O God, I am furrowed like the field. Torn open like the dirt. -Andrew Peterson
Today was a hard day at the hospital. It shouldn't have been that way. It's Saturday. I only go in to round. It takes a couple hours at most. And my adult medical service is currently less than ten patients. It should have been easy.
But it wasn't. I always start rounds by asking about new patients, so I can maintain an active list of everyone I'm taking care of. There was one new patient, a young guy in a coma, probably from malaria. There had been another new case, a 60 year old guy with severe malaria, but he died during the night, only about four hours after his first dose of antimalarial medicine.
I read through the chart as the student told me the story. He had actually spent the last seven days in the hospital, as the caretaker for another patient, which means he got malaria here at the hospital. Two days ago, he wasn't feeling well, and he wanted to be seen. Registration told him that he needed to pay the 1200 Burundian francs (about 50 cents) to see a doctor. Normally this cost is not prohibitive, but he refused, whether out of severe poverty or foolishness, I'll never know. He got sicker, and then went back to the ER last night, his blood swimming with parasites, and his platelet count bottommed out. We could only offer too little, too late, and he died.
It's so incredibly senseless. He had a simple disease for which we have medicines. It's not usually 60 year old men who get so sick from malaria, since they have a partial immunity. He was already at the hospital. 50 cents.
We pray, and we start rounding. The second case is a lady that came last Tuesday. Apparently, in June, she got into an argument with her husband, and he locked her into a room, occasionally sending her a bit of food. He never let her out. At all. Until Tuesday, when his neighbors and the local administrator showed up and forced him to come to the hospital. Now she is wasted, too weak to sit up without help. She has tuberculosis, at least in her spine, and probably in her lungs, probably as a result of her weakened state. The husband and her family are supposed to be staying with her in the hospital, but they are always trying to skip out on her. Yesterday, we talked to the nutrition service about adding oil to her porridge to help her nutrition. They brought a supply to last the weekend, and her sister-in-law apparently stole it and took it home.
Her belly is distended, especially in her pelvis. I think maybe her bladder is retaining urine, so after rounds, I grab the ultrasound to see what I can find. I find a tiny beating heart. A baby. She is pregnant. I wonder when in this tragic story she became pregnant. I wonder if we can get her through it, and what kind of circumstances this baby could be born into.
I pass by the ER to take care of one last thing and to tell my nurse about the pregnancy. A mom is holding her chunky five-month old, who was just referred from a health center. Before our eyes, the baby stops breathing, and mom bursts into sobs. We rush to get oxygen started. I notice that the baby's tongue is pale, and pull his eyelid down to find an utterly white conjunctiva. The baby has died from severe anemia, and there is no way we can transfuse him fast enough to get him back. We stand with the mom. She sobs and buries her head into the side of my med student. We pray. We cry out for peace. For peace that passes understanding.
I thought about not writing this blog. I didn't want to share it on the heels of Rachel's story about T. Believe it or not, we want to balance these things out. Our lives have a lot of light, as well as a lot of darkness. Everyone's life does. I decided to share it for two reasons: First, I just need to get it out. I need to tell the stories, because there is some small comfort in sharing it, like someone else really does share the burden. But second, I am writing this because this is how it's been this week. I don't know why. I think that things just come in waves, sometimes. But I know that many of us have had very hard outcomes in the hospital. So, in the interest of full disclosure: Voilà. There you have it.
What do I do with this? I don't know. I came home, and I found headphones (so as to listen loudly) and played Andrew Peterson's "The Sower's Song" multiple times. It starts: O God, I am furrowed like the field. I can identify with that. Certainly I have rubbed shoulders with some people who can. It ends with a near-shout: [The word of the Lord] will not return void! You will be led in peace and go out with joy. I try to follow the sweep of it, to identify with the promise at the end, just as I identified with the sorrow at the beginning. It helps somewhat. It feels good to shout a promise, sort of like a defiance of the darkness, even if I don't see what is going to happen.
What's lost is nothing to what's found, and all the death that ever was, if you set it next to life, it would scarcely fill a cup. - Frederick Buechner
I saw this as well this morning. When I found that baby on ultrasound, I caught a great profile image, with the curve of the nose, the chin, the shoulder, the elbow and the hand all visible. We told the mom, this long-suffering tortured mom. She looked at the screen and her voice caught in her throat: Akomeye? Is he OK? Yeah, I think he's fine.
Light and hope. There is more than we think there is, even on the bad days.
We do not know what to do, but our eyes are on you. - 2 Chronicles 20:12