dawn: adventures of a journeywoman

I have officially begun work at Kijabe Hospital as part of the team caring for the patients on the women's ward, alongside a visiting physician and a Kenyan clinical officer (similar role as a physician assistant in the U.S.) I have my own room in a duplex with a fluctuating number of other single women from all over the world who have come to volunteer. I have many luxuries including a very hot shower (very neccessary in this 50 degree climate), a stash of diet coke that I bought in Nairobi, and electricity that works more than 90% of the time (although it went out about 3 times in the middle of a procedure using ultrasound last week, causing the team to have to repeatedly start over).
As I have been contemplating my experiences so far in Kenya, the word that keeps repeating itself in my mind over and over is overwhelmed. My thesaurus is trying to help me find other words to express this emotion: to overpower, overcome, engulf, devastate, beat (down), and crush. So much of my first few days at Kijabe Hospital I have felt overpowered by the awareness of my insufficiencies. And they are many.
I do not understand enough Swahili to grasp the symptoms my patients are describing. (I must humbly and constantly ask the nurses and nursing students for help with translation). I finally looked up nini today, which I had thought meant “you” as this word was often directed toward me. Sadly, I realized that it means “what?”; quite fitting as even my American accent limits full understanding even when both parties are fluent in English.

I don’t know enough about how the hospital works here: where to go, whom to talk to, which tests and medicines are too expensive, and even what the lab values mean. The units are quite different even for simple values I know in the U.S. such as blood glucose (I have to multiply by 18 to convert to mg/dL). The acronyms are strange to me (An RTA refers to a road traffic accident instead of the what I use to in the US, MVA=motor vehicle accident).

I constantly recognize that my medical knowledge and skills are also insufficient. I was called in the middle of the night to evaluate a young child who appeared to be in distress in the middle of a blood transfusion. Was she reacting to the transfusion (which can be fatal, but she desperately needed) or was it the three other serious illnesses that were causing this? I decided to wake a physician to ask for help after temporarily halting the transfusion in hopes that this was the safest measure. I could tell at least 25 similar stories and I’m sure by the time I leave I will have hundreds more to tell where I am lost by my limited expertise.

The amount of suffering engulfs me several times a day. Far from a romantic notion of saving lives, I see so many lives that are cut short before my eyes. I declared my first patient dead two nights ago. The nurse called and explained, “Dawn, we have a patient here with decubitus ulcers and he’s passed. We need you to examine him.” My first thought was, “what did he pass out of his ulcers?” I started imagining all sorts of fluids until she explained, “Daktari, he has no pulse.” I dutifully reported to the patient’s bedside and started to look for indications of life. My medical school gave me several lessons on examining live patients, but never dead ones. So I got out my stethoscope and went through the ritual of listening for a heartbeat, breathsounds, examining his eyes, and feeling for a pulse on the young man. I tried to finish my exam without reflecting on the chasm between life and death that separated the two of us. In the last few days, this chasm has appeared smaller.

Much of the time I have felt overwhelmed, it is because I am not living up to my own expectations of what I feel my abilities should be. My inadequacies are discouraging and make me wonder if my presence is helpful at all. Yet, God cut through to me this week through his word through the psalmist. “I look up to the mountains-does my help come from there? My help comes from the LORD, who made heaven and earth!” Psalm 121:1-2 I was struck today how Paul writes to the people of Corinth about carrying around Christ’s death. “Through suffering, our bodies continue to share in the death of Jesus so that the life of Jesus may also be seen in our bodies.”

What does it mean to carry and share in death? As I read the word, “death”, I am assaulted by the smells of death stuck in my memory. And I also carry that stench of imperfection, of not caring enough, not knowing enough, not trying to understand enough. I now have an increased awareness of how much I fall short. And this is what led the One I love to die. I have tried to cover up this ugly smell of reality with the cheap perfumes of puffed-up knowledge, confident appearances, and false competence. But this cannot hide the truth that my humanness stinks and isn’t enough to save lives or souls. I am in desperate need of lifting my eyes up to the LORD, who is my help. His truth washes away the ugly odor of my weakness and replaces it with His strength, His life. “So now I am glad to boast about my weaknesses, so that the power of Christ can work through me.” 2 Corinthians 12:9b. My prayer this week is to see evidences of God's work in this place. May that be answered in whatever place this finds you, as well.

Grace and Peace,
Dawn ;)