With two kids now, I find my days very full with work at the hospital, running back and forth to keep up a milk supply, with free time spent kissing scrapped knees, redirecting, playing with, scolding, and laughing with an increasingly active and talkative two yr old, and when the kids are finally asleep in the evening, I just want to do something mindless or I fall asleep quickly from exhaustion. So I've written several short stories throughout the last months, and just now am getting it posted.
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| Young kids. So fun and cute. So exhausting too. :) |
Maggots
She came in walking a bit hunched over, but there was more
to it than that. It was almost a waddle. When we examined this elderly woman,
her problem was obvious. Her feminine parts were completely outside her body.
There was large ulcerated part of this mass that was the size of a grapefruit
hanging inbetween her legs. As we cleaned it off to distinguish what was
cervix, what was the ulcer, what was the situation, I noticed something moving.
This poor woman had been dealing with this complete prolapse so long that
maggots had taken up house in her ulcerated inside-out vaginal tissue, eating
dead tissue and keeping it relatively “clean.”
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| Sorry for those who get grossed out. For those who are curious, the skin of the vagina is shown, the cervix is the very bottom of the photo that is a bit purple, and the circular area is the skin worn away and the bladder hanging out. Maggots are the whitish yellow around the bladder. Ewwww. |
I indicated a vaginal hysterectomy, reduction of the
prolapsed, and closure of the vagina. Basically, I was going to take out what
was not useful, push everything back, and hopefully cut out the ulcerated,
maggot-filled tissue so that this poor woman could walk down the street as
proudly as every other woman who achieves the feat of old age in this culture
and this hard life.
At surgery, let me summarize it by saying I experienced a number of firsts: first time
operating with maggots present, first time I couldn’t find the rest of the
uterus even though the cervix was clearly in my hands, first time I couldn’t
find the abdominal cavity, first time mistaking the bladder for the uterus. It
was very difficult surgery, with distorted anatomy. In my experiences in the
US, I usually felt like we had a good deal of control. If bleeding was found,
we could cauterize, suction, readjust lights and find the source. If structures
were unclear, we could use fancy imaging to figure it out. We could call in
back up general surgeons, urologists, etc. But here, sometimes we tangibly feel the
powerful hand of God, we pray for Him to give us supernatural wisdom, to give us skills
we didn’t know we had, and to heal patients that probably shouldn’t have a good
result. It feels quite out of control sometimes, but God getting the glory is
exactly the sort of thing He prefers.
Back to this difficult surgery… we repaired the giant hole
we had made in the bladder. We removed the cervix and what we could find of the
uterus. We systematically replaced the mass back intra-abdominally, cut away
excess skin, and closed the vagina. It took 4 hours. During that time, there was a middle-aged woman with a relatively simple operation on the other OR table in the same room. For some reason, she coded- as in, her heart stopped. They did CPR, tried the
defibrillator, and eventually withdrew resuscitation efforts. It was traumatic to witness the death while trying to finish
my complex case in the same room.
In the days that followed, I kept expecting to have urine
leaking or some problems, but the only complaint that this woman had was that
the catheter was uncomfortable. We removed it the second week, and she fled the
hospital that night with her family. (This is not an uncommon occurrence with a
good chunk of patients unable to afford their care, however modest the costs
compared to US standards.) I am praising God for giving this woman the ability
to walk out of the hospital upright and without a strange gait, even if it was
in the middle of the night. Perhaps we’ll see her again one day, though I hope
she simply goes home and lives out the rest of her life maggot-free, with the
Lord as her guide.
Why did the Lord decide to heal this old poor woman with a
significant medical problem, and yet allow the young woman on the other side of
the room to die when the latter was receiving a relatively simple operation? Matthew 5:45- … for
He causes His sun to rise on the evil and the good, and sends rain on the
righteous and the unrighteous. This was a reminder to me that we only have the false perception that we are in control- it is the Lord who directs the outcome.
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| Sydney grabbed a boy's hand while we walked through the hospital. It was adorable, so I am including it. |
Who cares?
I was grabbing my towel after a swim in the Kwilu when a goat just a few hours old, flies clinging to its still (barely) wet hair, timidly sidled up to me with wobbly new legs and plopped down, right at my feet. Instinctively, I reached down to give it a pat. Who can resist one of the cutest baby animals in the world? I scanned the dirt path to the left along the river which disappeared around a bend of bamboo. No mama goat staring back at me. I glanced up the steep dirt incline towards the houses, and there was no sign of its mama. As I started to walk up the path, I hesitated. The tiny heap that was just at my feet was starting to make noise. Where was the mama? What kind of goat mama leaves its newborn like that? Just abandons it? I started to get angry. Then worried. What if the mama got chased by some boy running through the trees? What if the mama was herded back to a fenced-in enclosure and the owners didn’t notice she had already given birth? I started walking a little faster up the hill. I could hear a goat or sheep bleating somewhere. I needed to find its mama for that helpless goat.
A still small voice crept into my mind, chiding me. Who cares, really? Who am I? Do I think I care about that goat more than God does? Even if it dies? Yes, even if it dies, it’s not a surprise to God.
Who cares when a poor woman dies because she couldn’t afford antibiotics? Who cares when yet another mom comes in too late to save her baby, her uterus ruptured, all because there is an inexperienced nurse at the remote health center who didn’t recognize danger signs?
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| A face off between Sydney and a sheep |
But the sign given to me with the goat (who was shortly after spotted with its mama) was that God is in control, and God cares about Vanga more than I do. So whether we stay and are a part of God renewing this place, or whether we leave, God has got this. He is not surprised. And He cares so much more than I do. This is a great source of comfort to me amidst uncertainty about the future.
Rats... so many rats
They were eating our fruit. Every morning, we’d find
evidence that rats or mice were invading our house, with our fresh fruit
looking more like the moon than bananas and passion fruit. Our neighbors have
cats, and even a cat ladder to help them get between the roof and the house to
eat rodents, but we don’t.
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| The awesome cat ladder. Look for cat eyes at the top. :) |
Without a local hardware store to run to for a
mousetrap, we asked our househelp for suggestions. They assured us that it was
easy to poison them. They got a medication from the local pharmacy, put it in
some fish, and laid the fish in hard-to-reach places so that Sydney couldn’t
get to them. Wait. Now we had a fish smell. And then? Apparently the stench of
the fish is overpowered by the stench of a dead mouse/rat. Awesome.
The stench of the fish went away. The pieces were gone. But
still no stench of a dead mouse. Around the 3rd day, I remarked that
Zack’s diapers sure were potent- significantly more than normal. Our househelp
said the same thing, and asked to take his diapers outside before we got them
washed. I came home later that day to hear that the smell we had been blaming
on poor Zack was, in fact, a dead mouse behind the dresser. Yay. We got em.
Not so fast... I was changing
sheets on the beds when I noticed that the top layer was covered in ?rodent?
poo and pee. Surely not. I went to get a second opinion on what the stains
were. Just as we were lifting the top sheet out of the drawer, a huge rat
jumped and scurried further into the deep drawer. I ran away. I ran to get
reinforcements in our other househelp. They came together to combat the rat in
the drawer. They closed all the doors, but since the drawers were at the end of
a T shaped hallway, Sydney and I stood guard at the end of the T with a broom
in hand to scare it back. They took the linens out one by one, and eventually
were left with only the rat. Sydney got the honors of taking the dead rat to
the cats up at our neighbor’s house.
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| Taking the rat to the cats |
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| The black cat was a bit afraid of such a big rat, but the runt of the bunch (calico) seized the moment, jumped off her flower pot and snatched that rat up and ate it while hiding under a flowering plant |
Fast forward a week. I opened the cupboard to get a glass for water, and was startled by a mouse running on the second shelf. I ran to get our sentinel. He came in, gingerly took out the glasses in front of said mouse, and... whoop, the mouse jumped out of the cupboard and into his free hand. He clutched it against his chest, and took it out to the cat. This operation took all of a minute.
Fast forward two weeks. We came home from a weekend in Kinshasa, and our househelp showed me my prized imported mint M&Ms had been eaten by a rat.
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| Sad days. I love mint M&Ms and I'd been saving them. There is a hole in the bag and bites out of all of these M&Ms. |
Yep, bag bitten through, tiny rat sized bites taken out of the candy shells. You better believe we have more poison fish strategically placed.
Interestingly written. Sorry for the hard things. Are you bothered by big roaches? I hated those...stepped on them when I got up at night.
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