Vol 36: This new horizon

Well known for its beautiful beaches and world-class museums, Niteroi is a city in the southeast region of Brazil, facing Rio de Janeiro and just across from Guanabara Bay. It is also the birthplace of one of my patients, who like so many others, has had to overcome more than her fair share of challenges. With panoramic stunning sunrises in a kaleidoscope of colors, this was the setting into which my patient, hereafter referred to as Eliza, was born in 1935 and this is her story.


Eliza’s father was of German descent but moved to Brazil after the First World War. He eventually settled into the community and even in childhood, her father understood the importance of hard work. He and his wife had two daughters, Eliza being the youngest, and he taught them to respect their mother, to be honest and to appreciate the value of a dollar. But when Eliza was just two years old, her father died unexpectedly from pancreatic cancer.

Alone and afraid, her mother had to raise two children by herself during one of the most difficult times of her life. His absence left a gaping hole in all of their lives but they began to adjust and as things began to feel normal again, the unimaginable happened. Eliza’s mother became sick and died from an untreated blood infection. Eliza was six years old and the Second World War had just begun.

Now orphans, Eliza and her sister remained in Brazil but were sent to live with her maternal grandmother and uncle. Young, and fragile from the loss of both her parents, Eliza felt the palpable hatred that her uncle had for both her and her sister. Horribly mean to both girls and short-tempered, he never explained why he felt the way he did and Eliza now says she can only assume its etiology stemmed from an underlying resentment towards their deceased mother.

Her sister isolated herself and the two of them slowly drifted apart. Eliza missed her parents and for years felt safe and loved by only one person in the world, her grandmother. That was until she met the man she would eventually marry.

Eliza’s husband, who was in the army at that time, was of Scottish descent and he pursued her romantically for years. They were deeply in love and married at the age of 25 but her mother-in-law had already arranged for her son to marry the daughter of her close friend and she blamed Eliza for ruining that opportunity. Since then, Eliza referred to her mother-in-law as a wicked witch who put a curse on her and she’s blamed her for every medical illness that she’s had to endure since then.

Before she got married, she had lunch with her future in-laws and the next day noticed that the skin all over her face and body had turned a faint yellow. She went to the doctor, and routine blood work revealed that she had liver inflammation secondary to Hepatitis A, which is highly contagious and transmitted by consuming contaminated food or water. Fortunately, her symptoms resolved without any medical intervention and without any long-term liver damage.

Her suspicions of voodoo were further magnified when, not long after her wedding, she began to experience an intense and unrelenting pain in her right lower abdomen. She was diagnosed with kidney stones that had blocked her urethra ducts and she had to undergo surgery to save her life. Her kidney stones were removed and, despite that, she had recurrent stones within four months of her surgery that was as painful and debilitating as her first occurrence. A second surgery was performed to alleviate her symptoms. Unfortunately, this led to a significant decrease in her kidney function.

By 1988, Brazil had become a hotbed of criminal activity. Organized crime was at its peak and drug trafficking, violence and corruption were rampant throughout the country. When the daughter of one of her husband’s coworkers was kidnapped and held for ransom, Eliza and her husband made the decision to relocate to Canada for their safety.

She left behind the only home she’d ever known, the only horizon that had been a steadying place of peace and a palliative against the pain. But, Eliza worked assiduously to make Canada a comfortable home for their family. Things were hard but as the years passed, Canada began to feel like home and she’s now lived there for 30 years. During that time, the family grew to include two daughters and one son. For a long time, they were truly happy.

In 1997, her sister became very ill and died from liver failure. During that time, Eliza noticed tingling around her mouth so she went to the doctor and was diagnosed with Diabetes. She remembers the hollowness of mourning her sister while also confronting yet another medical diagnoses. As always, her husband was by her side boundlessly offering his love and support.

Suffering from heart issues himself, Eliza’s husband was deeply empathetic to her health problems and, not long after moving to Canada, he underwent a quadruple bypass procedure to relieve the blockages in all four of the arteries that fed into his heart. But it wasn’t until years later when he was diagnosed with Acute Myeloid Leukemia (AML), a form of blood cancer, that his health took a dramatic turn for the worse.

The cancer was aggressive and quickly spread throughout his entire body. No organ was left unscathed. He lost weight, experienced nosebleeds, shortness of breath and he was at all times so tired that he could barely stand. Even if he could, the pain coursing throughout his body was so severe that it destroyed any inclination to ambulate. He died within six months of his diagnosis.

While in her garage and going through many of the items that they’d accumulated during the course of their marriage, Eliza lost her balance, fell and smashed her head against the concrete flooring. The resultant gash in her head was so deep that she required multiple stitches. At the hospital she began to cry as she realized that for the first time in 53 years, her husband wasn’t there to hold her hand during a health crisis.

Losing her sister and then her husband was life-altering. Eliza no longer has anyone alive to reminisce with about her childhood. No one who remembers that panoramic view of her birthplace or the agony of being orphaned so young. The sense of aging and loss felt worse in the cold winter months and after 30 years, the Canadian horizon began to lose its sparkle.

The emotions coupled with another knee surgery that left her less able to move around freely propelled Eliza, now in her late 80s, to seek yet another horizon. She now spends several months a year in the sun-filled Bahamas.


Over the years, what’s she learned is that she has an inner strength that gives her the ability to survive even the worst of circumstances. Now while in The Bahamas, every day, with her entire memory still intact and in a ritual of self-reflection, she looks out of her glass door, gazing into yet another skyline. The red, orange sun as it sweeps across the turquoise ocean and the long stretch of pristine sand as the waves slowly roll into shore, has given her a calmness she never knew she lost.

As she traverses through 87 years of memories, Eliza remains unapologetically proud of every decision that she’s made, always still hopelessly missing her grandmother, parents, husband and sister and grateful to be surrounded by the children who love her unconditionally.

And in this, the final chapter of her life, this new Bahamian horizon reminds her a lot of her childhood running along the pebble streets of Niteroi, smiling and waving at all her neighbors and happily enjoying dinner with her family.

This is the KDK report.

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Vol 37: The North Star

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Vol 35: A wrinkle or two