The Pain on This Side

 Warning: This blog post contains some graphic descriptions of violence and difficult situations. Please read with discretion.

 

I sometimes hesitate to talk about certain experiences in my blog posts. There are a number of reasons for this—not wanting to dwell on difficult experiences, difficulty in expressing certain emotions, etc. Another reason, though, is that I know that I am in some ways representing the people of Papua New Guinea to those who may never have the chance to visit and have their own experiences. But all reports must in some way be limited as it is impossible to relate everything. It will always be skewed by the limits of my observation.

 

Therefore, I don’t want this to be read as representative of all those who live here in PNG. These are some of the difficult stories from the last month that weigh on my heart. But they are also relieved by the small kindness and love I see every day, the patient who brings me a papaya in clinic, the young mom who smiles at me on rounds.

 

 

On a call shift several weeks ago, I felt like I should go check out the ER after eating lunch as we had had a very busy morning. As I approached, I noted the large crowd of people, some of them wailing and crying. Our two trauma beds in the ER were occupied by two young men. One had a large cut in his abdomen with his liver and intestines protruding out. The other had a large laceration through his jaw and neck. Blood soaked clothing lay on both beds as the nurses attempted to get IVs started. They were brothers. They had been injured at a bride price celebration for the oldest brother (with the large abdominal laceration), the ceremony preceding the wedding where the groom’s family presents the bride’s family with money and pigs. The younger brother of the groom had come asking for money. When he was denied, he became angry and got out his bush knife. His two brothers became victims.

 

Our surgeons were able to take the older brother to the OR to suture his liver, clean out his abdomen and close the skin back together. We tied some large arteries on the other brother to try to slow down the bleeding and provided several transfusions. We intubated and had to perform CPR multiple times, however it soon became apparent that we could not fix his underlying condition and he slowly passed away on the bloody ER bed.

 

 

 

I had taken care of her for about two and half weeks before she started to deteriorate. She was young, around 20, and had a new baby as well as a three-year-old boy, who always looked at me with wide eyes before breaking into a toothy grin when I came to her bed. She had been beaten by her husband and decided to drink gramoxone, a commonly used herbicide. In the US gramoxone is heavily regulated and comes mixed with other chemicals to try to prevent ingestion, but in many parts of the world these precautions are not taken. Here it is a common method of suicide. Over days to weeks the toxin generates damage in the liver, kidneys and lungs, eventually leading to kidney failure and respiratory collapse.

 

For Helen (name changed) I initially had some hope. Her kidneys improved after days of IV fluids and her respiratory status was stable. However, as can often happen, the poison led to increasing fibrosis in her lungs over a couple of weeks. As her prognosis became clear, I sat down and talked with her and her family. She was scared and tearful, but she also knew where she was going after death, she had faith in Jesus.

 

The last day I saw her my heart sank thinking about her young children who would grow up without their mother.

 

 

 

She was transported in by a helicopter from the Jimi valley, a remote area of our province with difficult accessibility on a dirt road that can become impassable during the rainy season. She had been in labor for 36 hours, but her baby was sleeping sideways instead of up and down. The arm had come out but the rest of the body was unable to deliver.

 

I met her in the delivery room. I tried to sense how she might feel in this new setting, surrounded by bright lights and nurses and in immense pain. As I used the ultrasound to examine the baby, I confirmed what she already knew, her baby had died during the ordeal. We prayed with her and then prepared her for surgery.

 

 

 

As a doctor, I am frequently brought into some of the most difficult moments in people’s lives. It can be easy to forget within the comfort of our own lives what many people experience throughout the world, until that pain and brokenness comes rushing into our own lives. Without hope in a coming time when the light will break through and justice will come, it can feel bleak. But until then we pray for the coming of Jesus and try to let as much light shine through our brokenness.