Requiem

I've been thinking a lot about her lately, and wanting to write about her, but keep shying away from it out of fear of not doing her justice.

She was born in Guinea-Bissao, from a middle-class family, worked as a government clerk and was happily married. Then she got pregnant, and then everything went wrong: eclampsia, renal failure, a plane to Lisbon to get dialysis. Then here she was, alive but alone in a foreign country, with no support whatsoever from Guinea's embassy, as so many other renal patients. That's when I met her, as another recently arrived patient from Guinea.

I instantly took to this very fat and beautiful young woman, with the most happy smile and friendly demeanour I have ever seen. She was the kind of person that is born to be happy, always optimistic and with an indefatigable love for life, even when things went terribly wrong. And wrong they went, time after time. She lost her relatively comfortable life in Guinea, her husband soon found another woman. With no money, she had to support herself with cleaning work. A renal transplant failed, vascular accesses failed, the bone complications of secondary hyperparathyroidism crippled her and gave her constant pain and a hip fracture, she suffered from several blood stream infections from her catheters, she got hepatitis C.

A second transplant worked for a few years, but rejection followed, and she was back on dialysis. Meanwhile, she kept struggling with poverty - I remember being appalled when I knew her landlord had removed the doors and windows of her flat in winter because she was late with her rent.

But through it all, she almost always managed to keep her good spirits, her sunny disposition. She used to ask me about my children, and then always said: "Take care of me, I'm your oldest child! I'm counting on you!" "You'll never get rid of me, mark my words!" And her hearty laugh always warmed my heart, and I'd tell her: "Yes, you're just as foolish as my kids!"

And thus many years went by, I was her doctor for 22 years. It was always a pleasure to meet her, her smiling black face, her colourful outfits and afro wigs so typical of an attractive West African woman. We shared jokes about her weight, I would tell her how worried I'd be if she ever get thin.

And now she is dead, as so many of my patients. Another of the many complications she suffered from, only this time she didn't make it. And I'm so sad. Because it really felt like she was my oldest daughter. She was born to be happy, but fate dealt her a really gloomy hand. And I'm SO sad. Could I have helped her more? I feel so useless sometimes. She deserved such a different life.