The Struggles of a Struggling Optimist
The Struggles of a Struggling Optimist I’ll always remember her face as I saw her taking care of her sick daughter in one bed, out of 20 other beds, in a compact open room that we called the Le Soins Intensif, “The Intensive Unit” while I spent my time in South Kivu in the Democratic Republic of Congo. Her daughter was one of the sickest patients we had encountered while I was there. She was likely born with HIV that she got from her mother (who likely got it from her husband, who I never saw). Due to her respiratory symptoms and having to need oxygen, we were treating her Pneumocystis Pneumonia, but coverage had to be given for bacterial and also fungal pneumonia because I had no way to confirm her diagnosis due to the lack of diagnostic equipment I was given. There were some days in which she looked better than others. There were days in which I saw her drinking the local porridge and awake. I would try to wean her off oxygen and lower her oxygen. There were days in which she was tired and sleepy all day and I would try to figure out, along with all the other local doctors I was working with, what else we could do. Her mother was always there though. She never left her bed. She was always happy to see me and happy to give us her trust. Because, in the boondocks, in that part of the country, we were the best chance that she got with her daughter. She was looking great despite recently starting her antiretroviral therapy for HIV. I struggled with this patient. I was emailing the advisors for Doctors Without Borders in Spain every day about this case and asking them what else we could do. So that day when her daughter passed away was one of my lowest points of that time. I was in some other part of the hospital when I heard the mother’s scream as I ran quickly to her bed. I saw her mother on the floor, flailing and yelling horrendously as I saw her daughter’s lifeless body laying peacefully on the bed. We didn’t even try to resuscitate and doing so is pretty traumatic and often futile since we had no ventilator support anyway. Her mother ran outside and I ran out there with her. She was crying, yelling and all I could do was listen and take it all in. I put my hand on her back and just sat down and heard the cries, the yelling and I tried to burn that moment into my mind and soul. I wanted that moment to stick with me for as long as I live because it was a moment that signified what it really means to be an optimist, to try to be positive in an insane and absurd world where blatant inequality is such a slap in the face for most of the world. With each cry, with each tear I wanted to feel her pain, to feel her struggle, to feel that sense of loss of a young child because nobody in this world should have to feel that. Her daughter’s death was a failure of not only her state, not only her government’s country, but it is a failure of this world. Each premature death is a failure on us. It is a shame on us. While we can’t imagine our own children dying and struggling in that way, dying from an infectious disease linked to HIV, for the rest of the developing world, this is their reality. This is just the way the world is. That is where my optimism brought me. I ended my mission prematurely at 3 months (I was supposed to be there for 6) because I couldn’t stay there any longer.
I wanted to be back home. I wanted to hold my son. I wanted to see his face and realize how extremely lucky I am that he may never had to deal with that kind of struggle his whole life. Back when I graduated residency in 2019, I gave the graduation speech at my program. I was an optimist then, and I still am now, despite all that I went through, but at that point I was still young and naïve. I talked about Nelson Mandela and his autobiography; how he had to spend 27 years in prison to eventually become the first Black President of South Africa. He says, “I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one's head pointed toward the sun, one's feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lays defeat and death.”
The struggle of being an optimist is that we live in a world that is not kind to those who consider themselves optimistic. The more good you want to do in this world, the harder it is going to be to actually do good. It is a lot easier to cheat, to be greedy and to be selfish than to do the exact opposites. Now, more than ever am I seeing this to be more apparent. The world is struggling now with wars, dictators, climate change, extremism and everything else that could make an optimist decide to go the opposite route. But as Mandela says, “… but I would not and could not give myself up to despair. That way lays defeat and death.”