travelers-talesBy Rosemary Hanrahan

The healing power of being present.

“Give me five dollars, Blan.” A young Haitian woman, unknown to me, asked in perfect English and extended her hand.

I had received many such requests during my five months living in the mountainous rural community of Fondwa in Haiti as I made my daily journey up the mountain to teach at the university.

Sometimes the ask came from little children laughing like kids laugh everywhere—a shy grin erupting into silly, toothless giggles. Sometimes the ask came from a mother with an orange-haired malnourished infant in her arms, and sometimes from a weary, old woman in a dirty tattered dress.

Occasionally a smart-alecky teenager would want money or my cell phone or my watch and then mock me in Creole, probably not aware that I understood the language.

Usually during these encounters I  shook my head, offered an uncomfortable smile and continued on, knowing that most everyone in the village was in need of economic support. I didn’t want to encourage begging. My justification was that I supported the local peasant association, which offered health and education programs for everyone in the community.

But that day was different.

I hardly noticed the steep and rocky, rutted path, or the sweat dripping down my face, neck and back. Even though it was early morning and the sun was still low, no shade existed along the way. The trees have been cut for wood, for farming, for charcoal, and for the road on which I journeyed.

Unlike most days, that day I ignored my backpack so heavy with water and books that I was nearly bent at a right angle from my waist.

That particular day my thoughts were of my father and my family in the United States.  I had just returned from an unexpected trip home to attend my mother’s funeral. She had passed away a few weeks earlier from a long struggle with diabetes and heart disease.

Returning to Haiti and my commitment as interim director of the university was one of the hardest decisions of my life. My father, a gifted and well-respected physician, was not only physically devastated by Parkinson’s disease, but also experiencing increasing dementia—and now the loss of my mother, his wife of nearly fifty years.

“Give me five dollars, Blan!” The woman repeated a little louder and more insistent.

“What do you want from me? I have nothing else to give you.” I muttered to the rocky path, and immediately felt ashamed. Tears escaped my eyes and mingled with my sweat. My eyes stung as if I deserved the punishment.

Of course the woman didn’t understand my response. It was likely those were the only words of English she knew. Nor did she understand that my presence in Haiti was akin to my personal “Sophie’s Choice.”

In addition to teaching at the university, I was also pursuing a Master of Public Health from the University of Pittsburgh and my thesis work centered on establishing a Community HIV/AIDS  Program in Fondwa. The opportunity to live and share my medical knowledge and skills in a developing country was a lifelong dream. At age 48, how many more opportunities would I have?

But the realization of my dream came at a significant cost. It meant that I would no longer be there for the day-to-day needs of my parents. But having shouldered nearly all of the responsibility for three years, wasn’t it time for one of my other five siblings to step up?

My rational side responded, “Hell, yes!”

My always-the-responsible-daughter side was less certain.

As I trudged up the mountain each day after my mother’s death, I replayed conversations I had in the months immediately before I moved to Haiti.

On one of my father’s pretty good days, I asked him what he thought about my choice.

“I would do the same thing if I were you,” he replied and then drifted off to a sleepy confused state before I could ask him to share more about why. Did he find his life as a father and a physician less than he had hoped? Or did he see that my choices were different than his, but equally of merit?

My mother, on the other hand, was totally against my leaving. When I asked her, she said, “I just think you can do better.”

“Better” meant continuing to practice in the U.S., living near her and my father, and earning a nice salary and all that it afforded.

When she realized I had made up my mind, she added guilt to her disappointment—as all mothers do at times. “You’ll be sorry some day,” she warned.

On my anxious flight home to see my mother before she died, I wondered if that “some day” had arrived, and perhaps would never leave. The 1500 miles separating Haiti from Pittsburgh could not have seemed longer if I had swam to Miami and walked barefoot to my mother’s bedside. I was worried that her doctors were missing something or were giving up too soon.  And I knew, even if the time had come for her to go, that if I didn’t make it back to say good-bye, I would never forgive myself.

But I did make it back in time and we were gifted with a final short conversation when she acknowledged, “I’m proud of you. I hope you know that.”

Although I think I did know, I also needed to hear the words from her.

Within a few days of my return home it was clear that nothing I or anyone else could do would keep my mother’s heart beating. At the end, even the defibrillator and pacemaker that had been implanted in her chest two years earlier were wise enough to let her go quietly.

In the weeks after my return to Haiti, I found myself angrier at the constant requests for money, the hands extending out and pleading eyes that were inescapable on my walk—the walk I had once loved to make because it allowed me time for reflection. I reminded myself that I was not my thoughts. Yet, my mounting hostility threatened to engulf me and sabotage my relationships with people I cared about and respected and all that we hoped to achieve together.

The community HIV program we proposed had finally received initial funding, but was unfolding painfully slowly. At times, I questioned the commitment of my Haitian colleagues who were often distracted by other priorities and responsibilities. The constant struggle to communicate with the Cuban and Haitian faculty at the university was exhausting—despite knowing we all believed rural development was crucial to Haiti’s future. Even interviewing potential students, full of energy and idealism and eager to become a positive force for change in their troubled country, failed to rouse my enthusiasm.

All these worthy causes that had fueled my passion since my first visit to Haiti three years earlier, suddenly retreated from foremost in my thoughts and actions to the shadowy recesses of my grief.

I considered returning to the U.S. early. My heart ached for my father, and accomplishing all that I thought I could accomplish in Haiti, now seemed unimportant. But I feared if I left Haiti early I would never find peace at home either.

The evenings were most difficult for me. Dinner was a light and quick meal usually consisting of leftovers and finished just after Haiti’s early sunset. From seven o’clock on, I was left with my thoughts, the light of a my small headlamp and my mind crowded with the day’s conversations and thoughts of home.

One of those evenings I recalled a short conversation I had with my academic advisor in the U.S. a few days after my mother passed away.

I told him, “I  expected to get so much more done.  I’m not making enough of a difference.”

AIDS was taking mothers and fathers from families, and infants were being born with the disease at an increasing rate. We knew how to stop the progression; we had a plan in place. But my time and patience were running out.

My advisor suggested that I think of my months in Haiti as a gift  to the community and to myself—a precious gift given freely, without expectation of anything in return. He also advised me to start a journal and to make it simple and reflective, and non-judgmental.

I found a half empty spiral notebook where I had been keeping my endless “To Do List.” The list with numerous experts to consult, tasks to accomplish and websites to explore now seemed irrelevant. I tore out those pages, folded them and placed them in a drawer. And then, I began to write.

At first just random words and phrases came and then gradually I was able to put more structure to my thoughts. I wrote about gratitude for where I was, for the time I had with my parents, for the opportunity to be part of some greater cause beyond myself and my family. Journaling was a good first step back to finding the compassion and passion that had escaped me, but it was still difficult to sustain the positive energy when I confronted my busy days.

One day in particular stands out in my memory. I was walking along the road with my Haitian friend and mentor, Father Joseph and I noticed how he responded to one woman’s request for money.

When he encountered the same pleading eyes and outstretched begging hands that had distressed me, he didn’t turn away, or encourage her to take advantage of the community programs the peasant organizations had put in place. He certainly didn’t say that he had nothing to give or offer her a few goudes from his pocket. He simply listened for a few minutes.

Then he took the woman’s hands and smiled into her eyes, without a promise to do anything, and said, “I’m sorry for your suffering.” And he asked about her family.

Suddenly, I forgot the woman’s tattered clothes. I looked past the deep lines her troubled life had etched in her face and her knobby hands that had begged for money. I saw something I had not noticed before—the wisdom in her eyes as she agreed that life was difficult for her. I saw the joy in her face as she talked about her children and grandchildren, and the strength in her hands as she grasped Father Joseph’s hands when she smiled and said, “Wi, Bondye bon—Yes, God is good.”

Momentarily, I supposed that the connection was easier for Father to make because of his strong religious grounding and because he was Haitian. Then I realized, that while faith and spirituality certainly played a part, the transformation that occurred had more to do with listening. Father Joseph didn’t just hear her troubled words as I had heard. He listened to the fear and hope beneath her request and allowed her to find her voice and dignity.

I recalled  a lesson from early in medical school—to listen, see and touch first, solve and treat later.  I couldn’t do everything that needed to be done; in fact I couldn’t even do many of the most important things that I thought should be done—not for Haiti and not for my family. But I could do something. I could give my presence, a kind smile and a warm touch.

I can’t say my last few months in Haiti were happy; I continued to be plagued by sadness and guilt, which at times threatened to engulf me. But there were also beautiful moments of peace and contentment, that gradually stretched into hours and days.

Sometimes these moments came as I carried water back from the community water source, trying not to spill any and laughing with the other women when I always did. Moments of peace found me as I pinned my freshly laundered sheets to the clothesline in the morning, and again when I ran down the mountain and rescued my laundry from an unexpected afternoon drizzle. These simple meditative everyday practices gave me space and time to heal.

Moments of gentle clarity also came when I wrote words from my heart in my journal. Remembering these words became easier in the days that followed and I often paused on my way up the mountain to see and touch and listen to the men, women and children I was there to teach and heal and serve.

With a little time, I retrieved my “To Do List” and shortened it considerably to just a few immediate actions that we could reasonably accomplish during my remaining time in Haiti. With that, a little more of my lost passion and energy returned. I smiled, recalling the Haitian proverb, Piti piti wazo fe niche li—little by little the bird builds its nest.

Rosemary Hanrahan M.D., M.P.H. is a physician, author and professional wellness coach with 15 years of experience in the nonprofit sector and 25 years of experience practicing anatomic and clinical pathology. She has lived and volunteered in developing countries such as Nepal, Botswana, and Haiti. Rosemary was the 2003 and 2006 recipient of the College of American Pathologists Foundation Humanitarian Grant Award for her medical laboratory work in Haiti. In 2007, she also received the Delta Omega National Honor Society Award for Best Master’s Thesis in Public Health and the Outstanding Student Award for Academic Excellence from the University of Pittsburgh Graduate School of Public Health. Her first novel, When Dreams Touch, was released in 2014 and received multiple awards for independently published fiction. All proceeds from sales of the book are donated to health and education programs in Haiti.