Saturday, 8 February 2014

Explaining the inexplicable

Unexpected champagne.....warm crusty bread, Camembert, Gruyere cheese, red wine, chocolate mousse, coffee, more chocolates.....and unlimited free Internet access courtesy of the african airline, Air de Côte d'Ivoire. In the west we use words such as 'luck' or 'chance' or 'fate' to explain the inexplicable. Many people are uncomfortable with something being inexplicable. We want answers, we want to understand. Nothing wrong with that. But why, in a rather bizzare way, when we cant explain something, do we make up another inexplicable concept and call it luck or fate. What is luck and who gets it? What is fate and how do you get good fate not bad fate? Where I work in Africa, people don't believe in abstract concepts such as 'luck' or 'fate'. It is more personal. It is all in the hands of the God or gods, so the fundamental question when things happen is, 'who did this to you?' When bad things happen the mindset is often 'who cursed you?' And when one encounters a series of 'lucky events' the response is 'wow what favour you/I have!' What do you think? I ask because I am interested in how you might interpret the week I just had? Good luck or bad luck? Fate? Miracles? Blessings or curses? You probably know what I believe, but I will tell you at the end! I am writing this on a plane to Conakry, Guinea having travelled from Pointe Noire, Congo via Gabon, Ivory Coast, and Mali. Five flights and I am sitting in Business Class, seat 1A, having just been served champagne, European cheese, wine and chocolate truffles. My chair is so big and deep that my feet barely touch the floor and if I sit back in this giant seat my thighs are not long enough to reach the edge of the seat so my knees can bend properly! I was finally on route to Guinea three days later than planned. On Monday evening we had an emergency in the Operating Room (OR), which consumed my whole week and delayed my trip to Guinea. Simon was a young man with a severe abscess in his jaw which needed surgical intervention. When the team woke him up and removed the breathing tube from his mouth he suddenly and unexpectedly could not breath. A crisis call to the OR came over the ships loudspeaker. None of the 4 anesthetists including me were unable to reintubate the young man (put the breathing tube back in). It was also very difficult to assist his breathing using a mask or other airway device. So two maxillo facial surgeons performed an emergency tracheostomy (cutting a hole in his windpipe to place a breathing tube) just in time, to save his life. Simon had a lot of blood and pus in his lungs and we tried as best we could to wash this out and then supported his breathing using a ventilator (breathing machine) and kept him asleep with sedation and pain killers. We had great difficulty keeping him alive even with all our equipment. Even in England it would have been a struggle as his lungs were so damaged they could not absorb the oxygen well enough. I really thought Simon might die. So we cancelled my flights to Guinea, the team would have to go without me. Patients come first. Now was not the time to be planning future healthcare education when someone's life hung in the balance. Many people were praying for a miracle. By Thursday morning Simon had made a miraculous recovery, his airways pressures were lower, oxygen requirement halved, drains no longer bubbling and saturations the best for the last 3 days. At 5pm Friday (4 days after the emergency) he was sitting in a chair, without any of our machines and communicating with sign language. A miraculous recovery and I have not seen one so fast and neither had Alan, another consultant anaesthetist and intensivist from England. We all think we witnessed a miraculous recovery. From my perspective it was a busy and stressful week. Responsibility and worry on weighing on my shoulders. And then there was the visit to Guinea. Three of us were going to re-establish relationships with the Guinean government, port and logistics, and make a more formal healthcare education assessment (my role). The other two had left early on friday without me and my ticket was now booked for Sunday evening with teh remaining connections on Monday. That felt like good luck....or could it be miraculous provision on a more personal level? Simon was better, and I now had time to catch up on some much needed sleep. Fate or favour? And the story continued with the provision of free Internet at the guest house on Sunday evening after I flew to Brazzaville. Monday morning, free unlimited Internet at Brazzaville airport ( better than the with 45 minute time limit at Heathrow). Then my flight from Abidjan was cancelled so I was put on a later one, given a VIP pass to the airport lounge and upgraded to Business Class. Hence the champagne.....warm crusty bread, Camembert, Gruyere cheese, red wine, chocolate mousse, coffee, more chocolates ! All the free Internet access and flight delays meant I managed to catch up with all my backlog of emails and design some more training plans. Was this my lucky travel day....was the patients recovery just fate.....maybe? Or maybe there is a God who knew what I needed? God doesn't make people sick, that is the work of the evil one. But God does work all things together for good for those who love him. God worked a miracle to save Simon's life, I got a weekend I didn't deserve but did need, and even played a game of tennis and went swimming. Gods favour was on my travels, redeeming my time. I took 5 flights and ate 4 croissants (courtesy of the French influence on African airlines). I believe that God worked it to save Simon's life ( we don't normally do his type of emergency surgery on the ship), and so that I could still travel to Guinea and not be totally exhausted. We are building relationships in Guinea and asking them what would they like us to do to help, not just with surgical services but also with training. The saying 'give a man a fish and feed him for a day, teach a man to fish and feed him for a lifetime' has never been more true. One of our objectives in Guinea is to seek to understand what the training needs are as perceived by the ministry of health, the hospital directors, and individual doctors/nurses/other departments. Then we can try and match their needs to our training resources. Training is about change, not just of systems but of ourselves. And that is part of our vision, to 'transform individuals and serve nations one at a time'. That's why we are here. That's why I am here. And even though it is actually incredibly difficult to make a difference, to see the application of the things we teach effect lasting change, it is worth the effort. I believe in a God who really can do 'more than all I ask or imagine according to his power at work in me'. I am very grateful for the miracles I have seen this week in Simons's life and in my life - in real, tangible and personal ones that God gives me because he loves me. You see, I believe God is still performing miracles today. He hasn't stopped and he never will. What would it take, I wonder, for you to believe the same? To believe His love for you and his desire to bless you in the same intimate and personal way.