By Zahra Taji
In San Juan El Mirador, a traditional town in the highlands of Guatemala 2,500 miles from Stanford, pediatrics professor Paul Wise is working to transform the local medical scene.
“Doctor Pablo,” as the locals affectionately call him, has been traveling to Guatemala for 40 years now, ever since he was a teenager. He has met with doctors, policymakers and clinics from the area in an attempt to bring the tiny Guatemalan town up to Western medical standards. Last summer, local health promoters honored him with a ceremony.
Wise first visited Guatemala the summer after his freshman year at Cornell University. He had been interested in marine biology–specifically sharks–but was thinking about pursuing something that would have more of an immediate impact on the world. He headed to Guatemala to get a glimpse of the “real world.”
He got his wish. The hospital ward Wise was assigned to was full of severely malnourished children, with two to three children for every one bed. Initially, Wise was angry with the parents for letting their children become so sick. But when Sunday came and the local parents were allowed to visit their children, Wise saw that the problem was neither neglect nor lack of love. It had to do with the overarching medical care system.
That was 1970.
Wise, who is now a pediatrics professor at the Stanford School of Medicine and senior fellow at the Freeman Spogli Institute for International Studies (FSI), has since returned to Guatemala each summer to provide medical care, train local health promoters, conduct research and talk to various organizations and agencies.
“You have to get out and go to these places,” Wise said. “You can’t do justice work in Guatemala sitting in Palo Alto.”
Jake Rosenberg, a student pursing a joint MD/PhD at the Stanford School of Medicine, accompanied Wise on one of his trips last summer. Rosenberg said that Wise’s work always emphasized caring for each patient with individualized attention.
“Wise very much encouraged that you treat a patient in Guatemala with the same standards you would treat your mother [or as] you would treat a patient at Stanford Hospital,” Rosenberg said.
Wise earned his bachelor’s degree in Latin American studies and his medical degree from Cornell University, as well as a master’s of public health from the Harvard School of Public Health. After spending the first 23 years of his academic life at Harvard Medical School, Harvard School of Public Health and Boston University School of Medicine, Wise came to Stanford in 2004.
“I was here maybe three weeks and I was asked to do an informal brown bag lunch seminar [to talk about my research],” Wise said, recalling his first month at Stanford. “It was over the summer, and I didn’t expect many people to attend.”
But to Wise’s surprise, there were two Nobel Prize winners among the attendees.
“This would have never happened at Harvard,” he continued. “It struck me that this is such an intimate university…The intimacy and the ability to craft intensely across disciplinary kinds of work is very special here.”
In fact, Wise’s interest lies in interdisciplinary discourse, and he works “right smack in the middle of the interaction” between technology and social justice.
“A theme that has run through my life and continues to be the core of my academic work is the relationship between technical innovation and questions of social justice,” Wise said.
Gesturing to the Clark Center as a meeting place of technology, design and innovation, he emphasized the importance of respecting technological change while at the same time recognizing that technological innovation raises profound questions of justice.
“You can be an intensive care doctor, or a neonatologist, or a surgeon, and that is extremely relevant to the kinds of justice questions that take place in rural Guatemala, the Eastern Congo or in Burma,” Wise said. “These are not disconnected.”
Wise’s work in Guatemala is not only about providing physical care for the patients, but also the less tangible, yet much-needed, follow-up care. He described that part of a health promoter’s role is not just to translate the language, but also to translate the culture. He added that sometimes, the patients who need care have no obvious disease or symptoms–their problems are nothing like those that you could understand as a physician working solely in Palo Alto.
For this reason, Wise is not only a physician during his visits to Guatemala, but also a research figure who trains local people to work on and deal with their uniquely local situations.
“I strongly believe that we have a role to play and can make a difference, even freshmen undergraduate students,” Wise said. “I’ve been to a lot of very ‘complicated’ environments, war-torn areas, and what I don’t want students to ever feel is immobilized…particularly those getting into technical career paths [like] medicine or biodesign.”
“[They] have to recognize that the work they do is directly relevant to questions of justice,” he added.