When Death is Nearby

I named this blog post and started writing it over a year ago while I was still in language study and not yet even in the hospital. Recently I have been thinking many of the same thoughts and so I revisited the note in hopes of finishing it. It’s an interesting thing to look back at words you put down a year ago when you felt like a completely different person but here is the post with more updated thoughts as well. 

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Have you ever considered the number of funerals you have attended in your life? Even attending one funeral feels like one too many but I feel that often in the west this number is much lower comparatively. From classmates to church members to grandparents to an aunt and the excruciating pain of attending my young cousin’s service, I feel as though I have been to my fair share of funerals. Despite all of these and the memory of pain associated, death often feels in another room when you are in the United States. 

I think we are often aware of death but it’s unseen and seems so far away. For the most part, we rarely see death and just recently I was thinking about how the deceased body of a loved one is often not ever in our homes, but taken directly from a hospital to a mortuary or funeral home. While living in Ethiopia, I saw the practice of “wailing” for the first time and it was very different from any practice of mourning I had seen in the States. Though I haven’t experienced it first hand, I have been told the practice is common throughout the continent of Africa. I can tell you that in my time of living nearby to the hospital in Zambia I have found it to be extremely common and each time it stops you in your tracks. The practice from what I have seen is that upon hearing of the death of someone close, the individuals will begin to cry out in mourning. They will often throw themselves on the ground, crying out, and others nearby will join them. It is a communal practice that many partake in, even sometimes if the deceased person is unknown to those who are participating in the wailing. The commonality of death is palpable here and it seems like there are so many funerals on a weekly basis. 

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Since I have been in the hospital for the last 10 months I have begun to experience this much more first hand. I often walk past groups of people wailing as I maneuver through the hospital, recognizing it means someone just passed away inside of that ward. Just this week, while on call, my phone rang and when I picked up I heard the nurse say “Doctor, we need you, she’s not breathing.” I spend a lot of time telling the nurses I am not a doctor but many still refer to me as such. I knew exactly which patient she was referring to as I had seen this 12-year-old girl 2 hours prior as she was being admitted. I asked several quick questions and told the nurse to begin CPR and promptly raced into the hospital. This sweet little girl had fought the devastating disease of sickle cell for many years and despite having received a blood transfusion a few hours earlier her body had been fighting so hard to breathe for days and had been requiring oxygen via a facemask since entering the ward that day. Upon arrival to the ward I could hear that the wailing had already started. Working in a resource limited setting without ventilator capabilities there is only so much that can be done in a resuscitation effort. I quickly assessed the child but knew it was too late and there were no other interventions that could be done. I did what I could to comfort the mother and grandmother with my limited language skills and called the chaplain. The problem over and over again is that families have to travel hours or days to get to our facility and transport is expensive and roads are difficult and many of these patients arrive so late in the disease process that there is so little we can do by that time. 

Oftentimes death very much feels nearby. I knew coming into this setting one of the hardest parts would be dealing with death on a regular basis. Working in an outpatient setting in the US for 2.5 years I could count on one hand the times I lost a patient that I had taken care of and each of those situations I was not present for their death. To see patients pass on on a regular basis, especially children, weighs heavy on my heart. My prayer is constantly that the Lord would sustain me in this work, help me learn from each experience and have the capacity to provide compassion to each patient I encounter; even when I am fairly certain of a poor prognosis. My prayer is that in these situations I would provide an even higher quality of care and love so they have the opportunity to die with dignity. And yet, even the idea of providing care in that way is exhausting. Over and over again the Lord sustains and provides joy in this work and it requires that I consistently look to him for understanding and guidance. 

In these situations I feel as though it would be so easy to become angry with God, to become frustrated with the fact that hydroxyurea and other life changing medications are not readily available here for sickle cell patients that come in every week in a pain crisis. It would be so easy to get mad that malaria kills a child on the pediatric ward here routinely and it’s a preventable disease. I could easily give up doing this work when the 14-year-old girl I referred to a higher care facility due to a liver mass didn’t actually go to the facility but instead went back home with her family. Over and over again I could question what the Lord is doing and why he would allow so much suffering. And somehow he sees me in it. I so often am reminded of the story in Genesis 16 when Hagar fled from Sarai into the wilderness and learned that she would bear a son. In the midst of her suffering the Lord met her and she said to him, “You are a God of seeing.” These powerful words change my perspective, the Lord sees me and he sees the suffering of his children here. And his heart is breaking in it more than I could ever imagine. This reminder gives me what I need to provide love and compassion to all of those that I encounter. Don’t get me wrong, I daily fail in this endeavor but I am learning to lean hard into the Father and he will give me what I need to carry on. 

I think we can so easily get caught up in the mundane practices of life and forget to live in a posture of gratitude for the life we have been given. If you are reading this be encouraged that wherever you are, the Lord sees you in it. He is the God who sees and over and over again he is faithful. His mercies are new every morning and His love is steadfast. He will sustain you in whatever you are walking through. Even if death is nearby the Father is even closer, may you rest in that truth today.