Anatomy of a Medical Separation

Life doesn’t always go how you think it will. Forgive me for being so cliché, but that’s a thought that’s been running through my mind a lot lately.

A few months ago, I was medically separated from the Peace Corps. Throughout the time leading up to the end of my service, along with what came after, I found myself furiously scanning the internet for anyone who went through something similar. I wanted to find something to relate to, not necessarily as a source of comfort, but to use as some sort of gage that I could use to figure out how things were going to look for me in the period of time before and after things hit the proverbial fan. Or, perhaps, I was just looking for a form of validation for what I was feeling while going through this.

There are a handful of accounts out there, but not a lot. I’m hoping it might be beneficial to add something of my own.

Anyone who is at least somewhat familiar with the Peace Corps as an organization probably has at least a general idea of what a typical volunteer experience looks like: working a variety of different jobs in lower-income nations, while living in typically rural, isolated conditions alongside the populations they serve. Although the Peace Corps operates in over sixty countries, there are some common things that all volunteers will experience, one of them being illness. The ailments are largely what you would expect them to be, such as regular bouts of food poisoning and diarrhea, feelings of isolation, depression, and so on. No matter where you happen to be serving, you’re bound to experience all of these at one point or another.

In addition to the more commonly-found maladies, volunteers are, unsurprisingly, more likely to get sick from things that generally didn’t affect them in their previous lives.

Take me, for example. I served in Kyrgyzstan, a small, mountainous country in the heart of Central Asia.

Before joining the Peace Corps, I had a reasonable amount of travel experience, a good amount of it in lower-income countries. Luckily enough, I never really got sick outside of a couple of times during my very first trip outside of the states. However, from my first week in country up until my final hours, I was dealing with some health issue or another. It seemed like I was allergic to Kyrgyzstan.

For example, an unpredictable, insanely itchy rash added a veneer of anxious discomfort to most moments of the day. My joints hurt for some unknown reason. I also certainly was not spared from what we can refer to as “gastric distress” issues that affect pretty much every volunteer. Not surprisingly, these illnesses sometimes become a bit of a bonding mechanism for volunteers. As the saying goes, you swear in twice as a Peace Corps Volunteer, once during the actual ceremony where you are anointed to protect the U.S. Constitution from all enemies foreign and domestic, the second time being when you shit yourself in country for the first time.

But I digress.

Around a month after (officially) swearing-in and moving to my permanent site, my already somewhat-beleaguered health started trending from not-so-great to worse. I began to sleep horribly, usually no more than two to three hours a night. I completed a two-week, scorched-earth policy of antibiotics that left me weakened and unable to catch back up to whatever normal may have been. On top of this, I started to notice a dull pain on my right side.

Add this fun brew of medical maladies to living in an isolated community where you can express yourself about as well as a bashful five-year-old in the local language, and you have a recipe for somewhat of a stressful time. Instead of being able to work at the school I was assigned to, I was constantly shuttling back and forth between the capital for medical visits. My host family and community didn’t really understand what was going on. They were sure the cause of my poor health was just a lack of warm winter clothing, and that I was just running off to the capital to get away from them and the village.

On one of my half-dozen round trips to the capital, I was sandwiched inside one of the overstuffed minivans that are typically used to commute between the larger towns and cities in Kyrgyzstan. Wedged next to me was a man who was holding his small child in his lap for most of the five-hour ride. The road, while pretty well-paved, all things considered, wound up and down the hilly countryside. Coupled with the speeds at which local drivers typically vault down the highways with, the result is a gut-churning experience. At some point, the child was making those unmistakable retching noises, signaling that we were mere seconds away from a biological repainting of the van’s backseat. The father tried, as all parents so frequently, so unsuccessfully try, cupped his hands and attempted to catch some of the product. It was all in vain as the immediate area, including my pants and jacket, were repainted. I didn’t have it in me to do much besides wipe away the mess and set my eyes back on the road.

The next morning, I woke up for an early appointment to meet with the Peace Corps doctor to run some tests. My limbs felt like they were made of lead. Even the most basic efforts of putting on my clothes and washing my face required a monumental effort. It was an icy morning, and a layer of fog gripped the city. The hostel where volunteers are normally stored for medical visits was about a twenty-five-minute walk from headquarters. It took me forty. Each step forward was a battle of its own. The doctor, who I had grown pretty familiar with over the previous months, remarked that I “wasn’t looking so good.”

We went to a clinic for some blood tests, and to consult with another specialist. I didn’t understand much of what was going on, because my language training hadn’t covered Russian, the lingua franca of the capital. At one point, I found myself on a cold exam table with an old Russian woman instructing me when to breath in and out, jamming an ultrasound wand under my ribs with each successive inhalation. Some more back and forth followed between her and the Peace Corps doctor. It was clarified that I had “some liver inflammation” which, while concerning, at least explained the pain in my side.

After this, the appointment was finished, I went back to the hostel with the easy-to-follow medical advice to “take it easy.” On the way back, I looked at my phone and noticed something. It was Thanksgiving Day.

I returned to my site the next day.

I grew increasingly unsure of what I was going to do. Despite the best efforts of the local medical staff, my condition just wasn’t improving. Each week seemed to add a new illness to the list. I still wasn’t sleeping. I had next to no appetite, and the slog to and from the capital every few days was exhausting in my state. Thoughts of whether this was all really worth it or not kept gaining more and more traction in my head. For the rest of the month, however, I was plagued with indecision on what to do. I made a commitment, after all, and I couldn’t just discard that.

During my next medical visit to the capital, I scheduled a meeting with the Country Director to discuss what my options might be, or at least, that’s how I thought of it. At that time, I think, I had already somewhat made my decision, that I needed to go home to get to the bottom of whatever the hell was affecting me and recuperate in an environment that was a little more conducive to recovery.

The day of the meeting, I had a few hours to kill in the morning, so I went to get my hair cut. There hadn’t been many opportunities since going to my permanent site to get a good look at myself, and I was a bit shocked to see what was looking back at me in the barbershop mirror. To put it gently, I looked like a corpse. My skin had taken on a pale, waxy hue. The bags underneath my bloodshot eyes had grown to a size not even seen during my college days. I had been pretty aware of my condition up to this point, but this made me realize that things probably weren’t going to work out. I accepted that I needed to start thinking of risks to my long-term health posed by my stubbornness to hold on to a job that just wasn’t working out.

The low winter sun was sinking behind the skyline as I left the meeting to return to the hostel. The conversation lasted a little under an hour, and although I hadn’t signed anything yet, I realized that my short Peace Corps service was creeping to a close. The holidays were coming up, which complicated things logistically, but would at least give me some extra time to return to my site one last time to gather my things.

I languished in my hostel room for a few days before working up the strength and willpower to make the journey back to my site. Arriving in the evening, I hurriedly threw my things together, having to periodically lay down on the floor in between bouts of nausea. I tried, probably in vain, to explain the situation to my host family, but I’m not sure if I was able to get the point across that I was leaving because I was sick, not because I was fed up with them, the country, or something else they were at fault for. Soon, the morning arrived, they helped me load my things into a passing car, took a few last pictures with me, and bade me farewell. I knew I was making the right, but I was still filled with guilt. I realized it was Christmas Day.

The car wound its way through the various mountain passes, occasional villages dotting the horizon on the otherwise moonlike face of winter in rural Kyrgyzstan.

After some packing and repacking, closing my local bank account, and fighting through the mountain of paperwork that comes with any sort of change in a government office, it was time to go.

The sun set behind the peaks of the Tien Shan on my last day in Kyrgyzstan as I boarded the first flight of my long journey home. My journey, which had its roots set five years before, was over.

—

A lot of accounts of Peace Corps service that I read use the term ‘bittersweet’ to describe how things felt as their work wrapped up. To be honest, I’m not sure what I felt as I started that trip from one far-flung corner of the world to my own corner. I’m not sure what I feel now. Although there were plenty of things along the way that could be considered accomplishments, let alone undertaking it in the first place, I certainly didn’t feel proud at the moment, and I can’t say that I feel proud now.

I’m not sure if I ever will.

While I wouldn’t say that I feel like an outright failure, there’s a lot I wanted to do with my service that I simply won’t be able to accomplish anymore. I feel bad about the kids at the school I left behind, that I was only around long enough to leave an impression that foreigners, and Americans by proxy, are feeble and just aren’t capable of surviving in Kyrgyzstan. I feel bad for the school that was promised a volunteer, a colleague, a fresh face for two years who instead stayed for two tenuous months before disappearing back into the cold winter that he arrived with.

For any current or recently ‘R’ PCVs who might be reading this after going through something similar, I hope this has given you something to relate to. Deep down, I know I ultimately made the right decision in regards to my health, however, I think at some level there will always be some level of doubt in my mind. Maybe you’re different than me in this regard. Just don’t forget all that it took to get you here in the first place and all that you were able to overcome just to arrive. That alone is something worth being proud of.

As for me, I never really got any good answers as to what specifically was wrong with my health. Recovery has been a long, mostly uphill process. However, each day is a small improvement on the last, and for that I’m grateful.