quiet whispers: part six

After my call weekend, everyone returned  from their weekends away, and I welcomed their wisdom and company.  The prevailing sentiment that struck me most in Kijabe was that so much more was possible than we could dare to think.

The women that made up the pediatrics team – Ima, Mardi, Sarah, and Jennifer – refused to accept anything less than the best care that was possible. They had seen death from malnutrition and had refined a protocol that helped the inpatient babies grow safely. They saw death from respiratory failure and upskilled their knowledge in ventilator management and opened the ICU to children. They saw dehydrated babies going into kidney failure and figured out how to hydrate them safely, taking their mortality from 80% to almost zero. They worked with the pediatric surgeons and neurosurgeons to collaborate on care for children that needed critical care after life-giving surgeries.  They had sourced ondansetron and meropenem and other essential medications so we  could fight bacterial infections and dehydration with success.

But more than that, they believed with certainty in how much God loved the children they were caring for and how He was able to work daily miracles by their hands. They walked with purpose and humility and determination.

In Birmingham, I felt that I was the wild card. We had every medicine, test, and resource at our fingertips. I just had to figure out what to use and what not to use. With infinite resources at our fingertips, I puzzled and planned – but rarely prayed except in the most desperate of situations. In Kijabe, the unexpected happened often – the oxygen went out in nursery, and we had to share one cylinder with all the babies. The new CT scanner broke irreparably, and we had to decide if a 4 hour round trip up a terrible road was a worthwhile risk with an intubated child.  The ventilator dial would stick, and we had to adjust based on exam, not numbers. The monitored beds would be filled and we had to watch and critical kid without the benefit of constant monitoring.  And we worked hard, and we paced. We MacGyvered solutions, and we prayed. Medicine in Kijabe used the creative part of my brain.

And the children got better.  Not all of them, but so many. We cheered with moms, celebrated at their discharges. I laughed with the mom of the baby in heart failure on my first call as she came off oxygen and giggled as we played peek-a-boo. We watched tiny premies grow and go home with chubby cheeks.

I watched outcomes I would have sworn were impossible happen every day.

This, came the constant whispers, is what I have been preparing you for. . .this presence and hand in impossible things. This team. This place.

I wanted to practice medicine like these incredible pediatricians – with fierce determination and dedication and faith and trust in each other.  Samaritan’s Purse had created a program for  physicians just out of training who wanted to practice in hospitals around the world.  Mardi pointed out that I qualified because I was still a fellow.  When we wrote to see if I could still submit an application, I was told the deadline for our application was in only 4 days.

So from our porch in Kenya,  on our last 3 days in the country, David and I wrote two 30 page applications and  asked for 7 letters of recommendation from our friends and mentors. Then we got on a plane and hoped that everything would be submitted in time, over uncertain internet at the eleventh hour. It was improbable step #1, as I boarded a plane and told Ima and Jennifer that I hoped to see them in a year.

Everything made it it in time, and 1 week after landing in America we drove to Charlotte for our interview. Three (short and) long weeks later, I received a call from the program director while driving home from my shift that we had been accepted. I wrote this post on October 4, 2013.

In the midst of the year before that, we had run into obstacle after obstacle. I had tried to make plans that failed spectacularly. We had pursued plans that ended up being incredibly wrong. Now, though, the insurmountable nature of those obstacles seems full of grace. The waiting, necessary. Purpose coming from the pain.

After we were accepted, we worked on selling our house and car. I filled my electives with cardiology and NICU and ultrasound. I collected needed supplies and sent emails back and forth across the ocean.

As we went through scrap books and pictures in the final packing phases, my mom and I found the letter I had written when I was seven – supposed to be from me to my mom, 20 years in the future. “Mom, I got a new job today. . .I decided to be a missionary. . .I have a white coat. . .I’m heading for Africa. I figure it’s best.” She stopped talking mid sentence – “Arianna, look at the date.”

September 24th. A few years off, but the date we were supposed to arrive in Kijabe. Another whisper. Another reassurance, that despite my weakness, despite my doubt, despite my struggling, all was and still is as He had planned it to be.