This was written by one of the nurses who joined us for both the surgical and screening weeks this year. I (Kim) asked her permission to post it on our website because I thought it was such a beautiful and honest account.
Several of you have expressed interest in hearing about my trip. I’m sorry if I’ve been vague or non-descript in my stories…it’s just there is so much to process…It was like entering into another world. Now that it’s been a few days since returning home I’ve had a little more time to reflect on the last few weeks.
The words of the U2 song, Crumbs from your Table, crept into my head and played over and over as I watched a 13 year old boy hobble from the echo station (a machine used to see the inside of the heart) and out the door. “You speak of signs and wonders, But I need something other, I would believe if I was able, But I’m waiting on the crumbs from your table, Where you live should not decide Whether you live or whether you die.”
As he leaves someone grabs his hands and snaps a picture of his purple nail beds, which were rounded by some of the worst clubbing (due to lack of chronic lack of oxygen to the tissues) I’ve ever witnessed. He pauses briefly by the door to catch his breath and give a faint smile to the girl on our team who stopped him to give him a toy. His elderly grandmother places her hands under his armpits to support his weight as he steps out of the building and into the swarm of Mongolian children and their weary parents waiting outside.
My heart breaks. I just learned he probably won’t make it through another month; his lungs are so bad from his heart defect he can’t lie down without feeling as if he’s drowning in his own fluids. And yet, he managed to smile at me when I listened to his heart and his face lit up when I gave him a spider man wallet and NYC postcard. His eyes told of sadness but not bitterness. Do you think he knows that if he was born somewhere else he might be helping his grandmother out the door? He might be playing soccer outside with the other kids? “Where you live should not decide whether you live or whether you die”.
Two nights prior I stepped into the “pediatric intensive care unit” at the Women and Children’s’ Hospital in Ulaanbaatar. I’d only been there for an hour when a distraught couple came running into the unit carrying their 11 year old son. The boy’s eyes were rolled back into his head and blood poured from his mouth. We quickly cleared a bed and lay him down. Upon hooking him up to the monitors we saw that his heart had stopped. Immediately we started resuscitating him.
Things ran quite smoothly considering our resources. However despite sucessfully retrieveing a heart beat and blood pressure his pupils were dilated and fixed and his blood gas revealed that he was beyond a point in which we could do anymore for him medically. I watched as his heart stopped beating yet again. His parents who remained in the room as we worked, ran to the bed and his mother threw her body over his, weeping. His father stood back a few steps, attempting to maintain a controlled expression despite the tears that flooded his eyes. I stared on blinking back tears, as the nurses wrapped his body in preparation for the morgue with an efficiency and speed as if they’d done it several times before…
He was in end stage kidney failure. A condition that in the states we normally treat with dialysis. Many kids can live for a long time with regular dialysis treatments until they receive a kidney transplant. In America kindney transplant’s are performed routinely and with high success rates. Most of the time children go on to live a normal life after their transplant. Yet Mongolia doesn’t have dialysis and consequently he had no chance of survival. “Where you live should not decide whether you live or whether you die”.
I walked out of the hospital that morning, through the maze of concrete walls, paint peeling or simply omitted, hopping over the gaps in the flooring, feeling overwhelmed. I didn’t know how to process this.
Flashing back to the first week in Ullaanbatar, it was hard not to feel like celebrities. As we arrived at the hospital we were greeted by lines of anxious Mongolian families either anticipating a scheduled heart surgery or hoping they might get lucky enough to be seen by an American doctor. We had 3 cardiologists, a surgeon, two anesthesiologists, a perfusionist, 10 ICU nurses, 2 child life specialists, 2 bio mechanical engineers and 3 ICU intensivists all from the best hospitals in the U.S. The Mongolians smiled and waved as shuffled through the crowd awaiting us. Kim, one of our anesthesiologists looked at me as I commented on the situation saying, “It’s almost scary having so many resources because it gives you a false sense that we are in control…sometimes it makes it harder to depend on God when you seem to have so much”. Little did I realize at the time, I was going to learn such a life-changing lesson in humility through our “fame”.
We operated on a little boy named Tsend…he was very sick from the start. Because of his heart defect his coloring had a bluish hue from the lack of oxygen in his tissues and he only had enough energy to sit on his mother’s lap and weakly watch the other kids his age playing around him. After the heart surgery we performed he came back to our unit critically ill. He was requiring multiple medications to sustain his blood pressure and heart rate and a breathing machine to keep his oxygen at a level compatible with life. His prognosis didn’t look good. Tsend would have been a really sick unstable patient in the states and with our limited resources in Mongolia his condition was even more tentative.
That night I left the hospital with an uneasy feeling in my stomach. I wasn’t sure that Tsend would be there the next morning when I returned. Yet the following day he was still fighting. We continued with our planned surgeries. Our next patient to be operated on was beautiful little Bogi. Bogi’s very presence lit up the room. From her over sized pink ribbons to her sparkling black eyes, Bogi was quinescentially childhood innocence and joy. She’d reserve the brightest smile for every one of us no matter the circumstances. As Bogi awoke from her sedation after her cardiac catherazation she gave the doctor and nurses two thumbs up and a weak little smile. We all fell in love with Bogi…it was hard not to. Her parents loved her very much too. Bogi’s daddy walked three days from in the desert to make to the hospital in time to see her before her heart surgery. Bogi’s mom was a woman of faith I can’t begin to comprehend.
Bogi died just hours after her heart surgery. Her surgery was a “routine” one. It was one of the simpler surgies scheduled for the day. We’d expected her to recover from it in a day…and yet she died. I felt like the world stopped. I didn’t understand…how, why? Why Bogi of all the children? Why any of these beautiful children? “Why the pain before the child is born?” – Bono
I could hardly lift my fork at dinner that night…how was I going to muster any reserve to go back the next day and do it all over again. Bogi died…and little Tsend was probably on his way out as well. I tossed and turned all night. I woke up several times to pray…praying for a miracle. I’d made a choice to trust and follow Jesus…I didn’t understand what God was doing but I’d made a decision to trust Him…that night I had to hold onto that decision even though my heart was begging me to let go. I prayed for a miracle for little Tsend over and over that sleepless night.
The following morning…I could hardly compose myself as I walked to little Tsend’s bed and saw that he’d decompensated even further over the last 10 hours. God…were you not listening to me last night? I don’t get you. I watched, demoralized, as Kirk and our other doctors prayed over little Tsend’s bedside for wisdom. The offered him up to Jesus and waited. It was then they decided to take him back to the operating room and try to re-do his surgery. Thank Jesus that is exactly what he needed. Without the aide of the equipment and tests we could normally run in the states the operating room was our best option. The days to follow Tsend’s condition improved.
I had the opportunity to stay when the rest of our surgical team returned to the states, to take care of baby Tsend. I was able to see his breathing tube come out and let his mommy breast feed him again. It was a miracle…and it wasn’t because of our fancy American team, our years of experience at top hospitals or our shiny equipment. It was because God is sovereign and He is in control. Little Tsend taught me that there is hope in hopelessness.
I’ve been back in the states for about three weeks now. The transition is tough to say the least. It’s hard to have “normal” conversations about Brittany Spears and the Red Sox anymore. I find myself withdrawing a bit and tearing up at random times as flashes of memories from my trip ruminate in my mind. We are so blessed and so rich monetarily in America. The value of human life stretches beyond class, color, creed and country and yet it still holds true that, where you live DOES decide whether you live or whether you die. My prayer is that someday it will not.
Thanks for listening.