Mary Christmas!

The pain started around 3 o’clock on Christmas Day. At first it was just a few regular contractions tightening painlessly across my stomach. But in minutes the tightening became achiness and then gradually cramps until eventually even the allure or Turkey and apple pie to a very hungry stomach couldn’t keep me up. I guzzled a few glasses of water and went to lie down. After 30 minutes I started watching the clock. After an hour Bryan started loading the car.

Even though I already couldn’t talk through contractions on the drive to the hospital, I still wasn’t convinced we were in actual labor. Our baby was due January 20^th, and this was Christmas Day. Surely, just a few days of running just a little too hard were catching up with me. I was already preparing myself for the awkwardness of the “No, honey. Just go home and put your feet up…” speech from the nurse on call. What I got instead was the “Yup. You’re dilated to a five. I’ll go call your doctor…” speech to which I think I stupidly replied, “You mean this baby is coming today, for sure?” The nurse smiled and said, “This baby will be here in a couple hours.”

As you can imagine I experienced a dizzying blur of emotions in those moments. On one hand there was the incredible excitement of thinking how close I was to holding my baby in my arms, of meeting her for the first time and looking into her eyes. On the other hand there was the fear of her coming too early. What if she wasn’t ready for the world yet? What if something was wrong? I also felt a pang of guilt mixed with gratitude because for weeks I had talked about our daughter coming early. I was concerned about her showing up while we were still in North Africa and even back in Nairobi I had my doctor perform a couple unnecessary pelvic exams just to make sure she wasn’t showing any signs of coming while Bryan was still a thousand miles away. Now I was so thankful I had sensed this for so long. But I also worried, had my seemingly needless concerns prompted the very thing I feared?

As much as I missed my mother while the contractions gathered and grew, I have to admit, there was something incredibly intimate about being alone with Bryan as we labored to bring our baby into the world. I sank deeper into my own little world of hurt, bent over the bed, counting my breaths and moaning the almost comically inadequate word “ow” over and over again while Bryan led sips of water to my mouth, whispered encouragement in my ear and constantly, endlessly, faithfully rubbed my back. It was just the two of us together working side by side to usher into this world the life we had created.

Mary Katherine was born ay 8:35pm on Christmas Day at 5lbs and 14 ounces, 19 and ¾ inches long. From the first pang to the final push, my labor lasted just over five hours. Though she came out squealing, under the harsh glare of a heat lamp the pediatrician quickly decided that her weak grunts were not sufficient for breathing and carted her off to the NICU. Shaky and weak myself, I just got a glimpse of long bluish legs and big dark eyes before she was taken out of the room. Bryan got a closer look but didn’t get to hold her either.

The past forty-eight hours have felt like an eternity. In fact I still can’t believe I have only been a mother of two that briefly. Having both of my babies out of my arms and body leaves me feeling naked and alone. In all honesty, the sheer novelty of complete solitude was a bit of a luxury at first, but it didn’t take long for the ache in my heart to replace the aches in my body. I have been grateful for the culture of breast-feeding that I find myself in. The walk down empty corridors with blinking Christmas trees at 3am to go pump in a quiet nursery full of impossibly tiny babies attended by sleepy nurses is strangely comforting. I think I have been grateful for a physical outlet to express love for my little one when the only other thing I can do is sing lullabies through holes in an incubator while stroking her toes.

I was especially sad earlier this evening when Mary Kat’s breathing was still uneven and the latest test results on her infection still unavailable. I sat in my Easter-green hospital gown pumping with only partial success while a cheerful Kenyan woman chattered away to a bundle in a bassinet across from me. Eventually we struck up a conversation. I noticed her business shoes under the hospital robe and realized she must have come from home to nurse her baby. When I asked her about it I learned that her son was born several months early and has been in the NICU for almost two months. He was supposed to go home tomorrow but instead are going in for surgery to try and remove an accumulation of water on her baby’s brain. I asked her what her son’s name was as she said, “Gifton. But of course we just call him ‘Gift’.” I can’t imagine.

After supper and a bath tonight I got my own gift when I went back to the nursery to pump. A nurse was changing my Mary Katherine who for once was wide-awake and rooting with her IV bandaged fist. When I asked if I could please try nursing, expecting yet another, “Not yet” I was overjoyed to instead hear a “yes.” A chair was pulled up to her little incubator an IV stand, and swaddled and bleary-eyed, my beautiful daughter was placed in my arms for the first time. It was heaven.

My tiny daughter has a surprisingly strong suckle and we were soon working together perfectly. I never cease to be amazed at how much more than mere individuals we are, how even our biology seems to exist in community, in relationship. She created in my physical body what no machine could. Her tiny mouth pulled more milk from me than I knew existed and the thirst I had yet to feel after two full days of pumping soon had me guzzling water. She eventually fell sound asleep in my arms but only after a long time did I begrudgingly returned her to the nurse and her little pretend-womb. Hopefully she is only hours away from being free to stay with me. Until then I am counting the hours until I can get back to her.

I better go to sleep now while I can. In just a few hours my alarm will go off for another walk down late-night hospital halls and after that is a day-full of conversations with doctors and visits from precocious almost-two year olds who still don’t know exactly what “big sister” means. I’m not even going to read back over this before I post it because I know I will probably trash it if I do. I just had to get something up in the moments I had. Thank you all so much for your prayers. This has bee one of the most amazing Christmases ever. We have been given such an amazing gift.

(And if you think about it tonight, say a little prayer for Gift who is in the nursery with my daughter and his mama too. I know she would appreciate it.)     

Fever

So Annabelle’s fever didn’t go away.

Dr. Rob, an American doctor working at a clinic within shouting distance, made a couple of house calls to check out our lethargic baby with chills. Two malaria tests came back negative. There was no visible sign of a bacterial infection anywhere. Probably just a virus easily picked up from one of the hundreds of kids she has played with in the last two weeks. All you can do is keep her fever down and wait it out. 

Bryan and I weren’t overly concerned. After all, kids get sick no matter where you are, right? In fact, we have probably already missed out on several rounds of daycare and playgroup bugs that have worried our peers. Night-time syringes full of ibuprofen are just a part of the parenting package. So we waited.   
  

But by day five her high fever was still breaking through the ibuprofen after only a few hours and she wasn’t eating. And to make matters worse, Bryan got sick. Really sick. A quick finger prick showed that he had a good solid case of malaria and now that we were past the point of a virus’ lifespan, it was deemed prudent to treat both my babies for malaria. Annabelle’s coartem pills were crushed up and disguised in smears of peanut-butter only begrudgingly swallowed. She didn’t get any worse, but neither did she get better. Bryan swallowed his fistful of drugs willingly and got significantly worse. His fever soared and I woke up in the night to the bed shaking he was shivering so violently. But in 48 hours he was revived, eating and moving around again. Such a relief.

After a week and a half of the roller-coaster hope of seeing Annabelle up and playing or eating a cracker only to watch with worry an hour later as she lay in bed miserable again we decided to take her down the road to the nearest hospital. Dr. Rob had left by this point for his R and R and the mere doubtful mention of the word typhoid by his nursing staff was enough to make the fifteen minute drive by motorcycle seem like a pleasure ride (yeah, we’re not the more impressive NGO in these parts when it comes to transportation right now…). If my baby hadn’t been so hot and my belly so tight with harmless contractions, the image of me seven and half months pregnant with a one and half year old strapped to my back jostling behind my husband through the dust kicked up by land cruisers and herds of cows, I would have been laughing the whole way there. 

The hospital is a cluster of oddly built cement structures staffed by one doctor a couple of nurses and a handful of dubiously trained lab techs, surgical assistants and the people who take your temperature and clean up all manner of things from the floors. As we walked in the courtyard we stepped around people lying on mats in the shade while their relatives cooked sorghum porridge over small fires. We were welcomed with hugs by a lab tech who was a dear friend throughout our time across the border and he quickly ushered us around the corner to see the doctor. We picked our way through the steady flow of men, women and children and waited for a moment while our friend knocked on a green door. In a moment a man in scrubs, boots, gloves and a shower cap peeked his head out and gestured for us to remove our shoes and then follow him back inside. I stepped into the dark room in my bare filthy feet and realized with a feeling close to dread that we were in the OR. A young girl was lying naked on a bed and crying, more from fear than pain I think, as she was being prepped for surgery. Various people in surgical masks scooted politely around us as plastic chairs were scraped across the floor for us to sit in. 

The doctor took his time examining Annabelle right there in the OR and eventually grimaced apologetically and said he would recommend putting her on a quinine and heavy antibiotic drip immediately. He moved his head in the direction of the wards we had seen literally overflowing with people and said quietly, “But I don’t know if admitting her here is really what you want to do. We could put her in the maternity ward but even that…”

It’s a very disorienting sensation to experience two extreme and opposing truths simultaneously. On one hand I was struggling to be brave in the face of my moderately sick baby being touched and greeted by people in a place where a thousand different diseases festered in the very air she was breathing. I was feeling pretty proud of myself managing to do that too, until I entertained the prospect of her being hooked up to IV for a week in a bush hospital. And that scared me. On the other hand I was painfully aware of a kind of shame that came with the only doctor treating a thousand people infinitely more sick than my child being pulled out of surgery to give us his attention because of …what? The color of my skin, my friendship with hospital staff, my connections with the hospital donors? Those two realities felt like they were going to rip me in half in that moment.        

At this point all I could think was, I am not tough enough for this, I am not tough enough for this, I am not tough enough for this. My daughter might be but I don’t think I am.

While someone went to gather the medicine for Annabelle we sat outside on a bench and talked about options. Annabelle sat quietly on my lap and watched while a girl only a couple of years older than her on her own mother’s lap on the bench next to us was given an IV in her tiny wrist. Dingy bandages bruised with iodine covered severe burns across her back and torso. 

Life in North Africa seems to constantly throw serious decisions at us that must be made in approximately 30 minutes. (Or as it was politely pointed out to me recently, maybe Bryan and I just attract/are attracted to those scenarios in the first place…) After some deliberation we decided to take advantage of a cargo charter flying in the following morning with fencing materials for our new compound. We could give Annabelle an injection of antibiotics that night and then she and I would be on our way to Nairobi the following morning. A week of intravenous meds without lab work seemed like overkill for such a little girl. But ignoring her fever was out of the question. Our whole family flying out in twelve hours’ notice seemed unnecessary with so much left to be done in North Africa in the next two weeks. But us all staying in, especially a pregnant mama and sick baby seemed equally silly.

So after a short night, Annabelle and I said a modest goodbye to Bryan on Wednesday morning at the airstrip while a cluster of kids watched on and WFP helicopters reverberated overhead. By the time we hit Lokichoggio she has already gone her first twelve hours in ten days with no fever. We were unable to get a ride out of Loki so a friendly taxi driver helped me find “the best” local clinic (think one yellow room with posters of happy Chinese children overlaid with trite sayings about happiness fraying on the wall and wet basins stacked beside boxes of cough syrup in the corner) where an obliging doctor administered the second antibiotic injection.

By the time we reached Nairobi the following day and finally made it to our pediatrician’s office and shared our story, we were both fried. 

But, my baby was healthier than she has been in two weeks. 

Thank you God.  

Once again, I find myself battling mixed emotions. I am overwhelmingly thankful that she is healthy again. I breath such a prayer of thanks every time that cool little forehead snuggles into my neck. But a part of me wonders too if we overreacted. Now that I am in Nairobi for two weeks without my husband and with a perfectly healthy little girl, I can’t help but think, should we have given it another day or two? Plus, I suspect rumors have flown around the world (as much as we try to contain them) that my daughter was dying of some terrible refugee camp disease and had to be medically evacuated out. (If you could talk to the bush pilots who had to scrape three hours of cartoon stickers off their windows they would assure you that Annabelle was just shy of fine by the time they got to her.) And I also think about that doctor in North Africa who has seen it all recommending to put her on IV drugs immediately, and I know that while we can be thankful for a quick recovery, there are some things you just don’t mess around with in this part of the world.

I guess more than anything I am grateful. Grateful for the opportunity to overreact, underreact…just to act at all is more of a privilege and a gift than I could have fully imagined before last week.

Thank you so much for your prayers. We are richly blessed.