It’s been a little over a month at the time I’m writing this, and I’m finally feeling okay with having walked away from what I thought was the perfect path for me.
I had never had a mentor more strongly encourage a certain option, and getting into this fellowship entailed a total of eight interviews, turning down another job, changing cars (the car I had would have never made it), and convincing parents that I would be fine and back home for the holidays.
Just a few weeks in, I felt isolated without access to internet or cell connection. I would be moved to a new rural mountain clinic each week, and thus worried that I would be unable to build relationships with the people I would be surrounded with over the initial 6 month period. I couldn’t handle it.
On the left: the Pasante (a last year Mexican medical student working in a rural setting) with the nurse who aided a lot in public health. Center: The path walking back to the clinic after a town meeting regarding local trash clean-up. Occasionally a car or truck that passed would give us a ride, otherwise the walks back and forth were around an hour. On the right: things to take care - a cat and some plants that are in the house where the Pasante and nurse stay - both good ways to keep upbeat in these settings.
Where did I go wrong?
I have always wanted to avoid “voluntourism,” when you travel to a country to volunteer yet it turns out to be more of a vacation. There is definitely good in these, but not one that I perceive as fulfilling. I like to come close to living in the shoes of those around me, if anything so that I can understand their choices and daily lives better. Working with immigrants, asylum seekers, and refugees during residency peaked my interest in global health, and the only global health fellowship I applied to and was accepted into seemed like the absolute perfect fit. Until it wasn’t.
Did I ask the wrong questions? Failed to sufficiently research the area where I was selected to work? Maybe I had unrealistic expectations? I’ll never really know. I had a long chat with the fellow whose shoes I would fill, and asked him about the work and daily life. He let me know that I would be getting the short end of the stick given that my time there would be mostly during the rainy season, which meant that the water to my house would occasionally be filled with sediment. Not a biggie, I thought. I can handle that. I also spoke with two other physicians who had spent time there, one a month and one a full year, and felt inspired by their glow when the topic came up.
What I didn’t know was that I would feel isolated, and weekends that should have been relaxing were spent battling heat and mosquitos instead of catching up on sleep. You don’t know what you don’t know. My previous experiences in developing/underdeveloped areas were graced with cool, fresh evenings. Here, the room I slept in was like an oven, and if I opened a door or window I would have to contend with mosquitos and put up with the random bar goers across the street. I tried various tactics, bought a strong fan from a home depot that was a three hour trek north, and employed various mosquito repellants. I just couldn't hang. During trips up the mountain, where I had little to no connection with the rest of the world and barely knew anyone, I tried to stay positive through journaling and getting excited about how I could write about these experiences later.
But I hit a wall, and I knew I had to leave. I hated myself for it. I felt like I wasn’t resilient enough. I hated the thought of letting people down. And I worried that leaving such a well-recognized organization would burn bridges and leave me fewer options for the career path I have longed for and worked so hard to pave. What I didn’t expect was the strong support and continued outreach I got from the program when I finally mustered up the courage to tell them that I had to walk away. They recognized that I was making a difficult choice, and checked in regularly without trying to convince me otherwise. The ever-resilient local medical coordinator, despite her hectic schedule and people to keep tabs on, chatted with me until she felt that I knew her acceptance of my decision. She mentioned that I was not the first to do this, and that the loneliness was also something that afflicted previous fellows, some that chose not to come and one that also cut his time short.
Decision-making is not something we are taught in school, and quite frankly most of us are terrible at it. Anxiety-provoking situations might lead us to make choices that bring instant gratification or relief, and can often cloud the visualization of an optimal long-term decision. In reaching out to the internet to try to find an answer or direction for my dilemma, I learned about mental models. In brief, there are many mental models for different types of decision-making, and instead of trying to explain them, I will leave you with this great article on Farnam Street.