Nothing Pretty

It is 0500, it’s still dark and I’ve given up trying to sleep. There is a lady who lives somewhere near us that has a mental illness who throws a large rock to the ground repeatedly every morning and sometimes in the afternoon. The force of her throw sends vibrations and a thud through the nearby houses. I can hear her powerful throw as she chases away whatever torments her.

I’ve been awake a lot overnight. I was getting a lot of headaches so finally decided to get checked for malaria, despite having a cold and feeling like I was probably overreacting. I tested positive for malaria, much to my surprise and relief that the headaches will be treated and disappear. After I got home from work I started the oral treatment which side-effects apparently give me insomnia. It was also a rough day yesterday and I’ve been reliving my day at work while trying to sleep.

I didn’t want to write every time I had a terrible work day and I haven't but it does help me to process and so here I am again, thinking of my day, tears spilling and blurring the screen in front of me. 

I was on nights last week but returned to day shift this week and started off the week looking after a baby boy who I had met on a previous admission. He was only a few weeks old with a very attentive mama and grandma who cared for him and his twin sister so well. He had gotten sick at home and his mama had brought him into the hospital where he’d gotten worse despite treatment. I assessed him throughout the day and didn’t like how he looked but he hung in there. I was worried though.

It’s so hard working in a country where you don’t speak the language and you don’t know the culture well enough to know what you’d even say to the parents of a child or baby who is very sick. In some African cultures you cannot tell them someone is dying because it removes all hope. Thankfully the expat doctors here speak French and working with the Togolese nurses and chaplains, we try the best we can.

I arrived at work in the morning to find out the baby boy didn’t survive the night. I felt so crushed for the mama. They had already left the hospital which I was selfishly glad of because I didn’t want to see that mama’s heartbroken face.

I was looking after the paediatric ICU again that day, along with the nursing students sharing the load and I was also orientating an expat paediatric nurse. Before we had time to do much the nurse aid called me to our 4 yo girl with severe malaria. She was seizing. And so began the day. We gave medication after medication, blood, antibiotics and airway support. We threw everything we possibly could at her and hoped it would be enough. There were wires and tubes everywhere but when I wasn’t next to her cot, there was a relative at her side. At one point I put in a foley catheter and was surprised when the ‘urine’ that came out was the same colour as the blood transfusion going in. We called the doctor over for the hundredth time that day. She said she’d only seen one other patient with urine that colour in all her years working there.

Conversations were had with the family as we waited to see how she would respond to treatment. I looked at her vitals and knew that it would take a miracle and prayed so but I also felt at a loss for words. Jesus. Jesus.

We made a plan before I went for lunch and I wasn’t sure she would still be alive when I returned, but she was. She kept going for hours. Her little chest heaving breaths through crackly lungs. We hadn’t been able to get a blood pressure reading on the monitor or oxygen saturations for hours and then I couldn’t palpate her peripheral pulses. I stayed by the bedside with the family as I watched her little body stop working. There was no hope in coding her and prolonging her death so we let her slip away but the thing is, it wasn’t pretty. Her mama was sobbing and I stopped being brave and just let the tears fall. We stood there while she breathed her last gasping breaths, the CPAP still blowing air down her throat. And then her heart slowed and stopped and what I knew was going to happen, happened. She was still and lifeless. I stood there wondering what she had been like. Had she been a bubbly, lively little girl?

I stood helplessly next to the family, so desperately sorry that we’d lost another child. Another beloved child. I felt so angry that kids and babies are dying of something that’s been eradicated in other countries but also an element of hopelessness. When will it ever end?

There’s nothing pretty about this. No nice way to tie this up. I know Jesus walks with them in sorrow and oh how deep that sorrow is. I asked God to give me a heart that breaks like His and I think this is what it looks like.