Day 30, ‘Get Out!’

30/46 of daily Lenten blog…

Today, I cared for a patient that really got to my heart.  It’s easy to become numb to all the cancer and advanced disease processes we see routinely, but no one could be immune to this young lady’s plight.

Edna (not her real name) is only 32, married with a little boy and girl, ages 3 and 6.  She and her husband came in search of hope.  She went to a doctor in a town a couple hours away, for some pain in her abdomen, and swelling.  They did an ultrasound, told her something was wrong, and told her she needed to travel to San Pedro Sula to get a Catscan.  As her family put it, they told them to ‘Get out!’

She is very poor and couldn’t afford to travel to SPS (about 5 hours away) much less pay for a CT (usually about $166 American, which is a steal in the US, but is the equivalent of a month’s wages here, for many).

Not knowing exactly what was going on, they opted out of further testing.  But now, 2 months later, her belly has ballooned and become tender.  I looked over the ultrasound report that they brought.  It described things like “probable metastases to the liver and pancreas,” and ‘retroperitoneal Lymphadenopathy,’ as well as “swelling of the walls of the stomach, recommend endoscopy…”  All of these reports scream “CANCER!!”  But the other clinic didn’t tell her that.  They just told her to ‘get out,’ and go get a cat scan.

We had a pretty serious ‘heart to heart’ today, to let them know how dire the situation is.  It was painful for me to tell them bluntly that everything points toward a fatal cancer diagnosis.  “Why are you guys thanking me, and being so gracious?  I’m giving you horrible news…” I thought.   But still they were so appreciative of the time we took with them.  With the help of our pastors, and my lovely Honduran sister-in-Jesus, Alicia, we just spent some time communicating clearly, and loving on them.

I put her in the hospital to ‘tune her up,’ as she appears to have an infection as well.  Tomorrow, unbeknownst to them, our church will find a way to help them get a CT.

The reality is that she probably has a diagnosis that we can’t do anything about.  But she is young and has young kids and a husband, and so a ‘Hail Mary’ is possibly in order.

My friend and all around great surgeon buddy, Dr. Alex (ok, fine, his name is Dave, and he is not innocent…) just shared a similar hopeless story with me.   A 17 year old kid named Dash (not his real name) came in with massive swelling in his right armpit.  He and his family are from the mountains, and very poor.  It was suspicious of lymphoma, and he did a biopsy that confirmed it.  We didn’t think he would be able to access chemotherapy, due to being so destitute.  But out of nowhere, a solution fell in Dave’s lap, which resulted in free care for Dash.  He came in last week after starting chemo, and is showing an amazingly positive response. The tumor mass is almost gone.

So, please join me in praying for an equally unbelievable report for Edna.

In the Good News department, the little girl with the Twinkie-sized blood pressure (Gothel, day 27) improved, and I sent her home.  A blood test came back today, all but ensuring that she had a complication of a strep infection (post-streptococcal glomerulonephritis) which sounds bad, but is actually good, because it gets better on its own.  Whoohoo for the body healing itself!

Photo of the Day:

Ok, back to worms.  Elsa spit up another one, so I had to up my game with the photos.  Yes, that is my hand.  Dr. Dave thinks that I am now seeded with the spawn of this parasitic worm.  He won’t even be in the same room with me now…



Hasta Luego.

4 thoughts on “Day 30, ‘Get Out!’

  1. Pete Shepard says:

    Love your blog…both the happy and the sad….have to admit though, that the squirming worm in your hand, and knowing that they love living inside humans gave me a bit of the creepy crawlies….pun intended.

    Keep up the absolutely amazing work….you are truely in your element.


  2. Sarah Downen says:

    Many of your stories we have similar versions of ‘back here at home’ .. except worms. I’ve never held a guy like that in all my days here in the ER. 😆 great reading all your blogs!!


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