• ashirk@gmail.com
  • Kijabe, Kenya
on doing new things. . .

on doing new things. . .

Most days, I feel like I have a handle on the pediatric intensive care unit. I have been in the PICU 6 months each year for almost four years and rotating through it for 8. The vent and pressors and sick kids don’t make me nervous the way that they used to – when I had to take a deep breath and brace myself every time I walked in the door.

And then there are weeks like this week . . . when I can work through each patient systematically, but something is new to me on every. single. patient.

In the last two weeks, at bedside, our team of fellows, surgeons, nurses, and learners externalized a ventricle peritoneal shunt emergently, placed a tracheostomy in a child with a difficult airway, did a bone marrow biopsy and central line placement, drained a massive empyema, and did a pericardiocentesis (and if those words make no sense, just know they are big procedures on little people :).

We did all of these procedures amidst our normal intubations and extubations, echocardiograms, resuscitations, fluid calculations, complicated nutrition resuscitations and routine PICU and NICU care. We have been full – all 8 beds – every single day, and I have been rotating one child in as we transfer another out to the floor.

It has been an amazing month for outcomes and we had only one child not be discharged home despite the many impossibly sick kids. We have prayed and calculated and managed and coordinated and one by one they have gone home. . .

We have been two pediatricians in Kijabe all summer running the PICU, NICU, floor, and casualty – I am tired. Exhausted. Many days I have not made it home for lunch. But the weekend brings late and lazy mornings and Ima and I have tagged out for long weekends to breathe.

Tomorrow, Judy is headed back to Kenya, and last week, we interviewed 2 amazing pediatricians to whom we offered jobs with our team. Pray that all the details work out with the hiring process.

When I look back over the past 2 years, I am so proud of how our team has grown – how we have shifted and adjusted, fought and looked out for each other and our patients. These small every day improvements are what have made the last week possible.

We have built a department where we can step confidently every day into the next thing that is needed for our babies, and know that even in the impossible things, we are Carried by One who carries all things forward in infinite possibility.