Sunday, November 15, 2009

A Paradox

I am now nearing the end of a weekend of rest after what has definitely been the hardest week I have had here in Kapsowar. I had a wonderful time this morning worshiping with my new church family here and marveling in the sounds of about 200 Kenyan children as they praised the Lord with their voices. And now, as I type this, there's a beautiful rainbow over the valley outside my window - a reminder of the Lord's promise that He loves us and is faithful.
So, this was a very full week. Every day seemed to bring many surprises and emergencies. There were emergency C-sections, retained 2nd twins after a traditional birth attendant allowed a woman to labor at home knowing she had twins, too many D&C's to count including a couple that were in shock. On top of all of that, Ben and Cathy Sawer, who I have written about before, left to return to Canada. They left a hole here on station and we were all very sad to see them go.
The most consuming patient of the week was a 19 year old girl - we'll call her V - who was transferred from a health centre where she had delivered her baby prematurely and then developed postpartum hemorrhage. When she arrived at Kapsowar, she was hypotensive and had a hemoglobin of 6 (should be at least 12). She was given blood and seemed to improve a bit. Then, her blood pressure became high (probably what it was before delivery) and she complained of a severe headache - she had severe pre-eclampsia (toxemia). Who knows how long she had had it. So, I started her on appropriate therapy and she seemed to improve. Then, on Thursday, I noticed that her abdomen was becoming distended. Her exam was consistent with ascites, which can come from the liver being affected by pre-eclampsia. On Friday, it was markedly distended and an ultrasound confirmed that she had massive ascites. We decided to drain some of the ascites to make her more comfortable. As I was coming to do that procedure, I noticed that she all of a sudden was not very responsive, responding only to pain but not able to communicate. This was a definite change from how she had looked just an hour before. We quickly did what we could, but decided she needed to be transferred to Eldoret - a 2 hour drive and the closest ICU. One problem - our only functional ambulance was currently in Eldoret. So, we had to wait for it to get back in order to transfer her. We prayed over her and reassured her scared husband that we were transferring her where she could get better care. As we saw her off, I had a bad feeling. Why had she suddenly worsened? Was there something else I could have done? Should we have transferred her sooner? Only God knows the answers. All night that night, I couldn't sleep. I just felt like something wasn't right. I said so many prayers for V - that she would recover, that her newborn child (her first) would do well, that her family would have strength through this difficult time, that they would come to know the Lord.
I found out the next morning when I went in for rounds that V had died at 3 am. My first maternal death. She was only 19. The unfairness of it all was overwhelming. Why couldn't I have done anything else? Why couldn't I do the labs I needed to do to determine why she had become nearly comatose? Why would a 19 year old be taken away from her newborn child? As I sat and cried, I was comforted by one of the labor nurses and one of the cleaning ladies. They reassured me that this happens here in Kenya and it would be okay. But it's not okay I told them. It's so unfair.
While I will continue to mourn V, I think that the Lord had a lesson to teach me through all of this. First, He is in control and He does have a plan. Second, I am not in control and no matter how much I think I know, ultimately, my patients' lives are in His hands. Third, I have to just trust God that what I am doing for the patients is the right thing and leave the rest to Him.
So, despite the fact that it was an exhausting, overwhelming, and challenging week, I think it will be one that I will look back on as a turning point, perhaps. I now know, more than ever, that He is in control. And I praise Him that after we have come through the flood, He provides a rainbow of hope to remind us that He is there - yesterday, today, and forever.

6 comments:

Scott and Emily's Blog said...

oh christine, as i read your last blog i just am so sad for V's husband and child. did you receive news about how the baby was? my heart goes out to them and to you my dear friend. yes, He is in control, but it is so hard to understand...
love em

Unknown said...

Hang in there Chirtina, Gods plan works out in the long run. Saw your family this weekend and they look well. Has my bag came in handy yet?

Love ya Unca Chucka

Steph Montgomery said...

Christina,

Wanted to first say how very proud I am of you and the work you're doing in Kenya. A good friend/mentor of mine growing up spent several years there and planted a seed in my heart for missions through that time. I know you are right where God wants you and I also know He is using you in mighty ways - keep up His work, sister!

When I read your story about V and the baby - I will say my eyes filled with tears. Not only for the mom and family but also because it was all too familiar to a situation Darrell and I faced just this week.

While it wasn't a physical loss of a child/mom - we had an emotional loss that I cannot even begin to understand right now. Not sure if you knew this or not but we were in the process of a private adoption. We were only about 9 weeks from bringing home our baby boy and suddenly things took a different path. After a Dr.s appointment last week, the birthmom informed us that she had changed her mind and had decided to keep the baby.

While angry and hurt, empty yet filled with questions - I was reminded through your blog that God is in control, and that He sees the bigger picture that I truly cannot fathom. Thank you for sharing your heart - and for sharing a bit of hope for me today. I will pray for you and your continued work there - and for the families such as V and the baby that you work with daily. Please pray for Darrell and I that we will continue to seek the Lord for peace and direction for our next steps in the adoption process.

Love you!

Steph Montgomery

Melissa H said...

Christine- I have continued to follow your blog and pray for you. I find myself in tears right now over V, her family, and your loss. I recently have a really bad case here, with all our technology. It shook me for a little bit. I am so humbled by the fact that I am not in control. You continue to make us so proud! I know that you do everything in your power for your patients. I will continue to pray for you and your patients.

Melissa Hall

Christine Huang said...

Christina,
My son, Andrew, introduced me to your blog. This post touched my heart deeply. It is because I belive your tears reflect God's own heart. Yes He is sovereign and in complete control, but He also comes into the human suffering. That is the paradox. God the Almighty shares our brokenness. He suffers alongside with humanity because of His great love for us. After all He knows how it feel to lose His only son to the most heinous crime. That was the greatest injustice. When finally God's cup of suffering is full, our world's redemption is fulfilled. Until then, Christina, you and my son Andrew are called to use your medical skills to be God's coworkers in His restoration work. I thank God for you both.

Unknown said...

Hey Christina, this is the first blog of yours I've read (though I think of you often) and boy is it eye-opening. There are so many times that we feel we have failed, and forget that God's in control. Even with the medical technology here, bad things happen that are out of our hands. And believing that, doesn't always make a situation easier. V's family is in my prayers. And I pray for hope, strength, and courage for you as you continue on this amazing journey.