A couple of weeks ago, Joel T, one of the FP Docs, referred a lady to the city for an ultrasound exam. Seeing Loma de Luz on the referral, the radiologist, a friend, assumed that I had sent the patient , so sent her back to me with URGENT on the results. He saw evidence of uterine cancer. He also called a mutual friend, the GYN surgeon that I work with in La Ceiba, who took a quick look and confirmed the radiologist's finding. Dubis and her husband, Domingo, showed me the ultrasound exam. She reported that Doctor Sae told them that it could not wait and that I was the one who could make it work. Now and then her husband sobbed and interjected "There is NO Way, we have no money". With the exception of feeling that a CAT scan was appropriate to have a better idea if we were dealing with metastasis, it was easy to agree with the other opinions from a quick look at the ultrasound. The following day, Friday, I met with another radiologist who has the capacity for a CT scan and with the surgeon. We agreed on Tuesday as the surgery date, depending on the results of the CT.
On Saturday, Penny and I crossed 2 rivers and several creeks to visit with Dubis and Domingo. They agreed with the plan, but needed continual assurance that we would not let money stand in the way of her receiving the care she needed. "Dios puede hacerlo". (God can do it!) I wrote them the referral for the CT and called Dr Sae to confirm the plans.
As well, Penny sent a note to her "Foul Weather Friend" (FWF), Nancy, who responded that she would "pass the hat" in Sunday School class the next day. Indeed, "Dios Puede": the hat yielded enough to cover the deeply discounted prices of the CT and pathology exams and a good start on the anesthesia bill. Neither Dr Sae nor I will charge the patient and he (the owner of the hospital) will overlook the hospital costs.
Monday evening, with a CT result of "no evidence of metastasis", Dubis was admitted and at 7 am on Tuesday, we were in the OR. As we got to the point where we could open and examine contents of the uterus, we found what appeared to be a very different kind of probably benign tumor, and one that would be unheard of in a post-menopausal patient. On Friday, nine days after her first exam, and amidst Domingo's interjections that "we have no money" and that "Dios puede", Dubis was discharged. I am awaiting the pathology results.
On Friday while I was discharging Dubis, Penny was walking one of our young pregnant patients through the HIV clinic at the public hospital. On a VERY happy note, the clinic lab negated our positive, preliminary "screening" test.
But if you would, please pray for another of our young pregnant patients, whose screening test affirmed her HIV. Pray that she will both continue with her prenatal care and with the HIV clinic; that her baby is not infected and for her healing.
Dios es bueno! FWF
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