Sicknesses of the Heart and Mind

 A NYT piece on the Affordable Care Act indicates that people who have gained health care coverage are experiencing improved mental health because they no longer worry about how to access health care. One interviewee, who now has consistent care to manage diabetes stated that, “The heavy thing that was pressing on me is gone.”  I focus my research energies on the heavy things that press on people here in the Upper West Ghana. It turns out I’m not immune from my own heavy things either as I continue to cope with being a stranger becoming no less strange in a strange land.  

Medical anthropologists approach health in a holistic way. I study how emotional strife originates, navigates into the mind, and settles in the body. I investigate how illness, as medical anthropologists Nancy Scheper-Hughes and Margaret Lock (1987) assert, is a form of communication by which nature, culture and society speak simultaneously. Such an approach looks for how proximate biological symptoms have ultimate factors of causality that are social. 

Here in the Upper West region of Ghana, where farming is becoming an increasingly challenging livelihood, and access to other viable income earning opportunities are constrained, emotional strife is not difficult to uncover. No matter where you are in the world, managing a household on marginal incomes is stressful.  It involves daily decisions about how to meet immediate needs like food and health care while not neglecting future needs.  A common scenario in this region is the struggle to farm to feed children while also ensuring that their increasingly expensive school fees are paid.  The higher the educational attainment, the more likely they are to obtain a salaried job and the more likely they are to be able to take care of ageing parents constrained to farming.

People operating under these circumstances talk about “thinking too much”, a local idiom that describes a brain overwhelmed with the need to solve various economic problems. People who identify as doing too much thinking talk about how the activities of the brain result in poor sleep, body pains and dizziness.  Some people identify these symptoms as congregating in an illness locally known as worry sickness.   Thinking too much can also, and quite deleteriously, travel to the heart.  When worry settles in the heart, a more debilitating illness, which translates as heart sickness, can result.  This illness of the heart somewhat resembles hypertension and somewhat resembles severe anxiety disorders. Regardless of its clinical categorization, it greatly limits the amount of work that people can perform, thus reducing their income and feeding back into a cycle of thinking too much.

Not surprisingly, prevention of the onset of worry sickness and heart sickness is companionship.  Both men and women identify socialization as the primary way to put too much thinking at bay. Both men and women actively seek out their peers to discuss their worries and ways to mitigate them. 

It’s also not surprising that the most well-adjusted sounding anthropologists are those who have moved to their field site with a significant other or a family unit. 

Fieldwork is not hard because I don’t have indoor plumbing. Fieldwork is mother trucking hard because it is always emotionally overwhelming.  Without someone who is also simultaneously experiencing and understanding that emotional hurricane, it’s hard to keep these heavy things from pressing too hard on me.

I think I just took 5 days of Ciprofloxacin to cure homesickness.  When I get homesick, my heart feels like it’s sinking into my lower abdomen and I embody the “heavy heart” idiom common in the US.  And I’m beginning to suspect that this weighty melancholy instigates other physical symptoms.  Since starting fieldwork I’ve had phases where I become intensely nauseous. It’s a sickness that is not comparable to the “well I shouldn’t have eaten that” illnesses I have previously experienced here.  I think these phases of nausea have psychological rather than organic origins.  I think these phases are a way that my body is rebelling against my social circumstances.  The waves of nausea may be my body’s way of saying “Why the hell are you even here???”

If only emotional ailments could be treated with something like Gripe Water

Cipro won’t cure my heart sickness. So to keep my social protest stomach at bay, I’m trying to play with as many roaming puppies and babies as possible without looking too loony. I keep working my way through the WTF canon and am cultivating quite a fictional friendship with Marc Maron.  I’m also packing in as many evenings with my adoptive family as possible.  Even though we can’t share laughs over references to Arrested Development, we can drink beer together and share laughs over the universal funniness of flatulence. Sinking comfortably into the backdrop of a busy, loud and welcoming house (farty or not) is a pretty good social medicine for keeping those heavy things from always pressing too hard on me.