Sunday, November 21, 2010

No-Man’s Land of grief

If each story of each woman that came through my door could be summed up in a tight little paragraph for all the world to read, would they read it? What if the story got complicated and long? What if it wasn’t as interesting as the last one? Would it then be less worthy of the telling?

This week three women came through my door. They had similar stories - all tragic. Some are more tragic than the next. But can heartbreak be measured? Can you qualify that one woman had reason to mourn more than the other, just because she might die?

The challenge I faced this week was how I was to cope with all the death, loss, grief and pain I saw. I kept trying to shut out the pain and sear my heart numb. And when I thought I had succeeded, God would slice it open again in a new area, and gently whisper, “Feel this pain, child. Let it break your heart. It breaks Mine.”

“If you deaden the pain or shut it out, you might survive a little while. But ultimately you will lose your tears, your compassion and start thinking this is normal. It is not.”

So as I write you these women’s stories... know that I only got a glimpse of their pain. I will show you that glimpse. Please don’t dismiss it. Let it break your heart and move you to prayer.

A silent grief ~
Alual has been coming to our clinic for months. She miscarried her last child to an unknown and untreated STD. So during this pregnancy we treated her with all that we could. But our strongest stuff wasn’t working. I don’t know if her husband was treated or not. But I do know she wasn’t sharing her bed with him anymore - now that she was with child.

I loved seeing her in my prenatal line. She was always so happy and round and red. (She wore the same dress each time - a red, cotton dress with white spots.) Her name actually means “red cow.”

Well, this week she came into the clinic complaining of lower abdominal pain but no contractions. So I sent her home to rest. She was only 6 months along, perhaps what she was feeling were the innocuous Braxton-Hicks contractions.

The next morning, however, she returned holding a cold but breathing little girl in her arms. I was horrified.

She had delivered at home unassisted several hours before. Her child was glacial but breathing strong. As a team, we worked hard to get her body temperature up (kangaroo care, hot-water bottles, heat lamp) and started an IV. She only weighed 750 grams. Her heart beat was so strong I could see it beneath her rib cage. Clack-CLACK. Clack-CLACK. There was just one problem. It kept beating slower and slower.

We resuscitated and monitored her for hours. She made some great improvements but we couldn’t keep her heart going. Eventually we explained to Alual that there was nothing left we could do. She asked to take her home to die.

I cried... but she didn’t. She calmly wrapped her baby in her arms and went home. She wasn’t bitter or angry. She was sad but this wasn’t the worst thing she’d lived through. She’d go on.

A raw hopeful grief~
The very next day, another of my regulars came in holding a child in her arms. She, too, delivered prematurely in the middle of the night. Her little boy weighed only 1600g and was estimated to be about 32 weeks gestation. He was alive but fighting to remain so. His lungs lacked the surfactant it needed to fully expand and when we listened closely it sounded like a door slamming shut each time. Gasp-KLUNK. Gasp. KLUNK. But he was a fighter.

We started an IV and talked to the family about getting him to Wau. Perhaps they could do what we couldn’t. I didn’t have much hope but... they were willing to try. And I was not going to steal their hope. It was early enough in the day for them to get a bus to Wau and they hurried off, IV still running.

But this mom, she was young. This was her first child. And as she prepared to go to Wau, she wept uncontrollably. The reality of her child’s fate sinking in, must have finally touched her heart. I wanted to weep but I couldn’t. I didn’t want to feel her pain. It was too fresh. Too raw.

A grief unspoken~
And again, the following day another woman came in. Except this time her baby was already dead and she was not far behind. She was carried in by her family. The smell alone screamed of infection and death.

I came late on the scene but I was told she had a retained placenta that was offensive and possibly gangrenous. Margaret got it out but she kept ‘bleeding’ a thin, white, foul liquid from her uterus.

Her family explained that she had delivered a full-term, macerated baby earlier that day. It was black and decomposing which explained the smell and her condition. She claimed that it had only been one day that she hadn’t felt the baby moving but I doubt it. A baby takes weeks to decompose like that.

In addition to the severe uterine infection and continuous flow of fluid, she had a ragged 4th degree vaginal tear. But it had been too many hours since the birth to suture and heck... what do I know about suturing a 4th degree tear?! I don’t. My heart dropped when I saw the size of it.

Fortunately, she didn’t have a fistula (that I could find) and was stable. We treated her with several antibiotics and kept her over night. The following morning, her family was able to gather the money needed and took her to Wau. Or at least... I hope they did.

She, too, was young. She, too, delivered her first child. But she had no tears to shed. She had to stay alive to cry. Perhaps, she’ll live. Perhaps, not. I pray she does and is able to one day mourn her loss.

So there you have it -- a glimpse at my week.

For those of you who tend to worry, let me reassure you. I am not carrying these women’s burdens. I am sharing their pain with you. I weep for them and pray you will too.

Pray for me. Pray that I would learn to live in this no-man’s land -- that place between the joys of birth and the anguish of death.  Pray that despite the sadness and overwhelming pain I see here, I would not be a casualty of this war but instead victorious... and able to lead others into new life.