Tuesday, February 3, 2009

Over My Head

It was Friday morning, the end of a long week and thoughts of a carefree Saturday, of sleeping in and spending the morning doing yoga and passing the afternoon running and reading were not far from my half attentive brain that was going through the motions of lab work. Sauntering back into the lab after drawing blood from tearful children in the pediatric ward, I was greeted by the Hospital Administrator, Yves, who asked if I had free time to run down to Maternity to quickly test the hematocrit levels of a young woman in the process of giving birth. I said sure, grabbed my things and headed outside thinking to myself that I hoped this wasn’t anything too severe being that both Doctors had taken the day off.

The first thing I saw walking into the door was blood. No, not tiny droplets of red and not small smudges here and there… but pools of blood that were covering the entire floor of the delivery room and dripping off the delivery table. On the floor, slipping in and out of consciousness and writhing in pain was a small woman, 9 months pregnant, and soaking in her own blood while she steadily added to the expanding pool of red that surrounded her. Her hand was cold when I held it both to test for her blood type and to comfort her and her eyes were empty, unable to focus on anything. After briefly discussing with a local nurse, Ganava about what he thought had both happened and should be done, we came to the conclusion that her placenta must have ruptured and that there wasn’t much more that we could do other than make her as comfortable as possible for as long as possible.

I hung her first bag of blood donated from Sarah, another SM here and added Oxytocin to her IV drip in hopes that it would help her to eventually expulse the baby before it was too late and then stood back and waited for the medicine to kick in. (If the doctors had been there that day we would have immediately done an emergency C-section in hopes of being able to save both lives, but being that they were away for the day and no one at the hospital is trained to do operations, there was little that any of us could do). It is a surreal feeling to stand beside someone while their life is literally slipping away from them and to watch in horror as your heart tells you that you need to be doing something but your mind knows that there is nothing to be done. But that was all that I could do… just stand and watch, holding her hand, thinking that while the responsibility of this situation lay partially on my shoulders, the severity of it was way over my head.

20 minutes later I was running back to the lab to argue with unwilling donors in hopes of finding more much needed blood which is always a bit more tedious than necessary. Yelling and perhaps shocking a few I finally convinced an unwilling husband to allow me to poke him. Frustrated and shaken from the futile situation, I returned to the delivery room and was told that during the 30 minutes that I was away, fortunately the baby had just been delivered, dead, and that the mother was beginning to stabilize a bit. Hanging her second bag of blood, and checking some vitals I walked to the sink to wash the blood off of my hands and as I looked down for the soap I saw lying, without consideration in the sink, a fully developed baby boy, limp and lifeless, disregarded and overlooked. With tears welling in my eyes I reached for the baby, wrapped him in a towel and headed outside to face his family. Handing over this little life that never even had a chance to start, I turned away from his father’s disappointment and turned away from the hospital having seen and experienced too much for one morning.

That evening, I set out on a walk in attempt to clear my mind from an overwhelming morning and as the sun was setting over the mountains, the village still and my mind racing, two little girls joined me. As we walked in silence, their smiling faces looking up at me, their laughter the only sound I could focus on and their small hands in mine, it dawned on me that the thing about Africa is this; When things are hard, you’re shaken to your core, but when things are good… things are indescribably great.


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