Shared Fish, and a Signature

My office was in the Angolan Ministry of Health in a busy part of the busy city of Luanda. One of my colleagues there was Dr. Dulcelina, the director of the National AIDS Institute. We were about the same age, at similar points in our careers, had similar senses of humor, and I always considered her a pleasant person to talk with. Because she had such a busy schedule though, there were times when I had trouble getting a moment to meet with her. The obstacle was not language, since I speak Portuguese. Rather, it was culture, and perhaps the quiet distance between how we each saw the political world.

One day I needed her signature on a paper for a publication on which she was a co-author. At about 8:00 in the morning, I climbed the stairs from my office to hers and asked her secretary to let the doctor know I was there to see her. The secretary said Dr. Dulcelina was in a meeting and could not be disturbed. So I waited in the reception room. One hour became two hours, and I still couldn’t get a signature that would benefit her as much as it would benefit me. I believed we were working toward a common goal. I could not understand why it was taking so long to get a simple signature.

At last she stepped out of her office and walked towards the exit. She said she had to go out for a while and would help me later. I explained that I needed only her signature. She said she had no time for that now, and she left.

Around lunchtime she returned. I rose and said, “Dr. Dulcelina, could we talk about the paper I need you to sign?” She told me she could not because she was going to lunch. She and her colleague walked out and went down to the cafeteria.

I was frustrated. It didn’t make sense. Was she not understanding? Did she not value my time? Was she avoiding me on purpose? Was she sending me a message? I didn’t know, so I decided to follow her.

I went down the stairs and into the cafeteria. She saw me and asked if I wanted to join them. I sat down at the table beside her. She had ordered the fish, which I don’t normally like that much, but I decided I would go for the same. It arrived, and the three of us ate together.

She told me she had eaten fish for years during the war. Her mother used to make fish, and it reminded her of home, the family, the friends, the games, and the laughing that filled the nighttime of her home. Fish was one of her favorite lunches in the cafeteria.

Then she began to tell me about some of the things that happened during her child in the civil war, which had lasted more than twenty years. The war was fueled and funded from the outside, on one side by the Soviet Union and on the other side by the United States. Despite being alive during those years, I can’t recall ever even hearing the name of Angola during my childhood.

I looked at my plate, and the eyes in the fish head looked back at me. I was having lunch with someone who somehow survived growing up in a place of war, uncertainty, and violence. But at the same time a place of family, friendship, love, music. My background was peace and prosperity, without war.

I listened to her speak. I asked about her family, about the war, about what she thought of the United States, and about how the war had changed her life. Some of what she told me must have been difficult for her to share. Looking back, I’m surprised I asked, and I’m surprised she shared. It must have been the fish that was staring up at us from beyond.

She laughed and asked “You don’t like the fish head? In Angola, during the war, we didn’t waste anything, so I’m used to seeing the head.”

When it was time to return to work, she said, “Give me the paper, and I will sign it.” I handed it over and began to explain, but she had already signed it. She looked up, smiled, and said, “You did good.” Then she rose with her colleague and left the cafeteria. I wiped my mouth with the cloth napkin and wondered what had just happened. What did we just go through together?

Did she see me as an outsider who wanted something from her without caring who she is or how she lived? Did it make a difference that I showed some interest in her? Did I have to realize that things don’t always have to be on my schedule? It may be none of those things. We may have just made a connection at lunch thanks to the fish.

I learned that when I listen to people and notice and show interest, it counts, even if you can’t change what happened.

That lesson stayed with me through the rest of my professional and personal life. It has also shaped how I practice medicine. I try to give patients room to speak their mind so I get a glimpse of what their life is like. They feel heard. They can tell I am paying attention, that I have their interests in mind, and that I want the best for them. Being heard is a large part of making a connection, and connection is a large part of seeing real change in someone’s health.

When I listen to my children, my colleagues, my patients, my family, and my bosses, I am using a skill I owe in large part to Dr. Dulcelina. She was kind enough to share a fish and talk with me about Angola’s civil war.