Maria is healthy. Vigorous. Brown eyes alert, darting. Watching her 5 children, the 6th at breast.
Today, she just wants to know they're OK.
Basically, they are. Her care shows. All I can add is some vitamins and a dose of worming medicine.
Now it's Mom's turn.
Cursory history, Unrevealing. Ritual physical exam.
Heart sounds funny.
During the major contraction cycle of her heart, there is loud noise.
There should be silence or near silence.
But there's not.
Heart disease? Congenital abnormality? Ethical quandary?
She came to us healthy.
Arrangements are made to get a cardiac ultrasound done in town.
Wish I had my machine that I use Os, so casually Stateside.
Then I could tell her she'd be fine, the extra sounds come from a not-serious problem.
That she'd be here to dance at her girls' wedding.
She'd see her sons grow to young men.
But for now, uncertainty.
She came to us healthy and left sick.
Somewhere there exists a dissonance.
She is old.
Especially for Honduras.
But there she is, smiling a toothless grin.
She just came to be checked.
A review of her history: hemorrhagic stroke, a special stroke where blood leaps from its boundaries and invades the brain. A clot.
She had had surgery to remove the clot some 8 years prior.
I looked again.
Both arms function well.
Walks without a cane.
Rankin disability index? Zero. Nada. Zilch.
Blood pressure a bit high for her age.
A few blood pressure pills garner me a “God bless you.”
I think I'm the winner here.
Though I sure don't want to bet against this old lady walking proudly out the door.
It is unusually cold here in Comayaguela, Honduras.
To us Iowans, though, it seems about right, maybe April.
She is cold, though.
She comes in the exam room, 2 children in tow.
Miserably cold, shivering.
We shut the door; she is still shivering.
My translator sizes up the situation and acts.
Wrapped in a blanket, the patient visibly relaxes.
She tells her story.
We make a few interventions.
These won't change her life, maybe just ease it a bit.
Now it's time to part.
She's reluctant to leave the shelter of the blanket.
But she smiles, rises, proffers a handshake and a thanks.
I think we have the thanks part backwards.
Thanks for the blanket.
The pharmacy is impossibly crowded.
People wait in line, patient.
More patient than any American crowd!
They wait for hope.
We, the Americans, represent Hope.
Hope that our medical people know what they're doing.
Hope that our medicines work.
Hope that we can help lift a bit of the burden of the joy of living.
From the Americans.
To the Americans?
To us flow the other two: Faith and Love.
16 years young.
She had no specific complaints.
Asked the routine “Could you be pregnant?”, her answer was swift and sure.
“You seem very sure.”
“Because I'm going to be a doctor.”
She went on to describe her plan.
2 years high school.
A year off to make the money to go to college.
Then on to the Autonomous University of Honduras.
Six years study to her goal.
She wasn't sure in what area of medicine she wanted to concentrate.
She was determined.
We talked about the gap of a year off, how it could be a trap.
She listened well and considered.
I think she'll make a good one.
I hope she comes study in the States.
I'd like to see her grow up.
“Duele en pecho.”
It hurts in my chest.
“When I work or walk steep steps.”
“Pain in the left arm?”
“Yes, and to the neck and back.”
“Short of breath?”
“Only with the pain.”
“High blood pressure?”
I was on familiar Spanish ground now.
“Not any more.”
He grinned from ear to ear, clearly enjoying the exchange.
“What work do you do?”
“Hard work! Of what did your parents die?”
“73 and 80.”
“I don't know.”
I put him on low dose aspirin and sent him for heart testing.
He gave a round of hugs on his way out the door.
Yours from Honduras;