A woman presented to our hospital having seen a rush of fluid and
vaginal bleeding after just five months of pregnancy. An ultrasound
scan revealed twin babies, perfectly formed, measuring about 17 weeks,
but without any of the protective fluid in the womb needed for their
growth. Over the next couple of days, the bleeding continued and the
fluid showed signs of infection. Then the leading baby died. The
second one still had a heartbeat but no fluid, and mom's hemoglobin dropped
two grams in two days. I administered antibiotics and multiple
medicines in an attempt to deliver the now deceased baby and her
felt the chances of their mother suffering a serious complication were
too great. But nothing worked. Her body did not respond to the medications we gave and the time had come to remove her deceased baby and her terminally ill sister.
My heart weighed heavier and heavier as I approached the task ahead of me. I tried so hard to avoid it, but now I prepared to perform one the procedures I have come to abhor. I have only been forced into it a handful of times, but each one is hauntingly painful. I sensed myself bargaining. Perhaps another emergent case would come up and derail this one. Perhaps the surgery team wouldn't be ready in time and I would hand it off to the on-call doctor, who said she would be willing to complete it for me. But in my heart, I knew the burden of my decision and that it should be my responsibility. Mom understood and, having felt sicker each morning for the past three days, asked me to proceed.
"It's all wrong. By rights we shouldn't even be here. But we are."
Anyone who has known me for more than a day or two probably knows that I am a Tolkien fan. In the Lord of the Rings, Frodo and Sam undertake a perilous journey to rid the world of a great evil. In doing so, Frodo nearly succumbs to despair. Upon realizing that his own soul is changing because of the evil he sees and carries with him, he wants to give up. But his companion Sam sees beauty and light on the other side of their present darkness.
Some months ago a young woman presented to the hospital with painful
contractions after just seven months of pregnancy. She
delivered not one but three very low birth-weight babies ranging from
900 to 1,200 grams. In our setting, these little ones faced almost
impossible odds to survive. In those early days I counseled mom with a
desperate realism - that we would do everything we could for them, but I
did not think they would live. Each day I attempted to prepare her
for the difficult road ahead and the likelihood that at least one, if
not all, of her babies would die in the hospital. When they all started losing weight, I began to dread rounding on those three babies cuddled
together in their single warmer. The smallest developed an infection and
difficulty breathing. When I moved to a different ward of the
hospital I felt guiltily grateful that I might not have to be the one to
pronounce them. I nearly despaired.
"It's like in the great stories, Mr. Frodo - the ones that really mattered. Full of darkness and danger they were. And sometimes you didn't want to know the end, because how could the end be happy? How could the world go back to the way it was when so much bad had happened?"
Some weeks later a colleague of mine shared a request in our prayer meeting for three small premature babies in the nursery - triplets that, despite being small and seemingly frail, appeared to be making a turnaround. My heart was buoyed by the news. But I have held more tightly to cautious and expectant hope rather than unrealistic optimism. I remained downcast.
Some time later, I returned to our maternity ward. After a glance over the charts of the twelve expectant mothers we were managing that day, I entered our nursery. I could hear the hymns of the nearby church beginning the Sunday service. The crowded room bustled with young mothers and their little treasures - changing clothes for the doctor's arrival while delicately navigating intravenous lines and oxygen tubing. Several greetings of "moning" welcomed me and I collected papers, afraid that I might need to ruin many of those smiles with the day's news.
The first warmer I came to took my breath away.
Three healthy babies cuddled together wearing matching Sunday dresses. A young mother and a new grandmother smiled at my surprise. They were now the seasoned veterans of our nursery and could even be seen advising newer arrivals on how to look after their little ones. As I perused their growth charts I grew more and more stunned. Not only were they growing, but breastfeeding and approaching a healthy discharge home from the hospital! As the hymns continued in the background, I enjoyed a silent and misty-eyed moment of reverent gratitude.
"But in the end, it's only a passing thing, this shadow. Even darkness must pass. A new day will come. And when the sun shines it will shine out the clearer. Those are the stories that stayed with you, that meant something, even if you were too small to understand why."
"But I think, Mr. Frodo, I do understand. I know now. Folk in those stories had lots of chances of turning back, only they didn't. They kept going. Because they were holding on to something."
A decade ago we felt the distinct call of God to pursue caring for the least, the last, and the lost in the highlands of Papua New Guinea. Over the years, my initial heroic optimism has matured into a persevering hope. The enduring effects of our service here are evident in the children I see running around our village that I delivered, in the new doctors that I have taught, and in the grateful smiles of families I've cared for as we go to and from the market. But every once in a while, a moment of miserable darkness threatens to to blot it out. When another child dies, a mother loses her newborn, or the endless tribal violence fills our wards with casualties, I begin to wonder what I am holding onto. In some of my most challenging call nights, I have thought it would be simplest and easiest to leave these daily battles to someone else.
When I reflect on that call, I know now. I am not called to great accomplishments and great victories. Not even to be successful, though with God's grace we often are. I am called to fight for what Christ fought for - God's redemption of this world through the rescue of individual hearts. A contest filled with miracles, narrow escapes, blood, trials, deaths, and resurrection. At times, the gravity of it escapes me - while at others I cannot escape it. But in all times, I pray I would continue steadfastly in His hope.
"What are we holding onto, Sam?"
"That's there's some good in this world, Mr. Frodo. And it's worth fighting for."