When He Has Gone...

Anton Pigome, a Papuan man from Obano village. He had a wife with 2 daughters and 1 sons. They lived in the same area with me and my boss. He worked as a cleaning service in Puskesmas Obano for 20 years. But Anton did more than just cleaning, he helped me to wrap the powder (pulveres) for kids, he planted many trees and vegetables in the garden. He was my translator, my neighbor, my friend. He was just like a family to me. He treated Grace, Victor and I warmly.

On the first day of our arrival in Obano, Anton served us some baked sweet potatoes. It was so nice. He also helped us to fix some parts of the house and made a small bridge on the back of our house. He fixed the water tank on our house. He put many small stones on our yard so we could step on those stones.

He used to accompany me if I had home visit to my patients houses. I remembered when we had a home visit to Beko village in the afternoon, together with the students from Nursing Academy in Enarotali City. It rained so hard when we were about to come back home, so the soil became very muddy. I had to take my sandals off because my sandals were stuck in the mud, so I chose to walk bare feet. I can’t keep my balance and almost felt into the mud, so I screamed, “Anton help… I almost fall into the mud !"   Then he grab my right hand quickly and said, “Don’t worry doctor, you’re gonna be okay”. After that he led the way and I kept holding his hand until I found the hard soil. By the way, he always carry my “magic doctor box” every time we have home visit. Hehehehe…  In the picture you can see me, Anton was holding my magic doctor box & an umbrella, and many nursing students around us.

He used to carry the heavy cool box with vaccines and many ice inside, when we had Immunization program. We sang “Aku Papua” a long the way to Tipakotu village. Sometimes we ate boiled peanuts that we bought in the traditional market before we start our Immunization program. Like always, my mouth have to chew something. Hihihihihi…  Here you can see a video when we were going to have an immunization program. We were so happy at that moment. I took a short video from our house to the main road. First, it was Grace who hold the camera and then we switched. 

Anton always dream to be a state employee (Pegawai Negeri Sipil). After 20 years working in Puskesmas Obano, he really deserved to be a state employee. He tried so many times to apply as state employee but never received. One day, he told me that he was accepted as a state employee. He was so happy after waiting for 20 years. Before he officially worked as a state employee, he had to join the orientation program. So he went to Enarotali City to join the orientation. He and everybody in the orientation program have to do many exercises every day under the sunlight. After few days of the orientation program, his right foot became swollen so he stopped the program and went to Obano. I didn’t know about that because I was busy serving the mobile clinic in Kebo District.

 A few weeks later, Julianus my nurse said that Anton got sick. Julianus told me that Anton got fever and ache on his feet so I went to Anton’s house to examine him. I saw his right foot was wrapped with a black plastic grocery bag. As I opened the plastic, I smell the odor from his foot. I checked his right foot carefully and I found his foot swollen with 2 big wounds. Then I asked him, “I thought your right foot just swollen. How come you have 2 big wounds now?”  Then he answered, “I made 2 superficial cut on my foot in order to remove the water but then the wounds become bigger day by day so I wrap it with black plastic grocery bag.”   I said, “Who teach you to do that?”  and then  Anton said, “Everybody in the village do this if their feet get swollen”.

The wounds were big enough, about one palm of my hand on his instep and about two palms of my hand on his calf. The wounds looked really terrible because I saw many suppuration on his wounds and very smelly too. I told Anton that he had to go to the hospital to have wound treatment and I guessed he needed to have skin graft too, but the stubborn Anton refused my advice to go to the hospital. He said he didn’t want to leave his wife and children. He begged me to treat his wounds. He said, “Im sure you can heal my wounds doctor. Please help me, I don’t want to leave my family alone. My wife works hard gardening everyday and I feel helpless.”  I answered, “Okay, I will treat your wounds but you have to obey my orders”.  I clean his wounds that afternoon in his small room with only one door without any window and had a fire stove inside. The light can only entered the room from the door, so I asked him to sit near the door. I started to debridement his pus from his wounds,  mean while he said, “Im sorry if my wounds are too stink”. I told him that it was okay. It wasn’t my first time to smell stink wound. I knew it must hurt so much when  I debridement  his wounds but he bared his ache.

I washed his wounds with NaCl infusion then I put metronidazole powder on his wounds and wrapped the wounds with hydrophilic bandage. Of course it was non sterile hydrophilic bandage because we didn’t have autoclave machine. I gave him some oral medicines. I also give him 3 boiled eggs everyday. He really needed enough nutrition for his healing process.

I kept treating his wounds once a day, every afternoon. Everyday I always cut the long hydrophilic bandage and make it smaller for his wounds treatment. Every time I go to Enarotali city, I always buy dozens of eggs for Anton. One day I came to his house in the morning to give him the boiled eggs and then he gave me a baked sweet potato. He said, “Doctor take this baked sweet potato, I know you like it so much”. I looked at his food and he only had two baked sweet potatoes (he gave one for me), so I asked him, “Why do you give it to me if you only have two baked sweet potatoes? You need it more than me. I can buy it in the market.”  Then he replied, “I give you not because I have many but because I know how it feels to have nothing”.  Wow… he made me speechless as I walked to my home. I think I can’t do that. Often poor people are more generous than rich. And please trust me, you will never know how it feels to live in poverty until you've dealt with it. You will learn to appreciate life when you've realized it.

I really treat his wounds carefully everyday because I want him to get better soon. After one and a half month, I saw his wounds were getting much better. I was quite  happy to see that. I told to Anton that I was going to have a Christmas and New Year holiday in Jakarta. I wanted him to treat his own wounds because I know he can do it. I had prepared everything for him from the hydrophilic bandages, NaCl infusions, metronidazole powder, scissors, to oral medicines. He told me that he will be okay and he said, “Doctor could I ask for a Christmas present?” I said, “Sure, what do you want?”  He said, “I want a wristwatch. Just buy me a cheap one. I need a wristwatch.”  I answered, “Okay I will buy it for you but you have to promise me that you’re gonna be fine”.

Then I went to my home in Jakarta for Christmas and New Year holiday about 1 month. There was something unpleasant happened to me in Jakarta. I’ve got a cordis fracture (that’s Sinthya terminology for broken heart). I was not ready for that of course.

I came back to Papua with my sadness. I thought everything would be okay if I stay in Papua. I had many patients who wait for me so I had to be okay. As soon as I reached Obano, I went to see Anton to give him the wristwatch.  I was surprised to see him so thin, very thin and he was so weak and pale. He got so thin in a month so I bet there must be something wrong with him. Anton was sitting near the door, next to his friend. They both were bare chest. As the sunlight came to his house, I noticed that Anton look yellowish. I asked him, “What is the color of your pee?”  He answered, “It looks like tea”.  I asked him to lay down on the floor. I checked both of his sclera and they looked yellowish too, so I decided to palpate his liver. I found enlargement of his liver. His stomach looked a bit swollen. I asked Anton to seat in front of the door so that the sun could refract the light on his dark skin, because it wasn’t easy to notice yellowish on a very dark skin. Yes he looked yellowish. I was so sure he got jaundice, it wasn’t hyper carotenodermia. I said to Anton, “You have to go to the hospital” and then he said, “No, I don’t want to go to the hospital. Just give some medicine then I will be fine”.

He was so happy to receive the Christmas present. He said, “Thank you very much. By the way I dreamed about you when you were in Jakarta. In my dream I saw a truck full of medicine come to Obano just for you (*FYI, there were not too many trucks came to Obano, so if there was a truck in Obano, people would come to see it. It was like an entertainment for them). The driver said that all the medicines in the truck was addressed to me, but then doctor Sinthya said, “I still have enough medicine. Give the medicine to another village.”  Anton said, “How come you reject the medicine? Just take it!!! We will need it someday.”  Doctor Sinthya said, “The small branch of public health service need it more than us”.  Then the truck full of medicine went to another village. It was Anton’s dream about me. After he finished telling me about his dream then he said, “Bless you”.

Three days later, in the afternoon I came to his house to give him boiled eggs as usual. I saw his condition became weaker. I said to Anton, “You have to go to the hospital”. Anton answered, “I don’t have any money”.  I said, “I will take care about that”.  Anton replied, “I will discuss about it to my wife first”.  Finally Anton agreed to go to the hospital tomorrow morning. Grace, Berton (Grace close friend) and I collected our money to bring Anton to the hospital in the city. There was no help from our boss. He wasn’t in Obano at that moment. He was out of nowhere.

It was on Friday, January 28, 2011. We woke up early in the morning at 5 AM, we had a breakfast first and then we went to the harbor. Someone carried Anton to the harbor because he was too weak to walk. At 6 AM we went to Enarotali City by open motor boat. There were Grace, Berton, Anton, his wife, Nolin his little daughter Julianus my male nurse, and I. On the boat, we were splashed many times by the water. My clothes got wet and even my panty got wet. It was early in the morning, there should be no waves. The lake should be calm. I guessed it was because the wind was blowing pretty hard.  In the picture you can see little Nolin on the boat.

At 7 AM we reached Enarotali harbor. There were no taxi on the harbor so we took an ojek (some kind a taxi but we change the car into motor bike) to Kompas. From there we took a taxi to the one and only hospital in Paniai Regency. By the way, all the taxi in Paniai were public taxi so everyone was welcome to join the ride if there was still empty seat in the taxi. Around 07.30 AM, we reached the hospital. There was a long queue in front of the internist practice, so we had to wait until the nurse called us. After more than one hour, the nurse called us and we met the internist. I introduced myself to the internist and began to tell the history of Anton’s disease, but suddenly the internist interrupted me. The internist said to Anton, “What do you feel now?”  Anton answered, “I feel weak. I’ve stomachache, nausea, vomiting, shortness of breath and pain in my right foot”.  After the internist put his stethoscope on Anton for only less than 1 minute, he asked Anton to check uric acid. That was it, just uric acid!!!  He didn’t check Anton’s routine blood test and liver function.  Then Anton said, “Doctor I have cough” and the internist asked Anton to have thorax x-ray. The internist wrote Anton’s diagnose on the paper: “Acute Gastritis”.  Honestly, I was very disappointed with the internist. Didn’t he notice that Anton look so pale??? The internist didn’t look at Anton’s conjunctiva and didn’t check Anton’s routine blood test either. If the internist was Anton, would he want to be treated like that?

We went to the radiology department for Anton’s thorax x-ray and then we brought the result to the internist. From the thorax x-ray, the internist saw that the right lung of Anton was pressured by Anton’s liver, so the internist decided to “see” Anton’s liver by Ultrasonography (USG). The internist was surprised to see two masses inside Anton’s liver (I forgot the size of those masses). The internist suspect that Anton got hepatoma (liver cancer), but to make sure his diagnose, Anton must had a biopsy. The hospital in Paniai regency didn’t have a clinical pathology laboratory. Anton only got some medicines from the hospital: Antacid, ranitidine, ambroxol and vitamin B complex. He was not hospitalized.

Grace, Berton and I brought Anton, his wife and little Nolin to Anton’s relative house in Enarotali. The house was on the top of the hill and it seemed that Anton got too tired to climb the hill. He stopped few times. I took his picture while he was resting and sitting on a rock.

Grace and I decided to stay in Enarotali on the weekend. We had to buy our daily needs. We planned to come back to Obano on Monday. Too bad we didn’t get any boat to Obano on Monday, so we went to Obano on Tuesday.

It was on Tuesday, February 1, 2011. We just arrived in our house, but Julianus called us directly. He said, “Doctor you have to see Anton. He is dying”.  We went straight to Anton’s house. I talked to him but he gave me no response. His breath was deep and gasping, like Kussmaul breathing. Julianus said that Anton had a vomiting of blood since yesterday.  There was nothing we can do, so we went to the catholic priest to ask Sacrament of the Sick for Anton.  When the priest arrived in Anton’s house, Anton has gone. He has gone forever. Julianus said, “Anton only want to see me and Grace before he passed away”.  

I was so sad and my tears kept running down my face. Why did he have to go soon?  I was the one who supposed to say goodbye to him because my contract in Papua will be finished in 2 months. My head was so full with so many thoughts at that moment. I was the one who visited his home, cooked boiled eggs and treated his bad wounds for one and a half months. I was failed as a doctor. I started to regrets many things. Maybe I shouldn’t take the Christmas holiday to Jakarta. If I stayed in Obano, Anton wouldn’t be so weak and I wouldn’t have a broken heart too, but I could never turn back the time. Things were happened so fast and I can’t control them. Maybe my will was not God’s will.

I can’t sleep well at that night. I was very sad. I kept crying although I’ve asked my brain to stop me from crying but it didn’t work. I decided to send an email to someone. He was the only one who crossed my mind at that time. At least I’ve “talked” to someone.

Anton was buried early in the morning. I’ve missed his burial because I fell asleep too late. When Grace and I went to Anton’s house it was empty. People said Anton was buried near his uncle’s house, so went there directly. In the picture you can see the view from Anton's grave.

After Anton had passed away, me and Grace went to Enarotali city. Grace was going to go to Makassar her home town, so I stayed in Enarotali city. At that moment, there were only me and Hasyrul in the pink house in Enarotali for a week. My friend Dias had moved to Madi, while Melissa was in Wagethe Regency. Victor and Noer were in Palembang. There were many robberies in Enarotali city. Our friends had lost their laptop, mobile phones, clothes, etc. Since there were only me and Hasyrul in the pink house, I had to be more alert because Hasyrul used to sleep tight like a baby in his room (across my room). I chose to sleep with a knife under my pillow and a metal stick next to my pillow. I used to check whether the doors were locked or not for many times. I guessed I have Obsessive-Compulsive Disorder (OCD).  Maybe I was too punctual, too perfect, too careful and too alert. Hell yeah, that’s me!!! I kept doing that things until my friend Victor arrived in Enarotali city.

When Victor had arrived in Enarotali, we both decided to come back to Obano.  Days were getting harder in Obano because that place remind me of Anton. It was so quiet after the death of Anton. My boss still out of nowhere, Anton’s wife and children lived in another village for a while and Julianus family also moved to another village. So every day after we finish our work, we cook and clean the house, then we go to the kiosk (small store) to have a chit chat. Sometimes we watched television in our neighbor's house because they had a generator. In the afternoon we went for fishing on the lake. There were many things we did in the day, but at night, there was not many thing I can do. Victor listened to music in his room while I was alone in my room. I just laid in my sleeping bag and I let my curtain open but my window closed so I can see the stars in Obano sky at night. There was no electric and I only lighted one candle every night. Even when the candle has gone, I still can’t sleep. I really felt like I was alone, although I was surrounded by some friends in Papua. I really need a distraction to switch my sadness off.  So I listened to a song from my mobile phone. A beautiful song “Return To Innocence” by Enigma. For me this song was the perfect soundtrack of my life at that moment.  It was just me, the stars, the song and my tear drops. No one knows about this. I tried not to cry in front of my friends. I put my fake smile in front of them.  I didn’t want to look weak in front of my friends. I tried to be cheerful like I used to. People just don’t notice that sometimes behind a cheerful person is hidden a deepest grief.

This song were able to bring me fly so high in my imagination, and drown so deep in my emotion. I really understand the meaning of this song when I was sad. I thought I must cry to try to return to myself. I began to brood and cry. It seemed that crying was my favorite activity at night. Every night I hear this song and looking at the stars as if the stars were the only light that I had.  You can listen to the song in here. 

 

I can’t sleep early at night. Sometimes I sat in front of the candle and started to write down my feelings on a piece of paper then I burned it in the morning and wishing all my feelings would go together with the paper.  I really tried to distract my mind from sadness. Sometimes I talked to my maker and I guess it wasn’t a prayer because I kept complaining about my sadness. I said to Him, "I haven't heal from my broken heart. How come You give me another pain?"  Sometimes I browsed on the internet by my mobile and I found this interesting topic. It was 10 Life Lessons from Buddha. I’m not a Buddhist but I like Buddha’s philosophy.  

10 Must Read Life Lessons from Buddha:

1. It’s Okay to Start Small

“A jug fills drop by drop.”

2. Thoughts Become Things

“All that we are is the result of what we have thought. If a man speaks or acts with an evil thought, pain follows him. If a man speaks or acts with a pure thought, happiness follows him, like a shadow that never leaves him.”

3. Forgive

“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.”

4. It’s Your Actions That Count

“However many holy words you read, however many you speak, what good will they do you if you do not act on upon them?”

5. Seek to Understand

“In a controversy the instant we feel anger we have already ceased striving for the truth, and have begun striving for ourselves.”

6. Conquer Yourself

“It is better to conquer yourself than to win a thousand battles. Then the victory is yours. It cannot be taken from you, not by angels or by demons, heaven or hell.”

7. Live in Peace

“Peace comes from within. Do not seek it without.”

8. Be Thankful

“Let us rise up and be thankful, for if we didn’t learn a lot today, at least we learned a little, and if we didn’t learn a little, at least we didn’t get sick, and if we got sick, at least we didn’t die; so, let us all be thankful.”

9. Be True to What You Know

“The only real failure in life is not to be true to the best one knows.”

10. Travel Well

“It is better to travel well than to arrive.”
 

These life lessons has been affecting my mind. I always try to do those things in my life. With my profession, I’ve seen sick people died and new babies born. I know that life is too short but I never knew the true meaning until Anton passed away.  Sometimes it takes a painful experience to make us change our way (Proverbs 20: 30). 

I learn to let go things that I can’t let go. I try to forgive although it hurts. I try to accept things that I don’t want to happen because he has opened my mind. He wasn’t Abraham Lincoln nor Soekarno (the first president of Indonesia). He was just Anton Pigome a modest man from Obano. He was my good friend, my staff, my neighbor, just like my family. He changed my life. Now I really believe in the power of prayer, in the power of dream, in the power of song, in the power of positive thinking. I love my life now although I have many problems. I travel often with my travel buddy Timothy.

It really takes a lot of courage for me to write this story. It’s like reading an old book. Usually that old book smell brings back so many memories (actually, the smell is caused by the humidity, a variety of different papers, inks, glues and fibers used to bind the book together). This was the saddest part of my experience in Papua.

Before I finished my contract in Papua. I went to visit Anton’s grave to say goodbye. By the way Anton’s grave was far from the main road. I had to walk through a small path in the forest and crossed the river. He was buried far away from the road maybe because of his disease. It seems that people were afraid to get infected by Anton. His grave didn’t have a gravestone so Victor decided to plant the bougainvillea tree as a hint for Anton’s grave. You can see it in the picture.

Here is a video from Obano. You will see my friend Victor and Manfred (Anton’s little brother). You can’t see me because I hold the camera. You can hear my breath sometimes. I know I didn’t talk so much in this video because I wasn’t in the mood to talk. I only talked when the woman helped me to cross the river with torrential stream. Everybody in Obano was so nice to me. I took the video from Anton’s grave to the main road in Obano. The video stopped before we reach the main road, because I pressed the wrong button. Hehehehe..  It still took about 5 minutes to reach the main road after the video stop.  

 

 Some people have gone from my life but not from my mind.