An Inherent Tension

crispydoc Uncategorized 10 Comments

This morning I read a wonderfully nuanced piece of writing by Peter Hessler in the New Yorker, which explored several delicate themes with great empathy. The unifying theme was the inherent tension of being identified as "other" in society, and how such a misfit identity can create a disconnect in how one is treated by society. Hessler captures something that I have sensed but but been unable to articulate for many years.

A society can genuinely care for the misfit and express sincere affection for him. On the other hand, the status of not fitting into societal norms is used as justification for targeting the misfit for exploitation or worse. The article's narrative weaves in the betrayal of a foreign correspondent living in Egypt by someone close to him who exploits the foreigner at a vulnerable moment for personal gain.

Many of us choose to think of the world as a collection of people waiting to form meaningful connections across cultures. Some even blog about their experiences supporting this world view. But the truth can be a bit more nebulous.

During a rotation abroad in Nairobi while in residency, I experienced comical moments, such as when one of the security guards I became friendly with as I entered and exited the hospital compound decided to ask if I would grant him a scholarship to study in the US based on a couple of weeks' worth of friendly head nods. It was a brazen Swahili form of chutzpah, and I tried to see it from his perspective - you come from plenty, why shouldn't you share some of that abundance with me?

Then there are memories of more subtle and awkward experiences. I met AH through a friend while spending time in northern Ethiopia during fellowship. AH was an engineer teaching at the local university, clearly bright and ambitious, with designs on a future that was greater than his environs would allow.

We went out to coffee, took meals together, and he even invited me to the home he shared with three other friends to enjoy home-made Ethiopian food prepared by his sister. He was one of several close friendships I made during my time abroad, and I was grateful for our friendship.

On one of our perhaps weekly get-togethers, it was getting late and AH had to walk home in the cold, so I loaned him one of my favorite jackets. Weeks passed, and the jacket always seemed to get forgotten. He was a detail-oriented guy, so the repeated shrugs of, "Sorry, it slipped my mind," rang hollow.

This continued over a couple of separate trips until, awkwardly, I confronted him about the missing jacket during my final trip to Ethiopia before my fellowhip was to end. Sheepishly, he dropped it off at my hotel a couple of nights before my departure. We lost touch after that - something strange and extractive had insinuated itself into the friendship that ultimately resulted in its undoing.

The jacket incident was seemingly minor, but I've replayed it many times in my mind. I could have been less petty - it was just stuff, he was a friend, and the signs were obvious that he really liked it and cared about it more than I did. If he'd asked if he could keep it, I likely would have acquiesced.

But something bothered me deeply about his simply hanging onto it - perhaps it uncomfortably implied that our friendship was not genuine, that in the end I was a wealthy foreigner and he was in some way exploiting our friendship to get some shiny object he might not otherwise obtain. It left me feeling a bit used.

The irony is, one could have made a similar argument about exploitation in reverse: I was the outsider using my friend as an entry point to local culture and social networks that typically took years to develop. At some point I would leave the country, most likely never to return. Wasn't it only fair that I leave some form of payment for services, like a favorite jacket he was fond of? Isn't this what friends do for friends?

This tension seems greatest where there is greater asymmetry in wealth or power between friends - I would not have likely felt this way with a friend with similar resources, or from a nation with GDP on par with the U.S.

I'm often deliberately evasive when meeting new people abroad because I'm reluctant to play the wealthy foreign doctor - I'd much rather they look me over and conclude by my attire that I'm a middle-aged backpacker who can barely afford the hostels. I'd prefer they like or dislike me for who I am rather than what they can extract from me.

There's no great answer to be found in this confession.

When I got home, I couldn't wear the jacket any more, and donated it to goodwill within a couple of months.

I googled AH recently. He's built a successful life as an engineer in Norway. I'm happy for him, but I have to wonder: On visits home, does he question whether his family and acquaintances see him for who he is, or for what they can extract from him?

Comments 10

  1. Thought provoking post, as usual, CD.

    The tension with the jacket and your Ethiopian friend was especially poignant.

    It doesn’t have to be in a foreign country for that situation to play out again and again. I have been asked by some friends to help out with money when they could not afford their apartment rental payment etc and that does put a huge strain on a relationship. When there is a disparatity in financial circumstances between parties the one that has more can question the intentions of the relationship with the one that has less.

    It plays out in love too. Does someone like you for you or is it the perceived money you have?

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      I used to list my occupation back in my online dating days as “crisis management” instead of medicine, figuring I wouldn’t be interested in someone who needed the profession checkbox as part of their criteria.

  2. In my life I made plenty of money. Plenty of money means more than enough. Plenty of money means we could home school my kids which meant my wife would need to stay home and guide the education. I fully participated but someone had to be on the property so she closed her practice and we went in that direction. I’m guessing that decision cost us 1.5M but the result is my kids are precisely the people I wished them to be. I made plenty of money so the 1.5M was well spent. We exercised our agency over our lives to realize a particular outcome not really measurable in dollars and cents.

    I always set aside 10% to pay for “the other” because I made plenty of money. I didn’t do it for a tax dodge or some donor fund nonsense which I find to be bullshit. I gave 10% because of what it could do. My favorite was to build wells in villages with no water, typically that meant getting water was a 2 hour round trip daily to some river. In the case of dysentery potable local water plus some electrolytes might just be the ticket between some kid living or dying. One charity I worked through had a house design where you could build a near hurricane proof house for 2500. Give a family a house and they go from living on the garbage dump to having an address. If you have an address you have a basis from which to start to move into society and exercise your own agency. Often 1 house would anchor the family then a cousin would show up from the bush and he would get a start then get a job then get a place and some more family would get anchored. 2500 created something sustainable and the hurricane wouldn’t blow it away. One year a friend lost his job he had 6 kids so I gave him 1K/mo till he got employed since I had 10% sitting around needing to be spent. Another guy was a handy man working for me and he and his wife adopted some foster troubled kids. His car died so I bought him a van so he could continue his handy man gig and feed his family. A man has to be able to feed his family, it’s paramount to being a man. One year a priest rolled through my Parrish from India and his “church” was a tent open to snakes. He left with a check big enough to build a church in India which now serves a community in India and the guy doesn’t have to sleep with one eye open worrying about getting snake bit. Nasty snakes in India. I found one reliable charity that served school aged kids in the Philippines and the Caribbean Islands, and also took care of destitute geezers, old people who had no relatives. I always funded 20. Cost $300/yr/person. 1 iPhone = 3 people WTF

    Every year it was something different, some other particular need would crop up and I had 10% because I made plenty of money. It was built into my plan of life so I never felt resentment. A few of these people were friends of mine most lived thousands of miles away and I wouldn’t know if they bit me on the ass (I do have pics of the houses I built and the church and a few wells and letters from the kids) but I do know through my agency some difference was made and the difference made was to one specific person or family or community. It had a specific purpose and broke the odds in a favorable direction. The likelihood of success moved from being insurmountable, to possible, to likely. If I’d horded that money I would have retired sooner or I’d be a lot richer. If we didn’t home school we would have retired sooner but what’s the point of plenty of money if you don’t use the creative agency and leverage it provides?

    1. Post

      The creative agency, especially used to repair a broken world, is a powerful thing if you can adapt your life to harness it. High-impact examples, my friend, thank you for sharing them.

  3. That’s one of the MAJOR pitfalls of retiring in a cheap country.
    You can be there but you are never part of it.
    You will never be seen as in, but always as out, particularly if the races are different.
    That’s why most foreign retirees end up in expat communities where, after a while, the contacts with the locals are limited to transportation and cleaning services (often sexual services as well).
    It’s not so bad if the delusion is explicit.
    It creates of course an enormous resentment on the part of the locals. Sometimes unconscious.
    And often the expats cannot see reality but only imagine themselves as a great benefit for the locals. Which they are not.
    It sometimes result in theft, violence and even death.
    Mixing humans is a complicated thing.
    I have often noticed that rural communities in the US are actually very tolerant of misfits because they themselves as a whole are considered misfits by the elite.
    Whereas in the richest of the richest urban centers, those who consider themselves enlightened above the rest of the provinces (and the New Yorker magazine is a caricature of this form of implicit disdain) , live in forms of segregation (racial, financial, educational) matched only by third world countries.

    1. Post


      Appreciate your observations of how we tend to segregate both in life abroad and at home.

      My med school roommate had a father who was an engineer and a mother who cleaned houses before she was married – a type of fairy tale romance and mixing of socioeconomic classes that is getting increasingly less common as the self-segregation increases. The NY Times ran a couple of articles over the past 2-3 years about how the college-educated are far more likely to mate with others of similar educational attainment, reinforcing their advantages of wealth and education in the succeeding generations. I’ll leave for you to decide if my reading list betrays my complicity in such arrangements.

      (Speaking of which, not sure if you’ve ever read Barbara Kingsolver’s novel, The Poisonwood Bible, but it explores these themes quite beautifully.)

      When I was an undergrad, a grad student named Amy Biehl who was in Capetown as an anti-apartheid activist was killed by a local politically-motivated mob, essentially for being white at the wrong time and place. Her parents responded with a type of forgiveness that most of us would be hard-pressed to imagine – they forgave the men convicted of her murder, supported their release as part of the Truth and Reconciliation Commission, and even employed a couple of the men in the foundation they established in their daughter’s name in South Africa.

      All to validate your observation that, “Mixing humans is a complicated thing.”

  4. Wow. You’re a talented writer, CD.

    Beautiful prose, an engaging and thought provoking story, and a pleasure to read.

    I had a similar situation while traveling in Cairo, Egypt with friends after college. A friendly scented oil and papyrus store owner invited us to watch the nightly fireworks over the Great Pyramids on a rooftop after we perused his shop.

    We took him up on his offer and had a blast chatting with him and watching the show. (In retrospect, what were we thinking!?) But when he pressed us to come back the next day to his shop with the rest of our group, that prickly feeling of artificiality descended and smothered the good vibe. We slunk back to our hotel rooms with that same feeling of being used tainting an otherwise great night.

    — TDD

    1. Post

      It’s weird how things can turn on a dime like that, isn’t it TDD? The odd part is I wonder if our fear of not being taken advantage of is out of proportion to the actual risk – some of the happiest travelers buy trinkets from such friends for a trivial amount, and feel fine about it, keeping their sense of their experience preserved.

  5. I learned very early on there will always be an assumed power/wealth differential the instant people discover I’m a doctor. I similarly never tell people what I do for work because of that very reason.

    It’s not isolated to interactions with acquaintances or friends – the last time I went to the Philippines, it was most apparent with my family. The fascinating thing about the whole situation was the difference in how my mother interpreted requests vs my sister and I who grew up in North America. To her, it was an honour to be asked for things, whereas my sister and I felt any requests for us to leave “remembrances” were flagrant demands to leech us of our belongings.

    Perhaps the conflict arises from the fact that rules of hospitality are different across cultures, and I just didn’t have great enough of an appreciation for these nuances at the time. Not saying I even have them now since I’m still very cautious, but I’m more aware them now.


    1. Post

      Interesting observation – I’d even take it a step further that rules of hospitality are not only different across cultures but across generations.

      When my father arrived in the US from Cuba, he stayed with family friends for a few months before moving onto college. Similarly, my great uncle used to tell of how their living room sofa in Brooklyn was always occupied by family in transition from Cuba for several years after the revolution there.

      Now fast forward, and my father’s well-to-do cousin suggested a daughter soon to attend university in my hometown could not find housing, intimating that perhaps my parents might put her up. Although they had ample room in their home, my father preferred his privacy and replied with a list of available student housing with plenty of vacancy (in his defense, his cousin more than possessed the means to pay for housing).

      As my father recounted the story with a twinge of exasperation to my grandfather, who shared a far smaller home with my ill grandmother in the same town, my grandfather said, “Let her know she is welcome to stay with me for as long as she needs until she can find a place of her own.”

      I vacillate between my father’s desire to live the life you want and my grandfather’s sense of obligation to help others, and it’s anyone’s guess who wins out on a given day.

      Appreciate the thoughtful reflection, M.



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