a vapor

I (Jason) took this picture as I walked down the hill to the hospital this morning. I walk down this road most every morning, but today seemed different. It rained last night, the sky was clear, the air was cool, there was a vapor over the forest, it was peaceful. C. had just said over breakfast: "Daddy, I want to be a doctor too-then I could share your stethoscope, and we could help people together." Everything felt right.

I had no idea what was coming.

Yesterday afternoon, a 22 year old young man named Obilon came in to the emergency room very short of breath. He had had tuberculosis off and on last fall. He said he had been working last week when he felt a tearing in his left upper chest. He had gotten more and more short of breath ever since. He brought with him an x-ray of his chest from November 2008. It was the last chest x-ray that had been taken of him. It looked like he had blebs (large spaces that tend to burst and allow the lung to collapse) and chronic lung scarring on the left. Our x-ray machine here is still not working. Dr. Thompson and Phila thought his lung had collapsed, so they quickly placed a tube in his chest with an electric suction pump to help his lung reinflate. His breathing improved somewhat.

Last night during the rainstorm the power went out. Jean Claude was on call, he couldn't reach Dr. Thompson, and he called me around 2am to see if I could come help him with the tube. The pump hadn't been working, a clot had formed in the tube, and Obilon's oxygen level was 75% (very low). I went down and we put in a second chest tube. I could feel scar tissue inside his chest. He became much more comfortable and his oxygen level came up to 98% (normal).

This morning, five minutes after I took that picture, I came in and he was again breathing harder. His oxygen level was now 88%. Shortly after, we saw him as a group, and Dr. Thompson decided he needed chest surgery to release the scar tissue and allow his lung to fully reinflate. From there, it was a blur getting him ready for surgery. Getting all the special instruments. Getting his breathing tube in. Getting him positioned perfectly on his side. Trying to get everything perfect. Perfect is relative here.

Initially the surgery went well. We divided most of the scar tissue, and his lung seemed to inflate better. As we were nearing the end, his oxygen level began to fall. His heart rate also began to fall. Then to a dangerous level. Then into a disorganized heart rhythm. We hurredly began to squeeze his heart, to give medicines, to put on electric shock pads, to squeeze in IV fluids, to pray, the nurse anesthetist suctioning fluid from his breathing tube.

I kept thinking, "I can't believe this is happening, I can't believe this is happening here." "This is bad enough when this happens in the States, with a trained anesthesiologist, with more than enough of everything we could ever need-but here? Now?"

It was happening. Very fast. We finally got his heart into an appropriate rhythm and quickly began to close his chest. We were almost done when his oxygen level and heart rate again began to fall. We lost his pulse. We started chest compressions. More medicines. More fluids. More prayer. More compressions. More medicines. More prayer. Twenty minutes went by.

Nothing.

Obilon had died in our hands.

Our hearts tore.

We quietly began to close his incisions as neatly as possible. To take the tubes out. To put his clothes back on. To try to make Obilon look as presentable as a man who just died in surgery can.

We don't know exactly what happened. A thousand questions. Doubts. 22 years old. Nagging doubts. "We should have..."

We don't know if this man was right with God. "We should have..."

That picture. Each of us walk down that road every day. We think we know what will happen at the bottom of the hill. "Yet you do not know what your life will be like tommorrow. You are just a vapor that appears for a little while and then vanishes away." So is everyone around you. So am I.

"Conduct yourselves with wisdom toward outsiders, making the most of every opportunity."

Please pray for Obilon and his family, that God will have mercy on him, and on all of us.

"But You, O Lord, are a God merciful and gracious, slow to anger and abundant in lovingkindness and truth."