Having a voice.

Last Friday started off with a string of emergencies. A ruptured ectopic pregnancy, a preeclamptic post-partum (s/p c section) with an acute abdomen, and a compartment syndrome of a hand. They pushed my elective girdlestone and cystoscopy back until the afternoon. Finished up cases to find another surgical patient critically ill. There's only so much we have to work with here. No ventilators, dopamine the only pressor support, and no ice. It's an easy 110 degrees in the hospital, when a patient has a fever, trying to cool them down is a lost cause. At one point I helped reposition my patient in her bed, the heat emanating from her body was terrifying. Knowing the care and technology required by my patient was not available for her made my efforts feel inadequate even before her heart stopped proving them to be so.

My voice started to go the following day, and by Sunday I could barely talk. Work was interesting to say the least. But made it through somehow. Today I spent the morning in the OR, opting to take care of the elective c-sections that the midwives had scheduled for us. I didn't even attempt to help over in clinic knowing someone with successfully vibrating vocal cords would be much more effective.

It's an interesting perspective, not having a physical voice. It made me acutely aware just how frequently I get asked questions. Even without producing a sound, I still felt like I had a voice. It's this voice that matters. It's a voice of value, and that is the voice I try to listen to from my patients. Easier said than done.

A young lady was brought to the hospital after a moto accident. She had broken her leg, among other things.

Broken Femur

Surgery was recommended. Unfortunately despite our reasonable arguments and explanation that without surgery she won't walk again, family refused. Notice I said family. The patient's father was the village witch doctor, and in full animistic cultural belief he responded to our arguments that his daughter would be walking again within a week. The patient's husband of course chorused in agreement with his father-in-law. But no one asked the patient her opinion. Seemingly, no one paid her any mind throughout the entire drama. When we asked separately, without any family present, she retorted her father's/husband's wishes, but lacked the confidence in her delivery that they had exhibited. What voice does she have to say otherwise?

I know there are many layers of that drama that I do not understand. Despite my pepperings of questions to the long-term missionaries here, there are bottomless pools of information about animism that I've yet to understand. That voice of value I listen for is still heavily accented by American culture and preconceived opinions. Is this one of those lifetime struggles of missionaries? How to cross cultural barriers with that unspoken, yet more powerful voice.

I expect we will see her again one day. If I'm still here, maybe I'll get another chance to hear her voice!

Much Love.