[Skip to Content]
[Skip to Content Landing]
May 15, 1987

Third-World Interloper

Author Affiliations



JAMA. 1987;257(19):2642. doi:10.1001/jama.1987.03390190120036

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


I awake to the stifling heat of the Artibonite Valley. It is a place where the wind rarely stirs and where, in Haiti's summer of 1983, rain will not fall. A sense of purpose propels me along the dirt path from my concrete-block house. I am armed, as it were, with a decade of learning, teaching, and practicing internal medicine: a decade of intravascular catheters, enzyme inhibitors, and insulin pumps. It is my first day on call at Hôpital Albert Schweitzer.

I enter the outpatient clinic through the rear entrance, past the hospital kitchen, where the first of the day's two meals is being prepared. "We have very many today, Doctor," the Haitian medical assistant announces as we pass between the rows of wooden benches on which sit or lie today's patients. They have come on foot or by donkey, an overnight journey for many, to see the American doctor.