She was admitted to bed 6 on a busy Thursday. At the end of my shift I looked over her admission paperwork and nearly crumbled to the floor after reading her story. Her young mama was carrying the weight of the world on her shoulders: a new baby with severe deformities, a fiancé who left shortly after she was born, and absolutely no way to support herself. One day it all became too much for her - she slipped pesticides into her baby's bottle and then proceeded to swallow some herself. Sadly, she never woke up, but that strong baby girl did. Though neurologically impaired, the little girl survived. As I looked up at her now 8-year old fuzzy-headed-dimple-cheeked-toothless-grinned self I couldn't help but think, "Oh, who wouldn't want you, sweet girl?" My heart broke for her and for her mama, for the brutality of this broken world that led her to such a drastic decision.
He was admitted to bed 13 just a few days ago. Our last orthopedic surgery for the field service, in fact. He is all smiles, full of joy and giggles and questions about his "new legs." He likes to color and play with swords and learn English words. Just a few months ago this sweet child was homeless, begging and scrounging through dumpsters to survive. At 6-years old he was abandoned by his family, presumably due to the severity of his bowed legs. A kind-hearted local shop owner found him digging in her trash late one night and decided to take him in, raise him as her own.
She is right next to him in bed 12. At 11 years of age she doesn't look a day over 6. She has a horrible genetic disease called
Osteogenesis Imperfecta, which has left her entire skeletal system brittle and incredibly fragile. A simple fall as a toddler left her legs buckled and malaligned. Over the past two years teachers have refused to let her come to school. She's become too great a burden, they claim. This disease has not only wreaked havoc on her physically, but has now left her isolated from her classmates and any hope of an education.
Each and every one of our orthopedic patients come with stories of being outcast because of their knock-knees, windswept legs, club feet, or bowed legs. In their short lives they have become all-too familiar with the pain of being ostracized because of their stark physical differences. The burden of their disease often threatens to crush all hopes for a brighter future.
{Oh, this world has been hard on these bones}
He came to the ship severely malnourished, pot-belly and all. His bones cut like butter, said the ortho surgeon. Now, I may not be an expert on bones, but I do know they should be stronger than butter. His 3 days of bed rest came and went - it was time to get up and moving! With heavy casts on both legs that came to the top of his thighs, he just stood there behind his miniature walker with a deer-in-the-headlights stare and white-knuckled grip that screamed,
"Are you people out of your ever-loving minds? I can't walk!" The physical therapist and I got on either side of him, moved the walker one-pace forward, then picked up his heavy little legs one at a time. Crocodile tears rolled. He was sobbing as we made him walk a few steps down the corridor and back.
She had her first
external pin site care scheduled for our shift. As soon as we started the procedure, it was immediately apparent something was wrong. Concerned for potential infection, I paged the surgeon and we both agreed it was time to pull the pin. For those of you that aren't in the medical field, this involves removing a long metal surgical rod out of the bone. This responsibility fell on me as I was the charge nurse that evening. I did my best to explain everything to this teenage patient and her father, then we made our way down the hall to the treatment room. By the time we got there, her whole body was shaking. I stopped and asked, "Hey... what's going on?" She took some time to calm down and quietly squeaked, "I'm just so afraid." So we stopped. The sterile gloves came off, the procedure was put on hold and we just prayed right then and there. I asked God to give her courage and calm her heart. And He did, right there in front of my eyes. Her breathing slowed. Her shaking limbs stilled and her eyes closed.
He was sitting in the sand when I arrived at the outpatient center. A group of us came for a visit with a few activities to fill the afternoon. About halfway through our craft I looked down, saw him pick up a handful of sand, take a bite and then pour the rest down his cast. He looked up and gave me a muddy smile and I thought to myself, "Let it go, Jarah. Just let it go." The reality of kids in casts in a third world country is exactly what you'd expect it to be.
He was ready for surgery: chlorohexidine scrub done, premedications given, consent signed, NPO since midnight, checklist complete. Through it all he was calm as could be. The OR nurse came to pick him up and take him for surgery when the reality of the situation hit. You could see it in his face. He clung to my neck completely freaked out, crying inconsolably. I did my best to talk about how awesome his new legs were going to be, how he was going to be able to run and jump and play. Of course he knew all of that, but in the moment all he could see was his fear. It made me think about how often we grapple with this question: what if the pain of healing is worse than the pain of the status quo? How often do we resist change because we're worried it might hurt?
She was a pistol from day 1. I came in for a night shift and heard all about her spitting red liquid Tylenol in the face of one of my coworkers. As I sheepishly approached her bedside with the midnight dose, I was prepared to bust out every pediatric nursing trick in the book. Much to my surprise, she woke without a peep and took the syringe out of my hand without a fight. I thought she was going to take the medicine by herself (you know, like a "big girl"), when she suddenly threw the syringe across the pitch-black room. She certainly let me know who was in charge.
{Oh, this love has been hard on my bones}
He was wheeled off to surgery early one morning in a heap of tears. Sometimes, even after every positive coping strategy has been implemented, the kids are just plain scared. And who can blame them? Though it's quite normal for us as nurses, these kids have never been inside the walls of a ship or a hospital. And they certainly haven't been carried away from their parents by tall
vazahas (white people). After he was out of earshot, I saw his sweet mama drop to her knees. Not having any other way to comfort or advocate for her son, she did all she knew to do: pray. And pray she did for 2 full hours. What a beautiful picture of a mother's love.
10:00am & 4:30pm are ward exercise times. It's important to keep the kids moving... Leg lifts. Shoulder raises. Torso twists. Toe wiggling races. The kids pretty much hate it, so we do everything possible to make it fun. Don't ask me how this happened, but the theme song for ward exercises has become none other but the Macarena. It has turned into such a fun daily routine, the patients and their parents (and, ahem, their nurses) get super into it! A-ward is so full of laughter and life during these silly little exercise sessions. It's become one of the best parts of my day.
He says the kids are healing at a miraculous pace here in Madagascar and our orthopedic surgeon isn't one to exaggerate. The 3-week post-op xrays for our patients have revealed rapid bone growth and ossification. This is not only the work of skilled human hands, my friends, but of a good and mighty God.
The kids returned back to the ward after some fresh air on Deck 7. This time outside usually riles the patients up and this day was no exception. They came back full of energy! One of my fellow A-ward nurses found these long, crazy green balloons, so we decided to blow one up for each patient. Before long a massive sword fight broke out and everyone was in on the battle! We all played so hard and just had good pure FUN! Sometimes it's the silly things like balloon fights that make all the difference. Joy spilled over that afternoon and it was absolutely incredible.
The United States Ambassador visited the ship today. In preparation for his visit to A-ward, the kiddos practiced Silent Night in Malagasy so they could perform it for him. They announced that the guest of honor was coming soon, but when the doors opened, in walked our first ortho patient, sweet Patricia, cast free and walking on
straight legs! The entire unit stood to their feet and started clapping and cheering for her. The village gathered together, as they often do, in support of one of their own. It was a huge encouragement to the patients in the thick of their recovery to see a walking example of what's to come in their own lives. It was as if God was saying,
"I know you're all excited about this ambassador, but this is my guest of honor today and this story of redemption in her life is worth celebrating!" The Ambassador showed up a few minutes later and, in true A-ward fashion, the patients ditched the Silent Night plan in favor of a live performance of the Macarena. I think it goes without saying that it was a total hit.
{Oh, this God has been life to these bones}
“I have heard it said that for hope to be credible in the future, it must be tangible in the present. The healing that our patients experience today can become the seeds of hope for a better future for themselves, their families and their communities.” - Dr. Gary Parker
