The False Limitations We Put on Despair and Happiness

The pit of despair and the pool of happiness are bottomless. Which means you and I can both suffer and revel in glee to any degree without limiting the pain and joy of others.  

My partner works in the emergency department (ED) and I used to work there too (that’s where we met). From time to time, our non-healthcare friends will ask, “So if I have to go to the ED, what should I say so my wait is shorter?” When this classic question is asked, my partner and I glance at each other and smirk. Anyone who has worked in the ED can tell you that you don’t want to be the first person to go back to a room from the waiting room…because the people who don’t have a wait are the people most likely to never walk out of the hospital.

No one wants to go to the hospital. It is miserable to be there as a patient. But, let’s say you go to the ED because you broke your arm skiing. Your arm is painful. The friend who accompanied you to the hospital is desperately trying to help you stay calm while also struggling to maintain their own composure because the odd angle of your arm makes them sick to their stomach. While you and your friend wait in the ED, there are others who have been in the hospital for days and there are some who have been there moments; in each of these groups of patients there are people who will die during their hospital stay. I tell you this not to diminish the suffering of your broken arm. I tell you simply to say that we don’t suffer alone. Your broken arm is not made less painful by the heart attack and death of Mr. Doe that occurred while you waited in the ED, but his death might remind you that we do not all suffer to the same degree during a particular patch of time.

The same goes for happiness. Some of the joys of this COVID era are the baby announcements, the engagements, the house improvements finally complete, the adopted fuzzy friends, and the fitness goals achieved. My social media feeds are full of cute kittens, puppies, and shiny rings. One of the things I love about all these great landmarks in my friends’ lives is that the engagement of one friend does not detract from the puppy adoption of another. It turns out that my friend with a fiancé can be dreamy about their forever while my other friend can melt with love for their new puppy.

I think the infinity of the pit of despair and the pool of happiness are important to keep in mind. You can take as much as humanly possible from both or either and there will still be a limitless amount for the next person. Not many things in life are that way.

Since the COVID pandemic started and the death of George Floyd there has been arguing among individuals and over the news about the validity and gravity of the pain and inequity experienced by different groups in America. The argument goes some like, “I’ve also had a hard life. I’ve suffered from injustice. So, I don’t see why their hardship and the inequity they face is special.”

The suffering you’ve faced does not neutralize the suffering of others. The suffering you’ve experienced does not lessen the burden of suffering for the rest of humanity. Suffering and happiness have no bounds. The argument for equity is not that your suffering does not matter. Your suffering does matter. The argument for equity is that the systems we’ve developed so far to organize our government, personal lives, education, and work make it harder for certain people to access the pool of happiness while at the same time making the pit of despair easier to fall into. The underpinning of equity is simply that there should be no gatekeeper to happiness and no funnel to despair and, therefore, where they exist they should be eliminated.


I didn’t cry but my heart was heavy in November 2016 when I carefully folded up the American flag I’d always hung in my room and placed it safely in a box, making sure it never touched the ground. I folded it the way my father had taught me, which was the way his father (WWII and Korean war veteran) had taught him. As I folded the flag, I looked for tatters suggesting it needed a proper retirement—it didn’t. I swore that I would not hang the flag again until my country made me proud. Until my country no longer betrayed the promises on which it was founded.

The election in 2016 felt different than the others I’d experienced. There was a pit in my stomach about the future after November 2016 even though as a dreamer I am always hopeful about the future. It was uncharacteristic of me to care much about politics. I felt heavy. I told myself to wait and see how things unfolded. I told myself that US institutions were strong so it was unlikely that much would really change.

I was raised to believe the reality of the American dream. I took it as actuality that you could do anything and be anyone if you tried hard enough. However, as I grew older, I came to wonder if that was actually true.

My skepticism of the American dream increased as I worked through college. We all have our own challenges, but it’s hard not to notice how easy it is for rich kids to do unpaid internships and lead organizations that set them up for great success after graduation while poor kids work and try to fit in the internships and organization memberships they know are key to getting their dream job. That’s if the poor kids were lucky enough to go to college at all.

This year I no longer question the American dream because the beat of the American dream fell silent as a heart monitor goes flat when a heart stops forever. What took the place of my old belief that in America hard work is rewarded and anyone can pull themselves up by their bootstraps was a bitter taste. The bitterness was a truth I’d always known but refused to look in the eye: the American dream is an illusion. We don’t all have an equal crack at reaching our dreams. Some of us can climb, but the journey is largely about luck. Hard work pays, but being born the privileged sex and gender, class, and color pays more.

In the past 4 years I’ve seen America steal children from their families and put them in cages and call it justice. I’ve seen men supported and allowed to take positions of power despite overwhelming evidence that they had sexually abused women. I’ve seen the armed forces deployed against citizens, and I’ve seen military members accept that deployment.

I’ve seen so many people of color jailed and killed in the name of justice we could erect a memorial like that to the Vietnam War on the National Mall with their names and it would be more impressive than any war memorial. Just like for the soldiers who died in Vietnam, the people who were killed for their skin would have their names written on panels of black stone. Roses and notes would rest at the panels’ base, a tribute to the years the humans named there weren’t allowed to live and to the loved ones who miss them. When I lived in DC I visited the National Mall and Arlington Cemetery often. I visited these war memorials because it seemed the worst fate was to die and be forgotten. To have your name unspoken and your life discredited.

I’ve seen open fire on people in schools, places of prayer, and movie theaters. I’ve seen cities stopped by a pandemic, a virus that continues to kill and, yet, Americans would rather endanger grandmothers and grandfathers (possibly murder them with their breath) before wearing a mask.

I’ve seen taking part in global organizations and dialogue, environment protection, and offering refuge from persecution declared as no longer American.

Every time I’m bold enough to open the news I see more evidence that the American dream is not only dead but was never alive. Have we always been so cruel and hateful toward people different from us?

And I am angry. I know anger accomplishes nothing. Yet, as it becomes clearer how far America is from a country whose flag I’d proudly wave, I am angry and weary. I’m angry because so many of the horrors we’re seeing unfold today have always been there unaddressed. I’m angry because those in the highest places of power are clinging to the status quo which is one where only a select few are favored. I’m angry because the institutions I thought I could trust are weak.

Somehow, in the middle of a pandemic that has killed many globally and protests demanding equity long overdue, we must continue to live our lives. To love, work, study, and play. In some ways it is so easy to continue as if life were normal, even though 2020 has exposed many things that need our attention. Despite the desire and freedom to ignore what has been exposed this year, it would be an error to pretend that everything is okay. Should we choose to punt addressing our problems to a distant future, then it is not just the American dream but also America that has died. America is a place where all people have the right to life, liberty, and the pursuit of happiness and our country isn’t there yet.

I can’t help but reflect on how my life in a rural town is so different from that of someone living in NYC were people died in droves from COVID-19 and more people than the population of my hometown marched the streets to protest violence and inequity these past months. And just the tranquility of my life this year compared to many of the lives led by NYC dwellers illustrates how far we have to go to ensure that we all have a crack at life, liberty, and happiness.

As I slide closer to my second year of medical school, I continue to wonder what more I can do and what my role is in making America a place I’m proud to call home. When I think of action I am less angry, still weary, and very determined that though it will be a long journey, I might fly my country’s flag again. And while I don’t think I’ll live to see the American dream feel real again, I hope that we will lift ourselves closer to a society where every person is judged more for their work and kindness and less by factors present at birth such as the wealth of their parents and the color of their skin. I think if we can move forward, change, then we might call ourselves Americans with the meaning the American dream implied.

Friendship as a Trendline

When I was young and going through a rough patch with one friend or another, my mother always told me friendships go in waves. Sometimes you’re high on them, doing the most exciting things and seeing each other all the time. Sometimes it’s as though you don’t know each other (except you do, because you remember all the times that are past). I knew she was right, but when I was young I hadn’t had friends for long enough to see what she meant.

These days I’m not old, but I have friends who have been in my life for over 20 years and new ones who just arrived. Each friendship is different; the relationship components undulate as ocean waves do—always the same motion (hi…bye), never the same content (what is said and done, where and when we encounter). It’s only the movement, up and down, that’s constant over these relationships and across relationships.

When I think about friendships as waves, I envision the trendline as straight across with a sine wave tracing the points of each friendship. If you plot every friendship on the same graph, some will have wide peaks and dips, some will have steeper and more frequent slopes. But, regardless of the shape of each wave, when you follow the trendline as a representation of your life unfolding, you find that your time has been filled with moments shared with people you enjoy. Despite all the movement—especially the absences of certain individuals at certain times—you are surrounded by people you consider friends most of the time. In this way, the trendline makes you unshakable when one friendship wave becomes an outliner by dipping too low or dropping off the graph completely. And, also, it’s the trendline that helps you steady yourself if a friend becomes a partner and their friendship wave falls into phase (in sync) with your life wave magnifying your own emotional ups and downs.

For me, the visual of friends as waves (like an ocean view) takes a lot of the pressure off each moment because it makes me see them as part of something larger. It’s reassuring to realize that I can enjoy each crest before it crashes on the literal or metaphorical beach because it will be followed by others.

Happiness Comes from the Heart

Being a pre-med post-baccalaureate student, I take a lot of classes with humans that are 8-10 years younger than me. These young people are a dichotomy of vibrant energy and self-doubt. We are on same footing as we struggle to memorize microbes and how p orbitals shape molecules, yet we are not even in adjacent life chapters.

It’s nice to be a witness, rather than a participant, of the soul searching that comes with learning how to be an adult. I once was an 18-year-old too, but I’m glad that era is behind me. I know my young colleagues will come out just fine without any help. But, there’s one thing that I wish I could tell them so they wouldn’t have to go through the trouble of discovering it themselves. It’s simple but, alas, it’s something only experience can teach us: happiness comes from within.

I think many of us get lost in the weeds when it comes to happiness. We jump from shiny thing to shiny thing. We assume the next great object we possess will fill the holes in our soul. We look to family, friends, and partners thinking they can save us. We search for other’s approval of our look. We act based on strangers’ opinions, hoping that society will label us as “cool.” And as we skip and hop between all these outward forces, our emptiness expands until our core seems more like a beach ball than a rock. Hollow.

It’s not the doldrums, the pits, where the quest for meaning beyond ourselves drives us, but to stagnant waters and ships with limp sails. And, while some of my young lab partners might learn quickly that they are the only ones who can make themselves happy, many of them will take years to realize the truth. I’m not sorry for them. I know their journey will have many fun days and explosions of wonder. But, if they are like me, they won’t find peace until they understand that joy originates inside and spreads from there. I don’t wish the restlessness of the road upon anyone, but it’s a road we all must wander at some point.

While others might make our lives brighter, we’re the only ones who can decide if we’re going to let in the sunshine or draw the curtains. I hope that when the going gets tough and the days seem dark the young folks around me take the time to look inward. There are many things beyond our control, but our emotions and how we respond to the world do not fall among them.

Land of Plenty and Unemployment

I went for a walk in the evening the other day. My walk took me along the main road and down to a river that was swollen beyonds its banks with rain. We’ve had a wet year and the rainy season is beginning. All along the flood banks men and women were fishing with their bamboo poles. Here fishing most often involves a string tied to a piece of bamboo, no reel, no bells and whistles. There are two primary kinds of fish, super bony and bony. The average fish is about the size of my hand.

Most people weren’t fishing just because they think it’s fun. As dusk was falling, two men on a dirt bike passed me, they were laden with silver, hand-sized fish. People here eat fish and even the small ones. One day the mother of the family I’m closest to was telling me about a woman in the community who has eight children. That’s a lot of mouths to feed with only the father working, and in Paraguay there are few jobs that pay enough to easily support a family of ten. I asked how the woman fed all her children.

“Well, they fish…” the woman I was talking to said.

Paraguay is fertile and has a climate designed for growing things. Fruit of all kinds, except apples and berries, is all over–bananas, all the citrus, papaya, passion fruit, pineapple, mangos, and the list goes on and on. There are several kinds of fruit in season at all times, and bananas are always available. With a little effort one can grow vegetables year-round and harvest most crops more than once every twelve months. In addition to fruits and vegetable, animals are part of most Paraguayan families’ lives. People who don’t live in cities can raise chickens and pigs on their plots, and even if they don’t own grazing land they can graze cows on public land and land that isn’t in use.

With some effort starving can be avoided in Paraguay even if money is tight. Further, the temperature is moderate. Unlike Vermont where winter exposure is deadly, in Paraguay, a roof to protect from the rain is enough to survive. Simple, rustic living spaces where families depend on their own crops to eat may not be a dream, but are realistic ways to live in Paraguay.

The point is that Paraguayan climate and geography are friendly toward life. People who are creative and willing to work can survive on almost no money. But, as hospitable as the earth and rivers are in Paraguay, job opportunities are limited. It is not uncommon for one person in a family of many to work, even if several people in that family are working age. The common example of a father supporting his wife, adult children before they marry, and his young children is traditional but not what most families would choose. It is a reality here because jobs are scarce and opportunities for professional employment lag far behind the number of people who are educated and trained.

As I watched the sun set over the river and bordering marshland, I thought about the juxtaposition of existence in Paraguay. I like to think Paraguayan society is moving toward providing its people as many career options as the land of the Guarani offers food choices to the hungry. I believe it is. The students I worked with want more than just a roof and bananas with fish. They want to travel and have cars and cell phones. Paraguay must change to provide what its future leaders demand or it will lose them.

The Bosses

One knows when elections in Paraguay are on their way because public works, so long neglected, magically get finished in record time. The muddy street next to my school got cobblestones and it took less than a month. In a few weeks the highway by my house got repaved. The candidates also advertise themselves with signs plastered on every power pole and billboards propped above faithful business fronts. Conversations about what needs to happen in the community become more pointed, people of the same party meet to discuss politics, and candidates start visiting their supporters.

In other words, when elections are around the corner in Paraguay it’s not so different from September of a US election year. But, it is different when the elections are over and everyone is settled into their winning posts.

Paraguay is still a land with a mark of political corruption and political bosses —I guess you can argue the same for the States in some areas. Corruption by nature is often hard to see, especially from my view as an outsider, but Paraguayans grumble about it. The mayor a few towns over from my site was found guilty of taking large sums of money from the town coffers, yet I think someone told me he might run again. While I will leave the judgement of how much corruption there is among politicians in Paraguay to someone who has quantifiable data, political bosses are hard to miss for even someone like me who tries to steer clear of all Paraguayan politics.

Like most places, or at least the limited list of places I know, the best way to get a job in Paraguay is to know someone who has an “in” and who can help one by-pass the black pit of faceless applications. This is particularly important in a high context culture like Paraguay, where who one knows or is related to is often more important than what one achieved. Relationships in Paraguay are built over long conversations that develop slowly. Time saving and directness are not part of the traditional culture. But, in Paraguay there is often a deeper level of connectedness that will win one a good job, not just an okay job, and that is the political boss. If you’re like me and know US history by way of the different immigration movements and development of labor unions, you will know that politicians in the States had a long history of giving out jobs to win votes and saving the best posts for their most fervent supporters. And that is Paraguay today in a nutshell.

I don’t mean to say that without a political connection it is impossible to work in Paraguay, because that is not true, and I can’t speak for all Paraguayan towns when it comes to politics and work. But, this is what I can say. I’ve talked to a mother about her visiting the mayor so her daughter doesn’t have to…and the daughter ends up with a job in the city government. I know families that tow the party line and get side jobs in the local government, to supplement the money they already earn. I have seen families take steps to ensure that someone from their family is always at the political meetings and that the candidates they support pay them a visit to hear the family’s ideas. I don’t yet know first hand what will come of the political meetings and candidate visits, but if unemployed members of those families get work when their candidate wins, that will make me think a political boss had something to do with it.


Ghost Buildings

On the 2-hour bus ride from my home to the Peace Corps office are many sights that have come to symbolize Paraguay in my mind, but the most vivid is a vacant lot it which stands several incomplete apartment buildings. Those buildings don’t have roofs or windows and the walls are unfinished. The brick, mud, and cement skeleton of what might have been the home of generations of families grays with age. The grass grows tall and a sign that probably announced the development project when someone broke ground on the construction is too faded to read.

When I first saw the buildings I thought of a war-zone or a devastating fire. I wondered, “What happened here?” I still don’t know why that complex stands destitute until the rain washes the structures away, but I now know enough about Paraguay to be confident it wasn’t a tragedy that condemned the place. Most likely, the person funding the project ran out of money and walked away. Just as was the case with so many little houses I see scattered about when I travel—some with finished walls, some with partial roofs.

With little access to credit and varying access to good-paying jobs across the country improvement projects and development move slow. Paraguay is a place of dreams. A dreamland where the bridge between reality and aspiration is still being built. Some people are able to paddle across the gap, and some decide to dream on and live as they always have. Paraguay is a land of opportunity, but only the lucky and the determined make it big.

They Tell Me It Was Different Then

Paraguayans don’t usually talk about the dictatorship in Paraguay that ended in 1989. It’s a taboo subject. There are many reasons why one can’t talk about it, but one important reason is that Paraguayans are fiercely proud of their country and will not criticize themselves in an extreme way. Of course Paraguayans now, like all citizens of democracies, grumble about their new government, corruption among politicians, and what the government is not doing.

Despite the general silence, there is one way señoras talk about the dictatorship; it is usually in a positive light. It relates to security. Señoras are fearful of crime and degeneration of youth in their country—especially the older señoras. They think that women can not and should not walk around alone after dark. Regardless of whether it is late or not. Now, in some parts of Paraguay, like certain barrios in Asuncion, no one should walk around alone late at night. But, if one compares Paraguay to just about any other country in South America, Paraguay is pretty safe. I’m not suggesting that one should throw caution to the wind, but in the quiet towns of Paraguay usually señoras’ fear exaggerates the danger of nighttime. Darkness falls early in the winter months. It’s hard to be home by 5 pm even in  tranquil rural Paraguay.

When señoras talk to me about their concerns for security and the development of youth sometimes they reference the dictatorship. They tell me that things were different then. They tell me there was hardly any crime. They tell me that it was safer and the government was in control. I imagine they are right, but I am not well informed and I wasn’t here to know. Among the few pre-1989 Paraguayan history facts I know is that there was a curfew. I also read that people died if they criticized the government during that time. I will leave judgement of the government before Paraguayan democracy to history experts. However, every time a señora tells me “It was different then” in a hushed voice that is not critical or supportive my mind stirs with questions. Some questions can not be asked. And sometimes after I’ve narrowly avoided being walked home unnecessarily just after the sun sets, I wonder what it was like in Paraguay “then.”


What Does “Third World” Mean?

When thinking about the global community we throw around terms like “third world” or “developing world.” Coming from the first world, I’ve often heard those terms with an undertone of pity. The terms have a distributive property and rather than just being used to categorize a political territory they are used to describe people. And when these terms are distributed to people they usually mean: unhappy, uneducated, dirty, and disadvantaged.

It’s taken me almost 9 months in Paraguay to wrap my head around what “third world” actually means, because the first thing I noticed when coming to Paraguay is that Paraguayans aren’t unhappy, uneducated, and dirty. Actually, Paraguayans are almost annoyingly happy most of the time. The Paraguayan approach is simple: bad things happen, life goes on. It takes only a little time in Asunción to meet several trilingual Paraguayans and it takes no more searching than it does among the regular US population to find a Paraguayan who can have an intellectual conversation about politics, religion, sex, and health. Americans are ragamuffins compared to Paraguayans—unless you iron your underwear and know how to wear every accessory that exists in all the same color at the same time and make it look good, you ain’t got nothing on the average Paraguayan woman.

That leaves disadvantaged. Can people be disadvantaged or is it the system that limits them? My conclusion: “third world” is actually a term to describe a country’s systems and infrastructure. It cannot be used to describe people. Inefficient systems or poor infrastructure do limit opportunities and make life harder. However, people from third world countries are NOT an inferior people—that is to say that if the same person was born in the US rather than Paraguay they are just as well equipped to make a good life there as an American born in America.

So, third world can be used to describe systems and infrastructure. What does that mean in Paraguay? That means that there are communities without running water or there are families that use holes in the ground as toilets. It means that even if a community has running water, the water is liable to not work for a couple hours many days. It means that the power goes out all the time—usually for only a couple of moments or hours. It goes out when it rains. It goes out when the janky wires break or the breaker boxes explode (figuratively) because they weren’t designed to take the voltage they are handling. It goes out when too many people use electricity—like when it’s hell-hot and time for bed.

It means dirt roads are the norm and drainage systems are nonexistent, so when it rains not going to school is a safety precaution. It means that political bosses give jobs and bribes keep people out of the justice system. It means time in school is more loosely associated with learning than perhaps it should be. It means that there are laws and then there are those things that get a person in trouble—the latter is far scarcer than the former. It means that dirt bikes are all over because, well, they’re the only vehicles that can travel on all the roads. It means that people throw or burn their trash because most communities don’t have trash collection. It means that people wait for government handouts because the average person has no access to credit…or even a savings account. It means that even though healthcare is public in Paraguay local clinics don’t have all the medications or specialists the community needs. Some people simply go without because they don’t have the money for bus fare to travel to a medical facility that has what they need.

Third world does not mean helpless people who need to be saved. It means countries whose systems are underequipped to fulfill the needs of their population and because of this the people in those countries don’t benefit from all the modern conveniences our era has to offer. It is not a permanent description. Countries that are third world today are working to shake that status, and they are making progress. The fact that I can complain about my running water not working and that I don’t get Internet in my house means that process has been made in Paraguay. If I had lived in my community not so many years ago, I would have complained about hauling water from a well and not dreamed of Internet.