Set Free

I love many things about working in the maxillofacial ward but what I love most is the way my patients faces are changed and improved almost immediately (apart from some swelling). Someone who has a cleft lip repair looks beautiful straight away, other repairs take a longer time to heal and swelling to decrease before they look ready to face the world. I’m practiced at looking at faces full of distortion or blown out by a tumour. You learn to look past it to the beauty of the person behind the face. I have learnt a great many things working with these patients, but the attribute that stands out the most is how courageous each of them are.

This last week we had a patient who wasn’t physically deformed from the exterior but his jaw had been locked closed (ankylosis) at the age of 7. His teeth were clenched together and he hadn’t been able to open his mouth at all in 19 years. 19 years. He is now 26 years old and had been unable to chew food in all that time and so he was malnourished and very eager to have it fixed.

When he came for admission it was found that his blood type was very rare and the lab couldn’t find a crew member to match him. In order to complete a safe surgery the team came up with a plan for him to give a blood donation that would be saved for him later if he needed it and in another few weeks he would come back and have his ankylosis release. In the meantime he was disappointed, upset and unable to go home due to distance and earn money for his family.

Eventually the time came for surgery. He was admitted the night before and the surgeon came and discussed the surgery with him. When he came back to the ward post-op he was a bit unsettled after the anaesthetic drugs but he calmed down and slept during the night. When I came in the morning he was sleeping soundly but was woken by the surgeon on ward rounds, shaking his hand. We explained we were going to take the bite block out of his mouth that was holding his jaw wide open and we put a mirror in front of him so he could see how wide his mouth could now open. We aim for two finger widths between the front teeth. Give it a go. Put your index and middle fingers together and put them between your top and bottom front teeth. Most of you would probably be able to put three finger widths in but it’s not actually necessary to open that far.

Well, after we did this with him, he started crying. At first it was silent joyful tears streaming from the corners of his eyes and then came the sobbing. I looked around at the faces surrounding his bed. There was about 6 people on a vision trip from the Netherlands, 2 pharmacists, 2 surgeons, 1 local surgeon, 1 translator, 3 hospital physicians and me, plus the 4 ward nurses, 3 other translators and 1 visitor. I looked around at the faces surrounding him and saw Sandy, our lead pharmacist. Her eyes had pooled in joyful tears which caused my professional façade to break and tears to pool in my own. After this he started sobbing, he started shouting out, “I can’t believe it, I can’t believe it! It’s a miracle!” He was raising his hands in praise to the heavens, high-fiving people, shaking people’s hands, celebrating! The crowd of people around him celebrated with him. 

He’d been set free.

Bundles of Blessings

It’s been a while since I last wrote. The things that have been taking up my time are updating paper work for Guinea field service, creating new Nursing Observations sheets, making the nursing schedule for D ward, doing nurse evaluations, keeping track of all the patients and an eye on my two maxillofacial surgeons. The two of them have worked tirelessly these last weeks mostly doing all-day OR cases. Despite some late finishes causing three patients to stay safely intubated overnight, all have recovered really well and continue to improve. I have been so thankful for such an amazing team standing and working around me. The OR (theatre) team is amazing, talented surgeons, anaesthetists and OR nurses and my ward team (doctors, nurses and day crew) are strong and competent. I know I can walk away at any time and they will be just fine. So, amongst some days where my head is full of to-do lists of mostly paperwork, I’ve sometimes pushed it aside and sat down to play a few rounds of Jenga with a patient. It is always these moments that make me feel the most fulfilled because it’s the relationships that really matter.

We have four patients in the ward at the moment who have been on the ward for weeks. Despite me feeling bad about them staying so long due to infection or delayed wound healing, they have been so gracious and positive and thankful. They are such strong people and I am so blessed and challenged by the way they live their lives here. I love watching them interact from their beds, translating for someone or just having a joke and laughing. They are true heart-melters. God has been teaching me about learning through the journey, not reaching the destination. As I go on ward rounds each day with the team, I look at the patient’s individual post-operative day count increasing and God reminds me that He is still present, working through the journey. I wish that all the patients would have uncomplicated recoveries and short stays and be able to go home quickly but life isn’t like that. Some journeys are longer and more complicated. So we continue to pray that these patients would be encouraged in the waiting period. That they would meet Jesus in that ward where we do nursing care but also colouring and Jenga (among other things) and that he would heal their bodies and their souls. 

Thank you to those of you who prayed for sweet, courageous Adama. She has now been in the AFM hospital for more than 100 days after a complicated journey post-op. A week and a half ago we were so blessed with having a surgeon here who did a large surgery to remove the infected tissue and hardware and flap some muscle and skin up into a defect. So far she has recovered really well and I feel so hopeful for her future. She will need another surgery before she can be discharged but we are in such a better place now.

We also have a 2 month old baby of a patient in the ward at the moment. Due to the fact that his mama was in surgery all day, he got passed around (as his papa didn’t mind having some time off) and the female day crew enjoyed bathing him in a blue tub on the floor of the ward, although they did comment on his loud set of lungs. When he is hungry, he’s starving! I took him for a cuddle and ended up keeping him asleep in my arms as I continued working for almost two hours. What a sweet little bundle of blessing for my day.