Published | November 24, 2025 | by Ochuko Ogbon, Anesthesiology Resident and Internal Medicine Physician
The tenth hour of the clinic found me face-to-face with Madam Chioma and her goiter. She had traveled miles from a neighboring village, a scarf draped hopefully over her neck, believing we might finally offer a solution. What began years ago as a tiny swelling, mistaken for an insect bite, had persisted. A hospital visit had once offered a answer, but the cost, hundreds of thousands of Naira, far exceeding her yearly incomesent her seeking spiritual help instead with no solution. Now, five years later, she had come to the ANPA medical mission, praying for a medical miracle.
The size of the mass was staggering. After years of training in the US, I had nearly forgotten how conditions magnify with delayed care. As a senior internal medicine resident, I had never encountered one so advanced. I took her history, but she deftly denied the classic symptoms, weight change, temperature intolerance, loss of appetite, that would point to a thyroid imbalance. Her answers were rehearsed and perfect, yet a nagging suspicion told me she was hiding something.
The lab results hours later revealed the truth: severe hyperthyroidism. Confronted with the evidence, her story shifted. Yes, there had been some weight loss, but she’d welcomed it. Yes, she’d been advised to take medication, but she disliked drugs; she just wanted the goiter gone. All she wanted was surgery.
She looked just like my aunt, increasing my empathy for her situation. Gently, I explained the pathway for a hyperfunctioning thyroid like hers: the critical need to control the hormones first with medication, or even radioactive iodine, before any surgeon could safely operate. I laid out the dangers of proceeding now, cardiac arrest, thyroid storm and asked her plainly: was the risk worth being lost forever to her husband and children? As the reality settled, her resolve softened. The answer, we both understood, was no. She wanted to live.
This was my second mission trip to Nigeria with the Association of Nigerians in the Americas (ANPA) and one of the biggest in the association’s history, and while we cared for thousands, our ten-day mission couldn’t give her the surgery she craved. But it provided an education that would last a lifetime. My time in the pre-operative clinic solidified my next calling: Anesthesiology. Now, I could clearly see the crucial bridge between medicine and surgery optimizing patients, ensuring their safety, and guiding them through the profound journey of anesthesia.
While ANPA performed hundreds of surgeries, it was the patients left behind, like Madam Chioma, who posed the most important question: what happens next? Her case underscored the necessity of lasting collaboration with local health systems, ensuring her story was not one of “no,” but of “not yet.” As I continue my training, I carry her with me, fueling my drive for global health and look forward to the day I can give the next patient like her not just hope, but the safe, life-saving care they deserve.
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