St. Michael’s director of nursing research, Lianne Jeffs, shares her sentiments and experiences from the 2012 mission.
Dickens’ words “it was the best of times, it was the worst of times” echo in my ear as I write this blog after 12 full days of our medical mission. Saying that what we experienced with our hearts and hands is as dichotomous as the stark contrast between those who have and those who do not have in this world was glaringly and painfully obvious. Every outreach day brought a different group of people seeking medical attention. And every day, there were moments of feeling we were making a difference, and there were moments of feeling utterly helpless to affect the fate and misfortune for our sickest patients that we served on our mission. Our team persevered through the sweltering heat, lack of sleep, dwindling supplies, and our patients’ health and living conditions with minimal or no access to health services. We were struck by the resilience of people waiting to be seen who would try to queue the line or become aggressive at having to wait so long to see a doctor or receive their drugs. Digging deep, I have to say that if the shoe was on the other foot and this was the only chance to have my child seen by a doctor this year or ever – perhaps I would have done the same.
Clockwise from right: Dr. Dan Cass, Beth Rosenberg, Zenny Palacios Gepilano and Lianne Jeffs
There were a multitude of examples within and across our outreach days where we were able to bring smiles to people’s faces simply by providing vitamins, – dubbed, initially by Beth – a nurse from St. Michael’s Hospital – and subsequently referred to by our team as, “magic vitamins”. There were times where we were able to coordinate care for a patient by being collaborative without even knowing it. One particular patient that stands out for me is an older breast cancer patient that arrived through our triage station at St. Joseph’s seminary near Iloilo. This patient’s chief complaint was pain on her left breast and upon being assessed by Tessa, a perfusionist and Linda, a nurse from St. Michael’s Hospital, it became apparent this complaint was not to be taken lightly. A more in-depth assessment revealed a deep open wound with several lumps surrounding on her left breast indicative of advanced cancer. This patient was quickly referred for assessment by one of the local doctors who prescribed wound care. We were fortunate to be able to provide wound care on that day as our surgical team who joined the medical team post Bacolod surgeries had set up a makeshift treatment area including two geriatric chairs formerly used at St. Michael’s Hospital’s hemodialysis unit. This was where I first encountered our patient, lying down having her wound being carefully and meticulously cleaned by two nurses, Joyce (St. Michael’s Hospital) and Bev (University Health Network). As I approached the treatment area, I looked at this women lying down in the chair who had a look in her eyes that will stay with me a long time. It was a combination of feeling some instant relief from her pain – both physical and psychological – yet knowing that it may be short-lived. Consulting with the Joyce and Bev, she had not been given any medications for cancer or for her pain. Knowing that we had brought over Tamoxifin, a drug that is used to block the receptor site that can promote the spread of breast cancer cells, I ran down to pharmacy to consult with Jenny, our lead pharmacist around treatment options. Without hesitation, Jenny reviewed the patient chart and brought over a supply to last our patient a full year. As Jenny explained to our patient about when to take the medication and potential side effects, she looked ever so grateful.
Soon after this patient encounter, I had a chance to talk to my husband Dan, who was one of our physicians and medical lead for this year’s mission. As I started to tell him about this patient, a sinking feeling of helplessness and bewilderment came over me and tears welled up in my eyes. Although not perfect, we as Canadians have access to primary, acute and palliative care services which, if they existed in the Philippines would have potentially enabled the diagnosis of breast cancer sooner, once diagnosed medical and surgical treatment options at no or minimal cost would have been made available, and as the disease progressed or spread – where our patient clearly was at – palliative care that alleviates and minimizes pain associated with cancer could allow a patient to leave this world with some quality of life. I found as I had conversations with our team members over the next few days around this particular case, they also shared the same feelings, as Glenn, an anaesthetist from North York General Hospital, who has family back in the Philippines described the case as very sad as one can only imagine seeing the visible spread of cancer on her skin how much it had spread in her body.
There are several more stories to share by our team members, and this case is but one of what we saw in our days, which ranged from seeing 400 to over a thousand patients today. I am so honoured to been a part of Zenny’s Urban Angel team this year – despite some challenging situations we tried our best to remain compassionate, collaborative and caring.
