Tales From the Field - Part 7

The women lie in a row, their beds separated by a thin curtain that is rarely drawn enough to shield them from one another.

I see the team of midwives and doctors clustered around bed four. All I see is the patient’s dusty legs, but I have grown accustomed to this scenario. Her prognosis must be grim. I join the group, pulling the curtains around the woman to give her some privacy. The other patients peer at her from their own beds. They sense a heaviness in the air. Some things we can’t protect them from. 

I look at the woman in front of me. She is young and beautiful and clearly dying. Her breathing is labored even with oxygen. Sweat pools around her neck and I can see her heart pounding in her chest. Her stare is like that of a wild animal, looking past us and darting around the room. I put a hand on her glistening brown arm. I know it is a futile attempt to calm her.

“What else can we do?” I ask Denis the nurse anesthetist.

“Rien. There is nothing you can do. We’ve done everything already.”

She arrived earlier the night before, delivered a stillbirth, then bled postpartum. Her hemoglobin dropped to .9. After three pints of blood she started to decompensate. She began bleeding from her mouth and nose. Even though we don’t have the labs to prove it, we agree it’s likely DIC.

I can’t believe there’s not one last thing we can do. The night staff finishes report and our huddle breaks up. I linger at her bedside.

“Betsy,” Denis says, “she’s already gone.”

But I can’t ignore her. 

She is visibly uncomfortable. Mamman and I bring pillows to prop her up. They are instantly covered in sweat. Her body slouches even with the support beneath her.

I want to transfer her to the ICU where she’ll at least get more attention but Dr. Amodu fears she’ll die in the process. Her family might then think it was us who killed her. But they are nowhere to be seen. They have come and gone but I wonder if they realize what’s happening. 

I chase after Christienne, the OB who is always pulled in a million directions. What cocktail can we give her? We need some morphine but don’t have any. We end up giving her tramadol, adding promethazine to help sedate her.  

Even though I am trying to take care of other patients, my eyes are glued to this woman. She keeps reaching her left hand into the sky as if she has something she wants to say. Or so that she won’t be forgotten. 

Her family. I need to find her family.

With Halima’s help I am finally able to coral them all, her mother, father, and husband. I explain what is happening as Mamman translates. They listen quietly, heads bowed. It is her mother who speaks. In a cracking but strong voice, she thanks her daughter. She forgives her for everything.

“Nagode!  Nagode!” She cries, with her fist in the air. Thank you! Thank you!

In the following few seconds, her head nods crookedly to her chest as she lets out one final breath. Her father instinctively reaches over and closes her eyes. I can’t believe the scene that is taking place before my eyes. It’s as though she were waiting for this moment to let go, surrounded by family releasing her. Christienne comes with stethoscope in hand and pronounces her dead at 11:55am.

I watch as the men around her crumble. They weep. Her mother wails. Stella and I remove her wet and soiled shirt. We clean her body and face: the ritual of death, just as powerful and raw as birth.

We swaddle her like we would a baby, wrapping her gently in African print. Blinded by our own tears we hand her to the family to bring home.

There was one last thing we could do. We could help her die.