Dr I is only a few years older. She finished medical school here in Honduras and is now practicing as a general doctor while awaiting to get into a US residency. We really like it when she works with us at the clinic. She not only speaks English well, but she is so patient with our many questions, and all the times we ask her to act as a translator between us and our patients. She also goes the next step and uses each opportunity to teach us. She just took Step 2 CE (board written exam #2) in December so she knows what we need to study for our Step 2 in June.
This particular morning with her first patient she came to us in the other room, and said, "you should come see this." An elderly woman lay on the table in her exam room. "Just feel her abdomen, and tell me what you find" Dr I said. So we took turns gently palpating this lady's abdomen, but lightly because she was in obvious pain. There was a large something just below her ribs on her right side. What we call the right upper quadrant. Maybe an enlarged liver? Maybe she is really really constipated? Or maybe it's a mass? Dr I then began to give us some background on this lady. She came to the clinic 6 months ago because she had pain in her abdomen and was a little constipated. Dr I felt the same 'mass' then and ordered several labs to determine what was going on. She was concerned it could be cancerous, but wasn't quite sure without proper labs. Now 6 months later this woman returns in more pain, with more constipation, and weighing much less than she did prior. (Weight loss is what we call a 'bad symptom' it means something bad is going on, like a cancer, but not always) she brought back none of the tests Dr I had ordered, stating she couldn't afford any of them. So now, all we know is that she has a mass, likely Cancer due to her weight loss. But we don't know what kind, how bad it is, or what treatment will actually help.
Dr I tried explaining to her that she must go to the hospital. The same hospital I have worked in and written about how overcrowded it is. She tried explaining that we must see what's going on inside her belly, that it is very serious, and she must go. This lady really needed a CT scan, and a lot of labs, but there is no way she would be able to afford it, so we ordered an ultrasound instead. She and Dr I talked back and forth for a while while I just stared on without a clue what was being said. Dr I then explained that this woman told her she would rather die than go to the hospital. She had had too many bad experiences there. After some pleading Dr I made her promise to go, but the lady said if they told her to stay she wouldn't do it. Dr I knew the woman most likely would not go, but she even called the woman's daughter to try and explain the gravity of the situation. Then she called a friend of hers that works at the hospital to have him be on the look out of this woman and know what was going on.
We were all pretty discouraged after the woman left. We knew that whatever this mass was had already taken a great toll on her body over the last 6 months and it wasn't slowing down. If she doesn't go to the hospital, or if she doesn't stay, we know this mass will take her life. But she doesn't have to die, not from this. Dr I caught it long ago, but because she is poor, nothing as been done. It is so sad to see and realize the gap that exists between the rich and the poor. This would never happen to someone with even just enough money to pay for some tests. This wouldn't even happen to the poorest of persons in the US. If a doctor in the U.S. Finds a large mass in the abdomen of a homeless person off the street, there are ways to get that person the help he/she needs. Say what you want about our health care system or the crazy people that fill our emergency rooms, but at least they are receiving care, and quality care at that. May we not forget how privileged we are.
This begs the consideration then, what about her Spiritual condition. I didn't have the chance to talk with her directly, but what a difference it makes if she knows Christ as savior or not. God knows exactly what is happening here. He sees her pain, and the hard times she is facing. If she is His then we have full assurance that He will heal her, one way or another. We can rest in the hope that she will suffer pain no more and probably soon she will be worshiping as she was meant to for all eternity! But if she does not know Christ as savior and Lord than this situation is even more heat breaking than before! Instead of soon being relieved of her pain, she will come to know eternal pain and suffering. Oh, may we not forget the importance of the Gospel! Why do we do missions to 3rd world countries even when we can't give much medical care? Because the Gospel of Jesus Christ is the hinge on which eternity swings! It's not about catching and fixing life or death situations, it's more than life or death, it's eternity!
And this, this is why God sends us each into the world. Teachers, business men, accountants, whatever, we have the key to eternity. And the woman who lives next door to you who is dying of cancer and doesn't know Jesus is in the same grave situation as the woman here if she doesn't know Jesus. What does it matter if she receives top notch health care if she dies only to face eternal death? The Gospel of Jesus Christ, this is our hope, this is our mission, this should be our aim each and every day! As this rotation comes to a close and I head back to the US, I am heading back into my mission field. No the people I will see won't be in as much need of medical care as those I have seen here. And I surely won't be able to offer Americans as much as I can offer Hondurans, but my people are in just as much need of Christ. The Gospel, this is what my people need more than anything, the pure unadulterated Gospel of Jesus Christ!
