Comeback

Comeback

I found her thrashing on the examination table in the labor room. The time was around 1am, and I had been called to see her by the maternity nurse who said a woman was convulsing. She had had no prenatal care and her family knew nothing about the statuts of her pregnancy other than that they thought she was around 8 months pregnant. Her chest heaved with each breath and I could hear the crackles in her lungs without stethoscope. She would not respond to questioning and was barely conscient. Her blood pressure was 140/90. Eclampsia with pulmonary edema and impending respiratory failure. This lady was going to die.

I grabbed the fetal doppler and found a normal fetal heart rate. At least if I couldn’t save her, I might be able to save her baby. I heard a fetal heart beat in the normal range. So we kicked into high gear. We ran her gurney as fast as we could to the OR. Her respirations were becoming more and more labored. Time was slipping through our fingers and she didn’t seem have much left. Two venous lines, a hemoglobin, getting vitals, starting a little fluid, we hurried as fast as we could. The anesthetist looked at me and looked at her. I knew what he thought. This woman is dying. Why are we going to cut her open? 

To do the spinal, (we didn’t have any gas anesthesia during that time) we literally had to prop her up and hold her firmly as she was still thrashing and with altered consciousness. The spinal went in, miraculously. We painted her belly with betadine, scrubbed and prayed. Her oxygen saturation was in the 70s. 

I slashed her uterus open, took out the baby, and passed it off to a nurse. Then I reached for the placenta and instead found another baby. I passed off that baby and continued the surgery. And I looked over the drape at the machine tracking her vitals. Her oxygen saturation was now in the 80s. What?!

I finished the surgery and took a look at those now pink wiggly babies. Her oxygen saturation was now in the low 90s. She wasn’t still very responsive, but her breathing was a little less labored and a little less wet. I discussed with the family her grave condition and set up a plan for antibiotics and a little diuretics with the maternity nurse.

And sure enough, the next day she was a little responsive. And the day after she started to talk and take porridge. By the end of a week she was breastfeeding, normotensive, talking, and walking.

Walking, or rather dragging, is how we got our six sheep over to the Christian former nomad’s place where they were to stay during a missionary course Gabriel and I had to take last month. The fierce Chadian sun burned on our necks and the sheep balked and pulled at the ropes we had tied around their necks. They were not excited at this hot 2 mile walk in the desert. They much prefer lazing beneath mango trees. I kept thinking how silly sheep are, smelly, dirty and always ungrateful for our care for them.

Finally we reached the compound and introduced our sheep to their new 30 some-odd friends. Arabic sheep are tall and beautiful. Gabriel caught a perfectly white gangly lamb and held it in his arms. Praise God we no longer have to sacrifice these cute little guys.

We greeted all the extended family members in their ragged nomadic clothes, chatted a bit over cups of water, and then decided to return as the skies were getting dark. Our sheep seemed to be somewhat overwhelmed at their new living situation with so many new creatures. But sheep are sheep, I mean, how big is their frontal lobe, really?

Fast-forward several weeks to our return. We asked our maintenance man how things were while we were gone. He reported, humorously, that just a few days after we left, our compound guard found 5 of our sheep baaing in front of the gate late one night. What?! They came back? All that way? I, with my medical degree probably couldn’t find my way 2 miles through the desert in the middle of the night, but sheep? How did they find their way out there?

Out there is what I knew she was. She, the wife of the ringerleader of our crisis during the summer, was out there with a pregnant, previously c-sectioned abdomen. The ring leader was no longer employed at our hospital and living several hundred kilometers down south. His wife, however was waiting in Bere. Waiting for the time to come for her third c section. Her husband had told us (because he knows our hospital gives excellent care, especially surgical) before he left that he wanted her to deliver at our hospital still despite his separation.

One early morning the maternity nurse came to my door to tell me a previously c sectioned patient was in labor. I looked at her carnet (small medical record book) and instantly recognized the name. This is his wife. He who brought us so much anguish and stress and fear just a few months previous. He who was infinitely disrespectful to me in public and nearly got me kicked out of the country. And now his wife is in labor and needs a c section. And I have to be the one to do it.

During the time that she was preparing for c section, Gabriel and I continued our morning devotions reading through the Bible. That morning’s chapter happened to be Joshua 1 and His message for us was: “Have not I commanded thee? Be strong and of good courage; be not affrighted, neither be thou dismayed: for Jehovah thy God is with thee whithersoever thou goest.”

Joshua 1:9 

So we prayed and tried to swallow our fear, and I trudged to the OR to do her surgery with our new family doc missionary, Staci. And then, he came back, my first time seeing him since the crisis. The fears and painful memories crashed over me like an ocean wave. He came into the OR pre and post-op area also. He greeted me and shook my hand and then tried to direct aspects of her care. 

I feared the potential amount of scaring with her two previous c sections. Thankfully, though, her scarring was manageable and adhesions minimal. A small subcutaneous arterial bleed squirted me in the face, spattering me with small red drops. 

After her surgery I went out, as usual, to talk with the family. He greeted me, my face speckled with a small amount of his wife’s blood (no mirrors nor bathrooms in the OR). He shook my hand and thanked me profusely for the care for her. And what could I do but smile back?

The real smile, however, came when I saw them again. Of course I didn’t recognize their faces, but there were three similar-looking babies sitting in their family’s laps outside of the OR. They had come back for the 6 month breast milk only picture. The Netteburgs do have a program to give free formula to babies whose mothers have died at our hospital and to supplement breast milk for triplets. But somehow this mama decided she was going to do it all on her own. And so, 6 months after my delivery of them, she came back with Sarah, Gabriel and Prudence (the name of the maternity nurse that afternoon of her delivery.)

Her story had been that she delivered one baby at the health center and then the placenta wouldn’t come out, so she was sent to our hospital. The ultrasound tech had imaged her and discovered that not only was her placenta still inside but her two other babies! So with some oxytocin and breech maneuvers, the other two came out also. Spontaneous triplets are rare anywhere but even more rare here in Chad is their survival given their prematurity and need to share mother’s milk. 

Rare, also, is a thank you here in Chad. In fact, in the local language I have not found a word for thank you. They use the french, “Merci.” But sometimes, God gives a little pick me up and someone makes a come back.

“And if I go and prepare a place for you, I will come again and receive you unto myself; that where I am, there ye may be also.” John 14:3. Come back, Lord Jesus!