I would like to dedicate this post to the women of Northern Ghana, who are some of the toughest ladies I know. They smile at you every morning and tell you they feel "deswah" or better, even though they have a massive wound for which they have received receive nothing more than an over-the-counter dose of Motrin for pain relief. They balance literally everything, from piles of mangoes to bags of concrete on their heads. They are pretty top rate birthing champions, as well. Midwives have been known to slap a tired mother in the birthing chair while yelling at her to "Push like a woman!" 

One woman in particular just blows me away. She was a new mom who was finally brought in to the clinic by her husband after sitting at home with rapidly worsening mastitis for 2 weeks. I kid you not, when she walked in I thought she was swaddling her baby under her clothes. She wasn't. 

Dr. Cohen immediately admitted her and we incised and drained about a pint of pus from the abscess that night, without any anesthetic. I don't know if anyone reading this has ever had an abscess drained, but in my experience with previous patients it usually brings them to tears and causes at least one family member to pass out. the most this woman said to indicate her pain was, "woah woah waoh!" All while her husband was yelling at her for expressing her pain so verbally. It's good for the both of us I that I couldn't understand what he was saying. This poor woman must be in so much pain. 

We had to cut out dead skin and breast tissue later (using ketamine for anesthesia this time), leaving an open wound about the size of half her breast to heal on its own. Due to shortages of many medicines here, the heaviest pain killer is meperidine, and it is reserved for surgery patients. Everyone else gets a cocktail of Tylenol and Ibuprofen. Yet every time I pass by her she is smiling, nursing her baby on her one remaining breast, and chatting happily with the women in the neighboring beds. She doesn't despair over her mangled breast, nor does she complain of the smell or the intense pain. She is happy, she is downright giggly, even! I wish so much that I could understand her. I'm 95% certain she knows the secret to happiness. She is incredibly strong, and no one will ever really understand or appreciate how much.