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September 2015 Mission

By Beth Tammaro

I remember working most of the day in a rehabilitation home in the outskirts of the community. We treated and dispensed bandages, medicines and compassion to groups of profoundly injured refugees with TBI, amputations, SCI and significant PTSD. Although we were mentally and physically tired, we learned another part of our mission group was still seeing the lines of patients in the local clinic. We returned to the busy clinic late in the afternoon with intentions of helping our colleagues triage the lines of patients still waiting to be seen. Our doctors and staff worked steadily, but so continued the lines of patients waiting to be seen.

I entered the over-flowing, noisy clinic very much aware of the language barrier and immediately recognized that even without a translator; I could assist with crowd control and flow. As I was directing patients amidst 3 physicians working in a small room, one at a desk, one on the couch and the other using space in the adjoining closet, I found myself scurrying back and forth to the pharmacy to check for certain medication availability. One of the pharmacists alerted me to a man seeking a wound care consultation for his son, too ill to travel to the clinic. When I returned to the chaotic clinic room, I felt a gently tap on my shoulder and turned to find a man with a harrowed look on his face, a smart phone in his hand and one of our Jordanian med school student translators at his side. This was the man the pharmacy team had been referring to. Despite having extensive knowledge surrounding wound care, I was unprepared to see the image his Smartphone revealed. The photo was graphic; a foot with extensive tissue loss, black necrosis and dusky hue extending all the way to the ankle region. The foot so devitalized, that surely it could never heal. The man was imploring verbally and through sorrowful eyes for a medicine, a bandage or a treatment that would heal his son’s diabetic foot ulcer. He had heard that there were doctors from America and Europe in the clinic and he was hopeful for anything that may save his son’s limb. As the translator was telling me the history: smoker, diabetes, hypertension, high cholesterol, previous 4th and 5th toe amputations that had not healed, all I could think was, how can I tell this man, who had waited hours with his heart and head full of hope that it was hopeless. No bandage, no medicine, no ointment could restore life to this limb.

“Give them hope” the very essence of my intents and goals for these missions, was impossible. As the translator and man conversed quickly in Arabic I recognized the man’s sorrow and his devotion to his son. I focused on the positives: the diabetes and blood pressure were well controlled. The son was consuming good dietary protein and had quit smoking. I commended the fathers meticulous attention to wound cleansing and bandaging and told him that I could not think of any other way to manage it better that he was already doing and then very quietly and sadly told him that it was extremely unlikely to ever heal. Although only God knew for sure, his son might be best served by considering amputation. The man took my hand in his two, and told me that these were words he had heard before. He had been to several doctors and all but one had recommended amputation of the foot. He had arrived to clinic and waited patiently most of the day, hopeful that our team may have something better to offer. He stated it truly was in God’s hands and he was most grateful for honesty, empathy and assurance that he had been providing the best care to his son. I still wonder if he has chosen to proceed with the surgery and move forward with rehabilitation or if he awaits the next mission looking for hope.

Written by: Beth Tammaro