Friday, January 30, 2009

Delivering a Miracle

Do you believe miracles still occur today? Webster defines a miracle as:
1: an extraordinary event manifesting divine intervention in human affairs
2: an extremely outstanding or unusual event, thing, or accomplishment
3: a divinely natural phenomenon experienced humanly as the fulfillment of spiritual law

I was on-call Monday night and the phone call I received went something like this, "Daktari, that patient with ISS (code word for AIDS), I'm calling because she coded." My response, "Keep her alive until I can get there for the C/S." Running up the hill to the hospital I'm praying. This woman has been admitted for the past 2 weeks because of nausea, vomiting, active TB, severe fetal growth restriction, HIV encephalopathy, and wasting. Her pregnancy is only 30 weeks. I find her with agonal breathing explain quickly to her mother I am going to deliver the baby to save the baby but it will likely lead to her death. She's intubated without any muscle relaxation and minimal sedation. The baby boy weighs only 1200 grams but is alive. We all agree she has to be extubated because the situation is hopeless. The tube comes out, she breathes shallowly. Off to the ICU to spend the night. I hang a big sign over the bed DNR: Do Not Resuscitate. I check on her several times that night, her vital signs seem to improve, but she is unresponsive. The next day, she needs less oxygen. We consider putting a tube into her stomach to give her medication, but by the afternoon she is conversing. Not only conversing, but making sense. I had never met her coherent; she was always confused and accusing me of being Massai and afraid I would go tell people she was HIV positive. The following day she is walking, eating, taking medication, and thanking us. Her mother, who is by her side ever minute providing care, takes my hand and says many things I don't understand with tears in her eyes, but I hear one word clearly ,"Mungu" and I agree, the credit goes to God.

Friday, January 23, 2009

Amelia's First Day of Kindergarden

It was unrealistic to think we could homeschool Amelia and work full-time. So, we rejoice at the arrival of Teacher Sarah. She's just what Amelia adores. You can't beat the ratio: 2 teachers for 4-5 students. Amelia's grade meets 2-4 hours/day. Malin is also teaching the PE segment and helping the older kids get the Presidential fitness award. This afternoon is African geology; art, science, math, reading, and language were covered early this week. When I asked Amelia what she learned at school today she replied, "It was really important, but Mommy, some things are too important to remember." 

Thursday, January 22, 2009


We all need encouragement. Amelia needs encouragement right now for reading. Meredith for using the potty. Malin for still feeling tired after having malaria. And I needed encouragement today after spending 3 hours removing genital warts. I know that sounds unpleasant. It was unpleasant. But as I was feeling sorry for myself for missing lunch again, wondering if my surgery was making any difference in this patient with AIDS, Dr. Wesche quietly came in behind me. He had asked me to perform the surgery in the first place for this lady and has worked at Tenwek over 30 years. "Wow," he said, "Look at how much you have relieved her suffering. Some people wouldn't have bothered because of her status, but she couldn't even sit. You have helped her so much." These were the words I needed to hear and not forget. We are here to help however and whomever God places in our care.  My thoughts needed redirection away from myself and back to her. Dr. Wesche has set this example for countless years. His humility, compassion and servant's heart are spoken of frequently. What a legacy to leave and to encourage in a young physician!

Tuesday, January 13, 2009

Amelia rescues Liezel

    Amelia and I found a baby Bird who had fallen from a tree branch on the path to the hospital.  We looked for a nest above with no luck.
     Amelia took the bird home and we searched the web for urgent bird rescue techniques.  First Amelia named the bird 'Liesel' (she is into Sound of Music).   She then made a nest in a basket with towels and tissues for a blanket.   Amelia gave Liesel sugar water through a medicine dropper every 30 minutes.   He has a bright yellow tongue.  Liesel began to chirp and flap his wings.  The next day Amelia made a mix of cat food and water and as you can see in the picture Liesel takes food from tweezers .  We will see what happens as Liesel is getting stronger everyday.  This bird adds to Amelia's collection of geckos named Climber, Tom, and Hisser-Tisser.

19,340 ft.

I had the pleasure of standing on the rooftop of Africa by climbing Mt. Kilimanjaro in Tanzania with 5 new friends from Michigan.  All 6 of us were successful in climbing up to the crater and to  Gillman's Point and then on to the final summit at Uhuru Peak (Kilimanjaro has a 75% success rate).  We reached the summit at 5 AM--very dark and so cold that our water bottles had frozen despite being wrapped in socks.   We took a few pictures and watched the sunrise as we came down.

Friday, January 9, 2009

Climb every mountain....

Climb every mountain,
Search high and low,
Follow every highway,
Every path you know.

Climb every mountain,
Ford every stream,
Follow every rainbow,
'Till you find your dream.

A dream that will need
All the love you can give,
Every day of your life
For as long as you live.

That song from The Sound of Music is going through my head for 2 reasons: first, it is now Amelia's favorite movie and she watched it yesterday, second, Malin climbed Mt Kilimanjaro and should be arriving back at Tenwek today. Even though I did not physically climb a mountain, this week seemed like a long, hard journey. 

This week included several difficult deliveries, including a breech baby at 28 weeks, surgeries for ovarian and cervical cancer, 2 procedures I had never attempted before, and pregnant patients with pancytopenia, cardiac disease, hemoglobin of 3 (normal blood count is 14), and other various complex problems. Tenwek's local Ob/Gyn has been gone most of the week and leaves next week for 6 weeks so, I have been reading, studying and praying my way through most of these problems. 

Since, this is the first time this week I've had time to come home for lunch, it's been long days for the girls. I am grateful for the help and care other mothers provided this week for my children. I look forward to Malin is easier to climb mountains with friends, another Ob/Gyn is easier to climb mountains with colleagues, being off call next is easier to climb mountains when rested, and to spend more time in prayer for this is the only way the climb will be successful.

Sunday, January 4, 2009

Girls Only

Since this is the first post of 2009--Happy New Year. I brought the year in with 6 C-sections in 12 hours. Please pray for safety as I walk to and from the hospital in the middle of the night.  New Year's Day included a family nap. Malin left the following day with another physician here, Dan Hayward, to climb My Kilimanjaro. They'll be gone 8 days and 8 nights. Amelia, Meredith and I decided it would be the perfect time to have a girl sleep over. Amelia's friend Claire came over and we painted toe nails, ate popcorn, and watched The Sound of Music. We're moving in the Dan's wife and 4 boys for the rest of the week. Suzanne has graciously offered to help with the girls as I work (she also looks forward to some girls in the house).

In clinic this week, there was a man on my schedule. I said to the nurse, "I don't see men." She replied, "But you're a gynecologist." So I repeated, "Yes, that's why I don't see men." She said, "But you should be able to help him, you're a gynecologist." I smiled and said, "Yes, my training was in gynecology I have not seen a male patient in over four years." She laughed and said,"Really?" She eventually understood and ended-up calling someone else to see him. But for those of you that our wondering,  his problem was related to a unfortunate accident which he was thinking Viagra would cure. There are many things not available in Kenya, but the "little blue pill" is.