I picked her out because she looked like a child. Propped up in the bed, hospital gown slipping off her shoulders, the oxygen mask smothering her face, I thought she couldn’t be more than fifteen-years-old. I flipped through the paper chart and my American brain struggled to comprehend what I was reading. She was actually thirty-two – an HIV-positive South African woman who was also epileptic and dying from progressive multifocal leukoencephalopathy, a disease that eats away the white matter of the brain, caused by a virus typically only active in the profoundly immunocompromised. 

I was a twenty-four-year-old pharmacy student who had never actually touched a person wasting from AIDS. I didn’t know then how much this woman would come to mean to me. I just responded to her tiny shape, hair in braids, eyes never lucid. I followed her case like a religious pilgrimage. Watched her develop pneumonia and diarrhea and hover at that doorway of death.

Her name was Thembela. I know there’s such a thing as HIPAA, but Thembela is just a number in the masses of South Africans with HIV and she deserves to have a name.

I tried to make recommendations for her care. I would wipe out her thrush-ridden mouth with a cold, wet cloth and smear Vaseline on her cracked lips. Rub my thumb against her shoulder. Talk to her while she cried, her tears for nothing or no one in particular. She never spoke back to me. I’m not sure she ever saw me. Her dying mind was far away, hopefully dreaming of happier days – sunshine and friendship and African penguins on the beaches not far from this hospital ward.

One day I held her against me while a nurse changed her gown and scrubbed cream into the pressure ulcers. Her legs were the width of my arms, and herarms were as thin as my wrists. I gripped her hand, trying to imagine her life. Did she have a husband or children at home? Was she born here in this shanty town? Had there ever been a day outside of it?

As human beings, often our initial response to such suffering is anger. Why? How could it happen? Why does God let it happen? Which leads us to the age-old question – why doesn’t God do something about it? If He’s that great and good, why doesn’t He fix it? 

But how is it that we so easily forget that we have hands? How do we fail to realize that we have arms to cradle, knees to bend, words to whisper? The reality that we should be doing something about injustice and pain eludes us. True and pure religion in the sight of God our Father is this – to care for widows and orphans in their distress.

True, the weight of sorrow and injustice cannot rest on your shoulders alone any more than it can rest on mine. But we have a beautiful role to play. Jesus didn’t leave the impoverished and broken with nothing. He leaves His promises and His Spirit, yes. But He also leaves behind me and you. Eyes to see, minds to understand, hearts to care until He comes back to fix it completely.

Thembela grew worse but held out as tenaciously as an arum lily in the cleft of a rock. In the hospital beds around her, other women died. They were taken away. But Thembela clung to life week after week, even as seizures claimed any cognition she had left. Helpless, I stood by. I asked the medical team to stop crushing extended-release valproic acid for her feeding tube, but at the root of all things, I did nothing. I just waited with her.

But maybe that’s what Thembela needed. Someone to wait with her, to hold her hand. To whisper in her ear – I see you. I care. Even if she knew no other words than her native Xhosa, maybe still she understood the meaning woven in the sound of my voice. I see you. I’m right here.

Don’t get the wrong idea. I was no Mother Theresa for the days spent in that hospital. Far more often than helpful, I was paralyzed. Overwhelmed. Nervous. I lacked confidence. I watched when I should have spoken up. But I try to focus on the reality that we have to start somewhere. Power is only perfected in weakness.

We cannot stop all evil and pain any more than we can stand on the shoreline and hold back a wave. But there are other ways we are meant to live. To give our money and time freely, to love patiently, pray unceasingly. Maybe just to be present. To give a care that the child living in the apartment complex across the road needs a coat while he waits for the bus.

On my last day at the hospital in South Africa, I walked up to the floor, and like usual, searched for Thembela’s chart. Not finding it, I went to her bed to find another woman staring back at me. Another face, another HIV case, another one, but not Thembela. 

I asked a nurse and learned that Thembela had been taken to a hospice facility, the place where she would die, surrounded by other dying people. Tuberculosis and encephalitis and malnutrition – different diseases but the same fundamental horror. I went to the window, tears burning my eyes, aching to realize that she was out of my hands. I was going back to my home, thousands of miles away, but she would remain here. Maybe alone, for whatever hours, days, or weeks she had still stored up inside of her. 

To this day, I still think about Thembela and several of the other women I had the rare privilege of being with. I still see their faces in my mind and wish I could have changed things for them. Somehow loved them better. 

That letting go was the hardest part of all. We can try to care. We can be the hands and still feel like our efforts are futile. But still we love and cradle and protect because that’s the task we were given to do. A physical, tangible outreach of God’s love. An interim solution in an eternal plan. So whether we live in Pittsburgh or West Virginia or Cape Town, this side of the ocean or the other, that’s the gift we’ve been given.

In Xhosa, the name Thembela means “hope for.” I didn’t even realize that until preparing to post this. It makes me smile.