Life in a northern town

A few snapshots from this morning in the clinic, from the perspective of a non-medical support person. (This is a jargon-free zone.)

One of the first patients of the day was a smallish, friendly looking man with a quiet smile. He carried a tattered book in one hand, and said he was a teacher from Gonaives. After talking with the doctor about his various symptoms: fever, gastrointestinal pain, etc., he added, almost as an afterthought: “And when I eat, I can feel something crawling up my throat.” He said it matter of factly, as if everyone has an abdomen full of worms just squirming around inside them. Unfortunately, around here pretty much everyone does. On the bright side, we had already given him a dose of albendazole, the de-worming pill we give every patient at the clinic.

We saw a 17 year old girl, tall and lanky and beautiful, who came in with her mother. When Dr. Joe asked her, “Sa gan?” (What’s wrong?), her hesitant sideways glance toward her mother indicated she wanted her mom to answer the question. As it turns out, she is suffering from chronic bedwetting. After an ultrasound confirmed there was nothing obviously amiss in her abdomen, Dr. Joe conferred with Dr. Harold, a pediatrician, and offered the only treatment they could think of, which was to tell her that every night right before she goes to sleep, she should think about being woken up by a full bladder. Hopefully, this will have the same effect as when you know you have an early morning meeting, and your body involuntarily wakes you up several times before the alarm goes off, to make sure you don’t miss your appointment.

Then there was the young woman on Margaret’s table, holding herself and rocking back and forth, bereft. She lost her five year old son and her 19 year old sister in the earthquake in January: just saw them disappear before her eyes. Their bodies are buried under a building and cannot be retrieved. Since then, she has been beside herself with sorrow. She described wandering off, making foolish decisions and saying she couldn’t be trusted with scissors. She’s afraid she will do something to harm herself. Her heart is broken, she said. Margaret cared for her so compassionately, listening, comforting her, telling her that her feelings of sorrow and depression were normal, and that someday, although it’s impossible to believe now, it will be a little bit easier to go on living. She asked the woman if she could make sure to have friends or family around her when she felt like hurting herself, and she prescribed some medicine that might help her through her depression.

And an old woman on Dr. Joe’s table pulled down the bodice of her dress to reveal a breast that was deformed by cancer. This is at least the third case of breast cancer we’ve seen in the past two days, not to mention the cervical cancer and rectal cancer, the eight year old girl newly diagnosed with HIV, and so many other heart breaking stories that leave us at a loss. We can’t fix everything. We can’t eliminate suffering, or death. It’s challenging to send very sick patients away, knowing that their future holds more pain and sadness.

Sometimes I think that living with the concept suffering is more challenging for us, as North Americans, than it is for the Haitians whose lives have been riddled with agony and loss for as long as they can remember.

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