El Cruce de la Muerte: Fieldwork and Carework at the Crossroad of Death

El Cruce de la Muerte: Fieldwork and Carework at the Crossroad of Death

Anthrodendum welcomes guest blogger Amarilys Estrella, Visiting Assistant Professor in the Department of Social and Cultural Analysis at New York University. Her research examines the role of human rights discourse in transnational activism against anti-Black racism.

El Cruce de la Muerte: Fieldwork and Carework at the Crossroad of Death

by Amarilys Estrella

In July of 2017, one year after having moved with my family to the Dominican Republic for my dissertation research, I survived a car accident. Our car crashed directly into a coach bus that had lost control on the opposite side of that Duarte highway in an area commonly referred to as “el cruce de la muerte,” the crossroad of death. I had two broken bones, stitches, and a concussion that would require almost a year of physical therapy and ongoing psychotherapy. As irony would have it, I had spent my year of fieldwork exploring the theme of death with Black Dominicans of Haitian descent experiencing their civic deaths as stateless individuals, as well as the biological effects of racism, leading to the “slow death” of Black bodies. While I highlight in this post my personal experience navigating the Dominican health system and my quest to cope with psychological and emotional trauma in the aftermath of a car accident, I want to also explore carework in spaces of precarity. In particular I highlight the importance of family and community when psychotherapy is not an option, as was the case for many of my interlocutors. I note the importance of family and supportive academic institutions in my own recovery, while also pointing to the detrimental effects of racist government policies that limit an individual’s access to mental health resources.

Broken Bones in a Broken Health System

According to the World Health Organization’s 2013 Global Status Report on Road Safety the Dominican Republic is considered the most dangerous country for traffic fatalities with 41.7 deaths per 100,000. At the time of my accident, the people who had gathered and helped pry my passenger door open assured me that my children and husband were fine. One woman who was helping me apply pressure to stop the bleeding from the wound on my arm told me that I was lucky I had survived because, as she explained, “a esto aqui le dicen el cruce de la muerte”– they call this here the crossroad of death. Many had met their fates at that same crossroad and I was to count my blessings for having survived.

I had two broken bones (right tibia, right collarbone), bruising, and stitches on my right hand. I also suffered a concussion, at the time undiagnosed, which caused ongoing tremors during the first week and would require almost a year of physical, visual, and group therapy. At the time of the accident I was taken by ambulance to the nearest hospital. A plastic bottle placed under my neck for support doubled as a neck brace, while we crossed a series of bumpy roads to get to the clinic, which I was assured was private and therefore better than going to a public hospital. Once I arrived in the emergency room I was quickly taken into a room where a doctor began stitching up the wound on my hand. I stayed by myself, while my husband remained in the waiting area with our children until another family member could show up and help out. At one point I was left all alone, while the doctor and nurses confirmed the death of an elderly man next door. One nurse came in to see me during the ordeal and said as she was leaving again, that I was fine because I was tranquilita, calm.

Once the doctor returned, she asked my husband to go to the pharmacy and purchase two hospital gowns in order to be switched out of my bloody clothes. I was then wheeled away into the x-ray room, where two men in charge of maintenance helped transfer me over to the x-ray bed. Once the x-rays were done and it was confirmed that my right collarbone and tibia were broken my husband was asked to go to the pharmacy and buy the necessary materials to make the cast for my leg, as well as a sling for my arm. Having experienced emergency rooms in the United States where the billing happens afterwards, I was initially taken aback by the idea of having to purchase the hospital gowns. I was floored upon realizing that the next process would have to wait until my husband came back with the cast materials. Once the materials arrived, the orthopedist asked my husband to hold my leg up by lifting my big toe so that the doctor could start placing the cast on my leg. I had never broken my leg before, but I had also never had such a hands-on experience from a family member during an emergency room visit. What followed was a series of visits to the doctor where I would sit in my wheelchair for hours on end waiting to be seen by the orthopedist. In some ways, the torture of sitting in a waiting room for up to 5 hours at a time was ameliorated by the air conditioner that kept me cool during those blistering hot 95-degree summer days.

Seeking Mental Health Support for the First Time Ever

After spending five weeks recovering in the Dominican Republic, I returned to New York where I was finally diagnosed with a concussion. While being back home was quite the relief, it wasn’t until I found myself alone in a wheelchair that I realized the psychological toll the accident had taken on me. I woke up every day fearing that if I had not died during the accident, I was surely in some kind of process of dying then. I became hyperaware of my breathing, my vision, my fatigue and my general inability to focus on anything other than my body. Months without moving and anxiety had also caused dysphasia, making it hard for me to swallow. I felt fear taking over at all times of day. Although I was constantly checking in with my advisor, mentors, family and friends, I continued to feel lonely, anxious and overwhelmed.

Through my university’s health center, I was connected to a psychotherapist who to this day I continue to see. I had never seen a psychotherapist. The different communities I identified with dealt with our problems by showing our unwavering strength through it all, by showing how much we could resist. I had internalized this messaging and found it really hard to publicly discuss the need for a psychotherapist. Over time, this has changed, and I have found value in meeting with my psychotherapist once a week, while also holding on to my family and community’s collective healing processes.

During a recent psychotherapy session, I shared with my therapist the heightened anxiety that I experience as the anniversary of the accident approaches. I have learned to cope with the trauma the continues to live on in my body through mindfulness techniques, mantras and, yes, jumping jacks. But the fear will continue to be there. It creeps up when least expected. It recently happened as I finished watching the Teddy Pendergrass documentary. As I learned that he spent the second half of his life as a quadriplegic, I felt my chest tightening. I thought back on my own experience. I was reminded of the time I spent in a wheelchair, what it was like to not be able to bathe on my own, use the bathroom on my own and for some time eat on my own. I felt this wave of panic wash over me as I tried to understand why this had happened. Perhaps I also felt guilt in thinking that pure luck had meant that I had recovered all mobility, that I am once again walking, finishing up my dissertation, and traveling to conferences without assistance.

All of these emotions came rushing back as I thought about Pendergrass’s family and my family. They stepped in when a failed healthcare system was not available. It wasn’t until I experienced my own possible death that I understood the precariousness of a health system in which carework was almost entirely the domain of family and friends. They had become my support system. They were an integral part of my ongoing physical and emotional healing process. They bathed me, washed and combed my hair, held my hand and constantly reminded me that I was loved.

My very own traumatic experience allowed me to better understand how the necropolitics of the Dominican state had led so many Black Dominicans of Haitian descent, and Dominicans more generally, to add as many family members as possible to their funeral insurance. As a friend once told me in the Dominican Republic “funeral insurance is probably as important or more important than health insurance.” During my time in the Dominican Republic many of my interlocutors experienced the death of close family and friends. Oftentimes they talked about the hospital or clinic’s refusal to treat them because they didn’t have insurance. As impoverished, Black individuals perceived as Haitian migrants, thus outsiders, they experienced hours of waiting before anyone would come to see why they were there. They talked about the many inevitable deaths. These stories were in my thoughts throughout my recovery. I had been at the crossroad of death, yet privileged and lucky enough to survive. My hope is that in surviving I can continue to denounce statelessness and anti-Blackness as a global phenomenon and continue to highlight the many stories I came to learn about throughout this process of research, survival and recovery. I also hope that sharing my story will allow us to continue to destigmatize mental health support.

There are some key takeaways from my personal experience. The first, is the importance of providing mental health support and resources for mentors and fieldwork researchers that will allow them to be prepared to address circumstances that may arise during fieldwork. I was immensely grateful for the flexibility and easy access provided by my university’s health center. Providing a mental health resource guide for students before engaging in fieldwork research would be of great value as well. Second, the flexibility extended to me by my Inter-American Foundation fellowship allowed me to prioritize my health before the need to present the deliverables of my research. Not only did they allow me to take as much time as needed for healing, but they also allowed flexibility in determining the terms of my return to the field a year later. Finally, I would say to fieldwork researchers to ensure that you have identified a network of supporters who will be readily available when things do not go as planned. I am thankful for the support I received from everyone who was there with me during this journey. When life gives you lemons make sure you have friends, family, advisors and a therapist to help you make lemonade.

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