Wednesday, June 2, 2021

No expeditious road

I moved through the crowded emergency room toward bed 4 where a young man lay with his leg wedged in improvised pillows made of tattered old clothes. He was disoriented and his eyes drifted in and out of focus. His young mother, similarly clothed in a torn second-hand t-shirt, wasn’t sure exactly how old he was but I guessed 11 or 12. 

For a brief moment I thought, “We should be playing soccer together with my son.” 


 But the impressively swollen leg made that impossible, and his delirium told me that the infection in his leg was rapidly progressing through his bloodstream. With a crowded emergency room and outpatient clinic still full of patients to be seen, I hastily told the mother he would need powerful medicines through a “blood-tube” in his arm and to stay in the hospital. She looked a bit lost - as though she had never seen a permanent building before – but there was an implicit (and terribly beautiful) trust in her eyes as she committed her son to my care. I grabbed a nursing student to begin the IV antibiotics, wrote orders for an X-ray and made my way back to the clinic. 


The noise of a helicopter made me pause. Time to get changed into scrubs. Our provincial health team notified us earlier that a sick mother was being transported due to delivery complications. As I went to delivery bed number 1, our Papua New Guinean medical resident Sheila was already working with the nurses on emergency stabilization. Her lifeless form was pale and her eyes she searched the room for anything familiar, but quickly rolled into the back of her head again. While she wasn’t actively bleeding now, she had been for the past 3 days when her baby was delivered at her home in one of the most remote corners of the globe. A nearby aid post attempted to deliver the placenta the next day but the cord broke, oozing blood. After another day’s journey to the health center, the nursing officer at a small Anglican clinic at Koinambe managed to radio out for a helicopter and she arrived at Kudjip clinging to life with a hemoglobin concentration of 2.8 g/dL [normal range 12-14]. 

Dr. Sheila aggressively resuscitated her with IV fluids and 2 units of emergency type “O” blood in addition to strong antibiotics. But we knew that shortly we would need to remove the decaying afterbirth and pray that she responded.

Our family of six will soon attempt the journey back to the US for a short furlough after one of the most grueling terms of service I imagine a medical missionary has faced. And once again, I am terrified. 
Due to airline-imposed restrictions, we will need to pull off 18 negative COVID tests between the six of us to actually board our planes to get home. Airports are skeletons, planes are devoid of food service (never helpful with 4 young mouths to feed) and we are praying that we don’t land ourselves in a traveler’s purgatory of hotel quarantine. But none of those are the reasons I am scared to go back to my passport country. 
During our first furlough in the US some years ago, Esther phoned me to ask if I could stop at a store on the way home to pick up a few items (milk, butter and chocolate chips if I remember correctly – it sounded promising). We had only been in the country for a day, and I was still convincing myself to drive in the right lane. I got to the store and found my purchases but thought I would pick up band-aids. One step into the pharmacy department and I quickly turned around, made my way through the self-check-out, then bustled to the car and stared through tearing eyes at my dashboard for about 10 minutes before going home. The much-anticipated cookies helped calm me down. 
Now, as I glance into the pages of news sites or Facebook, I am similarly stunned. 
Just a year ago, those pages were flooded with the gestures of sympathetic people throwing together programs and projects to help amidst this new COVID “pandemic”. Health workers were applauded, meals were delivered to them. Everyone was encouraged to “look for the helpers” as Mr. Rogers taught us. I remember feeling a strong sense of global solidarity. Finally, the affluent world is having their eyes opened to the kind of reality that affects the 2/3rds world every day. Maybe this is the moment in which those nations decide to embrace the places of the world struggling to keep children and mothers alive against the miserable odds created by their poverty. 
But the vaccine arrived and is now available to pretty much any (rich) person who will take it … so we are instead trying to decide if our pets need to get COVID vaccines while opening clubs, bars, restaurants and movie theaters. 
Don’t get me wrong. I hope to enjoy some of our old favorite stomping grounds while getting a bit of a break and seeing family. I just hope I don’t say or do anything to get myself into too much trouble. 
“I could tell you my adventures – but it’s no use going back to yesterday, because I was a different person then.” -Lewis Carroll 
After two units of blood, Dr. Sheila and I addressed our now conscious mother. I explained to her and her cousin (the only relative that lived nearby) that she was incredibly sick – her placenta was rotting inside of her sending a cascade of infection throughout her body. Without removing it she would die. If we removed it, she had a chance to live. They agreed to go ahead. 
We saw the desperation melt from her face as the anesthetic took hold. Over the next grueling hour, my resident and I removed necrotic afterbirth and repaired lacerations in the birth canal as the septic smell assaulted our senses. Once finished, she returned to the ward with additional blood transfusions hanging and an anxious family member praying her through the night. 
My young patient with an infected leg looked worse the next day. His X-ray did not show infected bone, so I drained fluid from his joint and attempted to find a purulent pocket to aspirate in his leg – without success. I hoped that whatever germ was running amuck would respond to our antibiotics. 
As the on-call doctor, I drifted from the emergency room to the labor and delivery unit throughout the day. Reducing and casting limbs broken in heated tribal fights, counseling cancer patients, failing to resuscitate a newborn baby, repairing difficult birth trauma, admitting a COVID patient, completing miscarriages that threatened to take a mother’s life, balancing feeds and fluids in babies with malnutrition, and myriad other now-routine tasks that would seem quite exotic to many doctors in my home country. Lives were saved and lost. Prayers were said. Hearts were changed (including mine). 
“There is no expeditious road to pack and label men for God, and save them by the barrel-load” -Francis Thompson 
Like many young Christian physicians, I set out feeling like I had been called into this. I felt that God’s broken world could use the efforts of more doctors attempting to bring Christ’s redemptive healing and hope in the deepest dark. I have come to realize that, while I am called to be a minister of medicine, none of my patients are called to be sick. They are created to be whole – redeemed and rescued out of ferociously hostile enemy territory. While I cannot provide that, I can partner with the One who does. Not because I am a miraculous healer, but because I am not. I have not, yet, physically restored anyone with a simple touch or a word. But I have touched and spoken into some of the deepest miseries I could imagine. And each time I see that He’s already there. At times giving strength for the groaning road of restoration. At others, providing a safe haven for tears. But there in all.

1 comment:

  1. I can no longer sit beside you and pray with you in person, but I can sit beside you in spirit and pray with you. God loves your work and your reliance upon Him. Continue to do just that!!!!