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.
