Tuesday, January 7, 2014

The below story is reprinted from Narrative Inquiry in Bioethics. The title is "The Day I Touched Jesus." This is a story I wish was not part of my history

The Day I Touched Jesus

Jeffery L. Deal, MD, FACS, MA, DTMH

From Narrative Inquiry in Bioethics, Volume 2, Number 2, Fall 2012, pp. 81-84.10.1353/nib.2012.0051

          She deserved better. They all do.
I met her early on a morning that promised to be hot and wet, as Sudan tended to be at that time of year. Hot all the time. Hot and wet in the summers. I touched her for the briefest of moments, felt her leg move against my hand and caught a fleeting glimpse of a foot that was barely the size of my fingertip.
Her twin brother was born eight hours earlier, somewhere around midnight. The birth attendants managed the delivery as well as could anyone in the same situation. The last time I had attempted to manage such a problem delivery was almost twenty years earlier when I had been a Navy Lieutenant fresh out of my surgical internship on temporary assignment to a Marine Corp battle group in the Philippines. On that deployment, a corpsman brought me to a grass hut where a woman who looked barely more than a child herself labored against a breach delivery. I spent the day examining her while her family brought me things to eat that I do not believe should be eaten. After six hours of no progress, I radioed for a helicopter to take her to Clark Air Force base where they had operating rooms and obstetricians. In South Sudan, we had no such resources.
My oldest daughter, a premed student at the time who had worked with me in Sudan on other occasions, sat in the corner with her classmates and watched as I put my hand inside the Dinka mother. She was a large, robust woman who sweated profusely and occasionally caught her breath, but otherwise seemed unmoved by the pain of delivery. Fluids gushed over my gloved hand and the students gasped. I felt the baby’s leg retract slightly as if she resented my intrusion. I could not get past her hip and she was wedged tightly in the uterus. I had some medicines that were used to hasten delivery and, not really knowing if it was the right thing to do, I gave the mother some through her IV. Still I could not dislodge the child. I told the students and birth attendants that we would give her one hour while I rounded on the other patients in our remote and poorly equipped clinic. If she did not deliver by that time we would take her to a facility run by a Catholic relief agency several hours drive from us-- a drive  that due to war, weather, or mechanical problems we could not always complete.
I saw the rest of the patients in a hurry while browsing through all of the medical texts and the few books we kept at the clinic. This child’s only hope of surviving was for her mother to have a cesarean section, and as quickly as possible. After determining that none of our other patients were in imminent danger, we loaded the mother, the first born twin, and the grandmother into our vehicle for the long ride. One of the medical students who at the time of this writing was completing her residency in obstetrics and gynecology asked me if I shouldn’t pray for the woman while we drove. I felt guilty for not praying out loud without being prompted, so I reached back and placed my hand on the mother’s abdomen and prayed while I drove. I felt a slight movement that I could not be sure was not the mother or the road, but I believe to this day was the child again. I would not feel her again. I drove as fast as the rough, bomb-cratered dirt road allowed.
Mother and unborn child were doing well when we finally arrived three hours later. I knew the facility and many of the workers so I drove past the guard and directly to the obstetrics ward. Two nurses rushed out to meet us with a gurney and whisked the patient into a delivery room, a dusty place of peeling paint and old, powerless lights. They told us the surgeon was nearby and that they would take care of her.
The rest of us left to find something to eat and to purchase supplies. We were gone for a couple of hours. When we returned, we found the head nurse.
“The baby has died,” she told me with a professional mask of seriousness. “We felt the baby’s leg and thought we could make the delivery. The child died while we were working.”
We asked to see the mother and were taken to the ward next door. The mother we had worked with so hard sat upright in the bed with a sheet over her lower body. Amazingly, she still did not look tired. Her Dinka name, my wife reminds me, was Adut which means “Replacement.” It is a name given to the next child born after the firstborn dies.  Adut cradled the twin brother in one arm and stroked his cheek. The mother nursed the child and gazed at him with the look that only a mother can have—one of love, adoration, and hope. My daughter stood beside me while we spoke briefly to the nurse and to the mother. Adut did not seem troubled that we did not save her other baby and was content with the life she held to her breast. I had feared she would hold our failure, my failure, against us. When my daughter and her friends had left, I asked the nurse a question to which she responded, “It was a girl.”
I kept my face turned from the others as I got into the truck.
The ride back was mostly silent and seemed to take forever. Darkness had fallen over the flat land by the time we made it back to our tent camp. We all drank our filtered water, spoke encouraging words to one another, and went to rest for the coming day.
I have worked through epidemics of cholera, malaria, and meningitis where we lost scores of people each week and those hard days remain a distant and yet troubling memory. Something about the one, tiny being I encountered that day haunts me in ways that I cannot easily explain.
How low can a person be when she can die having never been held? Never been stroked or fed by someone who loves you? How low must a person be to die without a name in a place that will keep no record that you ever lived and where your own mother does not mourn your passing? It is hard for me to imagine anyone of lower standing than the girl who I touched ever so briefly that hot morning in Sudan.
Jesus spoke passionately of His desire for us to care for the poor and downtrodden in His stead, none more poignant that when He said “Truly I say to you, to the extent that you did it to one of these brothers of Mine, even the least of them, you did it to Me.”
The partially born girl that I touched that day had to be the least of the least. In retrospect, I could have administered enough local anesthetic to have surgically removed the child through a few incisions, but it had been years since I had done or even assisted in such an operation. We had no lights, no cautery, limited instruments, and no sterile rooms. Even had we had gotten the child out, we had no way to manage the bleeding and would have had to pack the wound open and rush her to the same hospital. It would have been like performing a cesarean section in your garage without electricity. Perhaps I should have tried. Perhaps I could have made the decision to drive her to the hospital earlier and she would have lived. Perhaps, perhaps, perhaps…, but I am not sure of any of that. Of one thing only I am certain.

She deserved better. They all do.