The Nightmare

I know this is rather lengthy for a blog post, but it is very interesting. My parents are in Honduras for ten weeks this summer, and my mother shared one of her nights at the EFM clinic. I do believe that she is the most interesting newsletter writer I know.

Diary of a Nightmare

Saturday, June 28, 2008

1:37 a.m. – “¡Hermana Ana! ¡Hermana Ana!” The night guard’s voice on the walkie-talkie startles me from a sound sleep and I leap out of bed, stumble over to the dresser and fumble in the dark to find the button on the radio to answer him. He doesn’t give any details, just that I’m needed at the clinic.

1:42 a.m. – “Pray for me, please!” I beg Rex as I run out the door. “I know they wouldn’t call at this time of night unless it’s an emergency.”

1:44 a.m. – No question about the emergency part! I’m greeted by the sight of a woman lying on her back in one of our labor beds - along with five inches of pale blue umbilical cord. “It’s a breech presentation,” Maribel the night nurse informs me, as she hurries to call the ambulance.

1:46 a.m. – Quickly gloving up, I gently check the position of the baby who is doing his best to enter the world knee first: definitely the wrong way. Then I help the mother to turn over and kneel, chest on the bed, to take the weight of the baby off the cord, while I anxiously listen for a heartbeat. The little one is still alive, but his heart is beating too slowly. I explain to the mother what we have to do and why, and have prayer with her, asking God in His mercy to spare the life of her baby so she can raise it to serve Him.

2:38 a.m. – “Where is that ambulance?!” Oxygen mask fitted to her face, IV fluids rapidly running into her vein, the mother has been ready to go for a while. The Red Cross Toyota Land Cruiser finally pulls up to the porch, the attendant apologetically explaining why they couldn’t get here sooner. “The ambulance wouldn’t start. We had to push it to get it going.”

3:06 a.m. – We bump across the rocks and out of the yard on our way to the large maternity hospital in San Pedro Sula, normally a two and a quarter hour trip. I brace my feet and fight to keep my seat on the narrow bench where I sit next to the stretcher, my hand still in place on the baby’s leg, firmly keeping him inside and off his umbilical cord until we can get to the operating room for the Cesarean delivery that will save his life. The woman’s husband sits beside me, holding aloft the bag of IV fluid in one hand and gripping his wife’s hand with the other. With the portable tank of oxygen and large garbage bag with emergency supplies that Maribel packed and sent “just in case,” there’s no room for anyone else in the back. The ambulance itself carries absolutely nothing except a vinyl covered stretcher, without even a sheet to cover the threadbare spots that have worn through with long use.

3:17 a.m. – I glance again at the tube feeding into the mother’s arm. This time instead of a clear stream of fluid, there is dark red blood backing up the line. Briefly letting go of the baby, who has been staying up where he is not pressing on the cord, I grab the IV bag and work to get the fluid running properly again.

3:18 a.m. – Glove on once more, I check the mother and discover with horror 2 inches of leg and knee that have insisted on being born. I ease things back inside with one hand, stretching with the other to slide open the tiny window opening into the driver’s compartment. “The baby’s trying to come! Please hurry all you can!!!” Instantly I feel a change as the driver accelerates. “Dear, Lord, please keep us from having a wreck!” I silently plead. At least it’s not raining, so we don’t have the hazard of slick mud added to the danger as we barrel along through the darkness.

3:34 a.m. – I’m still praying, but the words are different now. “Oh, God, don’t let me throw up, PLEASE don’t let me throw up, please, God, help me...BLAAH!!!” I lose everything in my stomach, thanks to the rocking motion of the speeding ambulance over curvy dirt mountain roads. I’m thankful that at least I’ve not eaten since 6:00 the evening before, so it’s mostly liquid.

3:39 a.m. – The woman’s husband follows suit, and I grab for the IV bag he can no longer hold as he miserably empties his stomach as well.

4:03 a.m. – We’ve been jouncing and bouncing for nearly an hour and have finally gotten to the paved section of road. The smells of sweat, diesel fuel and amniotic fluid swirl around me as the driver accelerates even more. I discover that I can drape the bag of IV fluid over my shoulder and hold it there with my cheek, giving one arm a rest. The other hand has started to cramp, but I grimly bend over and keep the baby pressed up inside as its mother coughs repeatedly. I gently rub her leg and smile at her. I can’t imagine the agony she must be feeling. All this time she’s been lying helpless, thrown from side to side and a few times banging her head against the back door as the ambulance careens down the mountain. Off and on she feels the urge to bear down but valiantly grits her teeth and obeys my commands to “Breathe, don’t push!” She’s doing incredibly well. I greatly admire her courage; the only evidence of her trauma is an occasional groan.

4:23 a.m. – I thought my stomach was empty. With both hands again occupied, all I can do is bend over and let the rest of what’s in there splat on the floor. At least that’s only two times for me, compared to the husband’s four. The siren wails as we fly along, swerving back and forth to miss the cars that don’t readily yield the right of way.

4:30 a.m. – We whip around a corner and pull up to the hospital’s emergency entrance, making the trip in slightly less than one and a half hours. I count at least five people lying asleep on the ground, with many others standing around outside as they wait for word from the staff on a loved one’s outcome. No such thing here as a husband or mother giving support to a laboring woman. No one is allowed to accompany her inside the hospital. But I trot determinedly beside my patient as she is wheeled through the doors, persistently keeping the baby’s leg in and off the cord until we get into an exam room and a troop of doctors and nurses converges, one of them taking my place. Another glides an ultrasound wand quickly and briefly over the mother’s abdomen. With relief I notice that the baby’s tiny heart is still beating. Thank God, we have made it in time! I follow the stretcher around a corner and down a short hall, stopping outside the operating room with the ambulance attendant to wait for our equipment to be returned.

6:57 a.m. – The ambulance pulls up once again to the front porch of our clinic. I stiffly step down to the ground, clutching my aching back, thankful to have the nightmare over and to have arrived back home in one piece. I want nothing more in life at the moment than a hug from my husband and a hot shower. Oh yes, and don’t forget to take a picture to go with the article for the mission paper!

(I found out a week later, July 6, that we made it to the hospital in time for a successful surgical delivery. Mother and son arrived safely home yesterday. I’m so grateful to God for His help, and for the part He allowed me to have in the drama. Such is a day in the life of an EFM clinic nurse!)