Traveling with Sugar. Amy Moran-Thomas
for the record any mistakes observed too late to actually be fixed.
These thoughts about acknowledging unresolvable past errors stayed close in mind as I learned more about painful colonial histories and their material legacies across the Caribbean and Central America. But as I set out to do ethnographic work in Belize, a more immediate scale of concerns also began to take over my daily routines and attention. In addition to meeting people around town and visiting the local hospital, I also began going on home visits with caregivers from a local clinic. Those home visits often felt like observing not only a healthcare system, but also its gaps—diabetic sugar was part of people’s domestic worlds in ways that far outpaced its “medicalization.” I was very careful to repeat again and again that I was not a physician or a nurse (although people still called me both constantly). On these routes, I worked to act within the parameters of what a volunteer would be permitted to do in a U.S. caregiving situation; by way of a guideline, I would only participate in errands and practices that an amateur would be allowed to perform in U.S. homecare, terms that I knew from working in home care during college. But I sometimes found it unsettling how much expertise and medical power people were at times willing to allot to me. I was asked to do things like remove stitches and give insulin injections—which, of course, I did not do—but I had to draw firm lines about the medical forms I was not willing to wield. The mere fact of being asked to assist with these technical tasks when stopping by people’s homes was a discomforting window into what they were facing: many of those diagnosed with diabetes also worried that they lacked sufficient expertise to safely inject themselves or their family members with insulin at home. Yet that was what therapeutic “adherence” often required.
During this time, I tried to mark myself as an anthropologist by avoiding certain symbols of the medical profession—for example, I decided not to wear scrubs as an everyday uniform when accompanying nurses or doctors on home visits, even though I was asked to do so once by a clinic director, worrying this would deepen people’s confusion about my role. Meanwhile, other things I had used in the past to mark myself as an anthropologist—such as a notebook, clipboard, or paperwork—are all signifiers that anthropology shares with medicine. These items seemed to confuse people more about my connection to the healthcare system, rather than clarify my purpose. So my digital tape recorder became important to me during this time, as a marker of “not-doctor.” The tape recorder often made conversations more awkward but felt like an important tool to try to make sure that people were telling me things as a storyteller.
It became apparent that there was also a local notion of research ethics circulating. This was explained to me by my language teacher on my first day in one Maya village where I worked. She told me the last anthropologist who had worked in their village had not “given back,” and as a result he had met a bad fate. (And it happened that this professor was suddenly killed at a young age.) This was how some people in the community read his death, and she kindly said that she wanted to warn me from the beginning, so I could go forward only if I felt comfortable with the risk. Her tone was nothing like a threat—more like a disclosure of the risks this research could entail for me. Was this also a version of informed consent? If something happened, it would not be her acting, she explained—it was not like the metaphysics of obeah or human-directed witchcraft. The language and cultural knowledge itself had a force that could take lives as collateral for upholding the ethics and reciprocity of our relationship.
But less righteous lethal forces were also at work. The stakes of negotiating different ethical fields felt much greater once people I knew started dying. Once in a while, I would go to visit someone for an interview and find out they had died. In addition to wider circles of less intensive interaction (people I interviewed once or twice), there were fifteen people I began visiting once or twice a week, every week, for a year—the kind of gradually built relationship in which you really get to know a person. Thirteen of the fifteen have died since then. I had not at all expected this intensity in advance, and because these events became personally overwhelming, they also changed the kind of impressions I gathered. Sometimes writing my daily fieldnotes felt like attempting to cast death masks of people in their final moments, trying to capture something dignified about their lives before they were gone. At one point I tried to think of these as tributes or memorials; but they are also something more uncomfortable than that.
At this time, I also began paying more careful attention to the Garifuna death rituals that were happening around me. Messages received from the dead were part of how people situated their diagnoses from the hospital. Many Garifuna rituals centered around a notion of feeding the dead by cooking enormous feasts for ancestors that are thrown into the sea or buried in the sand. Since I was studying diabetes, this use of food seemed important because it often involved the very dishes that people living with diabetes were commonly advised not to eat—white rice, rich soups with coconut milk bases, desserts, and rum. The same foods being used to keep memories of the dead alive had become dangerous for the living.
I felt a deepening sense of undirected anger and ineptitude as numerous people with diabetes I had known died preventable deaths in the fatal fictions of “noncompliance.” Through experiences such as sitting with a mother who asked me to take a turn holding her son’s dead body, I came to understand something more about the ways a lost sense of security might become a chronic imprint or bodily change in someone. Shortly before I left, someone tried to break into the room next to where I was sleeping one night. I later learned that the thief had most likely been a child; nearby that night, someone else reported a break-in where the footprints in the sand looked too small to belong to an adult. Only ham and a loaf of bread were stolen; a laptop was left untouched. Afterward, I thought often of the little ham thief. What does it mean for a child’s hunger to coexist in plain sight of tourists’ luxury resorts? What happens when such profound inequalities take root over time? It was a context in which being any kind of white person left one with an unshakable sense of complicity, crucial not to disregard and impossible to escape.
I did not know how to process that sense of underlying danger and inequality. Here I was trying to understand medicine in the context of Garifuna notions of death while also becoming paranoid about my own. I lost twelve pounds in four days to an acute illness in April, then got pneumonia. And shortly after someone had tried to break into the nearby window, I found out that I was—by sheer coincidence—working in a clinic built on the exact place where an earlier white anthropologist who worked in the village had lived. I did not find out until late in my research that he was murdered in Belize. The figure of the killed anthropologist was therefore a disciplinary legacy in both places where I worked, which I came to feel unwittingly but inescapably connected to somehow. Just by choosing to stay in the midst of bad omens, I found myself also touched by a kind of Thanatos, which felt entwined with the offerings to the ancestors and other dead unfolding around me.
At some point, this unsettling context of my fieldwork became more than the methodological realities of my research, but also a central heuristic through which I was coming to understand the things I saw in Belize: medicine in the communities where I lived; the way people I knew there sometimes thought of their illnesses as inevitable and the imminence of death as intractable; the way this intimacy often became part of how they communicated with their ancestors through rituals, food, and songs; and the way people bore their losses, by redefining love and communication as something that only grew more powerful in the face of death. Maybe this was participant observation in a way too: I came not just to observe but also to partially participate in an intermittent reckoning with death.
For me, these methods came to feel like a postscript of obsessively studied mistakes—some of which I observed in global institutions’ policy documents, occasionally witnessed and at times felt complicit in, or myself felt mistaken for engaging with in the first place. Of course, to some extent errors are part of human relationships themselves and therefore inherent to anthropological research, perhaps even part of the conditions for ethnographic possibility and its “troubled knowledge.”37 Carl Jung believed that “mistakes are, after all, the foundations of truth,” while Salvador Dalí wrote of mistakes, “Understand them thoroughly. After that, it will be possible for you to sublimate them.”38 Yet that does not change the fact that I still considered or experienced certain events as mistakes, whether witnessed or my own. Many of their consequences are unfixable. But I like to think that