joy

Thank you so much for your prayers.

Little Jonah came home today. I just checked his mama's Facebook (I know, aren't we so technological), and found this message that she wrote to another friend:

Dave and I have been in tragedy for the past few weeks. Jonah has been very sick and given a very grim possibility of life. He was on the ventilator for about seven days but has made a truly miraculous turn around. He was breathing with the help of some O2 [oxygen] for the past two days, and then decided he was ready to try on his own again. He was released from the hospital late today. He is very weak and fragile, but better at home than in the hospital. We have been praying, hoping, crying, begging for another miracle for our baby and God has listened. We still have a long, winding road ahead, but we have taken a huge step forward in coming home. If you have any prayers to spare, we could still use a few.

I read this and started crying just now. Maybe it was the horrendous shift I had at work (which I'll probably write about tomorrow, once I've amassed even more stories to share) or maybe I'm just tired, but I guess I never realized how sick my little friend really was. When his mama says a grim possibility of life, I know she's not exaggerating, because Jonah has been on that razor's edge so often that she knows its face far too well.

But Jonah is home now, tottering around on his little toothpick legs, learning to eat and walk and breathe again despite everything he's been through. Now if you'll excuse me, I'm going to chalk this one up in the miracles column.

And then I'm going to bed, because minor surgery on the ward, two feet from other patients on either side, is just not something calculated to make you feel well-rested after a shift.

Her name was Genevieve. She was a little older than my own mother, her eyes hard and dark and just a little desperate. The card above her bed was printed with all the details that defined her. Name. Age. Surgery to be performed. Left mastectomy. She sat silently, her hopes and fears hidden behind her impassive front as the evening wore on in its predictable pattern. Patients came back from surgery, anesthesiologists made their rounds, surgeons interviewed their new admissions. When Dr. Bruce made his way to her bed, Genevieve made her move and threw the wrench into the next day's carefully planned surgery schedule.

Non, she told us, her voice steeled against a hidden pain. Je ne veux pas. I don't want to.

We sat with her, reasoned with her, explained that her chances of survival, even in this country that has patchy access to a grand total of two different chemotherapy drugs, would be incredibly high if she let us do the operation. That the surgeon's knife was her best shot in an uncertain world. But Genevieve was adamant; she refused to sign the consent form.

Dr. Bruce eventually gave up and came to tell me the plan. Don't put in an IV yet. Feed her dinner. Give her time to decide. She'll let us know in the morning. So we put away her chart, gave her a plate of fufu and sauce and left her to her thoughts. Later in the evening, her nurse, Ursula, had a quiet moment and pulled a translator over to Genevieve's corner. After a long talk, she came back to explain to me why Genevieve would refuse a free, life-saving surgery.

It turns out that Genevieve isn't alone in her sickness. She had a sister, but her sister had the same problem. She waited too long, and by the time she had her surgery, it was too late. Genevieve also had a mother. Same story. They both had the surgery we were recommending to Genevieve. They both died. The family must be cursed; it was no wonder she was scared.

But I work with an amazing team of nurses, women from around the world who are filled with love and compassion and who will do anything to see their patients be healed. By the end of the evening, Ursula's quiet persuasion had broken through Genevieve's fear, and the next day, she went to the operating room as planned. The day after that, she was sitting up in her bed, calmly fashioning basket holders out of yarn and rope. In anyone's books, this would be counted a success.

The thing is, Genevieve also has a daughter. Her daughter also has a lump in her breast, has also been living under the same fear as the rest of the women in her family. When she came to visit her mama, Genevieve sent a translator to ask me if her daughter could also have surgery. My heart sank, and I replied with what has become our rote answer. Je suis désolé. There are no more doctors. Their faces fell, and they shrank back into their corner, defeated yet again.

But you see, unlike so many tragedies I have to share with you here, that wasn't actually the end of this story. We told Dr. Bruce about Genevieve's daughter, and he agreed to meet with her and assess the extent of her disease between his surgeries the next day. She had tears in her eyes when I handed her the little card that would give her admission to the ship the next morning, and Genevieve paused in her rope-weaving to flash me an enormous smile.

When I came to work the following evening there were a million other things to claim my attention, and it wasn't until visiting hours rolled around and Genevieve's daughter showed up in her now-familiar orange-printed dress that I remembered the appointment. Dr. Bruce was also in the room, so I shot him a questioning look. His smile told me the end to the story. It's just a cyst. She's not sick. Genevieve, already in happy possession of the news, beamed at me from her corner as her daughter hugged me and we danced across the floor of the ward together. Merci, she called to me from her corner, and then, summoning up all the English that she knew, Thank you. Thank you too much.

Because some days are way too long, and we tell far too many people to go home, to take their carefully nurtured hopes and throw them out with the trash. And other days are a celebration, a joyful dance across a ward with two women who have been saved from the curse of death and disease. I love the dancing days.

The last few days have been so intense. I find myself exhausted by about nine in the evening, worn out by the constant interactions, by my attempts to navigate myself through this world that's supposed to be mine. By finding my way again.

Some of it has been easy. More and more, I find that this blog is such a useful tool; because people have been reading my words all year, there's almost nothing they need to ask me. I've been able to pick up friendships where they left off, and when questions arise about Liberia, I can say Remember those entries about Baby Greg? Yeah, that was the hardest thing that happened this year. I drove home from my Granny's house the other night, the first time I'd been behind the wheel in eleven months, and it was surprisingly painless; it turns out that remembering how to drive is like riding a bike. You never really forget.

Some of it has been less straightforward. The noise and the cold and the constant stimulation are so foreign to me after a year on a ship in the third world. I'm getting carsick again, and I think it's because I strain to read all the billboards and street signs that whip past me at over a hundred kilometers an hour. I've already started to feel the strain of this culture, reminding me in subtle whispers that I look wrong. No matter how staunchly I remind myself that I am proud of my African shape, I've been feeling pudgy and oversized, and I can't convince myself otherwise.

The thing is, none of this confusion and uncertainty really has any kind of hold on me. Especially not after today.

This morning, I took a drive past icy lakes and up a snowy road. We stopped at the side of a river and made our way onto a bridge overlooking the water as it rushed down the chute that he had helped build to guide the logs downstream. The air smelled faintly of summer, somehow, recalling memories of long hours spent playing in the waterfalls near my grandpa's farm. He pulled four tie wraps out of his pocket, and he asked me the question I've been dying to hear.

So, you want to get married?

I said I thought we might as well, and then I chose green, like he knew I would. He threw the other three over the side of the bridge to be washed away in the freezing spate. He fastened the tie wrap around my finger, clipped the end with a pair of wire cutters he pulled out of his pocket, and then he took my hand in his. We stood there on that bridge with the cold all around us and the water rushing through my heart, and he prayed over our life together.

And then we went back, and I showed off my fancy ring to my beaming parents and he took an Exacto knife to it to smooth out the edges, and I have never known that it was possible to be quite this happy.

(For those of you who have never heard of this guy before, the oversight has been intentional. We both agreed that our relationship wasn't something that we wanted to chronicle on the internet, but I've gotten special permission to post about today, since there's no way I can keep this to myself.)

Phil is my best friend. He's been by my side through the hardest year of my life so far. He rubs my back when I cry and shakes his head when I'm hysterically laughing. When something funny happens, he's the first one I want to share the joke with. We can hang out for hours, not do anything, and love it. He believed me when I told him I didn't want an expensive engagement ring, and I know that means he trusts my word. When I'm sick, he cooks me Ramen noodles, and when we come inside he holds the door for me. He'll eat the mushrooms for me that I always feel the need to pick out of my food. He calls me out when I'm being lazy and challenges me in my walk with God. I never feel like I have to be anything but myself with him and yet, somehow at the same time, being with him makes me want to serve more and love more and be more.

It was Phil's sleeve I was hanging on to that first day in Tenerife, and it's that sleeve I get to hang on to for the rest of my life, no matter what comes our way.

Which, at the end of the day, is just about the best deal I can imagine.

When I was born, twenty-five years ago, I was named after my Aunt Ali, and I've lived my whole life as her namesake. Today, finally, I get to live up to that name. Because I'm an aunt!

My sister-in-law and brother had a little baby girl this morning, Mya Grace. I just got to talk to them on the phone, and they sound ecstatic and stunned and wonderful. They held the phone up to her little ear so I could say hello.

Hi Mya, I told her, this is your Aunt Ali. I love you very much and I'm in Liberia right now, but I'll be home soon.

At which point she started to cry. I totally see her point. Liberia is really far away. But I'll be home soon.

And until then, they better send me lots of pictures!

It feels like a lifetime ago that I sat next to little Sadie’s bed, holding vigil over his motionless body, willing him to live. Despite pouring everything we had into that boy, we failed and the cancer won. I was just thinking about how easy it is to focus on the failures. Despite a year of successful surgeries, lives changed and futures reconstructed, it’s the ones we couldn’t fix that haunt me in the dark hours of the night.

I think God knew about this quirk of human nature, our proclivity to remember the dark even in the face of so much light, because he recently sent us Esau. He came to us with an eye swollen and bulging. After surgery was done to remove the useless tissue, the diagnosis was confirmed: Burkitt’s lymphoma. Again. Esau lay in his bed, curled up in a little ball, his head wrapped in layers and layers of gauze as we tried to stop the bleeding. His father (or brother; he answers to both titles) sat at the end of his bed, alternately patting Esau’s back or turning his head away from the sight of a small boy so sick.

And because we couldn’t see another one die like Sadie, God didn’t let it happen this time. Instead, we were able to get a dose of cyclophosphamide, the chemotherapy that is almost always effective against this oh-so-treatable (if you catch it soon enough) cancer. We pumped it into Esau’s small body and we held our collective breath in a silent, desperate prayer for healing. Because we all knew we couldn’t do it again.

If today was any indication, it would seem that God was listening. The bandages are long gone; Esau now sports nothing but a little patch over his missing eye. He runs around the wards, dishing out hugs and smiles with reckless abandon. And he laughs. Oh, how that child laughs. If the internet will ever cooperate with me, I’m going to upload a video of this child laughing, and I defy you to keep a straight face as you watch it.

I was doing something in another corner of the ward today when I heard two people talking. They were discussing Esau’s condition and the history of his sickness. His father/brother probably had no idea how profound his words were, but they summed up our entire work here in two short sentences.

He was sad for months and months, ever since he took that sickness. But now ... now he can laugh!

When we sail in three weeks and patients are left behind, a few of them maybe not-quite-healed, it’s Esau’s laugh that I need to remember, not Sadie’s death.

Edited to add the love:


(See what I mean?)

Proof that I can indeed back a baby, compliments of Emily Adams and my ever-improving lappa-tying skills.

She sitting good there. You can back baby well, Liberian White Woman!

(Please let me stay forever.)

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.

The past twenty-four hours have been so hard. I've lived the last ten minutes of Greg's life over and over in my head, staring at the ceiling all night long as I fought back the panic that threatened to overwhelm me when I turned out my light. But there's something utterly strange about this community I live in. I seem to be among people who have forgotten that our world is broken beyond recognition. Or, at the very least, if they do realize, they've chosen to live as though it were whole.

You see, grace has been poured into my spirit from every source imaginable. In the moments after Greg flew last night, there were a hundred things a nurse needed to do; I've done them all so many times before. But I was given the gift of being able to stay with Marion as long as she needed me while so many loving hands swaddled Greg and wrote out the death certificate and cleaned up his stuff and got Marion's bags packed for her. Hugs and sad looks and pats on the back and genuine, sincere questions about the state of my heart have bombarded me from every side. We have cried and laughed and prayed together, and I can't help getting excited for heaven. If this is 'a foretaste of glory divine,' Christ can't come back fast enough.


In the midst of it all, there's another, wild note in my soul; spilling out past the raw hurt is a kind of pure, fierce joy. I realized at some point as I sat there and sobbed for Marion's broken heart and my own that the pain I'm feeling is a privilege. I grew up in a country where I was safe, secure, loved. I've never known war (not really), and I've never watched my life fall to pieces in front of me. I have no idea what it truly means to hurt. Marion does. Every member of her family does. Grampa said it last night, his words halting and small. We have all lost someone. Every time, there is someone who can die.

I count it a joy that my heart feels like it's been shattered. It means that it's still soft, and it means that my life has been blessed. I must live the rest of my days in the light of that blessing.

Today was not exactly my shining moment as a nurse. I'm stuck somewhere around thirty percent of my normal energy level, and couldn't muster up much in the way of enthusiasm for my job. Getting called at five after seven and realizing that I was still in bed when I should have been dressed and on the ward didn't help much either.

Despite the general apathy I was feeling, I was treated to what I figure is one of the best things about this job; I realized today that one of my patients had come alive again.

When I first met Abraham, he was a silent, withdrawn little boy. He refused to make eye contact, refused to leave his mother's side, refused to interact. When he came to the wards, it was the same. A small frightened boy, living entirely inside himself.

As the days passed after his surgery, Abraham began to make noise. I wrote about him last Sunday, how I finally heard him squeak like an anemic monkey. It wasn't much, but I would have taken anything at that point.

When I got my assignment today, I was excited to see that, for the first time, he was actually my own patient. I figured I'd be super-nurse and get him to talk and laugh. Turns out I was way behind the times, because as soon as I finished getting report, I felt the weight of him hanging off my leg. I looked down into his irrefutably smiling eyes and said good morning. He shrieked something unintelligible back to me and ran off in search of legos. All day long, we chatted (never understanding a word of what the other one said) and built lego cities and did puzzles and had tickle fights.

Abraham, like so many before him, has been reborn. Out of the burned shell of a boy, scared and scarred, has emerged life and joy and exuberance. It's the first time I've ever recognized it so clearly, and I'm hoping it won't be the last. Because it's one of the coolest things I've ever seen.

I wrote this in the middle of a long, long shift last night.

I’m sitting on an empty bed in the hushed dark of A Ward at two in the morning. The babies are sleeping, and I thought I’d take a minute to type. I’ll admit something right out of the gate here; I came to work tonight with a bad attitude. This is the last of three night shifts, and knowing that this ward is populated mostly with babies, all of whom have upper respiratory tract infections, I was dreading my shift. Babies with colds are never really pleasant; add a kilo or two of plaster to their little legs, and you’ve got a surefire recipe for sleepless nights.

I’m not saying I can’t sympathize, because loving on one too many sick babies means that I’ve also fallen victim to the virus. My head is pounding, my nose is running, and my energy level is hovering somewhere around twenty percent. Suffice it to say, I started the shift a little short of patience.

By eleven, most of the kiddos are usually tucked in and sleeping soundly. Tonight, just like every night so far, Anointed defied all my efforts. I gave him his medications. I snuggled him closer to his mama. I got him a clean diaper. And still he screamed. I had decided somewhere during my first night that Anointed and I weren’t destined to be friends. Because this wasn’t a scream of pain. It was a cranky, irritable, I-hate-everything-and-everyone-around-me scream. And it was getting on my already-frayed nerves in a bad way.

Somewhere around one o’clock, I had had enough. Anointed’s mother was sleeping soundly next to her wailing child while all the other babies on the ward were starting to join in with a chorus of their own shrieks. Frustrated with his mother’s lack of parenting skills, annoyed at his cries and just wanting him to stop, I grabbed him out of bed and carried him out into the hall. The crying got louder, and I immediately started to doubt my decision.

But I’m stubborn. Just about as stubborn as they come. And I refused to let this little ball of screaming fury get the better of me. I paced and rocked and sang until, all at once, he nestled his head in under my chin and stopped his crying. Moments later, the sudden weight of him told me that he had given up the fight and was asleep.

We’re sitting together on this bed right now, his small body splayed across my chest. His almond eyes are squeezed shut, and his curly little mohawk is soft under my chin. And my whole perspective on this night has been turned end over end. I just realized that I came to work tonight looking for a fight, waiting for things to go wrong, expecting to have a rough shift. Really, all I should have been looking for was the next baby who needed to be loved on. Amazing what a little reality check can do for your state of mind.

So Anointed and I are going to hang out here for a while. And when Johnson wakes up and starts screaming (like he’s bound to do any minute now), I’m going to summit my next mountain.

The rest of the night was spent with Anointed snuggled in my arms. It didn't even bother me when he threw up all down the front of my scrubs. Come five o'clock, when there was work to be done, I rolled his mother over, took her lappa and strapped him squarely on my back. He stayed there until it was time to give report, drooling and coughing into my shoulderblade, little toes poking out from either side of my hips. (For the first time, the other mamas didn't readjust him, telling me instead that he sit fine there. There's hope for my baby-wearing skills after all.)

I just keep thinking about it all. About how different last night was from the two before it. Changing my attitude meant I could get out of my own way and just love. For all I've been learning about love during the last few months, you'd think this lesson wouldn't have been so long in coming. After all, for as long as I remember, I've been repeating the mantra after Uncle Russ: I refuse to have a bad day.

Jesus said it best himself.

The Father loves me, and so I love you. Live in my love. Make it your home, make it your place of being. If you follow my example and do what I'm telling you to do, it won't be so hard. See? I've followed my Father all along, and I'm resting firmly in His love. And you know why I'm telling you this, right? Because if you can get this, if you can just love, then you will be filled with a joy so complete and so full it doesn't seem possible this side of heaven. So just love. Love each other like I've loved you. That's all. (John 15)

Every time I let myself be annoyed with the petty little frustrations that make up a day, I'm really just shooting myself in the heart. Because I'm missing out on love, and I'm missing out on joy. And that's just stupid.

As soon as I'm feeling better, I'm going to go try and make friends with Johnson.

Remember Abraham? My love from screening? In case you don't feel like poking around in the back pages of this blog, he was the three-year old who stole my heart back in February when we had our big screening day at the stadium. He came in this past week and had surgery on Thursday. For such a small boy, he had some major work done. His entire left hand, twisted into a ball by scars, was released and patched using skin from his thigh. His eyelid was reconstructed. The corners of his lips were widened. But when I went to see him after his operation, he wasn't crying. He wasn't fighting. He was just lying in his bed, curled up next to his mama, mute. And that's not normal for a three-year old. For the next couple days, I went to see him often and always got the same report. He's so good! He doesn't cry at all. Being a pediatric nurse, I was concerned. It's not right for such a small boy to be so quiet after having so much done.

But maybe that was just it. Maybe too much has been done. Maybe too much has happened to him in his short life. Maybe he's got nothing left. After all, falling into the fire as a baby and knowing nothing from life but pain and scars and surgeries isn't something that's calculated to make you into a social butterfly. I chalked it up to fear, but was still pretty worried about him.

I was working in A Ward this morning, a jumble of plastics and orthopedics patients. We had eight beds along one side empty, so we got to host church. On the floor in the middle of the room we spread out a blanket and piled on the B Ward kids. There are five or six of them, little dynamos of perpetual motion, unphased by huge bandages covering skin grafts and scar releases. I parked myself on the corner of the blanket and was pleasantly surprised when Abraham's mother dropped him off next to me. People kept on packing in until it was standing room only in the hallway. As the ward filled up, Abraham's uncovered eye rolled wildly around. He started looking more and more frightened, so I made my move. I gathered him onto my lap, his stiff little body unyielding against my arms. We sat that way for most of the singing time, until we started with a slow song about the great things God has done. I was sitting there, worshipping God, when I felt a weight in one of my hands. Abraham had taken his bandaged little fingers and rested them calmly in my own outstretched palm. And it wasn't long until I felt a small hand grab onto my other fingers. I looked down and there was Abraham, looking up at me, holding on for dear life. About thirty seconds later, my leg went completely numb, but I wouldn't have moved for anything. As the service went on, he relaxed until he was folded into me, his back matching the curve of my arm, fingers still wrapped around mine. Silent.

Not so the other kiddos. As Drew preached, they got more and more antsy, but I had come prepared. Out of my pocket came the finger puppets. Little sea creatures and jungle animals, you can get a pack of ten for a couple bucks at Ikea. To these kids, they're gold. Abraham got a monkey, and held up the finger on his unbandaged hand for me to help him out. The other kids amused themselves passing around my stethoscope, checking shark's heartbeat and octopus' breath sounds. (The physiology of that still escapes me.) They needed a good bit of silencing, since there's probably nothing more exciting than an elephant battling it out with a shark over stomping grounds on a big red blanket. Abraham, at first completely detached, slowly started turning towards the other kids until he was draped on his stomach over my leg, monkey inching hopefully towards seahorse. I looked away, trying to focus on the message, when I heard the kids start up again with the animal noises. I bent my head to quiet them, when I realized there was no way I could. It was Abraham, scooting his puppet along after shark, making squeaky little monkey noises.

Church was sweet today.

After church was pretty sweet too. The nurse I was working with hadn't been feeling well since we started our shift, so we sent her home at lunchtime. (Home being up a flight of stairs and slightly to the right.) This left me in charge of all eight patients and two new admissions on A Ward. Normally this would have been impossible, but God was on my side. (By my side, actually, to quote one of my favourite Liberian songs.) Everyone was stable. No one was having pain. I got to sit and talk to my patients and show them pictures of my family. When asked if I had children, I mentioned my glaring lack of a husband. To which my patient (lovingly referred to as the Reverend since he actually is one of the pastors at President Sirleaf's church) replied I will pray for you to get a husband. I will pray a strong prayer. (Apparently not just any old prayer will do. I need the heavy-duty ones.) He should be Liberian. So I can come to the wedding. And eat cake. It's amazingly simple when it's laid out like that. Liberian men should be lining up at my door any minute now.

In the middle of all this, I heard a knock at the door. I opened it to be greeted with the toothy grins of my B Ward boys. They hurled balloons in my startled face, jumping up and down, shouting Balloon party! Balloon party! over and over and over again. Things quickly devolved into a game of hallway soccer, kids dwarfed by a big, yellow physio ball, and soon enough I had the blanket spread out on the floor again and my friends were building a city with the help of one of my new admissions.



Any other time in my life, I would have told you that having ten patients plus four or five extra high-energy kiddos under my care would have been beyond me. But some days, God just gives extra grace. Today was one of those days. I wouldn't have traded it for the world.

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.

It's one o'clock on a Wednesday morning, and I should be asleep. But I close my eyes, and all I can see is Esther. I want to tell you her story.

Esther was married when she was fourteen. Her first baby was a boy who died in childhood. Her second was a girl, a fine girl. And then the war came. In 1995, when Esther was pregnant with her third child, the country was being torn apart by rebel forces. So when the pains came, there was no hospital Esther could go to. She stayed home, waiting for the baby to come. It was up so high. It just stuck here, she said, gesturing to her heart. It don't come out. The baby die. And still the baby would not come out.

Help arrived in the form of a man Esther refers to as a 'first-aid worker'. He took a pair of rusty scissors and cut the baby out of her from below, damaging her bladder in the process. Esther was left wounded, broken and massively infected. Urine leaked constantly from her body. She sat quietly today, every eye fixed on her downcast face, as she described being carried out and laid on banana leaves, being washed as the maggots fell from her skin. She let her arms hang heavy as she explained how she had not had the strength to brush away the flies. Her eyes were filled with pain as she told us that she was sure she would die.

Her head snapped up. But Daddy God, He save me. Slowly, Esther regained strength. She was able to start taking food again. Her husband went into the bush one day to find some cassava for her and met a band of rebels there. He never came back, and Esther started her new life as a widow. She went to her family's town to tell them of her problems, and they wept together, knowing all to well what it meant for her life. She journeyed to Ivory Coast to seek treatment and was met only with disappointment. For ten years, Esther lived the life of an outcast. When men found out about her problem, she was left alone, clutching a broken heart and empty promises.

When hope seemed lost, Esther heard about a ship that was going to come to Liberia, a ship where they could help problems like hers. She made her way to Monrovia and inquired at hospitals about how she could come to the ship, but greed had reared its ugly head. Extortionists set up shop, demanding outrageous sums of money (fifty, a hundred, even a thousand US dollars) for the chance to register for an appointment. Esther didn't know any better. Didn't know that the ship would come full of people who wanted to love her and have a hand in her healing and who would ask nothing from her in return. She went back to the bush and began burning charcoal to sell so she could scrape together the phony registration fee.

Enter the Ghanaian. A man of God, when she told him about her problem, his response was love. You are my true love. Your problem is my problem. I will wait for you. Together they discovered the truth about Mercy Ships, and Esther got an appointment card, a ticket to freedom from the bondage of her body's betrayal.

So, in 2005, Esther came to the ship. And she had surgery. And she was dry. At which point in the story, the twenty or so ladies packed into our half of A Ward erupted into shouts and laughter and clapping. And Robert, Esther's ten month old son, looked up from his place in her lap, grinned a mostly-toothless grin, and clapped his own pudgy little hands.

Because there is life after VVF. There is hope and there is healing. No, not for everyone; there were a few ladies who silently listened to Esther's story, stoic faces masking their own disappointment as they felt their beds grow wet again beneath them. But Esther and Robert reminded us today that new life can come from brokenness. Healing can come to even the most shattered places.

Before I came to the Africa Mercy, a friend gave me some advice. If you ever lose sight of what you're doing there (interesting choice of phrase, that), just go down to the eye tent when they take the bandages off the cataract patients. Seeing that will totally renew your faith in your mission.

I'm not quite to that point yet. (And the more babies they pile into B Ward, the less likely that is to happen.) But, since kids stay overnight after their cataract surgeries, I do get to be part of the 'eye reveals' at times. There's one in particular that I'd like to be there for.

I admitted Shidou yesterday. I greeted his mother, and in his upturned face and milky eyes, I could read Shidou's story. He's eight, and ever since he could crawl, his world has been growing steadily smaller, shapes and colours fading as the cataracts thickened in both his eyes. He was scared, and showed it in true Liberian-boy style; he wrapped himself tightly in his mother's lappa and pretended to sleep. I was busy, with meds to give, dressings to change and old men to help to the toilet. (The stories of my adventures with 84-year-old patients will have to wait. Suffice it to say that I am learning a lot over here.) So Shidou was left to himself for a couple of hours. He stayed still, shielded from the ward (probably mostly from me) by his mother's cloth.

Once things had calmed down and the baby was alseep and the papa was safely back in bed, I went over to Shidou, a bucket of lego like a peace offering in my hand. I gave him a piece. He rubbed it on his cheek, the closest thing to sight he has right now. I gave him another one, and he repeated the drill. I took his hands and guided them to click the pieces together.

His head snapped up. Blind eyes searching out my face. Serious as any world leader declaring war. I gave him another piece.

He took his time with this one. Felt it all over, making sure he knew just what he was dealing with. His little fingers explored the tower taking shape on the bed in front of him, probing for the best spot for this new brick. He locked it into place.




If you have never seen a blind child smile with his whole body, eyes included, you are missing out on what I just discovered to be one of the greatest joys in life.

(Except maybe for slow-dance shuffling across the floor of the ward with an ancient Liberian man. But, like I said, that's a story for another day.)

I don't know exactly when joy came back to the wards, but I know when it came back to me.

Today I got to take care of the smallest patient in the whole hospital. Anthony is six days old and had surgery to repair a meningomyelocele. Now, instead of fairly certain paralysis and almost certain death from infection, he's snuggled up next to his mum, making small, squeaky baby noises. When I move his blankets, he kicks his feet. Both of them. Hard enough to dislodge the wires hooked up to monitor his heartrate and breathing patterns.

I sat with Anthony's mother, Grace, after I changed the dressing over his surgery site, and I explained how the surgery had gone. How, instead of the golf ball-sized lump protruding from the bottom of his spine, Anthony now had flat skin. How his legs were working (and so was his bladder, since, in true little boy fashion, he had tried to pee all over me twice during the dressing change). How everything looked good. A wide smile broke across her face.

Now, something the Liberians love to do is shake hands. We greet each other constantly in the streets and on the wards. In general, handshakes here are rather sedate affairs. In fact, by American standards, they're often downright limp. The only real exception I've seen to this 'rule' is in cases of extreme excitement.

This was one of those cases. She pulled her arm back as far as it would go, her smile got even wider, and she shook my hand as hard as it's ever been shaken. Laughing, she pointed to her name tag and said, 'The Lord has shown me mercy, and He has given me Grace.'

I'm going to take Grace to the Sunday meeting here on the ship. She wants me to take a picture of myself and Anthony for her. 'I will show him when he grows old. This is Alice, and she cared for you.'


'She cared for you.' If that's all the legacy I leave here in Liberia, it will be more than enough.