Day 145: Powerless

In the eyes of the Afghan people, we Americans are perceived as a country with unlimited resources. Despite the repeated requests for village elders to limit the amount of patients that are sent to the free clinic to 30-40 patients per week...well today, close to 300 showed up at the front gate!! Yes, I said 300!!! Unfortunately, we had no choice but to turn the vast majority of them away. We still ended up taking care of 45 patients which was 15 more than what we had prepped for, but I couldn't help but feel powerless as I wish I had the resources available to take care of all 300 of those patients.

Hanging out in the waiting room!

Of the 45 patients seen at the free clinic today, one particular patient stuck out in my mind. He was a 19 y/o male who was cachectic, bedridden, and had multiple painful pressure ulcers on his lower back and arms with some sores eroding down to muscle and even bone. Apparently, his family was not aware of the need to turn him regularly. When I saw him, he was in so much pain that his family couldn't take him out of the car seat so I could evaluate him. I attempted to obtain what ended up being a very convoluted and broken-up history regarding his medical condition which, in the end, still rendered me clueless as to what was going with him. Wow, if there was ever a time in my medical career that I felt so powerless...it was now. As I talked with him and painfully took down his old dressings, I could sense the hope that his family had in me as the "American doctor" who can do anything and everything.


In the world of medicine that I'm most familiar with...this patient would have been admitted to an inpatient facility and a multidisciplinary medical team would have been involved with his care. But, in the world of medicine that I am currently working out of...I had some gauze, sterile water, tape and my own 2 hands working out of the front seat of a beat-up Toyota Corolla for a hospital bed.


After painstakingly cleaning his wounds, replacing his dressings, and telling his family that the liklihood of finding him specialty care was highly improbable...I couldn't help but feel like I was letting them down. But, as I reflected on the deeds of the day, I realized that in my simple acts of "powerless" medicine, in the eyes of the Afghan people, I was still seen as powerful...not because of the uniform I was wearing, but because of the character I was displaying.

"But a certain Samaritan, as he journeyed, came where he was: and when he saw him, he had compassion on him. And went with him and bound up his wounds..." Luke 10:33,34 KJV