Derne

Derne is the name of a little boy I met at the interior Dolisie screening day. I went with a team of 13 from the ship, driving one of the most dangerous roads in the Congo to reach this town 3-4 hours away. Derne was one of the 187 patients that turned up to be seen by us.

I’ve waited to write this story in hopes that there was a photo taken of him by my photographer friend Michelle. But alas, when I looked there was none. Even as I sit here, computer on my lap, my fingers resting at the keyboard knowing what words are about to flow out, my heart has sunk into my stomach.

Derne walked into the room where I was sitting with another nurse taking patient histories and the OR supervisor who was scheduling follow-up surgeon screening days. We all had translators by our sides.

Derne was with his mother. He climbed up to sit on the blue cushioned chair, feet dangling off the floor, face solemn. I greeted them both and then through translation asked them why they’d come to see us. Derne had a very nodular mass on the left side of his neck. It was a large size and by large I mean it was more than half the size of his 9 year old neck. It extended up to the bottom of his hair line and down to his collar bone. He looked at me with a blank expression, eyes solemn, giving away nothing of what he was feeling. It was difficult finding out exactly what the history was except that it had been growing and getting larger now for 3 years. Mirjam, our screening co-ordinator, had seen him outside in the patient line and had written a note sent in with him “?Lymphoma”. I took it out of his hand, my heart not wanting to believe what she suspected, knowing that I might agree with what I was reading, although the diagnosis still being a guess. We had no doctors with us, no equipment and no way of actually telling them what we thought it was. They had been to several hospitals and seen doctors and he was having treatment for tuberculosis (TB). Whatever the mass was, a TB mass or lymphoma, he wasn’t a surgical candidate for us.

When I asked the mother how far they had travelled to be in Dolisie, she looked at me with an exhausted expression on her face. She said it had taken her and Derne three different taxi trips to get there. Translated for you, that means a LONG time sitting in taxis, squashed with many people, fresh produce and animals over bumpy roads for hours and hours. I looked to the other nurse in the room with me, taking histories on another patient, asking her for her opinion because I almost couldn’t bear to tell them that we couldn’t help him. They had travelled so far in hope that we could help, how could I bear to turn them away? Jasmin and I talked about it, both coming to the conclusion that he shouldn’t come for a further screening. My heart broke as I turned them away knowing they won’t get a phone call from us offering hope of a cure.

Derne didn’t leave my mind even after a couple of weeks. As I was second guessing my nursing judgement and all that I have seen here in the past four years, I emailed my screening co-ordinator friends to ask about him. The reply came and with every word my heart sank deeper and deeper until I wanted to cry. She wrote, “I talked about it with Jasmin for a long time, discussing & questioning our decision, & we appreciate you asking the question.  Screening can be difficult in that we can never predict a diagnosis with 100% certainty.  However, we need to make educated decisions in order to bring the most appropriate surgical candidates… I’m very sorry, but we will not ask the boy to come down for further screening.  We definitely don’t want to raise his expectations when we are almost certain that there’s nothing that we can do for him.  I’m sorry.”

I wanted to cry even though I think I already knew what their answer would be. It is true, we have to pick the people that are the best surgical candidates for us on the ship, that is our specialty. It’s just that my heart breaks for every one person that we meet who we cannot help. I guess that’s why I still haven’t left this floating hospital ship. Every one counts. Every day on board we do about nine surgeries. That’s nine lives changed. Even if the surgery is as simple as a hernia repair that helps a man to live without pain, it is one life changed and while the patients are here we pour out our love like no place I know on earth. Love overflowing from the One who loves us. The One who gave everything He had to save us. Even though we can’t help everyone, the One that loves us has not lost sight of them. I know that He sees Derne and has a good plan for his life even though I can not be a part of it.