Saturday, September 20, 2008

Losing a dear friend and patient...

Healthcare in Liberia is a setting where often care is fragmented and it is hard to develop the same kind of long-term doctor-patient relationships that make family practice satisfying. But this week I lost one of my special patients—this gentleman was a pastor from up-country in Liberia and a friend who had been through an awful lot.

I first met him several years ago when he was hospitalized for about 2 months with severe congestive heart failure and poor kidney function. He required such high doses of medication that the treatment threw off the balance of chemicals in his blood (like sodium and potassium). And so keeping him “tuned up” was a constant challenge of trying this and adjusting that and testing this and modifying that. He had a missionary friend who helped pay for his treatment, so that was a blessing as well. Joseph was a “stick-with-it” kind of guy—if your treatment wasn’t working for him, he’d complain and try some more and give you the feedback until you got things right. This kind of willingness to stick with one medical provider and one hospital even when things were not always perfect or going his way was the key to success—and is not the rule in Liberia. This guy would have died on several occasions if we had not built a successful doctor-patient relationship, built on trust and our common commitment to God. Joseph was a young man—I believe only in his 40s—with a dear wife and young children. Several times during the last few years we were able to get him “tuned up” enough so that he could return to Nimba county, where his church was, to be with his family and his church and to do the work of pastoring that he was called to do. He would stay up there, taking his medication, sometimes for 4 or even 6 months, until something would get “out of whack” again and he’d start swelling up or getting short of breath. Then he’d return to Monrovia for a long course of treatment and retuning.

When I returned from the US a few weeks ago, I met Joseph in the hospital, looking worse than usual. He had a lot of shortness of breath, and looked very uncomfortable. Usually removing fluid from the chest (where it had gathered around his lung) helped him feel a lot better—but this time, the fluid in his chest had become infected. We had to insert chest tubes on both sides to drain the fluid. In addition, his electrolyte levels (sodium and potassium) were very hard to balance. After several weeks of inserting drains and treating with antibiotics and doing x-rays and other tests, pastor Joseph was continuing to get weaker. Monday morning I sensed that he was doing worse, ,and that he might not recover from this episode. We talked for a while and prayed together. Joseph told me he wasn’t afraid to die—he knew where he was going. He was just concerned for his wife and children.

Monday evening about 8:00 pm Joseph breathed his last. He fought a good fight, and finished the race. I was grateful to have had such a good relationship with this dear brother over several years. It is these kinds of connections that make medical work fulfilling for me. I will miss him, but I know he is enjoying being with his Lord.


Gene Brooks said...

Rick, you're an awesome doctor.
Gene Brooks

Anonymous said...

It reminds me of my own father who suffered from congestive heart failure and kidney failure...he was always walking a tightrope of balancing his various medicines and would "adjust" things on almost a daily basis. He was a physician so he had some idea of what he was doing, and his ability to make daily adjustments probably extended his life by a couple years. But when he fell off the tightrope he'd get confused and needed outside assistance, and even in the states it was hard for his doctor to figure out how to get things back into balance.

Steve Pennings

Melodie said...

What I sweet post. Our family was also so grateful for your care. We are rejoicing with Pastor Leelear and hope to be a blessing to his wife and children when we get back to Liberia soon.