Thursday, November 30, 2006

Zambia, Here I Come!

It’s true! It’s true! I finally heard from Dr. Ang! Today, I received word from the missionary doctor and medical director at Mwami Adventist Hospital out in Zambia, Africa, stating that I am welcome to come to Zambia for a mission elective in January. Dr. Ronilo Ang is an anesthesiologist/surgeon, and he has been a missionary in Zambia for 12 years! He also happens to be the uncle of Liz, a friend of mine who is a nurse at the hospital where I work.

Quiz Question #1: Where is Zambia?
Answer: In South Central Africa.

I am elated. I have been trying for a few months now to get the signatures of approval from an attending physician in Africa so that I can move on with the process of getting approval from my own institution. Things had not been working my way, especially in these last three weeks, as I had been repeatedly attempting to go to the Lusaka Eye Hospital site in the capital city. All my plans were thwarted, however, and I was fast approaching the deadline in which my paperwork needed to be submitted. I began to pray for God’s will to be done. Then, I heard word from Dr. Ang, who immediately responded positively to my inquiry about rotating with him during my elective month in January. After several days of correspondence, I realized that this may be God’s will for me instead. Hopefully, my hospital will give me approval to embark on this four-week adventure to Mwami. Nonetheless, I am going to start working on getting my malaria prophylaxis, immunizations, plane tickets, and visa. I have a lot of work to do! But praise God,…I think I’m on my way! =)

Quiz Question #2: Where is Mwami?
Answer: Close to Chipata.

By the way, I have officially begun my long-awaited week of vacation. This weekend I will spend some time in Northern California to visit my brother, James, and my friend, Nyein. The rest of the week will be dedicated to wedding planning. Wish me luck!

Sunday, November 26, 2006

My Night on Pediatrics

My heart is still pumping. It’s about 4 in the morning, and I just finished in helping resuscitate a baby.

I had fallen asleep in the call room at around 2 am after examining six newborns that were born back to back through the night. At about 3 am, I was rudely interrupted by my “baby pager” obnoxiously beeping away. The voice on the other end screamed into my pager, “Please come to Room 14 for prolonged decels. Room 14 for prolonged decels.” I crawled out of bed and rushed to the room. No supplies were set up, so the NICU nurse, Respiratory Therapist (RT), and I quickly assembled the equipment.

Newborn resuscitation bags/face mask/oxygen tubing – check
Delee/connection tubing for suction – check
Bulb suction – check
Scissors – check
Endotracheal tubes/stylets x2 – check
Laryngoscope handle and blade – check
Meconium aspirator – check

As we were working on the neonatal supplies, the Ob/Gyn resident was attempting to deliver the baby. The laboring mother was a 40 year old Hispanic G4P3 (interpretation for all you non-medical people: Gravida 4 = has had a total of four pregnancies, irregardless of whether they were carried to term; Para 3 = has had 3 viable births) whose last baby was born about 11 years earlier. All of a sudden, the baby’s head was seen to be out of the birth canal, but it was stuck! A nuchal cord was present (umbilical cord wrapped around the neck), which was essentially choking the newborn and preventing the body from coming out. Everyone seemed to go into a panic. The Ob/Gyn resident began shouting at the mother, “Push! Push! Empuja!” Two delivery nurses jumped onto chairs and began pushing down on the mother’s uterus. The resident was pulling on the baby's head with all her might. The laboring mother’s husband and sister were frantically encouraging her to push. I watched helplessly in the background and silently offered up a prayer to heaven for the mother and baby, that all would go well.

After what seemed like an eternity, the baby was extracted! It was a girl! The Ob/Gyn resident quickly clamped the cord and brought the baby to the infant warmer where I was standing. I had never seen such a miserable looking baby. She laid completely apneic, blue from her head to her toes, as floppy as could be. The RT tried to intubate the baby. The nurse tried to stimulate the baby. I listened for her heart rate. Greater than 100! Those were the only 2 points she earned on her 1 minute Apgars. The intubation attempt failed the first time, so we decided to simply bag the baby. We vigorously cleaned off the baby with warm blankets, trying to stimulate her to cry, and suctioned out her nose and mouth. In the middle of our resuscitation efforts, the aunt cried out, “Is she okay? Why isn’t she crying?”

“We’re working on it,” was all I could say.

After what seemed like another eternity (perhaps about 30 seconds after we started the oxygen), the baby finally began to cry. I realized that everyone in the room must have been holding their breaths, because at that moment I heard the strange sound of a collective exhalation.

We delee’d the baby (suctioned out her mouth/stomach), percussed her back, and continued to bulb suction her mouth and nose. Fortunately the baby did well after that, receiving a final Apgar score of 9 (out of 10). Her color was now a pinkish hue, her tone was good, and her cry/respirations were vigorous. As I left the room, I breathed a prayer of thanks to our Lord for saving the life of yet another baby. It was a close call. My heart is still pumping.

Friday, November 24, 2006

My Little Chapel

Four nights ago one of my fellow residents, Pat, introduced me to a special spot that has now become my favorite place in the entire hospital – the chapel. Although I am at a county hospital not affiliated with any religious group, there is a chapel available for anyone who wishes to pray and meditate. It is a cozy rectangular room near the main entrance of the hospital. It is simply furnished with six or eight short pews, a small podium at the front, a table filled with artificial flowers, a Book of Prayers (a journal available to anyone who wishes to write down their thoughts and prayers regarding life and their loved one in the hospital), and a beautiful stained glass window depicting Jesus with a flock of sheep. However, to me the most coveted object inside this chapel is a small organ that sits in the corner.

When Pat led me to the chapel and I spied the organ, I thought to myself, “Does it still work? Is it locked up?” To my amazement, I discovered that it was a fully functioning instrument! There were a few hymnals lying around, so I proceeded to play hymn after hymn. As it was the middle of the night, however, (I have been on Pediatric Night Float this entire week of Thanksgiving) I made sure that the volume was turned low. Nonetheless, it was wonderful! For some reason, that night during those few hours I was in the chapel all the babies refrained from being born into this world so that I could have a short period of respite.

Each subsequent night this week, I have had the opportunity to sneak down to the chapel alone to pray and play the organ and sing hymns. It has been a wonderful reprieve from the duties of work and residency. I am delighted to have discovered this haven, and I look forward to many more visits in the future.

Wednesday, November 15, 2006

The Memorial Service

Mr. Won Koo Lee, My Late Uncle

Today we held a memorial service for my Uncle at our church. Perhaps some of you have never attended a Korean funeral. I have attended many weddings in my short lifetime, but I have not frequented many funeral services. Floral arrangements such as the ones pictured below seem to be a big part of the Korean tradition after the death of a loved one. The service itself was well thought out and meaningful. It was also a nice time to reunite with other family members and friends. The highlight of the evening was to see my estranged cousin and uncle, whom I have not seen in close to 15 or 20 years.

Some of my extended family

Translation: Uncle, may you rest in peace until Christ's second coming. From James "Hyun-Uk" and Janie "Hea-Ryung" Lee.

More flowers. . .

And even more flowers. . .

Sunday, November 12, 2006

Tribute to My Uncle

Three hours ago, my uncle breathed his last breath of life. He was the eldest brother of my father. He has been gravely ill for the last few months – frequenting the hospital wards and the intensive care unit, going through the discomfort of intubation and extubation, suffering multiple paracenteses for his ascites, even going through a period of hepatic encephalopathy when his ammonia level was through the roof.

But now he is finally at rest. He is in a state that the Bible repeatedly refers to as “sleep” (Acts 13:36; Acts 7:59-60; John 11:11-14; 2 Kings 14:29; Job 14:10-15; Daniel 12:2), awaiting the soon return of Jesus Christ. Apparently, the nurses called my niece, Joanne, at seven o’clock this morning to let her know that her grandfather was not doing well. She and her family rushed over to the hospital, and it was about that time that he was pronounced dead.

As soon as my family was notified, we drove out to the hospital as well. My brother is back in town for a wedding this weekend (he recently transplanted to Santa Rosa, California, for a new job), so he was able to join us. Fortunately, today was my day off from work so I was able to go as well. However, my father could not come, as he has recently been afflicted with a bad case of the shingles and has been bedridden secondary to severe pain.

Upon arrival at the hospital, I found my uncle lying motionless in bed, wearing a light hospital gown and covered up to his neck with a simple hospital sheet. His mouth was partially open, and his eyes were closed. His skin was pale, and smattered with purpura due to his coagulopathic state. He was cold to touch. I checked for a pulse, but I could not palpate one. I resisted the urge to reach for a stethoscope or check for a corneal reflex or perform a cold calorics test. I took in a deep breath and simply accepted the fact that he was indeed dead.

I embraced my niece and hugged my other cousins and aunts and uncles as they trickled into the room. Pretty soon, our church pastor and a few church elders entered. They performed a simple but meaningful worship service, dedicating my uncle to the Lord and praying for him and his family. Despite the mourning there was a deep sense of community and unity. Without exchanging many words we all understood one another’s grief and yearned to comfort one another.

The strange thing about dealing with death of a loved one is that suddenly we come face to face with our own mortality. When life is smooth, when finances are stable, when wars are only in faraway lands like Iraq or Sudan, we forget about our own finiteness. Our own mortality. We get swept away in the pace of life and forget to reflect on the things of true import.

Life is a gift. It is a time allotted to each individual. For some it may last 76 years. For others the gift may last only 26. Some may choose to squander the life given to them – taking part in activities that only hurt them and others around them. Others choose to live a life of dignity, integrity, and purity – taking part in activities that only uplift themselves and others around them. May we celebrate life while we still have the breath to celebrate. May we appreciate one another while they are still alive. May we learn to love and be loved. May we comfort those who are in despair. And most importantly, may we live lives that are pleasing in the sight of God, that peace and joy may abound.

I look forward to that day when “God shall wipe away all tears from their eyes; and there shall be no more death, neither sorrow, nor crying, neither shall there be any more pain: for the former things are passed away.” Revelation 21:4. I look forward to the day when I shall see my uncle in heaven. Please say a silent prayer for my uncle and his immediate family, that they may take heart and be comforted by the Holy Spirit.