brokenness

We couldn't do it.

The discussions went on through the morning, with doctors weighing pros and cons and reviewing x-rays and trying to see their way clear. But at the end of it all, the message was delivered to me in the ward. It's a no. We can't do the spinal, and her condition's not bad enough to risk it under general.

And yet again I'm faced with the reality that where you are born so often determines the course of your life. Because this little girl was born in a village in West Africa, there was nothing that could be done when her parents saw that her leg was twisted. Because Togo has just one doctor for every twenty-five thousand people, there was nowhere to go, no way to have it corrected.

It feels so wrong that we started to show her a way out, allowed her to hope maybe for the first time and then were forced to pull that hope out from under her and pray that she doesn't break when she falls.

I could see the tears in her eyes when she left today, dressed in her Sunday best, the clothes she had picked out to come to the ship for the surgery that she isn't going to get. I watched her walk slowly down the hall, her head weaving side to side with the broken rhythm of her walk, and I wanted to scream. To beat my fists against the walls and rail against the unfairness of it all. But instead I watched her, watched her walk away with her strange, jerky grace, and I prayed that I could learn to hold my head just as high as she did in the face of disappointment and pain.

And as her hand came to rest for a fleeting second on her still-flat belly, I prayed that she would teach her baby to be just as strong as she is.

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.

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.

It happened at ten this morning. His papa had come in to visit, had listened while I explained that Hubert's small body was shutting down, organ by organ. His mama sat on the next bed over, in the same clothes she's worn for the last month, the silent tears tracking down her cheeks. And then, just like that, it was time.

We turned off the medications and disconnected the IV lines. We silenced the alarms and put him in a fresh diaper and I lifted him out of the bed and into his papa's arms. They sat there for a few endless minutes while the ventilator continued its relentless pulse and Hubert's heart slowed and his mama held his feet in her hands.

And then he slipped away. His heart stopped and we turned off the ventilator, took out the tube, removed all the wires and IV cannulas, covering the places with clean white gauze. His papa started to rock him back and forth, back and forth, speaking softly into his son's ears. I looked up at my translator who relayed his words. He is asking the baby to breathe. He says he should breathe now. He says he should try. And in my ear I heard the mother's cry, the same sound they all make when they know it's over. The high, keening wail that voices a grief that should never be felt.

They sat there, the small family, ensconced in their pain, while another translator rocked Hubert's sister to sleep on the other side of the ward. His papa finally looked up, asked us if we could bathe him and surrendered his son into my arms.

I had forgotten how heavy he was. He had been so small when he first came to us, but we had fed him and he had gotten fat and now the weight of him nestled against my chest was almost enough to stop my own breath. I laid him on the bed, and my eyes filled up and my translator chided me. Sis Alice, you must not cry. Don't cry now. I told him that I had done this before, I'd done this too many times before, and I always do it with tears in my eyes. His voice softened. Okay. You can cry. It's okay.

He looked like he was asleep and his curls were soft and fuzzy as I bathed him, removing all the traces of what we had done to him in our struggle to keep him alive. I gave him to his mama and she dressed him, looking startled when his little arms didn't reach through his sleeves like they used to.

One by one, the nurses who had cared for him came into the little sanctuary of his room, sat with his mama, poured out their love and their tears. And over and over I reassured them. It was quick. He went quietly. He was snuggled in with his papa, and he just slipped away. I signed forms and called the appropriate people and cleaned the ICU while my translator taught me how to sing in French, and I told everyone that I saw in the halls that I was fine.

But now I'm back in my cabin, and I can't stop thinking about what Hubie's papa said, right before they left. I want to say thank you, because I have seen the result of your efforts. I know why you are here. You have done well for us. And then they took their dead baby, strapped him to his mama's back so the taxi driver wouldn't charge them more, and they walked down the gangway.

I can see the tears in his papa's eyes, and that slight memory is enough to break me, to send me spinning across the floor in a thousand tiny pieces, my heart in splinters in my hands.

It's going to take some time to mend.

I should be asleep right now, not writing. I have to get up in a few hours, and the baby I'm going to be caring for is so sick. So very sick.

Oh Hubie.

I don't know if it'll ever get easier. Sitting with a family, explaining that the hope I told them to cling to is fading fast. Watching that single, silent tear track down a mama's cheek to hit the floor with a tiny splash. Pulling back blankets to let a papa touch his baby's foot before he rushes out into the evening, unwilling to sit vigil with his wife, his hard eyes suspiciously red.

It's so hard to pray for God's will to be done when I'm getting more and more convinced that His will isn't what I want.

So when I say Pray for Hubert, I mean so much more than that. I mean pray for his mama, because now, maybe so close to the end, she finally cares, and if he does go back to Jesus, it's going to hurt her. I mean pray for the doctors. We don't have a PICU doctor on the ship, so we've been pulling from the jumbled expertise of everyone around, doing the best we can. I mean pray for the nurses. We've been letting Hubie get a firm hold on our hearts for the past month, and now he's so sick, and we don't know what to do. It's so hard to look at a baby who was getting better, getting fat and happy, and see him pinned to the bed by tubes and wires, his little body shaking with each breath of the ventilator.

I keep praying for God to fill me back up, with love and strength and wisdom, so that I can go back into that room tomorrow and pour myself out again.

I'm starting to think I might be a little too broken to hold all that right now.

It happens infrequently, but I'm always caught off guard. I'm so used to pouring out my thoughts into writing that the days when I have nothing to say seem somehow wrong. The past few have been like that.

I'm not sure what's been stopping me. I don't want to sit here and moan about how sad things are on D Ward, but the truth is, they are. After my shift on Thursday, I came back to my cabin and I cried and cried and cried. The kind of tears that jut run down your face and you can't do anything to stop them because you know, deep down, that it's okay to be hurting.

There are three little ones on the ward who are getting treatment for Burkitt's lymphoma. It's a cancer that is both incredibly fast-growing and incredibly responsive to treatment, and the drugs are available in Benin. This shouldn't make me sad, I know. But I look at Rachelle's swollen face and the tumors showing through the skin of her abdomen and I wonder if we caught it in time. I look into the eyes of Madinath's mama, and I see desperation, a silent fear that her only child will be taken from her. Aime's name means like, but he screams when we come near him. This is his second round of chemo, and he knows that we hurt him and he's only two so he doesn't understand that it's the only way to make him better.

On the other side of the ward, in the corner beds like bookends, are the two little babies who were admitted through the feeding program. Their cleft lips and palates are in various stages of repair, and neither of them is eating enough to gain weight. At four and nine months old, they weigh as much as average sized newborns. And their mama's don't seem to care. They hand them off to any white person who comes near, hoping that they won't have to do the work of mixing the bottles. They lie curled up in blankets while their babies scream next to them, and they don't hear. Or they won't. I'm not sure which.

And little Joy, my darling little girl who had surgery to remove the tumor that took the place of her eye? She's home now, with an appointment card and a phone number. The card is for a date three months from now, when she'll come back to get the biopsy results and have her other eye evaluated for possible surgery. The number is for The School for the Disabled here in Cotonou. Because her right eye doesn't have a cataract like we thought. It's more than likely that the tumor that took her left eye will grow in the right too. And even if it doesn't, her retina is so hardened and scarred that she has no chance of ever seeing.

So I sit here and I cry, because I can try to smile, but sometimes I just can't. Sometimes I cry.



(Stay tuned and I'll share a much more upbeat story with you, the story of my shift today. It included so many ridiculous events and featured, at one point, my fine African shape. I just don't have the heart to type it all out right now.)

Ingrid puts it best.

we are so fragile
and our cracking ribs make noise
and we are just
breakable
breakable
breakable
girls and boys

I had one of those awful, frustrating days today, where nothing is wrong and nothing is right. It wasn't a bad day on the wards; I wasn't even working since, in a rare twist of fate, my weekend off actually coincides with a real Saturday and Sunday. I just felt absolutely, entirely too small for what I'm doing here, too stupid to make a difference, too broken to do any good.

It's an old fear of mine, this feeling of not-enough. I've struggled with it my entire life, for reasons that even I don't understand. Call it culture, call it teen angst that never quite went away, call it any of a million names, but the truth remains that I believe lies about myself. Instead of seeing myself as a child of God, cast in a divine mold, I stare at my face in the mirror and see only what I lack. Beauty, brains, charisma; I've been shortchanged in every department. (At least, that's what I tell myself.)

Some days are better than others. Some days I can rest confident in the knowledge that God made me, and He don't make no junk, a saying that I had printed in every colour of the rainbow on a t-shirt I used to wear as a child. But the bad days? They're no joke. They're the days that make me retreat into myself, turning over all my past failings and sins and shortcomings, holding each dark secret to the light and hating myself all over again for things I had thought were forgiven.

It all came to a head during our Sunday evening service. We were getting ready for communion, and the bread and wine lay covered with a clean white cloth on the table as I fought with myself during worship. You know you can't take communion tonight. You're not allowed if there's something between you and God. And, holy cow, is there ever a lot between you two. Don't try to fool anyone. You'll never be good enough.

When the speaker started outlining the form of the Trinity, listing characteristics of each facet of my God, I started to cry. Just turn to the person next to you, tell them which part you need the most tonight, as I rubbed my eyes and hung my head and ever-so-quietly admitted.

Forgiveness.

Comfort.

Truth.

And while the man in the front of the room held up the round loaf, tore it in half and repeated the age-old request to do this to remember, I sat in my seat, paralyzed with fear. Because I knew I didn't deserve it, that I wasn't allowed to join in the ritual without a clean heart, and that my heart was just about as full of pain and lies and ugliness as I've ever known it to be.

Until God, sitting next to me in a form that looked strangely like my husband's, took my hand and whispered in my ear.

You're more than enough.

The baby I mentioned yesterday, the one who I said was so sick, went to Jesus last night. Her little body just wasn't strong enough, didn't have enough reserve, couldn't take any more. It's all over now; the monitors have been disconnected, the last of the supplies cleared away and the sheets on the bed have been changed. Her family is making their way back to their home in Togo, their shattered hope wrapped in a little blanket. This is when the questioning sets in, when I start going over everything in my head, examining my steps one after another, reassuring myself that I did all I could. This time, I'm not sure I did.

Just typing those words makes me want to scream. To throw myself on the hard floor of my cabin and weep for the family that can never be the same again. Everything inside me rises up in revolt against the idea that I did things wrong, and a hundred reasons spring to my lips. There was no way she could come back from that kind of deficit; it's not your fault. She came to us already malnourished; it's not your fault. This would have happened no matter what we did; it's not your fault. There were other patients, other sick children who needed you, and it's okay that you were caring for them, too. It's not your fault.

Intellectually, I know that all of those statements are true. But intellect is a force that pales in comparison with guilt and grief. I know that there was nothing I could have done to change the course of Akouvi's passing, but my conscience burns me, peering into the dark corners of my heart and holding my fingers to the flame.

You knew her potassium was already low on Tuesday night. You should have pushed harder, told more people. You knew she was sick when Andrea called you over to her bed early yesterday morning. You knew she looked bad, and you should have said something. You let her lie in the corner all day, and you knew something wasn't right. You were so busy with your patients, with the babies who would have been fine if you had left them alone. You failed her. You failed.

As I curl up into myself, ready to shoulder what I can only see as my rightful share of the blame, another voice starts to make itself heard. This voice is softer, barely audible through the accusations flying through my soul, and I'm so weary from blaming myself that I would have missed it had He not been so insistent.

Child, stop. Quiet now. Just stop. Don't you know Me by now? Haven't you seen enough to know that I don't make mistakes? When have I ever given you cause to doubt Me? And as much as I want to be calmed and reassured, I'm still crushed, because it's not Him I'm doubting this time; it's myself. I'm the one who messed up here, not You.

Again, the voice, a whisper in my heart.

You think this was your fault? You think there was anything you could have done or anything you didn't do that would have changed that little one's outcome? Don't you know Me by now? I am the Author; I am the One who wrote Akouvi's story. I wove her together in the secret places, when she was nothing but a carefully nurtured dream in her mother's heart. I opened the book of her life, and I penned every beautiful page before she was even born. I knew the number of her days, dear one. I knew the days she would laugh, and all the days she would be in pain. Today, so early in the morning, her days were finished, her story ended.

I knew.

I have always known.

I can't stop thinking about yesterday. I'm sitting here by the side of a pristine, blue pool at a posh hotel here in Cotonou. I just finished eating some pita bread with fresh humus, my skin is starting to turn brown from the sun, and I can't shake the feeling that something's not right at all.

There were over a thousand people in that line yesterday. Our hospital manager, who spent the entire day making his way up and down the line, handing out cups of water, showed me the final figure that he had scrawled on his hand. 1,150. And we sent them all away. All except for the ones whose names we put on waiting lists, the ones whose hopes will almost surely be dashed even harder when they realize that the ship has sailed and they never got the call to come.

My alarm rang at seven this morning, plenty of time for me to grab breakfast and make my way to community meeting with the rest of the ship. But as I swam into consciousness, before I even sat up, their faces were before me, their eyes silent and reproachful. I saw the old man whose hernia bulged through the cloth of his pants who put his hand on my arm and pleaded with me. Je souffre, he told me. I suffer. I saw the little boy with pale skin, hanging limply on his mama's back. He had a problem when he was born, she told me through my translator, and he didn't have enough oxygen. He doesn't walk. He should walk. I want him to walk. I saw the young girl, her back twisted by the most severe scoliosis I have ever seen, bent forward and to the side, leaning heavily on her stick as she stood for hours in the line with the rest of them, uncomplaining in the heat. I saw the old woman, her legs swollen and infected by tropical ulcers who took every step in pain. She refused to leave the line even after Abdel and I had explained that we didn't have the right doctor to help her condition. That she would need to go home. Her voice was soft, and the language she spoke made it sound like she was literally trying to swallow her disappointment as she begged us to reconsider, refusing to understand the truth.

I saw them all and a thousand more, and I couldn't face their pain. So I turned my alarm off and went back to sleep. I, at least, have that luxury, and it's hard not to resent myself for it. To hate the vast divide between rich and poor. To rage and rail against that impossible fact that I'm once again so squarely faced with; that where you were born is so often exactly what decides how you die.

I know it's good to be faced with these realities, to be forced to confront, even if it’s just 1,150 at a time, the billions of people in the world who scrape together their livings from hopes and prayers. I know it’s right to wrestle with the sadness and the outrage that I feel when I realize that I’m not going to be able to fix it all, that so many will die disappointed and unloved. But in the early morning hours, when their faces scream a silent pain, I want to put my head under my covers and hide from it all. I can’t hide from His voice though, and it breaks through my fears and my walls and my stubborn resolve to shut myself away.

Have you forgotten what I’ve called you to? Pour out your soul for the hungry. Invite the homeless into your house and clothe those who go without. You think this is too hard? If you but try, your light will rise like the sun, your healing will soon be evident; the very God of Glory will secure your path. You’ll pray, and I will answer you. You will call out for help and My voice will be in your ear before your tongue has fallen silent. I’m here. I have always been here. And I will never leave your side.

So I guess it’s going to be okay.

There have been a few times this year when I've felt absolutely and utterly far from home. I really didn't think American Thanksgiving was going to be one of them.

We've never been big into American Thanksgiving. It was just the second round of turkey in a three-month extravaganza that marked the end of the year. My siblings and I were born in the States to Canadian parents, so we've all grown up as dual citizens, complete with the resulting double holidays. Canadian Thanksgiving was first, and seemed to mean a lot more, since that's when we actually got to see the cousins. Then came American, which really only felt like a wind-up for the big show in December. That's when we got to pile into the van again and make the eight or nine hour trek back up to granny's where gummy bears after meals and Christmas crackers with silly paper hats awaited.

Last night as I sat on the computer wasting time before talking to a friend, my brother came online. We chatted a bit about Mya and how their first night at home went. My mother signed on. She told me she was up there, cooking a turkey for everyone. That my sister was flying up to join them and my other brother took the day off and was coming for dinner.

They were all together. My whole family, plus the little one I've never met, and it hurt my heart so much not to be with them. It's hard being overseas, eh? my brother asked me. I said yes, but the truth is that I haven't ever given it too much thought. With internet and phone lines at my fingertips, it sometimes feels like I'm just in the next room, not half the world away.

Last night, the reality started to sink in. My family is incredibly close, despite the fact that we've grown up in separate countries. We have something, my cousin often says, that no other family does. It's hard to put a finger on. We don't really have to though; we all know what she's talking about, because we're family. But if this is what I'm being called to, this life and these people and this continent, then Mya's birth isn't the only thing I'm going to miss. It's going to be a lifetime of experiences lived apart from my family. Last night, that thought was so hard to wrap my heart around.

Oh, child, He says to me through my tears, nowhere did I say this would be easy. But you need to hold them lightly, this family I've given you. You need to be ready to turn your back on them, all of them, even Mya, if this is really what I've called you to. Just realize that what I have in store for you is more than you can imagine even in your wildest dreams. Trust Me.

Can you see why it's hard, though?

This place is such an odd kaleidescope of conflicting emotions. Twist the glass one way and your sides hurt from laughing. Turn to face the light and your heart is shattered. Today was a day of both.

Dawayne is eight. He's in third grade. (Do the math and you'll realize that he's in the right year for his age. It's the first time I've seen it since coming here.) He's a bright kid, and I'm not just talking about the lightness of his skin; he read me the story of Jonah this morning, only stumbling over words like Ninevah and repentance. He's really not too sick; as I was leaving work he was being called to the operating room to have his hernia repaired.

This morning, Dawayne provided me with two of the funnier moments I can remember. I went over to him, needles in hand, and explained to him that I needed to juke him small for an IV. That I would make sure I got it on the first try. And that, if he held still, I would give him not just one, but seven whole stickers. His eyes lit up and he stuck out his hand, brimming with confidence. His bravado failed him, however, as I approached his skin with the needle. His eyes rolled heavenwards in supplication as he screamed out in utter seriousness, JESUS, take me now! I had to stop and compose myself before starting that IV.

A little while later, the mamas in his corner called me over. They prophesied over me that, once I get back to the States, the first thing I will do is born a baby. While my ovaries don't mind the thought of that, I explained that I had to get a husband first. One mama laughingly offered her three-year old son. I told her he was too small and that I needed a big man. At which point little Dawayne rolled over, looked up at me, and with raised eyebrows and a sassy little head tilt delivered a perfect impression of Joey Tribiani. How you doin'? I almost peed myself.

And the kaleidescope shifts and Eddie fills my view and laughter is the last thing on my mind.

Eddie is four months old. From the neck down, he's like any other baby. He's the firstborn in his family, a little porker with chubby thighs and a miniature pot belly. Eddie is cherished. When he was born in the middle of the rainy season, his mama made sure to always cover him with a mosquito net when he slept, to make sure he didn't get malaria. About two months ago, an aunty was doing something by candlelight as the baby slept, secure under his net. She placed the candle on the ground, and in just a few seconds, little Eddie's life went up in flames. The net caught fire around him, and his face and head were horribly burned.

I hold Eddie and rock him and kiss the angry pink skin on his cheeks. I tell him he's beautiful. To anyone other than us, though, he's hideous. He doesn't look like a baby anymore. His eyes can barely open and close. His lips are a static mass of scar tissue. His nose is gone, leaving only two small holes in the centre of his face. The top of his head is an open sore. Everything else about him is the way it should be. His skin is creamy brown, his fingers delicate and perfect. It's just his face, the first thing everyone will see for the rest of his life. It's just his face that's been destroyed.

His mama loves him. She holds him and rocks him and dresses him in little outfits that we've scrounged from the bottom of donation boxes. She can't bear to be there when we change his bandage, so we take him to another room. He wails as we soak the infected sores on his head with vinegar, shaking from side to side, trying to make it stop. And then he quiets, submits, gives up, and that's maybe worse than all his screams.

I'm afraid for little Eddie. I'm afraid of what his life is going to be. He will never know what it means to be normal. He will live forever with people staring at him. People hating him. People ignoring him or making fun of him or calling him ugly. We sit here and we tell him he's beautiful (and he is, really; you just have to ignore the obvious), but he's not going to hear that very often when he leaves here.

Which made it all the more poignant when I heard his mama singing. I looked over to their bed in the corner to see her lying down, Eddie propped up on her stomach. From behind, all I could see was the plumpness of his diapered bottom, encased in a clean, white onesie, and the fresh whiteness of the bandage around his head. She bounced him up and down as she sang quietly.

I am on the Lord's side.
I will never give up.
I am an overcomer,
For the Lord God is on my side.

I pray that Eddie would be an overcomer. That he would somehow have the chance to grow up and go to school to learn to read like Dawayne. That he would be surrounded by people who can see past the scars.

That he would know love.

As if I needed another reason to love my family, my cousin, Becki, recently created this.

It breaks my heart in places I never even knew about, ripping holes in parts I thought were going to be forever sturdy. And it's the reason that, come December, I might not make it home entirely whole.

I've been hesitant to write about this. Truth be told, I've spent the last four months or so hiding it all away, and so the prospect of spilling my proverbial guts on these pages is a little overwhelming. However. I find that I no longer want to keep this to myself.

It started a few months after that needlestick. I was always tired, and every time I worked night shift I would spend the next couple days recovering from violent illness. I caught every cold going around, and I felt like an absolute weakling. It all seemed easy to explain, though, since I live on a ship and breathe the same air as four hundred other people.

It was around the time that Baby Greg first came to us that I signed up to be a blood donor and gave a sample to the lab for routine testing. I was sitting by Greg's bedside in the ICU, willing him to breathe, when the crew nurse poked her head around the door and asked me to come to the clinic. I figured my hemoglobin was too low or my electrolytes were out of whack from my latest round if sickness. I just wasn't expecting Dr. Craig to say what he did.

You have Hepatitis B.

My world quietly crumpled and I sat, numb, while he drew more blood to repeat the test and explained to me that the man whose blood I had injected into my finger must have been very recently infected. That there was only a small chance of the virus going chronic. That I would probably recover.

And the whole time, all I could see in front of me were the yellow eyes and swollen bellies of patients I've cared for with liver disease. I found my way back to the ICU, back to my critically ill baby, forcing myself to concentrate. Willing myself to believe that it was going to be okay.


But it's hard to believe that things are going to be okay when you're a couple months away from your twenty-fifth birthday, living on a ship off the coast of West Africa, and infected with a potentially deadly virus. I'll admit it now; I was angry. Back when I was preparing to come to Liberia, people constantly told me to be careful. It's so scary over there! I can't believe you're doing something so dangerous! Anything could happen! I smiled and shot back the same glib answer every time. If God wants me there, He'll protect me.

But He hadn't. I'd somehow slipped out from under the shelter of His hands and into the big, bad world where things like incurable diseases lurked. I couldn't figure out why He would let it happen.

I spent the next three months waking up in cold sweats, wondering how I'd be able to afford a liver transplant. (I'm not sure Talent Trust covers that sort of thing. They do, however, make provision for repatriation of mortal remains. Which I was also thinking I might have to use, in a worst-case fulminant-hepatitis sort of scenario.) I dodged questions as to why I was drinking soda instead of Club beer with my dinners when we went out on a Friday night. I held on to my little secret, feeling dirty and diseased, and I tried to pretend that everything was all right.

Which, in true I-worried-about-this-for-nothing style, it is.

I'm now, as of a couple weeks ago, the proud posessor of another little pink slip of paper that bears my latest test results: negative. Just like over ninety percent of everyone who gets infected. (Those odds, interestingly enough, don't seem so great at three in the morning when your cabin is dark and your mind won't stop racing.)

I still don't know why it happened. I'm still a little bitter, if I'm being totally honest. Because I can't help thinking He failed me.

But, oh, His voice speaks into the silence of my pain. I know every hair, He reminds me. I knit your body together as you grew in the secret places. Every day and every moment of your life, I planned it all. Have you ever known me to make a mistake?

No. No. A thousand times no.

Funny how I was just commenting on my cathartic need to write. Because today will take some sorting.

I've been here almost seven months now and I'm one of the more experienced nurses around. Scary, I know. So they've asked me to start doing some charge shifts. It was inevitable but, truth be told, I'm not jumping out of my skin with excitement. I'm much more content pottering through a shift with my four or twelve patients and not really worrying about anything else. God, however, knows what's best for me, so off to charge-land I shall go. Today was my second day of orientation, and I was starting to get a feel for things. At which point, The Call came.

Hi. This is Reception. There's a patient out on the dock.

I asked my boss yesterday what I should do if I ever got The Call while in charge. She made it sound so easy. If they're not someone we did surgery on, tell them no. Send them away. Be firm. Be kind. Tell them no.

And when we went outside there was a white woman holding the smallest brown baby and it was raining and all her suitcases were huddled around her like sentries and he sounded like Baby Greg when he breathed. I took him in my arms, stood there on the dock and my prayer was a silent scream. God, no. I can't do this again. I can't watch another one die.

We found shelter at the top of the gangway and discussed what to do. The little one in my arms gasped and coughed, his lip split in two angry gashes, his palate a gapaing hole and his hair soft in tiny ringlets against my arm. We couldn't admit him; we don't even have enough beds for our own patients right now. So we brought them inside to wait until we could find someone willing to drive them to the MSF pediatric hospital where he could be seen by a pediatric doctor.

I stood in the cafe, my body swaying in a rhythm I didn't know as the small one's cries quieted and he fell asleep. The woman sitting in the chair in front of me, eyes tired, shared her story with me.

She wasn't planning on any of this. She was just a mother from Minnesota, a mother with one child alive and two taken from her in a car accident a few years ago. She was just a nurse, an ER nurse who wanted to come and serve God for a few weeks in Liberia. She had been working up country at a bush hospital when she heard of this little one. He had been abandoned by his mother, convinced that her own pregnancy had been stolen from her and this evil spirit baby with the hideous face replaced in her womb. Of course she didn't want him. (At which point the little one grunted and settled closer into my arms, one tiny hand curled up against a mocha cheek.) Cathi, the woman sitting in front of me, explained that they were just feeding him water, waiting for him to die.

No, she said. He needs milk. I will give him milk. There was no milk at the hospital, and if she wanted him to have it, she would have to take him home. So she did. She got back to the house where she was living, and her understandably surprised roommates asked her the baby's name. She pointed to the two men who had seen her home safely; Matthew Steven. 'Left with adoptive mother' is what the note in his chart read, and she figured Why not make that truth?

You see, Cathi has a room in her home in Minnesota all ready for a baby. She and her husband have been working for years to adpot a baby to fill that room; she just wasn't planning on finding him in the Liberian bush, clinging to his little life with dogged persistence. God, however, seems to have had other plans, because all the paperwork for the adoption was finalized within two weeks. I'm not going to lose this one, she told me, her expression unreadable, somewhere between despair and determination.

We drove through the market traffic to the MSF hospital, descending from the car into a sea of babies and mamas and little children swathed in thick bandages, the edges of their burns showing angry red where the gauze had slipped. We opened the door to the ER to see skeletal children being fed through tubes, babies lying listlessly, two or three on each low cot, and a group of doctors and nurses quietly trying to save the life of a newborn on a table in the middle of the room. No, this isn't urgent. We'll wait outside.

Back out into the damp heat to smile and pull faces at the little kids surrounding me, trying to ignore the thoughts in my head. These are the kids who will need Mercy Ships later on, when their burns have healed badly and their little fingers and elbows and necks are locked in scars. These are the babies who need to be fed every few hours, but there might not be enough milk here either. These are the ones you can't help. You aren't doing enough.

Matthew was seen by the ICU doctor. He didn't have pneumonia and wasn't sick enough to be admitted. We brought them back to the ship and another crew member drove them to a local hotel where Cathi is going to continue her vigil until he's well enough to fly home. And I went back to work. Played with the kids on our wards. Put in some IVs, answered some questions, fought back tears.


How is it okay? How can I go to sleep in my room tonight knowing that Cathi is in town somewhere, fighting for little Matthew's life? I'm sitting here and I can't erase the images from my head. All those kids. Waves of suffering and humanity and hope and we drove up in our white Landrover and they surrounded me and then we drove away and some of them looked bewildered. Because we're supposed to help. We live on the white ship and we have white skin and we're supposed to be able to help.

Sometimes it feels like we're making some kind of difference; our wards are full right now. Kids are bouncing off the ceilings and the VVF list reads like an awards ceremony. Dry. Dry. Dry. But it's not enough. It will never be enough. This world we live in is so hurt and broken and I have no idea where to start in putting it back together.

I'm glad I'm not the one in charge of that.

It's hard to know what to say when faced with the death of a baby. What can I possibly offer to a mother who has just lost her heart? What words can I say that will blunt the searing pain? And what comfort can I give when that mama is faced with the sight of her son's bed, occupied by another small, brown baby, one who is sitting up and smiling at the world around him?

Marion came to visit me today. She's something of a celebrity around here, and it took me almost fifteen minutes just to get her down the stairs to the hospital as almost everyone we passed stopped to say hello. As we walked down the hall towards B Ward, she was all smiles, laughing and greeting her friends, nurses, translators and disciplers. It was only when we were inside amidst the bustle of a full ward that the flood of memory overwhelmed her. I stood there with my arm around her tiny shoulders as tears coursed silently down her cheeks. She turned twenty-one yesterday. She's a child herself, and yet she stood there, mute and small, mourning the loss of her third baby.

We turned away and went upstairs to eat lunch. We sat at a table by the window as she pushed the rice around her plate and told us about a dream she'd had. In it, she was out walking. Or working. She wasn't quite sure. People came up to her one after another and told her what a fine baby she had. Asked her how he was. She repeated to them over and over that she didn't have a baby. That he had died.

No, they said, he's right there. He's right there on your back. That was a good dream, we agreed.


Bendu, the sassy-pants who was burned after she had a seizure and knocked over her kerosene lamp, was back for a dressing change in our outpatient clinic. She and Marion became close while Baby Greg was still with us, so when Bendu's appointment was finished I signed her back in as my visitor too. We passed the rest of the afternoon like any silly twenty-something year old friends. We wandered around the ship, ate grilled cheese at the cafe, tried to call friends in Canada and hung out in my room for a while, laughing and filming video messages on my camera.

Weeks ago, as we stood by Baby Greg's bedside, watching him fight to breathe, Bendu told me that she was very sad. I asked her why, and she went on to tell me that she was going to be alone for the rest of her life. She didn't meet my eyes as she gently touched the warped, pink skin of her cheek and forehead. Quiet tears filled her eyes and as she explained that no man would want to marry her, not given the way she looks. So I will be alone. That is what makes me very sad.

Marion is a woman living under the shadow of curse. The longer I spend here in West Africa, the more aware I become of the reality of spiritual warfare. It's easy to be in my comfortable room and scoff at the idea that words could have such an effect on someone's life. But then I leave this room and go out and sit with Marion in her house and I am utterly convinced that this battle is so much bigger and so much more intangible than I could have imagined.

Given all this, I was struck today at how normal the day was. I think I expect women who have lost babies and been terribly disfigured by burns to be somehow different. More sedate, more aware, in a way, of the cloud surrounding them. But apart from the small moments when they retreat into themselves, lost in worlds of pain I can only guess at, Marion and Bendu are you and I and any woman ever. They're maybe more broken, a little more shattered, but underneath the scars and shining through the tears, I can so clearly see their love.

I want to love like this.