Editor’s note: Guest writer Kaiser Permanente physician, and educator Martin Shearn and his wife Lori traveled to Brazil in 1973 where Dr. Shearn served as chief of staff for the SS Hope hospital ship docked in Maceio, a poor coastal community in Northeast Brazil.
For the year we spent with Project Hope in Maceio, Brazil, we were ever aware that the sick and disabled in the region were hoping against all odds that the American doctors on the big white ship would cure them.
While in Maceio, the Hope staff admitted 1,400 patients for treatment in SS Hope’s 108-bed floating hospital. They performed 1,135 major surgical operations that required a total of over 1,350 hours in the ship’s three operating rooms.
Many patients’ health was improved and many were cured. Some became worse (for any number of unknown reasons) and some died. Like in any hospital, anywhere, most patients demonstrated diseases in the worst possible form.
Some of my days were spent working very closely with the patients. I assisted the staff working as a ward clerk. In addition, when the need arose, I filled in as admissions officer.
I enjoyed introducing patients to their first exposure to the Hope Hospital, an American institution. They were frightened and confused. Fortunately, I could understand and speak Portuguese well enough to allay their fears.
The stories of the children were particularly touching. There were hundreds of children born with cleft palates and/or lips. The magic of plastic surgery for those who were admitted for the procedure was incredible, but unfortunately, not every child who was afflicted could be accepted under the criteria worked out by the community and the doctors.
Four-year-old Moises was the very first patient of the year. His tiny face was split by a complete cleft lip, which was overgrown with an enormous protuberance obscuring half of his face. Nevertheless, he never stopped smiling and he became poster boy for Project Hope with his photograph in all the newspapers.
The operation was successful in creating a beautiful new face for him. His young parents could not believe their good fortune, and after Moises discovered a tiny rocking chair, he spent his days in the hospital happily rocking, melting the hearts of each of us who passed him on the hospital floor.
The parents who brought 9-month-old Manuel knew their baby was very sick. He was the youngest of many children, and they wished to relieve his suffering. He had a brain tumor and he was comatose, but there was just the slightest glimmer of hope that if the tumor were benign, its removal might save the child.
Upon surgery, the doctors found that the tumor was indeed benign, but its location was such that it could not be removed without impairing major brain functions.
The parents remained on the ship faithfully throughout the baby’s surgery and convalescence. Manuel was terribly important to them. Even though (in 1973) 50 percent of the children in the Maceio area of Northeastern Brazil did not live to be five years old, parents were not in the least matter-of-fact about losing a child.
Manuel’s death was slow and terrible, and all the family and staff suffered with him. The saddest blow of all came on the day Manuel died and we learned that the parents could not afford to buy a coffin.
Throughout their ordeal they had held up pretty well, but not to be able to bury their baby properly presented an unbearable burden. Fortunately, staff donations paid for a tiny coffin for Manuel and his body left the ship for the last time.
Maria Luisa was 12 years old. She was brought to us because of a basketball-sized tumor on the side of her neck. It caused her to hold her head at a permanent angle. How much anguish that child must have suffered!
Her experience with the local hospital nine years earlier was heartbreaking, but typical, as described by her mother:
“When Maria Luisa was three years old, a small lump appeared on her neck. We live a four-hour bus ride from the hospital, but I brought her in to see the doctors at Santa Casa (the local community hospital). They said it was some kind of a tumor and they wanted to do some tests on my baby,” her mother told me.
The local hospital performed a biopsy on Maria Luisa and two weeks later, the doctor told her mother that the biopsy had been lost, and that they didn’t know what to do for the child.
At that point, the distraught mother went home, expecting the tumor to kill her baby. Instead, years later on the Hope, they saw that the tumor had continued to grow and grow and somehow, the child had learned to live with the grotesque burden as best she could.
Hope found the tumor to be benign, not malignant, and doctors were able to remove the gigantic cyst that weighed 20 pounds. Her neck muscles had to be retrained to hold her neck straight, but after convalescence and physical therapy, Maria Luisa went home without the huge tumor to a new life.
The stories of Maria Luisa, Moises and Manuel have stayed with me and I feel gratified that we were able to touch their lives, even though happy endings were sometimes elusive.