in the middle of my mess, you wash my feet.

Today I was in the admissions ward. You may remember an earlier story from the first time I reported to duty in admissions room. Once it was an unfamiliar place, but it has grown to be one of my favorite spots in the hospital. As a student it’s a great place to be. Every patient who gets admitted into the hospital comes into the room to be seen by the Post Graduate doctors. This means all the abnormal and complicated cases in addition to the “normal” cases. The women are seen, given a vaginal exam, have their blood drawn, and an IV inserted so some type of oxytoxic drug can be immediately administered. This might not seem like your idea of a good time, but all these things are blast to me. Getting this type of practice and experience feels like hitting the jackpot for an eager midwife student, as myself.

 A regular day could include cases such as, eclampsia, HIV, hepatitis B, obstructed labor, cephalopelvic disproportion, abortions, cesarean sections, and yes even an occasional unsuspected delivery or two will take place. A field day of learning opportunities and a great opportunity to be the first welcoming, safe, and loving face to the women come in contact with.   

As I stepped into the room today it seemed a bit calm. I didn’t hear any shrieks or cries for help and the overload of patients to be seen by the doctors seemed bearable. I headed into the examination room (and by “room” I mean spot behind a thin, ripped up curtain where scans and vaginal exams are preformed.) As I made my way behind the curtain I saw a woman on a gurney. I think it’s the first time I have seen a gurney in the exam room so I was immediately drawn to the situation. 

I looked at the woman and realized her placenta cord was hanging out. “Does she have a retained placenta, why is her cord still out?” I wondered out loud. One of the interns overheard me.

“One twin delivered. One still inside.”

“Well…alright, another delivery on its way. Lets do it,” I thought. Already eagerly reaching for some sterile gloves. However, before I could get them on a few other doctors surrounded her. One doctor began the exam.

“Hand presentation,” she said.

Everyone, including myself, perked up and was a little eager to have a feel. A hand presentation may not make sense to you. But it is totally abnormal and seems extremely interesting for a person who usually feels the top of the head upon an examination. As eager as I was to have a feel, after 3 other doctors checked her without any consent from her I decided it was best not to do the exam just for the pure sake of my curiosity.  Those situations are often difficult for me. I’m a student. I need to learn. I am allowed to learn. But there has to be an acknowledgment of what’s more important: learning or trying to leave a woman with the little dignity she has left after such an evasive thing being done by so many people?

A hand presentation indicates that she is in obstructed labor. She will not be able to have a normal delivery and must be taken for a caesarean section. They did a scan on her to have a look at the baby. No movement was found. I went to get a Doppler (a device used to check the fetal heart rate.) As I began to check her, she looked up at me searching my eyes for just a glimmer of hope, “my baby…?” she asked open endingly.

I know what she was getting at. Through her broken English I knew she was asking me if her baby was ok. If the baby who was left inside of her would still be alive.

I wanted to tell her yes. I searched frantically with the head of the Doppler around her stomach to find the heart. No sounds were heard.

She began to speak more to me. The proficiency of her English surprised me.

“You understand what I am saying?” I asked her.

“Yes, madam,” she said through her contractions.

“Has anyone explained what’s going on to you?

She shook her head, no.

“How is the first baby? Where is it at? When was it born?” I earnestly asked her the questions I wasn’t getting answered from the hospital staff.

“Born 1:45am. Female. With my sister,” she responded.

It was around 10:30am. This means that it had been over 9 hours since the first baby was born. I am a student. I am still learning so I naturally had questions about whether or not its ok to leave a second twin inside for 9 hours. I searched through the logic in my mind though and quickly concluded that it’s not okay.  

It’s just not okay.

I can’t justify any reason to leave the baby inside. She’s obviously fully dilated because she has already delivered. Had they not done a scan previously? Had no one palpated the stomach in 9 hours and checked if the baby was in a position that would allow for a normal vaginal delivery? Why hadn’t she been taken in for a c-section earlier?! Has no one checked if the second baby is distressed? If the heart rate has dropped?

“Where is this woman’s case sheet,” I wondered, frantically, again out loud.

“I don’t know, I just got here,” another unsuspecting intern popped out from the woods to answer. 

Feelings of helplessness began to wash over me. I couldn’t make this about me though.  Not when someone really was helpless right in front of me.

“What is your name?” I looked into her eyes and asked.

“Vereema,” she responded.

“Ok Vereema, I am going to look again for the heart beat. And then I am going to pray for you. I am going to pray to Jesus for you.”

“Oh, thank you Madam. Thank you, thank you, Madam,” she gratefully responded.

No heartbeat.

Jesus, please let me see a miracle here. Please, protect this woman and her baby. You have said we can pray and we can heal and You have given us this authority. Please, God.

I held her hands in mine and put my other hand on her stomach and sincerely prayed out for her.  As I was praying one of the new post grad students came in.

“Did you find a heartbeat?” She asked me.

“I cannot find.” I told her.

“It is too late,” she said to me, verging on an attitude lacking emotion.

“Maybe you can see a miracle today,” I implied back to her.

Alright God, you gotta come through for me on this one. Think of how greatly You’ll be glorified! This woman, her baby, her family, AND now the hospital staff. They will see that You have brought life and healing and they will know that You are a good, loving, and a true God.

A man came in to transfer her into the operation room. I promised her I would come to see her in the postnatal recovery room after the operation and that I would continue to pray. She was wheeled away from me and I tried to go back to work but it just wouldn’t settle with me.

I quickly headed over to the “Theatre” as they call it to join her for her c-section. Sometimes they don’t allow us into the operation room. Truthfully, we have no reason to really be there so I wasn’t sure if they’d let me in today.

“I want to go in with Vereema,” I said, halfway pleading.

They gestured for me to follow. I put on a sterile uniform and scrubbed in.

She noticed me in the room. I made eye contact with her as to tell her that I was going to be there with her- no matter what. Within minutes she was under and the cutting began.

I watched. And prayed. And prayed. And interceded for the life of that baby.

I wanted to cry when I saw them pull the lifeless body out of her mother. She was perfect. A beautiful looking little baby girl that was lacking nothing but a heartbeat.  The cleaning lady who normally takes the babies was no where to be found so they left the baby to lie near the mother while they removed the placenta.  I silently still hoped for a miracle. When the cleaning lady eventually came in carrying a cardboard box I was a little confused.

Confused-until I saw them pick the baby girl up and chuck her into the box. I wish I was exaggerating when I say that they chucked her into the box. I shrieked out loud. Her body slid across the box and bent unnaturally.  That is a human. And no one in the room even cared or gave any value to the body that lay before them. They see this countless times everyday and the sanctity of life begins to just wear off.

Please, Lord, never let this happen to me.

They began to suture her back up and I knew that I was due to relieve some girls in the antenatal clinic (ANC) right about now. What a flood of emotions. I wanted to stay. I needed to stay. I wanted to be there when she woke up, alone, without her baby and without any explanation of what happened to her. In these moments I am torn.  I know my teammates would have been understanding, but I know that I have a job to do and I committed to be somewhere at a certain time. I also knew that it would probably be a good hour before she was awake so I made the choice to leave her, knowing in my mind I would be back as soon as my shift in the antenatal clinic was over.

Straight from the operation room I headed over to take blood pressures in ANC. I wiped away the tears from my eyes and sat down to an overwhelming sea of pregnant bellies. The line of women waiting for me to take their blood pressure was wrapped around the hall.

God, how do I show each one of these women I care about them right now?? I don’t want to take their blood pressure. I WANT to go and be with Vereema, and I WANT to read her case sheet and I WANT to know why that baby died. I WANT ANSWERS. 

My first mom sat down and I opposed my feelings of apathy with a warm smile. I had to fake it at first, but eventually, in some miraculous way God gave me His grace. And even though at this point I wanted to be anywhere but sitting in this crowded, smelly hall taking an absurd number of BP’s- I was able to see His face in each of theirs.  And taking their blood pressures didn’t seem so monotonous anymore. I offered pray to each woman who came to me.  After I finished my 65^th blood pressure, I took off my stethoscope, rubbed my aching ears and headed back over to the operation room.

Vereema had already been transferred. I searched the whole hospital for her. I couldn’t find where they put her and I couldn’t get anyone to give me a straight answer.

I wish I could finish this post with a happy ending. These are the days that I leave the hospital with a lot of questions and “why” just doesn’t seem sufficient. I need answers. I want to know why the God who can breathe life back into a body wouldn’t do it when I begged Him for it, publically for others to see? Why didn’t He save this family from the heartache that they would have to endear? Why didn’t He show His glory to the unbelieving hospital staff?

These questions remain unanswered for me, but I know not forever. In the mean time, I will still choose to know that God is a good, just God and even when things that happen around me try to tell me different I will stand firm on this truth. I know that God’s heartache for this woman is greater than mine and I know that even though I didn’t see Him answer me on my terms it doesn’t mean that He didn’t. There are things we do not understand. While we may only see a glimpse of an image, God has the whole picture. And I will choose to trust in His painting.

 “In the middle of the storm, You are the peace.

In the middle of the desert, You are my strength.

In the middle of my mess, You wash my feet.

In the middle of it all…You are, oh Lord.

You never leave.

In the middle of my brokenness, You are my strength.

In the middle of my nothing, You are everything.

In the middle of my mess, You come down and wash my feet

In the middle of it all… Here you are.

You never leave.

In the middle of my storm You are right here with me. Walking right beside me.”

(a song by Jonathan David Helser)