In full disclosure, this entry is not a happy story. It involves the death of a child. And if you are the sort who cannot bear to read of such events, I encourage you please do not read this. I am writing it not merely because it was horrific and troubling, but because God spoke to me through it.
In medicine, it is easy to get lost in our accomplishments. Toward the end of my time in Bangladesh, I fell into this trap, thinking to myself, "How many lives have I saved since I have been here?" God forgive me. I have no power to save lives. I have never saved a life. Only the Lord heals.
On the last full clinical day of my stay, I went to the physician's room after lunch to do reading on typhoid when one of the nurses came in to inform me they were currently doing an emergent c-section on a 29 weeker, and my presence would be appreciated. My heart sank. In the States a baby born at 29 weeks stands a good chance of doing well. In Bangladesh, our hospital does not have surfactant, CPAP, or ventilators. I walked to the operating room praying, "God, what can I possibly do to help this child?"
When I got to the room, the baby was not breathing, and the anesthesiology tech was appropriately intubating the baby. The intubation went well. There was bilateral chest rise although the air entry was still poor throughout. They gave me a quick update on the clinical scenario. As is often the case, they weren't entirely sure of the gestational age of this baby, but based on size they thought the baby might be a bit older, between 32-34 weeks. Mom had been given steroids and antibiotics prior to delivery. They weren't sure why the mother went into respiratory failure. This was mom's third pregnancy. She had no living children. We got a chest x-ray. I looked at it, and my heart dropped. The hope I had after hearing that the baby might be a bit older quickly evaporated. The baby's lungs were closed. He needed surfactant. We had none.
The baby started breathing on his own. We took the tube out to see how the baby would do and because we do not have a vent anyway. His oxygen saturation plummeted. We started bagging with 100% oxygen, and the baby's sat improved. We took turns bagging. We placed on our hands on the baby and prayed. The decision was made that we would bag for 2 hours, and at that time, we would reassess (and if the baby could not maintain oxygen saturation, we decided we would have to call it). I was trying hard not to lose it. One of the American nurses realized I was heartbroken. She looked at me and said, "I know this is hard. We do what we can to help save lives. Ultimately, only the Lord saves lives. In the end, we must rest in the Lord." We bagged, and we bagged, and every time we gave the baby a chance his saturation dropped. The rest of the staff had not eaten, so many went to eat. Another OR case was going on so the OR techs left as well. Eventually, I was alone with the baby. I bagged for 45 minutes. I cried. I prayed to God begging Him to open the baby's stiff lungs. I prayed, and I prayed. I felt helpless. My prayers are all I had to offer.
And in this moment, I feel God spoke to me clearly. He reminded me that I am not the one who saves lives. I never have been, and I never will be. Only the Lord saves. He is the Almighty God of love and kindness. He is the Healer. I am merely an unworthy servant (Luke 17:10). The 2 hour mark had passed. I was still alone. The baby had failed numerous trials on the oxygen cannula. I begged God to let the baby breathe and to let him maintain his saturation. I even foolishly attempted to bargain with Him. I prayed, "God, if this baby breaths, I will tell the story and give you all the glory. I will not steal your glory God. Please let this baby live. Please let him breathe." I took off the mask and watched the baby. One minute and still over 90%. Two minutes...still there. Five minutes. Still there. Ten minutes....Still there. Fifteen minutes...praise God. Miraculous. The nurses returned. They asked if we could take the baby to the nursery. I said yes.
He was in respiratory distress, grunting, flaring, and retracting. He still needed surfactant. He needed positive pressure. But for now, he was at least maintaining his saturation, which was more than I could expect. When he left the operating room, his mom was still intubated. But praise be to God, she was extubated and able to hold him before he died.
I wish that this story had a different ending. I am motivated to be a servant to Christ and submit myself to serving him by declaring His glory and being a part of His healing. I am hopeful that I will return to Bangladesh, and that I will find a way to get ventilators, CPAP, and surfactant. Whether we have these things or not, I know that I am not the savior and that only God deserves glory and honor. To God be the glory, great things He has done.
In medicine, it is easy to get lost in our accomplishments. Toward the end of my time in Bangladesh, I fell into this trap, thinking to myself, "How many lives have I saved since I have been here?" God forgive me. I have no power to save lives. I have never saved a life. Only the Lord heals.
On the last full clinical day of my stay, I went to the physician's room after lunch to do reading on typhoid when one of the nurses came in to inform me they were currently doing an emergent c-section on a 29 weeker, and my presence would be appreciated. My heart sank. In the States a baby born at 29 weeks stands a good chance of doing well. In Bangladesh, our hospital does not have surfactant, CPAP, or ventilators. I walked to the operating room praying, "God, what can I possibly do to help this child?"
When I got to the room, the baby was not breathing, and the anesthesiology tech was appropriately intubating the baby. The intubation went well. There was bilateral chest rise although the air entry was still poor throughout. They gave me a quick update on the clinical scenario. As is often the case, they weren't entirely sure of the gestational age of this baby, but based on size they thought the baby might be a bit older, between 32-34 weeks. Mom had been given steroids and antibiotics prior to delivery. They weren't sure why the mother went into respiratory failure. This was mom's third pregnancy. She had no living children. We got a chest x-ray. I looked at it, and my heart dropped. The hope I had after hearing that the baby might be a bit older quickly evaporated. The baby's lungs were closed. He needed surfactant. We had none.
The baby started breathing on his own. We took the tube out to see how the baby would do and because we do not have a vent anyway. His oxygen saturation plummeted. We started bagging with 100% oxygen, and the baby's sat improved. We took turns bagging. We placed on our hands on the baby and prayed. The decision was made that we would bag for 2 hours, and at that time, we would reassess (and if the baby could not maintain oxygen saturation, we decided we would have to call it). I was trying hard not to lose it. One of the American nurses realized I was heartbroken. She looked at me and said, "I know this is hard. We do what we can to help save lives. Ultimately, only the Lord saves lives. In the end, we must rest in the Lord." We bagged, and we bagged, and every time we gave the baby a chance his saturation dropped. The rest of the staff had not eaten, so many went to eat. Another OR case was going on so the OR techs left as well. Eventually, I was alone with the baby. I bagged for 45 minutes. I cried. I prayed to God begging Him to open the baby's stiff lungs. I prayed, and I prayed. I felt helpless. My prayers are all I had to offer.
And in this moment, I feel God spoke to me clearly. He reminded me that I am not the one who saves lives. I never have been, and I never will be. Only the Lord saves. He is the Almighty God of love and kindness. He is the Healer. I am merely an unworthy servant (Luke 17:10). The 2 hour mark had passed. I was still alone. The baby had failed numerous trials on the oxygen cannula. I begged God to let the baby breathe and to let him maintain his saturation. I even foolishly attempted to bargain with Him. I prayed, "God, if this baby breaths, I will tell the story and give you all the glory. I will not steal your glory God. Please let this baby live. Please let him breathe." I took off the mask and watched the baby. One minute and still over 90%. Two minutes...still there. Five minutes. Still there. Ten minutes....Still there. Fifteen minutes...praise God. Miraculous. The nurses returned. They asked if we could take the baby to the nursery. I said yes.
He was in respiratory distress, grunting, flaring, and retracting. He still needed surfactant. He needed positive pressure. But for now, he was at least maintaining his saturation, which was more than I could expect. When he left the operating room, his mom was still intubated. But praise be to God, she was extubated and able to hold him before he died.
I wish that this story had a different ending. I am motivated to be a servant to Christ and submit myself to serving him by declaring His glory and being a part of His healing. I am hopeful that I will return to Bangladesh, and that I will find a way to get ventilators, CPAP, and surfactant. Whether we have these things or not, I know that I am not the savior and that only God deserves glory and honor. To God be the glory, great things He has done.
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