Sample chapters
Sample: God in the ICU
Chapter One
A SENSE of DESTINY
Hey God, can You hear me?”
The shrill, triumphant voice of a six-year-old boy pierced the morning air from a treetop.
I had climbed to the summit of the Jacaranda tree in our garden and was savouring the victory. The ground was dizzyingly far below me and I felt sure that the top of the world could not be far off. And of course, I was close to heaven and therefore close to God.
I do not think that there was ever a time in my life when I doubted the existence of God. I remember at the questioning age of adolescence, when one thinks about things more intently, and questions everything, I was at a camp in the Zimbabwean bush. I had looked around at the flat-topped thorn trees providing shade for our tents and the tall Bauhinias, whose leaves fluttered in the wind like butterflies; I had listened to the ku-kurrrrrrrr of the doves overhead and seen a timid bushbuck dart through our camp; I had observed the sensitive, complex ecosystem – everything designed to harmonise and sustain life in a slow, purposeful rhythm of seasons and I had settled the question once and for all. This could not have happened by accident: God was there.
This is the tale of how He took my hand and led me down the path appointed for me, to show me the way in which He responds to our prayers and demonstrates His love in all manner of situations.
The story starts in 1940 in a simply furnished pre-fabricated house, nestled, with four others like it, amongst Msasa trees and tawny grass in a remote part of Zimbabwe overlooking the Umniati River. It was home to the engineer who supervised the power station. His young wife was looking anxiously at their newborn baby. He had not been well for two days, but today he looked worse. Instead of crying fretfully he was drowsy and listless and could not take the breast.
She glanced at her husband beside her. “We need to get him to the hospital, Jack. I’m worried.” It was a three-hour bumpy ride in their old truck along a bush track to Kwe Kwe, the nearest town, and to the anxious parents each minute crawled by as their child lay still and pale beside them. They rushed into the Casualty Department, anxiously presenting the little bundle to the staff. After his examination the doctor was abrupt.
“Why did you leave it so late? Your baby has malaria. There is no chance to save him now. He is going to die!”
Without even sterilising the skin, he plunged a needle into the little buttock, administering a massive dose of quinine, more as a token of treatment than with any true hope.
In anguish and guilt after the doctor’s comment, the mother and father kept an anxious all-night vigil over their baby. Remarkably, the next day he had improved, and although he developed an abscess from the quinine injection and pneumonia as a complication, he survived.
That was my introduction into this world. When I was old enough to understand, and heard them recall the story, it engendered in me a sense of destiny. God had spared me for a purpose. From the age of seven I knew I wanted to fulfil that destiny in the field of medicine and everything was assessed in terms of how it would help me to become a doctor. I devoured stories of doctors of compassion such as Dr Paul Brand, a Christian surgeon who worked amongst lepers, transforming their lives by making groundbreaking discoveries of the cause of their deformities and devising operations to counter their disabilities. I thrilled to tales of humanitarians such as Albert Schweitzer, a famous musician who then studied medicine and went on to found a mission station in Lambaréné, in the former French Equatorial Africa (now Gabon). And Taylor Caldwell’s Dear and Glorious Physician, a novel about St Luke, the doctor disciple of Jesus, set my heart aflame as I dreamed, romantically, of the healing role I could play in society.
I somehow never doubted that I would be accepted for Medical School, but it was nevertheless a thrill as I set off on a three-day car journey from Zimbabwe to the University of Cape Town.
My time at Medical School came at a pivotal time in South Africa’s history. On 21 March 1960, one year after my enrolment, a group of 20 000 unarmed people gathered at the police station in Sharpeville (a township near Vereeniging), to protest against laws which required every Black person to carry a ‘pass’. The handful of police, confronted with such a large number of people, panicked and fired live ammunition into the crowd, massacring 69 people including women and children. Those were tense days in the history of the country and I have a vivid memory of an endless line of thousands upon thousands of Black people marching solemnly along De Waal Drive, the main highway into Cape Town, led by a young lawyer named Nelson Mandela. They were protesting against the Sharpeville massacre and demanding compensation.
In response the South African Government passed a bill indemnifying the government retrospectively from responsibility for any such compensation. So, in my third year at Medical School, the African National Congress turned peaceful opposition into an armed struggle and we lived in a declared State of Emergency.
In that atmosphere of secret government atrocities and acts of sabotage by Umkhonte we Sizwe, the military wing of the African National Congress, I was accumulating knowledge that I hoped would set me on a different course of compassion and healing.
At last the day arrived. The results of the final examination were pinned up and, pushing through the crowd and craning my neck, I saw my name on the list. I rushed to my excited parents to be greeted by my dad, for the first time, by my new title, “Hello, Doc!”
It felt so good! I was fulfilling my destiny.
During my time at Medical School I had fallen in love with a beautiful nurse and Penny and I were married two days after I graduated. Our honeymoon was spent travelling back to Zimbabwe so that I could commence my internship at Harare Hospital.
My introduction to medical practice was dramatic. I waited nervously for the phone to ring on my first night on call and jumped apprehensively at the shrill ring. I answered quickly, “Hello.”
“Hello Dr Walker. Could you come to Casualty immediately: we have a child here whose arm has been bitten off by a crocodile!”
I raced to the Emergency Department to see a six-year-old boy lying on a trolley, the whites of his wide eyes shining against the black of his frightened little face. His right arm was missing, with the bone protruding through putrid flesh bloated with gas gangrene. This was a prelude to a hectic internship. With only four interns to manage a one thousand-bed hospital handling such dramatic cases, it was a baptism by fire. It was a time of busy days and gruelling nights, but we gained great experience very quickly.
And yet there was more…
During my time at Medical School I had become very
interested in anaesthesia. To see someone close their eyes and drift into
unconsciousness in response to an injection was fascinating. I learned that it
was the anaesthetist’s responsibility to keep the body functioning as normally
as possible while it was being assaulted by the strain of surgery and blood
loss. The anaesthetic itself produces side effects and the anaesthetist must be
aware of these and be ready to counteract them in the best possible way.
Anaesthesia requires dexterity in placing intravenous, arterial and epidural
lines, a comprehensive knowledge of how the body functions normally and under
surgery and a thorough understanding of drugs and how they work. The idea of
using skill and knowledge to be the guardian of the patient, sheltering him
through a major crisis in his life, had great appeal. Hence I enrolled as a
registrar in training in the Anaesthetic Department at Groote Schuur Hospital
in Cape Town.
Sample: Prayer, Medicine and Miracles
Chapter eight
Atheists and believers
“But God chose the foolish things of the world to shame the wise; God chose the weak things of the world to shame the strong.” (1Cor. 1:27) NIV
Although there were mockers at the hospital, and friends who deserted me, my life was filled with joy and sheer inner exuberance as I experienced the reality that God is with us in all that we do, ready to respond to our prayers. A few days after my radical experience of God, I decided to buy a Bible. I parked my car in town and then realized I had no clue where to find a Bible shop. I prayed “God, I’ve never done this before, but I’m asking You to show me where there is a Bible shop”. Imagine my delight when I walked down the street, took a right turn after a couple of blocks and there, before me was a Methodist Bookshop. It was my first experience of directly answered prayer and from then on, no amount of skepticism could stop me. I prayed with my patients, I offered to pray with colleagues, I prayed for the people in the car in front of me in traffic jams, I prayed for beggars who asked me for money and I prayed, of course, for my family. While I lost a few friends and endured some ridicule, I found new friends who loved Jesus and I saw God respond to my prayers in wonderful ways.
On my preoperative round, my usual approach to my patients was to examine them and get the medical side of things sorted out. Often the surgeon, in his round with the sister, was intimidating, and I would be the first person the patient felt safe enough to ask about what would happen in the operating room. I tried to familiarize them with the procedure and then said something like this:
“I just want to tell you that I am a committed Christian, and I have seen the way God responds to us when we entrust these difficult times to Him. I’d love to say a prayer with you for tomorrow, if you’d like me to.”
Sometimes, of course, I would feel a nudge not to pray for a particular patient, but I usually prayed with themunless there was a definite prompting not to. It was not always easy to pray with my patients; there was always the fear of offending someone, although I tried not to be coercive in any way. I remember visiting a large man, built like a wrestler, with a Men’s Health and a hunting magazine beside his bed.
I held out my hand as I entered his ward. “Hello, I’m Dr. Walker and I’ll be giving you the anesthetic for your operation tomorrow.”
“Hrmph!” He gave my hand a quick shake.
Then I went through my usual questions.
“Any previous operations?”
“Na”
“Any medication? Allergies?”
“Mmm-gmm”
All my questions were answered in a grunt or a monosyllable. I was not connecting.
At the end of it, rather intimidated, I was tempted to just move on to my next patient. But I knew the check in my spirit was from fear of this macho man and what he might think, not from the Lord. I took a deep breath and offered to pray with him if he would like.
“’Kay.”
I prayed. He gave no response and I left thinking I wonder if I should have done that?
I visited him with a little trepidation the day after his operation and was surprised to be greeted with a big smile.
“Come in, Dr. Walker. Come in.”
“How are you doing, Mr. Jacobs?”
“I’m doing fine. A bit sore, of course, but fine.”
He was friendly and ready to talk.
After some small talk, he said, “Thank you so much for praying for me, Doc. I can’t tell you what it meant. I was terrified when I came in. Could hardly speak. But after you prayed a peace came over me and I went into the operation as calm as anything.”
Jesus breathes peace. Whenever He appeared to His disciples after His resurrection His first words were either, “Don’t be afraid” or, “Peace be with you.” He is the Prince of Peace.
I have found there is a big difference between saying to someone, “I’ll pray for you,” and actually praying with them. Time and again my patients expressed a calmness, allaying their fear before an operation, as I prayed with them and their hearts were opened for God to do His work of peace.
I seldom had anyone refuse prayer. There was, however, one man who broke my heart. That was George. I entered his ward on my preoperative round and he greeted me with a friendly smile.
“Hello Mr. Stafford. I’m Dr. Walker and I’m going to be putting you to sleep for your operation tomorrow.”
“And wake me up afterward I hope.”
It was my turn to smile. “That’s part of the deal.They’re going to be opening your tummy. Have they told you what for?”
He was perfectly at ease. “I’ve got something nasty in there apparently.”
“Do you mind if I have a feel?”
As I laid my hand on his stomach, I felt my heart recoil. It was as if I had seen a black hood placed over the head of someone about to be executed. A hard, craggy lump extended from his ribs down to his lower abdomen. There was no doubt, from its hardness and the rough uneven edge that this was cancer. I wondered if George knew the seriousness of his condition; he seemed so cheerful and unconcerned.
I offered to pray with him before his operation but he politely declined. “Sorry, I’m an atheist. Don’t believe God exists.”
The operation confirmed what was obvious clinically. A wicked looking cancer had spread beyond the scope of any surgery, other than a minor procedure to make sure the cancer did not obstruct his bowel.
I went to see him afterward. He looked as cheerful as he had before his operation.
“The surgeon has spoken to you?”
“Oh yes.”
“So you know the prognosis?”
“Yes, not good.” He might have been talking about the weather.
“I’d love to pray with you. I’ve seen God do some wonderful things in the lives of people with your kind of prognosis.”
“No thanks, I’m an atheist”
I could not stay away from him, however. He was such a likable man who would soon be gone, but who did not seem to appreciate the dire straits he was in. I visited him daily. He was always cheerful and friendly. I longed to discuss the deeper issues of life, but the conversation was always superficial. It was bizarre. Here was a man who had barely a few months to live and all we spoke about was the cricket score, the weather or the pretty nurses. Every day I offered to pray with him and every day his reply was the same. “No thanks. I’m an atheist.”
Finally George was discharged from hospital. He left a card for me which would have been funny if my heart was not crying for him. It read:
Dear Dr. Walker
Thank you very much for your kindness in visiting me each day while I was in hospital. I looked forward to your visits.
God bless you.
George Stafford.
God bless you?
As well as praying with my patients, I also made friends in surprising places with others in the hospital who loved Jesus. Two of the porters who worked in the operating room were passionate about the Lord. They were uncomplicated folk with a simple outlook on life, but I sometimes think that is an advantage. The gospel message is essentially a simple one — God loved the world so much that He was willing to die for us so that we can be in a loving relationship with Him — and while we can marvel at the depths of the wisdom and glory of Christmas and Calvary, we can also get entangled in trying to reason out what is far beyond reason. Anthony and Brian had no such problem. They just loved Jesus because He had forgiven them.
Anthony had suffered brain damage as a child. It left him with a speech impediment in which all his words ran together in rapid speech. “WonderfulServiceonSunday. WonderfulWonderful. SpiritMovingDrWalker.”
I loved talking to him and Brian because of their simple faith that put my intellectual, doubting colleagues to shame.
One day a thunderstorm was raging outside. The air was dark and ominous. Torrents of rain threw themselves angrily against the operating room windows and a split second blinding light was followed almost immediately with the crackle and roar of thunder. Anthony was standing at a window looking at the spectacle. One of my mocking partners decided to have a little fun with him. Sidling up to him he said, “Just think, Anthony, that lightning could come right through the window and strike you dead.”
Anthony tilted his head to one side, gave him a crooked smile and looked at him through shining blue eyes. “DrChadwick. ForMeInstantDeathIsInstantGlory!” That silenced my partner and delighted me, as I chuckled inwardly at my simple friend’s wisdom.
I also discovered that many of the nursing sisters I worked with were Christians, and it was a pleasure to be able to pray with them, either about their situation or about the patients in their care. Sometimes they were outspoken about their faith and not afraid to include me in their outspokenness.
Celia was in charge of the ICU at Grey’s Hospital. If we had prayed with a patient, she always included it in her daily report to the Matron’s Office:
Jeremy Hosking:
An uneventful day. Still on the ventilator. Oxygenation good on 35% inspired oxygen. Vital signs stable. Fluid balance good.
Prayed and laid hands by myself, and with Dr. Walker and Sisters Stewart and Goodall.
I was greatly encouraged by these believers, especially in the early days of my walk with Jesus. Somehow, when I had been mocked or was the object of a sarcastic remark, God always put a believer across my path to encourage me.
As I grew in my walk with Jesus, however and saw Him work in wonderful ways in response to prayer, I became more confident and had fewer disparaging remarks. When I prayed, I no longer hoped God would work; I expected Him to work.
On one occasion my senior partner, knowing my interest in ICU, asked me to take over a patient of his who was steadily deteriorating. When I looked at the way my partner was managing him, I could not see anything I could add to his treatment. I changed nothing in his management; I merely started praying with the patient and he improved and was discharged from ICU a week later.
The nursing staff, too, encouraged to pray with their patients, saw remarkable results. This is one of them:
Marie was a young university student who was in love. Each day she looked forward to the end of lectures when John picked her up on his way home from work. Time with him was music and song. The trees and flowers shone with the luminance of young, passionate love and the air was fragrant with deep conversations as she shared her heart comfortably and freely with the man she loved. She did not notice that he was not sharing his heart with her. Until he stopped coming. He had moved to the next girl.
In a fit of depression, Marie swallowed a bottle-full of paracetamol.
As the paracetamol entered the liver, the cells there processed it by combining it with another molecule, ready for excretion. But the paracetamol kept coming. Marie’s liver, desperate to inactivate it, broke it down to smaller molecules. One of these, however is toxic and attacked the liver cells. If one could have looked at Marie’s liver, it would have been pale and swollen, filling with fat it could not process. The cells were dead or dying. Her only hope was a liver transplant.
Marie was admitted to the Coronary Care Unit while on the waiting list, because she was being cared for by a physician. I visited Coronary Care occasionally for fellowship with the Christian nursing staff and, one day, saw Marie and heard her story.
I looked at the young blond girl in the bed. She was semi-conscious and deeply yellow, sighing with each breath as the toxins which were unable to be excreted by the dead liver poured acid into her system.
How deeply the young feel, I thought. How world-shattering and overwhelming is rejected love. How close the horizons of their lives that they cannot see anything beyond the immediate crisis.
It was a race against time for Marie. Many patients die before a liver is available. Would Marie be one of them?
I did not visit the Coronary Care Unit for another fortnight. When I did, Marie’s bed was empty.
“What happened to Marie? Did they find a liver, or did she die?
The sisters smiled. “Neither. She got better.”
“What? She was in a coma from liver failure.”
“Yes. We prayed for her and after three days she opened her eyes. By the end of the week her jaundice had gone and she was discharged. The doctor admitted that he’d never seen that before. He said it was a miracle.”
Sample: Listen to the Music
I think I made a mistake. It’s not easy being a governor in a foreign land — especially one with such crazy bigots.
I had the whole pack baying for his life, because he didn’t toe their theological line! How do you keep the balance between order and what you know in your heart is right? Things were heading for a riot as they yapped at my heels like hunting dogs slavering for his blood. I couldn’t let it go on.
So, I killed an innocent man.
I don’t usually care. I’ve done it before. Even enjoyed it, watching them writhe and seeing the people cower at the power I can wield — or grow angry, depending on their mood. It’s never affected me this way before. What’s it to me as long as I can keep law and order? That’s the priority.
But there’s something bothering me about this one. He was different. He wouldn’t cower and he wouldn’t talk, but his looks were eloquent enough and I didn’t like it. He seemed to look into my heart, and that’s a private place. I don’t even like going there myself, sometimes. For all the pleasure I get from seeing others squirm under my power — especially those filthy Jews — sometimes the inner door opens a chink and there are longings……..and doubts…….I like to keep that door shut.
There was something else in his eyes, too. What was it? That’s part of what’s bugging me. I’ve spotted fear in eyes a hundred times or more and enjoyed the smell of it. I’ve seen arrogance, too and I like that even more. It spurs me to greater cruelty with no remorse.
His eyes had neither. The closest I can come to describe it is… let me see… pity? No, though there was some of that. Love? Perhaps. Compassion! That’s it. It was as though he was looking at ME with compassion. I had the power of life and death in my hands — his life — and he’s looking at ME with compassion. It was so absurd that it unnerved me.
And that conversation about truth! Everyone knows that truth is relative, changing with our experience. Yet when I looked at him, he seemed so completely integrated, so sure — as if behind the man was a colossus, solid and unmoving — eternal, almost. I had the weirdest feeling I was looking at Truth itself. I had to turn away and give a mocking, “What is truth?” But in a sense I was asking myself the question…. and wondering if he could tell me.
That’s when I decided to let him go.
I tried my hardest. I tried to flog and release, and when that didn’t work, I used the Jewish feast to release one prisoner, trying to persuade the Jews to accept him as the one. Nothing worked with those unbending fanatics. Then the crowd started getting ugly and it was order first, as always. I washed my hands of the case and let them have their way.
But no matter how much I wash my hands, they still feel smeared with his blood.
I heard some of the things he said from the cross — strange things to come from a dying man, especially one unjustly tortured. When I heard of them, I had a flashback to those eyes. I thought I saw that same compassionate look that unnerved me when I questioned him. How could a dying man plead for the forgiveness of those killing him? And did that include me?
I heard he even had words of encouragement to that scoundrel crucified next to him. He spoke as if that wasn’t the end of him — that they’d meet again.
And the eclipse that lasted so long (why hadn’t our astronomers predicted that?) at the same time as an earthquake. Was it coincidence that it all happened round about the time of his death?
Yes, I have a feeling that for once I made a mistake. This was one man I should have let free. Claudia thinks so too. She’s not one to nag, but she told me on the day of the trial, and I’ve never heard the end of it since!
But why should I worry? No-one can touch me. I’m Pontius Pilate and I have all the power of Rome behind me.
Yet, this one thought keeps bugging me:
“What if he wasn’t just a man?”
Sample: Crisis in the Children’s Ward
Chapter one
Trees reared up and flashed past in a disjointed blur. A group of children waving and flashing white from their black faces, was dimly seen. The round huts with domed tops of woven grass, the ploughed fields and straggly crops of stunted maize, the far-off mountains, mysterious and majestic in the distant haze, went unnoticed.
Jason turned up the radio full blast until the music reverberated through his body. He shook his head vigorously and shouted to himself.
‘Come on, Jason. Not long now. Keep going. You’ve gotta keep going.’ He raised his eyebrows, but his lids were reluctant to follow. Everything momentarily disappeared. The crunch and bump of tires over dirt and grass woke him as his car hurtled towards a tree. With a wrench at the wheel the car rocked back onto the road. It was a losing battle. His pounding heart told him he should have stopped long ago. As he headed over a blind rise, he hit the brakes.
Suddenly there was furious hooting and the tearing sound of tyres skidding on dirt. A car ripped through the bush beside him and came to a standstill. Coughing and squinting through the dust, he rushed to the other car. Fully awake now, he pulled at the door handle as the dust settled, and momentarily recoiled at the fire in the eyes of a flushed and glowering Snow White, whose hands still gripped the steering wheel.
She started speaking before he had opened the door fully, her voice shrill. ‘What were you thinking, stopping on a blind rise like that? Are you suicidal? You could have killed us both!’
‘So sorry. I … I just wasn’t thinking. I’m impulsive. I was … I was sleepy and just thought ….’
‘Well, that impulse could have been your last.’
Before his eyes the colour drained from her face, the paleness contrasting with her pitch black hair. She started shaking, still gripping the steering wheel. Jason opened his mouth but no words came. He bit his lip, looked at the sky, at the car tyres half buried in sand, at the surrounding bush, back at her.
Snow White sighed, relaxed, and with a weak smile, extended her hand. ‘Trish Breeze. I guess the Lord had His angels looking after us.’
Jason ignored her remark and took her hand.
‘Jason Langley. Can I help you get this car out of the bush? Of course, I’ll pay ….’
She brushed the air with her hand. ‘We can talk about that later. Let’s see if it’ll still go. I need to get to the hospital.’
‘Oh. You a nurse?’
‘No. Just visit the patients. Encourage them. But there’s a meeting I need to get to. Children are dying unexpectedly. We’re discussing it.’
Jason let her alight and took the driving seat. ‘I’m also going to the hospital. I’m the new doctor. Driven up through the night from Cape Town. Was falling asleep at the wheel.’ The engine gunned into a roar. Trish stood back as the car lurched forward, bouncing over grass tufts until it was on the verge.
Jason noticed Snow White – er – Trish looking at the large scratch down the side and decided not to say anything now.
‘Well, I’ll see you at the hospital.’ With the tyres kicking stones and dust she was back on the road and disappearing.
Wide awake now, Jason focused on the road ahead. ‘Great start, Jason.’ He shouted over the blaring radio, then reached to turn it down. ‘You’re not even there and you’re making enemies.’ He paused. ‘Great little figure, though,’ He replayed the incident in his mind. ‘Didn’t think such blue eyes could carry such fire ….’ His mind replayed the scene. ‘Pity. She looks like some chick.’
His body felt like lead as the tension eased. Dodging potholes and stray cattle on the 1 700 kilometre journey from Cape Town was tiring enough without a near accident as well. But with the weariness was a vague knot in the pit of his stomach. He had no qualms about his ability to tackle the medical problems — his academic record was testimony to that. Yet this rural hospital in the foothills of the Drakensberg … it was so different from the shiny, hi-tech teaching hospital in Cape Town. What challenges would there be there that he could not anticipate before they were upon him?
Nevertheless, when the post had been advertised for a Medical Officer at Livingstone Hospital in Yesigodi, Natal, he had jumped at the opportunity. His mind went back to that day ….
——————– o ———————
Without knocking, Paul came bouncing into Jason’s room, flicked on the light and sat on his bed. ‘Hey, buddy. I’ve found just the job for you. I know the place — used to live there — and Dr Blythe is a great guy! A bit eccentric, but great.’
Jason squinted against the light. ‘Paul. Uhh …. What time is it?’
Paul glanced at his watch. ‘One.’
‘It’s one o’ clock in the morning, Paul. I’m on duty at six. Can’t it wait?’
‘No, Jason, my mate. The guys will be queuing for this post. And I’m on night duty and you’re on days. I had to tell you soon. You need to apply.’
He opened his laptop. Jason rubbed his eyes and looked at the screen.
Livingstone Hospital in Yesigodi, Natal was looking for a new Medical Officer to work alongside the senior doctor. It was a 70-bed establishment with paediatric and obstetric facilities and a small theatre for minor surgery. He scrolled to the pictures. Corridors of polished concrete with green painted walls led to large general wards with iron beds made neatly with wine-red blankets.
The Children’s Ward seemed to be an annexe, with wooden floors and walls. Little black faces with wide imploring eyes gazed at Jason from one picture. Jason, all sleep gone, looked intently at each face, aware of a vague excitement. Children were so vulnerable and yet so uninhibited in their spontaneity.
He moved to pictures of Yesigodi. The main street, in common with many South African towns, led up to the church, in this case along an avenue of russet plane trees. The houses on either side, indistinct in the pictures, seemed typical colonial houses; brick or stone structures, with corrugated iron roofs and spacious porches on more than one side. Another picture showed the village a kilometre or two away from the town. No doubt most of the patients would come from there. Many of the inhabitants of the town would be wealthy enough to seek private medical care.
The hospital was in a different street. It had an unimposing entrance half hidden, in the picture, by a large plane tree. A utilitarian sign at the gate announced its name.
Paul was right. He could postpone his compulsory year of community service no longer. Many of his friends had been posted to hopelessly under-equipped clinics, with no supervision, returning broken in spirit, frustrated and insecure. With that as an alternative, Livingstone would be heaven.
Two weeks later the post was his.
————— o ——————-
He braked violently as a mongoose hurried across the road.
‘Focus, Jason, focus.’
The clatter and rattling abated as the dirt road became tarred, Victorian houses made their appearance and he slid behind a truck that was persuading all to ‘share a life, share a Coke’. He turned the radio down further as his eyes scanned the side of the road. Ah, there is was. HOSPITAL. The signpost pointed to the right. This is it. Just like the picture.
Jason hesitated, took a deep breath and knocked just below the large letters announcing MEDICAL SUPERINTENDENT.
It was opened almost immediately. ‘Come in. Come in. Been expecting you. Must be the new doctor.’
Jason opened his mouth to answer but the man kept going. Was he talking to Jason or to himself? ‘Difficult time. Difficult time. Come in. Come in.’ He was wiping a grey, bushy moustache distractedly and Jason thought how perfectly it matched his wild eyebrows.
Then he seemed to collect himself. He extended his hand, grasping Jason’s arm with his other hand as he did and looked up into his eyes.
‘Blythe. Geoffrey Blythe. Glad you made it. Roads are bone shakers. And the cattle! Jason Langley, I take it. Take a seat.’
Jason chose the chair not quite opposite the large mahogany desk while the voice continued. ‘Yes, difficult time. Number of deaths in the Children’s Ward. Having a meeting about it. Think you should come. In fact, come to the ward. Get some background. Paperwork can wait.’
Jason jumped up, hurrying to follow the stocky form disappearing through the open door, and caught up with him in the corridor that led from the Admin block to the wards. They turned away from the passageway that led to the adult wards and into a covered walkway. As Jason had suspected from the pictures, the Children’s Ward was a wooden annexe, separate from the main hospital.
It was an effort to keep beside Dr Blythe to catch what he was saying.
‘Children over their illness, almost ready for discharge. Suddenly found dead. No reason found. Post mortem, nothing. Just nothing. Very worrying. New sangoma in the village. Villagers blaming him. Putting a spell on them so they’ll go to him instead of hospital.’ He was still murmuring, ‘Very worrying. Very worrying.’ when they arrived at the ward.
Jason ran his eye professionally around those in bed. The emaciated child with tell-tale ginger hair and a pot belly; kwashiorkor, malnutrition from a protein-deficient diet. In the next bed a little girl on an IV infusion; dry lips, sunken eyes, turgid skin; dehydration — probably from gastro-enteritis — a major killer of children in Africa. So preventable with a little education on basic hygiene.
One of the rooms was a playroom where those who were on the mend could play. Jason bent his long body to level his eyes with a little boy colouring in at the play table.
‘Hello, what’s your name?’
He put his hand under the boy’s chin and looked him in the eye. The little voice was just audible. ‘Mpile.’
‘Mpile. That’s a nice name. How old are you?’
He didn’t answer. The whites of his eyes shone starkly from his black face as Jason held his gaze.
‘Let me guess. I think you must be three.’ He deliberately underestimated his age, and Mpile shook his head.
‘Oh, you must be two.’
Mpile shook his head vigorously.
‘Are you four?’
For the first time Mpile gave a little smile and nodded.
Dr Blythe was at the door of the playroom. ‘Come, Dr Langley. Meeting due to start. Must go.’
Jason straightened up, giving Mpile’s hand a squeeze. ‘My name’s Jason. I’m a new doctor. I’ll see you later.’ Mpile nodded solemnly.
As the people came in one by one to sit around the boardroom table, Dr Blythe introduced them to Jason. Philip, the pharmacist; Dr Khumalo, radiologist; Simon, orderly (‘Official title orderly, but much more. Knows about everything. Want anything done — want to know anything, ask Simon.’)
Trish came in and Jason’s face felt hot. He avoided her eyes. ‘We’ve met!’
He moved his attention to others still coming in as Dr Blythe looked at his watch and cleared his throat.
‘Must get started. Thank you for coming. As you know, four deaths in the childre ….’
Suddenly, his pager went off at the same time as the door burst open and an enormous fat lady, the buttons of whose uniform seemed about to burst, rushed into the room. She was sweating profusely and stammering for words.
‘What, Sister Bongani? What?’
‘Come, doctor. Come quickly. Mpile. Come.’
An insistent voice from the pager filled the air, ‘Cardiac arrest in Paediatric Ward. Cardiac Arrest in Paediatric Ward.‘
Jason was out of the boardroom quicker than Dr Blythe and raced for the annexe. ‘Wait, let me have a look.’ He pushed aside the nurses who were trying to put an oxygen mask on the lolling head of the little child and pushing feebly on his chest.
His heart did a somersault as he saw the grey, lifeless body. Those wide, shy eyes from a moment ago were half closed, unseeing and unresponsive.
He watched the chest carefully – there was no movement. He put his ear against the child’s nostrils — no breath. He felt his neck in vain for a pulse and immediately issued orders, as Dr Blythe came hurrying in.
‘Quickly, get me an Ambu bag. And the defibrillator. Get ready to intubate.’
Jason put his mouth over the mouth and nose of the lifeless boy and blew into his lungs. Then he took his mouth away and allowed the breath to come out.
‘One.’ He repeated the procedure. ‘Two.’
He started chest compressions, counting as he did. ‘One. Two. Three. Four. Five.’
‘Nurse, where is that Ambu bag?’
‘Here, doctor.’
Jason looked up at Dr Blythe apologetically.
‘Sorry to barge in, sir. Would you like to take over?’
Dr Blythe shook his head. ‘Good job. I’ll ventilate. Keep going.’
Jason handed him the Ambu bag and he started pumping oxygen into Mpile’s lungs.
‘One.’ Breathe out. ‘Two.’
Chest compressions. ‘One. Two. Three. Four. Five.’
‘One.’ Breathe out. ‘Two.’
Come on Mpile, come on …. He’s not responding!
Simon arrived. ‘Simon, we need an IV line.’
Simon moved quickly, a nurse at his side.
‘One. Two. Three. Four. Five.’
‘One.’ Breathe out. ‘Two.’
The defibrillator arrived and Jason applied the monitor leads. A flat line.
‘Epinephrine. Simon, give him epinephrine.’
‘Epinephrine in.’ Simon’s voice came clearly.
The monitor bleeped and the flat green line jumped. It wiggled erratically across the screen before flatlining.
From the corner of his eye he saw Trish there. Her lips were moving silently; her head was bowed.
He was grateful. God, if You’re there, just for once, help this child.
‘More epinephrine, Simon.’
‘One. Two. Three. Four. Five.’
‘One.’ Breathe out. ‘Two.’
‘Come on, dammit. Kick in.’ How long before we got here? I hope his brain’s OK. Suddenly, the trace on the monitor was racing, 140/minute, 180. Down to 130. Up to 200.
‘Slow down, little heart. Slow down. But please don’t stop.’ Down to 130 again, and holding there. Then up to 160.
What was going on? There was some kind of a trace on the monitor, but Jason knew from his time in ER that not all heart monitor activity translates into a proper heartbeat. It doesn’t always mean a return to life.
Once again, Jason put his fingers on Mpile’s neck to check for a pulse, willing the limp body to respond … the room was thick with anticipation.
