I am delighted to host this guest blog from Dr. Eric Bing, physician and professor of global health. We share a passion for fighting disparities in health, a passion is deeply rooted in personal experience, and that comes through in this poignant essay.
I was a Harvard-educated physician yet I couldn’t save a patient
from an easily preventable disease. In
her death, my life found new purpose.
Her name was Lorraine. She
was abandoned when she was just six weeks old—left alone in a dark building on
a cold winter’s morning. Wrapped in only a soiled blanket, she had nothing to
soothe her cries. She might have died if not for those cries, for someone heard
her and carried the tiny body to the infant’s grandmother. In Philadelphia in the
1930s, neighbors knew everything about each other, and the existence of this
child was not a secret. Her grandmother took her in. She had already raised
15 children of her own, so what was one more?
As
a little girl, Lorraine grew up fast. Even with her sharp mind, like many black
girls at that time, she had little money and even fewer opportunities. She
slept in the crawl space under her grandmother’s stairs. When she was 12,
Lorraine began working as a domestic servant, cleaning houses and caring for
children not much younger than herself. She later dropped out of school,
and while still a teenager began having babies of her own.
She
was so busy taking care of others that when she began having light, occasional
vaginal bleeding, she ignored it. She
had already gone through menopause so this was nothing to worry about.
But over time the light bleeding became heavy and the occasional occurrence
became alarmingly frequent. After an anxious trip to the doctor, tests
confirmed that she had cervical cancer, caused by the human papilloma virus she
had acquired years earlier.
Lorraine’s
life was once again in danger, but this time from an easily preventable disease.
Cervical
cancer can be diagnosed in its earliest stages by a simple Pap smear. In
developing countries where Pap smears are too expensive, it is being diagnosed
using a few drops of vinegar or prevented in girls with a simple vaccination.
And it can be treated at an early stage by freezing lesions off, like a
wart. But in order for early care
and treatment to work, you must not only have access to care, you must use
it. And like many women, she did not do that; the needs of others always
came first.
By
the time her cancer was diagnosed, it had already spread throughout her
pelvis. From there it would move to her liver, bones, and lungs before
spreading to her brain and taking her life.
I
cared for Lorraine until the day she died, however she had cared for me from
the day I was born.
Lorraine
was my mother. And her death from an
easily preventable disease changed my life.
I
was a psychiatrist in Los Angeles when my mother died in 1999. Today I am the senior fellow and founding
director of global health at the George W. Bush Institute in Dallas and the
founding director of the Center for Global Health Impact at Southern Methodist
University.
At
the Bush Institute, I helped launch, Pink
Ribbon Red Ribbon, an innovative public private partnership to combat
cervical and breast cancer in Africa and Latin America by increasing access to
cancer prevention and treatment. In developing
countries, where Pap smears are too expensive, cervical cancer can be diagnosed
by putting a few drops of vinegar on the cervix, which is then examined under a
lamp. Lesions appear white and can be treated at an early stage by freezing
them off.
A
recent study from India showed that this simple vinegar test that costs less
than $1 can reduce deaths by nearly one-third. There are also inexpensive
vaccines that can prevent the viral infection entirely. We can defeat cervical
cancer now in simple, cost-effective ways.
The
challenge is access. In Pharmacy
on a Bicycle: Innovative Solutions for
Global Health and Poverty, Rice University business professor Marc J.
Epstein and I show how even access to care barriers can lowered in developing
countries for many diseases, by shifting care to lower-cost providers, focusing
on efficiencies, strengthening existing systems and by stimulating partnerships
among governments, businesses, nonprofits, entrepreneurs and women of all ages.
And, as my mother's death taught me, we must mobilize women to recognize their
risk and realize that by protecting their health, they can live to protect the
ones they love.
As
my mother lay dying in her home in North Carolina, her house was once
again full— with people who had been helped and touched by her over the
decades. My mother had scoffed at the notion of filling a funeral home with
flowers for the dead. "Give me my roses while I can smell them," she
had said. So people obeyed, coming to bid farewell while she could still
hear them.
Despite
the steady stream of people at her bedside, she fretted in her final days about
what she saw as her lack of accomplishment and lasting impact: She was
intelligent but uneducated. She was courageous yet lived in fear. She had done
nothing with her life, she felt. She had not fulfilled her life's mission.
When
she was finished reliving what she thought was a string of disappointments, I
began to re-tell her life story—not as she understood it—but as I saw and
experienced it as her youngest son.
I
told her that I believed that her life's mission was to unleash passion and
purpose in the lives of those she touched. Not only had she raised five
children who went on to careers in business, education and medicine; she had
applied her quick mind, hearty laugh and steel backbone to helping anyone she
came across who was in need.
She
taught us that love is what creates a family. She helped us see that
a good heart must be coupled with hard work in order to succeed. Those
that she had helped were now helping others, and they would in turn help
others, and they, still others. Through others, her spirit would live on,
continuing to change the world.
As
we spoke, I could see a shift occurring within her as she sat there
quietly. Softly, a warm smile filled her face, as though she was looking
in the mirror and for the first time loved the woman she saw.
My
mother died in my arms, leaving the world far more peacefully than she entered
it. In her
death, my life found new purpose.
Eric
G. Bing is the co-author of "Pharmacy
on a Bicycle: Innovative Solutions for Global Health and Poverty" and senior fellow of global health at
the George
W. Bush Institute. He
is also a professor global health at Southern Methodist University and founding
director of the Center
for Global Health Impact.
A
version of this article originally appeared in the LA Times, June 23, 2013, as A
cancer that need not kill, by
Eric G. Bing. It is reprinted here with
permission of the publisher.
