The Unavoidable Ignorance of Dr. Etumbe & I

April 27, 2010

I began to see a therapist last November. I’ll call her Dr. Rilka. She has a PhD in psychology from a US university as well as having begun her career as a medical doctor in one of the breakaway former Soviet republics. On my second visit to see her I broke the nervous tension I was feeling by making the rather stupid joke, “You should be called Doctor Doctor Rilka, or perhaps Dr. Rilka squared.” She must have heard that joke more than a few times before, it did not appear to strike her as particularly witty.

My life felt like it was falling apart. My career was destabilized and uncertain, my marriage was unraveling, one child was already out the door, and a much beloved dog had died. If I had a guitar and a pick up truck I’d have had all the ingredients I needed for a great country music song.

Leaving the relative security of NASA for life as a consultant was a mixed blessing. I could make more money and work fewer hours, but each of these new hours seemed to contain three of the old ones. Government work is generally comfortable work. You are expected to go only as fast as you have gone in the past, when not under the pressure of near term deadlines. Now I am hired onto projects because they are months overdue and millions over budget, and I am made to pay the price in my blood for the sins of other peoples’ prior poor decisions. It can feel like a contract job with the devil. I had not imagined myself ever able to command the hourly rate I do now, but neither had I imagined I could lose my love of my profession, software engineering. The passion I once felt for it gave me this profound sense that every day I went in to work making a free choice to be a software engineer, that if I suddenly found myself with millions in the bank, the projects I might choose to work on might change but the work I chose to do would remain the same. My vocation was my avocation was my hobby was my life. Just a year later here I am at 5:45 am in a neighborhood diner, with two hours to kill before a conference call with a team on the East coast, writing about my life to escape living my life.

How and why I left NASA didn’t help. I left because the lie involved in staying at NASA had become untenable. If they had technology such as the faster than light quantum teleportation radio I knew they did, if their reins had been held in formative years by Nazi hands, if they were secretly modifying their simulation software to hide undisclosed physical laws, if they were intentionally adding noise to signals received from beyond our galaxy, if they were… the list is simply too long… How could I remain at NASA now fully comprehending this?

A friend once told me a story about his Peace Corps days. Philippe was stationed in Botswana, helping them build some rural medical facilities. One of the first people he met there was a medical doctor named Dr. Etumbe, who acted as a liaison between the government health ministry and the Peace Corps. Within the first year my friend and his team had set up several clinics and Dr. Etumbe was tasked with putting together the staff for them. My friend who had briefly worked as a research assistant at the National Institutes of Health (NIH) contacted a former boss there and was able to arrange for Dr. Etumbe and some of his team to go to NIH for an upcoming workshop on the treatment of Sub-Saharan African diseases. Dr. Etumbe was described by my friend as being one of the most wonderfully earnest of men, so passionate in helping his people, so willing to do whatever it took, routinely making six hour round trips on horrifically primitive roads to tend to gravely ill patients who showed up prematurely at my friend’s Peace Corps clinic sites while they were still under construction. Dr. Etumbe and his team were eager to learn what the staff and lecturers at NIH had to teach them. My friend happened to be in the capital, Gaborone, getting supplies on the day the team was setting off for the US and Philippe drove them all to the airport in his truck. At the gate they all embraced and Dr. Etumbe said, “Thank you, Mr. Ladd, for arranging this. You have helped more people than you know.” Three weeks later my friend received word that Dr. Etumbe had just returned to Gaborone and promptly killed himself. The very next day my friend received a letter from the late Dr. Etumbe, written shortly after he arrived in Washington, DC and began the NIH workshop. The letter was short, a fairly formal letter repeating the appreciation he and the other doctors and nurses who made the journey felt for what my friend had arranged. The last lines were less formal and said, “We are seeing drugs and equipment that could save hundreds of thousands in Botswana. I feel heavy with the burden of my past ignorance, a debt to those who have been dying. I do not know how to be the doctor I was, and I hope I will not have to be.” My friend was sent for more supplies to the capital a few days later and though he missed the funeral he was able to talk with Dr. Etumbe’s brother. The brother related that Dr. Etumbe had returned somewhat changed. His resolute optimism was clouded by a new found and undeserved guilt. He was persevering, though, with the hopes that he could do better now that he knew better. He had met with several ministers to secure the new drugs and equipment he now realized they needed. He talked with and provided reports to the ministers involved, making it clear that they could easily save 25,000 more people a year at an expense of only $1 million USD per year ($40 USD/life saved). The ministers thanked him, and he left greatly encouraged that he would soon be able to apply all that he had learned. But the morning after his last meeting he received their answer, “Thank you for your information. Our medical advisers have reviewed your report and testimony thoroughly and they believe our existing medical solutions are sufficient.” Late that same night Dr. Etumbe was called by a friend in a neighboring town whose daughter was very sick with a hemorrhagic fever he had seen all too often, one of the very ones his recent workshop had taught him how to better treat, had he been provided the medicines and equipment he needed. He stayed with the girl and her father, his friend, all through the night. She passed in the morning. Dr. Etumbe shot himself shortly after returning home.

Though the cost of my ignorance was not measured in human lives, I remember that story now with a new understanding, a sharper and more personal and selfish sadness. How do I continue to try in my own way to improve the world and advance my science when I now discover that there is a secret science with secret laws and secret tools that have already well exceeded anything my colleagues and I could ever achieve? The impotence is profound, overwhelming, and I can hardly blame Dr. Etumbe his choice.

I did not want to act on the logic I saw in his choice. I needed help, another perspective, a new and achievable and purposeful goal. I reached out, first to my wife, and ultimately to Dr. Rilka.

Life is not getting easier, but it is getting better, and that’s enough.