alfred

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.

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

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

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

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

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

Hi Bady.

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

to Anut Ail Walk

From Alfred.Mather.Scinetist.Renner

translation (as near as I can figure):

Hi Baby

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

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

To Aunt Ali Wilks

From Alfred Matthew Scientist Renner

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

Because baby, I'm shining like the sun.

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

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

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

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

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

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

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

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

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

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


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

I forgive you.

I guess the chicken foot was worth it after all.

I realized something just now.

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

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

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

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

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

Can you handle just one more story about Alfred?

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

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

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

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

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



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

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

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

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

Today was one of those shifts where everything is funny.

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

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

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

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

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

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

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

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

---

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

I'm glad we're friends now.

---

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

---

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

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

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

We're so in love.

There is too much to share. Here are a couple more stories.

I spent my two shifts this weekend happily ensconced in B Ward with my wailers. They vacillate between best friends and mortal enemies at the drop of a rattle. But in between, they play and snuggle and crawl around the ward with their little casts banging against the beds and walls. And I love them.


Saturday started like any other. Iron and vitamins all around. Assessments and vitals and over to A Ward to steal some supplies. While talking with the charge nurse, I overheard that President Sirleaf's son was coming to the ship and would be stopping by B Ward. This didn't register until several minutes later when I was standing there shaking his hand, introducing him to all the patients and walking him through the process for surgical correction of club feet. At which point I realized who it was I was talking to and said the first thing that came into my mind.

Your mom is an amazing woman.

Smooth, Wilks. Really smooth. I just said your mom to the son of the president of Liberia. But he agreed with my assessment. Yes, she really is. And she put this on my calendar for me today. Told me, 'Don't forget! You have to go to the ship to visit!' Just another example of how surreal life on board this ship can be.

I also met Alfred on Saturday. He said he would like me to tell his story. Alfred suffers from Proteus syndrome, an extremely rare disorder (rare in the sense that the chances of being born with it are literally about one in a million) that causes overgrowth of skin and bones. You might be familiar with Proteus syndrome in relation to the 'Elephant Man' John Merrick, a circus sideshow in the late nineteenth century. There are only about a hundred or so cases worldwide, and Alfred is one of them. His right femur has been growing too fast, along with the toes on that foot. Two days ago, Alfred had his femur shortened and some of the growths taken off his foot. On Sunday, he went to church on the ward and he gave testimony.

My name Alfred. Praise God. Before I came here, I was having a problem in my leg. Now I had a operation and the doctors they fix it. I want to thank God. I want to thank Mercy Ships. I want to thank my nurse here.

After church, the doctors came to see Alfred, and they removed the dressing from around his thigh. He was disconcerted by the swelling in his leg, more than a little concerned that it was so big. As far as he could tell, the doctors hadn't really fixed the thing after all; it was still so different from the other one. We told him that it was alright, that the swelling would go away. He was clearly skeptical.

In standard little-boy fashion, he had to prove this for himself. Starting with his good leg, he used the span of his fingers to measure the distance from hip to knee. Head bent in concentration, he did the same on the other leg. Paused for a long moment. Looked up at me with eyes so full of wonder I almost started to cry.

It's the same.

If I live to be a hundred years old, I will carry moments like that with me until the end.