You are a 52-year old Haitian man, lean and muscular. You found a bump in your right armpit 21 days ago. Now it is as big as a mango. It feels hard like grapes. It is bumpy and ununiform. Upon examining you, Dr. Bob found a similar, smaller mass behind your left clavical.
The options?
If we took it out, it would be back--maybe a few weeks, probably a month and a half. Your left side has been getting tingly and your shoulder is too stiff to move.
Dr. Bob is sure it is lymphoma--we could wish that it was a temporary lump associated with Yellow Fever, but you are too healthy and it wouldn't have shown up in your armpit--there would be bumps lining your neck.
Surgery? Why?
To make you sleepy with Vicodin, slow your bowels, rip you open, dig around, and sew you up? To take it out?
There are more, smaller ones, probably pinching nerves. That's why you can't move your left shoulder; why you tingle.
Take them all out?
Not with surgery alone.
Surgery would force your family to live here, in the hospital, bringing you sheets, food, hugs, and worries as you recover to find new lumps. You wouldn't be able to work. Where would the food come from?
You are 52 and strong.
I would have placed you at 35 years if you hadn't told me you were born in 1968. With chemo and surgery, the prognosis would be excellent. Dr. Bob says, "it'd be easy to kill with chemo--especially in someone as healthy as him--even though it's aggressive."
They don't do chemo here though. Before the quake you could have possibly gotten it in Port-au-Prince, but the hospital was destroyed. So, if you had money--lot's of money--you could go to the Dominican Republic or fly to the US for treatment.
We asked you if you would consider doing that--the nice way of verifying that you don't have the funds.
You laughed--the bitter cynical laugh that acquiesces to injustice.
Then, we talked in English that you don't understand to figure out how best to help you.
I looked at you while we were talking. Your eyes were wet and your teeth were pinching your lower lip--biting back the tears.
Dr. Felix, the Haitian resident, took you to privacy to have a serious talk in Creole. "Talks" in Haiti are always loud. You scream your pain here.
I'm biting my lower lip too. We couldn't help you. When you left the room, you said "Meci." (thank you)
It's polite for me to respond, "C'etait un plaisire (it was a pleasure)." But, this was not a pleasure.
I did not enjoy translating the certainty of your death; that would be a ripe, juicy lie.
I said, "De rien." (It's nothing.)
