Intensity and gratitude (24/7/11)

For the last week and a half I just haven’t had the headspace to be able to blog.  Some of you know that I was able to go to the UK from July 4-9 for my darling friend Fiona’s wedding to the dashing Irish David, with the wonderful bonus of being able to see Catherine Wait, my closest friend from high school who moved to London in January.  It was a precious few days – spending time with dear friends who know me in a way not a lot of people do, just being able to be myself, and to rest.  It was a blessing, made possible by my amazing husband parenting children solo in Kenya, while Jennifer sacrificed time with her own family to fill in for me at work.

I got back on a Sunday, and had 3 wonderful days reconnecting with the kids and Andy, being able to be present and rested, able to give Andy some space after surviving a pretty horrific week with sick kids and sick daddy.  Our family works much better with 4 people than 3, and it was nice to be back.

And then, back into the work maelstrom.

For the last 3 months, Jennifer and I have been supported incredibly in our pediatric work – Dan Entwistle, a pediatrician from North Carolina, had come over to help us (and so that his family could be close to RVA for the last 3 months of his son Jesse’s senior year, attending rubgy games and all things senior), and we also had Immaculate working on the pediatric ward.  It all worked out beautifully – Immaculate and Dan taking care of inpatients, supervising outpatient clinics and doing consultations for pediatric surgery and neurosurgery, managing critical children in the ICU.  Jennifer and I were able to take care of the newborns in special care nursery, attend caesarian sections, resuscitate premature babies, educate our team and update protocols that were outdated or lacking, run a clinic at the boarding school on Thursday, and run a private pediatric clinic on Wednesday afternoons to try and cater for those children who are missionary kids or whose families can afford it, bringing some extra money into our just-squeaking-by-non-profit-hospital.

Until a week and a half ago, when Dan left and Immaculate remained away on annual leave.

For the last 10 days, Jennifer and I have been keeping our heads above water.  Just.

We decided that rather than both of us working full-time to fill in the gaps, sacrificing our families and children, that we’d keep to our half-a-week-each schedule and just work twice as hard when we were at the hospital, until Immaculate returns on August 1st.

It has been a lot to handle.  First thing in the morning, I’ve been rounding on 15-20 inpatient children and seeing the surgical/neurosurgical consults with CO Lillian, a FP resident and intern, while CO Bob and 2 interns manage the nursery.  Then, dashing off to nursery to see the 15-20 babies, some of them as small as 1100 grams.  Rushing back to the paediatric ward to see if Lillian and team need assistance with discharges, procedures and paying children’s bills from the Needy Children’s Fund because they can’t afford it – trying to free up the peds team to get to the outpatient clinic because at least 30 children a day need to be seen there and many have been waiting since 8am.  All the while, hoping that the beeper doesn’t go off for an emergency c-section, or admission from Casualty or clinic, or deteriorating baby, or new consultation.  At 2pm, looking at my watch realising that I should attempt to run home for lunch (quicker, actually, than going to the cafeteria…) because if I don’t go now, my beeper WILL go off and the day will be gone.  Rushing back to tie up loose ends, check results, followup tests and make sure I haven’t missed anything critical, see the admissions I have missed during my 20 minute lunch break.

That was Friday, and then I was on call on the weekend, involving the same thing without the clinic on Saturday, capped off by 3 admissions at 1am on Saturday night.  Sunday we don’t really round if we’re on call – but with 35 babies/children on the service many need checking so I was in from 9-12:30 just putting out small fires… followed by new consultations in the evening and deteriorating babies at 3am.  Breathing space with the family on Monday and Tuesday.  Then again Wednesday, Thursday (which included running to private clinic to see a last minute booking, even though I’d cancelled the clinic, because a colleague’s wife is at breaking point with their 3 year old twin boys whose behaviour, it turns out, is probably so difficult because of their not-quite-officially-diagnosed autism which has not been well explained or supported).  Another night on call Thursday, then Friday, Saturday morning rounds (kindly supported by Jennifer who realised I was losing the plot…) – then, a deep breath.

I was supposed to go  away again next week from Monday to Wednesday – I was going to join the pediatric surgical team who go monthly to Dadaab.  Dadaaab is a refugee camp in northeastern Kenya that was intended for 90,000 people and currently houses over 400,000 with thousands streaming in from nearby S-m-l–, stricken by drought and now being denied aid by its own spiritual leaders.  I have wanted to be a part of the team there since arriving – humanitarian organisations there refer difficult pediatric cases to us, and pay for us to evacuate them back to Kijabe, treat them and send them back up to Dadaab when they are well.  I am disappointed to not be going, but the timing was atrocious  and there will be other opportunities – I think I and the whole family would have spontaneously combusted if the balance had been so upset again so soon.  And I think my kids would have begun to wonder, where is Mummy again, and why isn’t she with us?

It has been an intense 10 days.  I am so grateful for so much – that I have had no critical babies in intensive care.  That I am sharing this job with Jennifer, whose advice when I am clueless is invaluable and without whom this would have been 13 straight days of lunacy  with only 1 day off to breathe.  That I have such a capable and hard-working team of Kenyan COs and interns.  That Immaculate is coming back in August and that we are not handling this load all the time.  That I have an amazing, supportive husband who knows when I need rest and space, who knows when to ask me if I am doing too much, who supports me and the kids so practically and graciously.

I am grateful that I am exactly where I am.  Despite – or because of- the intensity of this job, it is deeply fulfilling to be here, where the need is so great, and to be walking this tightrope of family and career, of being and doing.  To know that when I think I’m at the end of my rope, that the edge of my comfort zone is the place where I need to be.  To see my weaknesses, to see my priorities, to be able to assess, what am I supposed to do today?  How do I be a Mum, a wife, a pediatrician, a friend, a daughter of the King?  I think those are good questions to keep asking.

- M.