Peru

This vignette by my sister gives a little taste of how special she is. Not to mention an excellent writer!

PERU
by Kristi Rose

Outside the cement schoolroom, the loud speaker was blaring Spanish
music to try and keep the enormous crowd entertained while they waited
in the sun, the rain, and the heat.  The rain had turned the dirt play
ground into a mud pit.  All the patients started coming into the
schoolroom with brown mud caked to their brown skin.  Next in line, I
invited a timid mother behind the drop curtain we had fashioned to
create an exam room.   Her dark, brown, hazy eyes bore fright and
pleading.  I couldn't speak her language, but one thing I learned in
Peru, is words are not always needed to communicate.  She handed me
her thin, tiny baby wrapped in a blanket.  Unfolding the blanket I
beheld this frail, sickly child.  The face clearly showed Down
syndrome characteristics.  I had never held a child so apparently ill,
but I immediately loved this sweet little girl that lay limp in my
arms.  She had no muscle tone on her legs or arms, her tiny bones were
covered only by a thin layer of skin.

Through an interpreter, I asked the mother why she had come to see us.
Her baby wasn't eating.  She had tried everything - nursing, bottles,
and the little child would only take very small amounts and even then
would often throw up.  She then revealed that other doctors had told
her that the little girl's intestines had not formed properly and that
she was going to die.  This mother was watching her child die and in a
gesture of desperation, she had come with hope to see if there was
anything the American doctors could do to save her baby.  I went and
got our doctor to have a look at the baby.  He took one look at the
child and knew instantly that the baby was not going to live much
longer.  I explained to him what the mother had already told me and he
said she probably had a fistula.  Common among Down syndrome children,
the esophagus doesn't connect with the rest of the intestine, so food
isn't even able to get to the part of the body where it can be
absorbed.  Our doctor told the mother there was nothing we could do.
I just kept saying to our doctor, isn't there anything we can do,
can't she have surgery.  I probably asked him that four different
times.  Back, in the United States, surgeries for this kind of problem
were performed all the time.  He finally just looked at me and said,
let it go Kristi.

This experience will be with me forever.  I will be a different doctor
because of this experience.  I learned that even as a doctor, I am not
always going to be able to help patients.   This is a hard lesson to
learn, because we go into this profession with eyes wide open,
idealistic, ready to cure the world and fix all the problems that come
our way.   Could I have learned this lesson working on the wards in a
large teaching hospital with advanced medical technology at my
disposal?  Probably, but I don't feel like it would have the same
impact.  Knowing the capability existed to fix the problem and yet
still sending that teary-eyed mother back into her life of poverty
really impacted me.  It made me realize there is so much more to
medicine than just treating patients and sending them home.  It's
about listening, communicating, touching, empathizing, and
understanding.   Students that have the opportunity to learn outside
of our American medical paradigm will be much more enriched,
compassionate, and better doctors for having experienced something
beyond themselves.


Kristi in Peru