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Journey to Afghanistan

Coud-e-Barq - Chapter 10 - Page 28

Another young woman who was in her mid twenties was brought in by her father. She had slowly progressive weakness in her legs and could no longer walk. They told me through the interpreter that a surgeon was wanting to operate on her back after taking x-rays. She had no particular pain nor history of injury, and yet had some sensation in her legs. They wished another opinion (just like at home). She had findings of marked leg weakness, sustained clonus and hyper-reflexia (signs of upper motor neuron injury), and with normal findings in her arms the lesion was apparently in her spinal cord below the neck area. On inspecting her back carefully no abnormal protruberance of gross malalignment was evident. I encouraged them to go ahead with the good surgeon who had x-rayed her. But many things went through my mind: Tumor? Multiple sclerosis? Injury that they didn't wish to mention? I so wished for an MRI scanner, certainly not available here and probably not in all of Afghanistan. She pulled her burqa about her face and as her father knelt and bent in front of her, she reached her arms about his neck. He left the room carrying her on his back. Her legs dangled uselessly. There was no mistaking the sadness on their faces. What would become of her? I felt devastated.

One dad brought his little two-and-a-half year old boy. His concerns were several. The child had entered the world with a sizable lump posteriorly at the base of his skull. It had enlarged some as he grew and was now a bit bigger than a hen's egg. Since birth the little one had crossed eyes and much leg weakness, even yet not being able to walk. Later as I journeyed with them to see the neurosurgeon at the Jordanian hospital the tremendous love reflected back and forth through the smiles of this father and son was profound. The lump might hold brain or spinal cord tissue as well as fluid. Surgery was arranged. I left Afghanistan before it was done and have not heard how this turned out.

"She is sad" was the complaint regarding one young woman. It was obvious in her face. Her husband had been killed in the fighting a year before. Because of lack of the surety of good long-term follow-up, I seldom started antidepressants. But I did for this lady. She seemed a suicide risk. Two weeks later she was some "better." She was now this brother's second wife. I hope they were able to keep her on the medicine for a few months before gradually backing off.

A young mother and her tiny son were among these patients. As she sat down by the table near me my interpreter said, "They are starving. They come from a village far away." The tiny boy had stick-like legs and both had thin old-appearing faces. I talked with them about several possibilities for getting food, but she felt none of these were possible. We had only a packet of biscuits but could give each a supply of multivitamins to last several weeks. In leaving she would need to keep the biscuits hidden under her burqa or others would likely take them away from her.

So very often my limitations were apparent and I had to say, "God, I put them in your hands." Most Afghans would understand that.

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