quiet whispers: part five

Because things are never clear in memory, I am going to post this from an email I sent to my best friends after that first call weekend. If you have been following us from the beginning, this is familiar ground – the part of our short term trip that began the rest of our lives, and the part of the story I tell most often.

Part 1 – Part 2 – Part 3 – Part 4

july 22, 2013

this was . . .as the long term missionaries here described it. . . a horrendous call weekend.

Saturday at 7am I walked in to a toddler with a heart rate of 220 (high, for those nonmedical people) who was combative with fever and oxygen at 50% and a head injury the day before. . .and sent my first child to the ICU. We rounded on our 24 inpatients and then I was called to the nursery to help a 27 weeker breathe and do spinal taps on a seizing child and 2 neonates with fever. We admitted several children from the ER and then that tiny newborn in nursery stopped breathing again, and the nurses knew it was over before I could even return. I sat with his 17 year old mother as she absorbed the news and placed her baby in her arms.

I came home and went to the playground with my joyful girls and had some lunch before getting called back to the hospital for some more deliveries and admissions. I fell into bed at 2am.

Sunday, at 8am, I rounded on the ICU patients, the nursery patients, and the ward patients – no residents, no long term people, just me.. . .

And then I got called back to the nursery to tap another child with fever, and then the 24wga (that’s 6 mo preemie, and super tiny even for our NICU in the states), who they have been resuscitating and caring for so valiantly for the last 44 days in the nursery, stopped breathing and died – I could not get a heart rate back, could not get the oxygen up. I called in the long term missionary to help me tell this mom, who had a hysterectomy from postpartum complications, that her only child was dead. And then one of the children in the ICU who had been breathing on his own all week needed to be put on the 1970s ventilator. I figured out the correct way to set it. . .and then I got called to the ER to admit two more patients.

One had saturations of 50% on room air and such a large heart on chest x-ray that I could not see her lungs. At 10 months old, she looked like an 80 year old man in florid heart failure with pulses in her neck and a liver I could fell all the way down to her hip bones. I gave medicine to help her pee off fluid, admitted her to the special care unit and turned around to see the next child. This 9 mo had a heart rate of 230 and was gray and so sleepy, hands like ice, and blue on 5 liters of oxygen. I ran to the ICU to tell them I needed a bed and told my intern to get an IV. When I returned the child had stopped breathing, and his heart was slowing down. He wasn’t responding as we desperately stuck him – we put lines in his bones and intubated but his heart rate plummeted to nothing. . .and I had to tell yet another mom that her child was dead . . .and she sobbed and held me as the father held the child and wept.

Then, the anesthesiologist who had helped me intubate told me to call the chaplain. “You are needed in Theatre,” he said, “Two babies. One heart.” They had just completed the ultrasound to prepare for c-section and had seen conjoined twins, full grown and inseparable.

So, we went to the theatre and the OB delivered two beautiful baby boys – one crying in protest from the minute he was born and the other silent, needing our help to remind him to breathe. They had perfect hands, perfect toes, beautifully rounded heads, and they they shared one chest- one heart, two lungs for two baby boys. We rushed them to the nursery were the promptly peed on each other and then began to cry and stick their hands in each others eyes and mouths. We started an IV, and just sat in disbelief and marveled. We looked up the statistics- baby boys, joined at the heart, delivered alive – about 1 in 10 million – and we were watched them breathe.

That was my turning point two years ago -watching those babies breathe. I had been grumpy, angry that God would give me so much heartbreak in 48 hours, exhausted. And then I stood there, witnessing something that very few people in the world get to see.

It was another whisper,

I’ve got this. You are right – you don’t know what to do, but I do.

That kind of sovereignty  and grace is true anywhere in the world. But for me, in that moment, it was more real than it has ever been.

After I went home and slept, I woke up and wandered into the living room on the edge of the Great Rift Valley. David looked at me, gave a half smile, and said “You want to come back, don’t you?” I nodded. “Good, me too,” he said.

And that was it, our long, drawn out discussion about moving our family across the ocean. 10 whole words.  The decision was strange and certain. The same feeling we had about pediatrics, and Birmingham, and the ER. The same comfort we got from David’s accidental career as a wedding photographer.

We started wondering how to get back to Kijabe, and other plans fell away.

Part 6