Tuesday, July 30, 2013

Complication after complication

I went for a walk with a few of the short term volunteers up the mountain behind the hospital. A good chance to get away from the cares of the hospital. Nope, nevermind. Way up on top of the mountain path, I got called by the midwife about a patient who I had seen earlier in the morning on rounds. She was complicated, her water had been broken for seven days before she came to the hospital, thus she had begun to have a severe infection in the uterus. I had been treating her with antibiotics. As well, she had preeclampsia, a problem of high blood pressure which can become very dangerous, eventually lead to seizures. I gave the nurse some orders, telling her to deliver the baby. The mom wasn’t having contractions any more, but the baby was sitting there ready to come. A few minutes afterward, my phone rang again. The midwife hadn’t followed my instructions, in fact she had gone home. The next shift had just arrived, and there was only confusion. I could tell that things were going from bad to worse. The preeclampsia was getting worse, the fetal status was getting worse, the communication was getting worse. I tried again to make them understand that they needed to proceed with delivery. I began realizing that the chance for a poor outcome was going up exponentially as I heard the panic in the voice on the other line. I made sure both mom and baby were stable for the moment, and told them to just monitor them and wait. I would be back within 45 minutes. I told the hiking group that I would have to leave them, and headed back. A few minutes later, I saw a rare moped riding along the slippery, rocky mountain trail. It seemed like a God-send. Only rarely do they they ride so far up there to take someone home who lives out in the bush, since the path is terrible. I waved him down. It took a minute to bargain him down to a reasonable price, but then I hopped on the back and off we.

Bumpety, bumpety, bump over the rocks, slipping into the ruts of the path we rode (or slid in many places) down the mountain. The waft of alcohol occasionally passed from the driver’s breath to where I could smell it even riding behind. I held on tightly to the bar behind my seat. I came up with a theoretical plan, that if the bike should begin to fall due to the rough terrain or the inebriated driver, that instead of trying to put my foot down and catch us (as seemed natural), I would spread my feet and catch myself, to let the motorcycle pass in front of me before it fell, leaving me behind and safe. Sometimes I make a “just in case plan”, thankfully, I rarely end up using it.  Too many of those prior motorcycle drivers (and riders) have passed through the orthopedic ward and now hop around with crutches on their one leg.

We made it back in a fraction of the time that it would have usually taken me on foot. I walked into the maternity ward and checked the patient. The mother was lethargic from the medicine that she was on to prevent seizures. We lifted her onto the delivery table. Then I grabbed the gloves and checked everything out. Things were not as had been reported, and they were even a bit worse. I described to the mother that I needed her to push with all of her heart. I applied a vacuum device to help pull the baby out. A few minutes later, out came a floppy and tired baby, barely able to breathe. The resuscitation began on the other side of the room. Meanwhile, I knew that the mother had many risk factors that could cause her to bleed after delivery. And she certainly did. I was almost up to my elbow inside her trying to arrest the bleeding. As I worked deep within her, it felt as if she was on fire with heat from the infection inside her womb. I glanced at the baby, knowing that it too was doing poorly because of being exposed to the infection for too long. The bleeding continued as I returned my eyes to focus on the mother. Medications were coming, but seemed to take so long to get drawn up and unwrapped and such. Finally, the bleeding slowed and I knew that we were going to be okay.

After I wrote a note in the chart, I headed back to the house. My hiking shoes had blood splattered all on them. My arms were tired. My passions were tired. So many problems, both with the patient and with the management of the patient. Another close call, too close. Another sick mom and sick baby. There are so many women and babies at risk, and so many opportunities for poor outcomes. But almost each time, earlier recognition and intervention could give a better outcome. I sometimes blame the staff. I sometimes get so frustrated. I know that it could be so much better. I am praying that God will engage the hearts of the staff to desire to learn more and care deeply. But I am thanking Him that in spite of our failures and lack, He often provides for us anyways.  There were so many other routes that could have ended their story. One complication seemed to pile on the next. But tomorrow, a healthy mom and baby are going home together. Thankfully, this is the story that they get to own. 

Friday, July 19, 2013

The Borrowed Life

I got to borrow back a life from a girl I knew not too long ago. She was carefree and fun, and it was awesome to fill her shoes for a while. It was a time marked by wind blowing in my hair while driving down the road, snuggling with my nieces and nephews all wrapped up like a pretzel on the couch, laughing til tears filled my eyes, and a thousand other treasured moments.

I didn’t initially think that it would be worth the short time available and significant cost to come back home during my time in Cameroon, but I did have some vacation time that I was able to use, and the stress was wearing me down. After considering all the options, I realized that there wasn’t anywhere else I’d rather go, and no people I’d rather see, than my family and friends at home. So, graciously, a family member helped me get some super secret airfare to take that long flight over 3 continents and one mighty big lake to return to Travelers Rest, SC.

I got almost uncontrollably patriotic when I felt the wheels of the airplane land on American soil. My heart beat fast and I had to hold back from breaking out in the national anthem. The other folks on the plane all seemed to not even notice that something awesome just happened, like it wasn’t a big deal. But, oh, it was a big deal – “the land of the free and the home of the brave!”, and incidentally the place on earth that my heart loves most.

Well, then the fun actually started at the beach, where I surprised my family on their vacation. I came swimming in from the ocean to meet up with my sister’s four kids (who I lived with for four years prior to leaving for Africa). I told them that I swam in the whole way from Africa to meet them at the beach for their vacation. There were other additions to the story, including the aid of dolphins and sea turtles, but I’ll spare you the details. And don’t worry, the only one who believed me was the youngest, and I came clean from that lie within a couple days. It was a blast. Then we came back toward home, where I got to continue loving on and being loved by those around me. It was a return to what was once pretty normal. But now I appreciated normal in exceedingly greater capacity.

But it was somewhat of a borrowed life. It felt like the time was extra and surreal, as if I had been given extra days to live beyond the scope of the life that I considered “mine”. As well, literally, most everything in it was borrowed. My mom let me borrow clothes, a car, a room, and many people invited me in to share a meal and/or a little piece of their life.

It reminded me of the fact that we are all really living lives that are borrowed, they are given by another, and after a while, to be taken back by Him. Some are easy, some more difficult. Some parts of them are given directly (like where we were born or our natural giftedness) and others, we work to grab ahold of. But no matter how much we put into them, we can’t really keep them.

I used to see a physical image of this concept when I went to the gym (which I really miss nowadays). I don’t mean to put down exercise all together, of course, it’s just to give you a picture. I always would see people who were pouring their entire energy into their physical body, with apparent disregard for any other worthy thing. Day after day, they were as religious with the pursuit of physical fitness and beauty as a pastor to his Bible, a greedy man to his money, or a lover to his object of affection. Now, no doubt, they were amazingly fit individuals, fine specimens of human physique. But they were consumed by a love that was eventually going to let them down. It was going to age, and wrinkle, and droop, and break, and scar. I always wished that I could remind them that this body was more along the lines of a rental property. They were treating it as if it were being permanently bought and owned instead. It’s good to keep a rental up - make it stylish and comfortable, improve it, and put some of yourself into it. But it would be only a fool who would pour his whole life savings into it. The day will come when he will leave that rental property empty handed, and then all he has labored for will have been lost. So too with those sculpted frames which will one day be frail and fragile, and some later time than that, will return to dust after death has encompassed them. Only the invisible, often ignored portions of humanity will matter then. Each will have given back the temporary loan.

So, let me encourage you to live this borrowed life well. God has given, to most who will read this, exceedingly graciously in every area. I have been reminded of that once again as I have walked through the days that we would call ordinary. It is beyond my understanding as to why He has lavished such physical provision and blessing on us  in the USA. But this part we do know, we aren’t to waste any part of our lives. We are to live the ordinary days with extraordinary views of how to image Christ into the world as we walk through it. We love, seeking to display the same kind of love that He has shown to us. We give, seeking to reflect His generosity towards us. We rejoice, for we have been made to be His by the broken body and spilled blood of His Son. Let’s not live a forgetful and wasted life. For it is borrowed, only borrowed for a short time. Make it count.