Thursday, December 5, 2013

The small physician degraded, the Great Physician at work

I was called after liters of blood were already on the floor. Besides a dead baby being delivered and now lying in the baby warmer, now another complication with massive blood loss. I went through all the possibilities of how to treat her, and none slowed the bleeding. The only option left was to go to the operating room. It was a quick surgery without complications. Unfortunately, her uterus had to be removed in order to save her life. I thought that we were out of the woods. I was a little bit proud of myself, that now these complications don’t really get me too excited, not like when I first came out to work here. I’ve had an awful lot of “opportunities” and experiences of big cases for this one to get me flushed.

I went home for lunch. I hate to miss a meal. Just as I finished my soup the call came. Her incision was bleeding heavily. A moment later the phone rang again, now she was bleeding profusely from the vagina too. I knew it wasn’t a surgical issue, all the areas had been repaired well and were not having any bleeding issues only a short time before. I also was aware that such bleeding is much worse than something that can be stopped by surgery. See, sometimes when someone bleeds excessively, they run out of the particles in their blood that actually make the blood clot (yes, DIC for you medical folks). I knew that this was the case with her. Some blood had already been given, but she needed something more. She needed fresh blood to get her the substances that would make the bleeding stop. Really fresh blood. I asked the type, and of course mine would do.

So, off I went to the lab. I sat upright and squeezed my arm, watching the life-blood drain out of my arm. Finally the bag was filled. I knew that if I didn’t take it directly to her that delivery would be much slower. And I knew that every minute counted,  she really needed it immediately. I thought I could do it. I grabbed the blood and walked toward the ward.

The surgery ward lies uphill from the other walkways. In order to get up to it, there’s a sidewalk with a grade. Usually it’s no big deal. But there are times, like when you are emergently pushing a patient, that you realize it definitely has an incline. When you’re pushing that stretcher, you can feel the back of the thighs and butt really having to work to get up the hill. Well, that day, there was no stretcher, and no pushing. But by the time I reached the top I knew that something bad was about to happen. That incline got me. I hadn’t had anything to drink all day. And my body screamed at me that it wasn’t going to take dehydration, followed by the blood loss in the lab, followed by a brisk walk. It was over. Things started spinning and flashing. I saw one of the anesthesia students who is a friend walking by. I reached out a hand with the blood and said “take it to the ward”. Then I sat down, put my head between my knees, and tried to recover. At this point my autonomic nervous system decided to continue the craziness – was it passing out that was coming? No, vomiting…wait, diarrhea… one wave of possibilities followed the next. Even in my current status of degradation and confusion, I could imagine things getting worse and more de-humanizing. I hoped it would just be vomiting. One of the staff saw me and came by to see if I was okay. I could only say, “Get Doctor Keith”. He is the anesthesiologist, and a friend of mine, who I knew was there because he was also watching my bleeding patient. I never lifted my head, just said, “take me home”. He came and shuffled me into a wheelchair. I looked like I was dead. Normally I am one of the palest ones at the hospital (ha ha, like my joke?), but today was especially pale. As well, I was doubled over with my head between my knees, slumped in the wheelchair. Anytime I lifted my head things would start spinning again.

Being a doctor-patient with all the hospital watching was embarrassing. On and on we went, over speed bumps and gravel. I could hear people talking, but couldn’t see anyone with my head tucked down. Even without vision, I could feel them all watching me. Keith kept saying “She’s fine, I’ve just gotta get her home”. Finally I saw the grass passing beneath the wheelchair, and I knew that we were almost there. I heard Anna’s voice from inside the house. (She is one of my best friends here and works at my house one day a week, helping to prepare stuff to cook cause everything is really from scratch – like grind your own corn kind of scratch). I could tell she was a bit scared. I told her I was okay as I wobbled to the bedroom. Within four minutes, I could hear voices in my house. My initial thought was, “Why are their voices in my house? Intruders, and I am not even able to fend them off!” Then heads peaked around my bedroom door frame, and I saw that it was the clinic and maternity staff. They had let themselves in so they could catch any action. When they realized it was just me laying in the bed, unable to get up, they lost interest, said they hoped I felt better, and went back to the hospital. Forty-five minutes later after a good bit of water and a coke, I was pretty much back to normal. I headed to the hospital to check on the patient.

She stopped bleeding when my blood got into her. I’d like to say it was cause my blood was exceptional, however, it was really just God’s grace. She was even starting to make a little urine, which is a great sign that someone is having enough blood in their vascular system. I was cautiously delighted, at least she didn’t look like she was walking straight for death’s door anymore. She had turned the first corner.

I got the call at dinner that her condition was again deteriorating. The hope from earlier quickly began to dissipate. Now she was vomiting blood, and her belly was distending out. When I saw her, I knew that her condition was not just deterioration, she was standing at death’s door again. And this time there wasn’t really anything more I could do. All over the world, her condition would have a high mortality rate. Anywhere in the world, the doctors would have done the same thing and would be hoping that somehow she would turn around. But hope was dwindling. I talked with the family, letting them know that there was nothing that I could do to intervene. I told them that we would watch her, but that likely she would not make it. They understood. I left her there to die.

I thought of her each time I awakened in the night. Finally in the five o’clock hour I woke and reached for the phone. I wanted to see what time she had died. I asked about her, and they said that she had not died - she was still alive! I hung up the phone, praised the Lord, and jumped out of bed to do a little dance. It was no attractive, choreographed dance, but a soul thrilled, wild expression of delight. I was like a little kid jumping around. It was so exciting to hear, so beyond medical expectation, I couldn’t help it. The doctor turned into a four year old jumping and spinning around, giggling laughter and praise. Death was grabbing hold of her by big handfuls, in such a way that no medical intervention could help, and yet now ALIVE!!! I got it under control a bit, dressed and went to see her. From a beyond-treatment, miracle-hoping condition, to talking to me and asking if she could eat. I was so thrilled but cautious – I laughed and like an overbearing mother, then cautioned her - “no eating, no drinking, no moving, no nothing, just lie there and breathe”.


And she did. She kept breathing, and kept doing better and better and better. Day after day she improved. I did eventually even allow her to move and perform all other bodily functions. And then this afternoon I wrote on her chart, “D/C home”. I stepped over to the bed to tell her goodbye. Tapping her leg, I gently woke her up. I gave her the general instructions to call if there was fever or pus or worsening pain. And then I gave her a little glimpse from within my eyes. I told her that she had gotten so sick that I knew that there was nothing that I could do. Walking away from her was the first time that I just left a person in their bed to die. She had been beyond our medical capabilities. We gave her all we had, yet it was not enough. But God had been gracious, and had amazingly restored her health and life. She was the closest thing I’ve seen here to a medical miracle. Like God was just showing off His Great Physician skills. They were indeed great, beyond my capabilities and my mental grasp of possibilities. I am so thankful to watch Him move. I revel to know that He is indeed the one who controls all things, and that sometimes, beyond reason or expectation, He just chooses to save. Bless His name.

6 comments:

  1. Remarkable!!!! Bless the name of the Lord! Bless you Christie!

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  2. Awesome... may God continue to bless your work!!

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  3. What a blessing you are to these people and what a blessing God is to them!!
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  4. I can just see you tapping her leg and telling her that. Miss you! My daughter will be in Uganda for two months this spring...serving in an orphanage. So excited for her. I hope I can get there one day. Keep using the gifts God has given you. I'm sure you bring much joy to those whose lives you touch!

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