By Deborah Berruti Knight, OT
We had a visiting specialist from the US come to West Africa to perform surgery on a number of unique cases that had been set aside for her. One case, specifically, was a young man named Isaac*, whom we estimated to be around 20 years old.
Isaac’s mouth had been overtaken by massive tumor that incorporated his lower set of teeth and slowly prevented him from eating solid food and speaking intelligibly. He walked around with a plastic bag suspended from his ears which collected his draining saliva. Even drinking water had become a highly unsuccessful task.
The surgeon approached me one morning explaining that she believed removal of the tumor would be possible, but it would require a significant amount of follow up speech therapy. I quickly reminded her that I was an OT. She graciously inferred that without intervention this man would have no hope.
I agreed to consult some SLP colleagues via email and get back to her.
I consulted with three speech therapists, and they all said the same thing: we’ve never worked with a case like this, it’s extremely complicated, you will be way over your head. The ENT reminded me that we were the best shot he had.
Isaac underwent 13 hours of surgery for a total mandibulectomy. The musculature at the base of his mouth could not be saved; as a result, he experienced sensory and motor loss of the left half of his tongue and lower lip. Using a specialized strap I made to provide under-chin support, Isaac worked extremely hard to relearn to swallow his saliva and thickened liquids. He spent hours learning to control his tongue movements practicing his speech.
Isaac spent nearly a month at the hospital both as an inpatient and therapy outpatient before returning to his village. During this time, we shared with him the Good News of God’s grace through Jesus. Three months later, he stopped by to see us and reported that, despite not having bottom teeth, he was eating everything, even meat! He told us how thankful he and his family were for the care he had received.
We were all very pleased at how well Isaac had recovered and counted him as a true medical success story.
About three months later, Isaac was back.
Only this time, a massive tumor was growing at the base of his ear.
At the time of his surgery, it was necessary for his mandible to be severed rather than the TMJ (Temporomandibular Joint) being disarticulated. It was in this small bit of bone that the cancer remained.
He had no complaint of pain and no impaired function. Before sending him to consult the surgical team, the therapy department gathered to pray with Isaac. The surgeon said there was nothing more they could do for him, and sent him home.
I struggled at a spiritual level with Isaac’s cycle of illness. I plead with the Lord to intercede and heal Isaac to somehow redeem the process he went through.
Three weeks later, Isaac returned to see us. The tumor had visibly increased in sized and had begun growing posteriorly. He was in a lot of pain, had difficulty standing up from a mat or chair, was tripping while walking and was no longer able to swallow solid foods.
We prayed with him again and brought him to see a visiting palliative care doctor.
Dr. Kelly* gently explained to Isaac that not only was there no further treatment available to him, but his cancer would take his life soon. She then said to him, “Isaac, I’ve given you a lot of bad news, but could I share some good news with you?” He agreed. She explained that when God created the world He did not intend for sickness or death to be in the world. She shared the story of Abraham’s willingness to sacrifice his son at God’s request, and the substitute that was provided. She explained that God has provided a substitute for our sins as well.
Then she asked Isaac, “Do you know who that is?”
“IT’S JESUS!” he proclaimed. “I’ve seen His movie!!”
The foundation of the Gospel had been laid during his first stay in the hospital. He had watched the Jesus Film several times in the waiting room. Our local evangelists spent time praying with him, and we shared the story of Jesus numerous times.
While he was with Dr. Kelly, he confessed his belief that Jesus is Lord. Using a cup of water, one of the hospital’s pastors baptized Isaac right there in the doctor’s office. He was given an audio Bible and was sent home.
A few days later, our small therapy department went to visit Isaac in his village. It took us over three hours in a 4×4 to get there. We were amazed at the efforts he went to come to journey to the hospital. He literally lived in the middle of nowhere!
As we sat and visited with Isaac and his family, members of his community slowly filled up the courtyard of the house. Everyone was curious who these foreigners were. Isaac’s grandfather invited us to address the crowd.
I stood and began to tell the story of redemption that God had given us. The community listened intently as the Gospel was presented. Children were hushed and instructed that what they were hearing was important.
We returned the following week with Dr. Kelly, and she presented the Gospel to the village again. Two weeks after that, we returned again, getting the news that Isaac had passed away. But we were asked to share more about Jesus and His story of hope.
We maintain our relationship with Isaac’s family and pray that the seed of the Gospel will take root in his village and many of his kinsmen will have new life in Christ.
Deborah Berruti Knight is a MedSend occupational therapist serving in Niger. Isaac’s story is excerpted from one of her reports from the field. Niger is a country within the 10/40 window.