the great battle

11 April 2011

hey.  tomorrow night?  movie night?” someone asked.

”why not,” the surgeon answered, reclined on a mattress we’ve leaned up against a wall below the razor wire. “i’ve got nothing else on.”

”i can’t.  i’ve got tickets to a concert,” our nurse said. “i’ll try to come after.”

we laughed, then more at the laughter.

”yeah, tomorrow i can’t either.  i’m having a dinner party.”

”i’m playing someone above me on the squash ladder.”

“swimming lessons.”

”ice capades.”

we faded to smiles, our shadows cast perfectly on the cement behind us by the harsh security light.

it is not easy to write about this place.  it is not for a lack of opportunity, for after the work is done, hours of curfew yawn.  it’s not a matter of material; so many stories bear repeating. i struggle because of the sudden, severe beauty that passes so quickly in front of me, words won’t do it. you'd have to follow me through the hot yard where people perch under trees, their children beside them on mats, and we'd pass a boy, his striped shirt stretched over an abdomen so swollen by his liver that he looks like a bumblebee, his mother dabbing blood from his nose as he patiently tries on a rubber glove we gave him, and then he sees us, and with a wide smile, he claps, begging for us to blow more bubbles. Next to him, an older sister and we start at her, feint a grab, and she screams and runs behind the tree where she peeks out smiling fist from one side, then the other.  A cleaner comes over, takes off his hat, extends a long arm, wishes us a good morning in the only English he knows, and we’re not even halfway to the lab.

a tough morning report today.  An infant who I saw before I left last night, seizing and febrile, coughing for days before the mother had the courage to come to hospital, died this morning gasping in twitches.  On his heels, a 3 year old girl arrived  after a week of diarrhea to have her heart stop on the hard wooden bench outside the emergency.

In Europe, is it the same as it is here, the nurse asked? Some things, yes, i said.  Fevers, coughing.  But a child dying of diarrhea, he said? No, no. Never.

I wonder what seeps into our subconscious as we move throughout our days, what dramas work there as we look for something certain in a world that can seem careless.  does it play out in our dreams, or how we live our days? is it what makes home fit so poorly once i get there?  I listened once to a psychologist who supported the notion that we live trying to answer questions we asked ourselves when we were infants, before we could form them into words.   as someone once said, be kind to everyone you meet, for he too is fighting a great battle.  even if its deep underneath.

no word on the girl who i gave my rhinoceros to, and hers.  i was in nairobi last weekend, and tried to find her.  i called the national hospital.  who?  they asked.  a girl.   from dadaab.  she came on wednesday.  i gave her name.  i stayed on hold for almost half an hour, and finally hung up, visions of teeming wards and a weary nurse reading through stacks of paper charts that dropped from the desk.  i’ll find out.  she has my rhino, after all.

though i could do it more, i find that in medicine, like in life, its usually best to let yourself go, to hope deeply, even if it means the pain of it being dashed.  to release, as much as you can, the tiny elastics those pains have placed around your heart because if you don’t, you can forget what its there for, and with that, what we’re here for, this short time on a rock spinning wild and green around one of a trillion trillion stars.

this work is good exercise. you're asked to give as much to the 35th patient as the first, pull out the elephant (i bought another in nairobi) with the same shock of amazement as the bed before, counsel the mother as gently, so that she can spread the word, and next time she passes a child feverish on another woman's back, she might give directions to this place.