Saturday, September 21, 2013

Generations and Restoration

Her diagnosis preceded her exam. The odor of urine made me want to turn away to get a clear breath. But her sweet smile and nervous eyes drew me in and I welcomed her into my exam room. I knew that she had a fistula – a condition where women get damage to their bladder and vagina during labor, and then leak urine continually thereafter. Now I had to find out how she got it, and figure out if I could fix it. Most women in the developing world get such problems through prolonged labor and delivery. Most are having their first baby, and lose it in the process of delivering. But that wasn’t really the course that led to the steady stream of urine running onto the floor.

No one wrote down how long she was in labor, or anything about her labor course in the little book she handed me. Her story seemed to indicate that it wasn’t too terribly long. Nor was there anything written about the C-section that was performed. They never really told her any of that either. So, it seems that though she labored, she wasn’t able to deliver normally. But surgery was done and a healthy baby was the end result. That is all I knew. But ever since the surgery a couple weeks ago, she had a stream of urine leaking down her legs. I performed the exam and saw that it was quite extensive, but appeared related to surgery rather than specifically a long, abnormal labor. 

She asked if her father could come in to hear the counseling. In came a smiling, joyful man. He was beaming with hope. It was as if the grin couldn’t leave his face. A few teeth missing and one short black one, his continual smile showed his excitement. He said that he was so glad that someone could help. He said that he brought me something. I didn’t really understand what he was getting at when he said that part though. It was only after they had left the clinic that the nurse brought the lettuce and scallions and celery – special things that most people don’t grow, as a gift for the certain success that he envisioned. He wasn’t a rich man, he was a farmer. As I stood there talking with the two of them,  I had to tell him what the expected hospital charges would be. The prices are only a fraction of what most hospitals in the country charge, but still can be significant for the patients and their families. I expected the usual, “doctor, it is too high, can you reduce it?” that I hear from so many patients. Instead, I heard, “no matter what it costs, I will pay it. She is my daughter”. It almost made me tear up to hear him. As if he would plant every vegetable, till every inch of soil, sell at every market, whatever it took, to see her healthy again.

Her eyes, his smile. They were creeping in on me. They were becoming more human than usual. She was somebody’s baby. In her arms, she carried her own firstborn, their next generation. She was ashamed of her condition and in obvious need. She was void of dreams for the moment, except for the great dream of being normal again. He was densely filled with optimistic anticipation.

It was refreshing to see such a father’s love. Here was his daughter with a newborn baby. There was no man around who had helped conceive this recent birth. Now there were complications and responsibility. It wasn’t as fun anymore. I asked her dad when I saw him a bit later if the father of the newborn baby was still around. His answer, still smiling, was “He has escaped. Now I am the father.” The only man in her life right now, was the one who had been in her life since day number one. He still stood steadfastly in her time of need, willing to do anything that could help return her to health again. He wasn’t rigid and austere like many fathers, he was loving and kind, willing to pour out himself, no matter the cost. If he hadn’t been like that before, her need had exposed his love.

But it wasn’t just refreshing. It was a bit burdensome. He looked at me with eyes filled up with hope. He brought vegetables in anticipation of some great outcome. I felt the weight of it. When people lift you so high, you’ve got a long way to fall. What if surgery failed? What if I couldn’t fix it? What if when they left, I had let down their hopes? I don’t like to hold people’s big dreams. I don’t want the chance to disappoint them.

So, I took it before my kind and gracious Father. The one who has poured Himself out for me. The One who has sacrificed greatly for me. The One whose love for me has been clearly exposed through the work of Christ. I asked Him for help and wisdom. I told him of my inadequacies, but He already knew them. I told him of my anxiety, but He already knew it. And though the weight of hope and expectation made me uncomfortable, I was reminded that He was big enough to bear it. So then I just rested and waited for the proper time to do the job that He has given me to do.

Surgery day came a little while later. She was the last patient for the day. She hadn’t eaten all day, and it was late in the afternoon. There was no complaining, though the wait had been long and she dripped urine all around her as she sat. As she waited on the wooden bench in the entry area of the operating room, her family brought the newborn baby to breastfeed periodically. She waited, and waited, and waited. Finally her time arrived. My neighbor, a general surgeon, assisted me during the procedure. There was plenty of scarring inside, with everything matted together that should be clearly separate. As I dissected the layers free, it became clear that the prior C-section had been improperly performed. The cut was too low, actually below the uterus. And then the bladder had been directly sewn into the vaginal incision. “Surgical misadventure” was the cause of her condition. We opened and explored, took apart and put together. We added an extra layer to keep the structures separate to try to avoid recurrence of the fistula. And then we closed it all up.

Post-operatively she did well. An ideal patient. She slept on dry sheets for the first time since her prior surgery. She sat on a dry skirt. The lack of normality now made “normal” feel extraordinary. She felt so good that she asked to go home on the second day after the procedure. There they went, she with the now brightened eyes and urinary catheter in tow, and he with that same big, bright smile.

She walked away a bright, young woman – not the nervous, embarrassed, malodorous girl from just a few weeks before. God allowed us to take part in restoring her wholeness. And I loved to see her bloom. Praise His name for restoration – body and soul.  

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