“Maybe what you need to do is try to care a bit less about yourself, and a bit more about others.”


That was his advice?

Just over 24 hours in the country had already completely overwhelmed him. If his phone had any reception, he would have been contacting someone, anyone, to come get him out of this rat-infested hell-hole. Literally rat-infested.

Seth arrived in Kibuye the day around 6.00. The sun was setting as it does every single day of the year 2º from the equator. Since then he had spent ten hours working with Dr. Tom, not just ten hours working, ten hours in surgery. Ten excruciatingly long hours inside a poorly lit, damp room that shouldn’t even be called an operating theater. That concrete room with holes in the ceiling, handmade wooden furniture, old donated surgical equipment and DIY tools.

After a single hour of sleep Dr. Tom sent someone to pound on the metal door of the small guest house. Seth jumped to see what the emergency was, only to find Muguru.

Without even an apology for waking him so early, he said “Good morning Doc-tah. It is the time to do rounds.” Then he stood there, waiting.

Seth realized he was still dressed from the night before, so he snatched his white coat. He stared at Muguru as he tore it from the chair, hoping that his displeasure in this whole situation would be evident. In his haste, he neglected to notice he grabbed the bottom of the coat off the wooden chair.The contents of his pockets sprayed around the room, sliding across the concrete floor. His stethoscope, the Montblanc pen and Moleskine notebook he kept in his left chest pocket, and his phone.

“Sorry, sorry,” was all Muguru said as he scurried to help Seth pick up everything. He was closer to the phone which stopped only when it hit the brick wall next to the door.

“Oh oh – Sorry, sorry,” he said again as he saw the shattered screen and handed it back to Seth. A phone whose brown leather case with lovely patina cost more than what Muguru made in a month.

“Take. Me. To Dr. Tom.” was all Seth could say without screaming at the man, or throwing something else across the room.

When they reached Dr. Tom he had already finished rounding on several of the patients they operated on less than 12 hours earlier.

“I need to talk to you” Seth allowed the words to seethe out from his clenched mouth, dispensing with anything resembling pleasantries.

“Go ahead,” he said, inserting these two English words in between his Kirundi questions to the patient and his French instructions to his nurses.

Realizing that Dr. Tom had no intention of pausing his work to speak to him somewhere else Seth added: “.. in private?”

“If you’re concerned about privacy, there is no one in this room who understands more than a few words of English… so go ahead.”

When presented with the opportunity to list his grievances, he was not even sure where to start. The lack of respect, the working conditions, the assumptions about, well, everything. But he tried.

“Look. I am not supposed to be here. I am a pediatric craniofacial plastic surgeon, and I was supposed to be doing cleft-pallet cases in the capital. Someone dropped the ball, and I got stuck with no patients. Then I got sent up here, and I’ve helped you with patching up all these trauma patients last night. But listen, I’m not an ER surgeon, I’m not going to round on these patients, in fact, there is nothing for me to do here. I was about to call to get out of this place as soon as I got up, but my phone shattered when you sent your nurse to wake me up for rounds! Now what do you suggest I do?”

That’s when he said it. That’s when Dr. Tom turned the orientation of everything around, in a Copernican way he shifted Seth’s religiously held belief that he was, in fact, the center of the universe.

“Listen. If you don’t want to be here, please leave. I can arrange a driver to take you back down as soon as we find a car and ensure there are no bandits on the road. But before you do, perhaps you should realize what is going on here.”

Here he paused, asked the patient one more question in the local dialect, and shook her hand for the third time since they had been standing there. They moved away from the bed, and out the open door.

“That older woman that we removed the bamboo pole from her belly last night, she’s alive. In the next bed is a man who surely would have died had he not been brought here. He lost his wife last month in childbirth… their seventh. So there are seven kids who are not orphans because he didn’t die last night. The 14-year-old girl whose leg we amputated will never walk, but she will live. What our surgical team did last night was not insignificant. The 55-year-old grandmother who we removed the end of the fence-post from her leg, she died overnight. So did the 5-year-old whose eye you saved… turns out he already had an undiagnosed very advanced bone infection in his leg and was too weak to recover. 18 others died last night in that accident. But, we were part of saving many others. There are hundreds on this hill full of grief and mourning, and amid all that, they all have to find some way to work their fields or their families won’t eat tonight. Not to mention the family whose house was crushed, and now have to dig up mud to make bricks, to start the process of rebuilding even though they probably don’t have one dollar.”

Here he paused, shook hands with someone who passed by. An ancient looking man, walking with a stick taller than him, that he used as an aid for an obviously lame leg.

Dr. Tom continued in his calm manner, his words cut, yet his tone was still compassionate. “Yet you came in here, and you didn’t ask about any of them. You didn’t ask about those who died, you didn’t ask about who made it. Never once did you ask about their families. You assumed what you had to say was more important than what we were talking about. You’ve talked about your skills and certifications, about ways you were inconvenienced, about how things didn’t work out how you had hoped. About how a phone you can replace without the slightest impact on your financial well-being has been damaged. You view the entire world through a lens that can see no one other than you. If you would pull back even just for a moment, you would realize what we were a part of last night was the worst tragedy for some on this hill, and the greatest gift to hundreds of others.”

He paused, and he placed his right hand on Seth’s shoulder, an action that if it had come in any other circumstance, he would have swatted it away. Yet now he somehow felt paralyzed by what Tom said. Not because the words were mean, or the tone was harsh.

But, because they were true.

“Maybe what you need to do is try to care a bit less about yourself, and a bit more about others.”

Just then, Muguru approached Dr. Tom, saying something Seth would not have heard even in a language he understood, and the two disappeared into the OR.

Seth was left standing there, under the corrugated asbestos roof that covered the sidewalk linking the buildings. Only then did he notice a group of women who had gathered to stare at him and Dr. Tom, as white-skinned people were so rare in the country, and unheard of outside the capital. The women started to withdraw as the rain began. While only a sprinkle, it sounded like an oncoming truck on a gravel road. Seth looked up to see a line dragging across the dirt field, the front line of an advancing army. They left him there alone, with the thoughts inside his head pounding like the drops hitting the covered walkway. No one had ever talked to him like that – at least not that he could remember – and perhaps that’s why he felt something he never had before.