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Friday, July 18, 2008

Precious, not pictured

I was asked to name a baby today.  Her weary mom seemed out of ideas on her 9th child.  Or perhaps she did not want to bind herself too closely to this tiny and deformed little girl.   I had been called by the midwives to examine the baby, and found a full term but very small baby with a cleft lip and palate, missing skin on the back of her scalp, a small extra sixth finger on each hand, and a huge omphalocele, which means that her bowels protruded in a sac of membrane extruding with her freshly cut umbilical cord.  This is a classic combination for the highly lethal Trisomy 13.  In a rural African health center, what can we do for her?  Cover the gaping abdomen, keep her warm, and offer milk.  Not much more than that.  Though I debated taking the same aggressive referral risks that saved the little girl Kabajungu in the picture below, I decided not to send this baby anywhere.  Her prognosis with full Western medical care is a 50% mortality rate within the first month of life.  So who am I really helping if I push the family to take a long and uncomfortable journey to an unfamiliar place, to struggle in a dysfunctional medical system, and probably return empty-handed?  Still, it is hard to make the decision to pursue comfort and palliation and not surgical correction.  I feel the heaviness, the gravity of such a decision, and the draining tiredness of having to make it.  I’d rather not.

When I was filling out her admission forms and asked the mother for a name, and she told me to choose one, I thought for only a few seconds. Precious.  My Lubwisi falters on matters of the heart, so I called a nurse to help me explain that the name symbolizes that this little girl, even with all her problems, is precious in the eyes of God, whether she lives a few hours, days, months, or decades.  The testimony of friends from Chicago whose son Micah died of lethal congenital anomalies the day he was born came to my mind:  from the perspective of eternity, a life of 7 hours and a life of 70 years are the same, both immeasurably short, and both infinitely precious, worth the attention and love and sacrifice of God.

And while part of me would like to take a photo of Precious for scientific purposes, I decided that on this post she should not be pictured.  Because her earthly body at this moment is a very distorted picture of the eternal reality of who she is, of what she will look like when she is made whole.  The privilege of watching bodies become whole is one of the greatest ones I have experienced here, but this time I will have to wait for Heaven.

3 comments:

Trisomy 13 Life with Natalia ~ Transformed by Love said...

Your post popped up on my trisomy 13 google alert...
You sound like a compassionate Dr. that many of our trisomy 13 families would love to have caring for their child.

Your "perfect" name of Precious is fitting for such a uniuqe & perfect soul.

Back in 2000 when my child was born, all you would see on Yahoo image search was pathology images of the most severe trisomy 13 children. Many posted for Scientific purposes. Never were they shown in the loving arms of their parents. Yet after these precious children pass, what every parents wishes they had was more time and some photos to remember, as time fades so does the visual memory.
Often parents cherish those photos as in many cases with trisomy 13, that is all they will have.

I hope you've had the opportunity to see the Living with trisomy 13 site. We share lots of beautiful photos of these precious children.
http://www.livingwithtrisomy13.org

I might suggest you take the time to offer your services to capture some beautiful photos of this mother and child together, Or try contacting or viewing NILMDTS http://www.nowilaymedowntosleep.org/

You can view other families with the omphalocele...
(you may need to copy and paste this url)
*off the SEARCH mode of the site, you can view many children with the specific abnormalities that come with trisomy 13..

http://livingwithtrisomy13.org/searchresults.htm?cx=011933564717467394377:mhiwgktrp88&q=Omphalocele&sa=Search&cof=FORID:11

May God Bless you for your love and compassion for those you care for. It was a pleasure to visit your blog.

ThereseAnn, mom to Natalia with Full trisomy 13 and almost 8 yrs old!
http://livingwithtrisomy13.org/album14.htm

Anonymous said...

Jennifer: I share your grief as you struggle with making the best decision for Precious and her family. Never have I felt so close to that awful concept of "playing God" than when I helped parents to make a decision to enjoy what little time their baby had, rather than send them off to "the Center" for pain, suffering, and almost certainly the same ultimate outcome. As we continue to push the technological envelope regarding the beginning or sustainability of life, it is those decisions that are the most difficult (i.e. to do "nothing") which sometimes can define us as compassionate pediatricians. God bless you, and Precious, and her grieving family!

Kevin said...

As I am sending in my secondary applications, I wonder when I read Post like this, how would I do in the same circumstances? I don't really know. It is heart wrenching.

We will pray for Precious, her family and all of you.

God's peace to you,
Kevin