Providing palliative care in Guatemala

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Photo Credit: Victor Englebert/Photo Researchers, Inc
Photo Credit: Victor Englebert/Photo Researchers, Inc

As a nurse practitioner, one of the most amazing things I've been able to do is to travel to Guatemala for medical mission work.  There is a team of about 40 people consisting of NPs, nurses, surgeons and internal medical practitioners who go each year.  I learn so much every time I go and use skills that I often don't use when I'm at home.  

However, on my fourth and most recent trip I found myself in an incredibly sad situation advising a patient about her terminal condition, death and dying.  My patient was a gorgeous woman, about 55 years old and traditionally dressed.  She had a history of stomach cancer, diagnosed about a year prior.  She presented to us with a mass in her abdomen, weight loss and decreased appetite.  It was obvious to us that her cancer had returned.  

After consulting with other providers, we were sure that there was no medical treatment left other than comfort care.  A translator, Nancy, came in to work with us, and I was the medical voice – the one that gave her the words to speak.  The patient's family – her niece, daughter, sister and brothers – came with her to appointments.  I was amazed at the family's commitment to take her home and love her, to give her comfort and care in her last days on earth.  The patient clung to me. I held her, kissing her dirt-streaked cheek, and answered questions from the family. 

The love enveloping her was palpable.  The family embodied strength for me, and remembering them has special, personal significance for me today.  My dear uncle was terminally ill with metastasized prostate cancer. In my own family, I see the same strength, the same palpable love, the same joy and appreciation for my uncle and for each another as I saw in that family in Guatemala.  I can't help but to cry now as I type this.  

My uncle passed away this weekend.  May we all pass so gently and full of love as his passing was, surrounded by the love of our family.  I hope my patient in Guatemala is blessed in this way.

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