She’s here on a Wednesday. My Wednesday morning gynecologic clinics are usually my day for established patients; Mondays are for new consults. But, she’s here as a more urgent referral from one of my colleagues in our outpatient department. Her diagnosis – cervical cancer. Yet, for a brief moment, I doubt the diagnosis. Surely she can’t have an advanced cervical cancer. The woman in front of me can only be in her mid-twenties. She has no children and she recently left her husband because he took a second wife – something all too common for many of my patients. I begin to examine her. My heart breaks as I quietly assimilate the signs I’m finding throughout her body that indicate to me this cancer may very well be too advanced for me to offer her anything.
In more developed countries, cervical cancer is primarily “treated” through prevention. We administer vaccines, perform Pap smears and biopsies, and do minor excisional procedures before the abnormal cells ever become cancer. These things mean that to see an advanced case of cervical cancer – one such as those I see on a weekly basis here – is practically unheard of in the US. And when cervical cancer is actually seen in the US, it is often caught at an early stage where we can offer surgery and give radiation therapy that may be curative, or at the least, give years more of life to our patients. Currently, in the entirety of Papua New Guinea, there isn’t a single functioning radiation therapy machine. Sometimes we try for surgery on patients who would typically be deemed ‘inoperable’ due to their advanced disease because it is their only hope for a little more time on this earth with those they love.
So, I scheduled her for surgery. I prayed with her and for her – that we may be able to help her, that even if we couldn’t, Jesus would abide with her. The day came for her surgery and instead of being a several hour intensive surgery, it lasted less than 30 minutes. Her cancer was in her bladder, it was in her para-aortic lymph nodes, it was simply too far advanced. An attempt to give her palliation by surgically reducing her burden of cancer likely would have just resulted in more complications that would have made her already short time left even more full of suffering. She will continue to come to my clinic on a semi-routine basis so I can offer her the best palliative care I have to offer, which still isn’t much beyond Tylenol with Codeine. We will continue to struggle together through her horrendous disease that is progressively claiming her life until she just stops coming.
I began to write this post several months ago now. And then life happened, and now, here I am finishing it from an airport in the middle of our long three days of travel to come back to the US. This past Fall, I began to experience pain in my wrist while operating. What started as a mild aching pain that I had hoped would go away with time continued to worsen and I developed weakness in the strength of my dominant hand. A steroid injection initially helped some, but the pain returned in another area. At the end of December, I had carpal tunnel surgery – a minor procedure that I thought would fix the symptoms I was having. The surgery went well and it did help some symptoms (particularly my strength). But, as I have recovered from the surgery over the past month, the pain in my wrist has only continued to worsen. I have reached a point where I cannot safely operate, nor can I do many of my daily activities without significant pain. The month of January made it clear I have more complex issues than a simple carpal tunnel syndrome and that it needed addressed by a specialist in order for me to recover fully and continue my work. So, here we are – headed back to the US for me to see a hand specialist, to find a diagnosis, to get treatment and physical therapy. This was not in our plans for this year and I’d be lying if I said this past month was not a challenge as I struggled with the realization that I would need to put aside this work I love for a time in order to ensure my ability to sustain it for the years to come.
[God] “comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort too. If we are afflicted, it is for your comfort and salvation; and if we are comforted, it is for your comfort, which you experience when you patiently endure the same suffering that we suffer. Our hope for you is unshaken, for we know that as you share in our sufferings, you will also share in our comfort.”
2 Corinthians 1:4-7
When I initially began writing this post, I had been reflecting on the consolation of Jesus. How do we receive His consolation; how do we, as Christians, give one another this consolation we have received? The task can feel frankly impossible when I’m sitting next to my sweet, young patient with a terminal diagnosis of a horrendous disease and so little to offer her medically. I pray a meager prayer with her and tell her I will continue to look after her in the days to come, hoping she senses how deeply I care for her and wish to lighten her burden just a little. The following is an excerpt from a book called Promises in the Dark we recently worked through during our weekly Friday morning doctor’s meetings; it comes from the chapter on consolation that I had the opportunity to lead for our group.
“Galatians 6:2 tells us to ‘bear one another’s burdens, and so fulfill the law of Christ.’
It’s a curious thing that we can bear one another’s burdens. It seems like it would be impossible. It seems like there’s this existential distance between every human soul that cannot be crossed. Though we may sincerely desire to lift part of the burden for someone else, it’s simply an unfortunate impossibility. It feels like the load is theirs alone to bear.
The mystery is that experience suggests otherwise. Not every time, but it does seem to happen. How? By the fulfillment of the law, which is, of course, love. Those who truly love, risk, hope, and trust can actually make someone else’s burden lighter. It will cost us, for bearing a burden means precisely that one’s own journey is made more difficult. In the immortal words of Samwise Gamgee, ‘Come, Mr Frodo! I can’t carry it for you, but I can carry you.’ It is never easily done, and we will have to keep walking with others as long as we would bear their burden. But the calling is not in vain, for the one who calls us all is the same God who is the source of all our comfort.”
Eric McLaughlin – Promises in the Dark: Walking with Those in Need Without Losing Heart
When I think of the sudden loss of my dad for which each February marks a new anniversary, and even our current unplanned circumstances that have temporarily pulled us away from our life in PNG, I see the hand of God in the consolation I have received. So many times in our own struggles, we have had our burdens lightened, even if just a little, by those around us who love us. I pray, and will continue to do so when we get to return to our work in Kudjip, that I can be that same consolation of Christ to the women I so love to care for in the mountains of PNG.