Thursday, 7 October 2010

Miracle on Mercy Street

The road that brings you to Kudjip Hospital enters the station by the main gate, goes past the ER of the new hospital, and ends at a place we call "the circle."  This road was formerly called Mercy Street.  I remember taking a picture of the street sign when I came to PNG as a medical student.  The road has been renamed to something like Knox Road after the first Nazarene missionaries to PNG.  Though I rather like the thought of our hospital being located on Mercy Street :).

Francine, a volunteer medical student for the month, and I were on call together two Sundays ago.  Sunday on call is almost never as bad as a Saturday, but this one was pretty bad.  We started out the morning doing rounds on maternity, and were notified about one of the mothers in labor.  Her water had broken about two days before and the nurse was concerned that the baby wasn't positioned correctly.  We quickly evaluated the patient and discovered that the baby was breech.  Mama needed a c-section.

Lucy was taken to the operation theater and we were ready to begin shortly after lunch.  Let's just say that things didn't go well from the beginning.  Our nurse anesthetist had difficulty putting in the spinal anesthesia.  This is the medicine that numbs the lower half of the body during surgery.  I thought that I was going to have to give it a try, which is ironic since I myself have never given spinal anesthesia.  (Though I am told it is basically the same procedure as doing a lumbar puncture.)  Margaret, our scrub nurse for the case, is well known as a prayer warrior.  She said a prayer and the spinal went in smoothly without my help.

A few minutes later, we started the c-section.  I made a Pfannenstiel incision and the first few steps of the surgery were pretty routine.  Upon entering the uterus, I was surprised to find that the presenting part was a hand rather than breech.  Uh-oh... the fetus was transverse.  Babies who lie side ways are often a challenge to deliver.  I struggled for a few minutes trying to get the kiddo out, but he just wouldn't come.  Finally I made the dreaded T-incision, an extension of the cut so that it looks like like an inverted letter "T".  You should be able to get any baby out of a T-incision.  You should, but I couldn't.  I struggled for what seemed like eternity but the baby was stuck tight.  I paused to take a deep breath and Margaret prayed again.  I extended the incision one more time and thank the Lord we were able to deliver the baby.

But the drama continued.  The baby came out floppy and was not breathing.  I broke scrub to help with the resuscitation and left Francine holding pressure on the bleeding uterus.  We bagged the baby and attempted intubation several times but were unsuccessful.  He had a strong heart beat at first, but because we weren't ventilating well the rate began to drop.  At one point he seemed to stabilize, so I re-gowned and continued to put mom back together.  I broke scrub a second time when the baby's heart rate dropped again.  We still couldn't get him intubated and started doing chest compressions.  I had no hope that this baby was going to survive.  I re-gowned again and returned to finish the surgery, tears streaming down my face.  I told the nurse to stop the resuscitation.  This time it was Francine prayed because I couldn't find the words.

Wait a minute... what?  You were finally able to intubated and gave epinephrine?  The baby has a heart beat and is breathing on his own?  Can you repeat that?  You said he is breathing on his own?  UNBELIEVABLE.  The tears flowed again, but this time they were tears of joy.  I thanked the Lord for his mercy and this miracle.

Baby of Lucy was taken to the nursery and was extubabed shortly after we finished the c-section.  He had a bit of a rough start, with a seizure or two in the first day of life and a little bit of trouble with feeding.  We started him on IV fluids and antibiotics.  The seizures stopped and he learned to breast feed.  He has made an amazing recovery and is now doing quite well.  This baby truly was a miracle on Mercy Street.

"The desert and the parched land will be glad; the wilderness will rejoice and blossom, 
it will burst into bloom; it will rejoice greatly and shout for joy.
They will see the glory of the Lord, the splendor of our God.
Strengthen the feeble hands, steady the knees that give way;
say to those with fearful hearts, 'Be strong, do not fear; your God will come.'
Then will the eyes of the blind be opened and the ears of the deaf unstopped.
Then will the lame leap like a deer, and the mute tongue shout for joy.
And a highway will be there; it will be called the Way of Holiness."
~ excerpts from Isaiah 35

1 comment:

  1. Stephanie, I cannot even tell you my feelings reading this! How amazing and yes a miracle!