This week, we met with Olivia’s birth family in Panajachel, a town on Lake Atitlan about three hours northwest of Antigua. The family—Olivia’s birth mother, “Ana”; her grandmother, Abuela, and her older brother and sister, now 18 and 16—traveled to Pana by bus from where they live in Totonicapan. Opinions around the subject of international adoption are mixed in Guatemala, ranging from supportive to very negative, so to protect Ana’s privacy we always meet in Pana, two hours from her town. (In small villages such as the one where they live, outsiders never pass unnoticed.) As you can see from the photo, Olivia is almost as tall as Ana, and about the same height as Abuela. Olivia had just turned seven the first year she met her family; next month she will be 11.

This meeting was a little different from our previous ones for two reasons: first, because my sister Patrice usually accompanies us on birth family visits and couldn’t this time. (We missed you, Tia!) And second, because Abuela’s shoulder was bothering her so much she couldn’t move her arm to do anything, including lift a fork to eat. The lightest touch caused her to wince with pain. Bear in mind, this is a woman who for decades has chopped firewood, hauled water, made tortillas, and washed thousands of loads of laundry by hand.

Olivia wanted to take a boat ride to another village on Lake Atitlan—she doesn’t like to feel conspicuous in “our” town of Panajachel—so we did. As usual, our first stop was to pray together in the town’s Catholic church, and may I just say that the faith and goodness of Olivia’s birth family absolutely humbles me.

Afterwards, we ate a nice lunch, over which we perused the photo albums from last year’s visit that I had assembled and brought. But none of us could ignore Abuela’s obvious suffering. Trying to ascertain the exact nature of the problem, I could make out the Spanish word for “bone,” although nothing about a fall or injury. As far as I could determine, a visit to their local clinic in Toto hadn’t revealed a root cause.

Long story short, I called Nancy Hoffman, my fellow adoptive mom who owns a travel agency in Antigua, and she said the desk clerk at our hotel knows a good doctor. Turned out he does: Dr. Luis de Pena, the physician who runs the clinic at Mayan Families, the NGO many of us adoptive families support, and where, in fact, I had been last month with Mateo, dropping off shoes donated by Olivia’s Girl Scout troop.

Our group clambered onto the next boat to Pana, piled off and into two tuk-tuks, and zipped up to Mayan Families.

After a physical exam, Dr. de Pena made a diagnosis: bursitis. If the injection he administered doesn’t work—he sent me out to buy the syringe from an NGO-subsidized pharmacy around the corner and two blocks down, “Fe, Salud y Vida”—and other causes are ruled out, Abuela may need surgery. This only can be performed in a hospital by an orthopedic surgeon, and in Guatemala, apparently, orthopedic surgeons’ numbers are few. If necessary, Abuela must travel to Guatemala City or Quetzaltenango.

Today’s report is that the pain has subsided somewhat. We’ll see.

What I appreciated most about this visit was how natural it felt. Abuela was in pain, and we did our best to help her feel better. That’s what family does, and we’re family.

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