It was a humid night as a storm quietly crept along the Santa Cruz Mountains. A soft, sultry steam seemed to float along the Emergency Department floor. I remember it being hot; I think the air conditioning was broken. Beads of sweat rolled down my Attendings forehead...It was that kind of hot. The chants had grown incessantly louder from her room. A young lady in her native garb was surrounded by half a dozen people. They had all placed their hands on her, as she continued to writhe in pain. Her wails and moans only outdone by the rumble of thunder shuttering the hospital frame. Outside the storm still blew.
Her room was dark, only a dim light casting long shadows over her bed. The curtains were drawn around her bed, as a huddled mass continued to chant. Her bed looked like a tent lit with only a flickering lantern, waiting as the storm approached. She was from Ethiopia and she was a gaunt skeleton of her former self. She had only been in the country for 8 months before her health went bad. Dressed in a colorful robe of mango, and purple velvet, her face was a skull with skin draped over it; high arching cheek bones framed her jutting teeth, her eyes 2 deep sunken pits filled with a deep azure. Her neck and arms were tattooed with tribal images: a primitive mosaic of animals and birds. The desperation for a cure was palpable. Her health failing, it was her 5th visit to the Emergency Department for the same reason: projectile vomiting, and an unrelenting gnawing in the pit of her stomach. She had lost 30 pounds over 3 months-unintentionally. She had been scanned, prodded, scoped, and lit up with enough radiation to light a small village-all without a diagnosis.
She continued to vomit and wail. The storm crept closer. The congregation around her was mostly comprised of family; all wearing traditional garb. Her cousin pleaded with us, palms open, tattooed face, "Please doctor, you must help us...please…all we have left now is prayer…” The chanting grew; a beautiful cacophony soared through the misty halls from the dimly lit tent.
I had a feeling in my gut, that tonight something magical was going to happen. A real sense of urgency had grabbed hold of me. I moved around the department possessed. I told my attending the whole story: Ethiopia, the tests, the blood work, the countless hours prior of those before us trying to make a diagnosis, trying to give this poor soul some relief.
Outside the storm grew. The lightening was closing in. Gusts of wind rattled the ambulance bay doors. It was very strange to see a storm like this in these parts. The gripping case had now captivated my attending… “Tonight we are going to nail this thing….” I remember him saying with a crazed look in his eyes…. I cackled back wiping the sweat from my face. We suddenly were ravenous for an answer. We sat, and started scribbling like mad on scraps of paper. She sat moaning, showered with earnest mantras. I heard the sounds of drums and yelps-cries of desperation to a higher power I could not grasp. I remember the sweat dripping off by bosses nose onto the paper.
The feverish pace of the ER blossomed around us: 3, 4, 5, 6 ambulances had come through the doors, the intensity of the lightening, the din of a busy growing, moaning ER was even louder now. The storm, the energy, the sweat, the chanting, "we have to fix this,” I remember thinking. We wrote frantically, bouncing ideas off of each other, whatever came to our heads...odd maladies and common things that cause persistent nausea and vomiting: glaucoma, heart attacks, Schistosomiasis, HIV.....the lightening persisted. The chanting became louder, a man walked into her tent with what looked like a monkey on his back...he was quickly escorted out.
The sweat like rain poured, steam swirling around our ankles; renal failure, Addison’s disease… The nurse yelled “They are throwing her up in the air!!! They are bouncing her around the bed like a ping-pong ball!!”….The drums were louder, a light soared from her room, throughout the department….was that lightening? We both looked up at the same time…..wild eyed, teeth glistening….one cataclysmic lightning bolt, a final blood curdling scream….. Now..."HER BRAIN!!!!" We both exclaimed....
The CT scan confirmed our enlightenment: Danja from Ethiopia had a 5cm by 5 cm tumor in the back of her brain. For 6 months it had eluded everyone…stealthily causing her central vomiting center to malfunction….I entered the newly consecrated haven…quiet…Danja resting on the bed, finally. Seven people around her, each with a hand extended, touching her...quiet chants in a language I could not understand. I told them the news…usually a horrific thing to have to tell someone….now an odd sense of relief. “Tonight, we knew the answer would come doctor….”
I still do not know what happened that night, but it was nothing short of divine intervention: an unspeakable force had seized our small universe and guided us towards her salvation. Dana had her tumor removed-she has finally found relief. Healing often occurs when left in the hands of Someone else.
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