Beautiful

We had a vesico vaginal fistula screening again at the beginning of this month.



VVF patients suffer from fistulas - or punctures, holes, tears- that are in the rectal wall or bladder due to prolonged labor or trauma in the vagina. Often times a woman who is impregnated at an early age before the pelvis has had time to form will suffer from prolonged labor. These women often give birth to stillborn children after having been in prolonged labor for three to ten days. The stress creates these obstetric fistulas.

Because they are constantly leaking urine or feces, they become outcasts in society. They not included in society because they smell, because they are seen as failures in the one thing that will give them validation in their society - to be a mother.

We have about twenty of these VVF ladies in the ward right now. Last Sunday, during ward church service, two of them were sent home because they had been cured. Dressed in a beautiful new gown, Mary stood up, she sang a song of worship and started walking outside of the hospital. Where was she going? She wandered out of the ward doors and then took the hands of a big, smiling moustached white man. She held those hands, so precious in her own. They were the hands that cured her. Dr. Steve grinned from ear to ear, a bit embarrassed, but a glimmer of a tear crept up to his eyes. Mary gave thanks to God for what He did through Dr. Steve.

From the last VVF screening, here are some healed and happy ladies. (And my friends Zoe and Doris, Liberian dayworkers - second from left and third from left - whom I have taught how to knit, and are now teaching the VVF patients)



Tonight, there was a screening of A Walk to Beautiful. The movie focuses on three to four VVF patients in Ethiopia who travel at least six hours by foot to the nearest road, then take at least a 15 hour bus journey to the city of Addis Ababa, Ethiopia. There, they meet women who have also been left by husbands, rejected in their own homes, and shut out from society. They receive physical healing, but also psychological support. (Incidentally, Dr. Steve also worked at this center for 3 years. He is not in the film, but his dog appears briefly!)

In one scene, a group of women are sitting around knitting. In fact, all of them are swaddled in colorful, garter stitched patchwork blankets. Several of the nurses turned to me during the film and smiled. My roommate Ellen yelled, 'Hey Michelle, have you been there?' To me, it was a small sign that I am in the right place right now. And that kind of 'knowing' is a relief in life, no matter how big or small that what I thought I would be doing here, is what I am really suppose to be doing. And let's not forget, after all, we are 'knitted' in our mothers' wombs!

Under Kaybo's skin

** Warning. The following post is about my time observing surgery and there are photos that some may find gory and graphic. So if you are on your lunch break and think you can’t hold that ham sandwich in your stomach, I suggest coming back at some other time. But I do hope you come back as this has been one of my best experiences here!**

After a couple slices of bread, some tomatoes and rice, I run down to the Women’s Locker Room to change into scrubs. I wonder to myself why they suggest eating lunch before observing surgery, since I assume some may have trouble holding onto their lunches. I pull the loose blue scrubs over my head and wonder if my lunch will stay in place, especially in the midst of riding out that stomach virus this week.

Right before 1 pm, I tell the OR (operating room) supervisor that I am ready to go. There are three surgeries going on. One involves some bone fusing that has been going on since the morning time and looks like it will take the rest of the day. Lots of blood. Everywhere. Second, a 15-minute surgery that involves removing some tongue that has been stuck to the bottom of the mouth. Third, the removal of a large egg-sized tumor from the carotid area as well as two fat packs from the patient’s arm.

‘Which would you like to see?’ she asks.

Bone fusing, tumor removing, tongue releasing. My lunch is about to give her an answer, but then I say, ‘If possible, may I watch the tongue surgery and then switch over to the tumor?’ I really want to see a surgery from beginning to end, and bone carnage is at the bottom of my list, anyway.

I walk into OR One and see that Dr. Gary has started begun. Only the patient’s mouth is in the open. The rest of the body is draped in aquamarine drop cloth. He has already freed the tongue and is now sewing the sutures. Like a skilled craftsman, and not unlike advanced knitters or embroiderers I’ve seen, his hands are swift, nimble, and very precise. He uses two forceps to sew up the suture. I am unable to see anything, and at this point am unsure if I want to see anything. It is very calm, very quick and as promised, fifteen minutes pass and he is done. The nurse asks me to step outside and wait for the tumor operation in OR Four.

As I am waiting outside, Dr. Gary comes out. I have never heard a bad word spoken against him. Gracious. Capable. Respectable. Those are commonly spoken of Dr. Gary. He is the kind of man who can smile with his eyes (which helps especially when constantly wearing a surgical mask.).

Dr. Gary stops to explain the tumor surgery to me. It is a tumor in the carotid area (neck, underneath the chin) on the left side. He has to be careful in cutting out the tumor because it is close to some nerves essential to blinking, smiling, and other functions he’s sure the patient wants to keep. It will take a while, he says. The patient has also developed two fat packs on her shoulder and forearm which causes her to look very disfigured.

When the patient is fully anesthesized, I am allowed in the room.

On the operating table is a fully grown woman with closely cropped hair. Her small feet poke out from beneath the aquamarine cloths and in passing I notice her chipped toe nails. Her head is turned to her right side and on her left, the tumor, as described by Dr. Gary. It bulges outward. The jaw line ceases at that point as the tumor hills and crests behind her ear.



Dr. Gary draws a line with a marker. This is where he will cut.



He asks Donna, the anesthestist, who this woman is.

‘Her name is Kaybo,’ she says.

Dr. Gary lays his skilled hands on the patient’s head. He says a prayer for her before he begins.

‘Kaybo, did you say?’ I ask. ‘I just selected her yesterday as my patient!’

I saw her name earlier in the week hanging on the poles for our ‘adopt-a-patient’ program and had a feeling about her. She is 49 years old. She will be here from anywhere from four days to two weeks. I had not visited her yet due to my own maladies, but here I was witnessing her surgery.

‘Well, that certainly isn’t a coincidence!’ Donna replies. Suddenly, the surgery took on a newer meaning. Here was someone I had chosen out of so many to take care of during her stay here. And, perhaps, not quite randomly, she was chosen for me ahead of time.

Dr. Gary picks up a scalpel. The first incision is small but decisive. The skin automatically splits and a layer of yellow fat tissue is revealed. There is a little bit of blood, but not much. I listen to the beeping of the heart monitor. Donna monitors her vitals.



Cut, snip, push, tuck. The movements are both gentle and firm. The tumor is revealed and blood begins to drip out. It is lumpy, foreign, and against the rest of the human body which seems to make sense, one can tell that it should have no place in this woman’s body. Yet, this thing has grown to be a part of her body and is nourished by her blood.



I remember what Dr. Gary says about his need for caution around this area of the body. Just then, he takes he finds a nerve and pokes at it. Kaybo’s mouth twitches. He’s found the nerve and it was only 30 minutes into the surgery. With this information he is able to move about faster.





Dr. Gary and his OR nurse, Steffa, proceed to cut, snip, push, and tuck some more. The tumor is coming out. I feel my tear ducts pinch. I’m about to cry. This woman’s life will change for the better without this tumor and I am so happy for her.







Dr. Gary plucks the tumor out and puts it on a cold, stainless steel tray that Debbie, another nurse, is holding.

‘Dinner?’ She jokes. Dr. Gary sews up the sutures in a neat, clean line.



Dr. Gary moves onto the fat packs. When he opens the skin, the fat cluster bursts out. The cluster is the color of flan, or meringue, or the hue of a bridesmaid’s dress for a summer wedding. He pulls it out with a pair of forceps as matter-of-factly as pulling out a ball of hair from the shower drain. He hands it to Steffa and she puts it on the instrument table. I want to poke at it, but decide not to.





After the second fat pocket, Dr. Gary looks over all the sutures he’s closed up. Kaybo’s heartbeat is normal. She’s breathing evenly. He gets up and removes his gloves, his mask, and outer gown. I thank him for the incredible experience, noting how God has made such amazing machines for human bodies. He makes a casual and humble remark about how it is even more amazing that surgeons don’t get in the way of God’s creation.

‘Wow and all before 3.30!’ I say. I mention that I’m still able to go to my practice fire drill, which I am a part of as my role on the reception team.

‘You’re not staying for OR One?’ He is already down the hallway. ‘I’m doing another surgery right now!’ I laugh, but dismiss myself. He’s in charge of one kind of life saving, but these practice fire drills are so that I can help in another kind of life saving, I hope.

As I leave, I pass by OR One. I see the patient lying down on the operating table before he is anesthesized. We make eye contact. He is very afraid.

Don’t worry, I say to him in my mind. You are in good hands.