baby o'brien

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.

I'm sad right now. O'Brien's going has left a bigger hurt in my heart than I thought it would at first. I keep thinking about him, about his poor, broken mama going home with empty arms. I can't stop replaying those last few moments of his life while he slipped away and we just watched him go. I still have the photos of him on my computer, and I keep stumbling across them and a wave of pain just washes over me again.

And then yesterday. I heard my name shrieked from the ward where they were doing a surgical screening, and I stuck my head in to see Antoinette, a patient from last year in Benin. I sat down to talk with them, as far as we can talk with my few words in Fon and her few words in French. We hadn't been there long when mama beckoned over a translator. We usually muddle along just fine without one, so I wondered what she needed to tell me.

She spoke a short sentence or two, and the translator turned to me with no preamble, nothing to prepare my poor, bruised heart. She says that baby from last year died. I think the one named Maomai? No explanation, no other information. Just a baby who was fat and happy and smiling in my arms the last time I saw her, and now for some unknown reason, has died.

I don't even really know what to write. I'm sad and I'm discouraged, and I can't see my way forward through all this. I know I won't stop loving; that's not an option. But if loving means I get hurt like this, I have to be honest - it's hard. It's hard to know that giving my heart to a baby here in West Africa means there's something like a thirteen percent chance of that child dying before it reaches its fifth birthday. (To put it in perspective, in the States, it's more like 0.78 percent. Not even close.)

How can I love in the face of all that? How can I just open up my heart and invite the pain that's almost certain to come?

I guess it's because Maurius went home yesterday. Fat and happy and smiling in his mama's arms, and before he went, we stood in a circle and we prayed over him. Prayed that he would be the one to prove all those statistics wrong. God, not another Maomai. Not another O'Brien. Let this one live. Let him live.

Last night as I was falling asleep, I saw an image of an old man, sitting on a wooden bench, children scattered at his feet, asking him for their favourite story. And so Old Man Maurius smiles and tells them the story all over again, the one where God saves his life and he grows up fat and happy, smiling and holding his grandchildren in his arms.

I don't know if that's really what God has in store for Maurius or if it's just the cry of my own selfish heart that can't bear to hear more bad news. I do know that it's what He wants for Maurius, for each one of these precious children of His. And I know that He's entrusted me the task of loving them while they're here.

So I guess I won't be stopping any time soon.

Another little sparrow fell today.

I was on an admin day and didn't know how things were going on the wards, so around shift change I stopped by the ICU to check on O'Brien. I was met by Hannah, who shook her head, her face speaking volumes before she ever said a word. He's going, she told me, and I looked to his bedside where his mama, Evegenie, held him, the monitor showing numbers so, so low.

I knelt by his mama's side and put my hand on her knee, explaining to her that his heart was slowing down. That it wouldn't be long now. And as I spoke the words, the numbers fell to zero, and I knew that he was gone. I took the little tiny stethoscope that hung on his IV pole and listened even though I knew I wouldn't hear anything. I'm so sorry. His heart has stopped.

The tears streamed down Evegenie's face, falling unchecked onto my hands as I gently peeled the tape from his cheeks and nose, pulling out the tubes that had been hurting him for so long. We took out his IV as Evegenie sobbed quietly, making the same, wounded noises that every mama makes when her heart gets shattered.

She looked up to the translator, and asked if I could take a photo for her, and so I flew to my room for my camera. I stood by the side of his empty bed as she held him up for me to focus my lens, and I took the picture, praying that it would come out even though I couldn't see a thing through my tears.

We spent the rest of the afternoon doing all the things that you do when a baby goes back to Jesus. We bathed him and dressed him in a soft little pair of overalls. We gathered food and water to sustain her on the journey back to Benin. We made prints of his hand and foot and laminated every photo of him we could find so his mama would have something more to take home than just the little broken baby who had flown too soon.

It feels like falling, trying to make sense of all this. Like the ground has just dropped out from underneath me and I can't find a place to stand. I don't understand why our prayers made the difference between life and death one day but not another. I don't understand why so many of these children have to go back, why the only reason O'Brien died is because he was born in West Africa and not the first world.

I do know that Christ has overcome, that the victory over death has been won, whether I can understand it or not. I know that I've seen a different kind of miracle today, one where the healing is forever, not just for a few weeks.

It's just hard to fall so many times and not know when it's safe to get back up.

Today was a strange day, so full of contrasts. It's that mix of joy and heartbreak that's so common here, the mix that somehow never feels quite right.

There was Maurius, sitting like a king on his bed, propped up in a wash basin, tucked in all around with lappas so he couldn't fall down, reigning over his corner of A Ward with wide eyes and ready smiles. He's drinking all his milk by mouth now, and if he keeps this up he'll be home by the end of the weekend, fat and happy.

But then, of course, there's O'Brien in the corner across from him, struggling so hard to breathe that his tiny heart has started to fail him. And so, under the watchful eye of King Maurius, we bundled O'Brien up and made the walk back down the hall to the ICU yet again, the place where we saw his life miraculously spared just a few weeks ago.

Knowing what happened before, we haven't been hesitant to pray for healing, gathering in little groups all across the hospital to plead God for life, but miracles have been slow to appear today. Instead, we've watched as his body struggled to get enough oxygen. We've tried everything short of a ventilator (something that isn't an option anymore, given everything else going on), and still his body is failing him. We've been MacGuyver and Inspector Gadget and the Professor from Gilligan's Island, rigging up one failed solution after another to help him breathe, but nothing is really working. Right now he's wrapped up in his mama's lappa, a wire hanger twisted around to form a frame for the plastic bag, being filled with pure oxygen, that he's resting inside, and still he struggles.

I don't know what's going to happen with O'Brien. I don't know how many days God wrote into his book before he was born, and my heart trembles to think that we might be nearing the last page.

And down the hall in A Ward, after praying for our little sparrow baby at handover, we all stood in a circle with Aissa in the middle, and we danced the chicken dance. Nurses and translators and a little girl with her head all wrapped in a bandage, dancing the chicken dance right in the face of all this pain.

It's hard to get used to it.

.....

In other news, I wanted to share a photo of Liz, Aissa and I on Togo's independence day, while we had Aissa hard at work churning out those Togolese flags. (Remember; give her a task, and she's set.) It's hard to see behind the flag she's holding up, but you can catch a glimpse of the balloon tower taped to her head. She is one classy kid.

And speaking of classy, there's just one more day to register for the giveaway. Don't miss your chance to win a little piece of Africa! I've been having so much fun hearing from so many of you who don't normally comment. It's amazing to hear about people who've adopted from Africa, people who have a heart for this continent, people who've done hilarious, dangerous things and people who think that jaywalking somehow counts towards living life on the edge. (coughDinacough) I think I'll definitely be doing this again soon.

I spoke too soon about our little man Maurius. It seems so unfair that these little ones who struggle so much just to gain weight should struggle in other ways too, but Maurius has aspiration pneumonia, the same problem that almost took Obre from us. It's not uncommon among these kids; it's a wonder more of them don't suffer from it, given the fact that there's an open hole in the roof of their mouths, just inviting milk to slide down into their lungs.

We knew Maurius choked a bit while he drank his milk, but last night he started coughing even more than usual, and an x-ray showed the telltale signs in his lungs. His surgery was canceled and he was started on antibiotics and breathing treatments to help him heal so that we'll be able to reschedule his operation.

With all this going on around her, Maurius' mama sat on their bed, looking forlorn. She could almost touch her heart's desire, and yet we snatched it from her outstretched hands, and she was bewildered at how fast the plans had changed.

I don't even know her name, but that woman and I have become good friends. She delights in my open admiration of her baby, and will call me over to his bed whenever she thinks he's looking particularly cute, knowing that I'll give him all the praise he deserves. Today, though, she was quiet, openly disappointed, so I came up with a plan to cheer her up; I printed out the photo of him that I posted yesterday, the one where he looks so near death with his skin hanging off his bones.

I scrawled a note on it in a language I knew she couldn't read, and then got a translator to speak it to her in Ewe. Look how fat I've gotten! Love, Maurius. Her response was just what I hoped. Her face brightened and she jumped up, throwing her arms around my neck and slapping me on the back like we'd both just won the Stanley Cup. We danced for a moment while Maurius looked on from the bed, a slightly-wheezy buddha-bellied little man, grinning his lopsided, broken grin.

Figuring my mission was accomplished, I turned to head back to my desk, but she caught my arm and pointed to the low ceilings of the ward. We both looked up as she shared her heart in words I could understand, words I spoke with her in her joy. Akpe na Mawu. Akpe kaka. Akpe. And then she knelt next to her bed, eyes tight shut, hands folded, and spoke those words over and over again. Thanks be to God. Thank You so much. Thank You.

Even though Maurius' lip hasn't yet been fixed, we are already winning this battle. She has chosen life, and she has chosen it in the name of Jesus. In just two months Maurius has gone from near-death to bursting out of his clothes, and we know she will not stop fighting for him until she can kiss him with an unbroken lip.





And now, almost directly across from Maurius, tucked into the other corner of the ward, are Obre and his mama. He's officially out of the ICU, and the plan in his chart is simple; when he can keep his oxygen levels up without the little puff of oxygen near his face, we wait two days to make sure nothing happens and then we send him home to continue getting fat. That's it. Just wait and watch and marvel all over again at what Mawu has done and what He is continuing to do down in those wards.


(Keep praying for our little ones and for Hettie, the nurse who oversees our Infant Feeding Program. So many of the babies have been tough cases this year, and she's doing an amazing job working with them.)

When I met Maurius, he was skin and bones, just like so many of the little ones we've seen this year. His mama loved him, it was clear, but the hole in the roof of his mouth was just too big; she didn't know how to feed him.

Despite his deformity, Maurius came to us in style, dressed in the typical outfit of grown African men; a cloth suit with a button-up shirt and pajama-style pants in matching fabric. He weighed less than a newborn but was already sporting clothes far beyond his years, and the first time I saw him I burst out laughing.

Mama, I told her, when I could breathe again, you have a little man in a big man's clothes! She laughed along with me and told me that, with God's help, he would soon be big. Her faith was well-placed.

Today, I found myself drawn to Maurius' bed over and over. He ended up being admitted a day early, so we've had lots of time to enjoy a happy, pre-surgical baby. (For some reason they're never quite as much fun once they've been through the operating room.) Have you clicked on that little thumbnail to see his photo bigger? Go do it, and then come back and I'll tell you how he looks now.

Gone is the listless baby with tired eyes. Instead, he holds his head up, wide-eyed and bright, looking around the room to make sure he doesn't miss anything. He smiles at the slightest provocation, the sides of his lip splitting even wider with his grins. Where the skin used to hang in wrinkles off his bones, he's got round rolls and dimples. And instead of ribs showing, all you can see when you lift his shirt is a big, plump belly.

Tomorrow Maurius will go to the operating room to have his lip repaired. And when he comes back, we'll dress him in his little cloth suit again, a suit that's starting to get tight around the waist.

Big man in a little man's clothes.


(And, in other cleft-lip-baby-news, Obre is still doing splendidly well. He started receiving formula through his tube again today, and it hasn't caused him to have any problems breathing. We are still in awe as we watch him grow stronger.)

Yesterday, when I was writing to you about my adventures in Ghana, all I was thinking about was the little baby down in the ICU.

My office day had suddenly turned clinical when Jenn paged me. Can you help us with the baby, she asked, breathless, and then hung up. There was no question which baby she meant; Obre (or O'Brian; we're not entirely sure which name is his, since his mama uses them interchangeably) is the continuation of last week's sadness. At four months, Obre tips the scales at a hair over six and a half pounds, small even for a newborn. He has a bilateral cleft lip and palate, and was very, very sick.

Three seconds later, when I was at his bedside in B Ward, Jenn met my eyes and my heart sank as I realized that we were losing, that it all felt far too much like Baby Greg. We knelt together with Obre's nurse, holding the mask to his face as he struggled to breathe, and we knew that it wasn't looking good.

This time, though, we had something we didn't have back when Baby Greg was with us; a ventilator that can give support through a mask, the less invasive step before a breathing tube. With this huge tool in our arsenal, the decision was quickly made to transfer Obre to the ICU and let the ventilator help him breathe.

It took a long time to get him settled, and all the while I felt a sickening sense of déjà vu, watching his pitiful struggles mirroring Baby Greg's, so long ago. All that kept running through my mind was, But we lost Baby Greg. And we lost Ani. And we can't lose any more. It took forever, but Obre was finally settled and I headed to bed, fully expecting to come to work in the morning and find that he had deteriorated overnight to the point of needing the breathing tube.

Instead, the ship is buzzing with news of the miracle.

Around midnight, Obre started to spiral downwards, his heart racing and his oxygen saturations falling. His nurse, Natalie, tried every trick in the book, but soon realized that nothing was helping. She called anesthesia who called Dr. Gary and they gathered around the baby in the dark of the night. They quickly decided to intubate, since there was no way Obre would survive otherwise. Natalie and another ICU nurse, Jenny, moved to collect supplies and draw up medications, preparing for the procedure. As they worked, they looked over to see Dr. Gary, his head bowed, hands on the baby, praying to Jehovah Rophi. It was 12:20.

At 12:25, Obre's oxygen saturations increased from sixty to a hundred percent. His racing heart slowed to normal, and the bewildered nurses put down the tools they had collected. The surgeon and anesthetist slipped away, and Obre was left, requiring just a little oxygen blowing hear his face to keep him stable. No mask. No tube. No ventilator. Absolutely no medical explanation.

There was a miracle last night. My heart has been full to bursting all day long knowing that God is so absolutely here. That He cares for each little sparrow baby, knowing that this one was falling and intervening in a way that leaves no room for doubt.

As I type, our sparrow baby is either tucked into a nest of pillows and blankets or snuggled into his mama's arms, where he's been all day, breathing easily.

We had a miracle last night. Do you know how exciting it is to be able to say that?