And Last but certainly not Least...

Tonight is our last evening in Kenya. Our hearts are heavy, and we feel like the job isn't done - in fact, we feel like the job has just started. Our last week here has been particularly challenging. For me (Bryan), probably the toughest nursery week yet. This past weekend was wonderful. We took our safari and saw just about every animal possible with the exception of cheetahs and elephants, which are not endemic to the park we were at. We took some amazing pictures! Sarahbeth will have to post them on facebook. We went with a local driver, Philip, and a missionary from Passion church named Emily. I think our time on the safari was magnified 100x because during the trip we sang hymns, hillsong, and Chris Tomlin (who is huge in Kenya! Philip knew all of his songs). We shared our stories on the way back and bonded in a really neat way. I also learned a little swahili. Philip was sad to see us go. We returned Monday with Sarahbeth on call (we take call from home, so I was also on call...). I learned a very valuable lesson - I grumbled a bit as she asked me to assist her with a delivery. I was convicted of my bad attitude and swung my feet over the edge of the bed at 11:30pm and headed to the hospital. Boy, am I glad I was there. The resuscitation was a nightmare. The call was a meconium delivery with bradycardia. The baby came out totally lifeless. I intubated and suctioned 3 times. Sarahbeth was able to get some practice and intubated and suctioned once. I have never seen so much meconium in a baby's airway! Every time we suctioned we got more and more out - I kept thinking "there is no way this baby could fit more meconium in his airway. The heart rate began dropping and I was preparing to start CPR. Fortunately, the baby started crying after Sarahbeth suctioned the last time (it took a woman's touch). Two days later, the baby is doing great, on room air and will likely go home tomorrow. Later that night, another one of my meconium babies (don't ask me why we've had so many) started deteriorating, so we put him on the vent. He's required a little dopamine, but now doing a bit better. Sadly, there have been several other babies that did not do so well in the past week. Notably, I had a trisomy 13 (patau syndrome) baby born on Sunday and die the next day of a heart defect. Mom was devastated. There really isn't much prenatal care and she was expecting a normal infant. We were able to provide comfort measures. Sarahbeth lost a patient to lupus nephritis. She was a 14 year old that presented with decompansated heart failure. We suspect she also had some cardiac involvement, but not having a full time peds cardiologist, we couldn't get an echo. Our hearts are heavy at these losses. Sadly, things present so late here. In the words of Sir William Osler, when a patient presents late, the diagnosis is easy but the treatment difficult. We are packed and ready to head home tomorrow. We cannot wait to see everyone and share what we have seen and what God has done! We also can't wait to return to finish the job... - Bryan