fourteen

What do you think?

Dr. Gary asked me that question so matter-of-factly, standing in the hall outside the OR office. Like my opinion would count in all this confusion. Like I would somehow know what to do. Like anyone could really know.

What do you think?


The day had started out less than desirably. Today is the presidential elections here in Togo, and as a result there are travel restrictions and the potential for civil unrest. We worked with a skeleton crew of translators, only one for each ward, and brought all the patients we wanted to operate on through next Tuesday onto the ship yesterday. The result was somewhere around fifteen or twenty admissions, all in various stages of paperwork with no fixed plan as to when they would be going to the operating room. It's usually a big jigsaw puzzle around here; the elections just magnified that exponentially and the result was something that felt vaguely like chaos.

Among the things that slipped through the cracks from the admissions process was a pregnancy test on the little fourteen year-old girl in Bed Seventeen. Since everyone was pitching in and helping out, her nurse sent off the sample to the lab this morning, expecting to be able to call the OR and get her scheduled for surgery to straighten her leg when the results came back.

The lab technician slipped through the door a little while later, her face ashen. I just need to make sure this is the right patient. Please tell me it's not. We compared ID numbers with what was marked on the slip and confirmed the truth. My little teenaged friend was going to be a mama.

Which is where it all gets heartbreaking and where I'm not sure I'll sleep well tonight, thinking of her down there on the wards. Normally we'd just say no. It's incredibly risky to give a pregnant mama general anesthesia in the first trimester, so sometimes for small procedures we'll hand out an appointment card and some multivitamins and tell them to come back in a few months. But in a few months the orthopedic surgeons will be long gone and this little girl will be sentenced live life a cripple, her foot twisted and her leg bowed inwards.

So when I stood in the hall and explained all this to Dr. Gary, our Chief Medical Officer, all I wanted was an answer from him. Yes or no, just don't make me be involved. Don't make me weigh a little girl's future against the future of the baby inside her. Don't make me give an opinion when I can't see straight through eyes blurred by these tears. Don't let me help you decide, because what if we decide wrong?

What do you think?

In the end, I don't know what will happen. There are doctors and anesthetists and surgeons all consulting with one another, trying to come up with a way to do the surgery without general anesthesia, trying to find a way to give both these little ones a future.

And tomorrow, when I go back to work in the morning, we're all going to have to sit down together and decide.

What do you think?