FAITH, HOPE and LOVE...

This morning I came out of my slump.  You know whenever you step out of your comfort zone, to do hard things, you are bound to go through what I am calling a slump.  To me, a slump includes things like doubt, sadness, apprehension, disappointment, feelings of inadequacy, fear, confusion, or some other “difficult” feeling that persists for a while.  I have noticed that every single one of us who serves at this mission station goes through times of slump.  For me, returning to inpatient care has accentuated my “difficult” feelings.  Yesterday, I was the senior doctor for pediatrics; my colleagues: an intern and a brand new resident.  Did I mention that I lack training in this specialty?  The day was extremely difficult.  It started at 7:30 am with the 8-month-old in the ER with septic shock.  Then we began rounds.  One of our patients was two-days old, having been born six weeks before her due date.  Again, I sensed my lack of experience and training.  At 10 am, we were called back to the ER to resuscitate the septic child who had stopped breathing.  It seemed that we had resuscitated him successfully and he was prepared for transfer to the ward.  We returned to rounding on the inpatients and finished at noon.  We were on our way to the outpatient clinic to see the 60 patients who were awaiting our arrival, and we were called to the operating room.

Here is the highlight of the day.  The patient: a woman who had lost her first four babies (either in utero when they were full-term, or at the time of delivery).  She was having a c-section while this baby was still alive; I prayed that she would receive her first live, healthy child.  We were there to care for the baby in any way that he might need.  THANK YOU GOD…this little guy (whom they had estimated to be four pounds, by ultrasound) came out crying and weighing at least six pounds by my estimation.  All I had to do was dry him and examine him.  He looked perfect.  I was so happy…I wanted to kiss the adorable little guy!  To avoid being misinterpreted as eating her child, I settled for big smiles and telling the mom that she had a beautiful, healthy baby boy.

Unfortunately, during this c-section, we were called again to the ward; the 8-month-old had a respiratory arrest again, and this time he died.  I made it in time only to say to the mom that I was so sorry.  One-o-clock: finally on our way to clinic.  There were some of the usual diagnoses that we see in pediatrics (pneumonia, ear infections, etc.) but there was also the five-year-old who weighed barely more than twenty pounds.  Her TB is now cured; why isn’t this child growing?  After some help from a Nepali speaker, this is what I discovered: the mom is made to work all day long, by the husband who beats her if she doesn’t obey.  While she is out in the fields, there is nobody home with this five-year-old and she goes all day without eating.  She is simply not being fed…and she shrinks away.  I feel that old pain in my heart again. 

We did our best to see the 60 patients in 3 hours; that’s how much time we had before we were called to the maternity ward for the 2-day-old.  She had stopped breathing.  We breathed for her, with a hand-held resuscitation bag, off and on, for three and a half hours.  Unfortunately, not one of the doctors on duty yesterday knew how to use the ventilator, which this baby might have most benefitted from.  I spent a few hours that evening consulting with other doctors to see if we could find someone to be responsible for the ventilator for the night so that she might make it to morning when we could investigate the potential causes of her apnea (the cessation of breathing).  In the end, I had to release the nurses to tend to the other patients and we stopped our resuscitation efforts.  Ouch.  Are there any pediatricians out there who can come to Nepal to help the generalists like me?

It was such a difficult day.  I came home and had a long talk with Dave.  I realized that without him, to talk to after such days, I might not be able to do this mission work; it might break my heart.  So, I thanked God for my husband.  We talked again this morning and something suddenly became so clear to me, that I came out of my slump.  We lack skilled personnel here, and I myself lack knowledge and experience that I wish I had.  Still, I keep going to work, with a learning attitude, hoping to keep becoming a better clinician.  I find it hard and humbling.  But, this morning I realized that I do have three things, and these three things will last forever: FAITH, HOPE and LOVE.  These I have in abundance.  These I can freely give.  And I do.  I demonstrated love to every patient that I saw yesterday, as best I could.  I hope that they saw and felt it.

Faith, hope and love abide, and the greatest of these is love.

Thank you for being somebody who loves us enough to follow along in our journey,
Kimberly