The story of Peanut Better almost never even started. It was the summer of 2007 and I was on my first trip to Haiti. I was scheduled to be in the country for 4 weeks to set up a Ready-To-Use Fortified Peanut Butter feeding trial to evaluate its possible benefits in the treatment of malnourished children. I would be working and living at the Lifeline Christian Mission in Grand Goave, Haiti. At this time, Lifeline was regularly hosting medical and home-building work teams that would come down and work for a week or so before flying back home. While I was not officially part of these work teams, I would be working alongside several different teams during my 4-week stay. After a long first full day in the country, making arrangements to get the feeding program up and running, the team was scheduled to attend an evening church service after dinner. As I am sitting in the dining hall enjoying my dinner of beef(?) and rice, I suddenly begin choking on some of the meat. Fortunately, after some gaging and gasping for air, I can get the food down past the opening of my trachea so I wouldn’t immediately suffocate. The good news is that at least I can breathe, but I now have a crushing pain in the center of my chest. I have managed to lodge a big hunk of beef (maybe) about halfway down my esophagus. I quickly take a sip of my drink to force it down, but that chunk of meat has decided it really likes my esophagus and tells that fruit punch to hit the road. This forces me to run outside and start vomiting fruit punch into the flower bed. So I begin to think, “This is good because maybe I can vomit up this chunk of meat.” Yet, somehow, that piece of meat is stronger than my full-body convulsions. It is at this point that I begin to think we may have a problem. Luckily for me, there was plenty of help around. This week's team is comprised of several nurses. My real problem was with having to asking for help. All I could think about was how I needed to tell them the guy that came to help malnourished children is too dumb to chew his food properly and now has a hunk of meat lodged in his throat. This has happened a couple of times before, and it always goes down…eventually. So naturally I think to myself, “No worries, I will just give it some time and it will go down.” With dinner now complete, very abruptly for me, the team piles into an old yellow school bus for a 20-minute ride to the aforementioned church service. It is on this little bus ride that I quickly come to realize that not only can I not swallow my fruit punch, I can no longer swallow my saliva. As it turns out, my little meat friend has completely obstructed my esophagus and I am now forced to stick my head out of the moving bus every couple of minutes and spit out a mouthful of saliva. I still haven't told anyone, so I am just some weird guy in the back of the bus drooling out the window. I did my best to try and play it off, but no one looks cool drooling out a bus window! But then something else hits me— if can't swallow liquids, it is only a matter of hours before I become dehydrated. After all, this is Haiti. Daytime temperatures in June are consistently over 90 degrees. Nighttime doesn’t get much cooler, rarely falling below 86 degrees. Now I am starting to get worried, but not worried enough to tell anyone. Instead, my pride has convinced me it is better to look like a drooling moron with his head stuck out of a bus window than to ask for help. We make it to the church and, fortunately for me, by now it is dark so my drooling is way less obvious. I take my seat in the church and I am relieved to discover that the church has a single gas lantern located on the pulpit and a dirt floor. Thank you, Lord, now I can drool in the dark onto the dirt floor and no one will know. It has now been about 2 hours since that little food bolus made itself at home in my esophagus. I am miserable, to say the least. I'm hungry (this happened on my second bite), thirsty, in pain, feeling alone, scared, and pretty mad at myself. I am sitting in thatch hut church listening to a small group of Haitians pouring out their hearts to the Lord in worship and all I can do is sit there in the dark and drool on the floor. This Haitian adventure is not going as planned. We make it back to the mission house and I have finally come to terms with the fact that I need to tell someone. It has been about 4 hours since Mr. Meat made a seemingly permanent home in my throat. I am getting desperate. So with my red solo cup in hand- or rather, my spittoon- I tell one of the nurses about my problem. To say that we had limited medical resources would’ve been an understatement. They whip up some concoction of medicine in applesauce and do my best to swallow it and it stays down for about 30 sec. In no time I am back outside again in the same flower bed throwing up medicine-flavored applesauce. I keep thinking that I am going to have to be emergency-flown back to the US and have this meat removed from my esophagus. Worst of all, all the months of work that went into planning the project would be for nothing. I had been in Haiti for barely 24 hours and already failed! It was then decided that if I could not take medicine by mouth, we would have to find another way. Now, you may think an I.V. would be a good option. It would have been, except we didn't really have any IV fluids or medicine. What we did have was a Phenergan suppository. Looking back after having now practiced medicine for over 10 years, I have no idea what possessed the nurses to suggest this medicine for my food impaction. I knew what a suppository was, but I had never needed one until then. To my shock and embarrassment, one of the nurses offered to give me the suppository. My pride which had been beaten down to the point of near death quickly experienced a Lazarus-like resurrection and prevented me from accepting her generous offer of assistance. Instead, I insisted that I would give myself the suppository. This definitely marked a new low point in my life. With my pride in shambles and my medicine "in place,” I headed off to my bed with my new best friend: my red solo cup. After a quick cold shower, I climbed into bed around 11:00 P.M. with my solo cup positioned under my mouth to catch the constant flow of drool and drifted off to sleep. The next thing I remember is the feeling of something really cold on my chest. No, it was not the cold finger of death, which at that point would have been a welcomed relief. Coming out of my Phenergan-induced coma around 3:00 A.M. I realized that my drool-filled solo cup had turned over and I was now covered in 12 fluid ounces of my own drool. I immediately sat up on the side and contemplated my next move. Should I change my sheets, move to another bed or just lay back down in my own drool and admit defeat? Then all of a sudden it happen, I swallowed without even thinking about it and my spit finally went down. I had never been so excited to swallow my own spit before (or since). I immediately grabbed my water bottle, put it to my lips, and drained it. I then laid back down on my drool-soaked sheets and drifted back off to sleep. Before you judge me, remember that the overnight temperature in the dorm room is around 86 degrees, so those drooled-soaked sheets actually felt really good! I learned several lessons from my near-death experience in Haiti. First, always chew your food thoroughly, especially in a country with no gastroenterologist. Second, humility is not weakness. Pride is rarely helpful and can be dangerous. Proverbs 11:2 tells us, “When pride comes, then comes disgrace, but with humility comes wisdom.” So let us all strive to take ourselves a little less seriously, embrace humility, and most importantly, resist the false comfort of pride.
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