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In 2002, I returned to the United States following a trip to Nairobi, Kenya, where I initially lived in a slum area. I enjoyed my time in Africa, making friends and memories, but I never imagined I would return to the United States with “reverse culture shock.” Life in the US would feel foreign to me. I also never imagined that this would lead to my first full-blown psychotic episode, and radically change the course of my life.
My first host in Africa was an intelligent and beautiful Kenyan woman, Naomi* a recent college graduate in Nairobi. Following college, she was passionate about going back to the slums, living in a small house there, and advocating to improve the lives of impoverished teenage women.
In the middle of the summer, I visited Nairobi Chapel, the wealthy church in the downtown area, which was attended by businesspeople from around the world. At church, I met a successful Kenyan woman, Joyce* with a husband in real estate and three children. She left a high-paying job and dedicated her life to volunteering in a slum area. Joyce invited me to stay with her. I joined Joyce in her work in the slum where her charity was located. She fed many women and provided basic work doing art projects for pay. When transitioning from living in the slums to living with Joyce’s family, I began to experience my first serious signs of reverse culture shock. I felt guilty to have access to Joyce’s refrigerator and nice clothing. I felt that maybe I should not eat meat and was uncomfortable riding with Joyce in her nice car to get to the slum.
I was very much in need of counseling when I finally returned to the United States. Joyce tried to talk with me about my feelings of guilt about Naomi and her girls living on so little while I had access to a comfortable life. In hindsight, I wish I had been more open and listened to Joyce. She was also living in a divided world, working daily with the poor but living like a typical American; she made her peace with it.
What I did not realize was that my brain had begun to shut down, and I was no longer thinking rationally.
On my return to the United States, my brain would continue to fail me. I was about to begin my senior year of my biochemistry bachelor’s degree program, a program I had once loved. I bought books and attended lectures. Everything seemed easier than it had ever been before, but my exams were returned with failing grades. Then I entered a period of denial, telling myself I did not need a college degree. This was my first psychotic episode.
In Africa, both of the two women who hosted me had enriched their advocacy skills for the poor through the completion of their college degrees. I had every reason to finish mine as well. But instead, overcome with confusion over my sudden inability to pass, I told myself I was the next Mother Teresa. Since she did not have a college diploma, neither would I.
I returned to America in the fall of 2002. Looking back, I believe that my reverse culture shock would stay with me every day and perhaps even grow worse through my transition a few months later into homelessness. Paranoid of friends and family, I was convinced I could not accept help.
I started taking my first antipsychotic medication much later, in the spring of 2007. My schizophrenia went untreated for over four years.
Today, on medication, I have graduated with my molecular biology degree from the University of Cincinnati, near my parents’ home. I run my own charity with a medical school professor. I do not serve the poor and needy in Africa, but I do reach some of the neediest people with schizophrenia here in the United States.
I am in touch with Naomi but too embarrassed to make contact with Joyce. I hope that if those I served in Africa ever hear about me, they will be proud of my triumph over schizophrenia and my work.
*Name changed.
