Monday, April 14, 2008

Monday In Paradise

The two concepts seem mutually exclusive to me--"Monday" and "paradise." I have never liked Mondays. In college I once wrote an essay proposing that Mondays be legally banned. I reasoned that if Congress could change the dates of dead presidents' birthdays, surely they could eliminate Monday. I suggested that the 24 hours thus left over each week could be used for other noble purposes, like last-minute study, or leisure time. I even suggested an account in which individuals would be allowed to save up a certain number of these hours for use later for vacation, or whatever they wanted.

In Kudjip, the Monday after being on call is the worst kind. Chances are that I've gotten even less sleep than usual, and what I got was probably of poor quality, knowing that the phone next to my head may ring at any moment. Sometimes, like today, I get called into the hospital early in the morning, which gets Monday off to a particularly bad start. This morning it was for a drunk guy who had been trying to tuck an illegal handgun into the waistband of his pants, and had managed to discharge it in the process. The bullet passed through a fold of skin, came back out and then re-entered his upper thigh, never to be seen again. It managed (apparently) to avoid any vital structures. I admitted him to the ward for observation and antibiotic treatment, but he left a few hours later, as soon as he'd sobered up.

Call hadn't been too busy, but in some ways it was a hard weekend. I'd made several trips in to try to help Godfrey, the little boy on bed A3. He'd come in for a simple-seeming gastroenteritis (you'd call it a "tummy bug") but quickly got sicker. He probably developed a condition called DIC (we don't have ways to prove it either way), which causes the body's clotting mechanisms to do all the wrong things--clot where no clots are needed, not clot where clots are needed. Two or three times he had gone into cardiopulmonary arrest, but had responded to the staff's CPR. His blood count was very low as he lost blood into his stomach and intestines. The transfusion I gave him Saturday did only brief, if any, good. Then Sunday evening I was called yet again. This time he rallied only briefly with CPR before his little heart gave up.

Usually you don't have to tell parents when their child has died--they can read it in your expression, in your sigh, in the way the frenetic activity which has been directed at the child suddenly stops. So Godfrey's mom and aunt had started to cry before the words were out of my mouth. I waited a few minutes, and then offered to pray with them. I prayed that confused, struggling prayer that I pray so often in this situation, affirming faith in a good God, and asking His comfort for this family. Apparently they had phoned his dad as well (we are now in the affordable cell phone era in PNG), because he was coming up the sidewalk when I left a few minutes later, crying as he came.

Then there was Titus, the man I'd prayed with Saturday morning on rounds. I had just forced myself to be honest with myself as well as with the patient, and admit that what he had I couldn't treat. I stopped the medicines that I knew were useless, and addressed spiritual issues with him, the issues that were now the only really important ones in his life.

I asked if he was ready to see God. He said that he was a pastor. I agreed that that is a good thing, but that hadn't been my question. I asked if he had repented of his sins and asked Jesus into his life. He assured me that he had. I asked him if he were actively following Jesus, and reminded him that he and I both knew plenty of pastors who are not. He, his wife and son all laughed nervously and agreed with me. He assured me that he was, indeed following Jesus.

I then prayed with him. I asked for relief from pain and suffering, I asked for peace for him and his family, for wisdom, for strength. Then I prayed that whatever happens to any of us, whether in life or in death, that we may bring some measure of glory to the God who made us, loves us and saves us. Titus, along with his wife and their son said a hearty "amen" to that prayer. Titus' body died that evening. Titus lives on.

Often I find that I think more about the ones who die than the ones who don't. I should maintain at least a little balance. While I was on call this weekend, I discharged about ten patients. They had all either recovered, or at least experienced adequate control of a chronic condition to allow ongoing care at home. They didn't die. They didn't even get worse! They got better, some completely well.

That's something that I should think about on Monday.

Yours and His,
Andy

Photos:
#1 Paradise
#2 A busy morning on the peds ward
#3 A happy mom and baby in the hospital

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