Dear Suburban America, especially the Moms and the Dads,
I love you but I don't understand you.
1. You shell out for organic, soy, sensitive, Free range, IQ boosting formula but won't breast feed your babies. You shell out for organic, homemade, free range, rice based baby food.... But you won't breast feed your babies And you are really snobby about their organic free range formula.... There is nothing more organic or natural than breastfeeding.
2. You shell out for your Baby Can Read products/Baby Enistein....in hopes of enriching your babies college admissions potential...turn off the TV and talk to your baby, read to your baby.....FOR THE LOVE....TURN OFF THE TV.
3. You yell at me for not prescribing antibiotics for your child's 24 hours of nasal congestion.....ITS A VIRUS. I can't fix viruses and it will be gone next week Yet you wont let me vaccinate your child against h. flu and pertussis both of which I have seen children die in the ICU from in the past two years. Nasal drops and Tylenol vs. watching your child seize in the PICU on a ventilator..... ?!??!?!!?! NOT TO MENTION THAT WHOLE VACCINES CAUSE GREEN HAIR/AUTISM/GENERAL BADNESS is bad, bad science and there is a very expensive law suit in England as a result of it.
4. You yell when we cannot get your child low fat, mint chocolate chip ice cream with rainbow sprinkles to your child in the hospital and threaten to leave AMA until we can produce it...(you can't make this stuff up)
5. One of my colleagues spent an hour with her Private Practice preceptor last week consulting an irate family about the lack of success of acne treatment...being a teen is rough don't get me wrong, my baby sister struggled with acne but yelling does not make it better and I counter yet again...acne vs. nearly every other medical problem known to man...what would you pick?
6. I recently observed a bunch of folks including health professionals and some Moms (not fellow residents) make fun of an Amish patient and another make fun of a patient from the inner city....cultural sensitivity is not our strong suit.. We say we want diversity, we say we want tolerance but we like it better when THOSE people stay on their side of town.Those kids are sick too and they need us pediatricians just as much as your baby.
7. We say we want women to be able to be mothers and work and do it all but its not acceptable for a women to pump at most places of work (although it is where i work :) ) and its often not culturally comfortable for a woman to breast feed outside of a cramped bathroom stall in public. Can you imagine trying to breastfeed your 2 mo and entertain your 4 yo in a 6 by 3 ft space mostly occupied by a stroller and a toilet...its time to come out of the closet people....its just a mom breastfeeding...heavens know there are far worse things on prime time cable.
8. Then there is the other extreme....(and I am about to be called a heretic)...the stay home at mom who is snobby about being an organic, free range, non-vaccinating homeschooling, Sunday School teaching, Women's Bible Study leading Mom who will condemn my single Moms/married but working two jobs in poverty sending their kids to day care and public school in the inner city for not staying home. Where is your compassion that you preach about? I love you and I grew up and went to church camp with you but I am ashamed of it. What the heck happened while I was in medical school?
9. You who see one of us come into the room and say "No way, I don't want a resident, medical student, fellow, attending under the age of 35 touching my child." Or my favorite: "They can practice on SOMEONE ELSE child." I understand Moms, believe me I do, I have had many clumsy orthopedic residents do a lot more than examine me over the years but in the end I also helped train a generation of pediatric/skeletal dysplasia doctors so that the next generation of my tribe gets better care. This is why so many training hospitals/Resident clinic are in the inner city or the worst part of towns because we care for the indignant SOMEONE ELSE child so we can finally get enough gray hair to graduate and move out to where we can take care of your kids. No Medical Education = No well trained doctors. I feel you Moms but we don't take this lightly, we have to learn or they will be no doctors, cut us a break.
10. And finally....Another colleague was recently at a church gathering where one of the other girls is pregnant and said: "I don't think I can go to a pediatrician because they are so militant about things like vaccinations and breastfeeding...." :).... Family Practice does 5 mo of pediatrics we do three years...just saying.
(BTW I went to a FP and loved her for 10 wonderful years....my Mom and sister still go to her...and most FPs are quite good but even they will admit that us militant pediatricians know babies)
Ok maybe I understand 10....yes I am militant but its only because I CARE ABOUT your baby. Its all about the babies and they are worth fighting for...no matter where they live, what language they speak, where they go to school or how much free range, organic gruel they are fed. I care even if you won't let me touch them or vaccinate them or be their doctor.
Lets work together for the Kids' Sake.
Love,
Dr. Amy
Friday, June 24, 2011
Saturday, April 30, 2011
London again
...there are several drafts pending of the last week of Kenya....for now I'm in London in a skirt made from a Kanga and Masai earrings trying to make the transition of eating ugali and chai to my starbucks chai latte....to a world with surfactant and human milk fortifier coming out our ears after using BUBBLE CPAP and prayers in substation From being a pediatric consultant (attending) where even in my inexperience I was what we had to being a intern and one of 150 residents at one of the top childrens hospitals in the world. . Back to the world where relationships come after duty and responsibility.... Its a HUGE leap transitioning back and I am grateful that I won't make it the way across the gulf of culture shock and injustice for several weeks since I have vacation and my sister's graduation this next week.
I will write more fully about my day in Nairobi but the traffic at the end was terrible. I nearly missed my transport to the airport. We had to get out our taxi and ran the rest of the way (about a kilometer) to the guesthouse where my luggage and transport were awaiting. I had seconds to say goodbye to my four Kenyan girlfriends who I spent the day with and in a whirlwind I was leaving Kenya. I admit I had tears in my eyes for a moment as we drove away from the guesthouse.
Despite all my traveling and Navy BRAT childhood I still hate goodbyes and there is so much left to do and be in Kenya. Ohio seems so not in need of me....although I course know now more than ever just how much experience and a little education can do.
for now a week of sleep, Carolina skies, family and non-smart books is very much needed.
I will write more fully about my day in Nairobi but the traffic at the end was terrible. I nearly missed my transport to the airport. We had to get out our taxi and ran the rest of the way (about a kilometer) to the guesthouse where my luggage and transport were awaiting. I had seconds to say goodbye to my four Kenyan girlfriends who I spent the day with and in a whirlwind I was leaving Kenya. I admit I had tears in my eyes for a moment as we drove away from the guesthouse.
Despite all my traveling and Navy BRAT childhood I still hate goodbyes and there is so much left to do and be in Kenya. Ohio seems so not in need of me....although I course know now more than ever just how much experience and a little education can do.
for now a week of sleep, Carolina skies, family and non-smart books is very much needed.
Wednesday, April 27, 2011
Shock and Awe
Last night thugs held up the emergency department with knives. They forced the interns and nurses to lay down on the ground, while one nurse was taken hostage to open up the cashier office. A patient was hit in the head and has a severe hematoma and a guard has a head laceration. They stole 80,000 shillings or around a 1000 dollars, a huge sum of money for Kenya.
This morning, Wednesday chapel was unusually full and many people stood outside and listened as the news was reported. Shock ripped through the assembly.
Kijabe is a bubble. Its a bubble of western culture in rural Africa where little old ladies sell English muffins and tortillas for a living to muzugus who are homesick. Where a party usually involves baked goods and Kenyan delicacies plus/minus a bunch of multinational children running around and/or an intense theological or medical discussion. Most folks both Kenyan and Western live in housing on the mission station that is often furnished and in close proximity to the hospital. We are a strange city on a hill.
What we forget is that the rest of Kenya is not like this. Its easy sometimes to forget about the slums of Nairobi that are only 40 mins away or the stories of violence that can fill the head lines of the Nairobi papers from time to time. We forget how much petrol costs or even the poverty that is so close yet so far from our day to day lives around Kijabe. I do not use poverty to justify the actions of the people who did this but I am reminded of how great the desperation can be. And how tempting of a target we must look with our peaceful, little village of muzugus and Kenyan professionals.
When I was in Mombasa last weekend (post is coming), I saw graffiti saying the following:
"Life in the Ghetto is Hard"
"Who will fight for the Poor?"
We should be in shock and sad and we should wish for justice and pray for peace to be restored. But let us not lose our capacity to try to understand, to offer compassion and in the truly divine way offer forgiveness.
This morning, Wednesday chapel was unusually full and many people stood outside and listened as the news was reported. Shock ripped through the assembly.
Kijabe is a bubble. Its a bubble of western culture in rural Africa where little old ladies sell English muffins and tortillas for a living to muzugus who are homesick. Where a party usually involves baked goods and Kenyan delicacies plus/minus a bunch of multinational children running around and/or an intense theological or medical discussion. Most folks both Kenyan and Western live in housing on the mission station that is often furnished and in close proximity to the hospital. We are a strange city on a hill.
What we forget is that the rest of Kenya is not like this. Its easy sometimes to forget about the slums of Nairobi that are only 40 mins away or the stories of violence that can fill the head lines of the Nairobi papers from time to time. We forget how much petrol costs or even the poverty that is so close yet so far from our day to day lives around Kijabe. I do not use poverty to justify the actions of the people who did this but I am reminded of how great the desperation can be. And how tempting of a target we must look with our peaceful, little village of muzugus and Kenyan professionals.
When I was in Mombasa last weekend (post is coming), I saw graffiti saying the following:
"Life in the Ghetto is Hard"
"Who will fight for the Poor?"
We should be in shock and sad and we should wish for justice and pray for peace to be restored. But let us not lose our capacity to try to understand, to offer compassion and in the truly divine way offer forgiveness.
Tuesday, April 26, 2011
Finding Home
Yesterday I came home and was on call (Mombasa epic post is coming...). It was an odd day, it was a holiday but the outpatient clinics where open so it was crazy busy with only two interns and a few consultants (attending like folks). I was playing a role in the later. The consultant on the day before me (who actually kindly switched calls so I go to Mombasa had a terrible, terrible night the night before). She paged me at 6:20 AM to ask if I could come in early so she could sign out. We had multiple premies, two codes and a kid with severe, severe dehydration and bilious aspirates to inherit. I rounded on the most of nursery and Gen Peds. It took me till 2 PM to get it all squared away. My severe dehydration kid had to have his labs drawn three time to get adequate sample. I felt inadequate because I am inexperienced with access because I get such few chances to try. Glad for my Anesthesia rotation next year. Finally when the labs came back his sodium was 199 and his Crt was 10. So dialysis is not an option, we aggressively hydrated him and I prayed that it would help. I honestly felt ok about the gen peds patients but some of the sick critically ill newborns are above my pay grade as a peads intern on my own.
I loved my first two weeks on nursery. But I am no neonatologist. My attention span is severely lacking when it comes to advancing feeds (about 5 mins in I am daydreaming about something else). I like the delivery room, the procedures and the codes best. I like talking to the parents (because we all know I like to talk and that there is really no one I won't talk to...including myself or the walls ;)). Details are not my strong suit and my big picture thinking makes NICU torture if I had to do it forever or ALL the time. But in small doses I like it which is good becuase I am going to do it in the future if I live here.
I have been on general paeds the last week or so and its not nearly as organized as nursery. Honestly, its barely organized chaos. But I sort of like it that way which most likely indicates some sort of odd personality flaw. (Although my highly OCD, complete opposite of me partner last month on Cards says that I am amusing and refreshing in this way). The attending treats me like a senior resident on steroids and I ran rounds by myself this AM. And surprisely despite the fact I am still very, very dumb. Somehow it worked and it was like I had been doing it for a long time. I admitted that I have no idea what to do with my GCS of 5 TB meningitis teenager minus praying (not really a candidate for a vent when we only have limited number and he is going to be in a coma indefinitely). But there were also things that I did know. I went back over the patients with the attending later and much to my amazement we changed very little of what I chose to do...awesome and scary.
I gave a presentation today on Diagnosing and Initially Managing Congenial Heart Disease (on a Shoestring aka NO ECHO and basically NO ECG). I really enjoyed it. Teaching makes me happy. In general, being here makes me happy. I love this work so much.
Everyone keeps speaking of HOME and how I am going there in three days but I find that a confusing idea. Where is Home? Is Home OHIO? Honestly...not really. Ohio is sort of like boarding school or boot camp or something of the like. I enjoy my work, my friends and my church but it still feels like I am camping there for a time. Is Home NC/VA? In some ways YES. I pine for old friends, BBQ, humid afternoons, Southern Draws and mountains. But there is no work for me there. Is Home Kenya/Mission Field? Yes, in some ways it is. It certainly is my professional home. In the same way my classmates seem to be finding homes in hematology and PICU and neonatology. This is what makes me excited about pediatrics. And even deeper, this is where some my most profound and most cherished relationships are.
I am both leaving and going home simultaneously in the strange paradox that is my life.
I loved my first two weeks on nursery. But I am no neonatologist. My attention span is severely lacking when it comes to advancing feeds (about 5 mins in I am daydreaming about something else). I like the delivery room, the procedures and the codes best. I like talking to the parents (because we all know I like to talk and that there is really no one I won't talk to...including myself or the walls ;)). Details are not my strong suit and my big picture thinking makes NICU torture if I had to do it forever or ALL the time. But in small doses I like it which is good becuase I am going to do it in the future if I live here.
I have been on general paeds the last week or so and its not nearly as organized as nursery. Honestly, its barely organized chaos. But I sort of like it that way which most likely indicates some sort of odd personality flaw. (Although my highly OCD, complete opposite of me partner last month on Cards says that I am amusing and refreshing in this way). The attending treats me like a senior resident on steroids and I ran rounds by myself this AM. And surprisely despite the fact I am still very, very dumb. Somehow it worked and it was like I had been doing it for a long time. I admitted that I have no idea what to do with my GCS of 5 TB meningitis teenager minus praying (not really a candidate for a vent when we only have limited number and he is going to be in a coma indefinitely). But there were also things that I did know. I went back over the patients with the attending later and much to my amazement we changed very little of what I chose to do...awesome and scary.
I gave a presentation today on Diagnosing and Initially Managing Congenial Heart Disease (on a Shoestring aka NO ECHO and basically NO ECG). I really enjoyed it. Teaching makes me happy. In general, being here makes me happy. I love this work so much.
Everyone keeps speaking of HOME and how I am going there in three days but I find that a confusing idea. Where is Home? Is Home OHIO? Honestly...not really. Ohio is sort of like boarding school or boot camp or something of the like. I enjoy my work, my friends and my church but it still feels like I am camping there for a time. Is Home NC/VA? In some ways YES. I pine for old friends, BBQ, humid afternoons, Southern Draws and mountains. But there is no work for me there. Is Home Kenya/Mission Field? Yes, in some ways it is. It certainly is my professional home. In the same way my classmates seem to be finding homes in hematology and PICU and neonatology. This is what makes me excited about pediatrics. And even deeper, this is where some my most profound and most cherished relationships are.
I am both leaving and going home simultaneously in the strange paradox that is my life.
Thursday, April 21, 2011
Photographic Essay of Kenya So Far
Here is a random collection of Kenya so far....
My sweet friends Miriam and Joel
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| Sunset from my flat |
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| Translating my talk I gave at Joytown. My translator Kelvin was awesome and a little bit of a tease. |
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| Some of the Joytown Kids |
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| Minus the word Special just about perfect! |
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| Adventures in driving in Kenya |
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| A sweet patient the day she went home after a month of being in the hospital for Meconium aspiration syndrome |
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| CPAP in Africa, so simple yet saves a lot of lives. Kijabe is doing a study on CPAP right now. |
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| Intern Bonfire and Dinner |
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| Tea fields |
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| Sweet little girl carrying her brother outside the hospital |
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| My sweet cardiac baby who is going to get surgery at Tewenk! AND IS OFF CPAP and O2!! |
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| 29 weeker I admitted last weekend! |
How to Ride in a Matatu when you are a Muzugu
So last Sunday, I braved the rain with my friend Loise and we went to Nairobi for church via Matatu. Matatu-es are a vast mini bus system that spans East Africa. The mini buses are privately owned and when you are muzugu (white person) in East Africa you are told many, many horror stories of traffic accidents, muggings and general mayhem in whatever sort of orientation/mentor/etc you have prior to coming. However, they are the staple form of transport here and I trust my Kenyan friends and wanted to go to church with them.
We took a private car of a friend of Loise that took us far as the top of the mountain up at the junction where the Nairobi road joins in with the partly paved road to Kijabe. It was pouring and we stood in a little hut that was built from sticks, traps and mazie sacks and waiting for a Matatu to come by. They did. I had my forearm crutch. My knee is nearly cured but I have been very protective of it and tend to take the crutch for anywhere longer than a little bit outside of my house. Although I can walk without it just find now and around the hospital forget where I leave it hourly. Anyway, everyone in the Matatu was pointing and gawking at the muzugu with the crutch and saying that I was sick so they gave us the front seat.
Step 1: Front SEAT!!! The most coveted spot: Seat belt, leg room and less vibrations. (use whatever means possible including possibly masquerading as a “sick person” ;) )
Step 2: Put on the seat belt, pull it tight.
They tried to over charge us because I was a muzugu but my fearless friend Loise told them NO and paid the normal fare.
Step 3: Know what the fare should be prior to boarding.
Step 4: Praying is helpful.
Step 5: Prepare yourself for frequent stops and breaking to pick up people along the road.
Step 6: Prepare for the general Kenyan driving adventure of avoiding pot holes.
Joking aside, it actually was fine especially up in the front. We arrived safely, walked around the U of Nairobi area, Central Park and then went up to church. The sermon was excellent and the worship was nice. We spent the afternoon with my friend Jackie, who is a pediatric resident at Kenyatta the national hospital here in Kenya. We watched Kenyan soap operas and lounged around and chatted. Then we went shopping and then we went to the Matatu stand.
The front seat was taken. So we got in the back. More and more people came. We hit capacity. So I thought my knee was cured but unfortunately when you stuff it in a very small contorted position with groceries, it is NOT cured. It was hot, crowded, there crying babies and very loud Rap music.
Step 7: Distraction is key, I counted 15 donkeys on the way home.
Step 8: Showers are nice afterwards.
Step 9: Its really not that bad, it reminds of riding the trams in Bucharest on a hot day or even the subway in NYC.
In the End we were home safe and sound with all our stuff and my knee has fully recovered.
Wednesday, April 20, 2011
What if for a moment we believe....in the crazy
Its been said I am optimist. Its also been noted I lack certain social norms...or rather choose to ignore them. You could blame my hearing loss but I think its mostly my cultural upbringing.
Although I grew up American, I think I really grew up as a gimp and disability has a cultural education all its own. For one thing pretty much no matter where you are born, you start out at the bottom of the totem pole of society. We are the beggars on the streets, the man selling pencils on the corner, the hunchbacks in the bell towers and the people that sometimes make you squirm because of our struggle to talk/walk/etc. The thing though that I have come to a greater personal awareness in the few years is that while the people at the top of totem pole (ironically including my peers, young professionals) look at me as different, scary, pitiful, the others who might be different/scary/pitful for many other reasons see me as a person who they can relate to (never mind my excessively expensive education, my car, my ethnicity or my profession). I.e. every janitor, every cafeteria worker including the ones who spoke primarily Spanish knew me by name at Wake in undergrad and half the janitors at Childrens know me. All the project search (young adults with developmental disabilities) employees know me by name and we have had a meal together. I have friends in Eastern Europe who happen to be Roma beggars who most of my peers are terrified of being mugged by. I have drunk champagne with a refugee family in Belarus who might have terrorist connections but had a daughter with a cerebral palsy who I adored and faithfully visited weekly for two months.. When my family went on a cruise I befriended the lady who cleaned our rooms, she was from Costa Rica. My family thinks I am nuts but mostly tolerates it because they know its hopeless to reform me normalcy at this point. I give this background to say that I have grown up in a world where the social axis is turned on its head. And sometimes I forget that the rest of the planet does not think like this. That the rest of the world system of value of human beings is pretty much the opposite of the way my tribe thinks.
Combine this with optimism and you get a lot crazy schemes and ideas.....
14 day old with VSD/ASD and pulmonic stensois, otherwise perfect. I have been praying for babies on ECMO (see below) and I just can't live with leaving this baby here to wait the 2.5-3 yr wait and present like my other patients in failure with cardiac asthma gasping for air with deadly pulmonary hypertension. I realize this is a needle in a giant haystack of stories and injustice. But I feel like this is achievable somehow...So I write some e-mails, I sell my case, this child has a repairable heart defect, this child has a beautiful family who love him...... And low and behold, somebody catches the vision and tells me there is a CT surgeon team coming to another hospital in Kenya in 6 months. 6-9 months is EXACTLY when the surgery should be done. The cardiologist takes my history, my echo and is optimistic that if we can keep his weight up, my baby is a great candidate for surgery. Every once in a while, miracles happen and for a moment our world shifts and babies with heart defects in East Africa get a chance.
Then there is my friend Miriam, she has some kind of dwarfism variant (I debate every time I see her....its an Acondroplasia like dysmorophology but worsening hip and hand disease...which does not fit). She was an orphan raised by her grandfather, who dropped out of school in 8th Grade to support her grandfather. She is now a single parent with a 9 yo also with the same disease who is wickedly brilliant (scored 585/600 on his national exam) and tells you in beautiful English that he wants to be a engineer when he grows up and figured out how to make games work on my computer in about 30 seconds. She has severe hip dysplasia, with bone on bone disease. Her hands have worsened. She used to operate a knitting machine but her hands have gotten too bad. She now sells what she can buy cheap in Nairobi textiles wise in the market here in Kijabe on the days her pain is not so bad and she can make it the 3 miles down the mountain. The locals tell me its getting worse. The peds ortho here says there is nothing to be done. I know how difficult and precarious adult skeletal dysplasia surgeries (ha!) are especially little people joint replacements. But of course this cuts me to my core because I have been exactly where she is (minus that I was not a single parent with an 8th grade education). There is very little I can do about this. But I have tried anyway, I have sent emails and am begging and persuading. And trying to think of micro finance endeavors. I have been unsuccessful.
So I did something that made my neighbors stare a bit. I invited her to dinner. I had no idea if she would say yes but she did. She showed up with Joel her son in their Sunday best. I made rice, Kenyan stew, potatoes and ice cream and chai for dessert. I showed them pictures of LPs from around the world that I collected on my computer. I listened to their stories and I found something remarkable. Miriam grew up in my tribe too and has the same ridiculous optimism. She asked me why shouldn't there be a Little People Group in Kenya like there is in America and Uganda and South Africa and England.... She said she wanted to start one for Joel. She also said, they could have a project that provided employment for people who would otherwise not have it. I sat there again and was amazed. Most people would not see her as an activist, most people wouldn't think much other than either hopelessness or sadness. About half way through dinner, I got a knock at the door. There was the very persistent woman who has been coming around to the Westerners begging for money. She saw that Miriam and Joel were there eating at my table. She looked stunned, she spoke to Miriam in Swahili, gaped at me open mouthed and then back at Miriam. She apologized in Swahili and English for interrupting our supper and left without every asking me for a dime.
And I realized that as inadequate as serving dinner seemed in the light of the bigger problems, I realized all over again as my tribe as taught me so well that just acknowledging the dignity and the worth of our fellow human beings is a far greater endeavor than all the medical endeavors and crazy development schemes.
Dignity and worth are a different kind of healing, a divine sort.
Although I grew up American, I think I really grew up as a gimp and disability has a cultural education all its own. For one thing pretty much no matter where you are born, you start out at the bottom of the totem pole of society. We are the beggars on the streets, the man selling pencils on the corner, the hunchbacks in the bell towers and the people that sometimes make you squirm because of our struggle to talk/walk/etc. The thing though that I have come to a greater personal awareness in the few years is that while the people at the top of totem pole (ironically including my peers, young professionals) look at me as different, scary, pitiful, the others who might be different/scary/pitful for many other reasons see me as a person who they can relate to (never mind my excessively expensive education, my car, my ethnicity or my profession). I.e. every janitor, every cafeteria worker including the ones who spoke primarily Spanish knew me by name at Wake in undergrad and half the janitors at Childrens know me. All the project search (young adults with developmental disabilities) employees know me by name and we have had a meal together. I have friends in Eastern Europe who happen to be Roma beggars who most of my peers are terrified of being mugged by. I have drunk champagne with a refugee family in Belarus who might have terrorist connections but had a daughter with a cerebral palsy who I adored and faithfully visited weekly for two months.. When my family went on a cruise I befriended the lady who cleaned our rooms, she was from Costa Rica. My family thinks I am nuts but mostly tolerates it because they know its hopeless to reform me normalcy at this point. I give this background to say that I have grown up in a world where the social axis is turned on its head. And sometimes I forget that the rest of the planet does not think like this. That the rest of the world system of value of human beings is pretty much the opposite of the way my tribe thinks.
Combine this with optimism and you get a lot crazy schemes and ideas.....
14 day old with VSD/ASD and pulmonic stensois, otherwise perfect. I have been praying for babies on ECMO (see below) and I just can't live with leaving this baby here to wait the 2.5-3 yr wait and present like my other patients in failure with cardiac asthma gasping for air with deadly pulmonary hypertension. I realize this is a needle in a giant haystack of stories and injustice. But I feel like this is achievable somehow...So I write some e-mails, I sell my case, this child has a repairable heart defect, this child has a beautiful family who love him...... And low and behold, somebody catches the vision and tells me there is a CT surgeon team coming to another hospital in Kenya in 6 months. 6-9 months is EXACTLY when the surgery should be done. The cardiologist takes my history, my echo and is optimistic that if we can keep his weight up, my baby is a great candidate for surgery. Every once in a while, miracles happen and for a moment our world shifts and babies with heart defects in East Africa get a chance.
Then there is my friend Miriam, she has some kind of dwarfism variant (I debate every time I see her....its an Acondroplasia like dysmorophology but worsening hip and hand disease...which does not fit). She was an orphan raised by her grandfather, who dropped out of school in 8th Grade to support her grandfather. She is now a single parent with a 9 yo also with the same disease who is wickedly brilliant (scored 585/600 on his national exam) and tells you in beautiful English that he wants to be a engineer when he grows up and figured out how to make games work on my computer in about 30 seconds. She has severe hip dysplasia, with bone on bone disease. Her hands have worsened. She used to operate a knitting machine but her hands have gotten too bad. She now sells what she can buy cheap in Nairobi textiles wise in the market here in Kijabe on the days her pain is not so bad and she can make it the 3 miles down the mountain. The locals tell me its getting worse. The peds ortho here says there is nothing to be done. I know how difficult and precarious adult skeletal dysplasia surgeries (ha!) are especially little people joint replacements. But of course this cuts me to my core because I have been exactly where she is (minus that I was not a single parent with an 8th grade education). There is very little I can do about this. But I have tried anyway, I have sent emails and am begging and persuading. And trying to think of micro finance endeavors. I have been unsuccessful.
So I did something that made my neighbors stare a bit. I invited her to dinner. I had no idea if she would say yes but she did. She showed up with Joel her son in their Sunday best. I made rice, Kenyan stew, potatoes and ice cream and chai for dessert. I showed them pictures of LPs from around the world that I collected on my computer. I listened to their stories and I found something remarkable. Miriam grew up in my tribe too and has the same ridiculous optimism. She asked me why shouldn't there be a Little People Group in Kenya like there is in America and Uganda and South Africa and England.... She said she wanted to start one for Joel. She also said, they could have a project that provided employment for people who would otherwise not have it. I sat there again and was amazed. Most people would not see her as an activist, most people wouldn't think much other than either hopelessness or sadness. About half way through dinner, I got a knock at the door. There was the very persistent woman who has been coming around to the Westerners begging for money. She saw that Miriam and Joel were there eating at my table. She looked stunned, she spoke to Miriam in Swahili, gaped at me open mouthed and then back at Miriam. She apologized in Swahili and English for interrupting our supper and left without every asking me for a dime.
And I realized that as inadequate as serving dinner seemed in the light of the bigger problems, I realized all over again as my tribe as taught me so well that just acknowledging the dignity and the worth of our fellow human beings is a far greater endeavor than all the medical endeavors and crazy development schemes.
Dignity and worth are a different kind of healing, a divine sort.
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