In medicine, there are some patients we refer to as rocks. I hope you’re asking what a rock
is.
A patient becomes a rock when his or her status changes about as
quickly as a rock changes. A
patient who sits on your service for weeks or even months, with barely any
evidence of change for the better or worse, and who has very little potential
for getting better in the near future… That is a rock. These patients are rarely more
interesting than finding quartz in a quartz mine.
In the beginning of December we had a bunch of rocks on our
surgery service. There were a lot
of abscesses. (There are always a
lot of recovering abscesses here in Tchad). They weren’t getting better fast. They weren’t getting worse fast. They were just sitting there.
Like rocks.
Dressing changes every day.
A little better. Not worse.
A little TINY bit better.
Doesn’t it look better today?
Then Christolph came in.
He joined our service of rocks.
He was the worst rock. The
one where when you come to his bed, you gather up your strength to hold a
straight face (one that is not putridly mean) and not vomit.
He was in his 30’s, though you would think older by how emaciated
he was. He was just in a terrible
state. One of those where you just
hope time passes quickly for him.
We’ve seen the same thing several times already here.
Abscess of his mediastinum.
The point of exit was his neck.
The pus was everywhere.
When he first came in we cut into his neck (just like you would cut when
you motion that someone is dying) to help the pus get out. The infected area extended up into his
neck. Not just a little, but way
up close to the base of his ears.
On both sides.
When he coughed, thick green pus came up out of the opening in
his neck. We did an extensive
dressing change, started antibiotics, and hoped he would die sooner instead of
later for his sake.
Then after a few days, he still didn’t die. What in the world? Apparently nobody gave him the
memo. He became one of our rocks
also. He didn’t die, but he wasn’t
exactly leaning towards the living either.
More dressing changes every day. Even to the point of just pouring bleach water down his
mediastinum. One day on rounds the
family stated that when he drank, water came out his neck.
“No way,” I said.
But I’ve learned to listen to my patients (as best I can with all of the
language barriers here) before I say to much. So I said, “show me.”
Sure enough. Water
came out of his neck after he took a sip.
As well as pus.
Not good. This means
that the infection had eroded through his esophagus.
Well, not much to do here in the bush. We might be cowboys, but we’re not operating on an
esophagus.
If Christolph wouldn’t have been so mentally alert, I probably
would have said to just go home and die.
This was severe. Every time
you pushed on his chest, his neck, anywhere, pus came out. Every time he coughed, pus came
out. I don’t know how he was still
breathing because you could see air coming out when he exhaled after a deep
breath. So the infection was
clearly eroding into his trachea (wind pipe) too.
Christolph spoke perfect french. So I could communicate with him. (I didn’t say my french was perfect. I said HIS was!).
After he leaked water out of his neck, I did the only thing I
could do that would help.
I prayed. We called
the family around and prayed at his bedside.
“Dear Father, Please help Christolph. Please relieve his suffering. If it is Your will, heal him. This is a terrible situation. You never want to see Your children like this. We can do nothing. We leave it in Your hands. Thank you for hearing us. In Jesus’ name, Amen.”
I asked Christolph what he wanted. Did he want to stay for dressing changes or did he want to
go home in peace with his family?
He clearly stated that he wanted to stay. Somehow he could still talk. It was like those people who have holes
in their trachea and have to cover their stoma in order to talk. It’s so hard to let someone die when
they clearly have a strong will to live.
My dad was visiting Moundou for the day to help James out while
he was in America. So I said I
would talk to him when he got back and suggest a PEG tube so that Christolph
would not starve to death. Maybe
this was being a little too aggressive for here, but it was either that or go
home and starve to death.
The next day Dad put in a PEG tube. We stopped everything by mouth and told his family to feed
him through the feeding tube that went directly into his stomach from his
abdomen.
More dressing changes every day.
A week or so later, he still didn’t die. Several times a week I rounded on the
surgery service so my dad could do more hernias in the OR. During this time I got to know
Christolph better. Ann, a visiting
midwife from France, had been helping with dressing changes and had given him
some books to read. He was with
it. He was alert. But his neck abscess was NOT getting
better.
It seemed hopeless.
We brought him to the OR to do a little more debridement. No anesthesia lest he lose his airway
and die. Everywhere you pushed,
thick green pus came out of his neck.
I extended his opening a little.
What he really needed was to remove most of the skin from his neck, but
that would be quite severe for here.
So I just did a little. The
big problem was in his mediastinum (deep chest) and we couldn’t get to
that.
The family had been pushing to go home. Christolph was always content staying. He wanted whatever we thought was
best. That was the problem. It was hopeless. And we didn’t know what to do. He was so skinny. He was so weak.
I told Christolph that we would try some really strong
antibiotics for 5 days. If it
wasn’t better after the 5 days, then maybe he could go home to be more
comfortable.
“Please try the medicine,” he said.
I rummaged through our office and found some expired Vancomycin
(really strong antibiotic) that someone had donated. We started 1gram every 12 hours. Plus the only vial of Zosyn. I gave that too.
If this didn’t work he was going home. But he had such a strong heart to live.
He got the 5 days of antibiotics. It was possibly a little better, but not hugely. So they went home. It was better that way. He would be more comfortable. I was sad, but knew I would see him again
in Heaven. He was a Believer.
We continued our daily grind. Life is sad here.
I avoided writing blogs because it’s true that life is sad here, and I
didn’t want to be too depressing around the holidays back home. People don’t like things that are too
depressing. Sometimes that’s just
the way things are here.
But then… this week I saw a ghost! I was just outside of the operating room looking for the
next patient to see.
It was the ghost of Christolph. He was walking with his brother from the hospital entrance
towards me. The point was that he
was WALKING with a cane. He was
weak, but he was walking! He was
NOT dead. It was a miracle!
I got tears of joy in my eyes as I went up to greet him! I wanted to tell everyone around that
this man was supposed to have died, and I could not believe that he was
living! It was truly a
miracle.
He looked fatter too.
The family had continued the dressing changes at home. They had lovingly continued to give
liquid food through his feeding tube.
They had continued an antibiotic through the tube. Ann had given him a natural supplement
to try also.
We know that God made him better. His feeding tube had fallen out 2 days before on its
own.
His neck looked surprisingly better. It was dryer, less pus, and smaller. His feeding tube hole was nicely healed
over. And he said for the past 2
days that he had been able to swallow water and liquid food without it coming
out of his neck.
We were all so happy that he was doing so well. I said that he needed to be a pastor
now because he had a second chance in life. God clearly has a good reason for keeping Christolph
alive. I gave him a french Bible
and a few other things to read. He
yearns to learn more about the true living Rock, who is Jesus.
It’s nice to see miracles here! Please pray for his continued recovery.
Wow, what an incredible miracle! That is an awesome story! I am a pre-med student from Cincinnati, Ohio and I really enjoy reading your blog. I am thinking about being a missionary doctor some day and your blog is really inspiring! I'm praying for you guys!
ReplyDeletethanks for sharing...u have uplifted my soul...God is Great!!..hope to see more miracles soon since i will be doing a short volunteer in Moundou adventist hospital this coming February,2014
ReplyDeletePraise God! He is so good. I am thankful for miracles; they are encouraging to us all. I praise God for saving Christolph's life. I agree with you, that God isn't through with His plans for him.
ReplyDeleteI pray that you all stay encouraged over there. I hear the undertones of sorrow in your writing, or maybe they aren't undertones at all. You have willingly gone where Jesus would go if He was here. To the dark places where hope has the chance to shine brightest. I pray that God will keep you focused on Him, so that no matter the circumstances around you, you will be able to have a rock-solid faith that can move mountains, and a peace that surpasses understanding, and a love that is unconditional. God bless you richly! *hugs*
Thank you for sharing - what an amazing story and a miracle that you can look back on when you wonder why things are happening the way they are.
ReplyDeleteWe hear that a lot of you guys are sick right now, so we are having extra family and personal prayers for you. Our toddler reminds us to pray for you at evening worship.
And please, if you want to write what is really happening, please do - your 'depressing' stories remind us why we are Christians, and that you and your patients need prayer. We can lift you up to God when it's the hardest, so keep sharing!
Hugs to you all,
Alison Cover
Wow!! Praise the Lord!! I'll praying of course!!! What an awesome God we serve!
ReplyDelete