Yes, that’s right! By the end of last week we were 3 for 3! Normally, we would have an emergency case that would need to go the hausik or be flown out of the country maybe once a month, if that. This week we’ve had three! The first one I told you about in the last entry (“Out of the mouth of babes and sucklings hast thou ordained strength”). That was Tuesday morning.
Wednesday, was our second doctor’s first day back in the clinic after returning from furlough. Our other doctor was off for the day. We had two patients that day but nothing big. One of our long-time patients called saying that her husband was having pain in his legs, could we give him something stronger than ibuprofen. After talking to the doctor, we got some stronger medicine together and she came by to pick it up.
Then 3:30pm rolled around and a family arrived from town. Their 4 year old son had been having low abdominal pain since yesterday morning, vomiting every 3 hours (until mom gave a medication that stopped it at 1am that morning), didn’t want to eat, no bowel movement in two days, and had not urinated since yesterday morning. He was obviously dehydrated but what else was going on? We began examining him, running various tests, drawing blood for labs, and starting IV fluids. He was a very brave little boy, handling it all so well! While we ran the laboratory tests and gave him IV antibiotics, he relaxed on the bed with mum and watched “Bug’s Life”, and after a while fell asleep.
Meanwhile, dad and the doctor began making arrangements to get him to surgery. The best we could figure out was that he was a very sick little boy who had either had his appendix rupture or had a perforated bowel or something that was leaking irritating substances into the abdominal cavity. He would need further testing and surgery soon. However, it was already dark. Our airport has no lights on the runway so night flights are not an option. The earliest he could fly would be the next morning. Our clinic cannot do surgeries of this extent nor are we set up to monitor him throughout the night. We decided to transfer him to the hausik where they could monitor him and could do the surgery if it was needed but ideally he would fly out on a MedEvac flight the next morning for Australia.
The trip to town went smoothly and we were able to transfer his care to the hausik staff. Mum had family nearby who met us there. While waiting for the doctor, Lance, the physical therapist for our clinic, and I got to go down to the Pediatric ward and check on our little baby we’d brought in the day before. (See my previous blog entry.) And there he was! Smiling that big toothless grin, eyes sparkling, and then giggling and rolling playfully away! Made my night!!!
We got our other little boy transferred to the care of the doctor there and confirmed to mom and dad that we’d check up on them in the morning, praying all the while that God would send the right caregivers and provide everything needed to heal this boy.
The next morning, Thursday, we could not get through to their cell phone but figured that they were flying out then with their MedEvac company, as had been planned. We received a text later that day that read: “[The boy] and his mum were MedEvac-ed to Australia. He went into surgery right away for a ruptured appendix. Many thanks!” Yes! God’s healing hand again!
Thursday was busy but mostly routine. A nice breather after the last two days. Then Friday morning we received a call from one of our long-time patients that her husband was still having pain in his legs and in his back and was very sick. She was very anxious and very concerned about him. We told her to bring him in. When he arrived, his daughter asked if we had something to help get him inside as movement was painful for him. We started to get the wheelchair out but they said, “I don’t think we can get him into that. Do you have a stretcher?” That bumped a concerning case to emergent! This man normally walks into the clinic for his monthly medication infusion, talking, joking, carrying on with business over the phone while the medication infuses and labs are run; his wife normally sits in the waiting room playing Fruit Ninja and other games on her iPad or reading a magazine. Now he was lying on the mattress that his family had used to carry him out to the car. He was weak, ashen and in pain.
The men quickly got him transferred, mattress and all, onto the stretcher and back into the clinic. We started IV fluids, drew labs, did an ECG, and put him on full monitoring (vital signs and cardiac monitoring). Emergency equipment was gathered in case we needed to “code” him. End-of-life decisions for care were gently but thoroughly reviewed with his wife, all the while praying that we wouldn’t have to use them. Because of the pain, he had been unable to get out of bed for the last day or two and had had trouble urinating. He was also very dehydrated and showing signs of confusion. We placed a Foley catheter but he was still very dry. Plans were immediately started towards getting him MedEvac-ed to Australia for care. It was decided that the MedEvac plane would not be able to reach our airport until after dark, which, as I’ve explained before, isn’t equipped for night landings; however, we had enough daylight left for us to take off from here and fly him as far as Port Moresby, the capital, where runway lights allow night flights. The MedEvac company’s plane and medical team would meet us there and we would transfer the patient to them by for the remainder of his trip to Australia.
This decided, we loaded up three vehicles and headed for our New Tribes Mission’s Aviation hanger (one car to transport the patient, myself, and the doctor; the second to transport the other nurse and the rest of the equipment for our flight; and the third with the rest of his family). SIL ministries is always gracious in loaning us one of their bush missionaries, a pilot, who drove in from his location to fly our larger plane used whenever possible for MedEvacs. (Our pilot for this plane is currently on furlough.) When we arrived, they stood ready to help us get loaded up and on our way. Our equipment was quickly stowed where we would have access to it, and the patient was transferred, mattress and all, to the “sled” used with our Life Port system in the plane (providing easier loading of the patient, oxygen and suction ports, electrical outlets and poles to hold IVs and monitoring equipment).
After the patient was loaded, we assisted his wife up the very narrow isle to the co-pilot’s seat. She had just sat down when she suddenly spotted the large instrument panel in front of her and exclaimed emphatically, “Oooohh!!! I’ll just sit up here and not touch anything!” The pilot laughed and assured her that that was perfectly all right.
Before long, we were rolling down the runway and soon into the air. By this time, our patient was looking quite a bit better, more color in his face, and less confused, better output. We prayed for a safe and uneventful flight.
As we began to climb into the cloud layer above the valley, I watched wispy clouds racing past us and thought, “Man! We’re flying by those clouds!” Then laughed at myself as I remembered where I was and that this was quite literally true!
An hour and a half later, we landed in Port Morseby and sat waiting for the other plane to arrive. Our patient had a few minutes of irregular heart rhythm that had us double-checking what meds we had on hand but slowing the IV calmed his rhythm and the rest of the flight was uneventful. He was doing much better by the time we landed, though expressing many concerns about getting their medical visas correct. Between his wife and the doctor they were able to assure him that all of it was being taken care of appropriately. It was nice sitting still on the tarmac, out of the way, with the door open and cool breezes blowing in. Our patient was stable and now not as emergent and all we could do was wait. A local ambulance, a police car and an anesthesiologist soon met us. They were the MedEvac team hired to take our patient the rest of the way. We chatted with them for about an hour before the other plane arrived, then waited and watched for about another half hour as they loaded their gear and prepared to load the patient. The jet the MedEvac had sent was a beautiful one but very narrow with a very narrow door. They just about had to fold our patient in half to get him inside as he had to be held in a high sitting position and then turned in order to make the corner into the plane around the seats they hadn’t removed! However, he was finally settled, they had the paperwork cleared and medical visas in place, and we gratefully waved them off into the night, praying for a safe flight and for the caregivers on the flight and at the receiving hospital, for the patient and his wife as they continue through the process of testing and diagnosis.
“Three for three,” I thought. God has used us to save three lives this week! I feel like the prophet Ezekiel when he saw the glory of God—he fell on his face before God, too weak and humbled to stand. Yes, God used us but I don’t feel like celebrating my usefulness. In fact, there was very little I could do in any of these cases. But God…God did everything! And I am so humbled to have seen it! The glory of the Lord has been shown all around me this week and I can barely comprehend what I have seen!
“I will praise You, O Lord, with my whole heart; I will tell of all Your marvelous works. I will be glad and rejoice in You; I will sing praise to Your name, O Most High.” Ps. 9:1-2