Those diseases which medicines do not cure, iron cures; those which iron cannot cure, fire cures; and those which fire cannot cure, are to be reckoned wholly incurable.
Hippocrates
Medicine has come a long way from the days of Hippocrates, but his quote is a surprisingly accurate description of our modern treatment algorithm. Trade iron for steel, and fire for cautery, and you have a pretty good handle on every surgeon’s underlying ethos.
The most common question I get from visitors is, “What types of things do you see here that you didn’t see in America?” closely followed by “What’s the craziest thing you’ve seen?” And I have seen some very rare diseases so far. My very first day in clinic, I saw a teenager with Melkersson-Rosenthal syndrome, a textbook-only syndrome that causes recurrent facial paralysis, lip swelling, and a fissured tongue. I have seen a malignant teratoma of the thyroid in an elderly lady, something that has only been reported a handful of times, and never in someone that old.
But what stands out the most isn’t the rare diagnoses or the large tumors. Rather it’s the attitude of inevitability that surrounds such horrible suffering, like life is supposed to be like this. An hour ago, I saw a lady from the Somali border who was blown out of a building by a bomb blast three days ago. Three other people in the room were killed; remarkably her only injury was a ruptured ear drum and concussion symptoms. She recounted her story like everyone has felt the blast from an explosive. Last week, I biopsied a large lip tumor (bottom left photo) in a 1 year old that is sure to be some rare malignancy. His parents were stoic at the news, but also disappointed that the lip didn’t look normal after the biopsy, betraying their underlying perception of the disease.
Low healthcare literacy mixed with a different cultural understanding of disease make conveying the reality of rare cancer diagnoses a task fraught with misadventure. People in Kenya don’t inherently have more medical problems than anywhere else in the world. Rare entities are certainly found more often in America than anywhere in Africa. The real, shocking difference is how many people have these life-altering problems without knowledge of what is wrong with them, and without any hope of help. Here, disease is shrouded in darkness—not just in a mystical voodoo sense that was so prevalent a generation ago, but also in the very real sense of being not understandable. Human beings are hard-wired to assign a cause to everything. When it’s personal, our brains don’t let us accept that some things happen randomly, without cause. Even when we have loads of evidence stating that some diseases are sporadic, we can’t stop speculating
The world is a broken place, where things are not as they should be. Jesus recognized that physical suffering is the foremost affront to the Kingdom of God; the prime example of the fallen nature of the creation, and the essential enemy of human dignity. As we wait for God’s perfect timing to roll out His Kingdom on Earth, physical suffering continues unchecked in many places around the world. We long for the day when physical suffering is extinguished forever, knowing that no amount of iron or fire is going to get us there.
Kenya Hear 