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.