It turns out there are not the right words to describe
heartbreak. Broken-hearted. Crushed. A hole in the heart.
When it happens to you, you struggle for the words to describe,
even just to yourself, this empty, hollow, wretched state. There
are not words for how you mourn as you breathe in and out. There is
no description for the way your mind twists around the losses now
and the losses for the future.
Even as the sadness weighs on you, you squeeze what hope is left
into putting one foot in front of the other, in getting through
this day, and then the next.
Vivian's heartbreak came with a small, pink slip of paper on
which the words "PCR reactive" were written. She thought she could
feel her pulpy, pumping heart slow and harden and stop beating as
the words came out of the counselor's mouth, telling her that she
was infected with HIV and so were her two daughter. She thought of
them, beautiful and bright, in between the slowed beats of her
heart. Monica in a red dress chasing little Deborah outside of the
house that morning, a 5-year-old mother trying to lift her baby
sister in skinny arms.
Vivian felt her hopes for herself and for her girls spilling out
of her heart and onto the floor. She had hoped to live to see her
grandbabies. She had hoped that her daughters might make it all the
way through high school, and even through university. She had hoped
that her small business along the roadside selling milk and eggs
and fresh vegetables might do well enough that she could have a
shop of her own and finance all of these dreams. Big to small, drip
drip drip spilled the hopes.
The man she called her husband left several months ago. She had
been hoping that he would return soon, that everything would be ok.
And now, in between the slow heartbeats, she started mourning
the loss of him as well. This was why he was gone, she knew now.
And her hope for him dripped to the floor as well.
Sometimes, our patients come in so sick that they need to be
carried, with bodies as frail as the pages of an ancient book that
crumble as you try to turn them. Sometimes, our patients come in so
drained of hope that their hearts are even more feeble and frail
than their bodies.
I have good doctor plans for restoring Vivian and her daughters,
Monica and Deborah. Medicines, food, exercise, work, school - all
the day-to-day menders of broken bodies and, sometimes, of broken
hearts. You can have many years, I tell her. There is reason to
But how to ease the weight when your love has left you? When
your life may, indeed, be cut short? When your dreams for your
children seem so much more impossible? When you have struggled your
whole life to carve out these dreams despite the grinding poverty
of life on $1 a day?
I don't seem to have much luck scooping hope up off of the
floor, so this is my motto for the week. (
What can I do in the this beautiful and terrible world? I can
try to figure out how to help Vivian and her daughters navigate
this world with more hope and less fear. I can try to figure that
out for myself and for our families in Kenya who walk with
this particularly terrible virus. And I know lots of families are
trying to figure this out for their own battles against the parts
of their worlds that they are finding terrible and frightening. How
to cling to the beauty. How to find the hope.
How do we do it? How do we manifest hope, a little more each
day? For my program in Kenya, I'm working on my toolkit: Shared
stories. Counselors. Support groups. Tools to connect you to other
families, other patients. Better medicines. Money to make our
programs more effective, more accessible.
Hope takes many different forms. We walk together. And I still
believe that love wins.