Thursday, August 1, 2013

Abdominal Pregnancy

Abdominal pregnancy. It's a very rare event that happens when the baby grows inside the abdomen, where all the guts and such are, instead of inside the uterus, where it should reside. It was one of those thoughts that always made my heart beat fast. What would it be like? Would the baby just hop out at me when I cut into the belly wall? The theory of coming across that obstetric rarity had always been sort of fearfully exciting. But as I stood there alone with the knife in my hand, there was no sense of excitement or adventure. There was only a very real sense that this patient could die in the next few minutes. She is alive right now, and she may be dead before she gets off the table. But there was no other choice.

I had called the surgeon on call with a fury of need and hope in the moments before scrubbing in to begin the case. But his phone wasn’t passing through. I had notified security to go to his house to get him, but he hadn’t come yet. I took a moment to pray my usual prayer for wisdom and skill and set my mind to act. I began to open the belly wall and found what I knew was a couple of cell layers away from disaster. I asked the anesthetist at the head of the table to call the surgeon one more time. I prayed that he would answer, and he did.  I waited, thankful that someone experienced with such possible complications was going to stand on the other side of the bed. He scrubbed in a few minutes later, and after seeing the mass, said that he had never seen something like this. If the mood were different I would have chuckled, since I was banking on his prior experience. The entire abdominal area was covered by the placenta, bearing its huge vessels boastfully before our eyes. If we got into those, the bleeding may not be controllable. The mass was attached to bowel from what we could initially see, and who knew what it was attached to beneath the superficial area of our vision. We found an area that seemed a bit thinner than the placental bed and opened it there. A gush of blood and fluid flooded out. I grabbed the baby’s feet and delivered it through the small incision that I had made. As we cleared all of the residual blood and debris, I noticed the importance of the exact area where we had entered. One inch higher and we would have injured the intestines, one inch lower and we would have been in the bloody placental bed. Indeed, God had guided our hands, just as I had prayed. After we could examine inside, it was clear that the possibility for catastrophe was even larger than we had known. The placenta had implanted itself in the large intestine, bladder, abdominal wall, and the kidney. How it spread to involve all of those organs was almost incomprehensible. But it certainly did. Removing it would endanger her life within minutes, so we packed some sponges inside to hold pressure and closed the belly up.

A day and a half later we opened her back up to remove the sponges. The surgery went well. She was in pain afterward, but overall was beginning to improve. I counseled her each morning on what the experts from the States had recommended for her further care. I prayed for her at night as I knelt on my bed. Last night as I prayed for her, all I could think about was making sure that she understood the Gospel. I determined to make sure to talk to her about it in the morning. But morning came and I again told her more about her condition and the treatment needed. She has so many possible complications and she had questions about each. I got lost in the medicine. It was evening as I read my Bible that I remembered that the one thing that I had set out to do for the day had been forgotten. I had covered the medical scene, but I had forgotten to make known the Gospel. Huh? I mean, am I a missionary doctor or what? Well, it turns out that I’m the very same doctor that I’ve been all along. How could I forget to mention the One I adore? Well, sometimes I get caught up in medical care and forget that something bigger needs to be addressed. It’s deep down in her eyes, past her figure, beyond her smile or frown, unseen and yet very real. Medical need is important, don’t get me wrong. The compassion to a patient through hands on care adds legitimacy to the claim that they actually are loved and cared for, that they have worth. But there is one weighty thing, and comparatively, the rest is feather light. And that is the truth of God’s love, poured out to us through the life and death of Christ. We call it the Gospel.

We all are sometimes carried away. Sometimes it’s by important things. Sometimes by just wasted time. We lose our focus and forget our purpose. We walk through hours, and days, and weeks like that. But people need to know that there is a God who loves them and who cares about what they are going through.

So, I walked back up there tonight to tell her about the goodness of the Lord. I’m no orator. I’m clumsy and stumble over my words sometimes. But I just started to tell her that God loved her enough to send His Son to make a way for her to be right in her relationship with Him. And that He cares about what she is going through now. The bad pregnancy, the possible complications, the treatments. He loves her, and He cares. I want her to rest tonight reminded of His great love for her in the midst of uncertain circumstances.

To those who read this, I want to remind you of His great love. All of life seems uncertain, but the Gospel allows us to rest in Him. He loves you and He cares. 

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