Reflections in the Rain

Dearest friends,

As I write there is a deluge of water pouring onto my roof, threatening the spaces between windowpanes and drowning out the music playing through my laptop speakers. The lights in my room are spontaneously flashing bright, then dim and thunder is reverberating through the walls. Have I mentioned it’s rainy season in Zambia? And I love it. There have been very few occasions over years of mostly dribbling California winters that even began to prepare me for Zambian rainstorms. I recall perhaps one or two unique school days when the rain was so heavy that crowds of students and teachers alike cluttered in cautiously opened classroom doorways to stare at the weather. Here, however, the downpours seem too common to captivate an audience. Still I have slipped out the door to gaze from my porch from time to time. From the shelter of my own covered space it is so humbling to stop and to listen.  For me the rain induces spellbinding calm and cause for reflection, so I suppose it is serendipitous timing that a torrential soak has begun just as I have stopped to dwell on this past week’s stories.

Although I’ve spent countless hours learning about and investigating cases of obstetric hemorrhage over these past weeks, it was not until a few days ago that I actually witnessed profuse bleeding. Twice. The first occasion I entered a ward just as a woman was delivering her tenth child. She did an extraordinary job and her newborn burst into the world ruddy and screaming. We all three, the midwife, the mother and I, gave a smiling sigh. But in the space of a mere moment the beautiful birthing scene gave way to anxiety as the delivery of a less than healthy placenta was followed by gushing blood. Uterine massage brought forth only a new glove-full of expelled clots (more blood) and poor contraction. Consequently, the nurse tried one more massage and managed to slow the pouring loss, but oozing continued and we soon discerned an internal laceration. Throughout this time my hand was solicited and I moved to collect gauze, place clamps, take vital signs and ultimately help to hold open the writhing woman as she was sutured without pain medication. When the thread was tied and the poor mother’s legs collapsed together I finally convinced another midwife to empty a syringe of medication into the woman’s IV. At last the bleeding and pain subsided, and I went home. The following day, shortly after my arrival to the hospital, I witnessed a second case. This time I stepped onto the labour ward at Ndola Central to find a gaggle of midwives, student nurses, obstetricians and one anesthetist anxiously surrounding a severely hemorrhaging mother. I particularly noticed the anesthesiologist, poking away at an outstretched arm, which would occasionally spasm then relax. After at least six unsuccessful attempts I learned the patient’s veins had collapsed. Nonetheless, the scrub-clad physician needled on. He worked at her forearm as a team of nurses hoisted her legs into stirrups and another doctor sutured and clamped at the site of her recent delivery. The candy stripers huddled and dispersed in turns, murmuring over this mesmerizingly horrific sight. I did little more than observe this case and mostly stared at a drape of blood, which hung between this poor woman’s legs. I counted tick marks as I realized in dismay that at least 1 liter of that life-giving fluid had drained from her body. When my attention was at last drawn away, I still didn’t have an opportunity to see a resolution. So over two more days I followed up on this patient until eventually in her case summary I wrote, “Discharged home stable,” something I scroll at the end of nearly every data collection form. This time, though, was quite different. I had never written those words with such depth of understanding and true relief.

The other less significant, if yet traumatizing event of this week was the entrance of one extremely unwelcome rat into my bedroom. At an exceedingly inconvenient hour I nonetheless exited my room to inform the night guard, and refused to return until said rodent was removed. Alerting half the main house with my complaints, Hope and a few others stood at my side as we all watched the squirming shadows of two grown men in their quest to kill the little beast. 15 minutes later they proudly emerged, one pinching the tail of that very unlucky creature between his fingertips. My apologies to any offended animal rights activists who may be reading. If it’s any consolation, it seems all other like-minded cheese-lovers were deterred (and thus sparred) by their brother’s ill fate … To my own great appreciation!

And so are a few stories of this past week, with routine filling the gaps and, as always, a promise of the unexpected in each new day.

It is now with tremendous anticipation that I leave you with this exciting news. For next week’s blog Stig will be sitting beside me, perhaps even massaging my shoulders, as I write. That’s right folks, it’s a six day, seven hour countdown. Here is to great cause for hope and joy in each of your own lives.

With love,

Jess


PS My photos are not loading, so you can expect a few to come later this week.