaving and have no idea when you'll be back? I didn't know what I was getting myself into when I applied for SOMOS back in my sophomore year of college. Or maybe it goes back even further - to the report I did on the Dominican Republic in my high school Spanish class. But the thing is that now I have a compromiso with this island - a commitment that I know will keep me coming back over and over again (hopefully next time to the Haitian side). There are health problems throughout the world, and there are countries and communities elsewhere that I have long wanted to visit. But my "brother" and "Dominican grandparents" in northern Santo Domingo, my close friends and colleagues from all sectors and walks of life, and the distinct locura of Dominican Spanish can only be found right here. I feel committed to the work, too. Even though I'll be moving on to other things very soon, I want to know who the next person to take up research on TB will be, what new innovations the programs here might develop over the next several years, and how the epidemiology will change over time. You see, I am a person who likes stories, and as much as we sometimes pretend they do, stories never end. What is challenging about life is that we must learn how to weave these stories together in order to create, a la Carole King, a tapestry. And weaving is an art that we learn over time.