January 27, 2009

How to save a life

It is amazing what anti-retroviral drugs can do for sick patients. Pakama, the woman who was so seriously sick with HIV last May and June and with whom I spent so much time navigating the health-care system, now betrays hardly any trace of her past illness. She is taking the right combination of drugs and is so healthy I barely see her because she rarely has to come to the clinic. (Nobathembu, another very sick woman I once wrote about, is also now shockingly healthy. She was practically dancing in the clinic this morning.)

During those long weeks of nearly one-on-one attention with Pakama, I often daydreamed about a day when she would be able to walk on her own and speak without running out of breath. But I’m not sure I ever really believed it would happen. It has and it’s shocking.

I mention her because about a week ago she came to the end of her tuberculosis treatment. It was eight months worth of pills, which she was starting just as I was getting to know her. As I did the paperwork to discharge her from our records, I noted to Jenny that she had finished. We both marveled at how strong she was and how much she had improved and then Jenny said to me, “You know, she only made it to the end of her treatment because of you. You saved her life.”

This made me very uncomfortable. I don’t like how it imputes so much agency to me - let’s be serious, who I am to be saving lives? - and it minimizes the numerous other factors that contributed to Pakama’s improved health. When I go to write the resume line for my time in Itipini, am I really going to write as one of my accomplishments “saved lives”? I don’t think so.

One time when I was in the volunteer ambulance department, I arrived on a scene first and soon after the patient had had a heart attack, started CPR, and did it all the way to the hospital. It worked, kind of. He survived another week, in a vegetative state, before dying. Someone noted to me then that I had saved his life and I was uncomfortable with the idea. I preferred to say to myself that I had “prolonged” his life, given the quality of life he enjoyed after my intervention. But in Pakama’s case, she has a pretty good quality of life and, while anything can happen, there’s no expectation she’ll die anytime soon.

This line of thought reminds me of Esther’s response to Mordecai’s plea that she help save the Jews. Basically, she says, “who I am to do anything?” Mordecai says, “Who knows? Perhaps you have come to royal dignity for just such a time as this.” (4:14) Basically he’s saying, “you’re the one in the right place at the right time.” To the extent I did anything to save Pakama’s life, I did what I did because I happened to be the person who was in the right place to offer assistance at a time when she desperately needed it. Isn’t that partly what mission is about? Putting ourselves in a new place to be of assistance when needed?

As a coda to this story, it turns out that one of the new high school students we are supporting this year is Pakama’s daughter, Babalwa. I had thought Babalwa was Pakama’s sister but Babalwa told me on Friday that she was Pakama’s daughter. I was a bit surprised and, as I had been thinking that week about Jenny’s comment, I didn’t know how to respond so I just sort of said, “oh” and looked away. But as I did, I could detect a look of gratitude on Babalwa’s face that told me she knew what I had done for her mother. And that was significant for me.