It had been a fairly “normal”
morning for me at the hospital, and I had even made it home by 12:30
for lunch. I started to eat while my little people and wife finished
off another delicious creation. Jedidiah had woken up early that
morning, and played hard. He likes to play hard here. He is always
busy moving part of our yard to another part of our yard, playing
with our new German Shepherd puppy, or making firewood. He finished
and reluctantly went to his mandatory “quiet time”, and Abigail
went for her nap.
After the daily protest the children
quieted down, and I finished lunch. I enjoy eating, and I really
seem to do a lot of it here. I find that eating has become one of my
major coping skills. I have never had so much stress in my life, and
eating is just such a simple way to unload a little bit of it. It
doesn't hurt anybody's feelings, my wife makes great food, and I find
a lot of my free time eating. I would like to think it is relaxing
and enjoyable, but in reality, I still have that nervous
butterfly-bubbling-stomach-electric-calf-muscle-feeling even when I
am eating that yummy food.
I finally finished, and started with
my back-to-work ritual. Gather my bag, don't forget the keys, go say
goodbye to the children again....today it was really quiet in
Jedidiah's room. He stopped taking naps a couple years ago, but
every odd day quiet time gets the best of him. Sure enough, 55 lbs
of all-boy energy and enthusiasm knocked out on the bed. They are so
cute when they sleep. I kissed him through the mosquito net and
rustled his hair as I said a silent prayer that God would save me
from losing these precious moments with my children. Just before I
left the room I saw them. I don't know why they stick in my mind so
vividly, but they are always there – little boy feet.
Now, little boy feet come in very
useful. I remember those same boy feet. At first it was the wonder
of how they could look just like mine but be 50 x smaller. I was the
designated tiny boy toenail cutter because mommy was worried about
hurting them. Then as he grew it was This Little Piggy, and Happy
Patty Cake Feet in the air. One time mommy bought these bright red
socks, and we still laugh about how they energized those feet that
they danced and jumped up and down the house every time they turned
red. I love that boy, and I love his little boy feet.
Today the red socks have been replaced
by a chalky orange. This orange comes from Malawi clay, and
Jedidiah's feet are rarely found without it. These days, his little
boy feet are busy getting orange. I smiled and reminisced for
another moment, then started back to work.
There is a struggle I have, and it
happens at least twice a day. I move in and out of two different
worlds. One world is familiar and comfortable – we speak English
and discuss familiar matters. We understand each other with saying
very little to nothing at all, and we are usually healthy and safe.
The other world is the hospital. Here the security is stripped away,
and the thin line between life and death—that line that I once
thought was very big and long and heavy--reminds me that I and my
family, and my endless stream of patients are merely mortal. Here in
Malawi it is a very thin line.
As I re-enter the hospital world, I
remember the events of the “normal” morning. There had been a 2
year old boy who was in a bad kind of way. He had come into the
hospital with a high fever, seizures, and anemia, and was at the time
of my morning review comatose. He had Cerebral Malaria – the most
deadly complication from Malaria which kills 25% of those who suffer
from it. The current thought is that death from Cerebral Malaria
results from diffuse swelling in the brain and brainstem herniation,
even though this disease is still poorly understood. Earlier that
morning, the child had classic findings of Cerebral Malaria, but was
also breathing fast with a fast heart rate. We decided to do a
lumbar pucture to make sure we didn't miss treating him for
meningitis, and started some IV fluids and antibiotics in addition to
the quinine he was already getting. It wasn't meningitis, but at
least we knew.
Unfortunately, this little guy hadn't
improved at all from the morning. One glance at him now showed his
little body was wearing out. I looked at his beautiful poor Malawian
village family – Mother, Grandmother, and an Aunt all sitting
dutifully, wrapped up in their best dirty clothes, expectantly by his
side. Looking at me feeling very confident he would get better since
an “Azungu” was taking care of him. His oxygen level was low,
and his lungs were filling up with fluid. I gave the family a
knowing look and tried to give an appropriate embrace as I knew that
the wailing would start within the next half hour. All of this is
unfortunately fairly routine. I was turning to leave the room and
write a short terminal note in the chart when I saw them. There they
were. I tried not to look, but it was too late: the little boy
feet. Those chalky orange little boy feet. Surely a few days ago
they had been running in the Malawian clay; they too succombed to
naps at quiet time, and looked preciously cute when they were asleep.
But today they have run for the last time, they are about to cross
that fine line.
Of necessity, I stiffle the emotion
somewhere inside, and move on to see the other baby in the room who
is also dying of meningitis. The “normal” day continues with
just a few flashbacks of little boy feet. The wailing starts from
the pediatric ward, and I take a deep breath. I feel hungry, but I
know food won't fix it, how can someone cope with losing little boy
feet?
Apparently all of the food hasn't been
doing its job, as I can't write this story without tears.
“He will wipe away every tear from
their eyes.” Revelation 21:4.
One day soon the thin line will be
destroyed, and the little boy feet of the world will run in the
chalky orange clay of heaven, and I will be eating heavenly food with
Jesus without that nervous
butterfly-bubbling-stomach-electric-calf-muscle-feeling. I can't
wait.
--jamie
