A mom's smile

One Wednesday a month when I open my clinic door, to call for the next patient, I find the face of a little boy staring up at me, his mom or dad right behind him.  Ambane is the boy, and he has ALL - Acute Lymphocytic Leukemia and is in remission.  He doesn't smile or say much, but he comes each month and allows me to check his blood and then give him chemotherapy, like we have for the past 2 years.  He use to cry when he saw me, then he would only cry when we put in the IV for his chemo, now he just watches the needle go in without flinching.  He has had more needles in his little body at the age of 5 then most people have their whole lives.

Although Ambane doesn't smile much, his parents sure do.  They smile because all four of their sons are still alive, because Ambane's hair is growing back, because Ambane is able to go and collect water and firewood for their house.  They smile because he is beating the cancer, something I doubted would happen because in my experience, we don't beat cancer in PNG.

A few pts after Ambane, a little girl walks into my room with her arm in a sling.  I only saw the pain of the girl's face and so I focused on her and asked what happened.  I found out she fell and after examining her arm, I set out to write for her to get an Xray.  I looked at the book to see how to spell her name and found her name was Erin, which isn't a very common name here.  This caused me to look up further past the girl to the mom, to inquire about the name, but as soon as I looked at the mom, I knew where the name came from.

Mom met my eyes and said, she is your namesake.  Erin is the sister of a little boy I cared for named Ismeal, who also had ALL.  He died in his first year of treatment.  Ismeal was probably one of my first leukemia pts that I started to treat and I was all excited, had great hopes of putting him into remission and curing him.  My hopes were soon dashed when he the cancer spread beyond his blood to his brain and the chemo quit working.  This opened my eyes to the realities of PNG cancer care and the limited ability we have to actually treat and cure someone, and put a guard around my heart for future cancer pts.

It has now been about 5 years since Ismeal died and I have cared for lots more cancer patients.  My eyes remain wide open and aware of the reality and almost certain death these patients will face due to their cancer, but my guard has dropped a little.  I let a lot of these patients in and am thankful for the small victories that we often see.  The weeks without pain, the months without recurrence, the decrease in size of the mass in their stomach.

I didn't really know what to say to the mom that named her daughter after me because I cared for her son that died?  In many ways after Ismeal I felt like a failure, felt like I should have done more, or certainly wanted to do more, wanted to be able to care for him like he would get care in the US and have him still be alive today.  Thankfully, despite not curing her son, mom didn't see me as a failure, and was thankful for what we did do for him and the care that he got and the love that we showed him.  Thankfully, mom too can smile, for the life that she has in Erin and the new hopes and dreams she has for her family.