ali's african adventures

Every six weeks, the ship takes a collective step back and goes on holiday for a day. The long weekends are gold to anyone who's been here more than a couple months, and for once, my on-call schedule actually coincides with my husband's, and I've got tomorrow off.

I don't think I've ever needed a break more than I do right now.

I sit here at my computer, and I'm trying to figure out how to say this without sounding like I'm whining, but I'm coming up empty. So I'm just going to say it: I'm tired. I'm so incredibly tired, and I've only been back for five months. I don't even know how the people who've been here the entire outreach are still standing.

With three weeks of surgery left, we're stretched to our limits. We've finished the two weeks of VVF surgery, but A Ward is filled with the ladies who are still recovering, many with serious complications. Next week's schedule boasts three maxillo-facial surgeons and a slew of complex, highly specialized surgeries on patients that are guaranteed to need long hospital stays.

We're at the end of ourselves, and I know that's where God begins. I know it. It's just that right now, when I've worked every day for the last thirteen, I'm having a hard time seeing it.

So I'm going to take a break. HoJ and I are headed to the beach to stay in a little bungalow overnight, and I'm going to leave my pager and all my racing thoughts behind, and I'm going to enjoy myself. I just got worried, remembering that it rained today, and realizing that there's potential for us to be totally washed out in the only time off I've gotten in a while.

And of course, like he always does, HoJ found a way to make it okay.

If it does that, we'll just get to hear rain.

So I'm going. If it's sunny, I'll enjoy the beach, and if it rains, I'll lie in bed for two straight days and I'll listen to the rain that I never hear through the four decks above me. And it's going to be just what I need.

I stopped into the ICU to get some supplies yesterday and saw my friend Suey, her face grim, drawing up medication in a syringe. Suey works with our palliative care team, so she's not usually on the ship, and definitely never in the ICU. She responded to my unspoken inquiry by cocking her head towards the side room. I peeked in to see a little form, still on the bed. Maddie.

Maddie is one of Suey's Burkitt's kids. She came to us first right after I got back to the ship after my honeymoon, and I fell in love with her. Her right cheek was swollen with the cancer, she was incredibly yovophobic, and her pregnant mama loved her fiercely.

Now months have gone by. Maddie's little brother, Abdul, is one month old, and her parents have fought so hard to get her the treatment she needed. Her hair is close-cut and her cheeks are even and smooth, with no trace of the cancer distorting their lines.

And yesterday, after fighting so hard for so long, Maddie died. It wasn't the cancer that killed her; it was meningitis. In the space of a few short hours her body gave out and she went to Jesus curled in her papa's arms.

Suey was, understandably, shattered. She's poured so much of herself into these kids, and to be blindsided by something like this, to watch a piece of your heart be torn out with no warning at all? It was more than we really knew what to do with. So we did what any pediatric nurses would do. I grabbed some sweet-smelling baby soap, and Suey washed her little body. We dressed her in a fresh, pink dress and wrapped her in a blanket that someone in a church far away crocheted and sent to us.

When we were getting ready to take Maddie home, the gravity of the situation struck us. This child had just died of an incredibly virulent illness, and her one-month old little brother might have been infected. So, for that matter, could any of the adults and children who lived in the same compound as them. I ran to pharmacy before it closed and got the end of a bottle of antibiotic tablets. We mixed an injectable form for the children and threw supplies in a brown paper bag; needles and gauze and alcohol wipes. Our weapons against death.

We wended our way through the streets of Cotonou, Maddie's papa holding her in his arms. I saw his shoulders tense, shielding her against the bumps, and when the car stopped at a light, he started to rock her gently back and forth, back and forth.

I have no way of describing what happened when we got to her house, no frame of reference to put it into. Relatives and neighbours crowded into a hot room as Maddie was laid on a couch. Her grandma stared me straight in the eye and told me there was no way it was true. That Maddie couldn't be dead. People streamed in and out while women clapped and sang and prayed for resurrection even as they made phone calls to plan for Maddie's burial. And somewhere in the midst of it all we found a quiet moment to explain about the infection and hold out our little packet of pills.

They lined up, hands outstretched to receive the pitiful solace we had to offer. And then we moved to the next room over where I sat on a concrete floor and drew up injections, handing them to Suey as she worked quickly to shield the babies and children from Maddie's illness. And through it all Maddie's mama sat on the couch, Abdul in her lap, her eyes empty.

I felt so small, so utterly insignificant in the face of it all. And that's when God reminded me of His love, of His concern with every single tiny little detail of what happened yesterday.

You see, in our haste to be on our way, when we threw our supplies in the bag and emptied out the bottle of pills, God was there. I had exactly enough pills for each adult in the compound, with one left over for Suey. I had exactly the right number of syringes and needles for the children, exactly enough antibiotic liquid that I drained the bottle when I drew up the final injection. In the midst of the overwhelming emotion and feelings of inadequacy, it was like God reached down and whispered in my ear, You see? I'm here. I won't let you fall. I know what's happening here. I know. Trust Me. And so, when it was all over, I walked back to the Land Rover with a light heart. Because Maddie is with Jesus, and He is there with her family.

Please pray for Maddie's family. Her mama and papa have been fighting for so long that they're not going to know what to do now that the battle is over. Pray for little Abdul, who has to grow up without knowing his big sister. And pray for Suey. Working palliative care, it's expected that her patients will die, but this one was hard.

I stopped by Dr. Gary's office for a chat today, and as I walked in I saw a sheet of paper stuck to his door with one of the ubiquitous magnets. (For those of you who don't know us, everything on this ship is made of metal, so everything gets held to the walls and ceilings with magnets. Many, many magnets.) At first glance, it looked like a black and white figure eight. I looked closer, and saw Oceane's name printed across the top.

It was a printout of one of the images from a CT scan that had been taken before her surgery on Tuesday. Her head was at the top of the screen, her brain pushed aside by the collection of fluid inside her skull. At the back of her head, where the bones of her skull should have been a smooth, unbroken line, there was a gap. The computer had measured it: 1.4 cm. Hardly anything, you might think, but that gap had allowed fluid to pour out from around her brain, pushing the skin at the back of her head into a massive balloon. The bulge at the back of her head was bigger than her head itself.

Dr. Gary and his team performed two operations on little Oceane this week. On Tuesday, they peeled back her skin and stopped that hole, and on Thursday they threaded a small tube under her skin from her brain all the way down into her belly. (That tube will keep the pressures in her head where they belong by acting as a release valve, absolutely necessary since he had closed the hole that had acted in the same way before.)

All that is a lot of medical mumbo jumbo for you if you're someone who doesn't normally take care of neurosurgical cases, I know. And I'm not trying to get you to totally understand what they did for her. Just know that it was an operation that would have been risky in any circumstances, in the most advanced hospital in the world.

I asked Dr. Gary why he had that particular picture stuck to his door, and he shook his head with a quiet smile.

I don't want to forget, he told me. There's something so much bigger than us at work here. We can work so hard, and we can do a good job, but ultimately, it's not us. There's something bigger.

And so, when I wandered on to the wards a little later and saw Oceane in her mama's arms, her now-tiny head wrapped in clean, white gauze, I couldn't help thanking God. Because when I stuck my finger into her little hand and she turned to me and her face broke out into a huge, baby grin, I knew that Something Bigger had been hard at work.

Colton Jack was born at 3:30 EST, and he's perfect. He weighed in at a hefty eight pounds, eight ounces, and he looks exactly like his daddy.

Everyone is doing well, and I can't wait for Christmas when I'll get to hold him in my arms, instead of just my heart.

Welcome to the world, Cole. You're going to love it.

Growing up, we were six. My mum has a brother and a sister, and within about four years of each other, each family had produced two girls. Two of our cousins lived far away, in Nova Scotia, but the other two were within a day's drive, up in Toronto. We spent every holiday together. Any long weekend was an excuse to pack into the van in the early hours of the morning and head up to see the cousins.

As time went by, my sister and my cousin Sarah gravitated towards each other. Both with their long brown hair, we used to call them the twins, and they reveled in the name. That left myself and Rachel to hang out together. It made sense to us; my middle name is Rachel, and so we fit together.

We were an unlikely pair. I was tall and brown-haired and awkward. She was a tiny, red-haired pixie, graceful and athletic. But it worked. Rach and I were best buddies growing up, and when she married my friend from first grade and moved to the States, just down the street from me, it only got better. There are some people who have never met their cousins, people who aren't close to them at all. In our family, cousins are sisters.

And this afternoon, my little red-haired sister is having her first baby. She's in the hospital, her husband and mother at her side, and I'm an ocean away waiting for news.

I know you don't know her, and you don't love her like I do, but I'm bursting with this news, and I just have to share it with someone. Because that ocean feels pretty wide right about now.

Back in the States, when I was a nurse in the Pediatric ICU, discharging a patient to the floor meant that they were well enough that they didn't need the specialized care in the ICU. We would take out all the unnecessary tubes and wires, pack up all their stuff, wheel them to their new room and hand off to the new nurse. It was always a good thing, going to the floor. It meant you were getting better.

Here, things are a little different. I discharged a patient, Donald, to the floor today. He was a little boy who had had surgery on the same day as his mama. Both had tumors removed, but Donald's was much smaller and his healing is almost finished. We took apart his chart and filled out his discharge papers, but that's where the similarities ended. We then proceeded to stick a note to the wall above his mama's bed, reminding the nurse taking care of his mama that he has some staples to be removed on Friday, please. We made up a mattress with sheets and pillows and blankets and we slid that mattress right under his mama's bed. Which is where he'll be staying until she's well enough to go home, too.

When I say he went to the floor, that's exactly what I mean.

The ladies are back.

A Ward has been filled with a sense of anticipation for the last few days as women wrapped in their best lappas have shuffled in and out, answering endless questions about their medical histories. The stories vary, but the end result is the same; I was pregnant, and now I am wet. Some ladies come with babies and little children, but these are the rare ones. Mostly, they share the same thing. The baby died. It was inside for too long and it died and now I am wet. When I meet their eyes, I read fear and rejection and despair and this unquenchable, overwhelming hope.

(Just know, as a caution, that I'm going to get slightly graphic in this paragraph. Not so much information for the kids.) Women with obstetric fistulas (we call them VVF ladies, as an umbrella term) are the modern-day lepers. During a prolonged and difficult labor, the pressure of the baby's head against the bones of the pelvis causes soft tissue to die. When the baby is finally born (almost always dead), the woman is left with gaping holes between her bladder and vagina. The rectum or urethra or any combination of all three can be affected. This, effectively, tears a woman's life apart, because when she develops a fistula, a woman becomes an outcast. Often, she is turned away from her family. Her husband leaves her and she lives on her own outside the village, smelling of urine and feces. Unable to stop the flow of her humiliation.

Maybe you've never heard of vesico-vaginal fistulas (VVFs). I'm not surprised. It's a problem that's almost unheard of in the developed world, where woman have access to medical care and hospitals and cesarean sections when things go wrong. Here in developing nations, it's estimated (by the WHO) that fifty to a hundred thousand women every year develop fistulas. There are over two million living with fistulas. And there are only about thirty thousand surgeries being performed every year.

You do the math.

We're standing in the gap in one of the biggest battles you can imagine. We've screened and selected twenty-one ladies. Twenty-one, in the face of a hundred thousand. I look at the statistics and I want to cry, knowing how many more will go to sleep tonight, weeping her shame as the bed underneath her grows wet again.

But for these twenty-one, we are offering the world. We are offering love where they have known rejection, acceptance where they have known disgust. We are going to try and put back together the ruined pieces of their lives, and I've got a front row seat.

The first lady came back from surgery this morning. She rolled into the ward on the OR stretcher, grinning at anyone who would look her way. I grabbed her chart and flipped to the operative report. Words like excellent, and full closure stared up at me, and I grinned as her nurse tried to straighten out the absorbent pad on the bed. The nurse smiled back at me. We might not need this.

Because this lady, and twenty more, might go home dry.

(For more on VVF, there's an amazing documentary about the fistula hospital in Ethiopia. If you've got a big enough stock of tissues, go check out A Walk to Beautiful.)

I don't really know this kid. I've been in charge of A and B Wards for the past month or so, and his bed is in D Ward. I'm not sure what his name is; all I know is that he had an encephalocele repaired last week, and that he sports a sweet, Rambo-style head bandage.

I met him while I was walking down the hall on Friday. I was busy, not really paying attention to what was going on around me. Truth be told, it was kind of a bad week. I didn't work less than ten hours any of the days, and I was exhausted by that point. I was focused on my next task, and so it surprised me when I felt a tiny hand slip into mine. I looked down into his huge brown eyes. They were crinkled at the corners while he grinned up at me, and there was no way I was going to pass him by.

I stopped in the middle of the hall and gathered him in my arms. He responded by placing a huge, juicy kiss on my cheek. My tiredness lifted, and I kissed him back. It's one of the things I love best about this place; it's not considered a breach of etiquette to hand out smooches to the small children in your care. (At home, they'd be calling for your job.)

I was getting ready to go back on my way when I felt my chin gripped in a tiny vise. The cheeky little monkey had his fingers dug into my skin and was trying to turn my face so he could plant one on my lips! I pulled away and shook my head. Eeyo, I told him. No. I didn't know how to explain it all in Fon, so I put a finger on my lips and shook my head with a frown. I touched my cheek and smiled to let him know that it was safe territory for his kisses.

He looked so confused for a second that I was afraid he was going to burst into tears. His face cleared, though, when he figured out a way around the system. His three-year old grin was absolutely impish as he kissed his own finger and then turned and pressed it firmly on my lips.

I dissolved into laughter and he scampered off down the hall, probably to find his next girlfriend. And my day was officially made.


(Photo by Meg Petock.)

Today was strange. I know I've been here for a while, and maybe I should be used to it by now, but I still struggle with the vast disparity of emotions this place brings with it. It's so hard to find my footing when I'm swinging between two extremes, hope and despair in beds on opposite sides of the wall.

Ismatou is twenty six years old, her neck swollen by a huge goiter. She came to us earlier this year, but was too sick for surgery. Sent home on medication and told to come back in a few months, she showed up at the ship yesterday full of hope. During routine pre-operative screening, we discovered that she was pregnant, which she staunchly denied, pointing to her one-year old little girl as proof. The evening staff gave her a bed for the night, and it fell to me to sort it all out this morning.

It's simple, really. Based on her last screenings and the information she could give us, her pregnancy was early in the first trimester. There was no way we would risk her baby's life to perform the surgery, and with the outreach drawing to a close, there's no time to reschedule her. I got to tell her.

She cried and she begged, falling to her knees next to her bed and holding her hands out to me, pleading for me to do something. To find a way for her to have the surgery. Her eyes were haunted and her fingernails dug deep grooves in her skin as she clawed at her neck, trying to tear out the curse she's living under. Tante Alice, she told me through a translator, you don't understand. I am ashamed. How can I continue?

I told her that she needs to be strong for her children, for the little girl staring at her mama with wide, frightened eyes, and for the baby growing inside her. She asked if she could come back on Monday. I will come back and I will not be pregnant. She doesn't have money for surgery at a local hospital, and so I know that the abortion she was thinking of having would be performed in a back alley somewhere. I told her, no, that she shouldn't come back, that we would not schedule her for surgery, hoping against hope that she would realize that an abortion was pointless. She dropped her eyes from my face and flicked her wrists, palms-up. So then it is decided. I will go home and I will make a poison and I will kill myself.

What can you actually do when faced with despair like that? I have no clue what she suffers, not the faintest idea of what it's like to go through life with a huge tumor on my neck, considered cursed by the people who see me. I had no words of hope to offer her, nothing to say that would give her a reason to live, and yet I was sending her out to face the world again. Alone.

So we prayed and we cried and she asked a few more times. And then she grabbed her child, tied her roughly to her back and was gone.


And then, on the other side of the wall, a shout went up. Nasif is a little seven-year old boy whose jaw had been frozen shut after an infection while he was a baby. He had surgery two days ago to graft some cartilage from his rib into the joints in his mouth, and he was trying out his mouth exercises when he discovered that he could do something he had never done before.

I rounded to corner to see a little imp in a purple, flowered gown, sitting on his bed surrounded by adoring fans. His head was wrapped in clean, white gauze, and everyone was cheering like he'd won a gold medal when he showed them his new-found skill.

Que est-ce que tu peut faire, I asked him, since I had missed the big show. What can you do? And in typical little boy fashion, he smiled and stuck his tongue out at me.

It's the first time in his life that he's ever seen his tongue. He knew he had one, but it was locked away behind teeth that didn't move, and now for the first time, he can open his mouth and smile and put a spoon straight in when he eats. And he can stick out his tongue.

So tell me, if you can, how I'm supposed to feel right now. I saw absolute despair and pure, unadulterated joy one after another today, and I'm just not sure where that leaves me.

In a French-speaking country, it's always a welcome change to have patients who actually speak English. It makes me miss Liberia something fierce, where I could always chatter away with my kids and their mamas, but I take what I can get around here.

Right now, A13 and A14 are home to a lovely mother-son pair from Nigeria. They speak English, and the little boy is appropriately comforted when I pat his back and tell him sorry, yeah? During report this morning, we heard that his mama needed an IV. Multiple attempts the night before had been unsuccessful, and so the lot fell to me for the final try.

Since we spoke the same language, we chatted while I got my things ready and started looking for a vein. My search turned up a sad dearth of possibilities, and given the sheer number of times she'd already been "jabbed" (as she put it), I figured I'd let her know that my own chances weren't the greatest. I explained all about valves, using the analogy of a door, shut tight against my needle. She nodded in understanding, her eyes wide as she peered at my Yovo hand, which I was using to demonstrate. (White skin has the advantage of letting veins show through nicely. My husband says I'm transparent.)

I tied the tourniquet, swabbed her arm with alcohol and looked up just in time to see her squeeze her eyes tight shut. She lifted her free hand to the heavens and proclaimed a blessing over my Yovo hands with the fervor and gravity of a Southern Baptist preacher.

In the name of JESUS, I pray that the door will be open to your needle! Amen!

I added my own amen, and stuck in the needle. Unfortunately, the door remained shut and locked, and I failed miserably, having to call the OR with my tail between my legs and explain why their patient would be coming to surgery without her precious cannula.

I appears that Jesus was not sanctioning IV starts this morning.

I can honestly say that I never thought my life would include things like sitting in a stadium with twenty-five thousand other fans, watching a World Cup qualifying match and cheering frantically for Les Ecureuils. Fortunately, I was wrong.

Yesterday, I got to watch Benin triumph over Ghana 1-0 in the last minute of extra time. I paid five thousand Cefa (about ten USD) to sit in a white plastic garden chair, surrounded by Beninoise people dressed in various shades of yellow, green and red. Not to be outdone, HoJ and I donned our jerseys and blended in with the crowd. (Well, more accurately, he blended. I stuck out like a sore thumb. As usual.)

The atmosphere was like nothing I've ever experienced. The fans were almost universally well-behaved, perhaps in part due to the presence of at least half of the Benin police force carrying tear gas guns. (Maybe not half, but during a quick count at one point, I saw a hundred and twenty uniformed officers around the stadium.) An entire section was fenced off and housed the Ghana supporters; I don't think they ever stopped jumping up and down during the entire ninety minutes. Our section, however was not to be outdone.

You know how, when you watch a sports game on TV, you kind of know when something awesome is happening because you can hear the noise of the crowd start to swell? I'm pretty sure this was happening at the Benin-Ghana game, too, but that's going to be purely a guess. You see, we ended up sitting directly (and when I say directly, I mean I think I got hit in the head with a drum once) in front of the West African equivalent of a marching band. Really it was nothing more than a bunch of guys with rusty, dented trumpets and a trombone. The percussion section consisted of a few African drums (obviously painted yellow, green and red) and some metal shaker things, similarly coloured. The less important members of the group just got two pieces of wood to smack together, and thus the band was born. I am not even exaggerating when I tell you that they stopped playing for all of about two minutes during half time. The rest of the time, from warm-ups until the final whistle, was one long celebration. The drums were ear-splittingly loud, and I heard a few worship songs thrown in there among the more traditional Allez les Ecureuils fight song.

And when Benin slipped the ball in off the post with about thirty seconds left in extra time? I have never heard a more joyful celebration in all my life. We drove home, our taxi driver winding his way through back alleys lined with throngs of people who just wanted to be in on the action. Every time they saw our yellow jerseys through the windows they screamed and cheered, and by the time we got back to the ship, I felt like I was the one who had scored that goal.

It was just what the doctor ordered after a tough week.


(All photos are courtesy of my good friend Murray.)

I've been sitting in front of a blank screen for a while now, wondering how on earth I can type when words are the farthest thing from my mind. It's just a constant loop, running images of his face, while I sit here and wish you could have known him.

Daniel Ossewanou was one of our translators. When I got back to the ship in June, I headed to the wards for my first shift and it wasn't long before I heard the sound of a trumpet and a guitar. Understandably confused, I searched the ward until I found a tall man dressed in African cloth, strumming away. The guitar mystery was solved, but I couldn't find the trumpet. I turned my back and heard it again, and when I looked back, I saw Daniel, a wide grin on his face, clearly enjoying my confusion. He winked, pursed his lips and all of a sudden I was hearing the trumpet accompanying the guitar. Patients forgot their pain and sang along and that's how I met Daniel.

Daniel was married. He celebrated his seven-year anniversary on October first, and he and his wife have two little girls. Yesterday, on his way to his second job, Daniel's motorbike was hit by a truck and he was killed.

We are undone. I'm okay when my patients die; it's expected, sometimes that babies so sick will go back to Jesus. But not Daniel. Not my trumpet-playing friend. He was young and healthy and so much in love with his God and his wife, and it's not fair that his little girls will never get to see their daddy again.

I stood with the rest of the translators yesterday while we broke the news. My friends wept in my arms and I had to be strong for them while my own heart was shattered into a thousand pieces. I watched the men and women I work alongside every single day crumple, folding in on themselves as they understood what we were saying, and with one voice they asked why.

We cried and prayed and read Scripture, and then Mathieu, one of the other translators, lifted his voice, cracked and broken, and began to sing.

Merci, Seigneur. Merci.

All around the room, people added their voices, joining together against the pain.

Thank you, my Lord. Thank you.

Right now, I have nothing else to say but a prayer of thanks to my God. I am so grateful to have met Daniel, to have worked alongside him. I have been so blessed by his love, by his grace and by the music that she shared with us. As much as I wish that my heart wasn't broken right now, I'm so thankful that I knew him.

Please pray for his family, especially his wife and little girls. Pray for the nurses who knew him and for the other translators who worked so closely with him.

And when you see your loved ones tonight, hold them close and tell them that you love them.

I'm in my cabin eating lunch, and I should really be heading back to the wards, but I need to tell you what happened this morning.

I was putting away some supplies when the eye team nurse came in to remove the patches from Oriace's eyes. He twisted and wiggled and cried, doing everything in his power to let us know that he really wasn't a fan of the tape coming off his skin. When the gauze was peeled away, he screwed his eyes shut against the light, absolutely refusing to open them. His mama looked up, worried, and we smiled back down at her, explaining that we would wait. That eventually, Oriace would be curious enough that he would brave the day. It happened after a couple of minutes.

First the left and then the right, his little eyes ventured open. His brow furrowed and his head wobbled and his arms flailed and we couldn't tell if he was seeing. Mama's eyes implored; can he see you? Oriace answered us in typical baby fashion when his wildly waving arm came a little too close to his face. Immediately, he went totally still, his tiny body tense. He moved his hand to the side, following it with his eyes, and his mama started to laugh. He did it again, and so did I.

Little Oriace spent the next ten minutes absolutely enthralled by the sight of his own hand. He followed it with his new eyes as he waved it back and forth, back and forth across his face. Finally, apparently satisfied, he popped both thumbs into his mouth at the same time, his curled fingers making the shape of a heart in front of his nose.

Seeing a child see for the first time? That, my friends, never gets old.

I love cataract patients. The ones we see on the wards are invariably the children, since adults undergo the procedure without general anesthesia. Kids, on the other hand, can't be trusted to stay still while a scary yovo doctor is fishing around in their eyeballs. (Go figure; there's something about logical thought that those little babies just don't get.) We're doing plenty of cataracts these days, so there are always a few little blind kids sticking close to their mamas' sides.

Today, things were busy. We've got patients from four different surgeons in A Ward, and patients are rotating from the operating rooms to the recovery room and back to the wards with dizzying regularity. A nurse is often just settling a patient after surgery when the operating room calls for another to be brought to the waiting area, so teamwork and flexibility have become the ongoing theme. As the charge nurse in A and B Wards on busy days like these, I tend to feel more like an air traffic controller than anything else.

Our pediatric nurse today, Becca, was at the centre of the whirlwind. The general rule of thumb is that surgeries are scheduled with the youngest patients first. (It turns out that, in yet another breakdown of logical thought, they don't do too well with being denied food, albeit for a good cause.) Three of her patients were first on the list in three different ORs, and they all seemed to go and come back within about five minutes of each other. At one point, she had just tucked in one patient and was waiting while another was wheeled back down the hall when the next OR called for yet another of her babies.

Becca's good, but she hasn't yet mastered the art of being in more than one place at a time, so I bundled the cloudy-eyed baby up in a fleecy blanket and walked with him and his mama down to the waiting area. I settled her onto the bench, her baby determinedly sucking both thumbs at the same time. As I stood there with the chart in my hand, the mama looked up at me with an expression of naked fear on her face.

I forget sometimes just how scary this must be. What kind of desperation does it take for a mama to walk up the gangway and willingly surrender her flesh and blood, to place her heart into the hands of strangers? My eyes clouded too, then, and I dropped to my knees to explain that she was doing the best thing for her boy. That bringing him to us while he's still small means he has the best chance of having optic nerves that actually work once his cataracts have been removed. That his young brain will be able to learn the sights of his world so much easier than if she had waited longer to gather her courage, like she so clearly wished she had.

The nurse from the operating room came out then. We checked him in and prayed together, and as she carried the blanket-wrapped bundle through the door, I waved. See you tomorrow, baby! The translator standing with us relayed my words, and the fear drained from his mama's face. Her smile broke wide and bright, and she threaded her hand into mine.

No, she told me. You will not see him. He will see you.

I don't usually post on the weekends, but here I am, Saturday and Sunday, throwing out a little something to my faithful readers. (Hi Mom!) I wasn't planning on writing today. In reality, I didn't have much of anything planned. I'm on call for the wards this week, and my pager keeps me in a pretty small radius. (Out to the dock to throw away trash is about as far as I venture.) I spent about an hour sitting outside on Deck 8 yesterday and paid for it with a bit of a wicked sunburn, so I wasn't even planning on going that far. In fact, the most exciting thing I had planned was a deep clean of my bathroom.

I'm happy to report that that task has been accomplished, right down to a freshly washed shower curtain. There are few things I love more than the smell of fresh laundry, so I'll admit that I spent longer than was really necessary re-hanging that thing, taking frequent breaks just to smell it. (Not that I'm crazy or anything. Seriously.)

When I came back out into the cabin, I smelled something that rivaled the fresh laundry scent of the shower curtain. A friend of mine refers to Phil as The Husband of Joy, and right then I couldn't think of anything else to call him. On the desk that doubles as our table was a bowl of fresh potato greens and rice, our all-time favourite dish from Liberia. The HoJ was at the counter, squeezing the last of a pile of oranges into the bowl he was using to make fresh orange juice, and that, my friends, is all you need for a perfect Sunday lunch.

It might not seem like much to you, but on a rainy Sunday in Benin, I got to go back to Liberia, just for a little while. I closed my eyes and saw the country where we fell in love, the broken buildings and torn-up streets. I could almost smell the salt air of the beach where I sat with him and knew that I would say yes if he asked me.

I think that beats a fresh shower curtain any day.