Tuesday, March 6, 2018

The Giant who Brought Down the Stone (Part II)


Though John was facing possible kidney failure and his health was my priority, it was, unfortunately, not my only concern. We had only lived in Malawi for four months, and I had relied on John to lend more than fifty percent to every decision outside of what to make for dinner. Suddenly I was fully responsible for planning an emergency evacuation and all the details involved in long-distance maintenance of the home front until we returned. If I agreed to the Medevac flight the church had so graciously scheduled, I would have to pick up the kids immediately and tell them we were leaving the country within hours. Alternatively, I could tell them we were leaving the country without them in a few hours. Neither sounded like a good idea, which is why I jumped on the opportunity to buy more time.

Dr. Smith offered to insert a catheter directly through John’s side into his kidney. He said it would offer instant relief from pain and pressure, bringing him back to coherency so he could be a part of these major decisions. He suggested that we look into commercial flights to get to South Africa as soon after the procedure as possible to have the stone removed in a place with all the necessary technology for surgery and aftercare. It was Monday and he needed one full day to order the necessary equipment to be driven up from a nearby Malawian city. I agreed, and we planned the procedure for the following morning. John stayed on Demerol and IV fluids for one more night, waking only to walk to the bathroom or ask for more pain medicine. I didn’t feel safe leaving him at the hospital alone, so I was very thankful to have good friends offer to sit with him when I couldn’t be there. 

Tuesday morning came and I was at the hospital immediately after dropping the kids off at school. Dr. Smith was there, and so was the equipment he ordered. We were just waiting for his assistant. I sat with John and talked to him as he was in and out of consciousness. One hour later the doctor popped his head in to remind me that it’s very Malawian to be late, a fact I know but was not aware applied to doctors scheduled for surgery. Another hour passed before the assistant showed up, saying he was in a hurry. Within minutes they had John’s railless bed careening down the hallway towards their brand new operating rooms—an addition that brings the hospital into the twenty-first century, rivaling any modern heath care facility in a first world country. I wasn’t sure how I felt about christening an operating room with a potentially serious procedure, but the doctor I trusted assured me he had it under control and that the room was sterile. 

Dr. Smith told me it would only be a matter of minutes. As an aside, I must mention that I have learned to accept miscommunication with Africans as my fault. I realize I am not yet familiar with the nuances of their culture and assume the bulk of responsibility when any bit of information is misconstrued. However, when an American--anywhere--says to another American, “It will just be a few minutes,” by all estimations, I don't expect that to mean more than about forty-five minutes at most. So, you can imagine my concern and borderline panic when two and a half hours had passed and I had not heard anything from anyone about how John was doing. I even approached one of the nurses on duty who dismissed my concern by telling me she didn’t know what was going on either but was pretty sure I would hear if something was wrong. I realized that hours had passed since I had a friend pick the kids up from school and drop them off at our house. Not wanting to leave them alone any longer, I called another friend to see if she could take them to her house. She said she could but reminded me that her kids had to study for exams and that they could not play. Exams! Oh no. I had forgotten that it was midterm week. I didn’t know how in the world our kids could pass exams after coming into the school year so late and now facing this upset. I promised her they would study and called to fill them in on the plan. 

Dr. Smith emerged into the hallway with the pleasant smile he wears for all occasions and explained that the assistant had left halfway through the procedure to pick up his kids from school. I can’t be sure but I think I laughed out loud. It wasn’t a ha-ha-funny sort of laugh but a you’ve-got-to-be-kidding-me laugh. He said the catheter and the guide wire he received didn’t match, so he had to “rig” it. He assured me it had done the trick and wasn’t going anywhere but said it took a lot more doing than he had anticipated. He couldn’t leave to tell me that because he was the only one in the room with John. As soon as I processed that my husband was fine, I called my friend to cancel the pickup and went to get the kids myself, hoping to get back before John woke up. 

When I showed up to the house, the boys were standing at the gate with their back packs. They were not happy to see me. I had forgotten to notify them of the change of plans. I thought they were upset because they weren’t going to get to play with their friends. After my rant and lecture about putting first things first and how it can’t always be play time, Jonah and Andy informed me that their concern was over midterm exams and not play time. They were actually looking forward to getting some attention from their friends’ parents. I’ve been too busy on the phone and Internet to be available for them. They were afraid they were going to fail. At that moment I realized I was being a horrible mother. Then John called and inadvertently reminded me I was also being a horrible wife. “Where are you? I need you. I just woke up and you’re not here.” Finally, Ben chimed in from the back seat to round out my guilty mood, “Mom, I’m really hungry. Can we please get something to eat?” Jonah and Andy are going to fail because of me, John is alone after surgery in a bed without rails, and Ben is starving. Now would be a good time for the world’s largest pothole to open up in front of me and swallow up this car. I pulled up to a stoplight with a beggar and handed him some pocket change, wishing I could hand him my place behind the wheel instead. I couldn’t hold back the tears, and the car grew silent. 

There was a nurse sitting beside John when we arrived. I was surprised to see her there. She told me she couldn’t leave, because he might roll off the bed. I thanked her and we all sat down, the boys opening their school books. John woke up and talked to us. He didn’t remember calling me. He grabbed my hand, and the boys asked questions about their upcoming tests. I gave Ben a cereal bar from my purse. Everyone was content for the moment. I breathed. 

John came home the next day and was soon up to discussing the details of our trip to South Africa. It was miraculous, really, and I was thankful to have his help. The hours I had spent all week on the phone and computer were less than fruitful. Our Internet only worked intermittently, electricity was spotty at best, and cell phone service came and went. Because communication with anyone outside of Lilongwe required a combination of the three, I lived frustrated. Most attempts at getting John the medical care he needed, went something like this: Someone gave me a lead on Facebook for a doctor in South Africa. I dialed the number to hear my cell phone service was not working at the moment. I drafted an email instead to find out that there was no Internet connection to send it. Later, I sent the draft and received a return email requesting a phone call. I called and was disconnected three minutes into the conversation because my prepaid minutes had run out. I decided to switch my focus to researching lodging. I went to a website that had been suggested but the electricity went out as I was looking at the details, so I lost the connection to my router, which kicked me off the site. I gave up for the day and went to take a shower. There was no hot water. I prayed and cried and cried and prayed some more.

How were we going to arrange plane tickets? Who was going to perform John’s surgery? Where would we stay? Who would go to the ATM every day on our behalf to stockpile cash for the rent that was going to be due on our house when we returned? How were our employees going to be paid and our dogs taken care of? Who was going to watch our house and pay the bills, which have to be paid in person? How were the kids going to keep up with their school work? How was I going to stay sane? I took the whole jumbled mess of questions and dropped them on God like so much clean laundry onto a couch.   

It took many hours for John to come out of the haze that is anesthesia, but we were sitting at a coffee shop the following day to discuss the answers to these questions in a neutral environment. I had as many calls and emails out as I could possibly juggle. The most promising lead was a urologist in Johannesburg who had agreed to do the surgery for cash without the safety net of insurance. He wanted to talk to me personally before scheduling the procedure. He called as we sat outside, enjoying the nice weather and planning our evacuation. He explained to me that the situation was much more serious than we had imagined. According to his assessment of the information we sent him, John was going to need a much more complicated battery of surgeries and at least a month in South Africa. His finding was that John only had one working kidney, and that was the one being blocked by the stone. In fact, he said it was an absolute emergency that we get to Johannesburg right away.