Tuesday, November 27, 2012

November Max-Fax Stories

     As we wrap up another month here on the Africa Mercy, I am overwhelmed by all of the amazing patients who have come and gone. I wish you could be a fly (or something less contaminating) on the wall of D Ward so that you could see their transformations. Daily I am reminded of the parade of miracles we get to witness, which makes the occasional hard times worth it. Here are a few that stood out for me...

     If I'm honest, I've had a couple favorite gals :) One of them I shall call Toulie, a girl no older than myself admitted with a large jaw tumor. I had the privilege of caring for Toulie after her hemi-mandibulectomy. This is a procedure that involves removing half of one's jawbone, as well as the teeth connected to that bone. Since the mouth has suddenly been turned into a raw battlefield of healing, a Naso-gastric tube is required for nutrition over the first week of recovery. There is also a drain out the bottom of your jaw, a large incision down the front of the chin and an enormous gauze head wrap involved. This is your typical hemi-mand, and this was Toulie's case. 


     But what stood out about her is that from post-op Day One, she greeted me with a grin. And every day after. If it weren't for the gauze, suture lines and multiple tubes inserted in her, you wouldn't have been able to tell she had just had extensive facial surgery. She never so much as grimaced, let alone shed a tear over the pain she likely felt. By the middle of the month, she no longer had a drain or NG tube and was eating soft foods, so she was cleared to discharge to the Hope Center! On her final day, I got to teach her to apply her pressure dressing, holding the mirror while she practiced putting it on and taking it off. She hugged me and left with a grin on her face. And when I visited her at the Hope Center the next week, she greeted me with an even bigger smile.


     Another endearing couple of gals were Grandma H and Binta, her teenage granddaughter who stayed as her caregiver and translator. Sometimes we don't have Pular-speaking day workers, so generally my words would be translated to French for the granddaughter and then she would translate into Pular for her grandmother. It was this game of telephone that my patient assessment info and teaching had to go through. The first day I took care of Grandma H, both she and Binta were kind but quiet, just smiling and staying to themselves.


     By the next day, they were suddenly my buddies! Anytime I came to talk with Grandma H, she wrapped my hand warmly in hers. And Binta turned out to be quite the teenage linguist. She showed me her coloring book, which was actually functioning as a notebook; it was full of words and phrases she'd been collecting. With her small English she began animatedly explaining them to me, writing out new words for me in French and Pular. She asked about my family, so I pulled up Facebook on our ward computer and showed her my mom, dad and sister, whom she said were all "so beautiful". It was such an epiphany moment, like this unseen gap was bridged - I became a girl just like her, with a family that I too loved. 


     This next young woman completely stole our hearts! I will call her 'B', and she took over our ward like a storm. 'B' had a large intra-oral tumor removed, which required her to have a tracheostomy in order to breathe and receive nutrition via a nasogastric feeding tube for several days. But though the trach made her speechless, you could literally hear her through her body language. And she was hilarious! At any opportunity, she was literally up and dancing, tubes and all. The joy and life that she radiated were absolutely contagious! (I'll tell you more about her in my next post, she's amazing)


     I'd like to finish with one of the most well known and prayed for patients on the ward. Here he will go by 'T', and he spent over a month with us. He is one of the faces I vividly remember from Screening Day. Even then, before I knew anything about him, his gaze wrung my heart. He sat there with a handkerchief draped around his head, partially concealing the enormous tumor that had taken over the right side of his face. What you cannot see is how the tumor has stretched his lip and emerged through his mouth, hanging about five inches below where his chin would be. 


     Anyway, 'T' came to us in October for pre-op care. He was extremely malnourished, only able to consume liquids plunged into his throat via syringe. From the beginning our surgeon explained to him the very risky road ahead. Before he could even have surgery, he would need to get stronger. So a gastric feeding tube would be placed to his stomach in order to give him appropriate nutrition. And because his airway might very soon be compromised, he would need a trach inserted in his neck.


     Long story short, T accepted the odds and lived on the wards for three weeks before any incision was made. As he began to build his strength, his tumor began to grow exponentially, now receiving all the nutrition it had been lacking. But he pressed on. And when the day for surgery came, we all prayed, day and night. The waiting was tense, as though everyone was holding their breath. This was the first time I questioned whether a patient would make it or not...


     But he DID come through, in the most remarkable way. Not only did the surgeon remove all of the tumor, but he was able to save T's right eye. 'T' spent one night in the ICU and the next day was on the ward again, back in his old spot. It was as though God took all of our worry and fret and just turned it on its head, saying 'See? I told you I had this.' Soon his trach was out, and shortly after that he began to use his new mouth to eat. Last week he was cleared to go to the Hope Center, this man that I thought would surely be in the hospital through Christmas. His recovery is unprecedented. The only word I can think to describe it is miraculous.


Friday, November 23, 2012

Holding on with Open Hands

     As we near winter (or at least what would be winter if we were in the Northern Hemisphere), I am becoming more and more aware of the passing of time. When Patrick and I first arrived in Guinea it was August, and the holiday season felt like a lifetime away. There was so much to adjust to and so much to learn. It was overwhelming enough looking ahead to the next day, let alone four months! So it is difficult to come to grips with the fact that November is nearly gone and our departure is three weeks away.

     There are so many memories, so many things that I want to carry with me. If I whittle it down, the thing that is so hard is the inevitability of letting go. As if we haven't said goodbye enough this year, we will soon be saying goodbye to our friends, our patients, and this way of life. Yes, it has only been a couple of months, but being on this ship, living and working in such close quarters with everyone, has knit us together in ways that I never anticipated. These people are like my second family, and I ache to think that when we leave it will never be like this again.


     This morning a few of us gathered for a post-Thanksgiving day brunch. We went around the table sharing what we were grateful for. It was lovely. One friend's response stuck out to me in particular. She said that she was thankful for her time on this ship, and the gift it has been to know each of us. Because God brings people, relationships, into and out of our lives just when we need them - not ours to keep, but gifts to be held with open hands. So this entry is for them, the friends both here and already gone; gifts that God has placed in my life for this season. For them I am so thankful, and because of them I am forever changed...

Hannah - Always there with a listening ear or much-needed hug.
Love this girl like a sister :)

Jen - Our soft spoken Italian with a heart the size of this ship

Noemie - A gal who took true joy from friendship

Andrea - Refreshingly real, genuinely joyful

Michelle and Rachel... enough said

Maura - Wears love for her patients on her sleeve!

Beth - So genuinely reflects the heart of God


Jasmin - I'd claim this Aussie for America if she'd let me ;)

Ann - Loves like she means it and has a laugh that can fill a room!


Maria - So easy going, with a contagious sense of adventure!

 The 'Other' Emily - Absolutely radiant in every way

Becky - The warmest smile and most tender spirit

Sunday, November 18, 2012

A Day in Dubreka


     For weeks Pat and I have attempted to get to a small region outside the capitol called Dubreka, known for its' beautiful waterfalls and lush landscape. Each time plans have fallen through for one reason or another, but it seems the third time was a charm! So on Friday we hopped into one of Mercy Ship's Land Rovers with a few guys in pursuit of adventure :)

Pat, myself, Ben and Cody, totally pumped!

     Our first order of business was to do some hiking. So once we arrived at the town itself, we turned down a small road leading into the valley. We parked in a quaint neighborhood and started walking up and in.

Only my husband brings a guitar on a hike :)

     We found a small river and hiked upstream with it on the right as our guide. It was absolutely beautiful, and the air was surprisingly fresh under the shadow of the trees.


     In about an hour we waded across to explore the other side of the valley. We found ourselves on a wide dirt road, and enjoyed a leisurely stroll with the sun breaking through the clouds.

Juan, Cody and Pat, who played us some strolling tunes :)

     Pretty soon our stomachs started talking, so we headed back to the car for lunch. After a quick bite we hit the road again in search of the famous falls. We came upon a promising sign that advertised "Site Touristique" and "Cascade", so we took a hard right and hoped. Fifteen minutes later we arrived at a small hotel and a long stair, and at the bottom was the most lovely waterfall I've seen since Niagara.


     A large pavilion was built parallel to the falls, allowing access along its' entire right side. So of course, the boys had to try to get as far in as possible :)

Contemplating the best method of entry

     Thankfully the ledge that led to the falls continued underneath it, and the rocks behind opened a bit. In other words, no one was washed away :)

Pat following the guys as they disappear beneath the falls

     After the impromptu "shower" we all headed down the steps and went for a swim in the waters below! The current was surprisingly strong, and the water surprisingly cool. I haven't been in fresh water like that since the States...it was the perfect end to the perfect day.

My best friend and I post swim :)

Monday, November 5, 2012

The He[art] of nursing, Africa style

     I have been working a lot this past week (hence the lack of updates!). This is not a complaint at ALL; on the contrary, it has been an awesome opportunity to measure what growth, if any, there has been in my nursing since we've come to live and work on the Africa Mercy. After all, it's been nearly three months, so I'd say it's time to check in :)


     Among other things, I've realized what an impact you can make without your voice. For those of you who have followed our journey, you know I had some reservations at the beginning about communicating with my patients effectively (for a reminder, here is That Blog). I thought that because I couldn't speak with my patients, I couldn't communicate with them. Turns out I was so wrong! This past week there have been so many patients and family members to remind me that love transcends language. Here are just a couple examples:

     In bed D8 sits a beautiful girl named Agnes. She is fifteen years old and every bit a teenager - some days happy and interactive, some days sullen and tearful. And she is amazing. Last week she had a surgical procedure to repair her cleft palate (the roof of her mouth, which had been open to her nasal passages). She has been receiving nutrition via a naso-gastric tube ever since. But what has been so amazing has been the relationship we have developed. After our first day together, we were buddies. We have laughed, cried, and even painted "Agnes loves Emily" and "Emily loves Agnes" signs for one another. Mine hangs above her bed and hers is pinned to my cabin wall, reminding me of the responsibility and privilege it is to genuinely care for each patient I am assigned.

     In D11 is the most adorable baby I've ever seen (I'm sure I've said that way too often, lol, but it's always true!). Her name is Batouli. She is three months old, has the most beautiful almond-shaped brown eyes, and had a teeny cleft lip repair a couple days ago. I was told in report that her mama seemed somewhat distant and disinterested in baby before surgery. So I decided to spend the shift doing a love experiment. Every time I passed them, I loved on that baby; tickling her little toes, blowing her kisses, cooing and making faces like a doofus. Each time I would also compliment mama, telling her how beautiful her baby is, what a good job she is doing (all in English, no translation). And you know what? Mama began to smile. Mama began to hold baby again. Mama came back. Maybe it was fear of the surgery or of this place, but it has passed. Now I catch her cooing baby on her own. And when I come by, we make silly baby noises at Batouli together.

     In D15, there is a 5 year old patient who is about the cutest, most well-behaved little boy you could ask for. He takes his medicine without a fuss, he plays kindly and picks up after himself - he is a dear. But behind every good boy is a great mama, and his is great. She can't be any older than I am, and she is absolutely beautiful - warm-hearted, always smiling, and genuinely loving toward her son. And for some reason, we have clicked. She greets me with a hand-shake and finger-snap every day, and she has nothing but smiles for me anytime I even glance her way. The other day we sat next to each other for a few moments in the middle of the ward: two young women perched on stools watching a Disney movie, saying nothing, holding hands. With that simple gesture she told me that she trusts me, and there are no words for the weight of that.

     I suppose what I'm saying is that I feel free to love my patients well here. Despite the limited resources and the crowded wards and the paper charting, I can be the nurse I want to be - one who cares for the heart as well as the body. Where I come from, none of the above examples would be considered "vital nursing". There is no quantifiable benefit for affection, no evidence-based practice for caring. And that's because there IS no way to quantify Love or Compassion, no way to value the effect of ministering to someone's Spirit. But I truly believe that our acts of love will echo through Eternity - which makes them priceless.