RHONDA

I’d like to introduce you to Rhonda Molnga. At 23 years old, she has a beautiful smile, a heart filled with the joy of the Lord, and a belly filled with her second child. I first met Rhonda about two weeks ago, presenting with concern for a lung infection diagnosed in Lae. She had been on antibiotics, but still spoke of some chest discomfort. Her Skelbuk (medical record book) said they’d done an x-ray in Lae showing Pneumonia in her left lung, but she didn’t have this X-ray with her. Listening to her lungs, there were diminished breath sounds on the left, but she otherwise looked great. I decided to Ultrasound her belly and check to see the baby was OK. 

When she took off her shoes to sit on the Ultrasound bed, I noted Rhonda’s Left big toe was missing, but didn’t think much of it – so many people here are missing fingers and toes because of prior infections or self-amputation (many here will cut off a digit to demonstrate their grief for another’s death…the last thing they want is someone to think they had caused the death through witchcraft). 

...NOT actual pictures of Rhonda's foot...

Anyway, the baby looked just fine on scan, measuring about 36 weeks gestation. I almost stopped there, but then decided to ultrasound her lung. Lung ultrasound usually isn’t helpful unless you’re evaluating an effusion (fluid collection), but in Rhonda’s case, there was certainly something abnormal in that left lung field. I sent her for a repeat chest X-Ray. 

The moment I put the CXR up, my heart dropped. When I see something bad here, I reflexively ask one of the other docs to confirm the diagnosis…maybe with some hope I’m wrong. Rhonda’s CXR was showing a large mass in the left lung with a couple of small round masses elsewhere….cancer until proven otherwise. The nearest doc at the moment was our veteran surgeon, Dr Jim Radcliffe, who confirmed badness, and then looking at Rhonda’s face, felt as though he’d seen her sometime before. Jim disappeared, returning moments later with pieces to Rhonda’s story I hadn’t found in her Skelbuk. Around the holiday’s, Rhonda had presented with an abnormal skin growth on her left great toe, which at the time was concerning enough for cancer that our visiting surgeon, Dr Kevin Karrington, had amputated the entire toe and sent a specimen to the States for pathologic evaluation. Dr Jim had just returned to Kudjip at that time, and had seen Rhonda in passing. With her chest x-ray now showing metastatic tumors in her lungs, Jim was shaking his head – “Ted, this is bad. The pathology shows Merkel cell carcinoma, a terrible prognosis even with the best chemotherapy”. 

[ASIDE: Merkel cell carcinoma is very rare, and is the only cancer known to be caused by a virus. Read more HERE.]

Every week I discover terminal cancers and terrible diseases, and with every patient I have to get my head and heart wrapped around just how difficult it will be for them to hear the news. What was worse in Rhonda’s case was that she had come alone. Young, full of life, and pregnant!, she was about to hear a death sentence. Sitting down with her in my clinic room, I started by asking about her faith. The direction I take to share bad news is always tailored to where each patient is in relationship with God. I was extremely relieved to learn Rhonda not only attends church, but knows the freedom and assurance of Jesus as her Lord and Savior. I could see the joy in her face as she said these words, and I knew all of God’s power and love would be present with Rhonda to hear this bad news. Each detail I presented was heard and understood, all the more because she speaks English fairly well, and while a sadness lingered behind her eyes, her smile testified to the hope she has in Christ.

We met with Rhonda and about 12 family members a week ago, to spell out her options. There were a lot of tears, and some mixed opinion about what to do. The major decision was whether or not to pursue chemotherapy, which would only be available in Lae. Secondarily, the question remained whether we should give her an immediate C-section or wait until the baby’s natural delivery. We left all of these options on the table for the family to decide upon, but cautioned of two things. First, the chemo would certainly depreciate her quality of life, and with a terrible prognosis she might prefer to forego the chemo side effects for better health in her final months. Second, chemo couldn’t be started until her C-section healed, which would be about the same time she would deliver naturally anyway. Meeting with her again today, Rhonda and her family have decided to deliver naturally here at Kudjip, then travel to Lae for chemotherapy. Before leaving, she asked if I would scan her baby again. Of course! This time, I turned the screen to let Rhonda and her mother ooohhh and aaahhh as I found the baby’s face, beating heart, moving limbs, and even some little boy parts. To give such joy to Rhonda today brought me Spiritually to my knees. Even facing death, Rhonda gives God praise for the good health of her unborn baby boy, and for His promise of eternal Life. What a testimony!

Would you join me in praying for Rhonda, for her baby who will deliver in the next 1-2 weeks, for her 2 year old son and all her family, and for the doctors in Lae who will be taking over her care? Pray for the Lord’s favor and His Spirit’s fruits to raise up this wonderful young woman, that she would have the same joy and peace through all the trials to come.

Romans 5:1-5

Therefore, since we have been justified through faith, 

we have peace with God through our Lord Jesus Christ, 

through whom we have gained access by faith 

into this grace in which we now stand. 

And we rejoice in the hope of the glory of God. 

Not only so, but we also rejoice in our sufferings, 

because we know that suffering produces perseverance; 

perseverance, character; and character, hope. 

And hope does not disappoint us, 

because God has poured out His love into our hearts 

by the Holy Spirit, whom He has given us.