Kristen here…
With the exiting of summer season and the entering of the
Christmas one there have been some cases at the hospital that have left my
heart soaring as I walk home from work at the end of the day. The stories of the two patients I am going to
share with you actually come on the coattails of the last blog I posted. The mother I blogged about that had lost her
baby, let’s call her Grace, had a great deal of influence on these patients. Her influence started a chain reaction that
resulted in, what I believe is the preservation of two lives that would
otherwise not be here today. God is so
good.
Grace had gone through a harrowing emergency c-section of
her premature baby. When she had come
into the clinic that day her blood pressure was so high she was in danger of
having a stroke. She was already on the
max doses of oral blood pressure medication that we could give her and wasn’t
responding to our IV drugs. Her baby
showed signs of imminent death and in a last ditch effort to save this precious
life we did an emergency delivery. The
following day it was proved to us that despite all of this, God wanted this
baby home as we watched her slip away.
I had a heavy heart as I was seeing patients that day in
clinic. That had not been the outcome I
had hoped or prayed for. It was
devastating. It was these thoughts that
rolled around in my head when Monica walked into my office. She looked tired and sick. She was in her second trimester, but clearly
this pregnancy was taking its toll on her thin frame.
Here, the appearance of a person often gives you some
insight into their standard of living and occupation. Monica’s cheek and collar bones stuck out
from beneath her skin in a way that most movie stars back home spend hours at
the gym to obtain. Her legs were long and slender, and her worn dress hung
loosely on her thin shoulders. This was
not the work of a well- used gym membership.
This was the result of hours upon hours spent in the fields tending her
farm –tilling the rows of crops by hand, hauling water manually from the river
to do wash, carrying a load of firewood on her back every evening from the
forest so heavy that she would be bent over double due to the weight. The cooking and cleaning and tending of her
children would also be her responsibility.
Her hair was “natural,” meaning not braided or decorated, another sign
of little money. This woman knew hard
work, this woman’s daily struggle was for basic survival. Here, it is the women that do all of the
farming. They are the ones that work the
soil, plant, weed, and harvest. They are
the ones that collect firewood and water.
They are the ones that keep that house running and the kids in order. They are the ones that do the manual labor.
I started looking through the records she had brought with
her and I could feel my eyes get large and my heart start to race. High blood pressure. Really high blood pressure. Not again.
Hadn’t I just had this problem yesterday and the outcome was heart
breaking? What was I going to do?
I started talking to Monica and discussing her critical
condition. I told her I wanted to admit
her to the hospital because she was very sick and I needed to get her blood
pressure down right away. She looked at
me skeptically. “I wasn’t prepared to
stay here. Let me go home and prepare
things and then come back.” I knew if I
let her go I might never see her again and “preparing things” would mean
working overtime to get things ready on the farm and with her children to be
gone for a few days.
“No,” I said. “You can’t go. I am very concerned about you
and this baby. I need to admit you to the hospital.”
She looked at me with a frown. “How long will I have to be
here?”
“I don’t know.” Given the look of this patient, I knew that she
would not go home and rest if I ever discharged her from the hospital. Her baby was too small and young to deliver
safely if I needed to. I had hoped to
keep her in the hospital for the rest of her pregnancy, but I knew that was
wishing upon a star.
“I can only stay a few days. I have children at home and I need to harvest
my maize.” I considered that a consent
for admission and quickly got the paperwork completed and IV lines started to
bring down her blood pressure. I wasn’t
sure what I was going to do beyond a few days, but I would take it one moment
at a time. The type of physical labor
that this woman endures every day would surely make her blood pressure
skyrocket out of control despite my best efforts and force the events of
yesterday to repeat themselves all over again.
Her blood pressure slowly started to return to the normal
range. I placed her on the max dose of
medications available with a heavy sigh.
I had nothing left if the situation worsened which I knew it would in a
few days when I sent her home.
The following day I was going one by one through the
patients on rounds. I saw Grace and
reviewed her labs and vitals. I cried
with her over the loss of her baby. She
was still having some medical problems and would need to remain in the hospital
for a few more days. After finishing
with Grace I pulled out the next chart and looked up suddenly. The patient in the next bed over was
Monica. I wondered how Grace felt about
this. Someone in a very similar
situation to her, still pregnant, still with a live baby, laying in a bed so
close to hers you could reach out your arm and touch the patient next to
you. I walked over to Monica and began
going over her labs and vitals. She was
barely being managed on her current medications and beyond this I didn’t have
anything else to offer.
“Monica,” I said. “Your blood pressure is still not very
good and from the ultrasound I did yesterday I am worried that your baby is too
small to survive if we have to deliver you early. I really would like to keep you in the
hospital for a while, maybe even for the rest of your pregnancy to insure that
you rest. I want to give this baby the
best chance at life that I can.” I was
sure I would be hit with resistance.
Surprisingly, though she looked up at me and smiled. “I know.
Grace and I have talked. She told
me her story. I will stay for as long as
you think I should.” My jaw
dropped. What a transformation from the
steel gaze and stubborn determination I saw yesterday. That was one battle I wasn’t expecting to win,
but I was so grateful she agreed to stay.
At least in the hospital she could rest and be relieved of her physical
duties back home. This would give her
the best chance at staying pregnant the longest. She didn’t have a plan, there wasn’t anyone
to look after her farm back home. She
didn’t have money to pay for a huge hospital bill. She would likely lose this season’s
crops. The stakes were high, but she
chose her child, she chose life and I can only contribute that to the long,
midnight conversations that she and Grace must have had. The prompting of one childless mother caused
a reprioritization of this pregnancy over all the other pressures pulling at
Monica’s attention. It was God that
placed these two women next to each other. It was not the compassionate thing to do in my
eyes, but it was the right thing to do to change the course of events for this
patient and her baby.
Over a month went by and Monica remained with us in the
hospital. Day in and day out she patiently
rested and did everything I asked of her.
We watched this baby grow and gain weight on ultrasound. Each day was a
victory and a gift. Eventually, it
became clear that it was time to deliver.
The baby had grown well and would do fine. I was so incredibly thankful that day for
Grace’s input and influence on Monica. It
changed everything for her.
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| Monica and her beautiful baby |
While Monica was recovering from her delivery over the next
couple of days with her baby at the bedside another patient walk into my
clinic. Lillian, had legs the size of
tree trunks and a headache that was incapacitating. After going through her history it became
clear that she had a blood pressure problem as well. Untreated chronic hypertension in pregnancy
can be a death wish. I discussed with
Lilian how concerned I was for her and that she needed to be admitted to the
hospital. She hesitated. She was a teacher and needed to leave to
organize time off from teaching. “Give
me a few days. Just let me get your
blood pressure under control and then we can talk about what to do from there,”
I pleaded.
After some prompting she agreed to stay, but only for a few
days. At least that was something. I would take whatever she would give me. Over the next 6 hours it became clear that we
were perilously close to needing to take drastic measures. I maxed her out on medication and prayed that
would hold her through the night. Ultrasound told me if we delivered her now
the outcome would be much like that of Grace. A nightmare none of us wanted to relive.
I walked in the following morning and grabbed Lilian’s
chart. Her blood pressure had remained
where I needed it to be! The medication
had worked. I walked over to her bed and
stopped short as I realized where the nurses had placed her. She was in the bed next to Monica.
Lilian looked up at me and smiled. Pointing to Monica, “She told me about her
pregnancy and her problems. She told me
how she stayed in the hospital and how now her baby is fine. I can be patient. I will stay here for as long as you need.”
I smiled and was relieved.
The upward battle to saving this baby didn’t look so steep any more. It was over a month later that Lilian
delivered a beautiful baby girl. Both went home healthy and full of life.
 |
| Lilian after delivery |
Grace suffered so
much during her time at Kapsowar Hospital, but her presence here was not a
mistake. She left with heartache, but it
was this heartache that gave life to these two babies. I don’t know if I will ever see her again, but
overtime it was the sorrow of her story that brought joy to these two women and
to my heart as well. An incredible lady
with an incredible legacy. I am so thankful
that God brought her to Kapsowar.
*Pictures and stories shared with permission by the patients
