My worst fears for little Estephanie were realized.


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Claudilene walked behind me, carrying nine-month-old Estephanie, her mind intent on every step. With each step, we made our way closer to the clinic, where the final diagnosis of Estephanie's condition awaited us. Our apprehension about the results went unspoken as we walked. The doctor's diagnosis was inevitable. We both seemed prepared for the worst.


Besides the nystagmus (involuntary oscillation of the eyeballs), Estephanie had obvious developmental problems, which, at nine months were apparent to all who knew her. Because she lived in the interior town of Labrea in the Amazon, diagnostic tests were inaccessible. After months of waiting to see a doctor, Claudilene brought Estephanie to me, pleading with me to help her discover her daughter's problem. Anxious to help her, I called for a small Helio floatplane to take Claudilene and Estephanie to Porto Velho, the closest city with medical attention.


Within two days of her arrival, we were able to see a neurologist. After ordering many neurological exams, the doctor sent us on our way with a grim prospect for her diagnosis. For the next few days, we waited anxiously to hear from him. Finally, he called us to come to his office to receive the test results.


And so we made our way together toward the doctor's clinic. As I opened the door to the clinic, I gave Claudilene a smile of hope. I wanted her to know that in the midst of the unknown, we could still keep perspective if hope for Estephanie was our focus.


Within minutes of our arrival, my worst fears for Estephanie were realized. The neurologist told us she had an inoperable brain tumor. The tumor could have been treated had it been discovered earlier, but at this point, it was too late. As I listened to his ominous prognosis, my heart sank. How could this be?


We walked in a daze, with all thoughts of hope forgotten. The next day I put Claudilene and Estephanie on the little Helio floatplane and sent them back to Labrea.


As I think about Estephanie, I wonder if I was any help to her. Through my tears, I wonder what good I did for her or her mother. Before she had come, Claudilene was able to keep believing in the best for her daughter. Now she faced a grim prognosis for Estephanie. My heart feels heavy with guilt.


And yet, through my tears, I remind myself of hope-the same hope I tell my patients to hold onto in the midst of trials. I know that now, when it is hardest to believe, is when it is most important for me to put hope into action. I must continue hoping for the best for all my patients, regardless of the diagnosis. Despite Estephanie's diagnosis, I can still hope for the best for her and her mother.


As a nurse, I cannot give up on hope, regardless of the situation. If I am going to continue to encourage my patients to have hope, then I must demonstrate hope. Second guessing my efforts in caring for patients will not fill me with hope. Hope cannot be found in circumstances. Hope comes from a heart full of love for patients. As a believer, I know that Jesus Christ is the only one who can give me this love to shine to my patients. For Christians, hope ultimately comes from trusting God, knowing he is with us to help us (Ps 33:18-22) and will work out his good plan in our lives (Rom 8:28).


Estephanie's life reminded me of the true source of hope, and that offering hope in God is the best spiritual support I can give in seemingly hopeless situations. I thank God for using her to keep me pressing on as a caring nurse, with Jesus Christ as the focus, and not the circumstances.