A patient came in with complaints of heartburns and joint pains and a mass in his abdomen. As I flipped through his OPD card, I noticed that Dr. Faile had written: large liver mass, likely malignancy… gynecomastia, distended abdominal veins. That was in 2004. He had only been back one time since then because I think he lives in Togo. When I examined him, I could not believe the extent of this man’s physical findings.
The liver usually filters the blood coming from the intestines through the “portal vein.” When the liver is not functioning properly, the blood is forced to find other routes back to the heart. Because of the way the vasculature is designed, there are other veins that can carry the blood, but these veins are not accustomed to carrying such extensive amounts of blood. As a result, the veins become very distended. This creates hemorrhoids and a physical finding I thought I would only see in textbooks called caput medusae or “head of medusa.” It is named for the resemblance that the abdominal veins have to the greek mythological character’s snakes.
Gynecomastia refers to the formation of breast tissue in males. If you look closely, the patient does have small breasts. When the liver is not functioning properly, an imbalance in the hormones occurs and the excess of estrogen (female hormone) causes the breasts to grow.
Despite the patient’s condition, he seemed to be doing ok. I suspect that he didn’t truly have malignancy, but instead has a failing liver with another kind of mass. I treated him for his current complaints and spoke to him about the Great Physician, Jesus. In this life, the patient may not be healed of his disease, but the life after death that Jesus offers is eternal, free of pain and suffering.
As a Christian and (almost) a doctor, I believe that relieving suffering in this life is very important. Christ had great compassion for the sick and hurting, but he always offered the more important spiritual healing whenever he healed physical needs. Our lives on earth are temporary. Our hope is in the eternal.
“All that is not eternal is eternally out of date.” – C.S. Lewis