grieving losses at a remote mission hospital

 "Dear friends, He is not slow in keeping His promises 

As some understand slowness to be

Keep a watch out, don't lose faith, He said, He would come for you

He's gonna come for you, you wait and see, just wait and see" ~ Charlie Peacock 

This song came to me like a serendipitous meeting with an old friend. In 1990 I listened to this song on repeat. I played it on my dad's car cassette player as I drove solo to and from my high school youth group. I got to drive my dad's car more often at that time because he wasn't using it much during the 7 weeks he was in the cancer ICU ward of Baylor Hospital in Dallas, Texas (silver lining!). It was a grievous time in my life as I stared my dad's mortality square in the face. I wrestled with my faith and angrily demanded of God to just fix Dad and let us go on with life already! I was weak and heartsick from seeing needles and chemo bags and a bloated father listless on a narrow hospital bed. My father was 38 and I was 18. It seemed especially cruel to be facing such mortality at those ages.

I am protective of my current team's privacy here at Bongolo Hospital and I am careful to only share my stories and not overshare or infringe on my teammates'/friends' stories. However I've been wanting to share about an especially painful death I experienced alongside our team. 

Can you spot the runway?

We had flown back from a few days in Libreville. I was just about to eat some instant udon noodles we had found in a grocery store in the capital city earlier that day (score!). I had had a random migraine earlier and was recovering but still feeling fragile. One of my friends and docs on our team sent out a text on our WhatsApp group asking for blood donors for a crisis patient in maternity. I was of the blood types requested and I immediately drove down the hill to the hospital lab. When I arrived there were already several on our team in the lab beginning the process to donate. We don't have a blood bank so when there is a need for blood often our docs themselves give their blood as well as asking other family members and friends of the patient to donate the needed blood. The blood is tested and immediately given. 

Sunset through the lab window that night

 The last time I was in an African mission hospital to give blood was in 2016 in Cameroon. My son Sam was in a bad state with treatment -resistant malaria. He was in crisis and needed 4 units of blood stat and I was the first to donate with 3 other international doctors in line behind me. I have always been embarrassingly weak around blood. I briefly became desensitized to it during my dad's stay in the aforementioned ICU cancer ward because encountering blood was a regular occurrence back then and gratefully it became a normal that I was able to deal with like I imagine other non-squeamish people deal with it.

Sadly that day in the lab I was deemed unable to donate as my blood pressure dropped inexplicably and I was out of the healthy bp range, I ended up nearly fainting and resting my head on the lab table focusing all my energies in NOT fainting. It may or may not have been related to remembering the trauma from the last time I was in that kind of setting. I was so embarrassed and disappointed to not be able to donate. Steve came to my rescue once again like a knight in shining armor bearing cookies for those that had donated and a cold Diet Coke for me. Also he replaced me by donating his blood. All this was happening as one friend was stretched out on the lab table actively and quietly giving her blood. Everyone was focused on me and my non-blood-donating-dramatic-self all fainty and fragile. Ugh. 

I can't remember exactly how many of us (teammates) and friends and family members of the patient gave that night but it was a lot. After I had recovered and Steve had donated blood we were leaving the lab when we spotted a water bottle one of our doc/teammates had accidentally left behind. We grabbed it and thought we'd drop it by the surgery department where she last was known to be. It was dark at this time and we walked into the brightly lit Operating Room waiting area. Steve waited outside as I entered a new world of sights and smells and people. 

I found our doc attending to the patient accompanied by a team of nurses and support staff. There were women lining the far side of the room in prayer, I greeted one that I knew. Our doc was brand new to our team and very fresh from language school. She was trying to give instructions to the patient that just wasn't translating. She asked me to translate the instructions so there would be no misunderstandings. I did so. The patient was clearly in distress but made direct eye contact with me and slightly nodded to let me know she had heard and understood my instructions. There was blood on the sheets and blood on the floor. There was a palpable courageous calm in the room. It was unlike anything else I had ever felt. I was only in the room mere moments but I will never forget that experience. It was a sacred and active battle ground. Life and death were hanging in the balance with a young mother hemorrhaging after an emergency c-section, donated blood was running through her at an alarming rate. Her tiny baby was in another department in distress. It was grim.

We heard late that night before we went to bed that the surgery had gone well and they had found cause of and staunched the flow of the hemmorrhage. It was such a relief and answer to many frantic prayers. In the morning I texted one of the docs and was informed that though the surgery had gone well, just a half an hour later in recovery the patient tragically lost her life. After that long night of battle after battle with many giving their absolute best efforts the sweet young mother died. The woman I had made eye contact with just hours before her death was gone. Her baby was still touch and go for about a week after his violent entry into the world. We all wept and prayed for this family and this tiny baby. Miraculously the baby ultimately pulled through and lived and was discharged to the grieving family. It was a significant silver lining to that tremendous dark storm cloud over Bongolo hospital. 

Life and death are common to every living person across all times and cultures. Death will come to us all. It is the great equalizer. No one has escaped... except one - Jesus. In the US we seem to sanitize the whole death process. We generally bury or cremate bodies within 3 or so days of the death. All the preparations of the body are done by professionals and we, the loved ones, are only nominally exposed to the dead body. Not all cultures do it the same way obviously. Here in Gabon, family members and friends very loudly and passionately wail and lament. The grief is an almost physical presence in and of itself. This is no polite or sanitized response. It is raw and real. The wailing can be heard from all around. 

In fact, culturally in these parts, if you do not outwardly demonstrate your grief loudly and with passion you might be accused of having cursed the departed one and blamed for their death, even if you are a close family member or friend with no discernible conflict with the departed one. This came as a shock to me when I first learned of this as it's so different from our cultural practices and understandings around death and dying. I don't understand all the cultural nuances here. I am learning. I will always be a learner here. I am sure there is much I am not communicating culturally here. Just like speaking a foreign language, I can speak it and understand it but in a very simplistic way. I lack fluency. I share this surface element of grief and dying here in the Gabonese culture to help you understand how very different things are even in some basic mechanics of how death is experienced in this place. 

Recently our member care team has begun discussions on how to process death and dying here as a medical missionary team. Death occurs regularly down at the hospital campus. One teammate shared that on one day she lost 8 patients. Just like the story above our OR's and various departments daily are sacred battlegrounds. Sometimes life wins out over death and sometimes death comes despite the valiant and tireless efforts on the part of our staff. Death occurs here that would likely be greatly mitigated in the West. That reality adds a particularly grievous element. Death has a cumulative affect. Unprocessed grief gets shoved to the dark recesses of the human heart. All energies and expertises are mustered for the next battle... and the next... and the next... and the next...

So we are beginning a process to develop practices and strategies to help contend with death and dying in a proactive and healing way. God is in charge of life and death. He holds each soul. He knows the number of hairs on each one's head and the number of days each one lives this side of eternity. He will show us a way to process this grief and continue with lighter hearts and souls. The opening song from my youth speaks to our God's promises. He promises to comfort us, to never leave us, to shape us and grow us more and more into His own image. We believe He is not slow in keeping His promises. This song is referring mostly to His return however there is a stone of remembrance in my heart from those days as I was encouraged and comforted to know He is near and present and provides abundantly, especially in times of grief, amidst all kinds of loss and heartache!