Kristen here….
August was a hard month. As I have tried to put my thoughts
together about all that happened it has been hard to figure out how to put it
into words. With the hospital understaffed and all of us taking extra call,
working for almost a month straight without a day off and with more than half
of those days being on call led to a lot of sleepless nights and exhausted
days. August, September, and October are
some of the busiest for labor and delivery in Kenya due to a lot of social and
cultural factors that occur 9 months earlier.
The steep increase in patients also lends itself to an
increase in difficult cases. Each case
takes its toll. At one point there was a
series of three days where I lost 5 babies.
All for different reasons, all incredibly painful. I found myself one
evening curled up in my husband’s arms sobbing and asking permission to
quit. Not wanting to be a doctor any
more, not wanting to have the weight and responsibility of human life upon my
tired shoulders any longer. Of course,
out of his love for me that permission was not granted and I trudged on.
Returning to work the next day, I found a rare quiet moment
that afternoon and sat down on the back steps of the maternity department to
breath and process the tragedy after tragedy that had occurred over the last
several weeks.
My mind wandered to a young, first time mom that I had been
treating for high blood pressure. She was on the maximum doses of blood
pressure medication available and had come to the clinic for a routine blood
pressure check and fetal monitoring. She
was feeling sick and with legs swollen to the size of tree trunks. Her blood
pressure was suddenly extremely high, the fetal heart rate tracing was a
Category 3 leaving a pit in my stomach. On
the dopplers of the umbilical artery there was absent end diastolic flow. This was a recipe for stillbirth, but at 27 weeks
and 1.2kg the chance of survival if delivered was slim. She had received
steroids two weeks ago, there was nothing else I could do to make this
better. I explained the situation to the
mother and with a heavy sigh she told me to proceed with delivery. An emergency c-section is what came next and
resulted in a beautiful cry from her baby boy.
My heart sored, only to cry in anguish the following day when at 24
hours of life this precious baby stopped breathing and went to be with the
Lord.
I knelt beside the bed of this grieving mother. Tears rolling down her face and all I could
do was put my arm around her head whispering ‘pole sana’, I am so sorry, over
and over again in her ear. Another
death.
I hate things like this.
I hate losing babies. I always find myself second guessing my management
when things like this happen….wondering if there had been another doctor here
would that patient have survived? The
reality is, there isn’t anyone else. God didn’t put me here at this hospital
because I am perfect, but because I am willing.
This, however, doesn’t make the sting of every loss any less
painful.
As I was sitting on those back steps with all of these
thoughts swirling around in my head this young, now childless mother sat down
next to me. I smiled at her through the
tears welling up in my eyes. What else
could I say to her? Little did I know
that she wanted the chance to talk, I
didn’t have to. As she started to talk
she presented me with a package of milk she had bought in the center. “This is for you,” she said in her broken
English. “I saw you sitting out here and knew that I must come talk to you. When
you came to tell me about the death of my baby I could see the hurt on your
face and I know that you cared too. I know you did everything you could and I
know that God is in control. When you told me that I needed a c-section, I was
scared, but when we made it to the OR, I had peace. I knew everything was in God’s control. This was
His will for my life and I must just accept. I wanted to thank you for all of
the work you do here. I want to give you this because it is good to share,
especially with those that are here struggling with us. I appreciate your work.”
I sat there stunned. This
simple act of compassion and kindness was so unexpected, so undeserved. What do
I say to her? Two days after her baby
died she comes to console me. I was grieving this loss, but surely my grief
did not match that of this childless woman.
Where did her words come from?
How could she see through her own pain to reach out and comfort me? I
don’t know how that is humanly possible, but it was exactly what I needed. God
knew this broken heart needed help, and He picked the most unlikely person to
be His angel to do it.
Dealing with grief at the hospital has been an interesting
journey for me. Grief is so much more
common here. Death and bad outcomes
happen far more frequently than I ever experienced back home. It is important to feel the pain and to be
gripped with sadness. It keeps you human, it keeps you grounded, it keeps you
compassionate, it makes you a better doctor.
But, it also can be crippling. Out
here there isn’t time for that because there is always another patient that
needs you. You must push on. I am human too and the pain does not escape
me. Quitting though, is not an
option. It has become this delicate balance
in order to stay healthy and to be able to keep going. It is learning to accept loss without becoming
complacent. Letting it bother you
without letting it beat you up. Some
days this is easier than others. Some
days it seems impossible and God sends you an angel in the form of the broken
hearted to pick you up and push you forward.
