+ and -

+ Kangaroo Care--this is how we had moms incubate preemies in Bundibugyo, and it is a well-proven boost for small infants. However at Kijabe with its big plastic warming boxes, monitors and alarms, few moms seem to take our suggestion. So I was very happy today to see that after I had put one preemie skin-to-skin under his mom's gown, I found two moms holding their babies that way. Samuel and Precious are both feeder/grower types, out of the worst part of the dangerous woods, but still vulnerable. Both babies gained an ounce since yesterday.

+ Noreen, came back for a check-up, now quadruple her 620-gram birth weight. And no longer jaundiced. And with beaming parents.

+ I asked Julia to bake cookies with our part-time houseworker during the school break hoping she could teach her how. Now the kids are back in school. And I'm not exactly relaxing at home baking cookies either. So I asked Abigail if she could try. Abigail is wonderful, a dose of mopped floors and wiped shelves and folded clothes that helps us survive. But she is extremely reluctant to COOK. So I was quite delighted (as was everyone else) to come home and find three racks of perfectly shaped and baked colossal cookies waiting.

+ Taught the lunch conference today, and felt very ill-prepared. Just as the intern who was to present the case stood up, he was paged to the delivery room, leaving me on my own. However there are several new residents rotating from the USA, and one in particular kept nodding, answering questions, and appearing generally interested and encouraging. Perhaps this person AWLAYS looks that way, but it was very helpful when standing in front of a few dozen medical students, interns, residents, and even a couple of consultants, to TEACH, to find someone tracking with me in such a positive way.

+ Star, our dear old dog, who loves us. Nice to have a living creature so excited to see me every morning. Nice to see her revel in her new environment, runs and space and exploration.

+ Half-way through the first week of rugby practice. Major abrasions needing bandaged, concern about a banged nose (not fractured), one lost toenail, one jammed finger. But all that is pretty minor. No broken bones or concussions or major blood loss. Yet. This sport is a bit of a medical-mother's nightmare. I try to remember how much they love it (the camaraderie, the teamwork, the exercise, the proving oneself) and try not to focus on the injury potential.

+ First JV girls' volleyball game. Julia did quite reasonably well. We were the only fans for JV, so we cheered a lot. The girls won 2 games to 1. Varsity plays best of 5, and boys and girls both won there too.

+ Caleb finished AP chem and calc. He's exhausted. Me too.

+ Went to the first delivery of the morning--full term twins, babies being born to a 40 year old mom with no previous successful pregnancies and a lot of loss. One boy and one girl, pink and squalling, very alive. Nice.

- Chapel ended this morning with a security announcement, which went something along the lines of, "the one who was killed has many brothers who come to our hospital, so keep a careful eye on them." It felt a little creepy, a little racial-profile-prone. I tried to imagine the thin mother of our baby with severe bladder and bowel anomalies as part of a plot against Kijabe. Couldn't see it. Yes, we have a significant patient population from an unstable m.sl.m country. But they come because they have sensed love and care, not because they want to overthrow or destroy. And most of the convicted Al Qaeda after the embassy bombings in Kenya, or other bombings in Kampala, do not appear middle eastern or north african. They look like everyone else around them, which is how terrorism works.

-Reading blogs and fb and talking to Kenyans about Osama's death. Felt guiltily unpatriotic day one when I didn't want to rejoice. Now feeling relieved by people like Grant Walsh who are introspectively trying to apply some of the tough Jesus sayings (pray for your enemies and those who persecute you) to the current world situation. Justice, it seems, but who really wants justice for themselves? Finding that there are Christians who are soberly cautiously grieved, which seems most appropriate.

- Falling asleep waiting for the slow crisping of granola. Barely keeping up with the food consumption.

-Telling parents of a week-old baby with severe hydrocephalus and total-body infection that their daughter will not survive. Praying Psalm 23 with them. Resisting the urge to soften the truth too much, to hold our the false hope that somehow we can fix all this, the one thing they really want me to say. Exhausting.

-Nelly, below in her traveling duds, a baby with cleft lip and severe heart disease, on day 40 of life and at her parents' request we transferred to a private hospital in Nairobi for expert cardiology management. A 36 hour nightmare later (they asked for a several THOUSAND dollar deposit pre-admission, transferred her to the public hospital, where the impatient dad wouldn't wait for the cardiologist) she came back, weight down a little but miraculously not much the worse for wear. This is a hard medical system to navigate for parents of special-needs kids.

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