Sustained and restored after cholecystitis

Psalm 41 says "Blessed is the one who has regard for the weak; the Lord delivers him in times of trouble." Indeed, "The Lord has protected me and preserved my life. The Lord has sustained me on my sickbed and restored me from my bed of illness. I said, O Lord have mercy on me; heal me..... "

It began abruptly just after 9pm on a Wednesday evening. Shortly thereafter I was unable to remain in bed due to the severity of pain. I paced and tried various positions; on my hands and knees, leaning over the table, sitting upright, to no avail. As doctors we are trained to ask, "Is there any position that makes it better or worse. Is there anything you do (eating, going to the bathroom etc) that brings it on or makes it better or worse." The answer to all of those questions was "no." The pain remained constant and severe, a band reaching from the middle just below the sternum to the far right side of my upper abdomen boring through into the back. After three hours I woke Jim up to examine me, not because he could do anything except perhaps be impressed.  I had Murphy's sign: as the patient takes a deep breath the liver is palpated and when the gallbladder is irritated there is an immediate cessation of breathing due to pain. I had been teaching this maneuver to 4th year medical students at the medical school just a few weeks earlier.  Jim agreed that it was most probably my gallbladder.  As I huffed and puffed, I prayed God would help me bear the pain and give relief. An hour later after vomiting several times the pain resolved within minutes (most likely after the stone passed into the intestines) and I was able to sleep. In the morning I proceeded to the get an ultrasound (+gallstones) and blood tests (my liver tests were 100 times the normal level). The clinical picture looked like a stone had been blocking the common bile duct. By the afternoon I developed a fever and started antibiotics. At that point I felt really exhausted and crummy. Friday morning Jim and I set out on a flight to South Africa. The ANTS taxi service took us directly to hospital where I was admitted and had repeat testing. Surgery was performed Saturday.  Less than 24 hours later I was discharged and we headed to the same B&B, The Crane's Nest, where Jim had recovered after colostomy two years previously.

Jim left Monday night to return to Zambia where Chris had fallen by the wayside with gastroenteritis. Then on Friday with my suitcase and backpack in hand ready to go directly to the airport I arrived at the surgeon's office only to be told the repeat blood tests were not all improving and some were worse. Jim felt the elevated tests were easily explained; the surgery, intraoperative dye study and the physiology of one test (alkaline phosphatase); delayed manufacture and release had all led to the increase. The surgeon insisted I remain. I returned to the Villas next to the US Embassy for easy access to the Internet and medical unit. Over the weekend I watched some of the winter Olympics (we don't have TV in Zambia so this was a treat).  Amazing what the human body can do.

On Monday the labs had all improved and it was agreed I would repeat them in Zambia in a month to be sure they were normal. I had the opportunity to share scripture with my surgeon who was troubled by a decision he needed to make. One of his patient's had end stage cancer and bowel obstruction. There was no further treatment or hope of prolonging her life. He was unsure as to whether to recommend a line be placed into a large central vein to give nutrition because this can sometimes result in discomfort and even infection and death. I asked him what the patient wanted and he said, "That's a good question." He didn't know. Doctors in South Africa do not always talk with their patients in the same way we do in the US. I went on to suggest that most people at the end of their life just want a little more time to be with family. We can always give hope and assure them we will be there for them. I told him that Psalm 139 has always been a comfort to me when it says, "Everyone of our days is already written in His book before there is even one." I cannot shorten or lengthen anyone's life. I am not God. I am grateful He is in control. Many times I can do very little for my patients except to be present at the end and that is enough." I sensed a deep loneliness in this man. He mentioned in a pained way that he did not have the same intimate relationship with many of his patients that an internist or a general practitioner might. People often did not even remember his name. As I left I thanked him and called him by name.

I thank God for all of you; my friends and family around the world who supported me in prayer, praying for my healing and for all the emails which were a daily encouragement and blessing!

Today I delivered food to the children in the prison. Last Friday I discovered a malnourished 9 month old with brittle reddish tinged hair, no family to bring food and a 3 year old from Congo, again no one to bring food. I was again reminded of Psalm 41 “Blessed is the one who has regard for the weak…”as well as the passage in my daily reading in Luke 14, ”When you give a luncheon, or a dinner …or a banquet invite the poor.” I don’t think God wants us to just read the words and study them. I think He’s serious about us doing them. So, today I delivered peanut butter, mango, potatoes, rice, Cheerios, avocado, biscuits and bananas.