Grace at the Fray
Our days in Kapsowar and at the hospital we hold two realities in our hand each day: beauty and brokenness.
Let’s start with the hard days. How do you tell someone’s parents that their child just died? I certainly remember in medical school where we did “breaking bad news” simulations. They taught us lines to say, body posture to conform to, but nothing can quite prepare you for that moment with a mother and father when you have to tell them their worst fear has come to reality.
I’ve unfortunately had to have a lot of these conversations this past week. Seeing babies and young children die far too young is the worst part of my job and certainly the hardest emotionally to deal with. I’ve had a child die every other day this past week as well as several adult patients. Having one child die a week is hard, but having to talk to two parents in a day can be soul crushing.
I was walking home after a difficult day and sure enough, as our family was sitting down for dinner I get a call, “Daktari Jack, we have a 18-month-old girl who was just admitted with several days of difficulty breathing and her saturations are now 60% on oxygen.” I tell them I am coming. I look at Regan and say that I have to go. I explain that I am sorry that I am missing dinner and helping put the kids to bed again.
When I arrive at the bedside the girl is struggling to breath and looks near death. I pick the girl up in my arms, grab the IV bag going into her, and run to the operating room recovery area, which also functions as our makeshift intensive care unit. I call one of the anesthetists for help and we quickly intubate her (where we put a breathing tube down her throat into her lungs). After several ventilator adjustments and after multiple rounds of labs (on our new blood gas machine; thank you so much to all of our financial supporters for helping us get this!) the patient was a little more stable, yet still in critical condition.
Our hospital has never really had patients on ventilators for a prolonged period of time, so that means I have to do the work of a nurse, respiratory therapist, and physician if I ever decide to put a patient on one. Needless to say, after several hours I started may way home in the dark at around 2 AM. After three to fours of sleep (that alarm clock wake up was brutal) I returned to the hospital to check on the the little girl in order to make sure she was still doing okay. Thankfully she was, but she was still requiring the maximum ventilator settings. Any worsening in her condition would mean that she would die. I called the referral hospital that has an intensive care unit only to be told that they did not have any ventilators and that they would not accept her as a transfer.
I talked to the family about transferring her to a private hospital, however, it is very expensive and the parents could not afford it. So we continued on, praying that she would improve. The whole day she was unchanged, neither better, nor worse. At the end of the day, exhausted, I told the night covering physician about her condition and what steps to take on the ventilator if anything happened. I fell asleep the moment my head hit the pillow when I got home.
However, three hours later I received a call from the physician telling me that the patient’s heart had stopped and that they were doing CPR. I jump out of bed, threw on my scrubs and sneakers, and ran to her bedside. They had been doing CPR for several minutes by the time I arrived. We continue CPR for over 30 minutes, but we were unable to get a pulse back. I stood there trying to figuring out what had happened, but it was unclear what led to her heart stopping. Next, I looked around, and located her parents, my heart struggling at the thought of what I had to tell them.
Earlier that the day I had a newborn with multiple congenital abnormalities require CPR and die. It was obviously hard talking to that family. But now, on minimal sleep, the second child I had lost this day, I didn’t know how I would muster the strength to tell these parents. I had invested a lot into this child. I had been at their bedside most of the past 24 hours, only for her to die. With the chaplain there I told the family how sorry I was, but that their precious little girl had passed. As the chaplain prayed, I looked at my shoelaces, tears welling up inside my eyes.
Something quite unexpected happened next. After the prayer, the little girl’s father looked me in the eyes and said, “Thank you, I know you have tried so hard. I have seen you here at the bedside over this past day, and I know how much you cared.” In the depths of his agony, that he was able to express these words is truly remarkable, and they were extraordinarily touching. They are words that will stay with me forever.
In contrast, several weeks ago my parents were here in Kenya to visit us. One day, Regan and I decided to jump in the car and just drive for little bit not knowing were we would go. Thanks to my parents visit, it was our first time alone without kids in over eight months. It was so freeing to be with Regan away from the hospital and have a chance to talk. After a half hour of driving through the remote hillsides, Regan told me to pull over at a nice lookout so we could enjoy the view more while talking. As we sat there taking in the beautiful vista we both suddenly heard, “Daktari Jack! Daktari Jack!”. As I looked down at the house below the hill we were seated on, I saw a mother with a baby in her arms, asking “Kunuwa chai na sisi?” (Would you have tea with us?)
So Regan and I descended the sreep hill to her house and I realized it was a baby I had discharged several weeks ago from the newborn unit. The mother was so happy to show me her baby and proudly declared that they were gaining weight and now over four kilograms (8.5lbs). She invited us into her home for a visit.
Regan and I just marveled. Here we are, half and hour into the rural countryside, and yet somehow people know us. Our life often feels confined to the walls of the hospital, but meeting this mom today reminded us that what goes on there has far reaching effects into many corners of this county.
Just pulled over to sit on a wooden bench at the top of a nice view. And we hear Jack’s name being called from the home below!
This mom was just at the hospital weeks before and so happy to show us how well her baby was growing.
The organization we are a part of is Serge, and their tagline is grace at the fray. These two stories I believe represent that phrase. It is into the frayed edges of the world that God calls us, to heal bring his healing and steward his his shalom (“peace”). He celebrates the wins, and grieves with us when we are downtrodden. It is with our daily acts of submission and service, at the fray, that we push back against the darkness.
It looks like pulling a child from the grips of death and seeing them leave the hospital in their mothers arms. Just as much, it looks like showing a family you cared, and that you grieve the loss, alongside them. So we continue on, to shine a light in dark places. God doesn’t promise us it will be easy. But He does promise us he will be with us through it all.
P.S. This is a picture my sister had on the wall years ago. It’s always stuck with me. Sometimes the work of God feels like this. In a broken world God calls us to work for His goodness and peace; to sew the frayed edges back together. And He guarantees us that one day, He will return, and make it all new again.