ali's african adventures

Family is one of the sweetest things in the world to me. I had the privilege of growing up in an incredibly close family, with cousins who were like siblings, siblings who are best friends and the best parents I could ever have asked for.

Last night, those parents came to Africa.

I haven't said anything about it yet, because I share one of my family's quirks; we don't tend to believe that exciting things are actually happening until they actually are. As in, I could be planning a four-month world tour and theoretically getting incredibly pumped about it without ever truly believing it would happen. (In this case, I think I'll be in China before it ever sinks in.) So while I planned activities for my mum and dad and told everyone on the ship that they were on their way, I haven't shared it here, because I wasn't sure it would be real until I actually saw them at the airport.

And then I was at the airport, holding a piece of paper with their names (a lifelong dream of my mama's) and all of a sudden it was real, and my worlds were colliding and my heart was spinning out of control.

Driving home through the darkened streets was like arriving all over again. I saw it all through their eyes, for the first time, even though we were passing things I usually don't see. Zemidjahns packing every available space and careening down the wrong side of the road. Little wooden tables lit by flickering candles, spread with anything you might want to buy. Women with loads swaying on their heads and a man carrying a string of shoes. I pass by all this every time I leave the ship, and two years has bred such a familiarity that I have stopped noticing.

Last night, it was all new again. I felt each bump in the road, my heart catching in my throat as the other cars came far too close. I wondered again what each little stall was selling, where the sellers lived when they packed their wares away at night, whether the children at their feet were ever going to get to go to school.

I saw it all, and it was all new.

And down on D Ward, there was another family today. A mama and a papa and their two girls, Amavi and Kossiwavi. Amavi is the proud big sister to baby Kossiwavi, twelve years to the baby's nearly-one, and she grinned from a lip split wide when I admired the little one. Papa is sleeping under Amavi's bed, mama with Kossiwavi, and all three of the girls have cleft lips. Mama has already had hers fixed here in Togo in a series of surgeries over a number of years.

Today, the girls had their lips repaired.

Kossiwavi went first, in the usual youngest-to-oldest style of the OR list, and so she was back to the ward before the morning was over. I was going about my work a little before lunch when I looked up and over to the corner where the little family is staying.

Amavi was lying half out of her bed, her neck twisted around to catch a glimpse of her sister. On the other bed, mama and papa sat staring down at their baby, their eyes wide with wonder. Kosiwavi lay sleeping on top of the blanket, tiny steri strips covering the neat row of sutures holding her lip together, and together they all stared at the baby.

A few hours later I got to be in the operating room, standing next to my own parents, while the three of us stared together down at Amavi's lip while the surgeon began making the cuts that would allow him to put her back together, too. For the first time in over two years, I got to share this place with the people I want most desperately to understand it, and for the first time in over two years, I know they finally do.

The only thing that could have made it better would be having my own little sister here.

There are moments in the wards here that I wouldn't pass up for the world. Some of those are poignant; the first time a woman looks into the mirror after her goiter is removed. The first, shaky steps on newly straightened legs. Kisses from a freshly-mended lip.

Some of the moments are far less profound, but no less memorable. This week has provided several of that sort.

For example, there was what happened today around Bed Six. The old man who sleeps in that bed just had a large tumour removed from the side of his face. We heard from the admissions nurse that he was blind, so, even though he's not a child by a factor of about sixty years, we allowed him to be admitted with a caregiver.

This morning, Natalie was getting ready to teach our old papa how to do his mouth care. She handed him a little cup of mouthwash and asked the translator to tell the man to use the green swab. But he is blind, the translator replied. He cannot see that. Natalie took this in stride, despite the fact that she clearly have rather known this information in advance, and asked the translator to tell the caregiver, who could then relay the message to the patient in whatever way was easiest for him to understand. That's why she was allowed to stay, wasn't it? To help out?

Imagine the sheer hilarity when, after the translator finished speaking, the woman made a face and gestured to her ears, shrugging her shoulders and moving to sit back down next to the bed.

It would appear that we admitted a deaf caregiver to help care for a blind patient.

(In our defense, on further examination, it turned out that she was only deaf in the figurative sense of the word; her ears work just fine, but they can't hear any of the languages our translators speak, so we're pretty much back to square one there.)

A couple days ago, we had another such moment, one where we look around, shake our heads and wonder aloud whether or not this could possibly be our lives. I have photographic evidence of this one. Emphasis, perhaps, on the graphic.

First, a little medical background. Each of us has fluid surrounding our brain and spinal cords. This fluid helps cushion our important parts and acts as a barrier between them and the outside world. This fluid is supposed to stay put, and when it leaks out of, say, a nose, this is A Very Bad Thing. One way we nurses have of testing whether the drainage from a nose is this fluid, known as CSF (cerebrospinal fluid) or just plain old snot, is to test it for sugar. CSF contains sugar. Snot does not. Or so we thought. (And I'm apparently Dr. Seuss.)

This week, we had a patient who was maybe leaking CSF from her nose. Seeing as how we live on a ship in Africa, our testing options are limited; the only thing we have to test for sugar with is a strip that's actually used to test urine. And since this particular patient's test was only coming up faintly positive, it led us to wonder just how much sugar was too much. Was there, for example, just a little bit of sugar in the normal nose? How would everyday snot test? Was this just a cold, or a sign of something much more ominous? There was only one way to find out.

And so, for a good half hour after my shift was over, we stood around blowing our noses onto little plastic strips, cutting out the relevant test square and taping them to a sheet of paper, along with notes that we felt were relevant in this incredibly scientific study.

Ali apparently has a CSF leak.
Beth, left nostril.
Katie. American. Right nostril.
Ali. Take two at not having a CSF leak.

To his credit, the surgeon did not, in fact, laugh in our faces when he was presented with his gift later on that evening. I'm told he even had the grace to appear grateful.

I'm not sure I would have gone that far, but I am glad that this is my life, as crazy as it sometimes is.

I sat at my desk this morning, running through the list of admissions for surgery tomorrow. Far too many for far too few beds, and I was reading without thinking until his name stopped me short and my heart fell out of my chest again.

KETOYE, O'Brien, the entry read. Repair of cleft lip.

We entered him into the database weeks ago, while he still had a chance. While we still thought the miracles were going to win out. We scheduled him for the very last week that Dr. Gary would be operating during this outreach, gave him every chance to grow and get fat, every chance to be ready.

Instead, the sight of his name brought me to tears, while all around me moved nurses who had never met him except through our words on virtual pages, and no one could really understand why it hurt so much to look across the room at the corner where I knelt next to his mama and pulled the tape from his tiny, still face.

This place changes around me too quickly, and I am left at my desk, my heart around my feet, wondering how it all went so wrong. How we could have lost him after all that love poured in. How his name in black and white in front of me this morning was enough to knock me off balance for the better part of the day.

How it's close to eleven at night and I'm not sure my footing has steadied yet.