End Notes
A Simple Truth
By Stephanie Smith, M.D.
The politics of a country in chaos are manifest in the mangled feet of a patient.
The man was clearly in pain, his cheap yellow sandals slapping unevenly on the linoleum with each halting step. From the end of the long hallway, I watched him stop at each doorway to bid the others hello in Shona before entering the exam room where I sat waiting for him.
Dr. N introduced me. “She is a doctor from America.” I blushed; two weeks after graduating, I could not help but feel the title was misleading.
The man shook my hand solemnly. He sat on the only remaining chair in the room, next to a bucket of soapy water used to wash the exam table between patients. He regarded me intently. “And why have you come to Zimbabwe?”
I had been wondering the same thing. This trip, my fourth to Africa, was spurred by a desire to see for myself what was happening in Zimbabwe. The media reported increasingly oppressive and violent state policies. Perhaps I thought that going to Zimbabwe would provide some insight into a complex political situation. As a doctor, what should I do for people in a slowly eroding democracy? “I am interested in the problems in Zimbabwe,” I told him.
The man nodded thoughtfully. “Yes, we do have many problems here. After independence, people thought things could never change again. Now, everything has been called into question: food, the economy, our political system. And me, my problem now is also walking,” he continued. His gaze held mine steadily.
He began taking off his sandals. “Sometimes I lose feeling in my feet, they go numb.” He held up one foot to show me the sole, discolored and swollen. “When I was in jail, they beat my feet.”
Dr. N interrupted. “It’s called falanga.” Like other methods of torture, it is used to exert social control. Those who can no longer walk to protests are less able to demand democracy.
I thought of the suffering caused by state-sponsored violence in Zimbabwe. “I am sorry for your troubles,” I said finally.
“I have a picture of myself.” The man pulled a worn poster from his cloth pouch. He unrolled it carefully and placed it on my lap. It said “Stop Police Brutality.” Three baton-wielding policemen surrounded a man covered in blood lying in the street. A yellow sandal lay next to him.
Earlier that afternoon, the nurse told me that patients were often afraid to come to the clinic because many were beaten afterwards for seeking care. Where did they find their strength?
“I have been involved in the struggle since liberation,” the man told me proudly. “They can do whatever they want to me. I will not stop.”
Dr. N finished writing a prescription for the man. Gabapentin, a drug normally used for neurological problems. I suspected torture sequelae was an off-label use.
The man tucked the poster back into his small bag and rose to leave. “Thank you for coming to Zimbabwe, Doctor.”
“Thank you for sharing your story with me.” I stood and offered my hand. The man grasped it tightly, pulling me toward him. His eyes bore holes in mine.
“It is simple, my young American doctor friend. We are all no different from one another.”
“That is true, my friend.” I replied.
His hand felt warm against my palm, rough like my grandfather’s. The man let go of my arm, and I watched him limp slowly down the long hallway, prescription in hand. MM
Stephanie Smith is a 2007 graduate of the University of Minnesota Medical School and is an intern in the primary care/social medicine internal medicine residency program at Albert Einstein College of Medicine in New York City.