Friday, November 28, 2014

Margret's Story

Credit goes to Gail Dooley for her creative contributions to Kudjip Hospital
When she first came to me, Margret complained of irregular vaginal bleeding. She was old enough (mid-40's) that my mind jumped to cervical cancer or DUB (Dysfunctional Uterine Bleeding) due to a fibroid, but she seemed otherwise healthy. She told me she had been married for almost two years, but had never had children - unusual for PNG, where most women are married off and start bearing children in their teens.

Here at Kudjip, one of the diagnostic tools I have come to dearly appreciate is the ultrasound machine. With much help from the other docs I have become very comfortable scanning our patients for a wide assortment of diagnoses which in the US might warrant a CT scan or MRI. At this point, I know what "normal" looks like and can identify the more common diseases (TB, liver/gall bladder disease, effusions, abscesses, etc), but much of the time I'm asking Bill or Mark (who's rooms are adjacent to the US room) to come help identify the mass or abnormality I've just found. In Margret's case, I placed the probe over her uterus looking for a fibroid (benign overgrowth in the uterine wall) or cancerous mass.

To be honest, the first thing I thought of when her uterus flashed into view was "that's a big worm". Something tiny was writhing around in her uterus, as you might expect a fish to flap around when pulled onto shore. Of course my logical mind immediately recognized the tiny wriggler as a fetus, but I still enjoyed a little mental laugh at my thought of parasitic invaders. I asked Mark to come have a look, since the fetus was small, and vaginal bleeding meant a threatened miscarriage. We measured the baby's head, and guessed him to be around 11-12 weeks, close to finishing the first trimester.

My heart broke a little as I thought about how to share this news with Margret. I would be providing her joy and hope to know she was pregnant for the first time, but then replacing that happiness with fear and anxiety in the knowledge that her situation didn't look promising. After sharing all this with her, I was amazed with Margret's reply. She said (translated) "I am happy with God's will, whatever comes." What a relief! She could have no better Comforter in this time.

 ~ Picture Intermission ~

(Left - gecko's in a HUGE flower     Right - the Highland sun)
(Left - butterfly birthmark!    Right - Cutest kid on the ward)

 ~ End of Intermission ~

When I saw Margret a week later, she told me there was still a little bleeding, but less than before. I hoped this meant her pregnancy was going in the right direction. After 5 minutes scanning the uterus for fetal movement, I asked Mark to join me again. He also couldn't find limb or heart movement, and we ended the visit with a prayer, asking for God's will, and for His healing peace. Margret would go home once again, to return in a week, or sooner if the baby miscarried on its own.

When she returned without having passed the fetus, we admitted Margret on medications to induce the process. The following morning we learned it had happened sometime during the night, but that she still needed some placental products cleaned out from her uterus. We prayed again with Margret, and Mark guided me through performing the minor procedure. This was only the second time I’d performed such a procedure, but being opposed to abortion, I experienced a lot of mixed emotions about the process – even though both times the baby had already died, and needed to be removed.

Thinking back on these events, I am struck with how Margret had waited patiently, endured the hard news and significant loss, and yet her Faith remained strong. We had prayed at every turn, and she gave me hope where I would have been at a loss. I believe this is one of the greatest strengths and responsibilities of the Body of Christ - to genuinely love and lift one another up - encouraging, serving, connecting in prayer, and admonishing one another to greater depths of relationship with God.

Ephesians 4:1-16
As a prisoner for the Lord, then, I urge you to live a life worthy of the calling you have received. Be completely humble and gentle; be patient, bearing with one another in love. Make every effort to keep the unity of the Spirit through the bond of peace. There is one body and one Spirit--just as you were called to one hope when you were called-- one Lord, one Faith, one Baptism; one God and Father of all, Who is over all and through all and in all. But to each one of us grace has been given as Christ apportioned it. It was He who gave some to be apostles, some to be prophets, some to be evangelists, and some to be pastors and teachers, to prepare God's people for works of service, so that the body of Christ may be built up until we all reach unity in the faith and in the knowledge of the Son of God and become mature, attaining to the whole measure of the fullness of Christ. Then we will no longer be infants, tossed back and forth by the waves, and blown here and there by every wind of teaching and by the cunning and craftiness of men in their deceitful scheming. Instead, speaking the Truth in love, we will in all things grow up into Him who is the Head, that is, Christ. From Him the whole body, joined and held together by every supporting ligament, grows and builds itself up in love, as each part does its work.

At Margret's last visit to clinic, she gave me a beautiful handmade “bilum” (shoulder bag worn by all PNG’ians). A few of the more established doctors here have small collections of similarly gifted bilums adorning their walls. Maybe the novelty of receiving gifts has grown old to them...but it's new for me, and I love the bag, tassels and all! 
Do we not serve an awesome God?!

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