Triplets

Tuesday, August 27

Today was a day so full that it went quickly but when I look back it seems like this morning was many days ago.  Tuesdays are the days that we just have an early meeting in the ward. The student nurses have all changed rotations and so we have a new batch and many of the medical staff were not there, so it kind of felt like starting over with relationships again.

The devotional was good and focused on the fact that God has chosen to place us each where we are and that He expects us to bear fruit where he has put us.  The charge nurse then used this as a launching pad to discuss with the students about finding work to do and using the time to learn and not be lazy. They actually were all busy scrubbing and cleaning at one point which was good to see.  There often seems to be a lot of sitting around.

I rounded on the few patients on the ward.  I had hoped that the medical officer would join but she stated she was going for tea and I never saw her again.  The diabetic and mom are in good spirits but it continues to be difficult to keep his sugars in the desired range on the Malawian diet. It will just take patience but he is out of danger for now.  

After the pedi patients were seen, I took a student and headed to the NICU.  We helped to round on the babies, but did pause once to ventilate a premie who was struggling.  The baby was pale and lab work was pending but it had some unusual features and was having some apnea.  We continued to round and at one point I looked up and noted that the baby was not breathing. We went back to it and found the heart rate was very low and started CPR.  We tried to resuscitate for about 20 minutes but the baby did not survive. The mother was called in. She took the news calmly, stating that she had delivered 4 babies and only one still lived.  She had seen this one was small and so she was not surprised. She handed over a chitenge and I wrapped the baby in it but she did not wish to hold it. In the nursery there is a low shelf where you put the dead little ones.  It seems so incredibly cold and yet the bed space is quickly needed. The task though does give me a moment to turn away and gather my emotions as I squat down. Then it is time to write up papers and review the resuscitation attempt.

I headed to lunch with a heavy heart.  I heated up some leftovers and sat on the porch to chat, but the phone went off.  A mother who is pregnant with triplets has been under close observation and now is ready to deliver.  I headed over to the hospital and Catherine, the long term missionary doctor, and I headed to the operating theater.  In addition, one of the Americans who teaches the Basic Life Saving class is a NICU nurse and joined us as well. I changed into scrubs and dawned the rubber boots I was given.  The look would not have inspired confidence in the US. We headed into the OR. There are large glass windows that overlook the African plains with the mountains in the back. I can not imagine that another OR in the world has a better view.

The mom was rolled in and is a tiny woman but as she leans back her stomach is impressive (in all the positive ways).  Marlene, the tropical medicine doctor specializing in obstetrics, came in and we all prepare. Prayer is said with the mom and we begin.  The three of us stand in line to accept babies from the surgical field. I am second in line. The babies all were a little slow to start crying but all did very well and ranged from 1.35-2.3 kg.  We rejoiced!!!! Then we plodded across campus in our giant rubber boots with our small bundles to the nursery. It may have been several years ago, but in my lifetime, I have have carried many infants from the delivery room to the nursery.  Today, however, was the first time I had to dodge a chicken along the way.

I changed back into my clothes and ran to an educational module for the family practice residents.  They had been given four articles to read and then they have a quiz and discussion about them. I had actually read them and had discussed one in detail with the students the day prior.  It was nice to sit around a table with active and honest discussion with residents from several countries.

I headed back to pediatrics and assessed the three new admissions we had gotten.  One with severe anemia who had a transfusion, one with an abscess that will have surgery tomorrow, and one admitted for malnutrition.  The one who is severely malnurished was simply admitted for feeds but on further exam has been running a fever, has severe developmental delays, and when I went to do her abdominal exam I found a stoma from a colostomy she had a few months ago.  A little more complicated than her admission papers suggested. My favorite part was that being the only doctor/officer around, the nurses seemed to be talking to me more and asking questions. I was even able to tease one of the head nurses and she responded really well to it.  Happy progress.

I ran back to the NICU to check on the triplets and the auntie had a giant smile.  She was more than happy to let me get a picture. All three are girls and mom already has two girls at home.  That’s a lot of girl!!! Additionally, the NICU staff had been able to do a neonatal resuscitation class with Meg and were celebrating getting their certificates.  It was nice to have a happy moment in the NICU.

By the time I headed home, it was already getting dark.  I chatted briefly with the others who were curious about the triplets.  The kids came over from the home and we tickled and giggled. I went and made some French toast-comfort food sounded good.  All of us are missing non-stick cookware and dishwashers. One of those copper skillets would be the ultimate gift for someone here.

My mind swirls with the emotions of the day.  I always struggle in wanting to see the big picture.  Why does God have me here? Am I helpful? Who am I here to serve? Is it about the patients, the staff, the missionaries?  Do I do more/less? Is it about medicine or evangelism?

And then I breathe and get still and remember that He is God and I am not.  It may not be for me to understand. My task is not to comprehend or buy in to God’s plan. I am simply to be obedient, to serve, to abide in Him, to love, and to always strive to glorify Him in all I do.  For now,I will work on the section of wall that is in front of me (Sunday’s sermon) and I will try to bear fruit in the place God has planted me (today’s devotion).