Thursday 27 February 2014

Soaking in Every Moment

I think I’ve said it many times, but I love to stand back and watch life happening before me, whether it is the patients in the wards interacting together or the kids on the ship playing or simple interactions between friends. There are always moments to savour, sweet little pockets of joy. I usually can’t help but tell the nearest person (most often a nurse), “Look!” and point towards the action. It is so hard to capture these moments, particularly when at work since I don’t have my camera on the wards very often, but I have caught a few.

This is what we do all day- love, love, love.

Old friend and a new friend

Squish your nose kisses

Spying love through the window

Smiling faces full of straight, white baby teeth


 “Gratitude unlocks the fullness of life. It turns what we have into enough, and more.” Melody Beattie


How beautiful does Natacha look now? She was My One from screening day

Chubby baby toes

Making my patient and her mama laugh by crawling into the mama's bed

Soothing a crying baby

“Abundance is not something we aquire. It is something we tune into.” Wayne Dyer

 
A smile breaks all language barriers

Squinty eye smiles

Peek-a-boo!



“That which God said to the rose, and caused it laugh in full-blown beauty, He said to my heart, and made it a hundred times more beautiful.” Rumi


Pedicures by a 5 year old

Being invited into a home and seeing love in action

Innocence

Letting a 7 year old do my makeup

Watching children learn and grow


Silhouettes

What are some of your sweet moments?

Monday 17 February 2014

Derne

Derne is the name of a little boy I met at the interior Dolisie screening day. I went with a team of 13 from the ship, driving one of the most dangerous roads in the Congo to reach this town 3-4 hours away. Derne was one of the 187 patients that turned up to be seen by us.




I’ve waited to write this story in hopes that there was a photo taken of him by my photographer friend Michelle. But alas, when I looked there was none. Even as I sit here, computer on my lap, my fingers resting at the keyboard knowing what words are about to flow out, my heart has sunk into my stomach.

Derne walked into the room where I was sitting with another nurse taking patient histories and the OR supervisor who was scheduling follow-up surgeon screening days. We all had translators by our sides.



Derne was with his mother. He climbed up to sit on the blue cushioned chair, feet dangling off the floor, face solemn. I greeted them both and then through translation asked them why they’d come to see us. Derne had a very nodular mass on the left side of his neck. It was a large size and by large I mean it was more than half the size of his 9 year old neck. It extended up to the bottom of his hair line and down to his collar bone. He looked at me with a blank expression, eyes solemn, giving away nothing of what he was feeling. It was difficult finding out exactly what the history was except that it had been growing and getting larger now for 3 years. Mirjam, our screening co-ordinator, had seen him outside in the patient line and had written a note sent in with him “?Lymphoma”. I took it out of his hand, my heart not wanting to believe what she suspected, knowing that I might agree with what I was reading, although the diagnosis still being a guess. We had no doctors with us, no equipment and no way of actually telling them what we thought it was. They had been to several hospitals and seen doctors and he was having treatment for tuberculosis (TB). Whatever the mass was, a TB mass or lymphoma, he wasn’t a surgical candidate for us.
When I asked the mother how far they had travelled to be in Dolisie, she looked at me with an exhausted expression on her face. She said it had taken her and Derne three different taxi trips to get there. Translated for you, that means a LONG time sitting in taxis, squashed with many people, fresh produce and animals over bumpy roads for hours and hours. I looked to the other nurse in the room with me, taking histories on another patient, asking her for her opinion because I almost couldn’t bear to tell them that we couldn’t help him. They had travelled so far in hope that we could help, how could I bear to turn them away? Jasmin and I talked about it, both coming to the conclusion that he shouldn’t come for a further screening. My heart broke as I turned them away knowing they won’t get a phone call from us offering hope of a cure.

Derne didn’t leave my mind even after a couple of weeks. As I was second guessing my nursing judgement and all that I have seen here in the past four years, I emailed my screening co-ordinator friends to ask about him. The reply came and with every word my heart sank deeper and deeper until I wanted to cry. She wrote, “I talked about it with Jasmin for a long time, discussing & questioning our decision, & we appreciate you asking the question.  Screening can be difficult in that we can never predict a diagnosis with 100% certainty.  However, we need to make educated decisions in order to bring the most appropriate surgical candidates… I’m very sorry, but we will not ask the boy to come down for further screening.  We definitely don’t want to raise his expectations when we are almost certain that there’s nothing that we can do for him.  I’m sorry.”

I wanted to cry even though I think I already knew what their answer would be. It is true, we have to pick the people that are the best surgical candidates for us on the ship, that is our specialty. It’s just that my heart breaks for every one person that we meet who we cannot help. I guess that’s why I still haven’t left this floating hospital ship. Every one counts. Every day on board we do about nine surgeries. That’s nine lives changed. Even if the surgery is as simple as a hernia repair that helps a man to live without pain, it is one life changed and while the patients are here we pour out our love like no place I know on earth. Love overflowing from the One who loves us. The One who gave everything He had to save us. Even though we can’t help everyone, the One that loves us has not lost sight of them. I know that He sees Derne and has a good plan for his life even though I can not be a part of it.










Saturday 8 February 2014

There's Your Smile!

The crazy thing about this place is that a miracle happened in the hospital last week and I haven’t even told you about it.
Last week while I was working an evening shift, I had a call from my supervisor telling me that a dental patient had come in with a big tooth abscess and needed to have it drain in the OR before he became septic. He was going to come back to a bed in the ward I was in charge of. She said the biggest risk for the patient post-operatively would be airway swelling. Apparently large tooth abscess' had been a ‘Liberia special’ (very common during the 2008 Liberian outreach). I remember reading a Mercy Ships article about it one time before I’d ever come to the ship, so I had an idea of how it could turn out.
I kept that information in the back of my mind while I sorted out problems here and there in the ward and while I was making sure the nurses got to dinner on time, I had a call from the OR saying that they were going to bring the dental patient to the ICU post-op on the ventilator. I hung up the phone and turned around to face the busy ward, noticing the nurses scurrying here and there, patient’s NG feeds running, others sitting up on their beds eating their dinner from the red bowls that we serve them in. I knew that even though I’m not trained as an ICU nurse (no ventilator training) I had nothing to fear because we have the best team I could ever ask for. All I had to do was pick one of the adult ICU nurses already working, reallocate her patients to other nurses and have her set up the ventilator, send a few text pages to let others know what was going on, look at staffing for the next two shifts and ask someone to save me dinner.
After letting the OR know that we’d be ready for the patient in 20 mins or so, they let me know that they’d had to insert an emergency tracheostomy in the patient. While they’d tried to extubate, his airway had closed right over, from the immense swelling and pus draining from this huge oral abscess. They’d tried and tried to reintubate but to no avail. With the tracheostomy finally in and the patient relatively stable on the ventilator, he was brought into our ICU. Later in the evening his oxygen saturations dropped and changing the settings on the ventilator didn’t help to improve it. We were pumping antibiotics into his already feverish body.
Over the next couple of days his condition worsened. His oxygen saturations dropped lower and lower and we were pretty much powerless to stop them. We tried everything that we had access to and continued to pray. I sent a call out on FaceBook to pray for this man because that was really all we had left.
By day three post-op his oxygen dropped to an all time low. We were scared for this man because his oxygen saturations had been quite low for a long time and it brought dangers of permanent brain damage. It didn’t look like he was going to survive. And then the miracle occurred. With no interference by us, his oxygen saturations began to improve. They continued getting better and better and the following day he was well enough to be off the ventilator and breathing on his own! The following day he was moved back to a bed in the ward and only a few days later his tracheostomy was removed.
Each day that I’ve seen him in the past week I have literally thanked God for unexplainably saving him, but ever since having the abscess drained he was very straight faced. Barely speaking when asked questions he would reply with a shake of the head or a raise of the eyebrows for yes (very common here). I barely heard him utter words, let alone show emotion. Yet when I looked at him, I wanted to jump up and down with the joy of answered prayer and his life being saved!
Today I was his nurse. Seeing him straight faced for so many days, made me wonder what on earth he must think of this whole situation. I sat down with him and a translator to explain that while he was really sick on the ventilator we thought he was going to die. While that was being translated, his eye brows shot up as he took in the information. I continued saying that God clearly had a plan in mind for him since we had so clearly seen him saved from certain death. He didn’t have anything to add and continued to sit there silently receiving whatever we said.
Later as I was doing his wound care, I was speaking to him using the translator asking him about his sister who had visited almost daily since he’d arrived, asking him what he does when he’s not in hospital. He didn’t say much in response, although he answered the questions using words. I then said that he seemed like he had a quiet personality and didn’t like to talk much. Much to my surprise, after it was translated to him, his face lit up with a smile, the first smile I'd seen. He told the translator, “No, I’m not really quiet. I like to talk.” Astonished, I looked right at him, my eyes wide, “You do like to talk!? And you just smiled! Why don’t you talk much? And you just smiled!!” I said this straight to him and I have no idea how or what was translated to him about what I said, but as I saw him watch my stunned reaction to him smiling, I got a glimpse through the window straight into his personality. To see the change in his face when he smiled and showed some spunky personality made me feel triumphant!
I saw him smile two more times that hour and even pull a face at a little boy patient. Each simple smile felt like we had somehow conquered the world. I have no idea what plans God has for his life, but I know He wants him alive!!!
Amazing.

Monday 3 February 2014

To Stare

I love the fantasy of photography. Often when I see an intriguing photo I would love to step inside of it and explore for myself. I guess this is why we love to hang grand scale photos on our walls and stare at them for hours.
I took some photos back in October in Colorado for some friends and during the shoot their little three year old was off on her own adventure in the woods. I love these photos because of the mystery. The sunshine is glorious and I want to step inside of little Ingrid and get lost for a time into the magical world of a three year old imagination.




These days I don't dream enough. I guess my fear is that it could never become a reality and so why dream?! But these photos make me want to dream again.

I’ve just finished a shift at work and perhaps for many different reasons I’m tired, not just because two little girls with their persistence for wanting things pushed me to the very edge of my patience (and perhaps a little beyond) but in the end when I thought I could bare it no more, I let the smaller one crawl into my lap and type on the computer with me. I controlled her hand movements but I let her type for me, the letter that explains to my team leader what changes have happened during the evening shift. After some typing, she lay back against my chest and finally let sleep overcome her. Along with her sleep came a deep breath for me as I let the frustration of her behaviour slide away.
It seems that sometimes when you are living your dreams, they still frustrate you, tire and wear you out. How many mums look at their children and know that they dreamed for them a thousand times yet they still find themselves frustrated with them more frequently than they wished? How many friends on this ship, some that dreamed of being here for years, look around some days and just want to be at home?
Sometimes I am overwhelmed at living in community, at living 30 steps away from the hospital I work in, at having people that challenge me constantly, at finding a way to deal with all these things when my only space is separated from others by a simple curtain. It’s moments like these that I want to find an escape for a little while. I want to crawl into an enchanting photo, stare into the mystery and imagine my life there. Yet my life here is still amazing, sometimes I need to take a step back and look at it with fresh eyes. To stare into the eyes of another whom I have been one of many to help bring the sparkle back. To imagine my life as theirs and remember all that I have to be grateful for.




I had a friend email me a few days ago. He was a day crew member in 2012, a local West African, during the Africa Mercy’s outreach. He worked as a translator in my ward and since then he has been unable to get a proper paying job. (This is a very common story unfortunately for many of our day crew after the ship leaves). He has been looking for jobs and asking around and has been told if he goes back to university and studies some more he would have a better chance of finding something. The only problem is finances. He needs $517.50 USD for one year of study (the course is two years). He asked me for help. I cannot as I don’t have the spare money but I thought perhaps some of you might? If you feel God tugging on your heart, please let me know. I told him I’d ask and see what God provided.


So, I continue to look up. I look to the One who sustains me through thick and thin, highs and lows. He is ever present.


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