A few months back a patient walked into my office frail and weak. He had come to pick his biopsy results for a suspicious growth. He had come in with his relatives; son, daughter and handsome grandson. I don't know why I took a liking to these strangers. Either it was the charisma and high spirit of the mzee or the non-Sumbua (non-fussy) nature of the relatives. We clicked !! I talked to them for a while, made them comfortable then slowly broke the news of the diagnoses. It was unfortunately the 'C' word. The 'disease' was at an operable location and I immediately knew that a trial of surgery was a viable option.
I never really get very involved with patients but for this special man, I went all the way. I privately talked to the surgeon (a visiting surgeon from Italy) and we agreed that there was no harm in trying as long as the tumor was localized. Again I gave it my all in doing the labs and the necessary radiological examinations. To cut the story short, a decision to try the surgery was made but there was that risk of local involvement of local structures by the tumor which was difficult to visualize on radiological examinations. I explained this to the relatives and they agreed to try it instead of doing nothing.
Surgery was unfortunately 'short' (lasted for only 20minutes) because we discovered that it was unfortunately too late. There was extensive local spread. Nothing could be done!! It was a matter of 'open, see and close'.
I met with the family the same day post-op and broke the news to them and again they were very understanding. I discharged the old man 4 days later and referred him for hospice palliative care. It was too late to even try chemotherapy or radiotherapy. The days we had him at the hospital were happy days because he would crack the other patients with jokes and stories.
I kept tabs on how the old man was doing and this past weekend, I did what I never do. I decided to pay him a home visit. I learned that he had to get weekly intravenous fluids due to dehydration episodes and I decided to spare him a hospital visit by buying I.V fluids, branula etc and do it for him at home.
He was extremely happy to see me and we had a chit-chat as the fluids run into his veins. He was having some brief episodes of confusion but I went a long with the mildly confused talk. He got very energetic and even stood and walked outside later that evening. I left him a content man with a big smile and he blessed me just as I was about to leave. I promised to visit often but little did I know that this would be my first and unfortunately last visit with 'Mr. Charisma'.
His grandson did call me today and informed me the Mzee had gone to be with the Lord. I said a short prayer for him and I'm so glad that I gave him the best care. I'm happy I went for the home visit. I learned a lot about remaining positive from this man and I pray that his soul rests in perfect peace. AMEN!!
