Friday 5 pm: The weekend begins with a downpour so violent and drenching that I decide to get sign-out for call from my house instead of going into the hospital (the picture above Mardi took, it is symbolic of our new life of sharing the nursery job . . ). Start to cook dinner, and call comes about a 4.8 kg two-year-old being admitted post-op to ICU. Thankfully I'd planned ahead on this meal so it's almost good-to-go, but it turns out the child does not need a ventilator and I'm not needed. Another call about a newborn with a slow adjustment to life-outside-the womb. Both stable. So back to family, spaghetti, one of the kids' friends comes for a home-cooked meal, I realize that with 5 teens I should have made more, so Julia helps me get a batch of cookies into the oven, while the boys clear and begin to watch a rugby game on TV.
9 pm: I've dozed while reading when the phone rings, there is concern about the labor of a woman in maternity, who happens to be the wife of one of the doctors. I hurry over to the hospital to find the baby already born, a lovely full-sized vigorous girl. One of those pleasant paediatrician moments, just hold the baby and congratulate the parents. Check in on the two other kids, both doing well, which bodes well for the night. I love the quiet corridors after dark, the slumbering hospital with its continuing pulse of life. Back home by 10.3 am: calls from hospital about post-op 8 day old with tachycardia (fast heart rate), hemoglobin drop by half, discuss plans for transfusion. Intern says baby is breast feeding and alert. Baby also has rising creatinine indicative of renal failure, but weight constant, so not dehydrated or overloaded. Complicated child who has had meningomyelocele (opening in back exposing spinal cord) repair, colostomy (because born with no opening of rectum in anus), ureterostomy (because born with only one kidney which is cystic and malformed, and obstructed outflow). There are so many babies like this at Kijabe, it is a magnet for rolling back the Genesis 3 curse about bringing forth children in sorrow.
6 am: up for early rounds, go direct to neurosurgical area to see the baby above who now is in the middle of a blood transfusion, with a dangerously high heart rate and murmur, and wonder if cardiac anomalies are part of her complicated anatomy. The baby is wide-eyed, but her mom is fast asleep in bed with her, and I don't wake her, certain that she's had an exhausting night. Write a note about her critical condition and marginal prognosis and go to make arrangements to transfer her to NICU. Which requires moving another baby out, because we're full. Scott is meanwhile starting OB rounds at 7 and finds a mother who needs an immediate C-section. He goes to theatre with one intern while I start rounds in Nursery with another, a competent and efficient young woman who has already done most of the morning's work.
8 am: Ready to transfer baby, go back to ward to inform nurses and primary surgical team . . .only to find out baby has just died. Mercy, or too little too late. Short discussion with medical staff. Back to finish rounds in Nursery.
9 am: home, kids getting up, time to make biscuits, cut up golden dripping sweet mangoes and an orange, set table . . but by the time I'm done it's almost 10, so I leave Luke, Caleb, and Julia to eat breakfast, Scott still not back from his morning rounds, and hurry up the hill to be on time for . .
10 am: Under-13 Rugby 10's mini-tournament, RVA and two other Kenyan/British Nairobi schools. Jack it turns out is captain of his team! I am just on time, and join the handful of other parents as swooping darting swallows comb the field for insects after the night's rain, and the sun warms the earthen bleachers cut into the hill on the sideline. Jack scores the first try, and kicks the conversion. By the middle of the game the whole family has joined to cheer. Jack is sometimes put in the U15 games, but here he is playing with his actual age-mates (though I think that "Under 13" is defined as having turned 13 after the previous July, and since he's a March birthday he's on the young side, but he's still among the tallest and fastest). RVA wins both of its games by huge margins, they dominate the other two teams. Jack scores about a third of the total points, and has many good tackles and runs. THIS IS A HIGHLIGHT DAY: whole family here, sunshine, Jack running about 60 yards through many opponents, tough, clutching the ball, scoring a try and touching it down over the end line. All of us standing and yelling as he makes this play. It is a joy as a parent to see your child affirmed in who he is and how he's made. I remember my Dad, my Uncle Harold, and Paul Leary always telling us that Jack should play American Football--this is probably as close as he'll ever come. A mental snapshot of that moment is filed in my heart.
1 pm: As we walk down the hill after the tournament, the joy of the day is tinged only by the sad ache that I wish my Dad had lived to see this, as a football fan, he'd have loved watching Jack run with that ball in his hands. And the realization that every kid should get that thrill, should have at least a few moments in life like that, cheering crowds, admiring parents, fun in doing something they love.
2 pm: Somehow the entire house took a spiral into chaos since Friday . . time to attack counters full of dishes, put clothes on the line for a few hours of drying, sweep several meals worth of crumbs, while Scott and Luke mix mortar to add the first layer of bricks to the pizza oven foundation, Julia goes to play soccer with her former JV team, Caleb works on never-ending homework, and Jack recovers from a morning of effort. Finish the last sweep just in time for . .
3pm: Two sequential visits from friends, one needs me to review all her daughter's immunizations and see what is lacking for their upcoming trip back to America; the other needs prescriptions for inhalers refilled. Both are women whose company I appreciate, and I'm glad that medicine gives the excuse for them to have come by, the setting for talking about kids and life. From walking into the delivery room to pre-college physicals, I like the longitudinal family-centered depth of paediatrics as a background to the day-to-day challenges of extremely ill inpatients. And having left intensely close community in Bundibugyo, I value highly such friend-time, when it happens (not often enough really).
4pm: I'm technically covering call during Saturday too, for one of the other doctors who wanted to go into Nairobi to see his senior son play on a rugby all-star team. Which is very important. It's been a quiet day call-wise, but just before he comes back another neurosurgical baby starts to have breathing difficulties, so I'm back to the hospital to meet the intern, examine, ponder, plan, draw blood, transfer to nursery again. We're just about done when the real on-call doctor returns, so I'm free to . .
5pm: go on a short run with Star just to stretch our legs and get fresh air, Scott and Luke are still finishing the brick-laying, one layer takes a lot longer than they thought (doesn't everything). Try to hurry everyone along because Saturday night is a special event at RVA. Our water pressure is limited, so showers have to be staggered, I jump in at a quarter-to-six. This is a dress-up evening, and my hair has been even worse than usual with frizz. What to do? Options limited, so at five-to-six I decide to give myself a haircut, an inch or two off all over, since it's been many months since my last visit to a salon in America. With springy hair like mine an inch cut translates into about 3 or 4 inches shorter when it dries. Put on my one fancy outfit, my Christmas skirt and shirt, call a friend with good taste like my sister's to borrow jewelry, in time for . . .
6:15: Sophomore Restaurant. An RVA event that is part fund-raiser for the 10th grade class, and part social event of the term. The sophomores sell tickets, and the adults an upperclassman buy them to come to the cafeteria which has been decorated in a theme (China this year) and be served a special meal. We had been invited to sit with two other couples, both are doctor-nurse pairs. It is a rare evening of going out, being served food I didn't have to cook, adult conversation. I enjoy learning about their pre-Kijabe lives, and hearing about their adventures and plans. The food is probably what you expect when American missionaries are cooking mass-production Chinese, but the atmosphere is very fun. The only sad moment, realizing both of these couples are finishing their terms in July. Sigh. More goodbyes loom.
9 pm: back home in another drenching rain, dripping wet, time to warm up. Jack and Julia are watching Ratatouille and we all watch the end. Chat about the evening, the week, consider watching a post-younger-kids-in-bed movie but the sound doesn't work on this disc, and we take it as a sign to get to bed by 11 anyway to recover from call and be rested for . . .
SUNDAY: family breakfast with coffee-cakes which stick to the pan but are so buttery that everyone declares them the best ever even if they are eaten in crumbles, iced juice, bacon and eggs, coffee. Our Sunday morning tradition has been more difficult to keep up here at Kijabe, but this morning it works. Kids off to Sunday school as I clean up, then we meet again for church, great worship.
1 pm: after church our houseworker Abigail has invited us up to her house for lunch, a rare chance to get off the insular world of Kijabe/RVA and into a real Kenyan home. Abigail lives with her son, her sister, and their elderly mother, surrounded by the homesteads of her brothers, with their kids. And their gardens, a polka-dot of cabbage and spinach, bordered by corn and pumpkins. Their village Maingi is on the top of the escarpment, about 9000 feet, chilly, in the clouds, which part for stunning views. Abigail's sister was our houseworker when Jack was born here, and we've stayed in touch ever since. ( There are pictures of our kids at various ages on the walls of their greeting room). We are escorted in to sit on plush red-velvet-floral covered couches, with low tables draped with lace in front of us, and two stuffed antelope heads leaning out of the split-log-painted-blue walls. This time we can at least exchange a few sentences in Swhalii with the non-English-speaking family members (small progress?). We pray together, and eat a mashed mixture of potatoes, beans, corn, and pumpkin leaves, accompanied by a stew of diced carrots and tiny pieces of meat, and chapati. When we insist "nimeshida" (I'm full) she clears the plates and all three women sit with us to drink chai and talk. This family has truly blessed us, and we pray for God to care for and bless them too.
Which brings us up to now. A weekend with friendship, community, work, worship, family, sports, food, home, projects, rest, all the essential ingredients of full life. At dinner last night someone asked us if we feel at home here yet, and today I would have to say yes. Which is no small thing.