A Sacred Moment

Kristen here…

 I was standing over the table in the OR about to start a c-section when the call came that there was an emergency coming to the operating theater.  I wasn’t sure what the commotion was about, but I didn’t ask question as we quickly ushered out the current patient and made way for the emergency.  I poked my head outside the building to see a team of maternity nurses rushing a patient up to the OR on a gurney.  The patient was covered by a blanket and on her hands and knees trying not to fall off the bed that has no railings as the nursing team turned the corner.  The other patients turned their heads with curiosity from the surrounding wards to see what all of the commotion was about.

As they reached the OR doors one of the nurses seemingly attached to the patient looked at me and said, “cord prolapse.”  Her arm was inside the patient trying to hold the fetal head up above the umbilical cord.  This is the maneuver that would save this baby’s life.  Cord prolapse is a true emergency.  The umbilical cord tries to deliver first which is a life threatening problem when the after-coming head of the baby slams down on top of it cutting off the blood and oxygen supply with every contraction.  It is exceedingly difficult to fight against the strength of every contraction and keep the head from pinching off the cord.  Time is of the essence.  “She was transferred here from another clinic for cord prolapse.  When I checked her I could feel the cord pulsating,” the nurse said as we ushered the patient into the operating room.  Pulsating tissue in the birth canal is pathognomonic of a cord prolapse.  “Is it still pulsating?” I asked, hoping that the answer would be yes, hoping that there was still a chance that this baby was alive.  “Yes, I can feel it pulsing,” she replied.  Relief washed over me as we moved the patient to the operating bed.  I left to go scrub as the OR exploded with activity preparing the patient.

 I stood across the table from one of my colleagues and flew through the maneuvers to do this c-section and deliver the baby as quickly as possible.  I had no idea how long the prolapse had been going on for or how much reserve this baby still had left.  I opened the uterus and reached my hand inside to deliver the head.  My fingers touched the fingers of the nurse still desperately trying to hold the baby up from the other side.  For a split second my mind paused, I couldn’t feel the cord. Something wasn’t right. 

I looked down as I pulled the baby up through the abdomen.  I couldn’t help the groan that came from deep within.  Anencephalic.   This is a rare condition where the brain does not develop properly in utero and much of it is missing.  The whole back of the head was sunken in where normal brain tissue should have been.  I looked down at the soft spot between my fingers and could see brain tissue protruding through the forehead.  This is what the nurse felt pulsating.  There wasn’t a cord. It was much, much worse. 

The baby gave a guttural cry as we cut the cord and handed him over to the waiting nurse.  My heart sank.  Though there is some very rudimentary brain function that allows for reflexes such as breathing and some gross movements, anencephaly is not a condition that is compatible with life.  The hours for this baby are very, very numbered. 

We finished up the c-section with heavy hearts.  How was I ever going to explain this to the patient and her family? I asked one of the nurses what the people in the patient’s village would say or what her family would think and she responded, “they will say that there was a curse put on the patient or her baby, or maybe they will say that there is a deep family conflict and god is punishing her.”  All of it is so far from the truth, but so much a part of the reality here. 

I went to check on the baby after we had finished in the OR.  Still alive.  Still breathing, moving, crying.  I wanted desperately for this mom to see her baby while he still had life.  I didn’t know how long that would be. 

After she got settled in her bed in maternity, I walked quietly over to her side and pulled the curtain – the only form of privacy on the ward.  Kneeling down beside her I began the heart wrenching conversation.  As I told her about the baby and the anencephaly tears rolled down the side of her face as she stared at the ceiling.  Still numb from the anesthesia she lay flat on her back, unable to move.  I described the baby’s appearance, reiterating that this was not a curse, that she didn’t do anything wrong, but unsure that she was hearing anything that I was saying.  After discussing that this baby may only have a few hours left I asked if she would like to see him.  She agreed with some hesitation.  Scared by what she might see and haunted by the thought that he might die before she had ever met him.

I could hear his cry as the nurse brought him down the hallway and set him on the bed beside her.  I stepped back as she took it all in.  The mixed emotions raging within this 19 year old mother came in waves across her face as she looked at him.  Slowly, she reached her hand out to touch him with hesitation.  He grabbed hold of her finger and held tight.

I knew in that instant that I was standing in the presence of a sacred moment.  Witnessing the bond between mother and child that God forms so strongly before they have ever even laid eyes on each other.  Something holy, something beautiful was happening in those few, precious moments.   It was a moment that I didn’t deserve to be a part of; it was a moment I will never forget. 

 

 

Life

Kristen here…

One of the things that the speaker said to us at orientation was, “you are the same person when you get off the plane as when you got on the plane.”  We all laughed at the comment because of how painfully obvious it was, but there was a lot of hidden truth in this one statement.  Just because you move overseas doesn’t make you a super hero, you don’t suddenly become more holy or a better person, you don’t have different needs or desires and your personality stays the same.  The point is that living on a different continent doesn’t mean that you don’t still have to do/want to do life. At the core you are the same person no matter what continent you live on.  The hospital consumes a lot of our time, but there is still a need for sanity and the need to “do life” outside of medicine.  I thought I would just give a glimpse into what “life,” aside from the hospital, means here.

Garden cleared and ready for planting

I helped! :-)

Recently, we planted a garden in our backyard.  This was a project that Dan dreamed up and has been really fun!  With the help of my in-laws sending us some seeds to get things started we have been able to plant. Things are now starting to grow and we are eagerly awaiting these much desired vegetables from home that can be hard to get here.  I have to confess that in residency I was given a small pot with a bamboo plant in it.  I single handedly almost killed the plant completely until my roommate took over caring for it.  I have wanted to learn how to garden for years, but knowing my epic failures with potted plants in my own home - I was aware of my limits and never tested those boundaries.  I can’t really take much credit for this garden either as Dan did everything.   All I did was drop the appropriate seeds on the ground where he told me to.  It has been really rewarding, though, to watch as the plants come up and to see success in our endeavors. 

 

Weeding

This last weekend we decided we needed to do some weeding.  It was time to sort out what we had intentionally planted versus the unwanted invaders.  We were getting ready to head outside, gardening gloves in hand, to tackle this chore when I had to admit that I didn’t know how to weed.  Actually, I didn’t even know what tool to use or how to properly pull up the plants.  The look on Dan’s face when I shared this shortcoming was priceless – complete disbelief.  This was then followed by so much laughing that he had to leave the room and wipe the tears from his eyes.  Well, there is a first time for everything and it was the first time this girl had ever pulled up weeds!

 

Weeds are all gone!

Other “life” things that contribute to our lives here in Kapsowar are learning how to make your own fun.  Back home you have a variety of things to choose from including going out to eat, going to the movies, going to a sporting event, various weekly church activities, spending time at the gym, etc.  In Kapsowar, “life” is different in that these types of run of the mill entertainment activities are non-existent.  Nevertheless, the desire for them, the desire for activities, for date nights remains the same.  Now, we just have to get creative. A few weekends ago Dan suggested that we have a date night – just the two of us.   There is nowhere to really go in Kapsowar at night so instead of going out for our date we stayed in.  We made dinner. Filled the house with candles.  Got dressed up.  We cleared the living room of all of the furniture and recreated our first dance from our wedding.  It was a priceless, special evening.  It wasn’t fancy, it wasn’t extravagant, but it was “life” and doing it together.

Date night fun

 

We have also recently added to our family.  We got a dog!  Moto is our newest member and has been really great.  He makes for a great companion for me when I am out hiking or running the trails in the mountains surrounding Kapsowar and a great watch dog for our home.  He is full of energy and keeps us busy as well as entertained with his antics. He eats vegetables and kills bugs.  Perfect for being overseas! He is so much fun.

Moto means fire in Swahili

 

Though the hospital consumes most of our time here, I hope this has given you a little glance into the everyday normalcy that is “life” on the mission field.  Sometimes you have to be creative, but doing “life” is an important part of staying sane, keeping perspective and being sustainable on the mission field.