Little Boy Feet

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Today the red socks have been replaced by a chalky orange.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