Three weeks into the rotation, I found myself surrounded by sick patients without a lot of good options for treatment, and I began to get a little discouraged. I had been through a couple of busy call shifts that week and had admitted several patients with advanced cancers and disease processes for which we had little to offer them in the way of treatment. One such patient was a relatively young lady, just a couple years older than I was. She had developed a tumor of the muscle tissue in her armpit that had been resected a little over a year ago in another hospital in Kenya. Unfortunately, the tumor recurred and had now grown to the size of a football, rendering her arm useless and causing severe pain. To make matters worse, the tumor had become necrotic and emitted a strong odor of decay. It also continuously caused a slow bleeding, which made the patient anemic and weak. In addition to her medical ailments, she had a dire social situation as well. Her husband had left her after they couldn’t afford to pay for the hospital bills anymore, and she was left with 4 children and no ability to work or care for herself or the children. We admitted her to the hospital but we had little hope that the tumor could be resected given its size and the fact that it was growing into the shoulder and part of the chest wall. Our best hope was to clean her wounds, treat her pain and decrease the necrotic tissue and the smell for her comfort and dignity. I wish that I could say that we performed a heroic operation and removed the tumor and saved the day, but unfortunately medical practice often consists of being confronted with its own limitations and understanding that sometimes alleviating suffering and providing some dignity in an otherwise undignified condition is the best that you can do. This is hard to swallow and is often discouraging. You feel helpless despite all of your training. This particular situation made me question whether I was doing anything of benefit for this patient. However, I consider myself a spiritual and religious person, and I was reminded of a passage in James that states “True religion is considered this: to look after orphans and widows in their distress”.

Medicine often is focused on achieving a “cure” or a better outcome for a disease process. The opportunity to take care of this woman who was left alone by her husband, with her children who were about to be orphans, impressed upon me the need and importance of being able to practice true religion.