Wandering the hospital with my IPhone, and pondering

This is my first full-Swahili patient visit. Our MCH (Maternal and Child Health) clinic bursts with charts, especially on Mondays. While I would like to stay free to consult on the patients already screened by the interns, clinical officers, or medical students, they sometimes get bogged down and I reluctantly pick up a chart on my own and at least try to get started before calling for translation help. I'm embarrassed by my stumbling slow progress. But for many reasons, not all of them noble, I just haven't invested the time and effort I should in Swahili. I do work with an excellent language helper two or three times a week, but I must be one of his more disappointing students. So this week I really celebrated when I called this baby back to an exam room, had a conversation about her condition with her mom, and finished the whole visit with no English and no help. I have to admit it was the simplest patient of the day. She was healthy. Her mom was returning for a check up after an admission to the hospital, and answered "no" to all my limited "Is she vomiting" type questions. I have far to go, but I'm still thankful for this baby step. Charity narrowly survived severe dehydration this week. I found her on Monday morning, having arrived in the middle of the night. When her sodium came back as 191 (almost the limits of the machine) I transferred her to the ICU for management of her fluids. She was also in kidney failure. But a few days later she is greatly improved. Her mom lost her previous baby to the same problem exactly a year ago. Pray for her. In today's political climate, I'm not sure just why a parent would choose to name their child Gadaffi, but this diminutive twin enters life with the burden of a very low birth weight, a need for a skin graft to heal a terrible IV extravasation burn from another hospital, and an ominous name. This darling little girl, Karen, was my patient months ago when she was transferred to our NICU for the expert care of our surgery team after being born with a developmental defect in her perineum-no rectal outlet. I remember how hard it was to get her to gain weight post-op, and when I last saw her she was scrappy and scrawny. In spite of a dangerous gastroenteritis and bacteremia with high fever a few days ago, she's healed and perky and almost ready for her next surgical step in creating a functional perineum. This is Bedan, who I posted pictures of months ago. He was born with a front0-nasal encephalocele and mid-facial cleft (his face was split open from between his eyes down to his lip, with a balloon of brain-lining-tissue and fluid bulging out). After a month or more in the NICU our surgeons were able to piece his face back together, and he returned this week for the next step in his reconstruction. He's about tripled in size as his mom feeds him well! Unfortunately he came with a bronchiolitis, a temporary lung infection that would have made his next surgery too dangerous, so it had to be delayed. His mom was abandoned by her husband after she delivered such a deformed child, so she struggles to get help to pay for his medical expenses. But she's a brave and dedicated lady doing a great job.

These are all kids who remind me that what looks like a disaster often turns out to be an amazing story of healing, or love, or something else intangible and important. Our moms' prayer group guide this week included this paragraph, even more poignant in light of the top news story out of Penn State football: " Where they (our children) have been the victim of evil, I pray that You would heal, restore, and lift them up above it. Bring good out of it. Just as You raised up Joseph to save a nation after evil plots on his life were carried out, I pray You would raise up our children to great things in spite of the evil perpetuated on their lives. In the meantime, enable them to navigate through this time and find “grace in the wilderness” Jer 31:2." What a powerful reminder that God is at work even when the hard realities of a fallen world impact our children. Whether it is having an application denied, or being born with brains bulging from one's face, or being abused by supposedly responsible adults, our kids suffer and our hearts ache, but we cling by faith the the story of Joseph, that evil can be transformed to bring good.