In a box she waits,
Neither dead nor alive,
Until observed.
In three months,
The box opens.
Tested, probed, scanned,
She learns the cancer has recurred,
In which case she is dead.
Or it has not returned,
In which case she is--not alive.
Boxed in once more,
Neither dead nor alive,
She again awaits the allotted period
Until the box is opened,
A quantum superposition which only death
Can collapse into a state of certainty.

"So how was your trip?" ask well-meaning friends and coworkers when I return from a medical mission to Engeye Health Clinic, in rural Uganda. Even years after my first trip there, trying to find the perfect words to describe it is a challenge.

I have been involved with Engeye since its founding, more than a decade ago. As the administrative coordinator with Albany Medical College's department of family and community medicine, I helped a second-year medical student, Stephanie Van Dyke, and a faculty member, Dr. Bob Paeglow, put together a medical-mission trip to the small Ugandan village of Ddegeya. The clinic was to be managed by a visionary accountant named John Kalule (born in Ddegeya) and staffed by visiting US physicians. My role was to recruit the medical teams and handle all of the trip's logistics.

 

I was a brand-new intern on the intensive-care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack.

Cassandra was in her twenties, like me--but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all wrong.

She had lupus, an autoimmune disease that unleashes the raw power of the immune system against the patient's organs and joints. Fortunately, my attending rheumatologist, Dr. Schmidt, was an expert in lupus and its intricacies. Although small in stature, he cast a large shadow in the field; physicians from near and far referred their most challenging cases for his consultation. He radiated confidence, and, like my teammates, I admired his clinical acumen.