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.
