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So far this trip has been a whole lot of fun and an incredible learning opportunity. The excursions out of La Paz have been magical, it has been too fun going out with our group, and the experience in the hospital has fueled my interest in medicine in a way I did not anticipate. The school system here is set up such that high school students continue on right into medical school. Therefore, the doctors believe that we are, and treat us as medical students. This means that we learn the procedures, do physical exams on patients, and the doctors walk us through each thing that they do as if preparing us for the exams. It is not something that I would ever have the opportunity to do in the States at this point in my life, and I am trying to soak up every moment of it.
Although this week was fascinating, it was also emotional and an experience of personal growth in a new way.
David, my unit partner for the week, and I walked into the Pediatric Oncology department on Monday where we were directed to put on masks in order to protect the immune-compromised patients of this department. We met the Oncologists, Dr. Salvatierra and Dra. Aranda who pointed us to the pile of patients' histories to look at before starting rounds. I opened the first binder of a 10-year-old girl and was completely taken aback. Her diagnosis was printed on the first page: Hodgkin's Lymphoma.
In the spring of 2007, after almost a year of various health-related issues, I was diagnosed with Hodgkin's Lymphoma: cancer of the lymph nodes. Going through treatment, which went relatively very well, contributed to my commitment to helping those less fortunate than myself and is a large part of why I'm here. Meeting Dana, a girl with a disease I know all too well, not only brought back memories but brought this experience home significantly.
I shared with Dana and her mom that I was a Hodgkin's survivor and their faces lit up. The mom told her daughter, "You see! She made it and she is okay and everything is going be okay!" later that day I asked one of the doctor what treatments she is receiving and he said palliative - Dana is terminal and is only being given treatment for quality-of-life until she passes away. This news was nauseating and frustrating to hear. Why is it that with the same disease there was hardly a question of whether I would recover, and this beautiful, innocent girl is facing a death-sentence? I felt guilty for giving them false hope, for never having received this horrible prognosis, and for realizing the extent to which I was more privileged than this girl under the same circumstances - privileges that saved my life. At the end of the week Dana made both David and me little angels out of beads - a little angel that will keep Dana with me forever.
Many of the other kids in the department have leukemia, the most common childhood cancer, which is fortunately also very treatable (even in Bolivia!) One of these children is Brayan, one of the cutest 4-year-olds I have ever met! This little guy has been a little low on energy recently because he has pneumonia (which can easily get out of control with a shot immune system - I had it too when I was in treatment), but he is still a giggly dude who loves playing with his cars and dinosaurs.
There is an 8 month-old baby with a liver tumor, which the doctors think can be completely removed with surgery. Another boy, 8-years-old, called Angel has a mysterious disease that we were not quite able to figure out from what the doctors were saying (not cancer). He is extremely anemic, and has gone through many different treatments including chemotherapy, transfusions, and a splenectomy. Nothing is helping and the doctors have given up. They told us that there is another procedure that can be done but not with the resources that are available and he will probably die. The reality of this situation is overwhelming for me.
There is also a 14-year-old girl, Rosario, with a hip tumor who is going through chemotherapy until she can have surgery. The doctors are hoping that she won't need an amputation. The oldest patient in this unit, Rosario is one of the strongest people I have ever met. She calms the other kids, and always seems happy and grateful. It's inspiring.
When I arrived at the hospital on Wednesday, I went to say hi to Rosario, who looked uneasy. She pointed to a bed, two down from hers, where a 5-year-old with a brain-stem tumor, Yhasatiri, had been the day before. The bed was empty. "She died last night," Rosario told me gravely. My heart sank. I had anticipated the death of a patient sometime during this trip, but could not have prepared myself for the reality of this experience. My first instinct was to walk out and take some time to myself, but I looked at Rosario and decided to be there for her. I asked her what it was like to be there when it happened, how she felt, whether she was scared. She shared with me the details and I was again impressed with her wisdom and strength. The whole department was off that day - parents, kids, and doctors. This community that survives off of hope and success stories was definitely shaken up. But they are survivors -the most resilient people I have ever met. Although paying for treatment is a struggle that people as privileged as us will never know, and there is no knowing how much worse or better the next day will be, these kids and their families live in the moment, supporting each other, holding each other, and are unwilling to give up. We can't forget that our worst days may be someone else's best. Life is so short.
- comments
Gilda farby Reading Shira's Blogs about her experiences in Bolivia is exciting. Shira is an incredible young women. Her description of her working program is so inspiring. I can see her with sick children, comforting, compassionate, warm and funny. She has it all. So carry on, beautiful girl, enjoy and learn from everything you do & see in Bolivia. Be it running around in the salt, laughing at the baby alpacas, enjoying the scenery or helping a sick child get well. Love you. Safta (Grandma) Gilda
shocky Shira, you are such an amazing and gifted person. and a beautiful writer. May all your experiences give you the power few have - to appreciate what you have - but know too, it's ok by me, in spite of all you have been through and see, to complain once in a while about things that might rattle the rest of us mere mortal. with love to you and all your incredible family, shocky
Aba -Shuki Shira, Cant say enough how impressed I am and how saddened I was reading about your 1st patient loss What a ride you are on and how wonderfully equipped you are to take it on Blessed to be your dad and can't wait to hear more of your un worldly experiences Love Aba
Your Ima Your writing is amazing. I cried when I read your blog. You are doing amazing things, touching peoples hearts in a way not many can. By writing your experiences, you are touching the hearts of everyone who is reading and you are an inspiration. All I want for you is to follow your heart. fulfill your dreams, have fun as much as you can on your journey and come home safe. I love you so much. I am so proud of you. beyond my words. Love Your mommy
דרורה ספא היי שירה יקרה זאת זכות גדולה להיות חלק מעולמך וחלק מהחוויות שלך את משתפת דרך העיניים, הלב, הגוף והחלק הכי חשוב הנשמה ויש לך נשמה גדולה שמרי עלייך יש לך הרבה מה לתת ולהעניק בעצם הנוכחות שלך בעולמם של אחרים זכרי שירה שקיבלת מתנה נהדרת: החיים! וכול יום תהני מהמתנה הזו. חיבוק ענק מלא אנרגיות ואהבה דרורה ספא. וכול המשפחה שבצרעה
Maude Lamont Thank you to your mother for sharing your blog with us; it was as difficult to read as it was wonderful. You make the entire Wilson community proud to call you one of our own, Shira. Take good care, Ms. Lamont
Debbie Wiatrak Shira, we are so proud of you. Your Uncle Brian and I began medical school in our late twenties, while you are experiencing patient care much earlier in life (without the disease detection and care we have in the US!) Your inquisitive and empathetic nature will make you a great doctor one day! Love, Debbie
Dina Shira, I was very moved by your latest blog. You describe your surroundings so vividly I could almost feel that I was there observing. It takes great inner strength to put aside your own feelings to empathize with your patients. Sometimes just being there to comfort your patient can help the healing process. Rosaria the young girl who selflessly helps and comforts others must have been very gratified to have someone to comfort her in her sadness. You are such a caring person and when you become a physician I hope you will always have opportunities to not only heal your patients physically, but help to heal their spirits and encourage them also. Seeing the difficulties of people less privileged will give you an awareness of suffering that it not always obvious. Sometimes methods besides medical treatment need to be used to speed up healing . Love Dina
sabba shlomo Shira...I have been catching up on your blog...having been off-line for a few weeks on Monhegan Island, off of Maine in the Atlantic. Your descriptions are wondrous...raising many issues about LIFE...and its human-made and maintained inequalities as well as what one person...such as yourself and the doctors that you are with...can and do DO in order to make a needed difference. Bless you, dear Shira for who you are and for who you are yet to BE. sabba