ali's african adventures

I love being a nurse. Some days, it all just feels right, and I always find it interesting when those days aren't the quiet ones. Yesterday we sat around for most of the shift, looking up quotes online to put on the back of our ward nurse t-shirts. The patients were lovely, and no one was in pain; I didn't do a stitch of work all day, but it didn't feel all that good.

Today was the opposite. Grace, Katy and myself were stationed amidst the kiddos in A Ward. We walked into a room full of kids in pain, started running from the minute we finished report and then got a second wave of cast-footed babies who will have more surgery tomorrow. It was, in a word, hectic.

Enter Team Awesome. I'm the only pediatric nurse out of the three of us, but you'd never have known it. Our evening consisted of passing kids back and forth, spreading out blankets and strewing toys all over the floor. We had children in casts all over the place and most of the time we didn't know which ones were our own patients. For about half of the shift, the air was filled with shrieks, a stereo chorus of ear-splitting protests over minor insults, more often than not entirely imagined.

The rest of the time, in between the hollering, it was heaven. Nessie, a bundle of braids sporting a neon orange cast, adopted the three-year old a few beds down. They parked themselves on the floor with Grace, surrounded by blocks and legos. I walked past to give some meds to one of my kids when I heard singing coming from below my line of vision. Nessie was delivering a heartfelt, if barely-intelligible, version of He's Got the Whole World in His Hands, complete with actions. I parked myself on the blanket next to her and joined in, suggesting verses about little babies and mamas and papas. We sang for quite a while, renditions of By My Side and other unknown-to-me Liberian gospel songs weaving in and out through the screams still occasionally emitting from the other side of the room.

Timothy had come in earlier in the day for a checkup and ended up getting admitted for surgery to take one of the pins out of his leg. After his surgery, I had to give him some pain medicine. I squirted the liquid into his mouth and prepared to walk away when I realized that his sly little self hadn't swallowed. I sat down on his bed and began to cajole. Swallow it. Swallow it. Have you swallowed it? Come now Timothy, just swallow it. I give you sticker. You want sticker? Every so often I'd ask him if he'd complied, to which he would reply by opening his mouth to show me that, in fact, all the tylenol and codeine were still swishing around in there. He eventually let the offending mixture slide down his throat, grinning a rotten, gap-toothed smile at me that made me realize that I wouldn't have minded if he had taken a half hour longer.

I love days like today. They're the ones that make me seriously question whether or not I'll ever be able to go back to American nursing.

This boy is the reason I go to work these days. Can you blame me?

Last night I was sitting at dinner, comfortably watching Meg learn to cut her food (which is a big step, honestly, although it sometimes results in rogue splashes of balsamic vinegar all over the table) and kind of expecting to be sitting there for another hour or so. It's my nightly ritual; I head into the dining room right at five, eat in the first ten or so minutes (I'm not a Wilks for nothing) and then just sit and chat until around six thirty. Last night my cucumber-cutting, vinegar-spraying friend disrupted my routine.

Let's go watch the sunset.

In the following hour and a half, I was on the receiving end of one of the more overwhelming visual assaults I've ever experienced. Every time I blinked, my eyes were opened again to new colours and shapes and patterns. The light danced on the water, oranges and pinks reflected on rapturous faces lining the end of the dock. The sun cut a trail of fire through the ocean wide enough that I thought for a wild moment that I really could have run across it, my feet buoyed by the liquid light. We stood there, talking and being silent, watchers at the close of a day as creativity unfolded across the open sky. The air was painted in colours so startling and bold that it seemed as though a child's hand held the brush. We turned to each other over and over again, seeking confirmation that you're really seeing this, right? This is really happening? Our fallen world can actually look like this?

And I may never sit in the dining room again.

















More here, as though glory could be captured through glass.



Addendum:

I mentioned the blazing sky in an email to my brother who responded with the following:

Wow. Totally awesome. I can't get enough sunsets; I think we inherit it from granny. I like to think about the fact that, although we usually see a sunset as a discrete event, it's really more like a 24 hour, 7 day a week, 52 week a year neverending display of glory. What I mean is, if you could travel at just the right speed westward, you would live in a world with an orange sky instead of a blue one.

Which is why I love my family so much.

Last night wasn't terribly fun. They say to be careful what you wish for, and I was rueing my desire to be back with my kiddos before thirty minutes of my shift had even passed. I just couldn't get caught up. Nine patients is a full load on a good day, but throw in three freshly post-operative children and several others who had uncontrolled pain issues, and you've got the makings of a busy night. (As a side note, there's maybe no one I'd rather have by my side on such a night than one Grace Berry. She is the stuff nursing legends are made of and the reason I'm still standing today.)

I came in tonight absolutely determined to have a better shift. At community meeting right before work, the speaker had talked about the bitter water of Marah. Don't worry, he reminded us, Elim is just over the next dune. Thus, it was with an appropriate sense of what I can only call glee that I looked at my report sheet to find that my oldest patient is a whopping ten. As I love to do when time allows, I spent the first hour or so of the shift kissing patients, making faces at kids, snuggling babies and laughing with mamas about the resemblance (or lack thereof) between myself and my most recently kidnapped child. Alfred (yes, he's still here) treated me and the orthopedics coordinator (another favourite of his) to a rap / gospel concert. I attempted to beatbox for him and he nearly fell off the bed laughing.

My patients are just the sweetest kids tonight. Last year, when I was applying to work with Mercy Ships, a nurse I worked with, Juanita, told me that someone from the ship was writing articles for a nursing magazine she gets. She showed me one of the articles, about a little boy with two club feet who would get his second foot fixed this year. We both grinned at each other and thought it would be pretty sweet if I got to take care of him. I had lunch with the author of that article yesterday, my fun-loving PICU friend, Auntie Megee. And the boy's name is Benedict; he's my patient tonight, the sweetest little boy to ever grace bed ten. When he's in pain, he just looks up at you, eyes filled with tears, waiting patiently for his medicine. And when he's not in pain, those eyes dance and shine as he laughs.

There's Jerry, a little tiny peanut of a baby who's snuggled in next to his mother and two brothers right now, a whole family jumbled together on two beds pushed side-by-side. Jerry and his brother Jonathan had surgeries today to take off extra fingers they were born with. Mom brought a third brother, Nathan, along to help out, so the whole thing is something of a family affair. Jerry has the softest puff of curly hair and tiny little bandaged hands. He and his brother also now have the chance to live their lives free from ridicule and accusations of being cursed. It's a happy family over there in the corner.

Acan is another favourite of mine (if I could even begin to pick sides in this crowd). A few days ago, I was caring for a patient in the ICU when I heard poorly-smothered giggling coming from the half-open doorway. I turned to see two little faces smiling up at me, one with ears that made me think of none other than Shrek. Acan and Benedict had come to visit, and would only be turned away after being adorned with shiny fish. (Right in the middle of the forehead, of course; that's how we rock the stickers LIB style.) Acan is still having pain issues, and he snuggles into my lap in the most endearing way possible while I give him his medicines. He's asleep at the moment, sprawled across his bed, stickers all over his face.

I love kids. I love taking care of them and soothing them and playing with them. I love the challenge of managing their pain, something that goes so much deeper than just giving meds and telling them to wait the requisite thirty minutes until the desired effect is achieved. I love catching their eye across the room and having them grin and wave. I love kissing their foreheads and tucking them into bed at night with a prayer. I am in pediatric heaven right now.



(credit where credit is due: Meg Petock provided the photographic genius for this entry.)

Rain is falling and I am far from home.

It's been over a hundred days since I've seen my family. It will be hundreds more before I see them again. A hundred days of learning and laughing and failing and crying and growing. I am surrounded by people who, four months ago, I had never dreamed of meeting, people I never knew existed. I call them friends, but now, when my world has been shaken and my footing is less than steady, I don't know who to turn to.

Beloved, I hear Him say, all this water cannot quench love. Don't you realize? My love is stronger than death, less yielding than the grave.

I have been placed, a seal over His heart, and I will rest there, in the hollow of His hands.



(Outside, the rain has stopped, and the sun is starting to shine again.)

I never cease to be amazed by God. You'd think I'd be getting used to it by now, no? After all, I'm living on a ship with over three hundred other people from thirty countries and none of us have killed each other yet; there's got to be some kind of divine provision happening there.

But yesterday was one of the shifts that just starts out wrong. I only had four patients on my sheet, one of whom never even showed up, but I didn't stop moving once in eight hours. It was the kind of day where everyone needed something extra. I went to give antibiotics to one patient, only to find that her IV didn't work and she would need a new one before her medication could be given. Another patient needed a catheter. My new admission needed to be settled. And the six or seven others in the ward who weren't mine all needed water or tissues or something.

Now, all this would have been well within my comfort zone, if only my patients had spoken English. But they didn't. Unless I spoke to my one lady in my thickest Liberian English, all I got from her was the slight eyebrow raise / barely-perceptible head nod which means I have no idea what you're saying, but I'm agreeing anyway. (Or, sometimes, I think everything you're telling me is absolutely true. It's kind of a toss-up.) My next patient was a child, and children don't tend to do well with things like getting jabbed with needles unless you lay a fairly thick foundation of stickers and silly faces and drawn-out conversations about football. This all takes time, and plenty of words. (The reward, however, is having the child hold perfectly still, intent on being a member of The Best IV Starting Team Ever, getting that IV on the first try and having said child's mother grin and shout GOAL!.)

The final straw was Alimou, my French-speaking source of worry from the weekend. He's much better now, 'awake, alert and oriented to person, place and time,' as we nurses delight in saying, but he's just unable to communicate. I can't imagine what it must be like for him right now. He's got a trach to breathe through, which means that he can't talk even if he wants to. So he's trapped, mute, in a strange, white world of people like myself who think that talking loudly or extra-slowly will somehow make him understand that I'm going to give him his dinner through his feeding tube now, thankyouverymuch. We give him a clipboard and a pen, and he scrawls things in Guinea French, his spelling so atrocious that even the usual French speakers aren't getting it. And then we all get frustrated, and he throws up his hands and closes his eyes and I move on to my next task. It went on like this for the first half of my shift. At one point, I was speaking to a Liberian translator who would speak Kpelle to the guy in the next bed who would turn and speak in Guinea French to Alimou. Alimou would put forth a complicated series of hand gestures which would be passed back through the neighbor and the translator to myself. (Is your head spinning yet?) This all took much more time than I had, and I was starting to get annoyed. So I went to dinner, because food fixes everything.

When I came back, Alimou had a visitor, a member of the team who had found him in Guinea and scheduled his surgery. They had the clipboard out and hands were flying as they tried to make themselves understood. So I did what seemed, somehow, totally natural. I grabbed Alimou's hand and said to him Qu'est-ce que tu veux dire? And the guy in the next bed told me, in French, what he thought Alimou was trying to say. And I translated that back into English for the visitor.

The only problem with all this is that I don't really speak French. Granted, I took a year of it back in grade twelve, but up until now the only thing I could say is Je veux du jambon. I won't go hungry in a French-speaking country, but it hasn't been a terribly helpful phrase in the grand scheme of things. Yesterday, everything I had forgotten seemed to elbow its way past the years of random junk piled into my brain, right to the very front where I was able to pull it out with startling ease. We weren't having in-depth conversations about the meaning of life or the social implications of his transformative surgery, but I was able to tell him when it was time to eat and ask him if he was cold and joke with the guy in the next bed about how maybe I'm too young to be doing this job. In French. A language I don't really speak.


I was reading through Psalm 119 the other day. Verse after verse about the truth and beauty and rightness of God's commands. And then, buried there towards the end, these words.

Your promises have been thoroughly tested, and your servant loves them.

And then I can't help but run through some of those promises in my mind. I will never leave you. I won't give you more than you can handle. You will never be alone. When times are hard, I will share that burden. I love you more than life itself. These past months have already seen me thoroughly testing these words. I can't see that changing any time soon, and that's a sweet thought, because I love those promises.

Sometimes when I pray, I have a hard time believing anyone's listening. I sit there and I talk to the sky or the ceiling or the floor, and it's a mind-bending exercise to think that my words are getting past clouds and carpet.

Yesterday, I did a lot of praying. I had switched a shift with a friend, so I came onto the wards in the morning not knowing where I would be assigned. I headed down to my familiar territory (A and B Wards) to find my name missing from the assignment list. Groaning inwardly, because max-fax is anything but my favourite kind of surgery, I backtracked to D Ward to discover my fate for the day. I was expecting twelve hours of chlorhexidine mouthwashes, smelly penrose drains and NG feedings. I was less than excited, but when I poked my head through the door, I was handed a report sheet with just one name on it: Alimou.

The last time I worked in the ICU here, I cared for two small boys who were too sick to save. It’s been close to six months since I’ve really had to think about communicating with a freshly trached patient or managing metabolic acidosis or weaning ventilator support. Add this to the fact that Alimou was from Guinea and spoke not a word of English, and you’ve got one former-PICU nurse running scared.

I got report, and before the night nurse left, we prayed together. I assessed my poor befuddled patient and I prayed over him. The anesthetist came in to consult and write orders and then came back to pray with my patient and me. Friends stopped by to check on me and to let me know that they were praying. I took him off the ventilator, attached the trach collar and prayed for him to breathe. I put him back on the ventilator and prayed for him to come out of his confusion.

Does anyone else see the theme emerging? The thing is, I’m a PICU nurse. (Or I was, when I got a paycheck.) ICUs across the board attract a certain personality, and mine fits right in; I’m used to going to work and feeling like I run the world, like everything is in my capable hands. But I walked into that ICU yesterday knowing full well that I couldn’t care for Alimou on my own. It was a humbling feeling. Looking at lab values and not knowing right away what to do. Having him wake up, scared out of his mind, and searching desperately for the words to calm him but coming up with nothing. Waiting and watching and worrying. So I prayed, and God answered. Because that’s what He does. Around eight in the evening, Alimou started breathing on his own, was able to come off the ventilator and started looking at us instead of through us. Paul got it exactly right when he was writing to the Ephesians, referring to the God who can do so much more than we can even imagine asking.


Milton, the pastor who’s been a patient with us for about a month now, (the one praying strong prayers for my Liberian husband who hasn’t shown up quite yet) gave testimony at ward church this morning. Standing in flip flops and a hospital gown that flapped open in the back to show his plaid boxers, he looked almost comical. Nothing like the pastor who preaches to the president. But then Milton started to pray. His voice thundered, belying the fact that he’s been trapped in the windowless hull of a hospital ship for the last four weeks. He prayed for the doctors and the nurses and claimed God’s wisdom and healing power for our hands. He thanked God for allowing the tumor to be removed from his leg. He stood there, and he praised God that he had been given his dignity back. And we believed in that dignity, because you can’t help but listen when Milton prays.


So I’m going to remember Alimou and Milton when I’m praying now. When I feel like I’m coming up against a brick wall or whispering words to the wind, I’ll think of these two men. One trying to jump out of his bed, calmed by the prayers of a desperate nurse, and the other standing tall in a threadbare gown, striding confidently up to the throne of grace. Because God listens. And that’s a startling truth.

Sorry about the silence, but this past week has been a much-needed break. I worked all of one full day during the course of the last seven, and those twelve hours were spent mostly in serial games of UNO and Rummikub. I don't have anything earth-shattering to share right now, but rather just a few disconected stories from the chain of my time here.

Two days ago, myself and two other nurses were assigned to clean. Instead of caring for patients, we donned scrubs, mixed up buckets of bleach and scrubbed the floors, walls, ceilings (any guesses as to who got that job?) and every single piece of furniture on one of the wards. While we were hard at work, another of the nurses came by to rustle up some balloons for a friend's birthday. He blew them up and left them in a big pile on one of the empty beds while he went to find some string. My back was turned when one of the balloons, filled past what it should have been, fell off the bed and burst. I thought nothing of it. Auntie Ali, called Gaye from the other side of the ward, please come here. Gaye is a sweet teenage boy who was admitted for some skin grafting on his foot. He loves to sit and chat and has most recently been industriously employed making friendship bracelets for pretty much every other patient in the hospital. He's wonderful. I went to see what he needed, and he broke my heart. Please don't let that sound come here again. That sound makes us think of the far past. And Liberia, we are finished with that now. Don't make us scary [scared] anymore please. Oh the privilege of growing up in a country where I can hear balloons pop and not immediately think of gunshots.

Yesterday, I realized all over again what a strange community I live in. I was sitting in the lounge after work, puttering around on my computer and asking everyone who passed what blood type they had. (I somehow found this completely normal.) There was a patient in surgery who needed a lot of blood, and anyone who was B positive was needed to get on the list in the lab. You see, we all live and work within five hundred feet of a hospital, and this hospital doesn't have the capability to do things like irradiate or refrigerate blood. So when a patient is in surgery and bleeds, the first healthy crewmember on the list is called. They walk down a few flights of stairs from their office and a pint or so of their blood is drained into a bag. The bag is flipped over, new tubing is attached, and the blood, still warm, is walked down the hall and given to the patient. We are a living blood bank, always on call. New Jersey blood shortages have got nothing on this.

A few days ago, one of our translators came up to me in the dining room. She handed me her cell phone and told me someone wanted to talk to me. It was Victoria, Kumassah's mom.. She told me she wanted to see me, and we set the date for this afternoon. When I went out to the gate to meet her, Kumassah was all smiles. She reached for me, and we snuggled all the way onto the ship. I took Victoria down to the ward and she greeted all the translators she knew. We showed off Kumassah to everyone we came across; she's a fat, happy five-month old little girl with rolls the size of Texas. And then I walked them back out to the gate. As she was getting into the taxi to go home, I asked her where home was. She named a place an hour and a half away, waved cheerfully and slammed the door. Three hours in a Liberian taxi, just to say hello. This is love I know nothing about.

This morning, I saw a face rebuilt. I'll write more about Blessing another time, when I have the time to properly research her condition and write more than what I know in passing about the disease that destroyed her lips. Right now, I'm still reeling a bit from what I watched. Two surgeons, working together in near-silence, slowly and painstakingly reconstructing a child's future as they crafted lips from neck and cheek. The hope, growing with every suture tied, that this child will be able to show her face in public and lead a life without being ostracized at every turn. When I left the room near the end of the operation to get some supplies for her bandage, I ran into Blessing's mom. The unspoken question loomed in her dark eyes. The child is fine. They are almost finished. She will be coming out soon. I held back and didn't tell her that, instead of the one lip she had been promised, Blessing now had two. I figured it was best for her to see it for herself. I only wish I could have been there.

So life moves slowly along. People are coming and going, patients are having surgeries, and I am content. Liberia is gaining an ever-growing hold on my heart, and I don't know how I'll be able to sail away from all of this at the end of the year.

Alfred is back.

He came in during the week for a routine post-operative appointment to get the dressing changed on his foot. There's no such thing as home health nursing here in Liberia, so when patients are discharged with complicated bandages, they come back to the ship a couple times a week (sometimes daily) to have our dedicated team do it for them. When Alfred came in, they noticed that something wasn't quite right about his foot. It wasn't healing like they wanted, so the decision was made to readmit him to the hospital. It turns out the decision was a good one; Alfred has osteomyelitis in that foot of his. So he's going to hang out with us for a while while he gets IV antibiotics and dressing changes and love.

I thought both of our faces were going to fall off from grinning when we saw each other the first day he was back in A Ward. We fell back into our pattern of Alfred trying to sweet-talk me and me trying to not get sweet-talked. He's even more comfortable here this time around (if such a thing is even possible). When they were trying to find him to slap a hospital bracelet on him, it took them about half an hour before he was discovered in the x-ray office, looking up photos of people with Proteus Syndrome on the internet. The boy is incorrigible. We spent all day today playing Rummikub and holding the debates for the presidency of Little America (aka the Africa Mercy) and discussing how Alfred is going to go to college in the UK and eventually be the one to find the cure for AIDS. (You heard it here first, kids. When this boy is famous one day, I'll be saying I knew him when!)

This weekend is a holiday weekend for the ship, which means no surgeries on Friday or Monday. That, in turn, means no admissions from Thursday to Sunday. Census has been dwindling and the hospital has been condensed into two wards. Everyone has been getting some time off, and we've all taken a collective deep breath and slowly exhaled as we've finally been able to relax. Since no one had to wake up for work on Friday morning, we all decided to watch a movie on Thursday night. Before heading to the lecture room (an impossibly noisy room with a projector that casts a yellow glow across the entire screen where we eagerly gather to watch movies, lying on the floor propped up against chairs turned on their sides) I stopped by A1 to see my man. His face lit up and he pushed himself into the corner of his bed, patting the now-empty spot and telling me to sit down small. He handed me a plastic bag. Choose any one, he told me, as I peered in to see a Fanta, an orange and an unidentified bag of what may have been Middle Eastern corn chips. Saying no to Alfred's food offerings is, I have come to learn, the height of insult, so I chose the orange. Good, he grinned at me. I already had one anyway.

It was then that he asked me to tell him my life story. You tell me yours, I will tell you mine, was the deal I was offered. I sat there, orange in hand, debating with myself. I started to say no, to ask him if I could come back another day for the sharing of histories. I had friends and laughter and a movie waiting. I was too tired to listen to his drawn-out Liberian English ramblings. I didn't feel like talking about my past. But something stopped me dead in my selfish tracks, so I leaned in close and got comfortable. Who's first?

I started. I told him about growing up in New Jersey, about my family and my summers at the farm. I told him about Johnny and how much I hated God for taking him from us. I told him about running and running and running until I finally turned around and realized I had gotten nowhere except deeper into God's own heart. I told him about praying for Africa and about my summer in Zambia. He laughed at my stories of youth group and he smiled proudly when I got to the part about coming to Liberia. So now I'm here. And we're friends. And that's all.

He asked me if I was finished, and then, as we passed that orange back and forth between us, he shared with me his life. I'm the first person he's ever told, and his story isn't mine to pass on to you. But I think my heart was broken, just there in the corner of A Ward, next to a small boy who has lived more in fourteen years than I ever hope to in the rest of my life.

It was after eleven before I left, but not before I made Alfred a promise. I told him I would pray for him every day, and I plan to. Can you pray too? Pray that healing will come to his body. We still don't know if he will be able to keep his foot, and for a basketball star like Alfred, losing a foot would be a tragedy. But mostly, just pray for his heart. Pray that he would somehow get a finger wedged into the idea of God's love. That he would rip even just a tiny hole in whatever's covering it for him and be blinded with the truth and beauty of it. Pray that he would learn what love is and that he would learn how to love. Because he's one of the most amazing people I've ever met, and his huge heart would be wasted on hate.

There never was a more holy age than ours, and never a less.

There is no less holiness at this time - as you are reading this - than there was the day the Red Sea parted, or that day in the thirtieth year, in the fourth month, on the fifth day of the month, as Ezekiel was a captive by the river Chebar, when the heavens opened and he saw visions of God. There is no whit less enlightenment under the tree by your street than there was under the Buddha's bo tree. There is no whit less might in heaven or on earth than there was the day Jesus said Maid, arise to the centurion's daughter, or the day Peter walked on water, or the night Mohammed flew to heaven on a horse.

In any instant the sacred may wipe you with its finger. In any instant the bush may flare, your feet may rise, or you may see a bunch of souls in a tree. In any instant you may avail yourself of the power to love your enemies; to accept failure, slander, or the grief of loss; or to endure torture.

(Annie Dillard in For the Time Being)

Living in constant community with some four hundred people has its advantages. I end up doing things like throwing nearly-silent parties at midnight, whispering the words to the birthday song so as not to wake up the girls one paper-thin wall away in the next cabin. Or sitting together with friends at breakfast talking about anything from lab reports to harebrained schemes for cross-country travel. Or feeling unwell, heading to bed and having someone stop me in the hall and pray for me right then and there.

But community living can get tiring at times. It's nice to know that walking out of my cabin and into the midships lounge means that I'm going to find someone to hang out with at pretty much any hour of the day. But the reverse is also true; walking out of my cabin and into the midships lounge means that I'm not going to be alone. We live on this ship, five hundred feet of four, six, ten-berth cabins, and we are never alone. The only escape is to get off the ship, which plunges me into the whirling cacophony of Monrovia. It can hardly be considered alone time when every eye is fixed on me as I walk down the street with my equally-white companions to calls of White girl! You fine! Marry me! You guys are princesses! Give me your number! (Exclamation points being absolutely essential to this particular style of communication.) And we can never be alone; it's just not safe. So Mercy Shippers go out in droves. Landrovers packed to bursting with eager, pale people who just want to get away from the wireless internet and air conditioning, if only for a few hours.

This is all starting to get to me, especially since The Exodus has begun. No, we're not clawing our way out of Egypt, but it seems like everyone on the ship is packing up and boarding planes for home. Between the end of April and the middle of June, almost everyone who I was friends with when I first got here will have gone back to their lives in the real world (if such a thing even exists anymore). Goodbyes consist of long group hugs on the dock and huge packs of people going out to eat food; there is no such thing as solitude.

To that end, Liz and I went on a date yesterday. Just the two of us. In a taxi. Nary a Landrover in sight. We stopped at the end of Broad Street and made our way up the hill through the cool green shade of mango trees to the Ducor Hotel. We climbed the seven or so flights of stairs and then the ladder all the way to the roof. We sat on the edge, feet dangling over stories and stories of air, shared our hearts and felt like we owned the world. We played with monkeys and ate dinner on a balcony overlooking the ocean. It was refreshing in so many ways. Liz has become a close friend in less time than I had thought possible. Perhaps it's a function of living in such close quarters and seeing each other all the time, or maybe it's just true that we actually are sisters separated at birth, but it's going to be incredibly difficult to say goodbye to her on Sunday. She's the kind of person who will drop everything for a two-man dance party at any given moment, whether we're on the ward at two in the morning or on the remnants of a dance floor on top of a ruined hotel with no music anywhere in earshot. She's the one I can go to on a bad day and know that I'll get sympathy and a cup of tea. And she's become the one to encourage me in my walk, reminding me often that God has big plans for the both of us, but that His timing isn't necessarily what we might think and that it's okay for next year to be a wide-open question mark.

Meg (my PICU buddy from Philly) says that Mercy Ships should maybe advertise about The Third H. We talk all the time, eyes shining, about hope and healing; it's what we do here. But no one mentions the heartache. Whether it's a patient's story of years of sadness and pain or the constant leaving of new friends, this place is hard on the heart. Some say the only way to combat it is to find your group of long-term friends and huddle over by the windows in the dining room, staunchly refusing to meet new people because it just hurts. too. much. to say goodbye again when they inevitably leave. There's much to be said for that method. For crying out loud, at home I'm still friends with the same people I've known since grade one. Creature of habit extraordinaire.

But if I do that, if I refuse to check the new arrivals list and I sit behind the glass at lunch, I'll miss out on all-night talks on the beach and extra plates of popcorn and so much dancing. And that's just not an option. Because I like popcorn.

To love at all is to be vulnerable. Love anything, and your heart will certainly be wrung and possibly broken. If you want to make sure of keeping it intact, you must give your heart to no one, not even to an animal. Wrap it carefully round with hobbies and little luxuries; avoid all entanglements; lock it up safe in the casket or coffin of your selfishness. But in that casket- safe, dark, motionless, airless--it will change. It will not be broken; it will become unbreakable, impenetrable, irredeemable. (C. S. Lewis)

Today was not exactly my shining moment as a nurse. I'm stuck somewhere around thirty percent of my normal energy level, and couldn't muster up much in the way of enthusiasm for my job. Getting called at five after seven and realizing that I was still in bed when I should have been dressed and on the ward didn't help much either.

Despite the general apathy I was feeling, I was treated to what I figure is one of the best things about this job; I realized today that one of my patients had come alive again.

When I first met Abraham, he was a silent, withdrawn little boy. He refused to make eye contact, refused to leave his mother's side, refused to interact. When he came to the wards, it was the same. A small frightened boy, living entirely inside himself.

As the days passed after his surgery, Abraham began to make noise. I wrote about him last Sunday, how I finally heard him squeak like an anemic monkey. It wasn't much, but I would have taken anything at that point.

When I got my assignment today, I was excited to see that, for the first time, he was actually my own patient. I figured I'd be super-nurse and get him to talk and laugh. Turns out I was way behind the times, because as soon as I finished getting report, I felt the weight of him hanging off my leg. I looked down into his irrefutably smiling eyes and said good morning. He shrieked something unintelligible back to me and ran off in search of legos. All day long, we chatted (never understanding a word of what the other one said) and built lego cities and did puzzles and had tickle fights.

Abraham, like so many before him, has been reborn. Out of the burned shell of a boy, scared and scarred, has emerged life and joy and exuberance. It's the first time I've ever recognized it so clearly, and I'm hoping it won't be the last. Because it's one of the coolest things I've ever seen.

I've been sick for the past few days. Living in the same square footage as all the nurses I work with means that differential diagnoses have been flying freely. So far, it's been anything from mono to worms to malaria. Personally, I think I just have a bad cold. Thankfully, my parents have been feeding into my TV addiction, and I have enough episodes of American Idol to keep me entertained while I live in my bed.

I've just been laying here watching Idol Gives Back. It's the night where all the celebrities and singers and big Hollywood names get together and raise money for charities worldwide. They travel to places like New Orleans and Angola and make heart-wrenching video montages set to inspirational music. Small brown faces, staring unblinkingly into the camera as the voice-over narration asks me to pick up the phone and donate. Just one dollar.

Carrie Underwood, clad in a gown that probably cost as much as it would to feed a small village for a month or two, just got on stage and sang a song that ripped my heart out.

These are the days of the open hand
They will not be the last
Look around now

These are the days of the beggars and the choosers
This is the year of the hungry man
Whose place is in the past
Hand in hand with ignorance and legitimate excuses

The rich declare themselves poor
And most of us are not sure
If we have too much but we’ll take our chances
‘Cause God stopped keeping score

I guess somewhere along the way
He must have let us all out to play
And turned his back
And all God’s children
Crept out the back door
And its hard to love
Theres so much to hate
Hanging onto hope
When there is no hope to speak of
And the wounded skies above
Say its much too late
Oh maybe we should all be praying for time

This is the year of the empty hand
Oh you hold onto what you can
And charity is a coat you wear twice a year

These are the days of the guilty man
The television takes a stand
And you find that what was over there
Is over here
So you scream from behind your door
Say whats mine is mine and not yours
I may have too much
But I’ll take my chances cause God stopped keeping score
And you’ll cling to the things they sold you
Did you cover your eyes when they told you
That he cant come back
‘Cause he has no children
to come back for

And it's hard to love when theres so much to hate
And hanging onto hope
When there is no hope to speak of
And the wounded skies above
Say its much, much too late
Well maybe we should all be praying for time

(Carrie Underwood - Praying For Time)

Do you cover your eyes when they told you that He can't come back because He has no children to come back for? I may have too much, but I'll take my chances because God stopped keeping score.

How often am I guilty of just this? Complaining that I'm too tired to work, when the wards are full of those very same little brown faces. Wishing I could switch a shift so I can go out with friends when I've been given the opportunity to give so much more than just my money. I'm ashamed to think of how often my attitude falls so much in line with those lyrics.

The thing that gets me through, though, is that that song isn't entirely true. Somehow, in this crazy little microcosm, things have been turned upside down. Here, I have seen Liberian children, loving despite hate. Sharing hugs and laughter when all they've known is scorn and ridicule. I have seen grown men with tear-filled eyes tell stories of war while they smile through the pain of their wounds and talk of things like forgiveness and healing. I have seen women with empty hands reach out and give to the child in the next bed.

It is not true that there is no hope to speak of. Because we have prayed for time, and it has been given to us. We need only to redeem it.

I wrote this in the middle of a long, long shift last night.

I’m sitting on an empty bed in the hushed dark of A Ward at two in the morning. The babies are sleeping, and I thought I’d take a minute to type. I’ll admit something right out of the gate here; I came to work tonight with a bad attitude. This is the last of three night shifts, and knowing that this ward is populated mostly with babies, all of whom have upper respiratory tract infections, I was dreading my shift. Babies with colds are never really pleasant; add a kilo or two of plaster to their little legs, and you’ve got a surefire recipe for sleepless nights.

I’m not saying I can’t sympathize, because loving on one too many sick babies means that I’ve also fallen victim to the virus. My head is pounding, my nose is running, and my energy level is hovering somewhere around twenty percent. Suffice it to say, I started the shift a little short of patience.

By eleven, most of the kiddos are usually tucked in and sleeping soundly. Tonight, just like every night so far, Anointed defied all my efforts. I gave him his medications. I snuggled him closer to his mama. I got him a clean diaper. And still he screamed. I had decided somewhere during my first night that Anointed and I weren’t destined to be friends. Because this wasn’t a scream of pain. It was a cranky, irritable, I-hate-everything-and-everyone-around-me scream. And it was getting on my already-frayed nerves in a bad way.

Somewhere around one o’clock, I had had enough. Anointed’s mother was sleeping soundly next to her wailing child while all the other babies on the ward were starting to join in with a chorus of their own shrieks. Frustrated with his mother’s lack of parenting skills, annoyed at his cries and just wanting him to stop, I grabbed him out of bed and carried him out into the hall. The crying got louder, and I immediately started to doubt my decision.

But I’m stubborn. Just about as stubborn as they come. And I refused to let this little ball of screaming fury get the better of me. I paced and rocked and sang until, all at once, he nestled his head in under my chin and stopped his crying. Moments later, the sudden weight of him told me that he had given up the fight and was asleep.

We’re sitting together on this bed right now, his small body splayed across my chest. His almond eyes are squeezed shut, and his curly little mohawk is soft under my chin. And my whole perspective on this night has been turned end over end. I just realized that I came to work tonight looking for a fight, waiting for things to go wrong, expecting to have a rough shift. Really, all I should have been looking for was the next baby who needed to be loved on. Amazing what a little reality check can do for your state of mind.

So Anointed and I are going to hang out here for a while. And when Johnson wakes up and starts screaming (like he’s bound to do any minute now), I’m going to summit my next mountain.

The rest of the night was spent with Anointed snuggled in my arms. It didn't even bother me when he threw up all down the front of my scrubs. Come five o'clock, when there was work to be done, I rolled his mother over, took her lappa and strapped him squarely on my back. He stayed there until it was time to give report, drooling and coughing into my shoulderblade, little toes poking out from either side of my hips. (For the first time, the other mamas didn't readjust him, telling me instead that he sit fine there. There's hope for my baby-wearing skills after all.)

I just keep thinking about it all. About how different last night was from the two before it. Changing my attitude meant I could get out of my own way and just love. For all I've been learning about love during the last few months, you'd think this lesson wouldn't have been so long in coming. After all, for as long as I remember, I've been repeating the mantra after Uncle Russ: I refuse to have a bad day.

Jesus said it best himself.

The Father loves me, and so I love you. Live in my love. Make it your home, make it your place of being. If you follow my example and do what I'm telling you to do, it won't be so hard. See? I've followed my Father all along, and I'm resting firmly in His love. And you know why I'm telling you this, right? Because if you can get this, if you can just love, then you will be filled with a joy so complete and so full it doesn't seem possible this side of heaven. So just love. Love each other like I've loved you. That's all. (John 15)

Every time I let myself be annoyed with the petty little frustrations that make up a day, I'm really just shooting myself in the heart. Because I'm missing out on love, and I'm missing out on joy. And that's just stupid.

As soon as I'm feeling better, I'm going to go try and make friends with Johnson.