Today, many burdens. Some burdens of prayer for those in our hearts, but far away. The Gilliam family, and our WHM family, grieving the abrupt finality of a slippery accident, lamenting the world at its most broken. Scott's dad, admitted to the hospital in CA with a "minor" stroke. Friends M and J agonizing over their future calling and direction. Our Bundi team, once again under attack, this time a threatened lawsuit from a disgruntled former employee.
Some burdens of prayer and hands and sweat, for babies closer to home. Baby Peggy's mother came to Kijabe a few nights ago in agonizing labor, though she had not previously been cared for here, something in her heart told her to come. She had an emergency C-section, and her baby was sent to the NICU, where our alert clinical officer Bob noticed an unusual amount of drooling . . . and by the time I arrived he had taken an xray showing the naso-gastric tube which failed to pass coiled up in Peggy's throat. A relatively rare congenital anomaly, esophageal atresia with tracheo-esophageal fistula, or in plain words her swallowing tube ends in a blind pouch at the top, and the lower section next to the stomach connected directly to the lungs. Which is, needless to say, incompatible with life. No baby with this anomaly has survived at our hospital, perhaps not in Kenya . . but generally they are transferred here in poor condition too late. This time we could call the excellent pediatric surgery team and within hours Peggy was in the operating theatre, having the two fragile sections of her esophagus disconnected from her lungs and reconnected to each other. Now she's in the ICU, fragile, complicated, with a chest tube and on a ventilator, with at least a chance of surviving. Baby Issa's mother spent her first 39 years in S0malia, given as a girl by her family to an older man. 9 children later and 9 months pregnant she accompanied her 80-year old husband over the Kenya border as a refugee, and then delivered an infant with an omphalocele, a defect in his abdomen so that his intestines protrude in a sack. Doctors in the refugee camp gave her a syringe and told her give her baby sips of water with it, and put her on a bus to Kijabe, which involved 12 to 15 hours of jolting through the desert. She arrived with a cell phone but no money, unable to speak to anyone, wearing worn dusty clothes, bleeding and sore. I found her this morning with quiet tears dripping down her cheeks, sitting by her baby, she pulled my arm to alert me to his oxygen mask slipping down. We found another S0mali mom on another ward who speaks English (and is a friend of our WHM-colleague Kimberly!) and I tried to explain Issa's situation, which is grave. She assured me that if he dies, that is OK, it is God's will, and she was anxious about her 9 children back at the refugee camp whom her elderly husband could not care for. I said God had led her here for a reason, so let us at least try to help Issa. Baby Richard's mother delivered him ten days ago, and went home, but he did not feed well, and her milk did not come. Perhaps because it was her first baby she failed to realize how sick he had become. Perhaps she worried about payment. I don't know, but when she walked into the outpatient clinic today he was shriveled and in shock, with dry skin, no tears, labored breathing, a too-slow heart rate, blueish feet, parched and acidotic. His labs were so off-the-chart that the machine could not register his sodium level, way over 200. We pushed in bolus after bolus of fluids, while testing and probing and treating. I don't know if he'll survive (we're at 160 cc/kg as of an hour or two ago, which is A LOT, with minimal improvement). These three babies and the dozen or more others on my service stretched me all day, and into the night. I pray for their survival, a tenuous hope at best.
But one of the things that I find most stressful is this: taking care of other people's children when my children are ill. While I recognize the life-threatening gravity of my critically ill patients, I had a hard time going back into the hospital this afternoon with Jack shaking his bed in chills and a temperature climbing up over 104. His peculiar illness puzzles us: fever and headache Saturday evening, then fairly well Sunday, dramatic spiking fever again Monday late afternoon, OK Tuesday, then a return of the terrible spasm of fever and headache again today. No runny nose, no cough, no vomiting, no diarrhea, no rash, no nothing but the wracking chills and fever, and an enlarged spleen. It looks a lot like malaria, but we've done three negative rapid tests and two negative smears under the microscope. White count and platelets LOW. In the midst of his fever today he sobbed "it's because I'm the only one who fell down and scraped my leg in the caves!" Hmmm. We started an antibiotic tonight in case of strange tropical rickettsia and spirochetes . . . but wish we knew what we were dealing with.
So .. . Gilliams, Myhres, M and J, Bundi, Peggy, Issa, Richard, Jack . . a heavy burden of prayer for today, we can only rest in the truth that Jesus carries the real weight as we pull together.