Monday, February 11, 2013

Loss and Anger

I tried to pray as I walked toward the hospital. But my angry thoughts even overtook those prayers. I knew from the call that I had just received that things had been going wrong for a long while before anyone decided to call a doctor. We all make mistakes, but this one cost some little baby it’s life. One more dead child, for a patient who had already had this circumstance once before. 

I walked in the ward, asked a few questions. I already knew what the answers were – the all too frequent excuses. Never do I hear the words, “I made a mistake”, there is always justification, someone else’s fault, some other shift’s fault. That is when the “self-control” button inside me turned off. My voice climbed in volume and the heat of it’s tone was no longer concealed. I just lost it.

As I finished my verbal assault, I turned and walked toward the patient. My heart and attitude completely changed to one of concern as I looked at her. I had to counsel her on what had happened.  I felt my eyes getting teary. How do you explain what shouldn’t have happened? Her face barely changed as I gave her the news. It made it easier, that she had no expectation of better outcome, and had no knowledge of what should have been.

I’m not sure what it would have looked like to glorify God in those moments. When my voice and heart were livid, there was something that felt very much valid about it. We actually should have provided better care. But I was very much degrading in my correction. I still felt somewhat justified, as it was a completely preventable poor outcome. But the nurse wasn’t even really aware of her mistakes. They seemed obvious. After I got done yelling, they were probably also obvious to her as well. 

But the whole world of medical care is different here. Excellence in patient care, that is what the whole system in America teaches. There are times when we all make mistakes, but trying to do our best seems to me to be one of the ways that we as Christians in medicine glorify God. However, it is very hard to provide care up to the standards taught in US training when training is so very different almost everywhere else in the world. The presumption that care should still be the best possible with consideration to the limited resources of a given environment often leaves me disappointed.  I am expecting the staff to bear weight which they have never been adequately trained to carry. Formal education indeed should have taught better skills, but it didn’t. And I should do more education to fill the depths of the gaps, but I feel pulled in too many directions to engage such an overwhelming task properly.

The patient, ignorant of medical issues, was full of much more grace and contentment than I. Sitting on the corner of her bed this morning, she looked up at me with a gentle smile. Her first words were a consolation for me - “Asha for work yesterday”, sort of meaning, “Sorry that your work was hard yesterday”.  In my own self centered thoughts, I considered that yes, it was difficult, quite frustrating indeed. But she’s the one lying alone in her bed in the midst of a ward full of mothers with their newborns nestled beside them. And her initial thoughts upon waking are about how hard my day was. I responded, "No, Ma, asha for you". 

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