You liberate me from my
own noise and my own chaos
“Dr. Mark – the
patient is going into arrest”
Nearly every day I hear
these words from one of our nurses. When I do, I generally drop what
I am doing and accompany the nurse back to the hospital ward,
harboring all kinds of doubts about what will come next.
Usually, a patient lies on
their bed, with nursing students around them trying to give them
artificial breaths and chest compressions while family members look
on in fear. As I arrive, a small opening appears and I go to the
bedside. Sometimes I tell the nurses to give medications, sometimes
I take a turn giving compressions, sometimes I put in a breathing
tube.
Then during a pause in our
efforts, I kneel at the bedside and place a stethoscope – that
quasi-mystical symbol of the medical profession – on that patient's
chest. In this moment the nursing students are quiet, the staff stop
speaking and the family members hold their breath with their eyes all
fixed on me.
And I hear nothing. No
heartbeat. No familiar sounds of life.
I look at the patient's
mother, father, son or whoever is standing watch over them and I say,
“Em i dai pinis” - “They are dead.”
And the wails of the
family erupt. Sometimes they throw themselves onto their deceased
loved one or onto the ground, howling for them to return. I lower my
head, say thank you to the staff and attend to my other patients
while the students return our resuscitation equipment to its place
and the family grieves.
Lately I have struggled
with the number of patients who die here. Every day I left the ward
thinking, “What can I really do, in the end?” Medically, I had
nothing else to give and each day people kept losing their fights and
dying. I grew tired of putting my stethoscope on silent hearts.
But one morning, as I sat
looking over my garden and the mountains of PNG in the distance, I
realized something.
Every moment that went
quiet, while I listened for signs of life in a dying patient, meant
an opportunity to listen for something more. Those moments take on
an intimate sacredness. I can use those times to close my eyes and
let Christ fill up the silence.
It is there that I will
know you and you will know me
One afternoon, our midwife
Sylvia came to let me know about a patient who recently arrived from
a rural health center named Stella. Stella was expecting her first
baby in a couple weeks. She couldn't have been more than eighteen.
She felt contractions for a couple days and went to her nearest
facility, but despite hours of pushing couldn't deliver her baby.
They sent her to Kudjip.
The nurses evaluated
Stella and came to get me. “Doc, I can't find a fetal heart tone”
As I wheeled the
ultrasound machine next to Stella, she gave me a soft smile, despite
her pain. With her contractions a baby's scalp was visible, but had
an unnatural color. I placed the ultrasound probe on her abdomen,
looked for a minute and then told Stella the news – her baby had
died.
Her cries filled the room
- the entire ward. And I wanted to run away.
But I stayed with Stella,
her mother and our nurse Theresia. Stella pushed. I pulled with a
vacuum. Theresia coached and supported her. We delivered Stella's
deceased child after a very difficult process requiring some
extensive suturing. I dripped with sweat and removed my surgical
head-light to complete some paperwork.
The baby lay silent next
to the bed and Stella slept under some anesthetic.
And I paused. The nurses
had left. Stella was quiet. Her mother had gone out. There were no
cries. I stood by her bedside listening. And I felt like I knew
God's heart – as He felt the loss and grief that filled that room.
Yet with a mingled affection for Stella who had survived this ordeal,
would wake up and recover, and who could one day find restoration
and hope again.
A few days later I sat on
Stella's bed with her and her mother. I explained to her that I felt
she would have children again, that they would likely be healthy,
that she hadn't done anything wrong to make this baby die and that I
wanted her to come straight to the hospital the next time she was in
labor. These bereaved ladies smiled while holding my hands in
theirs. And in a quiet moment I could only think, “sorry” and
went on to my next patient.
Someone needs to be able
to think medically when the noise and chaos drowns out everything
else. Someone needs to direct the nurses in what medications to
give. Someone needs to determine if we continue our efforts. And
finally, someone needs to pronounce that patient – dead or alive.
I have to be in that moment.
But Christ chooses
to be there.
He chose it two thousand
years ago, and keeps choosing it today. In the places of the world
where babies die before they see a sunrise, where families are
divided by conflict, and where children watch their mothers succumb
to AIDS.
He enters to speak in that
moment when someone's heart goes silent.
