A Day

Darkness fading, Bible reading, birds awakening, the morning scramble for showers and breakfasts and bookbags and byes. Off to chapel, exuberant, crowded, all staff condensed into a packed space. Nursery, wafts of heated humid air, examining the two newest admissions both scrawny and dehydrated, punching numbers in the calculator to plan fluids designed to gently normalize dangerously high sodiums. Pages, the intern called to receive babies being delivered by C-section in the OR. By Scott, who is working with the OB team today, and labors through 3 C-sections as an assistant then finally at 5 pm a 4th one on his own, sweating, cutting, dabbing, delivering. Slipping out for an hour mid-morning to circle with about ten women my age and above for "Moms in Touch", a prayer group for our college-kids, appreciating the collective wisdom and burden of love, sneak previews into my future. Called out of the prayer time for another admission, which turns into a two-hour life and death struggle, ending in death. The plump little six-week-old gasps and grunts, we prod and measure, dose and monitor, but he deteriorates. The care turns into a code, intubation, CPR, our arms tire of giving round after round of chest compressions, boluses of fluids, epinephrine, checking glucose, at the end even a taste of atropine, IV's and ng tubes, and then the blood froths up from his lungs, and we slowly lose ground in our battle. Pulmonary hemorrhage. The mom watches, anxious, I try to fill her in as we go, between listening for a heartbeat to return. It does not, and I am the one who has to call off the effort at last, to admit defeat. I tell the mom that he is gone, and she collapses in tears, I put my arms around her and feel my throat tighten and voice waver as tears try to come for me too. Not the time for it. Somewhere in the midst of all this I realize my kids are locked out of home and have no lunch. Scott is in the OR. So Julia gamely volunteers by phone to troop back up to school and eat in the cafeteria. By the time we sit and pray with the bereaved family, another complicated consult is waiting on the neurosurgery service. As I walk between wards a plane buzzes directly over the hospital, it is Caleb and his aviation group returning to Nairobi, swooping over their home. Around 3 I finally slip out for an hour, the comfort of cheese and crackers and an apple (my after-school snack as a kid is just what is needed after the strain of this baby's death), scouring books about pulmonary hemorrhage, trying to learn and evaluate what we did, for next time. Clothes in from the line before it rains, kids briefly touch base and off to sports practice, Scott turns back for the final C-section of the day and I follow to go over x-rays with our radiologist, and check labs. In between all of the above seeing two staff kids for various ailments, checking their labs too, writing prescriptions. Evening approaching, home at last, cooking, welcoming Caleb. Family dinner, tales of adventure from the skies over Northern Kenya, hard-core missionaries and lasagna in the desert, roasting camel meat on a dune, landing an airplane, swimming in Lake Turkana, hunting rabbits at night in dry river beds on ATV's. We sit on the couches and hear more from Caleb, checking CNN for the world news. A lead comes in by email for a school placement for one of our boys from Bundibugyo, so I make phone calls . .. answered prayer, a space in a school that looks nurturing. Budgets, money, a few emails to arrange a plan for this kid, then skype with Luke, pray for his housing lottery tonight for next year. Put in laundry, and debrief by blog under the comforter, eyes drifting shut even as I type, Scott asleep, wiped out from the day of surgery and checking in with his ward patients too, Caleb playing the guitar he missed so much all week, Jack and Julia off to bed with no new papers to write for a change, and now a few hours to recharge before it all starts again tomorrow.