It was the cold that made me miss the sunBy Tsi Njim, MSc International Health and Tropical Medicine (2017) Kellogg College
This is a story based on Tsi’s fieldwork experiences. He is a Physician from Cameroon whose interests include Maternal Health and Outbreak Epidemiology. His thesis is titled “A prognostic model for development of sepsis in patients admitted for severe falciparum malaria in Southeast Asia.”
06:55: International TropMed Residence, Room 507
It wasn’t a particularly humid morning. It was humid enough to make me miss cold days though. I woke up with the same thought that had kept me wide awake into the early hours of the morning. For some reason, my model had crashed. And as if only to annoy me, the alarm on my phone reminded me that I had a deadline to submit said model by the end of the day.
I put my earphones on and buried my eyes in the whiteness of my laptop screen. I had to work.
09:00: International TropMed Residence, Lift 1
I still had my earphones on. I can’t remember what was playing. Probably because I was still combing through my mind to find solutions to my model’s sudden illness. I had spent the whole morning going diligently through each patient’s records. Over a thousand of them. Each coded such that they couldn’t possibly be identified. Some of them had gone through significant distress. Others had lost their lives. Most survived. They all had become numbers. Nonetheless, the ethics of it all had us hide the suffering behind codes and numbers. It was easier on the mind.
09:05: The Sandwich Hut, Opposite 7/11
Indeed. It wasn’t a humid morning. The lady at the Sandwich Hut greeted me with a smile. Everyone always did here. It was one of the reasons I visited the Hut every morning. The sandwiches weren’t particularly good. But the smiles more than made up for any mediocrity. Nothing like a bright smile to start an unpromising day. She wrapped my sandwich in a bag. Another smile. I was grateful.
09:10: The Lobby, Building 4
I had to wait for the guard to sign me into the building. He was nowhere to be found. As I waited, I watched the wave of people hurrying to their jobs in couples and threes. A few in quartets. I noticed a woman in her fifties approaching the building. Or me. Alone. Slowly. Steadily. Assuredly. At that moment, I could feel in the depths of my belly that I was about to have an interesting encounter. Or at least, she would let me into the building. Of course. She had the key card in her hand. “Good morning” she greeted as she opened the door. I think I replied. I hope I did.
09:12: The Lift, Building 4
“Where are you from?” she asked. “Cameroon” I replied almost abruptly. It may have given the impression that I wasn’t ready for a chat. She was relentless. “So, what brings you to Bangkok?” she continued. “Research. I’m working on a dissertation. I’m trying to see why some people die of severe malaria.” I tried to be as explicit as possible hoping she will give up on the impromptu trial I was facing. She the prosecutor, I the defendant. “But we don’t have any malaria in Bangkok!” she looked surprised.
09:15: The Bridge, Third floor
“Erm, no you don’t” I said as we exited the lift.
“Then why Bangkok?” she asked.
“I’m doing a secondary data analysis and the data is kept here.”
09:18: The Lift, Building 5
“Ah! The data. It’s always the data. People keep flogging the data even after the patients are gone. I wonder what those patients will think if they know those hanging on to their data were not even there to at least hold their hands in their time of suffering.” She said smiling as she exited the lift.
09:20: Clinical Trials Unit
I’d have imagined she felt triumphant. I would have if I were her. She went in the opposite direction. Without even glancing back at me. Alone. Slowly. Steadily. Assuredly. The mystery data lady – I chose to call her. Her words kept resonating in my ears. She was right. Of course, she was. We had indeed hidden the patients’ sufferings behind codes. Patients, people had become numbers. It was ethical to do so. But then again after doing that, we kept using their data without any added benefit to them. Some of us weren’t even there to contribute in their healthcare at the time of their illness. To hold their hands. But somehow, we hoped that our work will help benefit people on a larger scale. Not the patients actually. No. They were long gone. The greater good. In truth, most of the time, it didn’t. It was a dilemma. It was my dilemma. My ethical dilemma. And it was something that kept me troubled with the idea of my secondary data analysis.
With that on my mind, the idea of my model crashing hit me like a wave. It was like my brain was trying to shock me into concentrating on what it thought was more important.
My model’s illness versus my ethical dilemma. Really, which was more important at the moment?
09:22: The Offices
I entered the offices. It wasn’t a particularly humid day. But the air conditioning unit had been set to subroom temperatures as it always was by my colleagues. It was freezing. It always was freezing inside the offices. “Good morning Claire” I greeted “It is quite cold” I complained as usual. “Yes, it is” she smiled back knowing fully well that nothing will be done about my complaint. As usual. She had a jacket on.
Surprisingly, it was cold in Bangkok. And it was so cold that it made me miss the sun.
Tags: Africa Oxford