Bed F12

It's 3 AM and even though my body was warm and comfortable under blankets and my head resting on a nice pillow, sleep was elusive.  The sound of rain beating down on the metal roof sounds as if we were living at the base of a waterfall.  A different pitch of sound is made from the water pouring out of the downspouts.  There is no other audible sound, as the sound of the rain and the water overpowers any other sounds in the house at this hour.

At the end of a long day in the operating room, I went to check on my patient in bed F12 on the female ward. Her bed is at the end of a long ward of 24 beds, 12 on the left and 12 on the right.  Bed F12 is at the end on the left.  Each bed has a dark green modesty curtain that can be pulled, and mosquito netting dangling down in a loose knot from above.

As I entered the ward through the modest nurses station, I peered at the chart rack to read the notes that had been made that day and to check the labs.  She was on five different chemotherapy drugs to treat her cancer, called choriocarcinoma.  My hand ran down the slots to F12.  The slot was empty, which was not at all unusual.  All of the other charts seemed to be in the wooden rack, and the counters of the nurses station were uncharacteristically barren of charts.

There was a solitary nurse in the nurses station and I queried here as to the location of the missing chart. Her expression told me before her words did.  "F12 expired this morning doctor."  Our eyes locked for a moment, and then I turned and peered down the tops of my bifocal lenses to the end of the ward.  F12 was empty.  The bed was made.  No care givers were sitting at the bedside of bed F12. There were no belongings on the shelf or piled on the chairs.  Just two days ago I had stood at her bedside talking with her about the side effects she was having from the chemotherapy.  I had held her hand and prayed with her.  I had slipped her two tootsie roll lollipops to put something sweet in her mouth to replace the nasty taste of the bile that resulted from the side effects of the chemotherapy.

Then I took a deep breath, let out a long deep sigh and turned and walked out of the female ward down the corridor to the hospital circle driveway, then down the hill past the hospital chapel, down the slippery muddy road past the helipad to guest house #11 where we have been staying for the past month.  As I walked the tears that had been leaking out of the corners of my eyes dried on my face.

F12 had died.  Another patient with a cervical biopsy which had shown a rare form of cancer called a rhabodomyosarcoma had been transferred to palliative care; a place where pain management and spiritual and emotional care are provided, but where cure is no longer the goal of therapy.  A third patient with even a more rare form of cancer called a sarcoma botryoides had also been placed in palliative care that day; her tumor replacing her uterus and filling her female parts with grape-like clusters of cancer; fixing itself firmly to the bones of her pelvis.

The aroma of something delicious filled the air of guest house #11.  Debbie, the wife of the pathologist here, had "dashed" (gifted) us with a freshly butchered chicken.  I found out later that Debbie's friend had done the butchering and plucking and my wife, Teresa, cut it up.  Teresa had found a delicious recipe calling for Italian dressing and brown sugar and she had baked a delicious dinner of chicken and pasta.  We sat around the table, sharing the events of the day. I heard about the boys hiking a mountain today at sunrise, and the different ways that our family had served at the hospital today.  My spirits were lifted by game a Hearts and successfully "shooting the moon" once during the game before Teresa could celebrate her victory by "shooting the moon" herself.

The last three weeks have been filled with new relationships and touching lives of others, teaching them what I know, and sharing with them the knowledge that I have been given.  Below are pictures and captions of some of these people.

Dr. Lema is from Tanzania and is currently in the PAACS surgical training program and doing a rotation at Mbingo Baptist Hospital in Cameroon for three months.  His wife and daughter are back in Tanzania.  He always has a smile and such a great positive attitude.  It has been a pleasure to work with him, teach him and to have enjoyed several meals with him.

Dr. Laura is a physician from Cameroon who I work with daily in the women's clinic at Mbingo Baptist Hospital.  She tirelessly addresses the needs of women here in the clinic.  She speaks French, English, and the local dialects and patiently has translated often for me.  She is a sponge for knowledge and it has been a joy to invest in her life while serving here.

Ty Nowazki, aka the "Gringo at Mbingo", is like another son to us, and has traveled to be with us here at Mbingo.  He and our son Andrew don't sit still for long, and have been extremely adept at finding different ways to serve here, doing everything from entering years of pathology data into databases to helping a medical student from Stanford doing research on amputees with his research.  Today Ty and Andrew are going to give of themselves by donating blood at the hospital. It has been fun to watch the impact of this experience on Ty. 

Dr. Amir is a PAACS resident from Egypt spending three months here in Cameroon at Mbingo Baptist Hospital.  I have had the pleasure of working with him and teaching him in the operating room and in the surgical classroom.

Dr. Carol has been one of my favorite people to work with here. She and her family live in Cameroon, and once a month she commutes 3.5 hours to come and work at the hospital for a week each month.  She effortlessly slips between English, Pidgin and French and engages her patients and colleagues beautifully.  Her son Eddie guided us up the mountain to the top of a nearby waterfall.  Without Eddie I don't think I would have ever have dared to make the trip through the tall brush, knowing that some of the most poisonous snakes in the world live here.  I just tried hard not to think about it as we forged our way up the mountain!  The view of the mountains, the valleys, the waterfalls and the hospital and clinics below made the hike (and overcoming my fear of venomous snakes) worth it.