Mother’s Day Thoughts

One of my favorite things about Cameroon is the many names I have here. I am Madame, Sister, Doctor, Mom, Mami, Mama. I am also called “Mom of …”(insert any one of my children’s names). Almost no one calls me by my first name. Any person who has a child can be called Mami (pronounced mah-mi) and I use this frequently when I talk with patients. I think it gives a sense of familiarity, especially when I can’t remember the patient’s name.

There are a few staff at the hospital who always call me Mom. This is my favorite title. It is rather endearing and makes me feel needed and wanted. However, with that title comes responsibility. I then need to be a model of kindness, respect, and compassion, taking the time to listen to the patient and do whatever I am called to do with a positive attitude and a grateful heart.

A favorite song at Mass here is “Mama Maria, mama, eh mama…” Mary is called Maria in Pidgin English. When we think about the formal titles we have for Mary like the Virgin Mary and Mother of God, she may not seem as accessible as when she is called Mama. As Mama, she becomes one of us. We need her and want her to intercess for us.

I also see Mary in the many mothers we see here with sick and suffering children of all ages. Mary’s heart broke when she saw her Son suffer and die. I think of the countless mothers here who have lost a child or children and endure that seemingly unbearable pain. Mary, then, becomes a source of comfort.

As I struggle daily with the mother that I want to be, let me look to Mary as my inspiration.

Celebration of Family Day

Instead of celebrating Mother’s Day at the children’s school this year, they decided to celebrate Family Day since some of the children don’t have mothers.  Each class did a song or skit and there were some raffle prizes, although some of these came at the expense of really embarrassing the parents.  Then the teachers served a lunch of chicken, rice, vegetables, and sauce which they cooked themselves for over 300 people!  Jennifer wore the traditional women’s attire for the first time and managed to keep her skirt on without it falling off.

Part 3

Morning report is a time to review, with the other doctors working in the hospital, the patients admitted and seen in the ER during the day and night before.  Jennifer quickly reviews the patients and then focuses on Miguel.  Brent arrives at 7:40, a bit late, but in time to hear Miguel's story.  The doctors then go down to see Miguel and the other patients.

Miguel is now breathing 50 times per minute, but his oxygen saturation has again dropped into the 80s.  His pulse is 180 and his lungs are tightening up again.  He is shows signs of tiring and is not able to maintain his oxygen at appropriate levels as his respiratory rate slows.

The team this morning includes doctors from Guatemala as well as from Spain and the United States.  Many specialties are represented including obstetrics, family medicine, and gastroenterology.  They realize Miguel will not be able to keep this up much longer.  They begin working in unison: continuous nebs, a phone consult to a pediatric intensivist in the US, comforting the parents, and preparation for intubation. 

Rapid sequence intubation is a process of giving sequential medications that paralyze the patient and allow for placing a tube into the trachea. This then allows the physician to take over the work of breathing for the patient.

Assignments are given, drugs prepared, high flow oxygen started.  All drug dosages checked and double-checked.

The ER this morning is a cacophony of sounds -- the bubbling of oxygen, the drone of the suction machine, voices of physicians and nurses and the labored breathing of Miquel.

The medicines are given and Miguel stops breathing on his own...... 

Seconds seem like hours during this moment as all attention is focused on placing the tube into the trachea.  

When intubating a patient you are always told to have a backup plan.  What will you do if you are unable to intubate the patient?  The last patient, Brent had intubated, was 6 years ago while working in an ER in Northern California.  Brent ran through the different options in his mind -- bag, bougie, laryngeal mask, needle cricothyroidotomy.

The first attempt is met with coughing, signifying Miguel is not completely paralyzed.  Another dose of the paralyzing agent is given and this time the endotracheal tube is passed without difficulty and taped into placed.  Oxygen is hooked up to the bag and one of the doctors rhythmically compresses the bag which now does all the work of breathing for Miguel. 

Miguel’s oxygen saturation increases rapidly to 99%.  He appears at rest now after working so hard for so long. 

The local volunteer bomberos (firefighters/paramedics) are called and Miguel is prepared for the 2-3 hour trip around the lake to Solola, the national hospital where specialists and ventilators are available.

Happy Mother's Day

Mother’s day in Guatemala is celebrated on May 10th every year.  It is a time to reflect on and give thanks to our mothers (and all mothers of the world) for their love and devotion to our children and to our families.    

The life of a mother in the developing world is very different, in many ways, from what I have seen back home.  The daily routines of cooking, washing and caring for the children is an all consuming endeavor.  The gathering of wood to cook, the fetching of water to drink and wash, the carrying of laundry to the lake, the making of clothing for the family, the trip to the clinic with a sick child.... the day is endless and the next day the same.

At times it is hard to find many similarities between the world I came from and the world I am living in now, but in a “mother” I can see a commonality with the mothers I’ve known best: my mother, my children’s mother, my sisters and my mother-in-law.  Their primary desire being the wellness of the family, is a commonality of mothers I see here and the mother’s most dear to my heart.  

This commonality is shown in their unique ability to focus on the day to day needs of the family and exemplified by the gifts of calmness and directness at achieving those needs, often times in the face of great adversity.  What underlies these gifts is an undying compassion and love for their children and families.

So today I wish to say “thank you” to my mother, the mother of my children, my mother-in-law and to all the mothers of the world for their love, support, compassion and care that they gave yesterday, give today and will give tomorrow.

peace and love,

Brent

P.S. I wonder how much better the world would be if a few more mothers of the world were leaders of the world?