Following Fifi

by John Crocker

  Once again, through creating a safe space for a patient to talk and through listening and asking questions, I was able to be both a doctor and a healer. As my medical training continued, I found that it was always important to try to be both. Doctoring may be something one does in the moment of diagnosis and prescription with a patient, but healing is something that needs to be addressed by taking a broader view of the patient’s well-being over the long term. Whether it is a broken ankle or a breakup with a close partner, the healing can take months or years, and I found that gentle reassurance along the way could be very helpful. The same gentle reassurance that was the hallmark of Fifi’s mothering—not overdone, but steady and available.

  Walking back to Gombe with Tommy, Abdul, and Rudo, I considered the possibility of spending time in Bubongo sometime in the future to learn more about the villagers’ health beliefs and their ways of dealing with illness. I was still curious about how healers in diverse cultures assessed the physical, psychological, and spiritual needs of their patients. It must have been frustrating to work as a doctor in Bubongo, as in other parts of the world, having few resources for preventing infections such as malaria and dysentery, especially in children, yet I was sure it was tremendously satisfying to help people in such dire need of care.

  I was also sure that there was a mutual benefit in sharing the lessons of Western medicine and those of traditional indigenous healers of East Africa and the rest of the world. The medical home model being developed in my Seattle practice includes psychosocial elements similar to those used by traditional Tanzanian healers, looking at illness in relation to a patient’s social surroundings and family. But it also utilizes a state-of-the-art electronic medical record system to track information and allow patients to communicate online with their providers. I envisioned a future for family medicine in which the best of both medical worlds—traditional indigenous and modern Western—would be merged. Our learning goes on.

  CHAPTER TWENTY-ONE

  GOOD-BYE AGAIN

  On our last day at Gombe, Tommy and I awoke later than usual, tired after our trek to Bubongo. By late afternoon we would be in Kigoma, and then on to Zanzibar before returning to Seattle. “What do you want to do on our last morning here?” I asked Tommy.

  “Not much,” he answered, almost falling back asleep.

  We spent the morning of our departure down by the lake, saying good-bye to people and taking our last swim. Small boats passed by, women washed clothes in the lake, and people strolled along the beach. The lake had been crucial to my tolerating the hot days of the dry season when I was a student and also provided me with memories of brilliant light spectacles in the sky as the sun disappeared beyond the horizon. Somehow the perilous side of the lake did not remain strong in my vision of the large body of water. Besides the occasional water cobra that would swim close to me at times, I also encountered a larger creature during one of my early evening swims. Having completed my tracking of Melissa and Gremlin, I swam out from shore farther than usual. Looking back at the shore I saw a group of Tanzanian men and women waving to me, and I waved back. As I noticed their waving becoming frantic, I looked away from the beach and toward the west to see a hippo staring at me from about fifty feet away. Hippos are known for being highly aggressive and are ranked among the most dangerous animals in the world. In the most adrenaline-fueled swim of my life, I pulled hard at the water without pausing to look back. I reached the shore in time for the larger group who had gathered to break into applause as they waded out and hauled me safely to the beach. This memory arose now but without the terror; I mostly remembered the support I received from the villagers at the camp.

  I sat down in the sand by myself and leaned up against some rocks to view the beach activity and expansive lake. The chimps never enter this territory, so with my back to the forest I felt that I had already departed from their world. But what I really wanted was to have a few more hours in the forest with Freud and Frodo and to find Gremlin, who was now the mother of twins. I wanted to watch them all one last time. My reconnection with the chimps had been fulfilling, but I wished I’d had more time with them.

  Looking down the beach, I pictured Hamisi walking toward me as he did when I stepped out of the boat, having not seen him for thirty-six years. Our connection seemed to transcend race, geography, and wealth. We each felt we shared similar personality traits, responses to our environment, and views of the world. I wondered what it would be like for Hamisi to visit my home in Seattle. From his cautious reaction to our past trip to Dar es Salaam and Kilimanjaro, I’m not sure how he would respond to the tall skyscrapers and intense traffic of our bustling city. Perhaps a kayaking trip in the San Juan Islands would be more appreciated.

  A small wooden boat with a ragged cloth sail breezed by, holding a family bringing vegetables back from the market to a village north of Gombe. When they caught sight of me they flashed big smiles, and I called out, “Hujambo,” hello. Just as I had pictured spending the night in Bubongo Village, I imagined spending the day with this family as they sailed to Kigoma and back with their bountiful produce packed in their small boat. I wondered what brought them joy and what stimulated them to carry out their lives the way they did.

  I thought about Tony, who had made Gombe his permanent workplace. I walked by his house on the beach, made of aluminum siding and thatched roofing with large screened windows open to the lake breeze, and realized that, although I didn’t choose that path, it would have been an amazing life to be so closely connected to nature. I acknowledged to myself the admiration I felt for Tony and how happy I was that he had assumed a major role in managing the work at Gombe.

  I walked by Jane’s simple house too. Stopping, I imagined her running out of the house, leaping into the lake, and swimming out to get the wrapped rose dropped from the sky by Derek, her husband-to-be. I pictured Grub at age seven, playing on the beach. Staring at her former dwelling, which now serves as a guesthouse for visitors, I thought, So much has changed since 1973. The people and chimps had grown much older, of course, living out their lifetimes in some cases, and Jane no longer lived here year-round. It was reassuring to see that the chimps were thriving and that the research was continuing, but I felt like an outsider now and longed to be a part of it again.

  To get a break from the bright sun, I wandered fifty feet into the forest and found a small knoll where I could pause and feel more connected to the chimps before leaving. Tommy remained near the beach visiting with the staff. There was a perfect, natural seat scooped into the ground, surrounded by amber-colored grasses shooting up from the red-brown earth among twelve-foot leafy trees with bright green leaves and dangling vines. Although far from Jane’s Peak, I thought I would privately name this John’s Peak. I concluded in my spiritual imaginings that this would make it more likely that I would return to Gombe someday, perhaps with Wendy or Patrick.

  As usual, the setting allowed me to focus on natural elements around me and not think so much about my worries and regrets in life. Sure I wished I had learned Spanish, spent more time with my kids just having fun, worked as a doctor in Tanzania, and developed musical talents. But at this moment of reflection, alone on the small bluff in equatorial Africa, I let go of these regrets. There was a bigger picture surrounding me physically and emotionally. As in my student days, I embraced a different perspective. I had fewer expectations of myself in this big, natural world around me. Although I appreciated Jane’s message, that each person can make a difference in the world, I felt less pressure to be or act a certain way. My feeling of purpose and motivation emerged from a stronger sense of myself and what I could contribute to society. Nature had a way of clearing the clutter for me and adding clarity, like the visual separation of pure white mountain snow against the deep blue sky on a clear day. I was sure Jane felt similar peace and connection in Gombe and was extremely torn when she made the decision to leave her forest home in the late eighties to begin her indomitable crusade across the globe to save species and land, i
ncluding chimps in the wild. Jane still visits Gombe a few weeks each year, and several of the field assistants told me quite confidently that the chimps know when she is around and show up in or close to camp soon after she arrives.

  After an hour of relaxing and thinking about my past days as a student here, I rose up, dusted off the dirt, and headed down to get Tommy for our departure. At two in the afternoon, when the boat was ready to leave, whitecaps spread over the lake. Tommy and I had packed our clothes, eaten a leisurely lunch, and unwisely chosen the afternoon to go back to Kigoma. I’d forgotten that the wind always picked up in the afternoon. I recalled a similar scene from my student days here, when the boat carrying prominent English judge Lord Denning and his wife Lady Denning, in their seventies, had to be lifted by sturdy Tanzanian men over breaking waves in strong winds to begin their return trip home to England. I had hoped our departure would be less dramatic.

  Abdul arrived to see us off as our boat driver readied the vessel. We smiled and shook hands, but our good-byes felt a bit rushed with the strengthening wind and the boat rocking in the waves. “You must come back here again soon, Bwana John,” Abdul said, as we instinctively hugged each other. Tommy smiled and made sure we had all our belongings. “Kwaheri,” good-bye, he said as he jumped in the rocking boat. Twenty feet from us on the shore a park warden held a rifle in his arms, a shocking sight to me on this return visit. That sight would have been unheard of thirty-six years earlier when I was there. With the 1974 kidnappings, increased poaching in other areas of Tanzania, and terrorism on the continent, some of the park wardens were now armed. I guessed if it meant protecting the chimps and researchers, it was needed. My eyes quickly returned to Abdul as he stood at the dock and watched the boat pull away. He kept watching us until we were out of sight.

  I looked back at the lush valleys and undisturbed beaches and wondered how they’d look in ten or twenty years. Would Gombe survive all the changes to come? Would Jane’s work and others’ ensure that the chimpanzees would thrive in this ancient forest for another century?

  When I could no longer see these rugged valleys and the beaches I knew so well, my thoughts turned to the logistics of the journey home. Like a switch, my connection with the chimps was turned off. I relished my new connection with Tommy and how our common adventure to chimp-land might bond us further as we share the meaning of that trip into the future. But for now, the chimps seemed like they were on a different planet. I could see some of them online over the coming years but would not feel the close connection I had the privilege of experiencing on two wonderful trips to the Gombe forest. In two days I would be back in the office, seeing my patients and hearing their stories of their lives and concerns, very different from those of the Bubongo villagers. I would keep the vision of my time sitting on the knoll and also in the warm sand on the beach close to me, especially during stressful times and long rainy winters. I would picture Freud and Frodo relaxing on the hillside as the sun approached the horizon, munching on milk apples before climbing up a leafy tree to build their nightly nests.

  CHAPTER TWENTY-TWO

  KEEPING UP WITH JANE

  It was hard not to think of Jane while at Gombe since she had been such a big part of that experience for me before and during my time there. And as I mentioned, we had kept in touch through letters, get-togethers, and memorable reunions—large and small—over the years.

  The first reunion took place within a year of my leaving Gombe. By coincidence, another student who had worked with Jane, Chuck de Sieyes, was also a student at Case Western Medical School. The two of us enticed Jane to meet us at the Pink Pig, a rustic retreat center on beautiful farmland in Ohio as a break from her tight speaking schedule in the States.

  It was 1975, and the ordeal of the internationally reported kidnapping of three Stanford students and Emilie Riss (whom I had worked with in the Gombe medical clinic) had just ended. The students had been taken by boat from Gombe and held hostage for two months by Congolese rebels. Very tense negotiations with the rebels had transpired in order to finally secure their release.

  Jane had been stressed and drained. I could see that the threats of closing down Gombe, ending her ties with Stanford, and worries about the students had taken a toll on her. But she still cheerfully said, “What an unusual and charming farm. I love seeing pink pig pictures on the walls throughout the center.” It was so heartening to see her laugh and have fun with us in this quirky setting where everything, including the walls, tables, floors, and barn, had a pink pig motif.

  “Jane, how are you holding up these days?” I asked.

  “Right at this moment I feel reassured having you and Chuck at my side, thinking of the good old days at Gombe together, but the kidnapping has taken my energy away. I appreciate having you two spend this time with me.”

  We reminisced about Gombe, walked the farmland as though it were the African forest, and enjoyed our time together immensely. Even years later, Jane shared how important it had been for her to reconnect with her students and feel our love and support.

  A few years later, Jane was speaking in New York City at the Museum of Natural History soon after another tumultuous time in her life. She had no idea I was passing through New York, but I bought tickets to her talk. Despite my reserved nature, when I arrived ten minutes before she was to be introduced, I asked an usher to please take me backstage to greet her and let her know I was there. When I saw her seated behind a massive curtain, gathering her thoughts for the talk, she looked distant and very alone. Derek, her second husband, had died of colon cancer six months earlier. Jane wore a beautiful formfitting dress subtly patterned with flowers that made her look serene and angelic, despite her sorrow.

  A smile crossed her face when she saw me, though her eyes remained sad and tired. She gave me a huge hug, and when I complimented her on the dress, she said, “Derek wanted me to wear this.”

  Some years later, the thirty-year Gombe reunion at the University of Minnesota, where Jane’s archives were kept, was an especially joyous occasion. Jane was full of energy, humor, and appreciation. As Wendy and I walked into a large reception area with her, she let out a perfect, very loud pant-hoot that echoed throughout the hall. Of course a resounding response of pant-hoots by most all of the people attending shook the walls. This set the stage for an evening of sharing memories of our Gombe days and getting caught up on one another’s lives.

  After dinner and Jane’s warm and sentimental welcome, Emilie Riss took the stage and talked about life after her kidnapping. “As most of you know, my husband, David, proposed to me immediately after I was released. After barely surviving a car crash while driving in Tanzania soon after this, we married and have raised three beautiful children on our farm in New Hampshire. David continues to work as a family doctor, and with my background as a veterinary technician, I devote my time to the animals and of course the kids.”

  Tony, the baboon researcher, described his long commute from London, where his Tanzanian wife and son lived, to Gombe, some five thousand miles away, where he worked with the baboons. “This separation isn’t easy, but I can’t give up either of these aspects of my life,” he acknowledged.

  When Jane began her talk, I could tell by her nonstop smiling and her laughter that it was an emotional evening for her, to have not only her close friends there but also the team of researchers and former students who were dedicated to the Gombe chimps and to environmental preservation. For me, this great escape from my time-consuming medical practice spent reconnecting with many of the forty fellow researchers and administrators was very stimulating and fed deeply into the highly sentimental part of my soul.

  “We are one big family,” she said in a soft voice, “and we must not let another thirty years go by before our next reunion.”

  Nearly one-third of the nineteen Stanford students who were part of the Gombe “family” over the five years of the university’s involvement became primary care physicians. We had all chosen human biology as our major, which
included a mix of anthropology, sociology, and psychology instead of traditional biology or chemistry, and perhaps that selected for more generalists (none of us became neurosurgeons). We all were fortunate to have had a break from classroom learning to witness how our closest living relatives survive in the wild. We ventured into an African forest of discovery and learned from “jungle professors”—the chimps and Jane—about primates’ basic needs. Both Jane and Fifi were superb instructors, and we all rated them quite highly.

  Words from Other Former Students

  Recently, I asked other physicians who had been student researchers at Gombe how the experience affected them in their careers as doctors, and three sent me their impressions. Because Jane, in her generous way, had included undergraduate students in her renowned research, each of these doctors had been molded by this extraordinary experience. Jane’s impact on their work as physicians was significant.

  For instance, Nancy Merrick, a practicing internist in Los Angeles, commented on how she came to better understand the genetic component of human behaviors:

  The Gombe chimpanzees taught me that much of who we are is to be found deep within our genes. Not all, mind you. Family and life experience also have played an important part in ensuring our well-being and values. But a vast proportion of the people we grow to be, I believe, was determined before our birth, encoded within our DNA.

  Years before genetic testing was able to determine the fathers of the Gombe chimps, we often guessed as to the various sires. It seemed, for example, that the fairly even-tempered Evered surely must have sired Melissa’s affable daughter Gremlin. Generations later, when Titan began to erupt into aggressive behavior, most everyone ventured that his father must surely be the belligerent Frodo. Each of these youngsters was reared by its mother, without the influence of the father, leading us to believe their likeness was inborn. In fact, genetic testing ultimately confirmed both.