Miscellaneous Fun

Thanks for praying for rain! We've had good rains twice in 24 hours.

I did the first C-section that I have ever done by myself. The other docs were gone for a walk when the maternity ward called. I looked around and realized that it was me or nothing. Ok, ok, I wasn't by myself, there were a scrub tech and a nurse assisting me. But no other doctors around. It went very well and mom and baby are doing great! And it made me feel loads better.

I found a wild kitten near the hospital. They let the cats live at the hospital because they keep the rats away. This little guy isn't much use yet, but he sure was cute and soft.

My roommate, Corrie (who, incidentally, I no longer share a room with) has her birthday this Monday. We are having a party for her Sunday night and I was asked to bake a cake for her. This was the result. I think if she was 5 years old and having a princess party this would go over well, but it might be a bit, er, pink for her.

Yesterday I assisted on a surgery to remove the biggest tumor I've ever seen in real life. Warning: it's intense...

This was from one of her ovaries. We're actually pretty sure that it is a benign tumor. It was sitting in her belly just about where I am holding it. (and please ignore the fact that it bears a strange resemblance to the cake above.)

Miracle!

This morning at 3am the phone rang. The Shona accents over the phone still throw me for a loop, but I caught the words "maternity ward," "bleeding," "can't find heart tones" and it was enough to set my heart racing and me racing down to the maternity ward. I arrived to find a young woman groaning in pain.

The report from the midwives was that she was 37 weeks along and someone had thought maybe she had twins. She was dilated to 3cm and had been having pain for about 10 hours. They had not been able to hear any heart tones for the baby. I asked for the small ultrasound locked in the c-section room and about 5 minutes later we found someone to open the door so we could get it. I struggled to get information from the 5-inch gritty black and white screen before me. Only one baby. Head down. And I saw lots of things that looked like mom's pulse, but not baby's. Then I caught a glimpse of something faster. A baby's heartbeat! I couldn't tell if baby was ok, but I had a strong feeling things were not ok. Mom wasn't bleeding a lot, but something seemed to be wrong. I checked her cervix and found that she was completely dilated. I believed that she needed to deliver now and the midwives encouraged her to push. This was her 5th baby. We broke her water and a few minutes later she pushed the baby out.

But my relief was over in a second. Baby and placenta came out together with a large clot attached to the placenta. She had abrupted (when the placenta breaks free of the uterus early and loses it's blood supply.) The baby was dead. The midwives sat it aside to deal with mom, but I was certain that I had glimpsed heart activity within the last 15-20 minutes, so I grabbed up the limp baby and carried him to the warming lamp. There was no pulse, no sign of life in the tiny body. I started doing chest compressions, pushing against the soft chest to push blood out of the heart and around the body. A nurse joined me and gave baby breaths with an oxygen mask and a bag. I began to pray, "Lord, please. Just give me this baby." "Please, Lord. Not another dead baby. Please, let him live." I just kept pressing on that tiny chest and praying. All around me the world was going crazy. Just behind me the midwives were working to deliver a breech baby whose head was caught. Across the room there were other patients in active labor. And still I kept pressing on that little chest. I could feel the tiny waves of blood pushing around with each compression, but no sign of life. The little body seemed so cold. I wrapped a blanket around his legs and moved the warming light closer. And then, 20 minutes after starting CPR, I felt something under my fingers. A tiny flutter. A heartbeat. We continued to breathe for the baby, squeezing the little bag of oxygen and I rubbed that little body dry and pink. Another 20 minutes passed and I prayed over and over again, "please, Lord, give me this little one back" and then the nurse held up a hand to stop me, pointing to the chest where it was now rising and falling with baby's own breaths. We kept the little boy under the warming light with oxygen and another 20 minutes later we were getting weak cries, almost squeaks, of protest and he was waving his little arms. The midwife who had delivered the baby and set him aside walked up to me and said, "baby responded well to resuscitation," and I thought "HECK YEAH!" "THANK YOU, LORD!" This morning, about 6 hours after his birth, I checked on the little man and he had started to suck and been trying to eat. He opened his eyes to my voice. I wonder whether he recognized it from those long minutes when I pumped his heart for him and told him to wake up, he had things to do. I am still completely overwhelmed, by the grace and mercy of this miracle. I feel like the Lord saved me when he saved this little one. It is by far the coolest thing in which I have ever played a part.

Some specific prayer requests:

1. We need rain here. This is supposed to be the rainy season, but rains have been sparse and the crops are suffering.

2. My boss, Dr. Todd, visited this week and will be heading back to Wichita in the next few days along with Dr. Leu, Dr. VinZant, and Todd's daughter, Sarah. Please pray for their safe travels.

3. Today, a 5 month old baby died suddenly and unexpectedly. Please pray for this family.

4. Pray for me that I will have endurance and represent Christ well in my work here.

Since last we talked...

So much has happened here.

A few stories...

Working in the OPD (outpatient department) last week, a sweet old Ambuya (grandmother in Shona) came to talk with me. She told me her knees ached, and her back ached, and her head ached. I examined her and checked her for arthritis. As we were finishing up she told me she was afraid to die. I told her that she didn't need to be afraid of that. Because of Jesus, she could go to heaven where her head and her back and her knees won't hurt at all. I told her that is where my Ambuya is and I am looking forward to seeing her there with Jesus someday. Hopefully I'll see this Ambuya there too.

The twin that I mentioned in my earlier post did great and has gone home with his mother. yay!

Several weeks ago I saw an older man who had leg pains and shortness of breath. After examining him and finding hard clotted blood vessels on his legs I believed he had a DVT and probably clots in his lungs. I put him in the hospital and started him on heparin and warfarin to thin his blood. Turns out we don't have the test here that helps to adjust the warfarin to the correct dose. Here we have clotting times, which I am unfamiliar with. So I'm trying to adjust his medicine, and asking the lab to check his blood every few days. The lab tech decides that I have already done the test twice and it was normal, so he won't do the test. I have to call and explain and argue to get him to do the test. The patient was with me for 2 weeks adjusting medicines. He spoke good English. Every day we would laugh together. He was anxious to go home, but I told him how important it was to get it right. Well, I left for my one month trip into town and another doctor saw him and the clotting time I requested came back a little too high, but the patient wanted to go, so the doctor discharged him home on the current dose to return in 6 days. I came back from Harare and the next day the man came back coughing up blood. We tried to reverse the blood thinning. But when I arrived to round the following day, he was in a coma in the "ICU" area of the ward. Looking into his uneven pupils, I recognized my worst fear. He had bled into his brain. I had to explain to the family today that he will not recover and will probably die soon, if not today. Please pray for Nelson and his family. I miss his banter and I know that he will be missed by many.

I struggle often with this paradox, that in trying to help I often see harm result. The Bible says Jesus experienced our struggles, but I wonder does he know what it is to make a mistake or a wrong decision and bear this weight?

A few days ago, we held a feast at the guesthouse. Currently, there are 19 people living here in 8 rooms! I was going to make Indian curry and invited people to have some. The others volunteered their help and by the time it was done, we fed 21 people with curry, rice, homemade chapatis (bread), mango chutney, samosas, and chicken stir fry. We all ate outside in the courtyard and it was a great success.,, only a bit of rice left at the end. I'm thinking if medicine doesn't work out, maybe a restaurant can be my back up plan. ;)

Tonight we were working on a Mexican feast (to feed 13) and had just finished setting everything out on the table. "Look at that!" I hear my boss, Dr Todd, exclaim for the dining room. Pleased that he is so impressed I walk around the corner to find the dining room, which moments before was filled with people, is now completely empty except for a baby trapped in her highchair. What Dr Todd was actually looking at when he exclaimed, was a Land Rover rolling down the hill past our dining room window with no one inside. It narrowly missed our guesthouse, launched off of a 4 foot ledge, plunged through a plumeria tree, and hit one of the missionaries cottages. Praise the Lord that no one was injured! (although the plumeria tree is beyond repair...) The house and Land Rover are both ok. They build things to last around here!

Here are a couple pictures of cute kids...

Elvis (his real name... and is that a "smoulder" on his face?)

This little guy was just too cute:

Okay, okay... Pictures of the Hospital

A view of the hospital. In the middle is the door into the pediatric ward. To the left of that building a path goes down to the men's ward, and a path goes straight back to the theatre (operating rooms). To the right is the outpatient department where we see hundreds of patients Monday thru Saturday. On the benches are the moms of many of the children admitted.

A picture of the peds ward...

Male Ward on a uniquely quiet day... (Last week I had every bed full and cots on the floor)

With my "sister" Lydia who works in theatre

Difficult things

Just one of our recent finds: a baby chameleon

Hi Friends! Sorry to have gone silent for so long. Here's the latest on my life in Zimbabwe. I spend Thursdays and Fridays in theatre (the OR) assisting with surgeries and other miscellaneous medical procedures. Most of the major surgeries are done on Wednesday, so Thursdays and Fridays are hernia repairs, appendectomies, EGDs (looking down the throat and stomach), D&Cs, and other randomness: last week we removed a 4.5 inch tumor from a woman's back, poked needles in almost everything, and removed half of a bone from someone's leg. Because the 81 year old surgeon has seen and done almost everything during his career here, it is so exciting to learn from him. Unfortunately I expanded the "almost everything" for him this weekend.

I was on call and received a phone call from the midwives about a patient with obstructed labor. I arrived to find a woman who had been pushing for 9 hours. yes... pushing. She was fully dilated but the baby was stuck. I tried to use forceps to help the baby move down, but no luck. Also tried to assist with a vacuum (suction cup applied to baby's head: creepy, I know!) but to no avail. Baby moved down slightly, but wasn't coming out and worse, we had seen that the fluid around baby was thick and looked like blood or infection. Time to get baby out. Unfortunately baby was so low we couldn't get a tube past the baby's head to drain mom's bladder. No biggie, I reasoned; we could do it during the C-section once baby was out. So we took her back and delivered the baby by c-section. We suctioned the thick, dangerous appearing fluid from baby's lungs before it could breathe in. So far so good. Then we went to close the uterus... only we

couldn't find it. After about 2 minutes of searching and trying to sort through the anatomy, we knew we needed Sekuru (means grandfather in Shona), the seasoned surgeon. He arrived and after several more minutes determined that the baby had been delivered through the bladder: a "first" he said. With the baby's head so low we couldn't use it as a guide and had mistaken a full bladder for the uterus. Sekuru helped us get things sorted out and repair her bladder. The baby looked ok, and mom was back in one piece more or less, but today I learned that the baby suddenly got a fever and breathing problems and has died. Mom still has a long recovery ahead and may need a follow up surgery. Please pray for this poor mom, for her healing and for comfort in the loss of her baby. Please also pray for us as this has been a very crushing emotional ride for us. I once again considered my other career options. However, God in his wisdom had us do another c-section later that day which went perfectly. I think we would have avoided doing c-sections forever if we could.

I made a new friend this week. Patience is a 10 year old girl originally sent to the hospital for hydrocephalus (swollen head), but when I met her she didn't quite fit that description. I think she actually has achondroplasia (a form of dwarfism). She isn't the least bit fazed by being different. She is smart, funny, loves Jesus, and has a beautiful singing voice. I will try to find a picture of her to share. We had great fun talking and discovered that we have the same favorite color: yellow. She needs some glasses which we didn't have. Please pray that God will heal her vision or provide her with glasses so she can continue to learn and do well.

There is another young man I'd like to ask for prayer for. Brian is only 10 and has what we think is Burkitt's lymphoma. He is going to die very young without a miracle. There is no chemotherapy available here. I told his parents this weekend that there is very little we can do, but that I would ask for prayers for his healing. The parents turned their heads away and cried. He is very weak and in pain and I wish so much for him to live. There is so much spark in his eyes.

I think I learn more everyday here than I did each month back home. But it is so hard to watch people suffering, and to know that I lack the skill to help them all. Which is why this little man brought me so much joy.

He came in before I arrived at the hospital with severe malnutrition (Kwashiorkor). His little body was swollen because he didn't have enough protein to hold water in his blood vessels. He also had wounds all over because of his poor nutrition. I have been working in the men's ward this month, but was back to visit the pediatric ward this weekend, since I was on call. I almost couldn't recognize him. He is now a healthy looking child with no resemblance to the one I met 3 weeks ago. Praise the Lord! His mother laughed at me because I was so astonished and excited.

Oh, and in my spare time, I've been trying to fix computers. I've been working on one for 2 weeks now and finally have the Start button back. This was the first virus scan that I ran on the computer.

Yep. 2074 infected files. umm. problem. I am pleased to report that it now has none. :)