(3 babies squeezed onto one resuscitaire bed this morning, two were dead by this evening)
(note neighborhood name on this file .. "Jesus Winner", still pushing the Gospel of Triumph)
One of my Lent devotions this week contained this paragraph:
Therefore, let no confusion remain. Lent is not self-improvement. Lent is not self-denial for the sake of some moral gratification. At its most basic, Lent is about awaiting death. It is the uncomfortable and unwelcome reminder that we will grieve and we will die. For this reason, we can embrace the pain rather than avoid it. We can lead one another in lament over death’s temporary reign.
Jesus' disciples in the 40 days prior to his crucifixion certainly were not, for the most part, anticipating a march towards death. They were still expecting the angel calvary, the miraculous zap to all enemies, the dramatic vindication. Even as Jesus talked about losing your life to save it, taking up the cross, being a servant . . . they were arguing about seating arrangements in the palace. That is me, too. Lament and embracing inevitable pain all sound noble in a devotion. But the actual determination to keep moving into areas of suffering, to keep facing death without fear, well, that's another story. Just when I think we are faithful, it becomes excruciatingly hard.
For us, the walk towards death occurs every morning when we get up and go to another day at the hospital. There is literal death, sometimes way too many. Yesterday I lost four patients, today so far two. Women arrive hourly with preterm twins, with a baby delivered on a bus still attached by her cord, with a convulsing lethargic infant, with an unconscious one-year-old deflated by diarrhea. There's no screening here, no shielding, the raw effects of poverty and stress and physical labor and not-enough-to-eat just wash up on this doorstep over and over and over. Yesterday as we tried to round and review the 38 babies we already had admitted in Newborn Unit, a nurse from radiology walked in with a rough wool blanket, inside was a 885 gram 26-week grey-blue limp newborn with no sign of life except a barely perceptible slow pulse. The mom had been sent for an ultrasound because of abdominal pain, surprise, that was labor and this was a baby. While I got the heart rate up and some response and breathing initiated the prognosis was very poor, and I had to decide to just leave this one on oxygen by pressure in an incubator while I ran to the operating theatre where Scott was delivering another 985 gram very small-for-age 32-week baby to save the life of the mother. I literally walked in as the baby came out, and that one also needed a lot of resuscitation, and by the time I got him stabilized on his airway the other baby was dead. And so it went. We lost a 1-week old readmitted who had meningitis, and another baby with severe lung damage from a too-slow too-stressed birth with meconium, and a 29-week baby who delivered at home and was brought in infected and jaundiced. And then 25-week twins, whose mother worked hard manual labor on farms.
(the very small-for-gestation baby delivered early to save his mom's life, so far still fighting)
But the walk towards death occurs in subtle ways, too. When we walk into that hospital, we never know what the staffing will be (38 babies, one senior nurse and one brand new one brought over from a dispensary to help on NBU, 50-some kids on the ward with two nurses as well). The patient with asthma is just not improving . . only to find out no treatments had been given. There is always something: your colleague has to go to a meeting, pick up a document, appear in a court case. The government is fighting with the university and interns are delayed in posting. We're out of almost every antibiotic, or none of the labs are done because the machine is broken. There are no gloves, or no IV cannulas. Or bigger picture, there are protests in Nairobi, or roads closed, or political uncertainties. There are wipe-you-out issues with people you care about. There are rebel threats on borders, or potentially fatal illnesses.
And death comes to certain dreams, or hopes. Like not being with your med student son when he has surgery, or your soldier son on his pre-deployment vacation, or ever seeing your youngest son playing sports, or being able to reassure your graduating yet-to-be employed daughter that she can always live with you for a while (she can, but it's a long journey!). Never having seen the rooms/homes/dorms of 3 of the 4 kids. Moms who we never spend a birthday with. Sisters who do almost all the attention for our mothers. Planning that needs to happen but keeps getting pushed off to late evenings, funds that need raising.
I guess this week I've just been reflecting that the determination to keep going back into that fray, to keep plugging on in hard places, wears one down. In my head I do believe that's what Jesus calls us to. OK some people glorify God by being stars, speakers, well-known, moving in circles of the powerful, but that's not really our jam. God asked us, we believe, to go to very dysfunctional places where injustice skews the outcomes, where every. single. day. something new doesn't work.
So later in the week, in another devotional time, this verse popped out in Psalm 25 (v 10): All the paths of the LORD are mercy and truth . . .David wrote that, David who suffered hunger, who suffered betrayal, who committed adultery and murder, who lost and regained his Kingdom, whose heart was broken by his son. David wrote about humility, and then asked to be taught God's ways.
So the Lent rubber meets the road, day after day, in our lives. Can we accept that the quiet plod of faithfulness in the dirty corners of the world, even when it is frustrating and exhausting and unrewarding and costly, is a path of mercy and truth? That being called to borders, to refugees, to cities, to isolated rural areas, to places where people are suspicious or hostile or demanding or incessantly persistently needy, is the very place where God pours out that mercy on us, and shows us the truth of who God is?
Let's lament the 6 babies who slipped away from life here in the last day and a half, and the uncounted others all around us. Let's lament the broken jagged edges that centuries of sinful unjust choices have created. Let's support each other as we call out the false Gospels of continuous triumph, always winning, comfort and ease as our birthrights. Let's challenge each other to keep walking towards the margins. Let's look for hints of mercy and truth, even as we walk straight into shadow, truly believing that this movement towards death paradoxically leads us to life.
(another peri-natal collaboration between Scott and me, this one had a rough start but is peacefully anticipating discharge tomorrow)
(In honor of International Women's Day, with my two interns at lunch as I gave them a talk on TB. These are two hard-working, unperturbed, non-complaining women and teach me to walk into challenge)