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September 08, 2009
Thuy
Her name had come up in several previous conversations because they often discussed the most effective form of treatment for her, but I was never attentive enough to place a name to the endless list of symptoms: precious puberty, café au lait patches, osteoporosis, and a permanent displaced fracture. I first met Thuy when her parents brought her to Hoi An Foundation Clinic Day for her a routine follow-up. Carried in by her mother, Thuy was wearing an oversized Victorian tea hat with large purple flowers that covered more than half of her face. Underneath the hat, Thuy’s face looked like a fully bloomed tulip with crystal clear skin and an intent gaze. Unfortunately, the Vietnamese people considered her smile ― with its slightly downturned lips ― the foreshadowing of an ill-fated life. We started out on an awkward note when I,with my reputation for too-literal translations, told the mother that we all thought Thuy was “just gorgeous. ” Compliments are seen as bad luck, and it is common for parents to call their children “ugly darlings”. The mother gave me a strange look like many I had seen when I have these mind slips, so I just sat back and observed.
Myra went directly for the cut on Thuy’s heel while the doctor read over her past medical history. Myra grabbed a large plastic bowl half-filled with water and soaked Thuy’s bandaged heel into the water. Then she proceeded to move Thuy and her family into the next room so the doctor could examine the next patient. That also meant that I would be the translator for Myra and the family. When Myra slowly removed the wet bandage I saw the most horrifying cut ― an entire piece of flesh was gone. Even with no medical school degree under my belt, I knew that she needed to be hospitalized until the flesh healed, or, as the Vietnamese doctors put it, she needed to “wait for the meat to turn red again. ” The family disclosed that they could not afford for Thuy to be an inpatient. Instead, they chose to hire a nurse at half the price to change the bandage daily and check to see when the meat turned red. The hospital was prepared to pull her skin over the cut once it healed. Her parents, who barely had money for basic necessities, were going to pay for a procedure that would probably permanently damage their daughter’s heel, if not her entire foot, when the obvious alternative of skin grafting was available. I guess it was not so obvious in Viet Nam because I found out that only one doctor in Da Nang hospital was familiar with the procedure, and it was only after Josh discussed it with him during a previous visit. In the meantime, Hoi An Foundation did not have the financial means to pay for Thuy’s hospital fee, so Myra could only offer to change her bandage every other day, pay for the family’s round-trip fare from Da Nang to Hoi An, and pick them up from the Hoi An bus station once they arrived. Myra’s offer allowed me to see Thuy frequently and eventually develop a bond that changed my outlook about the medical field
On Saturday morning, I received a text from Myra asking me to come over at three if I was available. Seeing as it was my day off and my plans were flexible, I rode my bike over much earlier than expected. Thuy’s family did not arrive until fifteen past six when I was half asleep on the couch. Instead of coming by bus, they had waited for Thuy’s father to get off from work and borrowed a neighbor’s motorbike to drive 15 miles down to Hoi An. The dressing that we had applied on Thursday had not held, and blood had started to leak through the bandage by Friday evening. I was afraid that changing the dressing every other day was going to help the family save money at the expense of Thuy’s recovery. When Myra was done she brought out a jar of lollipops, and Thuy grabbed two instead of one. She neither smiled nor thanked Myra, which was a very rare response to find in Viet Nam. However, Thuy was only four years old, and I was careful not to comment on her impoliteness as it would insinuate bad parenting on her mother’s part.
“Does Thuy smile more often at home?” I asked.
Her mother replied in the negative. I became more curious.
“Does Thuy ever smile?” I asked further.
“Not a lot, miss,” her mother replied.
When Myra went to grab the reimbursement for Thuy’s hospital bills, I resumed with my questions.
“Has she been quiet since birth or did her behavior changed after she became ill?”
From her mother, I discovered that Thuy was a silent child who barely cried as a baby and rarely talked as a toddler. I asked these questions fully knowing that I might be crossing the boundary by looking into her psychological well-being when we were only responsible for her physical well-being. As a matter of fact, Hoi An Foundation was providing Thuy with some of the best medical care in Quang Nam province. Yet, I let my curiosity and concern for Thuy get the better of me and did not stop until I got the facts I wanted.
By the end of the conversation, I started to glue together the pieces of the puzzle that made up Thuy’s life. Firstly, I could see the signs of sexual development before elementary school in a society with largely late physical maturity. Thuy would also be facing a lifetime at risk of fractures and collapsed vertebrae thanks to the very same doctors who caused her permanent limp when they could not align a displaced fracture. She would also grow up under the hardship of poverty in a land with limited financial mobility. Finally, as an extreme introvert, she was born different in a historically assimilating culture, in a country that largely ignores and misunderstands mental health. With all that being said, I realize that these were only the facts that met my eyes; Thuy’s life was a multi-dimensional experience shaped not only by the things given to her but her responses to them. However, it was in my nature to put the pieces of the puzzle together, even if a lot of pieces were still missing.
Thuy’s mother rang Myra up on Monday to report that the wound was starting to smell. Again, I had the opportunity to translate for Myra, except this time, we were paying her a house visit all the way in the city of Da Nang, approximately 16 miles away. We got off our bikes at the main road in front of her house and walked into a housing unit with just a few houses and a lot of curious eyes mostly staring at Myra. Thuy’s mother greeted us at the door and appeared apologetic that her daughter had fallen asleep waiting for us. I followed Myra’s instruction to grab supplies and caught glimpses of the house while waiting for the water to run. Her house was almost empty. It was hard to believe that four people were living in a house with one mattress, one cabinet, and only basic cooking and living supplies. There were no signs that children lived in the house: no color, no toys, and no mess. I stepped into the bathroom to take a breath but could not control my tears, so I gave myself a few seconds to recuperate. All of a sudden Thuy began shrieking. Her screams were not very loud, but they struck my nerves like lighting. I sat down across from Thuy to persuade her that Myra was only using the scissors to look at her wound and not to hurt her. She began trembling, and I held down Thuy’s foot while her mother stabilized the little girl in her lap. I could not control my emotions and openly displayed a frown before I turned my head away from Thuy. Her mother saw my response, but what she thought of it I believe I will be better off not knowing. Myra eventually stopped her attempt to probe the wound with scissors when Thuy began shaking violently. I saw Thuy’s pain through my mother’s eyes, a pain that even I was starting to feel.
In the past, I have comforted others with some version of “I feel the pain you are going through. ” Yet, when I think about what it really means, only a small portion of people who say it can truly feel the other person’s pain. I remember telling it to a neighbor after her husband died from lung cancer and left behind two young children, but there is no way that the loss I felt was tantamount to the heart-striking pain that she experienced at the time. I also remember telling it to the endless number of customers who told me about the deaths of their family members, but now I realize that I will never know the pain of losing until I have loss. Even then, there are so many who have suffered the loss of a loved one and only say that they can feel another’s pain because it is what is socially acceptable rather than because they were reminiscing on their own pain. However, the pain that I felt with Thuy was real, and it taught me the strength of empathy. I began to see the sacrifices that went into raising a child -- because Thuy has fibrous dysplasia, the mildest accidents can lead to deadly fractures. The empathy that her mother felt could be naturally explained by materal love, but my empathy was from one stranger to another. I realized at that significant moment that I belong in health care. Compassion will give me the strength to fight every patient’s battle as if their life was somehow connected to mine.
Posted by Cherilyn VyVy Tran at September 8, 2009 11:38 PM
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