ali's african adventures

Remember Abraham? My love from screening? In case you don't feel like poking around in the back pages of this blog, he was the three-year old who stole my heart back in February when we had our big screening day at the stadium. He came in this past week and had surgery on Thursday. For such a small boy, he had some major work done. His entire left hand, twisted into a ball by scars, was released and patched using skin from his thigh. His eyelid was reconstructed. The corners of his lips were widened. But when I went to see him after his operation, he wasn't crying. He wasn't fighting. He was just lying in his bed, curled up next to his mama, mute. And that's not normal for a three-year old. For the next couple days, I went to see him often and always got the same report. He's so good! He doesn't cry at all. Being a pediatric nurse, I was concerned. It's not right for such a small boy to be so quiet after having so much done.

But maybe that was just it. Maybe too much has been done. Maybe too much has happened to him in his short life. Maybe he's got nothing left. After all, falling into the fire as a baby and knowing nothing from life but pain and scars and surgeries isn't something that's calculated to make you into a social butterfly. I chalked it up to fear, but was still pretty worried about him.

I was working in A Ward this morning, a jumble of plastics and orthopedics patients. We had eight beds along one side empty, so we got to host church. On the floor in the middle of the room we spread out a blanket and piled on the B Ward kids. There are five or six of them, little dynamos of perpetual motion, unphased by huge bandages covering skin grafts and scar releases. I parked myself on the corner of the blanket and was pleasantly surprised when Abraham's mother dropped him off next to me. People kept on packing in until it was standing room only in the hallway. As the ward filled up, Abraham's uncovered eye rolled wildly around. He started looking more and more frightened, so I made my move. I gathered him onto my lap, his stiff little body unyielding against my arms. We sat that way for most of the singing time, until we started with a slow song about the great things God has done. I was sitting there, worshipping God, when I felt a weight in one of my hands. Abraham had taken his bandaged little fingers and rested them calmly in my own outstretched palm. And it wasn't long until I felt a small hand grab onto my other fingers. I looked down and there was Abraham, looking up at me, holding on for dear life. About thirty seconds later, my leg went completely numb, but I wouldn't have moved for anything. As the service went on, he relaxed until he was folded into me, his back matching the curve of my arm, fingers still wrapped around mine. Silent.

Not so the other kiddos. As Drew preached, they got more and more antsy, but I had come prepared. Out of my pocket came the finger puppets. Little sea creatures and jungle animals, you can get a pack of ten for a couple bucks at Ikea. To these kids, they're gold. Abraham got a monkey, and held up the finger on his unbandaged hand for me to help him out. The other kids amused themselves passing around my stethoscope, checking shark's heartbeat and octopus' breath sounds. (The physiology of that still escapes me.) They needed a good bit of silencing, since there's probably nothing more exciting than an elephant battling it out with a shark over stomping grounds on a big red blanket. Abraham, at first completely detached, slowly started turning towards the other kids until he was draped on his stomach over my leg, monkey inching hopefully towards seahorse. I looked away, trying to focus on the message, when I heard the kids start up again with the animal noises. I bent my head to quiet them, when I realized there was no way I could. It was Abraham, scooting his puppet along after shark, making squeaky little monkey noises.

Church was sweet today.

After church was pretty sweet too. The nurse I was working with hadn't been feeling well since we started our shift, so we sent her home at lunchtime. (Home being up a flight of stairs and slightly to the right.) This left me in charge of all eight patients and two new admissions on A Ward. Normally this would have been impossible, but God was on my side. (By my side, actually, to quote one of my favourite Liberian songs.) Everyone was stable. No one was having pain. I got to sit and talk to my patients and show them pictures of my family. When asked if I had children, I mentioned my glaring lack of a husband. To which my patient (lovingly referred to as the Reverend since he actually is one of the pastors at President Sirleaf's church) replied I will pray for you to get a husband. I will pray a strong prayer. (Apparently not just any old prayer will do. I need the heavy-duty ones.) He should be Liberian. So I can come to the wedding. And eat cake. It's amazingly simple when it's laid out like that. Liberian men should be lining up at my door any minute now.

In the middle of all this, I heard a knock at the door. I opened it to be greeted with the toothy grins of my B Ward boys. They hurled balloons in my startled face, jumping up and down, shouting Balloon party! Balloon party! over and over and over again. Things quickly devolved into a game of hallway soccer, kids dwarfed by a big, yellow physio ball, and soon enough I had the blanket spread out on the floor again and my friends were building a city with the help of one of my new admissions.



Any other time in my life, I would have told you that having ten patients plus four or five extra high-energy kiddos under my care would have been beyond me. But some days, God just gives extra grace. Today was one of those days. I wouldn't have traded it for the world.

Alfred and I had a good talk last night. I won't go into details (he deserves some modicum of privacy at least, poor boy), but suffice it to say that he now realizes that friend love is okay, but man-woman love is not. He's sad that he's been pouring water on a turtle's back all this time (wasting his words), but we just hung out for an hour or so, and the friendship seems to be intact.

No other patient stories for you right now. It's night, and for the first time in my career here as an I-can-take-care-of-more-than-two-kids-at-a-time kind of nurse, all of my ten are asleep. (Not before my two little boys grabbed their mothers' cell phones and held them to their ears, pretending they could get any kind of reception locked in the steel hull of a rail ferry, and hollered back and forth to each other for about fifteen minutes Hey! My man! My man! How are you, my man?)

I was talking to my mum on the phone in the middle of the night a couple days ago. It's one of the perks of working on the ward as opposed to in the ICU; the pace really does slow down enough overnight to allow for things like long-overdue calls home. I was talking to her about this blog at one point, and realized how cathartic writing it is for me. I mean, like I told her, I've always loved to write. I just haven't always had much to write about. Here, I have the opposite problem. My days are often packed so full that I'm picking and choosing, selecting just one story out of a hundred that I could share. I feel like I'm selling myself short sometimes. Like I'm going to come back here someday and wonder if really only one thing happened every few days. Wanting myself to revisit this place and fill in the details, all the boring and mundane, just so I won't forget a single moment of this.

Things like sneaking upstairs in the middle of a night shift to eat chocolate fondue and say goodbye to new friends who are leaving far too soon for my liking. Having one of the ward disciplers pray for me before my shift and quote to me the same verse my parents claimed for me when I was born. Dancing to Bob Marley covers at a rooftop bar and catching a taxi home just in time for curfew. Endless games of Man From Mars and Red Rover with the kids on the dock. Sitting long at meals as people come and go from my table. Waking up on the beach to see the waves hurling themselves against black rocks, white foam sillhouetted in reverse against a thunderous sky. Working night shift and tucking the kids into bed with kisses and hugs and then watching movies and having baked potato parties with my fellow nurse / partner in crime. The sheer joy of opening packages from home and finding the Sunday comics tucked inside. Screwing up my courage to open my eyes under the water at the beach and finding myself surrounded by every shade of turquoise. Late-night talks sitting in the hallway of the hospital and thinking what a sweet deal it would all be, if only I were getting paid. Ceilidh dancing on the dock and nursing the resulting blisters from weeks afterwards. Waking up every morning and realizing all over again that I really am in Liberia. These are a few of my favourite things.

Poll Of The Day: What do I do about this? (And I quote, letter for letter)

Hi Bady.

It me, this time to say
I am in love. but are
have a problme with your
this is about the weekend You
made on the beach, you do not
tell me that you was going for
a weekend I ask this
questinon because I am
Real in love with You, I
miss you for the two that
I not see you I was longly
on one was by side.
Baby Girl I am going crazy
You look lik a sun
That shink on the moon
I need your ans went get
this note.

to Anut Ail Walk

From Alfred.Mather.Scinetist.Renner

translation (as near as I can figure):

Hi Baby

It's me, this time to say I am in love. But I have a problem with you. This is about the weekend when you were at the beach. You didn't tell me that you were going for a weekend, and I ask this because I am really in love with you. I missed you for the two days that I didn't see you. I was lonely; no one was by my side.

Baby Girl, I am going crazy. You look like a sun that shines on the moon. I need your answer when you get this note.

To Aunt Ali Wilks

From Alfred Matthew Scientist Renner

So. Yeah. He slipped me that this morning, and I'm not sure what to write back. But I have until 9:30 tonight to figure something out.

Because baby, I'm shining like the sun.

Robertsport Take Two played out this past weekend. This time we went with the youth from the ship here, about eight altogether. We went in Mercy Ships cars and oh, what a difference a Land Rover makes. It would appear that the Pakistani UN (remember the helpful, brave and brisk men who rescued us from the ditch last time?) has been hard at work, and the dirt road had been graded. Smooth sailing all the way along, and we arrived to the beach just around lunchtime. The day was spent in sweet relaxation. We made peanut butter sandwiches and set up tents and threw a frisbee around. We hiked down the beach to get pummeled by the bigger waves. We floated in the calmer waters and ate a dinner of chicken and rice. We sat around the campfire and talked and told riddles and took polls and just did nothing. It was wonderful.

Wonderful lasted until about midnight. That's when Phil showed up from The Camp Down The Beach. A few friends had taken a taxi out from the ship and were staying about half an hour away in a secluded corner. And Liz was sick and stuck on a deserted stretch of beach with three boys who had no idea what to do with a barfing girl.

There wasn't much question of what needed to be done. I grabbed my backpack and some meds from Red's stash and headed off up the beach. (Side note: there may be nothing better than walking on the beach at night under the light of a moon so full that flashlights are absolutely unnecessary.) When I got there, she was in the middle of her latest round of sickness. Now, something you may not know is that Liz is probably the coolest girl around these parts. She won't mind me sharing this, I'm sure, but I think it was when I was standing there holding the toilet paper for her, toothbrush tucked hopefully into my back pocket, that I realized we were possibly sisters. It's nice to have family out here in Liberia, even if she is leaving in a couple weeks. And it's hilarious when your friend/sister looks up at you after she finishes being sick and gets out some of the only words she'll manage all night. At least the view is amazing.

When morning finally came, we packed up camp after enduring a torrential rainstorm with five people and their bags crammed into a two-man tent. Liz got piggy-backed up the beach to the main camp, and we followed slowly behind. Arriving back, we were met with the news that one Land Rover had already departed, carrying two more sickies who had been stricken in the night. Liz took my seat in the car, and I had the privilege of riding back in a taxi with the boys. There's nothing like being in a Liberian taxi for long periods of time. Bags of fish provided the olfactory basis for the journey, which was punctuated by stops to pick up and drop off passengers and loads of fruits and vegetables. At one point, we had the driver, two people and a baby in front, the four of us in the back, one more passenger perched atop the fish in the trunk, and the final guy sitting sidesaddle on top of the car, holding tight to the basket of mangoes. (There is no such thing as travelling light in Libera.)

We made it back to the ship in one piece. I'm coming to realize that this is the most I can really ask from a trip to Robertsport.

Sometimes, words just don't cut it. Case in point: Catherine. We've been getting to know each other over the last week or so, and there is no way in God's green earth that we speak the same language. Just now, I can't remember which tribal language she speaks with her mother, but when she needs something, I'll hear it flowing between them like water.

Things aren't quite as smooth when she wakes up in the middle of the night. Something I should probably explain is the sleeping arrangements for the mothers of our tiny patients. If the baby is small enough, mama snuggles up in bed, usually with an arm thrown casually across her little one, seatbelting him in place through the night. When a kid is bigger, we put a mattress underneath the bed, and mama squeezes herself under there, sleeping with not enough room to turn over. (I shudder to think what American parents would think if we tried this one on them...) It's no wonder that they're sometimes loathe to stir from their little caves in the middle of the night; it's no small chore to get tucked in there properly.

For the first few nights after the surgery to release her club foot, Catherine would wake up several times each night. I would hear the most heartbreaking cry coming from her bed, and would run to her side to find huge tears rolling down her cheeks as she grabbed at her cast. For those first few nights, I assumed she was in pain and medicated her appropriately. (Good PICU nurse that I am, I've never been stingy with my pain meds.) Somewhere around night three, her mama got tired of hauling herself out from under the bed each time Catherine woke up, so I was dealing with a frightened-to-death eight-year old who didn't speak my language. And I had no idea how to calm her down while the pain medicines took their soporific effects.

So I did something that probably wouldn't fly in hospitals back home, but what seemed perfectly natural at the moment here. I sat Catherine up and climbed into bed behind her. I gathered her tiny body close to my chest and rocked and sang and soothed. And she fell asleep. The next night, I tried it before giving her the medications, and it wasn't long until she was passed out cold in my arms and I was completely in love.

Today, I finally got to hang out with her during the day. Turns out, she's much more fun when she's awake and not scared to death of the dark. Once my patients had been sorted out and the fire alarm had been deemed a technical malfunction, (but good job everyone running around like crazy preparing to evacuate the hospital, thank-you-very-much!) Catherine and I had some snuggle time. She crutched over to me on the smallest crutches you can imagine, swinging her hot pink cast like an old pro, and hopped onto my lap. We amused each other for a good twenty minutes. We made animal noises back and forth. We made faces. I said things in American English, and she parroted them back to me, dissolving into shrieks of laughter after proclaiming such gems as What's up, dog? and Hi there. I'm Catherine.

Man, this job is fun. And man, does Meg Petock take a mean photo. These are hers.

There's a funny thing about forgiveness. It's sweeter in the middle of the night when swallowed along with a chicken foot and some fufu. How do I know this? Alfred and I had our first fight. Actaully, to clarify, it wasn't so much a fight as it was a massive misunderstanding, compounded by the fact that Alfred has been lied to and abandoned by pretty much every adult in his life.

It started last night when I told him we would take a walk in the halls together after I took care of some work. After getting sidetracked a few times, I checked back to find him fast asleep. I didn't wake him up for our nocturnal wanderings, since the boy is a night owl and needs all the sleep he can get.

When the day shift came on in the morning, I went to say goodbye to him. He refused to come out from under his blanket. I went to bed, perplexed, and stopped down on the ward again after lunch, expecting to find my happy, laughing friend. Instead, we sat next to each other for over an hour as I vainly tried to figure out what was wrong. Another visit after dinner was no more successful. I was able to get him to agree to a late-night fufu session, so I headed back down to A Ward around 11:00.

I sat next to him for a long time, trying to get him to talk to me, but was met first with the stony stare of a hurt boy and then with the impenatrable wall of a sheet pulled over a face. Finally he uncovered long enough to tell me to wash my hands.

When I got back to his bedside, he had the fufu ready to go. Out of the soup pot stuck a large chicken foot, and I knew what I had to do. I grabbed it. If I eat this whole chicken foot, can we be friends again? He agreed to a one-night truce, which was all I needed. I ate the whole thing and sucked the bone clean.

We talked for a long time then. We talked about hurt. We talked about being angry. We talked about telling the truth and about telling lies. We talked about the fact that grownups can make mistakes and they need to say they're sorry when they do. We talked about forgiveness, and we talked about God's son.

Somewhere in the midst of it all, Alfred remembered that he's going back to the OR for another procedure tomorrow. For a moment, he forgot that he was angry with me. Forgot that he thought I had abandoned him in the night. You can pray for me? You can pray a strong prayer? I put my hand on his leg and just started to cry. He's just a little boy. Wise beyond his years, to be sure, and more headstrong than I have ever been, but still just a boy. A boy whose mother left when he was two years old. A boy whose father disappeared yesterday and has yet to answer his phone. And he was scared and hurt. And he couldn't figure out why one more adult in his life would tell him something that wasn't true.

So I prayed for him. I prayed that the God of Love, who I'm getting to know a little better each time I'm blindsided by something like this, would cover his small body with grace. When I was finished, I told him I would come back tomorrow after his operation.

Why you coming back? You want to be my friend?
Of course I want to be your friend. Even when I can be hurt, I can still love you.
Why you come tonight?
Because I wanted to see you. That's what friends do.
You not here. Your body here. Your heart not here.
Alfred, my heart is right here on the bed next to you.
Oh.

I got up to leave. Halfway to the door, I heard a small voice. Come here. I debated with myself. Maybe he just had something else mean to say. Maybe he just wanted to scold me more for my offenses, real or presumed. Maybe God had been speaking to him after all.


I went and sat next to him on his bed. From under the sheet, barely audible, but shot through with a smile came his words.

I forgive you.

I guess the chicken foot was worth it after all.

I realized something just now.

I was sitting on an empty bed in the corner of the ward. The flashlight swinging from the IV hook above me illuminated the purple and pink plastic bowls sitting on the chair between Alfred and me. Heads bent close, voices hushed to a whisper and hands carefully washed, I was swallowing fufu with my friend. It's become something of a nightly ritual for the two of us; once everyone is in bed and meds have been given, he treats me to his aunt's most recent creation. This evening, it was simple fish and chicken foot, with enough fufu for both of us to eat our fill. Alfred decided early on in tonight's game that twenty four years are long enough to go without eating chicken foot. I protested weakly, but my excuses couldn't hold up to his pleadings.

It was when the pale, rubbery foot was halfway to my mouth, while I was steeling myself to crunch off a few toes (bones, nails and all) that it somehow came to me: God has actually given me my heart's desire. I am here doing exactly what He created me to do, and, for once in my life, I'm living firmly embedded in the center of His will.

How many people can say that? How often do we get to look at our lives and think, Wow. This is right. I've got the package deal and there's nothing I'd rather be doing. Granted, as I crunched the unfortunate bird's foot between my admittedly unwilling teeth, I wasn't feeling terribly fulfilled. But once the pieces had slid their way down to settle like a rock with the rest of my late-night meal, I looked up at my little friend and caught his eye. He grinned at me.

You're almost African. Next time don't make a face.

I'll keep trying. For as long as it takes.

Can you handle just one more story about Alfred?

Today when I came on, I was chatting with him and the orthopedic surgeon, who informed Alfred that he would soon be going home to Texas. When Alfred asked why, Dr. James told him it was because he missed his wife. Alfred rolled his eyes. You a big man, Doctor James. Big men don't miss anybody.

I told Alfred that I was a big girl, but that I missed my family. Aunty Diana, Uncle Matthew, Uncle Peter, Mama Fi and Papa Allan. All of them. He didn't believe me. He couldn't see me missing them. In my heart, I told him. I'm missing them in my heart.

He quietly unwound the stethescope from around my neck and put the earpieces into his ears. He placed the bell somewhere close to my spleen, listening intently.

It's true. You missing them in your heart.

He's a wise boy for all his fourteen years.



By now, I think everyone knows about Alfred and me. Most nurses I see in the dining room these days roll their eyes and inform me that he's been asking about me. Wondering if I'll be his nurse. Counting down the minutes until my shift starts. I'm not ashamed to say that I reciprocate his affection whole-heartedly. I send messages with on-shift nurses that I'd like to be stationed in A Ward. I visit him when he's out on deck 7 in the afternoons. And I definitely tuck him into bed whenever I get the chance.

In the States, all this love would be frowned upon. Boundaries, they say. You have to set boundaries, and you have to keep within them. You're getting too involved. For precisely this reason, I may never be a nurse in the States again. Because the more I read about God's son, the more I realize that what I've been shown is boundary-breaking, heart-shaking love. And the more I see that, the more I realize that it is exactly what I want in my life.

I want to love everyone who crosses my path, no matter how lovely or difficult, sweet or flat-out nasty they might be. I want to love in the secure knowledge that I'm following the best example, walking the truest path, sharing the highest call. I want to love so purely that they can look at me and see my Saviour.

I want to love so hard that there's nothing left for myself.

Today was one of those shifts where everything is funny.

It started out with all my new admissions coming early. They usually show up around supper time, but by 3:00 I had five full beds; little kids with twisted feet and stuck-together fingers. And they were all just looking at me, waiting for me to entertain them.

So we improvised. Before long, Becky (another former-PICU friend) and I had four of them lined up in a row in little chairs facing the linen cart, where a paper bag was hung up with IV tape. Another, smaller basket hung next to it. My kiddos took turns chucking rolled up patient gowns (and a small, purple stuffed elephant) into the hoops. Uproarious cheering erupted from all corners of the ward when the smallest patient, a little girl named Cathryn, was the first to sink her elephant into the ten-point basket. Alfred kept score for us all, faking tears of despair when he missed that same ten-pointer several times in a row.

Later on, we had another quiet moment. I was sitting at the desk, about to check my e-mail, when Alfred called from his bed. Auntie Ali. Auntie Ali! Let me check your blood. I think you got malaria. Without warning, this turned into a full-on show. I swooned onto an empty bed, faking heart palpitations and malarial chills. Alfred grabbed his crutches and hobbled over to my bed, where he patted my face, took my temperature (with a thermometer he pulled out of my pocket) and checked my pulse, telling me to breathe deep. Things continued on in this vein for a while.

Alfred (shouting over his shoulder): Nurse! Get my things!
Dominique (handing him the supplies to draw blood, minus the needle): Here you go, Alfred.
Alfred: Call me 'Doctor Alfred.'
Dominique: Sorry. Doctor Alfred.
Alfred (laughing hysterically and tying the tourniquet around my arm): This will only juke you small. It not gonna hurt.
Me: I can't breathe. It hurting me plenty. White girl die-o!
(shrieks of laughter from the rest of the ward)
Alfred: Don't die! Breathe deep! Where my needle? Nurse! Bring me my needle. Make it quick!
Me: You can't be mean to your nurse. Be nice.
Alfred: Make it quick, please.
Dominique: Here you go, Doctor Alfred.

The shift ended with a bunch of us sitting around the computer scrolling through the photos on my facebook, Alfred killing himself laughing at the sight of me dancing in the streets of Toronto and playing a leaf guitar in Hawaii.

I can't remember the last time I had so much fun at work.

I have happy stories for you, and I love it.

On Sunday, my kiwi roommate I went to the United Liberia Inland Church. We were met at the outside gate by the pastor, who hailed a cab for us, packed us into the back and rattled off to Sinkor. At church, they announced a wedding shower and a visiting preacher spoke solid words. The Christian life is a race, and you can not stop by the side of the road. Shortcuts can lead you into a trap. Stop for cold soft drinks, and you will find yourself at the end. You must run the race to win the prize. We broke bread, passed fruit juice around in the gold version of the trays we use at home, and all the while the choir sang softly about the blood of Jesus that washes clean our souls. The kids sat outside for Sunday School, and we could hear the words of 'Father Abraham' drifting through the windows as we prayed. Afterwards, everyone stood around in the courtyard and talked and laughed. We met the pastor's wife, Ruth, and one after another the kids came over to greet us. And then the pastor hailed us another cab, and we rattled on back to the ship. My favourite part of it all? Pastor John Bleah laughs just like Joel, and it felt like home.

---

This is Sadiatu. She's from Sierra Leone and she came to us with an encephalocele. The operation to repair the defect is not an easy one. It involves pulling the skin of the scalp forward, pushing the brain back in, and patching the hole in the skull. Sadiatu took it like a bear. She growled and screamed and tried to smack me every time I came near her for the first couple of days after her surgery. On Thursday, she found her smile again. Yesterday evening, I was going about my business on A Ward, and I felt small hands on the back of my legs. I turned around to see Sadiatu. She had toddled down from D Ward, aimless wandering that led her right to me. And she looked up at me, eyes finally wide open, and grinned.

I'm glad we're friends now.

---

Sonnie is still a champ. She had surgery to release an amniotic band that was constricting her leg, and also had the two middle fingers on her good hand separated. Shes been hanging out on D Ward, terrorizing friends on other wards and banging her camo cast into whatever comes across her path. She's delightful and I love her.

---

And then there's Alfred. We're practically dating. In fact, on Sunday I took my lunch down to the ward and hung out with him while I ate. I drew a picture of him with his leg up on a pillow and he drew one of me in a wedding dress. Yesterday I was his nurse and he repaid the food favor by sharing his fufu and sea monkey with me. (I still can't figure out what kind of meat sea monkey is. No one was able to explain the animal to me properly.) We hung a paper bag on the wall and played basketball with a balloon. We crutched up and down the hall, and he helped me clean and dress the incisions on his leg. He tried to speak with an American accent and failed miserably. We laughed a lot.

When my shift was almost over, I noticed Alfred looking more than a little downcast. I went over and sat on the bed next to his. He turned his face away and hid under his blanket. Not typical Alfred. Concerned, I tried to figure out what was wrong. Was he feeling sick? In pain? Upset about something? Finally he uncovered his face and turned to me.

You can sleep here tonight? There are plenty beds empty.

We're so in love.

Ten points to anyone who can tell me why I'm so excited in this photo.

I'm on my way to work, so I'll tell you the story later ...

I wasn't sure if I wanted to post this. I don't want this blog to devolve into a series of sob stories, each more heart-wrenching than the last. I want to be able to share the joy that this place brings me. The pure, unadulterated happiness I feel when I get to be the first one to show a mother the results of a surgery that has given her baby a chance at a normal life. The laughter and silliness that pervades the wards during downtimes when we sit on the floor and color or build lego castles or make balloon animals. The smiles on the faces of patients who come back to visit after they've gone home from successful surgeries.

Instead I have to tell you the story of Fatima, because she's the only thing in my mind right now.

I don't know exactly what kind of cancer is growing in her small body, jutting fiercely out from the place where her right eye should be. All I know is that it's going to kill her, and there's nothing we can do about it.

I sat next to Fatima's mother as we told her the results of the CT scan. Her body stiffened as Dr. Mark began to speak and then, as though her spine had been broken along with her heart, she crumpled. I went to get tissues, put my hand into the cupboard and came out with the a box of the same brand we used back in the PICU at home. And everything was suddenly the same as every other experience I've ever had with this sort of thing.

Mark and I sat there, helpless, tears in our eyes as she wept. She gathered Fatima into her arms, quietly keening the same cry that every mother makes when she's told that her baby is going to die. I sat next to her, mute, as she curved her body around her bewildered child, as though her own life could be an acceptable substitute. As though she could protect her.

Liberians make a hand gesture unique to this culture. They clap and then pull their hands open, usually ending with the palms facing upwards. It can mean anything. I'm tired. I'm hungry. I think what just happened is hilarious.

Or, apparently, My heart is broken. Because when Fatima's mother had gotten over the first bone-shaking sobs, she sat up and did just that. Clapped quietly and then just let her hands fall apart, defeat etched deep into her eyes, tears falling onto the bandage wrapped around her daughter's head.

And then my shift was over, and I left the ward to try and muddle through the rest of the afternoon with the sound of that quiet cry ringing in my ears.

And yet.

Don't be afraid. I have saved you. I have called you by your name, and you are (and always will be) mine. When you feel like you're drowning, I'm next to you in the deep waters. When you walk through the fire, I'm next to you in the pain, and you will not be overcome. Because I love you. And I would trade all of creation just to make you mine. (Isaiah 43)

This child, like all the others I have ever cared for, is God's. Created, known, and loved by Him. I am not called to save every life. I am called simply (if I can presume to call such a task simple) to be God's arms holding a grieving mother. God's hands winding fresh bandages around angry wounds. God's heart breaking when His children are in pain.

I think this is what it means when Jesus says Thy kingdom come.

(On earth as it is in heaven.)

I had a difficult morning just now.

If you recall, when we had the big screening day back in February, I was on play duty. We do smaller days throughout the year when the new surgeons arrive, and yesterday and today were screening for plastic surgeries. Since I had the day free, I volunteered to help out and actually get a feeling for what it entails.

Liz and I stumbled outside at the unholy hour of seven to find a row of patients lined up along the edge of the dock. Once the whole team had arrived, we grabbed pens and pink admissions forms and got to work. I didn't have much time to think at first, just worked fairly mechanically to get histories and sort through the line as quickly as possible. It was only later when I was helping move patients through their consultations with the surgeon that I slowed down enough to realize what I had just heard.

He roll into the fire.
She was on the bed and the lamp fall over and she catch on fire.
I step on something and then my foot get big.
She was born so. She can never move her fingers.
I was cooking rice and the baby fall into the pot.
My friend put gasoline on me and light it on fire.

I have never tried to meet the eyes of a woman who has lived the last eleven years with burns disfiguring her face. I have never danced with a little girl who can barely stand because her ankles are so twisted from old injury. I have never been faced with little kids who unhesitatingly used contracted fingers to lift their shirts and show me scarred chests and arms and backs.

And, in the middle of all this, I knew that at the screening the day before, we almost completely filled the surgeon's schedule. Which meant that most of the people we were seeing today were going to be told no. No, we can't help you. We don't have the time. We don't have the resources. We don't have the nurses. We're sorry. We have to say no.



While Liz and I were still out on the dock processing patients, Patrick walked past with his uncle and his suitcase. He was fighting back tears as he hugged us and said goodbye. We had to say no. With so many other needs pressing on the surgeon's time, the surgery to release Patrick's fingers isn't a high enough priority for us to operate on him during this outreach. He's going back to Sierra Leone to wait for the ship to come next year. We walked to the gate with him, and he gave us the address of his uncle's tailor shop in case we're still on the ship when it sails to Freetown. We watched him walk away.

And then I realized something. I've been praying for direction about what to do next year. I've been wondering whether I should come home at Christmas and do a course that would allow me to come back to Sierra Leone and stay on longer with the ship.

As I watched Patrick and his uncle slip out of sight, I got an overwhelming sense that I should be on this ship when it docks in Freetown. Because I have Patrick's address scrawled on the back of a sheet of stickers, and I get the feeling that we're not done yet.