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Saturday, May 12, 2012

Through fire and water

 To appreciate the next post I am about to write, just scroll through the random download of the last week's snaps from the phone.  A week of life involves a fair amount of passing through fire and water:  the fire of being handed not-breathing babies or complicated dwindling toddlers, the water of (I'm not counting but someone did) 42-plus straight days of rain, mud, damp laundry, mold and drear.

To start, the billboard on the left I just love.  A billion people live in Africa now, and that's a billion reasons for hope.

 Good thing last week:  Caleb led worship for the senior class, plus a handful of parents and staff.  A number of kids gave testimonies, including Caleb who is a true introvert but appreciated his classmates for their unique stories and exhorted them to go out into the world and tell them.  Closure is upon us. Every event like this is bittersweet.

Baby Cristobal, who arrived at 3.7 kg, 4 months old, skinny and lethargic, from an orphanage in South Sudan.  After a few weeks of nutritional rehab, he's gained almost 1.5 kg, is perky and smiling.  Love these tiny resurrections.

This 14 year old Maasai girl came in coughing blood, with a deathly looking chest xray.  TB.  The teens of course get to my heart most these days . . . after almost two weeks of anti-TB drugs she is no longer in pain, no longer coughing, no longer infectious and ready for discharge.  You have to love curable diseases and solvable problems.  

James has been in the hospital 33 days.  Something about intubating a person leads to bonding  . . I was uncomfortably on call in the ICU when he presented with meningitis and brain abscesses from a sinus infection gone awry.  He is a normal 15 year old kid.  Like mine.  Was in school.  And almost died.  His mom has stuck by his side every hour of those 33 days.  And after untold doses of antibiotics, several CT scans, days in the ICU, and a neurosurgical procedure to drain a little pus and assist diagnosis . . he is getting well enough to be bored.  I think he may emerge from this alive and well.

Last weekend we went to a wedding:  Stephen our nutritionist (who is excellent, he consults on about 80% of our admissions and always knows what is going on) married Ndinda our MO intern who had just completed her intern year.  Here are all the people from Kijabe who attended the wedding . . we're somewhere in the back row.

 Above, two of the seven interns from last year.  ALL have been posted all over Kenya, which is part of the point of what we do.  Scattering blessings.  Isaac and Fred are competent, dedicated young men.  It was a pleasure to see all of them return for the wedding.  And Scott and I enjoyed the sermon a few days before our 25th anniversary:  marriage is not a minor league, it is the CHAMPION'S LEAGUE.  You have to be fully committed for the long haul.

Below, the bride and groom after they are pronounced man and wife.  It was a meaningful ceremony full of Anglican tradition, purple dresses, bows and flowers and worship music.  The only non-traditional parts were the disco-ish easy-listening-romance music to which the bridesmaids did a swaying dance step for the processional, and the energetic praise music to which the bride and groom pretty much danced while standing up front.  It was lovely.

Anne is another of our well-loved and missed interns.  And Ndinda is entering escorted by both parents, who had a prominent role in praying for and exhorting their children during the ceremony.

The next day Acacia and Julia helped me address 130 thank-yous to the supporters and teachers who have prayed another child through to graduation.  We know it is no small thing to raise a child in Africa who not only survives but thrives. 

Wednesday, the Varsity girls' volleyball team celebrated a hard-fought victory over West Nairobi School.  Acacia had the largest cheering section!  Her aunt and cousin who live nearby, her grandmother in from Athi River, and her mom in from South Sudan!
 Every day there are challenges that stretch us.  Above a baby with an occipital encephalocele.  She was born at a small hospital far from Kijabe, and it took six days for the parents to decide to come, meanwhile she was nearly dead with meningitis from the leaking fluid.  Very little brain remained in her small head.  After consultation with the surgeons and chaplains and parents, we opted to support and comfort but not attempt surgery.  Tough, tough decisions.

On the other hand, here is smiling HS, the little girl from a neighboring country who arrived in the final stages of near-death from a chronic bowel obstruction.  One Saturday morning I spent an hour begging, cajoling, insisting that the upset father NOT take her home in despair.  The next day she had surgery, and we week later she was a normal little girl sitting here in her bed, smiling and eating and growing once again.  Thankful.

 Another South Sudan orphan, who was brought for care.
 One of the triumphs of the week was getting this little girl transferred to Kenyatta National Hospital for removal of her adenoids and tonsils.  The obstruction to her airway had slowly sent her heart into worse and worse failure, until she could not get off oxygen and her survival was uncertain.  We had admitted her at Kijabe numerous times, but she always seemed to be a low priority for KNH for surgery.  Finally we transferred her directly to the ENT service, and hope that something happens!

Below a mom whose face and manner I found so beautiful.  She also has a baby with a non-survivable hydrocephalus, her ballooning head stretching her skin to the point where she can't close her eyes, and her skin is breaking down.  This is her face the day we got a translator she could understand.  Thank God for translators.  I hate practicing medicine by hand gestures.
Meet Aaron and Moses.  Twins born to a (surprise) pastor who both came in for RSV bronchiolitis.  Moses went to the ICU and could have died, but they both recovered and were on their way home when I snapped this.
 Our visiting pediatrician Dr. Christine on her birthday in the NICU with our med student, MO intern, CO intern, and nurse.  A good team, and a busy one.  We've had 20-some patients on each service most of the month, which would  be nearly impossible without help from short term volunteers like Dr. Christine.  Mid-June to early August is also short staffed . . . anyone with vacation time and interested in hard work and great experience, contact us!!

 Julia is really improving in Volleyball.  We've been to every game so far.  She's a jewel.  Acacia is the youngest and newest player and is also learning and playing quite well!
Lastly a look at wet laundry.  Seems trivial, but it isn't.  With six people getting muddy in the downpours and steep paths (the day Jack slipped and fell and lost his art project was a low) and with mold growing over our walls and ceilings, well it gets a bit depressing.

My last night of call I was up nearly the whole night.  What do you do when you are paged to a code, arrive to find a baby 8 minutes old who is likely already suffering brain damage from lack of oxygen?  I intubated and gave resusitation meds and got the baby back, but not her brain I'm afraid.  After admitting her to the ICU on a ventilator I had been back home asleep for about half an hour when the same call came again.  Same action taken.  But the second baby will likely be fine. It was a long night. 

I finished the week absolutely spent.  Tough cases, demanding calls, a teaching conference I had to pull together and lecture, pouring into our own kids by cheering and attending and going to meetings, welcoming visitors, cooking and cleaning and draping wet clothes everywhere, and with a brewing URI.  Scott ended the week recovering from a pneumonia and a sprained ankle.  We were a pretty beat pair. 

Which is the context for the next chapter . . .

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