"Find me in the river
Find me on my knees
I've walked against the water
Now I'm waiting, if you please."
Often times I find it difficult to discuss serious illness with Papua New Guineans. I think the language is partly to blame. Pijin is not a sophisticated language, and rarely the mother-tongue of my patients. Describing a terminal illness or a permanent disability is challenging. I also think the cultural understanding of illness differs from the “Western” understanding. Illnesses are usually thought to be the result of the attacks of others or a spiritual imbalance, rather than misfortune or the result of a fallen world.
So when a patient comes to the clinic and I find that they have cancer, I know they will need a thorough explanation and a chance to ask questions, and I try my best to make enough space for that to happen, remembering the hundreds of patients still needing to be cared for that day.
Douni and her daughter Esther walked to my exam room in the morning, one of the first patients I would see that day. Douni looked to be almost sixty, slightly bent over with the long labors of her difficult life evidenced in her joints. Her daughter, Esther, lived in the nearby town of Mt. Hagen but brought her mother from the village to Kudjip because she had been having pains in her abdomen and losing weight.
Douni's skin and eyes glowed with an unnatural yellow appearance. Her abdomen held a soft mass in the right side near the ribs – a collection of findings known as Courvoisier's sign, which I've written about before.
An ultrasound confirmed my fears – Douni had cancer that couldn't be treated and she would die in the next few months.
I let Douni sit down on my exam table and put her clinic book down on the counter. I told her that she had a bad illness (“sick nogut”) called cancer. We had no medicine or surgery that could cure her. She did not get it from someone else and she would not give it to her daughter or her family. I advised her against using all of her money on bush-doctors or tribesmen selling herbs in the village. I could give her medicines to help her pain, and her daughter or family members could get new supplies of those periodically if she was feeling too weak to make the journey back tot he hospital. But nothing we gave her would cure her illness.
I give this explanation about once or twice a day to patients with various cancers – liver, pancreatic, ovarian or breast. Many times the patient and their relatives immediately start asking questions. “But can I eat something that will heal me? But can I go to Australia to cure this? How did this happen to me? A long time ago my brother fought me with a coffee stick and hit me there, is that why the cancer came up?” It makes my long-winded explanation feel like an exercise in futility.
But Douni and her daughter sat quietly through my talking with them, with their faces slowly dropping as genuine realization sunk in.
Then this beautiful Papua New Guinean mother (“lapun mama”) brought her hands up until she was holding my face in them. She said, “I thank God, because he sent you to help me and my people. Now the rest of my life is in His hands.”
We prayed together – Douni and Esther were not the only ones crying through that prayer.
Esther thanked me as she helped her mother off the exam table. I showed them to our dispensary to collect promethazine for nausea and paracetamol for pain - releasing Douni to her long martyrdom with cancer.
In the book of John a friend of Jesus, Lazarus, fell ill and it appeared he would die, so his sisters summoned Jesus – who advised his disciples that the illness would not kill him, but show God's power. But by the time they got to there, Lazarus had died and his body was already entombed. There are likely many commentaries about what happened next, but one of the most striking verses in the Bible follows.
Until moving to Papua New Guinea, I'm not sure I realized why this verse was impressive. I used to believe that this verse showed Jesus was entirely human, despite being entirely God. He had feelings and emotions - he struggled with sadness - he had close friends whom he could mourn. But reading through the rest of the Gospels, the humanity of Christ is already revealed impressively. His compassion on crowds, for example. There was more in this weeping than just being human.
Jesus knew that Lazarus lying in a tomb, wasted away by an illness, was a violation of God's plan. That the illness and suffering of the world were a tragedy. As he looked at the stone in front of the tomb I believe he saw the millions of graves around the world filled with mothers, children, grandparents and young men like Lazarus. He saw beyond Lazarus' resurrection to the need for a resurrected world, completely free of sickness and death. And perhaps, to this end, he saw his own tomb and knew what trials were in store for him.
I've only ever seen one person who I believe might have been resurrected from the dead.
But I've seen hundreds others who walk the long and lonely martyrdom of cancer, HIV or Tuberculosis that I can't cure.
And in one of those moments, to which I sadly become less sensitive, Douni brought me back to the front of Lazarus's tomb. Where the savior I serve let his heart grieve and weep. That I might truly be conformed to the fellowship of his suffering.
And I felt a beautiful joy. Knowing that, for some, I may not heal their physical bodies. But that their beautiful spirits now rest with Christ in a world free of sickness or suffering.
"But if the blessing's in the valley
then in the river I will wait."