Panama November 2017: The Compromise Going Forward

My time in Panama was as bumpy and turbulent as the Tuesday night landing through the gathering storm. As I had been warned, not all the siblings agree on what Minga should do. The most intransigent is the daughter with whom Minga is living, who believes her mother should give up any thought of going home to Rio Hato even for the weekend, that she should accept a much more limited and sheltered life in which she might be protected from falling or any other untoward event.

I wanted to hear from Minga, and as I expected, she is well able to articulate what she wants. She has failed kidneys, but not a failing brain, spirit, or will to live. She is afraid to receive peritoneal dialysis in her home, afraid that something might happen to the machine, that the solution might not arrive as promised, that she might get an infection. She is willing to stay at her daughter’s home from Tuesday morning through Saturday afternoon, and get hemodialysis at the hospital. Then she would like to go to the village when she has two full days without treatment. That compromise she can live with. She can see her friends, her village family, sleep in her own bed, eat the meals Humberto or Rufina will cook for her. She can have her Christmas tree and have the house decorated, which her family will do for her. She can buy a lottery chance or two from the sellers walking by on the road, and chat. Those simple pleasures are enough.

I made no headway with her intransigent daughter, nor did Minga, actually. But I was able to talk with other family members who came to the hospital, or who called. One by one, they agreed that the decision is Minga’s, and that they will support getting her to and from the village when she wants to go.

Minga said that Dr. Felipe, the nephrologist she trusts most, has told her that although many live a long time on dialysis, that might not be true for her because of her age and condition. Despite the dialysis, she is still sustaining organ damage. But he will work hard to give her the best life possible for the time she has left. She is accepting of that, grateful to him, not fearful.

We have a way forward.

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