Wednesday, February 12, 2014


When I first got here I wasn’t expecting the level of medical care that the government provides the people.  If you have a job you have one type of insurance, if you’re poor you have SIS (another type of insurance).  If you have cancer and have SIS you can go to a hospital in Lima and they’ll cover your chemo/radiation and all treatment costs.  The poor have access to the other specialties as well.  When I realized all this I questioned the need for Diospi.  But in no time I’ve seen the problems in the system and why the lines for Diospi continue to be long even though more and more doctors arrive.
                Yesterday I was working the ER and a 39 year old lady came in complaining of pain all over and breast pain.  She showed me her breast.  It was red, warm, deformed and hard with cancer.  I began to question her about her medical history, what treatment she’d had for her breast cancer, who was taking care of her and why she’d come to Diospi if she was receiving free care elsewhere.  She’d been diagnosed with intraductal malignant breast cancer in 2011.  They’d done a lumpectomy and a lymph node dissection (the lymph nodes were positive for cancer).  They’d given her 20 rounds of radiation therapy and she was still currently taking Tamoxifen. Evidently it was “gone” after all this treatment but then “came back” in August 2013.  She just managed to get an appointment with her hematologist in Lima (a 28 hour bus ride from Cusco or a 45 min flight if you can afford a plane ticket) a couple weeks ago.  They took a biopsy of the recurrent breast mass, gave her a follow up appointment in March to discuss the results, and told her maybe they’d have time to remove the mass for palliative care in July or August.  She also had what appeared to be a pathological fracture (ie the bone broke with little force or trauma because the bone was weakened by cancer eating away at it---likely metastatic cancer) of her clavicle on the right side of her chest as well that occurred in August 2013.  They’d sent her home with over the counter Tylenol/ibuprofen for pain control.
                I ran her case by a couple of the doctors here that know the system well in order to know how I could best help her.  She’d come to Diospi for a miracle. She’d come to Diospi because patients are treated and care for as individuals and not a just another symptom or problem.  Unfortunately, her best resources were in Lima.  Through her insurance and current care plan she had access to hematologist, plastic surgeons, etc.  All I could offer her was the love of Christ, pain medicines, and encourament.  She told me she had a strong faith in Christ, but I could sense her desperation and desire for hope.  I tried to fill this need with words reminding her that Christ is with her through this even if he doesn’t cure her and that we’re his hands and here to help her be comfortable and walk through this trial with her.  I think we’ll never truly know the impact that anything we say or do has on the lives we encounter, but I took her tears and a sign that she felt at least enough comfort to let her emotional guard down.
                You can definitely be praying for Mrs. Consuelo and her family. She’s only 39 years old, married with 2 or 3 children.

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