Compassion From The Brokenhearted

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.