Birthdays

Last week I had my birthday, and I thought I would write a little bit about what we did on my birthday, and I also thought it would be a good opportunity to write a funny story about someone else's birthday.

For my birthday, I was really excited because I didn't have to work until 9 pm, so I had the whole day free to do whatever I wanted. We decided that we would do a big meal all together to celebrate my birthday and Maria's birthday, which was the day before. So Ansley, Emily, Maria, and I all prepared the food. We had cucumbers with salad dressing, and big franks! Both my parents and Jacob's parents had sent us canned veggie meat, so we were able to have hot dogs with onion, mayonnaise, and ketchup that we had found in Lai on our bike trip. The meal was wonderful! And then, Ansley, Maria, and I made cookies. Sarah and James let us use their oven, and so we made some interesting cookies... We didn't have butter, so we used peanut oil, and we only had a few small eggs, so the cookies ended up tasting like slightly crumbly peanut butter cookies. They also had craisins and pecans in them! They were really good.

So that was pretty much what we did for my birthday. Then, that night I had to work the night shift, and boy was that a memorable night. Ansley and Augustin 1 (there are 2 Augustin's here) had been working and were supposed to pass the patients off to me and Gilbert. Unfortunately, Gilbert was really late, and we weren't really sure if he was going to come. He did come eventually; he had just overslept.

During change of shift we had something happen with one of our pediatric patients that affected me a lot. I can't explain why it affected me so much, and it doesn't make much sense, but here's the story.

We had one 3 year old boy in the urgencie room with tetanus and some other problems (probably malaria). Tetanus causes your body to have muscle spasms, and it's very difficult for your muscles to relax. Not many of our patients with tetanus survive because there's not a whole lot that we can do for them. We give them some medicine called Diazepam to try to relax their muscles, and there's an anti-tetanus medicine but we don't have it here at our hospital. The muscle spasms make it very difficult to breathe since your breathing is controlled by the diaphragm, which is a muscle.

So this boy had really ragged breaths, and he was having almost constant muscle spasms, they just wouldn't let up. And while Ansley, Augustin 1 (one of the local nurses), and I were standing there, he stopped breathing. So Augustin started doing chest compressions. I had never seen this boy before, that night was the first time I had seen him. I don't know what it was, but I just felt overwhelmed. I started crying silently and praying. It didn't make any sense, but I just started praying hard, "God, not him. Don't let this baby die." I even asked God to let him live, as a birthday present for me, which in retrospect seems kind of a silly thing to ask God.

Finally, he started breathing again. And the muscle spasms returned. And as we left his bedside, I thanked God, but I began to think about that baby and how tired his little body was from fighting. I prayed again that God would let him live, but then I prayed that if that wasn't best, that God would do what He knew was best.

About 20 minutes later, Gilbert came to find me and told me that he had died. I was really upset, but in some ways, I was glad for him to have rest. But it still doesn't make any sense to me why I was affected so deeply by this boy that I had never laid eyes on before, and why I had this overwhelming sense of not wanting God to let him die. That was the beginning of a long, long night shift. Generally on the night shift, we are able to sleep in between doing our work. We make sure all the 9 pm meds are done, and then we can sleep until midnight, do the midnight meds and vital signs, and then sleep until 5 am meds and vital signs. This is if all goes well and there are no emergencies.

By the time we were finished with the boy with tetanus, it was already 11 pm, so there wasn't much time before midnight meds. I decided that I would organize the registers where we keep record of what patients we have, and then I started the midnight meds and vitals. As I was finishing with the last patient, a man came up to me and said, "My sister, there is a delivery" (he said it in French of course...). So I told him to wait a minute and I would be right there. But I remember thinking, I can't do anything about it anyway-- Hortence, the mid-wife, is the only one with a key to the delivery room.

As I came to the end of the hallway and was almost outside, I heard the very familiar sound of a woman in labor. Very shortly after that, I heard the sound of a baby crying, loud. I turned the corner outside on the sidewalk, and was slightly shocked by what I saw. There was a woman squatting on the ground next to the sidewalk, and her husband was crouched down next to her holding a very agitated newborn baby.

I ran fast to get Gilbert over in pediatrics, and when I told him what happened he started running back toward the woman and her family. I wondered what on earth we were going to do because all the clamps, scissors, and bulb suctions were locked in the maternity room. Luckily, Gilbert had gone over to Hortence's house when the man and his wife first came in, so he had just come back with the key.

I sat down on the sidewalk next to the man and his wife and tried frantically to get the man to let me cover the baby with something, but he was rattling off some agitated French that I couldn't understand. I kept trying to cover the baby because it was cold outside and newborns can't regulate their own temperature anyway. Finally, Gilbert found a clamp, clamped the cord, and then cut it, so I took the baby away from the father and started covering it up. We moved the woman and her baby into the delivery room, and I began to work on taking the baby's vital signs and measurements. At one point, I remember turning around to see how Gilbert was doing with the mother, and I was met by a shocking sight. There was Gilbert with half of his hand inside the woman, doing his own little curetage sans anesthesia and sans sterile technique. I asked him if the placenta was complete, and he showed me that it was, so I'm not 100% sure what he was trying to do.

Just as we finished up all the care for the newborn and the mother, Hortence walked in looking like she had just rolled out of bed. She was about to ask how dilated the mother was when she noticed the newborn baby all wrapped up on the bed. Here's the exchange that happened between us:

Hortence: She already delivered?
Kristin: Yep.
H: Who delivered the baby, you?
K: Nope.
H: Gilbert?
K: Nope. (I smiled)
H: Well then who?
K: The father.

At this point, Hortence gave me the most shocked expression I've seen on a Chadian's face yet. It was pretty funny. So I explained to her what had happened. We moved the mother out into the maternity beds, and then Hortence insisted that we clean the delivery room right then, just in case someone else came in that night. Chadians do not know how to clean very well. Their idea of cleaning is pouring bleach water on everything. So Hortence began flooding the room with buckets of water and handed me the little thing they use to scrape the water outside. This was counterproductive; as I was sort of sweeping the water out, she was pouring more water onto the maternity bed, which then flooded the floor that I had just cleared.

Being very tired, and not wishing to continue with the counter-productivity, I just stood there until she finished. At that point, she grabbed the scraper thing and started sweeping the water out herself, which was fine with me because at that point it was almost 2 am, and I was tired and my throat was getting more and more sore.

Luckily, there were no more emergencies and I was able to get about 3 hours of sleep that night. What a night, and what a birthday.