Slow Moving Traffic

Village Life

I was directed to the following blog. In Peru we live in a developing nation. Lima would be developed, the jungles and sierras are undeveloped, and other places are somewhere in between. So not everything in the article is directly applicable to Peru, but I find much of what is written to be true of where we are living. In the article the author is trying to share what he believes to be the truth of village life. In the beginning he speaks about the idea of “it takes a village” to raise a child. His findings are pretty consistent with my own, and the truth is that it is better if parents raise a child. It is just one of his insights. Click the paragraph below to go to the full article on the blog Hare Translation Journey.

For various reasons throughout my life I have heard people talking about the virtues of “village life.” I generally do not say much on these subjects, as they tend to be a bit touchy, and to be honest, I did not have a lot to say. However, I realized that after living for a while in an African village, I can offer some facts regarding village life that most people would not know. My goal is not confrontation in this blog, but just information. As you are making decisions regarding your family, raising your kids, and how you counsel others, I hope you will find this information helpful. . . .

Sunday

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A little topography of Curahuasi. I copied this from our walk today up to the Mirador. I measured the difference in altitude from the canyon vista to the riverbed. 4430 feet! And it is practically straight down. When we first moved here, I could barely stand to watch my kids get within 10 feet of the edge. Now I barely blink when they lean to look over it. Below a shot of Allison getting low to buy our vegetables at the Sunday afternoon market. For those of us with back issues, shopping is a little less easy in Curahuasi.

Remember Abuse Causes Illness

I was in the hospital to see a patient who is hospitalized this morning. She is an interesting case, being one month past the delivery of her daughter, with an overwhelming parasite infection that she probably had for her entire pregnancy. She came in very malnourished and dehydrated. She has responded well to anti-parasite medicine and will likely go home early next week. But the case I would like to talk about is a young man I saw over several days last week. First he presented to me in the emergency room for chronic abdominal pain. He has already had one abdominal operation for gallbladder pain. It is quite rare for young 25 year old men to have already had an abdominal surgery, although it can happen. When I spoke with him and examined him he gave me no real reasons for concern, but he was very concerned. I did lab work as well as an ultrasound of the abdomen and it all came back normal. Because he was so concerned and had already received treatment for gastritis, I decided to proceed with an endoscopic exam of his stomach. The exam was normal. Because of his worry I asked him to see our psychologist. When I walked into my office this morning I found his chart on my desk with the following note.

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Emotional, irritable, lots of tension, with many memories of accusations and social violence.  Thoughts of persecution and paranoia. Diagnosis of depression with anxiety components and post traumatic stress.

The psychologist confirmed that much of what he may be dealing with is stress related. This is a young man who should be in the prime of his health, feeling invincible physically, who because of family violence in his past now is always with stomach pain which is most likely a manifestation of chronic stress and anxiety. I see so many young men in my clinic who come with vague complaints of abdominal pain. They are convinced that something is very wrong. I need to remember that family violence is endemic in our area. Almost everyone is abused, and even though in some ways it is socially acceptable, the people carry those psychological scars with them into adulthood. And I need to be sure to not miss the classic illness that cause abdominal pain while remembering that there are illnesses of stress caused by abuse that are not so easily cured.

Evidence of Many Years of Service

Tough Day

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Breast cancer recurrence.

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Allison says I have a disgusting job, and I have to admit that today was a bit rough. I was sick already with the standard Curahuasi problem of diarrhea and vomiting. This time it hit me and David. David got to stay home from school, although he did go up to do a presentation that was due on the pituitary gland. Way to tough it out David! I could not cancel my patients so I went in as well. I figured that as long as I did not eat or drink anything that I would be OK. It worked for awhile until the above patient came in. She came to our hospital with her last hopes. She has had breast cancer with a mastectomy a year ago. Then six months ago she had a recurrence and another operation. Finally after her second operation this tumor began to grow. The picture does not do justice to how big it actually appeared. She also could not breath, and her oxygen level was low. I did an x-ray followed by an ultrasound to confirm that her right lung was full of fluid. So I took her to the ultrasound room again to take off a liter of bloody fluid just as a palliative measure, so she could breath better. So I was in the room pulling off the bloody fluid and there came a smell that is a common smell of blood and perhaps a bit of tumor that usually does not bother me. However today was not the day. I started to sweat, my forehead getting wet, my knees getting a little weak. I had just finished pulling off the liter when I realized my luck had run out and that I had better get to the restroom to vomit. I ran out, leaving the catheter in the patient’s chest wall to be cared for by the nurses, moving rapidly to the bathroom across the hall, and proceeded to dry heave about 5 times. I guess it was good I had not eaten anything, or I probably would not have finished the procedure. I came back to the patient care room, and the nurses and ultrasound tech had taken care of her well, pulling out the catheter and applying pressure to the small needle stick wound. The ultrasound tech, Lyndal, was talking to her about her prognosis, sharing the gospel, and trying to be sure this woman, who is sure to die, knew the truth. There is nothing we can do for her other than palliative, and I doubt there is any treatment that she can receive elsewhere that would help her. She needs to know the truth of the gospel and to live with her family in as much peace and comfort as possible until she is able to move into the gift of her heavenly rest. I will see her again, I am sure as she will come back for more drainages in the future. And we will treat her in a palliative manner with the resources we have as we pray that she will know the love of God.