Yesterday afternoon was relatively quiet. There is no clinic on Wednesdays which means
there aren’t the normal lines of pts to see.
No elective surgeries are scheduled on Wednesdays giving the hospital
and its employees time to catch up and focus on just the emergencies and the
pts already admitted to the hospital.
The need here is seemingly endless and having a day in the middle of the
week that is designed to be slower so as not to spread people too thin was a
wonderful idea. During the lull of the
afternoon I was back in my room reading a passage in Phillipians 4. I knew that the words were hitting home with
me, filled with meaning, but I had no idea that they were really preparing me
for the night to come. This passage
talks about letting go of your anxiety, letting the Lord of all creation take
that anxiety for you. He promises to
cover you with peace when you fully hand over all of your fears. What an incredible promise! It is a truth that I have to constantly
remind myself of and am not very good at practicing. When am I ever going to learn?
I knew my break from the hospital had come to an end when
the phone rang in my room and I heard that all too familiar voice on the other
end, “Please! Come to maternity.” (Maternity is what they call L&D
here) I was on my way. A pt had arrived in labor that needed a
repeat c- section. Gladly. I was so thankful this happened late in the
afternoon instead of the early morning hours.
The c-section went very well. The
proud mother gave me a huge smile and grabbed my hand in the recovery room
after the surgery was over. I just
praise God for another wonderful life born.
I made my way back to the guest house for dinner and was just finishing
up when I got called to the hospital again.
Another laboring pt had gotten sent to us from an outside facility. It was back in the OR for another c-section
for us. Beautiful delivery number
two! Before we had left the OR we
received word that there was another pt that needed our attention immediately. Ed and I quickly went to see what we could do
to help. A young lady had come in with
complaints of abdominal pain, bleeding and a positive pregnancy test. The flags went up in my head. Something wasn’t right. Back home these pts come to the ER and often
have an ultrasound completed before I even receive a phone call, but here the
ultrasound was going to have to be done by me.
There were two things I was looking for, a miscarriage or an ectopic
pregnancy ( a pregnancy outside of the uterus which is not compatible with life
for the baby and can be life threatening to the mother). I have never done the ultrasound myself to
diagnose an ectopic, but as with many things on this trip, there is a first
time for everything. I placed the
ultrasound and didn’t see anything remarkable inside the uterus. I was praying that if there was something
that I needed to see somewhere else in the pelvis that God would show it to
me. I knew this was critical and if I
missed something it could catastrophic for this pt. As I scanned to the left the diagnosis jumped
out at me. There was an ectopic
pregnancy in the fallopian tube. There
was evidence of fluid in her abdomen and I knew at this point we needed to move
and move quickly. This pregnancy was
already starting to hemorrhage and as we waited to place the IV I watched as
this pt’s blood pressure started to drop.
Ed and I brought her back to the OR and opened her abdomen quickly
clearing the blood out as we went. Sure
enough, the dilated tube stared back at us as we placed our clamps and removed
the left side. I am so thankful this pt
came in when she did and that we were already at the hospital when she arrived
so that no time was wasted. It is
amazing how fast these pts can go from stable to unstable. Praise God that she survived and was doing
well this morning!
Nothing else was pressing so I went back to try to get a few
hours of sleep. That was not going to be
my last phone call of the night. My
phone rang again in the early morning hours.
A pt of ours had arrived, in labor, with a history of 2 prior c-sections
and the nurse was now not able to find the baby’s heart beat. My heart sunk as I pulled out my flashlight
and hurried toward the hospital. What
was I going to find when I got there? I
immediately turned on the ultrasound and took a look. The pt’s belly was so tender and hard. What I saw on the ultrasound left a pit in my
stomach. This was something I had never
seen before, but only read about – uterine rupture. From the grainy quality of the ultrasound it
looked as if the scar from this pt’s previous c-sections had burst open and the
head of the baby was now in the pt’s abdomen. Scanning some more I confirmed
that indeed there was no heart beat. It was too late to save the child, but we
still had a chance at saving the mother if we could get her to the OR quickly
enough. I made the necessary phone calls
and prepared for surgery. One swipe with
the scalpel through the pt’s skin was all that was needed to see the infant’s
curly hair poking out at me. I groaned
out loud as we opened further and I realized that the entire body of the baby
and the placenta was outside the uterus floating in the abdomen. I don’t think I will ever forget the
overwhelming sadness of scooping that lifeless body up and handing it to the
waiting nurse. If only this pt had come
in sooner, if only she hadn’t waited at home while she was contracting, if
only, if only, if only…..but it is not my place to play the if only game. I am not the one that holds the power to
correct the past and change the future nor do I want to be. I am not the one to question the events that
were, I simply must be ready to help in the events that are. Only God has the answers to the whys and the
what ifs and He is certainly not obligated to give me an explanation. I am so humbled. We stopped the bleeding and repaired the
damage. In all of the suffering and pain
that I have seen here thus far I have never once seen a Togolese woman cry
until last night. This would be her last
pregnancy. Her physical and emotional
pain is more than I can fathom as I watched her silent tears drip down her
face. Lord, I know there is redemption
in even this though I don’t see it in the moment. He loves this Togolese woman more than I do
and feels her pain even more acutely than what is piercing my heart. I am so thankful that two lives were not lost
last night and that the Lord was able to guide us through the necessary surgery
to save this mother. Why one woman made
it to the hospital in time and one did not I will never have the answer, but I
do know that the outcome does not change the Sovereignty of our God. Nothing surprises Him and nothing is too big
for Him to handle. God has broad
shoulders, much broader than mine and I have to rest in that.
Your posts are captivating and inspiring! Keep up the tremendous work, Doctor! Your St. Joe's family is proud of you!
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