Wednesday, January 20, 2016

More on Claudio . . .

Last week, I posted pictures of Claudio, who had a tumor on the back of his head that was about the size of his head.  Today, I read nurse Heather's post on her blog, "Girl.Nurse.Ship.Africa.DreamComeTrue" and had to reblog it for you.  May your eyes weep like mine . . .

Christmas eve I walked into my 7am morning shift expecting the same number of patients as we had the day before. Not much was going on these few days before Christmas. Surgeries had stopped for the week and the patients were all a few days post-op and were stable. I was surprised to see a young teenage boy in the bed closest to the nurse’s station. He was admitted late in the evening the day before. I read through the handover sheet from the evening charge nurse about the boy’s situation.

She wrote briefly that he was a 14-year-old boy with a large tumor on the back of his head that started bleeding significantly. He was rushed to the ship, then taken back to the operating room where they cauterize a superficial artery to stop the bleed, and then covered his head in layers and layers of bandages. Her note ended with a comment that made my heart sink. “He’s still a screening patient, has had a CT scan, but still needs a biopsy to determine if we can operate on his tumor. The doctors are saying that it’s unlikely.”

I’ve learned that “large tumor” has become somewhat of a subjective description. In this case, it was an understatement. It took but a brief glance at Claudio to see that the tumor on the back of his head, was about the size of his head.
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I was instantly filled with more emotions than I knew what to do with. He’s so young. The tumor is so big. And we probably can’t help him. Heartbreak for this boy, frustration at our limitations, anger that his tumor has been growing for 12 years and no one helped him earlier.

Shortly after meeting Claudio, one of our translators came up to me and told me that the boy’s caregiver, who I assumed was his grandmother, needed to go home for a few hours and then would come back later. My initial, emotional and defensive thoughts were, “She can’t leave him! He’s just gone through a traumatic experience and she wants to leave? What could possibly be so important??” My quick answer to the translater was that the boy is too young to stay on the ship by himself and we require that he have a caregiver stay with him at all times. Then I asked why she needed to leave. “She needs to go home to wash their clothes. There’s blood all over them..”

The words wouldn’t come. Only the tears that filled my eyes that made it hard to see the plastic bag of Claudio’s clothes that the grandmother held up. I’d also missed the spots of blood all over the grandmother’s shirt and her skirt, evidence that she’d used whatever she had to stop the bleeding from Claudio’s tumor as she frantically tried to get him help. “We’ll get them washed for her.” And with that I walked out of the ward so they wouldn’t see my cry.

It was Christmas eve and this boy was just trying to live through another day. He wasn’t worried about his holiday plans, or the presents he would get to open in the morning. He was worried about what would happen to him next.

With the bleeding stopped and a pressure bandage in place around his head, we asked Claudio and his grandmother if they wanted to stay on the ship one more day, and spend Christmas here, or if they’d prefer to go that day. They don’t live in Tamatave, but have a friend that they have been staying with in town. They said that they’d prefer to leave. The plan was to send him home with a follow up appointment to check up on him in a few days. After that, he was scheduled to return to the ship 2 weeks later for a biopsy to be taken of the tumor. I had chaplaincy come and talk with him, and stress the fact that when he came back, it would NOT be for surgery, but only a test. The results of that test would come a few weeks later and would determine if we would be able to operate on him. They made sure to explain that there was a big possibility that the tumor was inoperable.
© 2016 Mercy Ships, Photo Credit Ruben Plomp; Claudio 1 day before his surgery. 14 years old.
With all of the paperwork done and the hard conversations over, we were ready to send them down the gangway and on their way. The grandmother asked me if we had something we could give them to cover his head. There was already a large bandage covering the tumor but she said, “If we don’t cover it up, people will make fun of him”. I also realized then, that with them leaving so soon we hadn’t had time to wash their clothes. We found a new pair of clothes for both of them and gave Claudio a stylish hoodie that covered the tumor. He left with a smile on his face, though my smile was forced, as I watched him walk down the hallway unsure of what his life would hold.

I looked forward to January 5th with anticipation. With fervent prayers that the biopsy would come back with better information than was expected. Then in a charge nurse meeting before that day, I was told that Claudio wouldn’t be coming in on the 5th for a biopsy. But that he would be admitted the following week for surgery. I couldn’t believe it! I was sure he would end up being referred to the palliative care team. That he would be sent home with an apology that we couldn’t help him. After a review board meeting about his case the surgeons agreed that they could operate on him.

Last week, Claudio had surgery. They booked out the OR for the whole day and had 8 units of blood on hold for him knowing that his tumor was very vascular and was very risky. They staffed the ICU planning for him to go there after surgery. I’ve seen time after time how vital prayer is on this ship. How miracles happen every day in our operating rooms. How our patients tolerate severe trauma to their bodies only to recover so quickly. Claudio was out of the OR by 2pm and only needed 2 units of blood transfused. They removed a tumor weighing 7.5lbs. One hour after returning to the ward he was wide awake and hitting a balloon around from his bed.
© 2016 Mercy Ships, Photo Credit Ruben Plomp; Claudio 1 hour after his surgery. 14 years old.
I’ve visited Claudio every day since his tumor was removed and was greeted with a chummy smile each time. A few days ago he was my patient. He acted as if he never had surgery. As if he never had a 7lb weight dragging down his head. For the first time in years, he was able to lie flat on his back. He can’t wait to get back to school and see his friends’ reaction. I asked what they would say and he just laughed and shook his head, almost as if he couldn’t believe it himself.

I am inspired by this boy’s bravery. You know, he never stopped going to school as his tumor grew bigger and bigger? That he withstood the laughs and ridicule from people around because he wasn’t going to let them stop him from living his life.This boy is brave. He is inspiring.

He didn’t let fear have a place. I want to be like Claudio..

“Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you do.”-Joshua 1:9

 

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