Homecoming

No, I'm not talking about my return to the States, though it is right around the corner. 

Do you remember sweet Esther? Esther was my patient in the female ward two weeks ago. She was a joyful presence in the ward and I looked forward to seeing her face everyday. At 89 years old, she has doubled the life expectancy of most Zambians. Her heart was failing, her legs were swollen, her abdomen was sunken in except for the pulsatile mass that was protruding, her blood pressure was rarely stable. I worried about her condition every day she was in the hospital but finally we had her stabilized and she was able to go home. I was ecstatic to watch her walk, yes walk, out of the hospital on her own, though she was literally at a 90 angle because her spine was so badly hunched. Precious Esther. 

Monday afternoon, around 4:30, as I was trying to finish up the long line of patients waiting to be seen in OPD, Meg rushed into my exam room. Esther was being wheeled into OPD. 

From the second I placed my stethoscope on her chest, I knew she had deteriorated since I'd discharged her. Her lungs were congested, her heart rate was erratic, her legs had filled back up with fluid. We wheeled her over to casualty and hooked up the cardiac monitor where my fears were confirmed. Her heart was contracting irregularly and she was getting progressively weaker. I admitted her to the female ward that night and hoped her condition would somehow turn around. 

I stopped by to check on her yesterday morning and she was awake and feeling better. Her chest X-ray showed progressive pleural effusions and her oxygen saturation had dropped but she was hanging in there. As Dr. Joan came home from the hospital last night, she assured me Esther's condition was unchanged. 

I arrived to the hospital this morning and headed straight to OPD. I quickly got word that Esther had begun vomiting and was not doing well. I walked over to female ward and was relieved to see Tanner and Dr. Joan doing rounds standing by Esther's bedside. Esther was awake and talking so I went back to OPD to work. Around 11:30, one of the interpreters came to my exam room to tell me Esther had taken a turn for the worst and passed away. It literally took my breath away.

The heartbreak of losing another patient. It's always gut wrenching. It happens too often here, at least once or twice a week and it never becomes normal or gets any easier. Last week, three of my patients from the male ward died. One of which I was standing over when he stopped breathing. I listened to his heart as it stopped beating. There was nothing that could be done. His family looking on, watching me, hoping for a miracle. 

Esther told Tanner this morning that she was feeling well after a long time of prayer and confession. She was in good spirits and at peace. Her faith was strong.

Two weeks ago, I was rejoicing that Esther was going home from the hospital and while my heart is weary and grieving, today I rejoiced that Esther was truly going home. 

Hope remains. 

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit. Romans 15:13