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20 years ago, when Wilson was about 40, he was involved in a bad car accident (not that there are any good ones) that partially destroyed the left side of his pelvis, driving the top of his femur into and displacing the hip socket up and inward. This rendered his hip structure completely unstable and largely unusable. He came to Las Obras in February 2020, a couple weeks before COVID shut everything down, where he was seen by Dr. Parsley in triage. Dr. Parsley carefully crafted a plan to reconstruct and stabilize Wilson’s pelvis so that at some point in the future, Wilson could receive a new hip. The surgery went very well, so the plan was to give his renovated pelvis and hip socket time to heal and grow strong. Unfortunately, Brian and FIP lost track of Wilson.

2020, 2021, and 2022 passed by with no word from or about Wilson. Dr. Parsley wasn’t even sure that Wilson had survived the post-operative healing process. But on Sunday during triage, to Dr. Parsley’s great surprise, Wilson “resurfaced” at the triage clinic in excellent health, ready to receive his new left hip, which Dr. Parsley “installed” on Wednesday afternoon.

On Thursday morning, when we began our daily rounds, we found Wilson in the ward with the other gentlemen, grinning from ear to ear. After breakfast, he got up and walked for the first time on his newly constructed pelvis and hip and returned home on Friday morning.


19-year-old Elder came to the triage clinic on Sunday with an enormous osteosarcoma that had engulfed his left knee. The tumor began to appear some 18 months ago, so a few months later, while the growth was still small, he went to a clinic sponsored by an NGO (unknown to me) to have it looked at. Unfortunately, he was puzzlingly told he didn’t need treatment. When Dr. Conrad saw him, he knew with near certainty that it was malignant, so he put him on the surgery schedule for Thursday morning.

On Tuesday, Elder came to the hospital with his sister and the Faith In Practice volunteer to get a chest x-ray, an x-ray of his knee, and some blood work. Chappie saw him, reviewed the chest and knee x-rays, and confirmed that his surgery would be the first on Thursday.

On Thursday morning, we found Elder lying on a gurney in pre-op when we arrived at the hospital. Chappie, Kathy, and I spoke with him about the likelihood of amputating part of his leg because the tumor was most likely malignant. He was understandably distraught at hearing the news and asked to see his sister to discuss the situation. I was called away for a few minutes, and when I returned, Elder had decided that he did not want the amputation, at least not yet. While medically, that was a “disappointing” decision because of the likely risk to his life; it was certainly easy to understand. What a crushingly weighty decision for a 19-year-old to have to make, but that’s the sort of reality that people in developing nations must make every day in the absence of sound and consistently accessible healthcare.


30 minutes later, Elder was wheeled into the OR for a biopsy, which Chappie performed without event. Chappie said that the tissue was malignant but would have to go to pathology for confirmation which would take roughly two weeks. The big unknown is whether Elder will agree to a near-whole-leg amputation when he learns that the tumor is, in fact, malignant. Assuming he does agree to the amputation, is it already too late? Only our Lord knows the outcome for Elder. Please keep him in your prayers as he navigates a very uncertain, complex, and likely painful future.

Follow-up on Evelyn

Returning to 13-year-old Evelyn’s story from our Monday blog, I learned yesterday (Thursday) from Dinora, Evelyn’s FIP in-country coordinator/director, that she had been admitted to the children’s hospital in Guatemala City to begin receiving her badly needed chemotherapy. If all goes well, she’ll receive three months of therapy to retard the spread of the disease in preparation for surgery to either amputate her lower left leg or receive a new knee. Please keep her and her family in your prayers; no matter how the therapy goes, she’s in for a very rough “road” in the coming months and (hopefully) years.

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