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Monday, May 11, 2015

Life and Death, just a normal Monday



The interesting thing about Kijabe, you don't have to make anything up, it all really happens.

This is Mary W, a smiling bundle of 4th grade cuteness.  Last year she was paralyzed by a neurological disorder called Guillan Barre Syndrome.  We kept her in the ICU for a month on a ventilator, with a tracheostomy.  We didn't know how much recovery she would get, and how the experience would affect her.  So it is very kind of her mother to come back and visit, to adamantly encourage our current patients, to give them a glimpse of things to come. 
And our other patients need it.  J, pictured above, is also paralyzed with a tracheostomy, though from a different etiology.  She seems to flirt with death at least once or twice a day.  Today it was a plug of mucus in her breathing tube that almost did her in.

I walked into the hospital this morning after a weekend off, to find 4 of 5 ICU beds filled with kids.  Two with brain tumors.  One had a partial surgery which had to be ended due to her clinical condition, but will be completed later in the week.  We discussed a long time whether she was ready to come off the ventilator.  Some signs were encouraging, but her xray showed a totally collapsed left lung.  Hmm.  Maybe tomorrow I thought.  But as we rounded on the next patient, this girl on morphine and sedation wiggled her hands in the restraints and pulled her own tube out.  Nice when patients just make the decisions for you.  She managed to breathe, and we pray she'll eventually get all the tumor out.  The other child with a tumor had been dwindling for 6 months in Congo (DRC).  In March a hospital in Kigali told the mom it looked like a brain tumor.  But it took them 2 more months to get the money to come here.  Sadly this family was Jehovah's Witnesses:  NO BLOOD TRANSFUSIONS.  I pulled some good God-makes-exceptions-to-all-rules-to-save-lives stories (David and the showbread, Jesus on the sabbath) to try and convince the mom to allow a transfusion, because the surgeons refused to take him to the operating room for certain death without a potential to transfuse.  Meanwhile the little boy kept getting worse.  By this afternoon, his deterioration was outpacing our convincing.  After 4 rounds of CPR he was not longer even able to open eyes or move, and our tests showed he was brain dead.  His mom said this was not the last time she would see her son, they would be together in Heaven.  But when his heart finally stopped, she sobbed.  I am torn between admiring her faith and feeling very angry that false-theology costs lives.

Brain tumor from Congo?  Four complicated surgical patients in ICU?  Just a routine day at Kijabe.  Emergency page to help the nursery team?  Also routine, but by the time I arrived they had decided to stop resuscitating a newborn with many birth defects, premature, and not able to breathe.  His misshapen legs and large head made us wonder, did he have kidneys?  Was the amniotic fluid low?  The midwife remarked that they didn't have time to get a scan, but the fundal height was normal.  For a premature?  Mom still looked big and uncomfortable ten minutes post partum, when it occurred to me to ask, could this be a twin?  Sure enough, Twin two had plenty of fluid, a bulging sac, and I could barely put Twin one off to the side before two was out.  So this couple who walked through the door to have a baby, lost one, and gained another.  A beautiful hopeful image of redemption.  

Surprise twins and tumors and long days of work.  I do love Kijabe, and even though I'm emotionally turning towards departure, I'll miss crazy patients like these.  And even the craziness of Monday did not quite erase the loveliness of a weekend overnight for our 28th anniversary.  I'll close with one of Scott's pictures, that definitely makes us look better than real life.  Thankful for walking 28 years through thick and thin and countless Mondays with my best friend.

1 comment:

Steve Blackwood said...

Great picture!!!!!!!!!