Great Expectations

There is nothing like having great expectations.  Today a couple came into my consulting room their hopes built high.  They had heard people have come to me and hence avoided an amputation of their leg, so now that the elderly husband has been sentenced to an amputation they came knocking at my door. 

“Doctor, we have faith in God and after God in you that you can cure my husband´s leg:” Was the opening statement.  “The hospital in Quito wants to amputate his leg, but we know you are going to cure him.” 

“Does he have an ulcer?”  I asked, not seeing any bandages on his leg. 

“No doctor, he has a cancerous tumour in his leg.” 

My heart sank as I knew they were going to be leaving disappointed.  I was not going to be able to give them the hope of a cure they were seeking. 

The elderly man had developed memory loss two months previously, which was why his wife did all the talking.  He had had the growth just below his knee for 8 months.  His wife complained vigorously that her husband had been in hospital for 2 months but that the staff had “done nothing, not even given him anything for his pain.”  Looking at his test results I could see it already had spread to his abdomen.  The man did have a swollen hard area below his knee, but he was very relaxed and not in obvious distress. 

It was one of those moments when I would dearly have loved to be able to see into the future;   to know how aggressive his cancer is going to be, how long he has left and how much distress the tumour will cause him.  The couple face a difficult decision.  The hospital offers amputation as the only treatment.  But he already has spread to his abdomen – and maybe to his brain.  Amputation will remove the tumour in his leg but will not stop the disease that ultimately is going to kill him.  Is this traumatic surgery the best option?  Or will such mutilating surgery be too much for him to cope with? 

I do not know the answer, but I could help them formulate the questions they need to ask themselves and their doctors in Quito.  I could give him some medicines for his pain.  I could not cure the disease, as they had hoped, but I could offer to accompany them along their journey.  I pray the decision they make will be the one that causes that poor man the least suffering possible in the circumstances, and that their faith sustains them in the days to come.     

A month in the life of Andy in the Andes

It is Monday morning and my first patient is Maria: a fifty year old woman who has a diabetic ulcer on her foot.  She was told by the local hospital that her case was hopeless, and that she required an amputation of her foot.  The first time she came to me she was fearful and tearful.  She was terrified of losing her foot and distressed that there appeared to be no alternative.  She needed to be able to walk again, to be able to work again, to be able to provide for her family. 

Today she is smiling.  As we take off the dressings we can see the beautiful red skin growing over and closing the wound.  It is wonderful to be able to help patients like Maria, here in a forgotten village in Ecuador; to show them God´s love by caring for them in a practical manner, and to restore their hope. 

Later in the week I visit Señora Chuba.  She is an eighty year old woman dying of cancer.  Sent home from the hospital with no medicines and no follow up or support, she and her daughter are immensely grateful for our visit.  The nurse and I attend to her physical needs, and then she asks us to read the Bible to her.  We share Psalm 23, pray and sing a hymn together.  Such moments are amongst the most precious in my life.  They are real instants of heaven touching earth.   When her daughter phones me the following day to ask for the death certificate I know that Señora Chuba was ready for her final journey.  

The next week sees me organising a remarkable celebratory meal.  As well as running the village health centre I also run a sponsorship scheme for local children to be able to afford to go to school.  It is the end of the school year and seven girls are graduating from secondary school.  This is an amazing achievement for each and every one of them, and they have each dedicated themselves to their studies in a truly admirable way.  Angela is one of five sisters whose father abandoned them many years ago.  Their mother has worked washing clothes by hand for the neighbours every hour possible to put food on the table.  Sometimes the girls have gone to bed hungry.  They have walked half an hour to get to school in tropical rain storms and blazing hot sun.  Their mother never had the opportunity to study more than primary school.  Angela now has the chance to find a job as a bookkeeper in a local store in the day and to pursue a University course in the evenings.  She can become a professional.  Her life has been transformed by the support of her sponsor. 

Tania has funded her secondary education by participating in our village sewing group.  This afternoon she has brought me her final offering of some intricately embroidered bags.  The money I pay her for them will cover the cost of her graduation.  I am sure these will be a popular item when they find their way on to church stalls in the UK.  Martha has also come with some aprons she has made.  She is deaf and dumb and has not had any education, but she knows how to use a sewing machine really well.  The income from the sewing project enables her to feed and clothe her two young daughters. 

The month ends with my father-in-law´s birthday meal.  He is happily barbequing his favourite meat, guinea pig, while my daughters play and laugh at his side.  The whole family enjoys the special meal and the chance to spend time together. 

This article was published in Life and Work Magazine April 2013