Snake Cake

This week has been so busy I can’t even remember what all happened. I just know I am going through multiple cups of coffee every day and I don’t have wifi at my house. “Bado” means later. Some things are eternally bado.

We had some PA students come in this week for a tropical medicine rotation. They were supposed to arrive on Monday, but flights here are a bit chancy sometimes, so they finally arrived on Wednesday. A flight got cancelled with no notice, one of the two planes owned by this particular company broke, etc. However they are finally here and fun to be with. It’s been a long time since I’ve been overseas with people who have never been overseas. They’re very eager and excited, so it will be grand.

Clinic on Wednesday with all my favorite patients. A lady came in who needed a paracentesis. Plopped her on a bench in a hallway, the doctor stuck an 18g needle in her with no lidocaine, connected it to IV tubing, cut the end off the tubing, and drained several liters into a mop bucket. It took 4 of us to lift her onto the bench from the wheelchair. After her 6 hours of draining, she stood up by herself and walked out. She is so sweet and so grateful. The PA students arrived during our last few clinic patients. Guess what, I may not be able to speak Swahili, but after 4 weeks of repetition, I can understand the gist of medical conversations, so I translated. Have you had vomiting or diarrhea? I vomited 3 times today and had diarrhea once yesterday. Your pressure is high. Your sugar is high. Stop eating that. Can I eat this? How long have you been out of your meds? 1 day. 3 days. 4 months. I went on a trip for 5 months and ran out. Your joints hurt because you’re old. Don’t go to the witch doctor, take your medicines. Don’t take your child to the witch doctor, give him his meds. Stand up. Sit down. Lay down. Say “Ah.” Your heart is big. Your heart is normal. Have you had a cough? Do you have chest pain? Are your legs swelling? You have TB. You don’t have HIV. You have malaria. You don’t have malaria. He has a virus, stop giving him antibiotics and stop taking him to the witch doctor.

My personal favorite from a mother with a chunky 2 year old: “When I carry my child on my back and water on my head and walk up the hill I get short of breath and can feel my heart beating.”

Yup.

After clinic we went to go see a postpartum mother in heart failure. A little Lasix, a little oxygen, everything was great. We were walking out and saw a lady delivering in another room. We were invited in to watch. Apparently she had already delivered one twin and we were just in time to see the second one pop out. Baby #2 was not breathing. Baby #2 was blue. The person helping with the delivery was a nursing assistant volunteer. Not even a nurse, not even employed. This is not supposed to happen, but it does. The other people in the room were students. The guy kind of leaves the baby laying there and starts clamping and messing with the cord. The doctor’s like “What are you doing?” The doctor and I are both like “pick up the baby! Stimulate it!” The guy picks up the baby upside down and starts to jiggle it and we both make it abundantly clear to stop immediately. The guy finally cuts the cord and I snatch the baby and take it to the room where I knew there was suction and oxygen and an ambu bag, because of course that’s not in the delivery room. We work on the baby for quite some time, get him pinked up, get him breathing and warm. Now, the funny thing is we’re teaching a class next week on Helping Babies Breathe, so the PA students got to do it before reading the material. As we’re working on Baby #2, his sister, #1, is laying on the counter and screaming and she is a big baby and all pink, she’s fine. There’s also another baby laying on the counter who is dead. It was from someone else. This is all on a 3 foot counter. After a while baby #2 is fine, baby #1 is fine. I ask if we can take them to the mom, and they were like “We don’t do that here, we wait until mom is ready to feed them. The mom’s tired.” “It’s good for the baby.” “It’s OK, the mom doesn’t care.” Allrighty then. We give instructions to the nursing assistants what to do and to monitor them closely, etc. The next morning we learn in staff meeting that baby #2 died, and possibly baby #1, but we weren’t quite sure if they meant the 1^st twin had died or if they were talking about the other dead baby that was in there.  I was angry. While we’re on the subject, the other day I walked into a supply room on the ward and there was a dead 10-month old laying on the counter. I’m getting pretty tired of seeing kids dying. I work in an ER, we’re in the business of saving people. I see death, but not usually children.

On to more happy subjects. I’ve seen many people carrying interesting things on their heads. The most dangerous one so far was a lady walking with a rather sharp-looking garden hoe balanced on her head with the blade in front of her face. Crossing a very busy road.

We went to the market. It’s my favorite. The market ladies are so lovely and funny. I like them a lot and their fruit and vegetables are so delicious. Y’all should come.

“Slow obedience is no obedience” said my parents. As an adult, what does immediate obedience to God look like? I’ve been reading Matthew this week, and it’s a bit astounding to see the rapid response to God’s commands. “Get up” says God. Joseph gets up. “Go there” says God. Joseph goes there. “Don’t go there” says God. The Magi don’t go there. (Matthew 1:24, 2:12, 2:13-14, 2:20-21.) “Come follow Me” says Jesus. The fishermen go follow Him. (Matthew 4:19-22).

All of these people obey immediately. How can I learn to hear God like that and live like that? I believe I obeyed Him in taking this trip, but it was certainly a process with lots of doubting on the way. How do we get to the place where we walk so closely with Him that we know immediately when He is commanding us to do something and have the faith to act on it?

Yesterday as we were doing rounds at the hospital, a friend texts us and says he cut his forehead. Emailed me a picture. We voted unanimously that it needed suturing and piled in the car. The kitchen table was prepared. The instruments sterilized. Banana leaves cut for thread. Just kidding, we had real sutures. Never travel without your hemostats. Valuable tools, I’m glad I brought mine. Lidocaine was drawn up. Then realized there was no needle smaller than an 18g. The 2 PA students, myself, and the doctor all started giving each other sideways glances and doing little silent eyebrow communication: “That’s huge.” “Should we drive back to the hospital?” “Do you have any smaller needles?” “Would it be better without lidocaine?” “That’s freaking huge.” Patient speaks up “I see y’all, you know. I have a high pain tolerance. It’s cool.” He did great. Do not ever do that to me. If it comes to that, just let me go. I’ve lived a good life.

Oh so many thrilling adventures today. It was the doctor’s weekend on call, so he went to do rounds and took the PAs. I stayed home because I thought I could be productive. I did everyone’s laundry and tried to bake a cake. Now, I’ve never baked a cake before, but someone asked me to. Cookies are so much more portable and you can eat so many before anyone notices. I make 2 beautiful chocolate layers and some lovely chocolate pudding for in between. Everything is going great. My neighbor and I are having a lovely time in the kitchen. I make the fudge icing. I turn around. The cake is melting. It’s so hot the cake is crumbling and melting and the pudding is dying. We get the giggles. We try to cement it with more pudding. We try to put the icing on and it melts. “#Africaprobs,” says my neighbor. The genius woman breaks it up, puts it in a dish, and we sprinkle powder sugar on top. Done.

I very carefully walk across the way to put it in my fridge. Open my side door. Hear a noise.

Snake.

It was not a large snake. But it was not a small snake. It doesn’t really matter what size it was because it was in my house. Of course, I prioritize very well, so I yipped quietly and very calmly moved the non-cake and myself out of reach. Then I yelled for the neighbors, carefully returned the non-cake to their house, and walked back across to my house. The snake had crawled down a pipe where a washing machine is supposed to be hooked up. We saw its tail, then it was gone. We follow the pipe out. It splits, one side goes to my toilet, one side to my sink, and one side goes out to drainage far away. Cool. I put a candle holder upside down over the open part. The guard suggests pouring kerosene down the pipe. We eventually stuff steel wool in there, then stand around staring at each other, then shrug. I return to the neighbors and continue rolling out tortillas. The PA students return, I finish a few tortillas, then walk over to share my day. I’m explaining to them what happened and how it could come out, and I walk to the bathroom, hear a rustling, and there’s good ol’ Edmund, staring at me from behind the toilet. “What,” he says “I thought you said to come out this way.” I scream. The students scream. Edmund screams. The neighbor comes, with a shovel, the guard comes, in bare feet. We discuss our possibilities. The only way I’ve ever killed a snake was with a large, large truck, so clearly I am not suited for the job. The neighbor goes to get boots. We’re all meandering around. He gets back and goes to look, leaning over the toilet, I’m right behind him. I see something out of the corner of my eye and look up and the sly rascal has climbing the curtain and is hanging above our heads on the curtain rod. I scream again. Lots goes on. No one gets bitten and the snake ends up with its head off and its blood ALL over our bathroom floor and curtains. The floor gets mopped with bleach. The toilet gets very, very bleached. The non-cake eventually makes it safely in the house. I made a cup of tea to calm my nerves and decided I don’t actually like baking anymore.

I beg of you: do not ever ask me to bake a cake. They taste awesome, but horrible things happen.

I love you all. Please hug your children closely tonight and check your toilets for snakes.