Flori – How This Project Truly Came To Be

I promised in one of my first posts that I’d tell the story of Flori, who is a huge part of the reason this whole project happened. 

Flori started with a rather typical story – a desperate woman that inevitably was seen at the end of a long day of clinic when Anne was here last year.  She’d had pain and bleeding for well over a month and hadn’t gotten any answers despite her family pulling together the money for repeated medical appointments.  In fact, when she went for an ultrasound, she was happily told, “¡Está embarazada – la matriz está llena!” (“You’re pregnant – your uterus is full!”)  It was apparent that “diagnosis” was far from the truth, and a subsequent exam, pap smear, and biopsy proved that she had invasive cervical cancer.  Unbelievably, she had received a normal pap smear just two years prior.  She had done all of the right things to try to take care of her health, but ultimately the system failed her.

After desperate attempts to coordinate plans for surgery in Guatemala, the decision was made to bring Flori to Ohio for treatment.  The idea was to proceed with a radical hysterectomy, but a CT scan demonstrated the cancer had enough that radiation and chemo were the indicated treatments.  She bounced in and out of the hospital over the course of more than two months while receiving these treatments and struggling with the effects of both the treatments and her disease, including a brief stay in the ICU.  Finally, she returned to her family in Guatemala with true hope that a cure had been achieved.  We all celebrated when her first pap smear back in Guatemala was normal!  However, it later became clear that the cancer was not in remission.  Over the following months, she deteriorated, and last October she passed away leaving a grieving network of friends and family between Guatemala and Toledo. 

The basic story alone is heartbreaking, but even more so when you know more about her.  Flori was a beautiful, caring, reserved yet welcoming woman that died at age 29, leaving behind a wonderful family including her 3 year old daughter and 7 year old son.  She was easy to talk to (even in Spanish!) and a very thoughtful and passionate speaker.  Even as she was struggling herself, she spent a great deal of time speaking publicly (at events and even on the news) about cervical cancer and the importance of screening.  She loved her family, and especially her kids, and spent most of her illness worrying about them more than worrying about herself.  She and I were less than two months apart in age.

Flori and I spent a good bit of time together while she was in Toledo.  I happened to be on a rather worthless psychiatry rotation at the same hospital where she was receiving her treatments.  My attending wanted me to spend most of the day studying, so I chose to do so at Flori’s side.  Sometimes we would chat, other times I’d study while she rested.  I was there to help translate, as she spoke zero English, and to help advocate for her as she never wanted to inconvenience the nurses by asking for something.  Outside of the hospital, we were able to spend time together also.  When she didn’t feel well, I’d often just sit with her so that when she’d awake, there would be someone there.  When she felt well, we’d chat about our lives, our families, our cultures, and our future plans.  We’d marvel about how different our lives were despite being so close in age – we tried to pinpoint the time when our life paths diverged, but I’m not certain we were ever been on similar trajectories at all.  She loved to tease me about how I’d ever find a husband and have a family at such an old spinster age!  Despite the vast differences, we were happy sharing in each other’s company. 

Ana teaching me and Puja how to take the dried kernels off the corn

The first week of our trip in February was in a clinic in El Naranjo, where Flori grew up and most of her extended family still lives.  I was able to spend a great deal of time with her sister, Ana, which was especially fun because Flori and I talked about her all of the time.

I also had the pleasure of meeting this adorable baby, who I have planned to adopt!

 

When I told my mom and sister that I was going to adopt her, they assumed she had some sad story of being orphaned or abandoned.  I had to explain that she actually has a wonderful family (she is Flori’s niece), and admit that by “adopting” I really mean “stealing.”  But does it count as stealing when I told her mom I was going to do it and she suggested that Katherine would probably fit in my suitcase? 

Katherine being very helpful with baby Anita

 

Clinic days were busy as we were just getting the hang of it, however the patients were wonderful.  The majority knew Flori’s story, so they dutifully lined up for their pap smears fully knowing the importance.  We finished every day over at Ana’s house, which was the ideal location because 1) there’s no better way to unwind at the end of the day than by playing with a 15 month old and 2) it reminded us on a daily basis of the tragedies we were trying to prevent through this project.  Although we were aware prior to meeting Flori of the burden of cervical cancer in countries like Guatemala, the real drive for this month long endeavor came from our interactions with her.  They served to strengthen our firm belief that no one, and especially not a healthy young woman like Flori, should have her life cut short by a completely preventable disease like cervical cancer.  So it was with the very tangible idea of saving women like Flori from having to endure the pain and suffering that we saw her endure that we embarked on this project.  And with each woman that we treated, we hoped we were preventing another family from needlessly losing their mother, sister, daughter, and aunt.