Abstract
Sith Nihm was a Cambodian refugee, the wife of a high-placed official who had been murdered by the Khmer Rouge. She was near death when she arrived on the ward. Malnourished and diabetic, she had tuberculosis or multiple bacterial lung abscesses or both (we were never sure), and a terrible breast infection. Her damaged grace and vulnerability seemed to embody the Cambodian refugees we were trying to help. We gave her high doses of penicillin intravenously for the lung abscesses and triple drug therapy for tuberculosis. We administered insulin and developed a schedule so that different family members and even other patients on the ward took turns feeding her and helping her walk around the ward. Finally, after a mastectomy (even with antibiotic therapy her breast infection could not be controlled), she started to regain her health. Her breast was still bandaged a week after surgery when I made this photograph. Like many physicians, I've had patients that become part of the landscape of my memory—vivid figures that never entirely leave my life. I dreamed about Nihm, the first dream I had after I returned to San Francisco from Thailand, A month later, a colleague returning from the Thai-Cambodian border called to tell me that Nihm had relapsed and died.
Published Version
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