The End of a Story, and Hope doesn't give up

I had just walked out of the morning's monthly staff meeting when my pager went off, and I hurried to the HDU knowing it would be Vincent.  He had been vomiting, cold, listless, with abdominal pain through the night I had heard from the on-call doctor, worse than I had left him, but in the early morning hours told the nurse he was hungry.  His mother called the staff over an hour later, alarmed, because he was no longer responding.  I walked in to find him gasping in the way that people do as they die, pulseless, with the large unmoving pupils of the brain dead.  He was gone.  That gasp was his last, and as I watched the heart monitor petered out to a flat line.  We had long before decided that we would put every effort into his fluids, medicines, oxygen, feeds, and wound care.  But we would not do CPR.  The low-likelihood of helping high-pain violence of it would have been grotesque in this circumstance.  Vincent's suffering was over, even as we gathered around his bed stunned, and then held on to his shaking, weeping mother, he was free.  Free of TB and pressure eroding his paralyzed body.  Free of the monitors and hospital.  Free of our failed help.

Two things made this morning bearable.  First, a conversation with the nurse a few minutes after he died, as we reviewed the course, his treatment, what could have gone wrong or been done better.  "Did you know that Vincent prayed to receive Jesus last week here, as did his mother?"  No, I didn't, but evidently another nurse had been sharing Jesus with them even as she cleaned his wounds.  Second, the assurance that we had done everything possible, there was no treatment we held back.  We didn't just move him to a corner to die, we kept open the possibility of a miraculous reversal right up to the last minute.

I wish we had seen the Fall-in-reverse, the resolution of disease that we long for.  I was reminded by others later that we were discharging 4 other kids who had been healed, and many more the week before.  Most kids do get better, most of the time we are witnesses to improvement.  But Vincent's body was so weak, so spindly, so ravaged, so destroyed, the path God chose for him to healing was through the valley of the shadow of death, straight to the table prepared.  I do not regret the all-out effort to keep him alive for two weeks, which enabled him to experience the hands and heart of Jesus in those who cared for him, to encounter the living Christ.  I wish he had not suffered such pain or his mom such loss, but I know that he met Jesus in his suffering, and pray she does too.

Still it was a hard day, moving through the ward, back and forth to clinic, with sorrow in my heart.

Then in the mid-afternoon I went to nursery where we were sending a baby for admission.  Simon, the little baby who was in ICU for weeks after multiple surgeries and chest tubes to repair his congenitally non-functional esophagus and trachea, was still there.  His faith-filled mom is always content, hopeful, patient.  She greeted me warmly.  We have spent more time together over Simon than most people in her life.  His last chest tube had come out a couple days ago, and he is finally doing well after weeks of nearly dying.  I think she could sense that I needed to touch hope today.  "Do you want to hold him?" she asked.  I'm not sure any mom has ever asked me that. She gently scooped him up in his blanket and handed him to me.  Not to evaluate, just to enjoy, mom to mom.  It was beautiful.  Nothing speaks hope more clearly than a one-month-old who has survived against extreme odds, and is only a short step away from cure.

I tried to get Simon to smile as he chomped his pacifier.  I'm sure I smiled.  A lot.  He was the perfect reminder that God is at work in healing at Kijabe, in spite of the morning with Vincent, there is much good we can still do.