It turns out there are not the right words to describe heartbreak. Broken-hearted. Crushed. A hole in the heart. Shattered.

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.

girls by wall

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 hope again.

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. ( Thanks, Momastery)


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.


Posted at 07:41


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