Pamelas

*written in 2010

 

“Some parts of this work are unbearable and take a piece of your soul away. I suspect when I lose the capacity to feel that pain, it will be time to head home. For now, we must rebuild our smiles and our hope and tackle the next Pamela with courage – this place is full of Pamelas…”

– Joe Mamlin, referencing the death of a patient

 

They were my first Pamelas.  How do I rebuild my smile? Rebuild my hope?

“Wellington died,” I told her.  “No,” she whispered.

We sat on the porch of Neema Children’s Home, watching the younger children play in the yard, drinking chai, and keeping track of the five, ever-curious babies.  Three silver cars drove across Neema’s front lawn – here were the social workers, bringing with them two premature babies who had been abandoned at the hospital, and a little boy, dropped off by his father, who was extremely ill.

His name was Wellington.

There was an exchange of bottles, clothes, and diapers for the babies, who had come from the hospital where they had been well taken care of and provided for.  There was an exchange of one shirt, tattered and dirty, for Wellington.  There was an exchange of medical records, bottle upon bottle of medicines, treatment and status updates for the three children, all of whom were HIV +.  And then it was done: the children were now members of a new home, a new family.

We sat and watched, together, as Wellington’s father drove away.  We listened, together, as Wellington told us he knew where his father was going, and knew that he wasn’t coming back.

Unsure of how to make little Welly feel welcome, we brought out sweets and stickers. The sucker which we gave him was his first, and he, unsure, placed it aside.  The bracelet we placed on his wrist, meant for small children, was too big and continuously slipped off.  We placed a small, purple oval sticker with the word “Wow!” on his arm.  He reached to take it off, wanting to look at the letters more closely; when we peeled the sticker off, we were surprised to discover another oval – a layer of his skin, so weak and fragile, had been peeled away with the sticker.  Not knowing how to react or respond, I swiftly pointed to the sticker, saying “sema ‘wow,’ Welly!”

“WOW!” Wellington said, with a huge grin on his face.  “Wow,” we said. “WOW!” he said.

A little while later, our ride came and we were driven away from Neema House, and Welly.  We did nothing special with Welly in those short hours, did not take his challenges away from him.  We tried to encourage his sweet tooth, and took away some of his precious skin with our flashy stickers.  We were not doctors, were not therapists, were not the ultimate welcoming committee.  We were his short-term friends and in those hours, simply, we taught him how to say “wow!”

A week later, I received an email from Neema House, telling us that Wellington had died in the hospital.  I read the email, two, three, and four times. Wellington was not simply weak and sick the day we met him — he was the picture of hunger.  In National Geographic and advertisements for hunger relief agencies, we see the “hungry child.” Skin and bones with a distended belly, soft hair, and glassy eyes: that was Wellington. Wellington’s father was an alcoholic and had been buying drinks for himself instead of food for his son for a very long time.   It could be argued that in abandoning Wellington at Neema, his father did, in the end, have his best interest at heart.  He was, unarguably, too late.

“Wellington died,” I told her.  “No,” she whispered.

They were my first Pamelas.  How do I rebuild my smile? Rebuild my hope?

The phone rang.  I answered, and immediately knew it was about death.

Through chokes and sobs I hear it: “Britney died”.  I don’t hear it, I don’t believe it.  “Who died?”

“Dakuchapa!” This time I hear it.  This time I believe it.  Dakuchapa means ‘I’m going to beat you up’ in Swahili and was a term of endearment and humor we used with our dear friend Britney during our time at Sally Test.

From the moment I met this 5-year-old and her mother, I loved them.   The cancer caused Britney great pain and illness, but that didn’t stop her from being a joyous, wonderful child.  She loved to place her fingers around her eyes, giving herself glasses. She loved to make funny faces for the camera.  She loved to laugh and laugh and laugh.  She loved to roll up paper with me and have sword fights, shouting ‘dakuchapa!’

I remember Britney’s willingness to be cheerful as she struggled with illness. I remember the ferocity with which she splatter-painted.  I remember her perseverance as she waited again and again as her surgeries got postponed again and again.  I remember the mischievous grin that was seemingly emblazoned on her young face.  I remember her bravery as she faced operations, being strong as her mother told her to be. I remember her big, curious brown eyes peeping out from behind bookshelves as we played hide and seek.  I remember her fiery personality as a light amidst a place which is often full of grief.

Once, we were walking out of the hospital when a commotion, a yelling, a crowd, drew us to the side.  There was a young woman, thrashing, screaming, crying on the ground.  Someone rushed to get a nurse, thinking she was having a seizure.  And then the realization came: she wasn’t having this fit for any medical reason.  She wasn’t crying, tearing at her hair, grinding her face into the dirt because she was mentally unstable, insane, psychotic.  She was mourning.  The realization came: this was the pediatric wing, not the psychiatric wing.  This was right next to the mortuary.  This was not a medical outburst, this was a mama calling out for her baby to wake up.

I looked over and saw the other children, those who were still holding on to their lives, watching in awe.  I could see in their eyes that they knew.  They knew that if they too stopped breathing, the crowds would watch their own mamas grieve in agony.  I have never seen such sorrow; have never witnessed such raw pain.

Did Britney’s mama scream? Did she fall to the ground, crying out for her little girl?  Was there a crowd watching as she dissolved?  Did the other children see and wonder if their mamas would lie there, too?

The phone rang.  I answered, and immediately knew it was about death.

They were my first Pamelas.  How do I rebuild my smile? Rebuild my hope?

Children are sitting up all the time.  But this was Nick, and he was sitting up.

Nick was a fourteen year old who liked to talk with his eyebrows.  “Hi, Nick.” Eyebrows jut up quickly.  “How are you?” Eyebrows lift for a second, then fall.  Eyebrows rise slowly for “yes”.  Eyebrows lower for “no”.  Eyes are always sad.

At the end of his first day in the center, complete with one eyebrow jut, a few eyebrow raises, and eyes that are always sad, I watched Nick walk to his ward.  I watched Nick walk to the Upendo ward.  I watched Nick walk to the cancer ward.  Blow number one.

Nick was the big brother of the hospital, taking care of and watching out for the youngest patients.  He was the kind of kid who no one could help but love: he was quiet and kind, quick to smile, and eager to be helpful.   He was reserved — there was always something else behind those eyes which were always sad.

Suddenly, Nick needed surgery to reduce his stomach cancer.  Blow number two.

Suddenly, the surgery wasn’t on his stomach, but was rather on his heart, removing a fist-sized tumor which no one knew existed.  Blow number three.

Suddenly, Nick was in the ICU, struggling to live.  Blow number four.

There lay Nick, so small in the huge hospital bed, covered in tubes, surrounded by machines.  He was connected to breathing machines, connected to heart monitors, connected to seemingly hundreds of IVs, connected to too much for such a little boy.  Blow number five.

It was so unreal, so difficult, so much more than I knew how to handle.  We gave weak smiles, we squeezed his hand, we held back tears, we told him we would bring anything, anything he wanted.  Blow number six.

Nick said nothing, acknowledging our presence and words with flicks of his eyebrows – his language that we had once so admired now looked so sad, so desperate, so tired.   Then, in a cracked and tiny voice, he whispered: “I didn’t know it would hurt so badly.” Blow number seven.

It was all too much.

Then, suddenly, Nick was moved to the High Dependency Unit.   I am not a doctor, but I have seen dramatic, intense medical television shows.  To my naïve, TV-cultured self, this meant the end.  Images of feeding tubes, machinery, and someone yelling for a crash cart were flying through my mind.  As we walked towards Nick’s new room, I was preparing myself for the worst.   Blow number eight.

And then we opened the door, and how blessedly wrong I was.  There was Nick, sitting up in bed, flipping through a book and listening to music.  I thought I might explode.  My heart felt like it was literally going to break through my ribs, I was so utterly happy that I couldn’t even make my mouth form a smile. I felt myself rooting my feet to the tiled floor, insuring that I didn’t take off running through the hospital hallways in celebration.

Children are sitting up all the time. But this was Nick, and he was sitting up.

Amongst the seven, eight, nine hundred blows, the sitting up moments cannot be ignored.  They can’t be cast aside as ordinary, boring, or inconsequential.  They must be grasped on tight, held and carried always. These are the moments that rebuild our smiles, rebuild our hope.

When the statistics – 2.5 million children are HIV +, 50 million orphans, 1 child starves every 10 seconds – begin to overpower the ability to function, these moments must be remembered.  When two girls, who have been living on their own since they were eight years old, break down in tears for fear of being attacked, these moments must be remembered.  When a nine year old boy is immobilized because of a thorn that has been in his foot for five years, these moments must be remembered.  When a little girl stands to walk to her hospital bed and screams in pain because she is too weak to hold up her small body, these moments must be remembered.  When Nick, the protector and friend to all, looks up at you from his hospital bed, covered in tubes and wires, with fear of death in his sad eyes, these moments must be remembered. When Wellington, abandoned by his one remaining family member, is too far gone and dies before experiencing the loving family he deserves, these moments must be remembered.  When Britney, whose mama may have thrashed on the ground in mourning, doesn’t get to see her fifth birthday, these moments must be remembered.

They were my first Pamelas. I must rebuild my smile. Rebuild my hope.

The moment when Joan, a four year old who was assumed to die, dances around the room with a goofy grin, cannot be let go.  The moment when neighborhood children give an impromptu concert in banana-leaf hula skirts cannot be let go.  The moment when a baby, who in technical terms is an orphan, recognizes his new mama’s voice and screams in delight, cannot be let go.  The moment when 1000 students’ singing voices fill a hall in celebration, cannot be let go.  The moment when Wellington grins and says “WOW!” cannot be let go.  The moment when Britney leans in close and whispers “dakuchapa!” cannot be let go.  The moment when Nick is sitting up cannot be let go.

They were my first Pamelas.  There will be my next Pamela.  So I continue to rebuild my smile. Rebuild my hope.