I am in my first month in site, visiting strangers-turned-friends, when I find myself in a cargaleña. A cargaleña is a “wood-carry,” an all-day affair hauling and stocking wood before the winter rains. In between the wood carries, we drink chicha (fermented corn) from a big bowl. They tell me that I have fuerza. People pepper me with questions about the States: does corn grow there? Are there farms and country folk? Is there poverty? At lunch time, covered in brush and dirt, I go to a basin to wash my hands and splash water on my face. Out of the corner of my ear, I hear, “look, he’s pouring water all over himself.” I look back at the group to see them looking back at me in awe. One of the kids says, “va coger un pasmo bruto”: he’s going to get pasmo real bad.
Pasmo is just about as infused into the (Panamanian) Spanish language as God is. My God, for the love of God, God did this, God did that. If you are invited to an event but are unsure if you can attend, say “Si Dios quiere” (if God wants), that way if you don’t go, it’s because God didn’t want you to. Or, say, “Dios primero” (God first), for any future event: because no one ever knows if, in the moment, he/she is able. But God does.
In a similar way, you will hear some version of “dar” (giving) or “coger” (getting) pasmo. In a group of people, it is more than likely that someone already has pasmo in some form, or knows somebody else who has it, or that something will happen to beget its onset.
Panama is at 7 degrees latitude and has little seasonal and temperature variation. The sun is hot. Humidity is constant. Sweat turns clothes into a burden. A friendly debate could be had over whether the lack of rural development is attributed to corruption, pereza (laziness), or rather the climate. My body has been around 40 degrees latitude for most of its life, graded to the scale of seasonal swings. Here, throughout the year, my body hovers around the “hot” side of the spectrum. I am always looking to get to the cold side. But most Panamanian bodies exist on a hot-cold spectrum that is at once narrow and broad, and any number of factors can cause them to travel from one side to the next in a matter of seconds. The consequences of travelling so fast between extremes, according to the rules of pasmo, are detrimental.
Humans get pasmo. We cannot give it. Sun, heat, water, rain, mist, earth, air – these elements and their interaction with humans “give” pasmo. The classic example is that of Pardo, the son of the abuelo who lives alone, about 100 feet from my house. Pardo liked to bathe right after getting home from long days of working in the hills. One day, after bathing, he suffered a stroke. He was 40. The locals blame the stroke on pasmo: the discord or mismanagement of body temperature with relation to the temperature external to the body. Pasmo refers to the impossibly wide range of symptoms – headache, achy joints, congestion, indigestion, pain all over, nausea, chills, fatigue, malaise, etc. – that arise from this mismanagement.
Then there is Joaquin. One day, heading back from bean-planting, I passed Joaquin standing on a riverbank. He was looking down at the water, pensive. I said what’s up? He told me “you’re going to have to take me enhamacado.” He was hesitant to cross the stream (no more than a foot deep and with stepping stones), because his black work boots were hot and the stream cold. “Enhamacado” harks back to the old days before there were paved roads or cars: if someone was bitten by a snake, or otherwise gravely ill or injured, people would lay the patient in a hammock, tie the hammock to a wooden pole, and carry the patient up and down hills to the nearest medical center, up to five hours away. I crossed the stream, with my warm body and without hesitation, shamelessly abandoning Joaquin and any notion of pasmo. I still do not know how Joaquin crossed the stream. But I have seen him since, and can attest that he is alive.
Pasmo begs a tension that is difficult to reconcile. On one side, pasmo pins illness on one’s subjective bodily experience in relation to the immediate surroundings. It implies an awareness of body-in-place. It is organic, grassroots, machine-free. Pasmo seems ridiculous from an American perspective because a) our hot-cold scale is more stretched and b) we have no word equivalent to it in the English language. And maybe we don’t have a word for pasmo because we are unaware of its subtlety, until the symptoms manifest into something bigger, like a “cold” or the “flu.” Or maybe we devalue subjective experience when validating illness.
Last September, I was in the pueblo of Las Minas selling produce with my environmental group when I came down with a mystery illness. I had a headache, a fever that wasn’t, aches all over and an extreme lethargy. It felt like a minor league flu. It hit me not long after I bathed in the river at noon, after a morning full of errands. People asked me whether I had waited for my body to cool down before jumping in. I said no. They said it was pasmo. Hot body, cold river.
But I don’t know if it was the river that gave me pasmo. On the night prior, I had played two hours of intense one-on-one basketball with a good amigo by the name of Jack. Basketballs and hoops and courts are hard to come by in Panama, and at that moment we had all of them. At the time, it was implicitly clear to the both of us that anything less than total basketball-induced exhaustion would be a travesty. We played until we couldn’t. After, drenched in sweat, we went to the stand, where the group was selling goods, for another few hours. We sat at the stand, drinking fluids and shooting the shit, all the while letting that sweat and the night air drape our poor hot bodies like a cold wet blanket.
Jack and I spent most of the next two days lying down, achy and weak. The episode passed after two days, but a fatigue lingered in our bodies for a week. It never felt serious enough to go to a doctor – just that something was off. We self-diagnosed it as pasmo. (Jack had a separate incident he attributes to pasmo while he was in his community. In short, he bathed in the river, went to visit neighbors, came back to his house and fell asleep before he could change out of his damp river clothes. When he got out of bed the next day, he took two steps, and fell to the ground, where he stayed for several hours, prostrate from an incredible weakness and weight hanging over him. Jack was otherwise healthy; he could not think of anything out of the ordinary that would have caused his fall.)
The other side of the coin is that the broad application of the word “pasmo” lets in rogue interpretations, superstition, and false certainty. Anyone is welcome to use it to attribute anything to anything.
A neighbor once told me about Joaquin’s pasmo prevention techniques. Before he gets under his sheets at night, he puts shorts on pants on shorts, and a t-shirt over a sweater over a t-shirt. He wraps his head with a towel, and puts his feet, already covered with thick socks, into a burlap bag. [Yes, Panama has a dry, tropical climate.] The next day he does not rise until mid-morning, presumably to let his body warm up and recalibrate itself with the calor de la tierra – the heat of the land. He makes coffee, but then waits 20 minutes for it to cool before drinking it. He has a morbid fear of any moisture in the air, which is always “cold.”
Pasmo can happen to things, too. Another neighbor told me that, when cooking beans or soup, she does not add water from the tap to an already-boiling pot of water, because it will “empasm” whatever food is being prepared. To avoid such disaster, she says, you have to heat the water on the stove before adding it to the pot.
My host mother once served me a steaming hot plate of beans, and told me that they were cold. While washing my hands after milking a cow, a neighbor scolded me and said I would wake up with twisted fingers. I was once told I would get pasmo, and then a urinary infection, from sitting on the ground. Another time, an acquaintance told me to pee on a cut to avoid pasmo. And these are just a fraction of the possible pasmo iterations in Panama.
At its best, pasmo is ultra-bodily awareness; at its worst, empty hypochondria. But beyond this dichotomy, and more interestingly, is what pasmo tells us about our relationship to the world via language. Different cultures create different narratives to describe illness. “Modern” medicine, Ayurvedic, Acupuncture, shamanism, Qi Gong, pasmo: each narrative has a function, explains what others cannot. Pasmo was born hundreds of years ago somewhere around here, perhaps as a stab in the dark, in an effort to put words to the world. And the narrative has grown from neighbor to neighbor, from family to family, ever since. It does not matter if it is scientifically unproven; more importantly, pasmo is a palliative for the unknown.
Naming things beyond our understanding allows us to fear them less, comprehend a little more. But in using words, we become attached to their definitions, and so run the risk of being used by them. We create a Tool (word), and then, in a way (like Joaquin), we become tools of the Tool. “God,” “democracy,” “community,” “love,” “freedom”: nouns encompass so much that it is hard to know what we are actually talking about when we use them. Yet we still use these vague mega-metaphors liberally and in everyday conversation, oftentimes reducing them to a finite meaning. And then we argue and fight wars over who has the right definition.
This is how we get used: we build up religions and ideologies, and then forget that it was us, with our words, that created them. We prefer to give these things their own realities, independent of our words, rather than think of them as spoken figments of our (ancestors’) imagination. For Joaquin and other country folk, pasmo leapt from the imagination into the ‘real world’ a long time ago. Whether pasmo is valid as a medical phenomenon is, I think, a bit like asking ‘is God real.’ Both things have no reality beyond the language we use to adorn them. ‘God,’ ‘democracy,’ ‘community,’ ‘love,’ ‘freedom’ and ‘pasmo’ do not live without an observer.
We were in the last day of a weeklong backpacking trip in Cerro Hoya, a largely untouched forest and birthplace of several rivers that feed the Los Santos and Veraguas provinces. We meandered along the Río Cobachón. Together, we would spill out onto a small beach by the same name. I was walking with Alquiviades, one of our eco-guides. He had changed out of his black rubber boots into his Crocs, and was taking every precaution not to wet his feet during the stream crossings. I walked straight through the streams with hiking boots, thick socks, and half a mind on the beach. Alquiviades said if he did the same, he would get pasmo. As always, I asked what would happen next? He said that he would get a subtle pain in his joints – not immediately, but sometime in the near future. I said that I don’t seem to suffer from it. He then turned to me and said, “it’s different for everyone. It’s all about custom. If someone is used to bathing in cold water with a hot body, perhaps it won’t affect them. But my parents told me about the dangers when I was growing up. So I made a habit of not bathing with a hot body. And when I break the habit, I find it does me damage.”
Pasmo exists through custom and experience, upheld orally by Joaquin, Alquiviadies and other narrators in Panama. The narrative is all but unrecorded; when they don’t speak, an entire library disappears.
It is important for me to be reminded that no narrative explaining illness (or the ‘world,’ for that matter) is complete, and that there is value wavering in the multitude. Rather than deem pasmo as right or wrong, we can focus on how it enriches our narratives and promotes different ways of knowing and experiencing. I am skeptical of its liberal use, but recognize that it’s useful.
In illness or discomfort, people will reach for whatever explanation is most plausible with what words they have. If one narrative doesn’t work, we try another. Maribel tried her own treatments, those of friends, went to doctors and hospitals before healing herself through God. As for my mystery case, based on my experience of living in this place for two years and listening to others, pasmo sounds much more plausible to me than just some random virus. I will continue to believe so until it ceases to be functional.