Update

Thank you to so many of you who called or emailed me after reading my most recent entry, “horrible.” I have been meaning to write a follow-up and now that I’m home -- in Montana -- for the holidays I have a little time to reflect and even more time to post an update.

After Roman passed away, I cried for a much of the next two days. Angel couldn’t have been a better support, coming in to check on me, telling me how hard it can be working with “mi gente”, and telling me that it’s just not healthy to be too sad. Friday night I skipped dinner and he hurried into my room right at 6pm (dinner time), relieved that he caught me in time to warm me that there are lots of things I shouldn’t eat while being so sad. All I can remember is avocado. It turns out nursing women aren’t supposed to eat avocado either, according to local wisdom. Maybe that’s why there are so many avocados laying around on the ground. Anyway, he really was kind. On Tuesday, just three days after Roman passed away, Roman’s mother and a friend brought Jose in for a swollen penis. I was working upstairs with the health promoters and they asked to see me. I was thankful for the chance to see them again and check in. They were being strong and doing ok but Grandmother was really suffering, they said. I put Jose on antibiotics and asked if it would be ok if I visited them at home the next day to check on him. I told them I recognized it might be hard for Grandmother to see me but they said it would be really nice if I came by.

I mentioned to Angel I’d like to visit them and he very kindly offered to accompany me. It was really great to have his company, not to mention his skills in finding their house. Home visits in Guatemala are one of my favorite things for many reasons. First, it is really interesting to see where people live; it gives so much more context. Second, it feels like “the way medicine should be”, a doctor being as supportive as possible to the patient rather than making sick people always travel and wait in long lines to be seen. Three, the communication seems so much more horizontal and less vertical. They invite you in and you are thankful to them while you answer questions and they are thankful to you.

Anyway, back on track. As usual, the best we could do in finding their house was get to the house of the best known person in their neighborhood, Professor Thul. The tuk-tuk took us right there. Kids playing in the streets pointed us this way and that until finally, “that’s my grandmother.”. It nearly always goes like that. We knocked on the door and they warmly invited us in. Jose was sleeping peacefully under a mosquito net. They brought out plastic chairs and cokes. I checked on Jose, who was looking better. It was very strange to see him by himself and so oblivious. I asked how Grandmother was doing. She was out checking on a cousin who’d just suffered an abortion and, they told me, couldn’t come back for a day because one who has been around abortions, deliveries, or menstruating women can bring sickness to babies. They said she’d not been eating, had been very tearful, and her diabetes had gone out of control…she even passed out over the weekend and it took a bit to get her back. As I changed Jose, I could hear Angel talking to them behind me. He told them how upset I’d been and how much I’d been worrying about them. They told him how much they’d appreciated all the times I’d cared for the boys and were thankful that they’d always gotten better. They said they knew God had chosen to take him because neither Rafael nor the doctora (me) could find anything wrong with him (that’s not entirely true). It was helpful to hear them talk and to learn that, as devastated as they were, they didn’t blame me. I know it’s selfish to care about that but it was important to me. I also didn’t want them to live their lives feeling like he could have been saved if only a different doctor were there. That may be true (though I pray it’s not) but I think it would be torture for them to think that.

As I joined them in conversation and we finished our cokes, they told us stories from their year, a very difficult one for the whole family. There had been several deaths, some financial troubles, and unsuccessful relationships. They pulled out the one-and-only picture they had taken of the babies. It was taken just three days before Roman died. That is amazing to me. Thank God they had one picture at least. It reminded me that so many families don’t have that. In the picture, Roman and Jose are laying side-by-side. Roman is the bigger one of the two, though both are chubby and look the picture of health, kicking their legs up in the air. They are resting their heads on Guatemalan textiles and have a bible between them. It’s a very beautiful photograph.

We finally said our goodbyes and I told them they had my cellphone and could call me with any concerns, knowing anxieties would be running especially high. As we walked down the path towards the main streets, we saw a woman arriving in a tuk-tuk. I recognized it as the grandmother. My heart was racing but I just had to say hi to her. She collapsed in tears and gave me a big, strong hug saying “my angel is gone. I don’t understand why he had to go. I tried so hard.” I felt she was saying just what I felt. We cried together. Kids gathered around so I took the eggs she was carrying and we went up to the house. We sat and talked some more. She looked really tired and much older in just the week that had passed. But she was very kind to me and it helped so much to process with her and to feel sure that she would make it through, somehow.

I can’t even put into words how much it meant to me to get to see the family again, to visit them in their home and to show how much I was grieving for them. I can’t imagine having been more fortunate in having to go through such an experience to have the family react in the understanding way they did. It could have been so different. And then to have so many of my friends back home share their similarly trying times in medicine … and parenting and other parts of life … it just reminded me of how many wonderful people I have around me.