10 patients I will never forget

Time flies, and I find it hard to believe I have now been in Ecuador for ten years.  In these years I have met many patients I will never forget, and who have taught me valuable lessons.  Here are ten of them: 

1.       Maria`s dedicated nursing of her 46 year old sister-in-law, who had a fungating, stinking tumour covering her chest, showed me the acts of compassion people are capable of.  Maria had no training as a nurse, yet she dressed that nauseating wound every day with great kindness. 

2.       Señora Chuba had terminal ovarian cancer.  She demonstrated the inimitable Ecuadorean hospitality, receiving me with chicken and chips when I had waded through mud to reach her house to call in for a palliative care visit. 

3.       I learnt the privilege it is to have a patient put their trust in you as their doctor, when Felicita abandoned her herbal remedies in favour of conventional treatment for her diabetes.  She has been attending her check-ups faithfully, every month for many years now. 

4.       I was amazed at the body`s ability to heal itself when Don Dueñas` s pus-filled, condemned-to-amputation foot responded to being dressed with honey (along with some antibiotics).  This has given me the courage to try to help other seemingly hopeless cases. 

5.       The courage of Señora Guerrero, who lived life to the full, despite living with lymphoedema and pain from breast cancer, will forever stand out in my memory.  She never gave up.   

6.       I will never forget the peace and tranquillity of Laura, who despite suffering cord compression and therefore paralysis, as part of her terminal illness, never once complained.  She accepted the loving care of her son with gratitude and took strength from her faith.  

7.       I learnt the deep sadness of feeling utterly helpless as I watched a young mum die from AIDS, unable to access the antiretroviral medications she had needed. 

8.       I have had the joy of seeing fear turn to hope as a painful, threatening foot ulcer was reduced to an unthreatening scar.  The formerly tearful, shaking Amelia now attends full of joyful smiles.   

9.       I have been touched by the kindness of strangers who took in the emaciated little Erika, the victim of an accident who had been neglected to starvation.  Although her life could not be saved, her last days were filled with care and love. 

10.   It was the end of a long day, and I did not want to answer another knock at the gate.  Imagine my surprise when instead of finding another person coming to ask for help, I found an old lady coming to say “thank you”, with the gift of a cooked guinea-pig.  I will never forget her kindness.

Time is not money: learning to value relationships

 
Life as a missionary doctor certainly has its unique challenges, and one of those is trying to fit into and understand different cultures. Today, I find myself in the strange situation of knowing where I will be every day during June and July, while I am visiting the UK, but not knowing what I will end up doing this afternoon, tomorrow or next week. The two cultures I live between have vastly different attitudes to time.
I was brought up by a British businessman who taught me that efficiency and organisation are paramount to a successful life. Now, I am married to an Ecuadorean who literally plans his life and work one day at a time. I am surrounded by a culture where people are habitually late, invite me to their wedding on the day, and believe it is perfectly fine not to turn up to our meeting because ‘something came up’.
At first, I was aghast at the lackadaisical attitudes I encountered and was determined to teach the locals about long-term planning, appointment systems and punctuality. After all, time is money, is it not? All around me, people were throwing away time (and therefore money) with abandon – and seemed not to care about either.
Then, I began to take notice of the events happening around me. I realised that when someone was sick, they needed family members free to go with them to the hospital to help them find a doctor who was actually present and attending, buy their medicines and nurse them. When a man went bankrupt and was wanted by the authorities, his brother-in-law drove eight hours, at a moment‘s notice, to take him to his house and feed him for the foreseeable future. When my car broke down on an unmade road, I needed a family member free to come and rescue me. I began to appreciate that in the unpredictable circumstances of life in Ecuador, the ability to be flexible and spontaneous was actually a necessity.
As I stood back and began to try to understand the local culture better, I observed that people truly value time with each other. If they were having a conversation with someone, and had not yet finished what they had to say, they would stay and converse and be late to their next appointment. I understood this was telling me about the values underlying their seemingly laid-back attitude to time. Ecuadoreans do not believe time is money. They believe time is to be used to develop relationships. If investing their time in friendships means they have less money, they are happy to live with that.
I chatted to my local greengrocer. She had just had a baby. ‘I used to live in Spain,’ she told me, ‘I had to work all hours of the day, and had no time for my daughter, so I could not have more family. So, I decided to come back to Ecuador. Now, I have had three sons in the past four years. I have time to spend with them. I am happy’.
Her aim was not to have as many possessions or foreign holidays as she could in her lifetime. She simply wanted to have enough to bring up her children. Her contentment challenged me and my values.
I began to see that my determination to achieve A, B, C and D in a day could be detrimental to my relationships, if sticking to my schedule meant ignoring someone whose need was now. I observed my husband working on the premise that if A took all morning, instead of the planned hour, and then his sister phoned, having come off her motorbike, then B, C and D would simply wait until mañana. I was surprised by how many things could wait very happily, or perhaps did not need to happen at all.
I learnt to have a mental list of things to do, then each day I would see which tasks could fit into the circumstances that presented themselves. This left time and space to respond to those who encountered need that particular day. I learnt to adapt to being invited to a family birthday party on the day, and having my four- and six-year-olds up until 10pm on a school night. I enjoy the fact I can drop in on any of my friends, neighbours or family in Ecuador unannounced and know I will receive a warm welcome and plate of whatever is on the stove. I love the fact we can wake up on Saturday and go to the beach on the spur of the moment.
But more than that, serving in Ecuador has made me question the values of my own culture. I do not find the belief that ‘time is money’ in the pages of Scripture. I do find the instruction to, ‘Store up for yourselves treasures in heaven’ (Matthew 6:20) and to ‘fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal’ (2 Corinthians 4:18). The fruits of our lives that will last for eternity are love, kindness, goodness and faithfulness. Our relationships with Jesus and our brothers and sisters in Christ are eternal. Let’s use the finite time we have in this world to invest in each other and in sharing the gospel. The challenge is working out how we do that as individuals living in different cultures.

Posted on CMF Blog 13/3/2015