ali's african adventures

It's hard to sit down and quantify just what makes a shift good or bad. If you weigh the little boy with no front teeth who screams in laughter when you try to speak Fon against the other one with big, tumor-swollen cheeks who probably isn't going to live much longer, which one comes out in front? For the little girl with the extra toe, which carries more weight: the fact that her dimples frame a perfect smile, or the fact that the extra fluid around her brain means that she'll never learn to talk? When you sit down to teach a new nurse how to draw blood and she gets it on the first try, is that success at all diminished by the fact that you then turned around and put that hard-earned blood into the wrong tube?

I'd like to propose a new metric. As far as I'm concerned, the success of any given day can be measured by a simple formula. Take the number of patients who know my name and shout it when I walk through the doors. Multiply that by the number of mamas who offer to let me carry their babies home to America with me. Add ten bonus points for each of those babies that falls asleep in my arms while I chart on the kid in the next bed over. Anything over, oh, let's say ... fifty? That's a shift where the good outweighs the bad.

Today? Definitely a good day.

One of my patients today was a little boy who looked a lot like a kiddo I took care of last year. If this were a contest, (and I'm not saying it is, because that just wouldn't be right) Abie would be a clear front-runner for the title of My Favourite Patient Ever. After this morning, I'm thinking Perrin could give him a run for his money.

Perrin is four, and he had surgery yesterday to straighten his two crooked little thumbs. His hands are wrapped in boxing-glove bandages and with his energy, he's clearly the patient that they made the siderails-on-kids'-beds rule for. He also speaks French and Fon with a perfect four-year old lisp, and for the first time this year, I cared for him and his mama without the aid of a translator. The fact that he spent the day calling me Tante Alice (Auntie Alice)? Didn't hurt him in the stealing-my-heart department. Not one little bit.

One of the best moments of the day came early on. I wandered over to his corner, peeled him off the ceiling and explained that he was not, in fact, allowed to jump on the bed. I handed him his morning vitamin; Il faut craquer, I told him, (one of my more recently acquired French phrases). You have to chew it. He gave me an impish grin which faded as soon as he bit down.

His face fell, and he looked at me with what I can only call disgust, his mouth hanging wide open. As clearly as he could manage through a mouthful of pill shards he glared at me and mumbled, Mon Dieu! with all the gravity of an eighty-year old man.

When I had picked myself back up off the floor, where I must have fallen in my laughter, I got him a glass of water to wash down the offending tablet. He accepted it solemnly, glared at me some more and then apparently decided to forgive me.

I spent the rest of the shift hearing his shrill voice calling me from across the ward. Tante! Jeu avec moi! Tante! Vien! Mange avec moi! Tante! Tante! Tante! We built towers from Jenga blocks spread out on a blanket on the floor. We let the charge nurse decorate both our faces with stickers. I sat next to him while he ate his lunch, and he obediently took the rest of his medicines for me, testing each one with the tip of a finger first to make sure I wasn't trying to poison him like I did with that vitamin.

When it came time to leave, he beckoned me over to his bed one last time. He was curled up next to his mama, ready for an afternoon nap. Will I see you tomorrow? he asked, visibly concerned. I told him I hoped so, that I'd try to come before he went home, and that seemed to satisfy him. He threw one of his bandaged fists around my neck, pulled me close and kissed me wetly on the cheek.

Demain, he confirmed, tomorrow, and then repeated in in Fon, just to make sure. Eeso. I kissed him on his forehead, close to where we were sporting matching little star stickers.

Eeso.

On evening rounds:

Surgeon: Does the child snore?

(Translator relays the question to the mother in Fon. She answers, her face serious.)

Translator: Only when he sleeps.

A few of us nurses got together for a bit of a debrief today. We needed to sit and talk about and process everything that happened with Hubie, and since I was the one who was most involved, the one who helped him slip away, I got to head up the meeting.

It was informal. We sat around in an empty ward and we talked about what happened, all the medicine surrounding his death. And then we all cried about a little baby who we all loved. A little baby who had to go back.

After we'd been there for a while and the tissue box had been handed around more than once, I glanced towards the little window in the door of the ward. It's about four feet of the ground, that window, so I was more than a little surprised when I saw a tiny, brown baby with startled eyes dancing back and forth past the small pane of glass. I did a double take and when I looked back I realized that my friend Sarah was behind the action, holding the little one and waving him there for our amusement. I beckoned her in.

She deposited her charge on the lap of the first nurse she came to, disappeared and quickly returned with another little boy, this one slightly chubbier, but also sporting a little knit hat, just like the first.

Just like the tissues, we passed the babies around. We each took a turn, burying our faces in warm little necks, squeezing chubby thighs and feeling tiny fingers wrap around our own. And then, when we were done, we returned them to their mamas and we all went our separate ways, our hearts a little lighter.

Cheap therapy, that.

It happened at ten this morning. His papa had come in to visit, had listened while I explained that Hubert's small body was shutting down, organ by organ. His mama sat on the next bed over, in the same clothes she's worn for the last month, the silent tears tracking down her cheeks. And then, just like that, it was time.

We turned off the medications and disconnected the IV lines. We silenced the alarms and put him in a fresh diaper and I lifted him out of the bed and into his papa's arms. They sat there for a few endless minutes while the ventilator continued its relentless pulse and Hubert's heart slowed and his mama held his feet in her hands.

And then he slipped away. His heart stopped and we turned off the ventilator, took out the tube, removed all the wires and IV cannulas, covering the places with clean white gauze. His papa started to rock him back and forth, back and forth, speaking softly into his son's ears. I looked up at my translator who relayed his words. He is asking the baby to breathe. He says he should breathe now. He says he should try. And in my ear I heard the mother's cry, the same sound they all make when they know it's over. The high, keening wail that voices a grief that should never be felt.

They sat there, the small family, ensconced in their pain, while another translator rocked Hubert's sister to sleep on the other side of the ward. His papa finally looked up, asked us if we could bathe him and surrendered his son into my arms.

I had forgotten how heavy he was. He had been so small when he first came to us, but we had fed him and he had gotten fat and now the weight of him nestled against my chest was almost enough to stop my own breath. I laid him on the bed, and my eyes filled up and my translator chided me. Sis Alice, you must not cry. Don't cry now. I told him that I had done this before, I'd done this too many times before, and I always do it with tears in my eyes. His voice softened. Okay. You can cry. It's okay.

He looked like he was asleep and his curls were soft and fuzzy as I bathed him, removing all the traces of what we had done to him in our struggle to keep him alive. I gave him to his mama and she dressed him, looking startled when his little arms didn't reach through his sleeves like they used to.

One by one, the nurses who had cared for him came into the little sanctuary of his room, sat with his mama, poured out their love and their tears. And over and over I reassured them. It was quick. He went quietly. He was snuggled in with his papa, and he just slipped away. I signed forms and called the appropriate people and cleaned the ICU while my translator taught me how to sing in French, and I told everyone that I saw in the halls that I was fine.

But now I'm back in my cabin, and I can't stop thinking about what Hubie's papa said, right before they left. I want to say thank you, because I have seen the result of your efforts. I know why you are here. You have done well for us. And then they took their dead baby, strapped him to his mama's back so the taxi driver wouldn't charge them more, and they walked down the gangway.

I can see the tears in his papa's eyes, and that slight memory is enough to break me, to send me spinning across the floor in a thousand tiny pieces, my heart in splinters in my hands.

It's going to take some time to mend.

I should be asleep right now, not writing. I have to get up in a few hours, and the baby I'm going to be caring for is so sick. So very sick.

Oh Hubie.

I don't know if it'll ever get easier. Sitting with a family, explaining that the hope I told them to cling to is fading fast. Watching that single, silent tear track down a mama's cheek to hit the floor with a tiny splash. Pulling back blankets to let a papa touch his baby's foot before he rushes out into the evening, unwilling to sit vigil with his wife, his hard eyes suspiciously red.

It's so hard to pray for God's will to be done when I'm getting more and more convinced that His will isn't what I want.

So when I say Pray for Hubert, I mean so much more than that. I mean pray for his mama, because now, maybe so close to the end, she finally cares, and if he does go back to Jesus, it's going to hurt her. I mean pray for the doctors. We don't have a PICU doctor on the ship, so we've been pulling from the jumbled expertise of everyone around, doing the best we can. I mean pray for the nurses. We've been letting Hubie get a firm hold on our hearts for the past month, and now he's so sick, and we don't know what to do. It's so hard to look at a baby who was getting better, getting fat and happy, and see him pinned to the bed by tubes and wires, his little body shaking with each breath of the ventilator.

I keep praying for God to fill me back up, with love and strength and wisdom, so that I can go back into that room tomorrow and pour myself out again.

I'm starting to think I might be a little too broken to hold all that right now.

Today was horrible in so many ways. I'm drained, body and soul, and I just want to curl up under my covers and forget it ever happened.

Hubert took a turn for the worse this morning. He's now on a ventilator and still struggling to maintain the oxygenation in his blood. The pneumonia in his lungs is much worse, and we're not so sure there's a light at the end of the tunnel anymore.

Please keep praying. I know that's all I've been saying the last few days; pray, pray pray. But we're doing everything we can from the medical side of things, and so there's nothing else to be done.

There was so much more that happened, with another little baby who went back to Jesus, but I just can't talk about it right now because the weight of her body in my arms is still to fresh. I can still smell her on my skin and it's not fair that she was so small and so sick and that she never had a chance.

I'm going to go eat dinner and then I'll go check on Hubert and we'll all keep praying, right?

I'll be the first to admit that I maybe get a little too attached to my patients here. I don't know what it is, whether it's the brown skin so different from my own or the language separating us like a chasm. But there's something about this place and these people that challenges me to overcome those walls, something inside me that urges me closer than I've ever been.

It's no wonder that I was close to tears during my shift today.

I got a call in the morning asking if I'd be okay caring for the ICU patient instead of working as a charge nurse and I agreed and hung up before I remembered that it was Hubert in there and that I wasn't sure how he was doing. I showed up at two to find my little friend looking worse than I thought he would. His breath came in short gasps and in between crying he would cough a terrible little cough that made me want to pick him up and take all the pain away. His body was burning with fevers, his skin red and raw, and his mama sat helplessly beside him.

By dinner time, I was fairly sure that little Hubie was in a tailspin that would lead to him needing a breathing tube and a ventilator. I stood with the anesthetist and we wondered together how we would know when we were past the point of no return while Hubert laid in the bed, his heart racing so much faster than it should.

And then something happened. I'm not sure what, really. I don't know if it was the prayers that are going up all around the ship, all around the world really. Maybe the darkness was finally being pushed back enough that the light could shine through. But when Hubert's dad came to visit, the dad who wasn't sure whether or not he wanted to claim Hubert as his own, he asked to hold his son. He sat at the side of the bed, his little whimpering child in his arms, and he rocked ever so gently back and forth, back and forth, being careful not to dislodge the tubes and wires we've fastened to every part of Hubie's body.

Shortly before eight, when visiting hours are over, my translator called me over. I saw the question in the papa's eyes as the translator relayed the message. The dad would like to know if we could give the baby a bath before he has to leave.

Giving a bath to a baby who looks so bad isn't usually on my list of top priorities. Being able to breathe on his own seemed to be much more important right then, and I knew that having a bath might just send Hubert over the edge. But I looked again at his papa, who looked back at me with hope in his eyes and I knew that, no matter what happened, Hubert was getting a bath.

I gathered baby soap and towels and a basin of cool water, and mama and I worked together to wipe his sweaty body clean while papa hovered over the bed, holding tubes out of our way. We cleaned him from head to toe, applied fresh tape where it was needed, mixed up a new cream for his poor red bottom and snuggled him in with a clean diaper and fresh sheets. He fought us throughout the process, and I was fairly sure we had just sent him over the edge and that he wouldn't be able to stop his crying and coughing and struggling.

I watched in amazement as Hubert did precisely the opposite of what I expected. He opened his eyes, alert for the first time during my shift, and stared at his mama as she leaned over him, straightening the pillow behind his back. He fussed for a minute, and then I watched his mama do precisely the opposite of what I expected of her. Instead of sitting in stony silence by the edge of the bed, she reached into her bag and pulled out a little stuffed animal. She settled Hubie on his side, crooning to him in Fon, and the tucked the toy behind him to prop him up. She stroked his fuzzy head until he fell asleep, and then she took her other child, Pauline, for a bath. When they returned, she gathered sheets and pillows and settled all three of them into the big bed together, being careful not to disturb a still-sleeping Hubert.

Suey, who had been taking care of the family during the day shift, stopped by around nine to see how he was doing. I pointed to the bed and the three people sleeping together there, a mama and the two children that she had tucked in with love instead of harsh words, caresses instead of slaps.

You'll forgive us, I know, for coming so close to crying right there in that ICU.


Please keep praying. Hubert isn't healed yet, and we need to be storming the gates of heaven with our requests on his behalf. Thank you so much for standing with us in this fight.

Tonight at community meeting, we sang a song that nearly had me in tears.

You're the God of this City
You're the King of these people
You're the Lord of this nation
You are

You're the Light in this darkness
You're the Hope to the hopeless
You're the Peace to the restless
You are

There is no one like our God
There is no one like our God

It was when we got to the next part that my heart climbed up into my throat and my eyes misted over.

For greater things have yet to come
And greater things are still to be done in this City
Greater thing have yet to come
And greater things are still to be done in this City

Because there's a little baby lying in the ICU tonight who needs something great to happen in his life. He's not as sick as some we've had in there; he's still breathing on his own, but it's hard work for him and none of us is sure that we can see the light at the end of his tunnel quite yet. His name is Hubert. When his mama is feeling especially loving, she calls him Hubie, but that doesn't happen terribly often.

You see, little Hubie was born with a cleft lip and palate; he's had the surgery to repair his lip, but the roof of his mouth is still a gaping hole. When he was admitted, Hubie weighed less than eight pounds. He's nine months old.

Hubert's mama and four-year old sister sport matching scars on their cheeks, markings inflicted in infancy as part of the Voodoo religion. Hubert's cheeks are smooth and unblemished. When pressed, his mama revealed that she and her husband haven't had his face cut yet because they're not sure they want to claim him. And he lies in the bed, gasping and coughing as his mama sits by his side, her face an inscrutable mask.

I can't fathom it. I can't wrap my head around a system that tells you that your baby is cursed because of a birth defect. I can't come to terms with the fact that his mama cared so little about his life that he was probably just weeks away from starving to death when he came back to us. I just can't understand how you could look into the eyes of your tiny child and actually wrestle with whether or not you were going to take ownership over his life.

And now Hubie's sick. He's picked up a pneumonia, probably a virus that was going around the wards that attacked his already weak body, and he's covered in rashes, burning with fevers and gasping for breath.

But I firmly believe that greater things are still to be done here. We sang that song and I spoke the name of Jesus, because I know that in His name, there is no darkness that has power here, no evil that can cover Hubie's life.

Pray with us, will you? Pray that the darkness would be overcome, that Hubert's life would be saved and that he would be a testament to God's grace for his parents.

Pray for Hubert.

I wandered onto the wards last night to find two friends sporting significantly shorter hairstyles than I was used to seeing. I was a little puzzled, since we don't have an official hairdresser on board at the moment, and since they both had long hair the last time I'd seen them, I was naturally a little curious.

They informed me that an OR nurse is gathering donations for Locks of Love, and that they had sacrificed their ponytails to the cause. One of the girls, Sarah, pulled me over to the computer and poked around on Facebook for a while until she found the photo she was looking for.

This is my best friend Alex, she told me, pointing to a gorgeous, smiling woman, one who just happened to be completely bald. She's got breast cancer. Alex beamed back at me from the photo, the strength in her eyes unmistakable and I felt my own hair on my back and I knew what I had to do.

In the end, it's not about making a statement. It's not about being altruistic or even about getting a free haircut out of the former hairdresser on board who's been making the rounds, collecting ponytails in little plastic bags.

It's because we all know someone who's been affected by cancer. We all know someone who's fought, and most of us know someone who's lost. I see kids on the ship all the time, kids like Aime and Madinath and Rachelle who are fighting their own demons, waging their own battles against this horrible disease. And I have watched helplessly from this side of the ocean while a woman who is as close as family to me went into the operating room, refusing to let the cancer take her from us all.

So it's for them, I guess. For Laura and Rachelle and Sadie and all the others, it's my way of standing up. The only way I know how to say that it isn't fair that some have a harder road to walk than others.

(And let's be honest; this is going to make staying under the two-minute shower limit way easier.)

I saw Maomai yesterday. I had wandered down to the wards to drop off some papers, and the charge nurse greeted me with a smile. Maomai's here. Pelagie, her mama, had her back to me, so I snuck up behind her and threw my arms around her shoulders. She responded in her characteristic fashion; she jumped up and down, yelled some random English words, hugged me and grabbed my butt. C'est beaucoup! she assured me, in case I had forgotten in the time since I had last seen her. I looked around for the baby, and Pelagie caught my look. She grinned proudly and pointed across the wards to where another nurse was holding a little brown baby in what I assumed was a very big blanket.

It turns out I was wrong. It wasn't the blanket that was big; it was Maomai. I took her in my arms, startled by the weight of her, solid and substantial where she used to be all tiny bones and loose skin. Her hair is coming in all curly, and her cheeks are growing at an astounding rate. They're almost symmetrical now, with little pink scars the only reminder of the enormous tumor that used to distort her face. Her thighs are a mass of rolls and her fingers are dimpled and round. She's crossed over from death to life in every way imaginable.

When Maomai was just a tiny baby, her mama had a dream. In that dream, she recounts, I saw a person, who told me I should be quiet and pray; that salvation shall come. Yesterday, as I held her and felt my arms getting tired from the weight of her body, free from tumors and tubes, I knew that the salvation Pelagie had dreamed about had come. Not just for Maomai, but also for her mama.

She should have abandoned her baby, given her up for lost when that mass started to take over Maomai's face. Her culture told her that her child was worthless, a burden, better off dead, and for such a long time we were so afraid that her culture would win. We fought back our frustrations while we tried in vain to rouse a sleeping Pelagie for nighttime feedings. We watched in dismay as she retreated into herself, unwilling even to change her baby's diapers, and we thought we had lost again. Lost to a fatalistic system with roots far deeper than we can understand. Lost to a darkness that we so often feel so powerless to overcome.

And then, almost before we realized it was happening, the light came back to Pelagie's eyes. She took charge of her baby's life, patiently mixing bottles and learning how to manage a gastric tube and cooing back when Maomai smiled and gurgled.

In a place where we lose so often, where the darkness feels like it's everywhere, it's no wonder that I stood there with that fat little baby in my arms and I cried. I cried because hope is real, because love is real, because salvation, at least for this tiny family, is so very real. As real as the little baby who laid in my arms, staring up at me while I cried and laughed and danced with her mama.

And Pelagie, understanding my tears, came close to my side. In a rare moment of tenderness, she threaded her arm gently around my waist and kissed me on the cheek.

Thank you, she said, looking up at me with the same quiet expression as the one on her daughter's face. Thank you.

After a tough couple of weeks on the ward and in the ICU, this weekend away was just what I needed.

We woke up before four in the morning and stumbled down onto the dock, the night still thick around us. When the cars finally arrived, we climbed in and made our way through Benin and over the border into Togo with little ceremony. Our driver, Spiro, was taciturn, his silence most likely stemming from the fact that he understands about ten words of English. He seemed bent on getting us there as fast as possible, weaving in and out of the steadily growing traffic, lurching over speed bumps and jerking around potholes. I kept my eyes shut for as much of the journey as possible, choosing to believe that if I couldn't see the danger, it couldn't possibly be real.

When we reached the town of Kpalime, nestled into the shadow of Mount Agou, about two hours north of where the ship will be docked next year, we stopped for some Fan Milk and some directions. After refreshing ourselves with the little rectangular pouches of ice cream we arrived at the hotel, where we all promptly fell asleep on the concrete around the pool. The afternoon was spent in napping and exploring the town before we came back to the hotel and feasted on steak and fries.

On Friday, we climbed the mountain. Our guides, Gregory and Jean Baptise, stopped us at the base of the mountain and explained that we would be taking the small way up, that we should be careful, that there would be two more villages before we reached the top. We set out in good spirits, our guides carrying food for lunch, our feet steady on the path. Gregory spent a good portion of the time singing, and for a while we had enough breath to join in.



Before long, it became clear what they had meant by the small way. In plain English, it turns out that this translates to, You will be going straight up the side of the mountain. Even though it's overcast, you will soon be drenched in sweat. There will be rocks, like a never-ending staircase, and you will climb them until your calves beg you for mercy. And Gregory will sing the whole time.

When we reached the first village, we stopped for a while to catch our collective breath before pressing on. The jungle closed in around us, branches and long saw-edged grasses clutching at our clothes as we squeezed through, and still the rocky stairs led up up up. The searing pain in my legs took my attention away from the fact that I couldn't really breathe and then, all of a sudden, we saw houses through the trees.

How can I explain that second village to you? From our vantage point we could see for miles. Towns and villages dotted the valley below us, smoke from cooking fires rising in wisps into the damp air. Everything was green and orange and brown, and the little mud-walled houses clung to the side of the mountain behind us, turning up their noses at the inexorable pull of gravity that threatened to send them spinning down down down. Ropes strung between the houses held lappas in every color of the rainbow, and baby goats bleated their calls to their mothers as they tested their tiny legs on the steep incline. Children materialized from nowhere, chanting their familiar song. Yovo, Yovo, bonsoir. Ca va bien, merci. They usually sing it to us to make fun of us, assuming that it's all white people know how to say in French, but way up on the side of the mountain, these little ones didn't even know enough of that language to know what they were singing.



After a picnic lunch of chicken sandwiches, fresh avocado and pineapple, all laid out on banana leaves that Gregory cut from the bush on our way up, we shouldered our bags and set out into the clouds. Our guides tried to get us to turn back, pointing out that the cloud covering the top of the mountain meant that we weren't going to see anything once we got there, but we hadn't come so far for nothing. We convinced them to lead on, and finally, bone-tired and sweat-drenched, we made it to the top. They were right, those guides of ours; there was nothing to see, but we stood at the edge of the cliff and let the rolling cloud wash over us, cooling us with its mist, and we knew that we had made it.

We set off down again by another route, greeting the old women and little children who squatted by the side of the road, spreading corn out to dry on top of lappas in the dirt. Our shins protested and even Gregory had fallen silent as we marched down towards to waiting van.

And then it was Sunday and time to make our way back to the ship. Spiro, silent as ever, drove us through the countryside towards the border, where I managed to negotiate the whole crossing in French, much to my own surprise. Our passports were stamped and we were back in the van, bumping and swerving our way towards the ship and I should have been scared but my hand was in my husband's and so I was invincible.

I can still see it now, sitting in that car, trying to remember a time when my life didn't look like this. Elephant grass stretching ten feet tall, curving over the road and swishing gently as we pass. The late afternoon sunlight turning everything to gold. Women walking slowly along the sides of the road, babies bouncing on their backs, their heads piled high with stacks of firewood or buckets of bread or any of a thousand things they were selling in the market that day. Everything smells like smoke and earth and rain, and the children look up from their place in the dirt and call out to us, their arms waving frantically, Yovo! Yovo!

I catch my husband's eye and we grin at each other, silently content to be sharing this adventure. The sign says Cotonou and the arrow points straight ahead and my heart says home.


(The rest of the photos are here)

Expect silence from this end for the next few days. It's a long weekend on the ship, and I have a friend (coughSueycough) who was lovely enough to work a shift for me, so I'm headed out of the country. We're going back to Togo, to hike and hang out and maybe find a waterfall or two. I'm not really sure. All I know is that I get to do it with my husband, and when I'm with him, I'm not nearly so scared about being in car accidents.

Should be fun!

First of all, I need to mention that today is my brother Matt's birthday. He's the only reason I'm even blogging today, since he set up my site and acts as my ever-ready tech support. So if you happen to see a really tall guy with a gorgeous wife and the cutest little blue-eyed, bald-headed baby in the world wandering around Toronto today, give him a high five. Because he made it through another year.

Now, on to the other excitement: I learned some more Fon today. Christine, a wonderful, quiet woman whose cheeks are deeply grooved with tribal markings, crochets fluidly while she teaches. My tongue stumbles, but she is patient, repeating the phrases over and over again until the mamas around the ward can understand my greetings.

I came back to my cabin after my shift was over and started poking around the internet, wondering if there was a Wikipedia article about the Fon language. (We all know how much I love my Wikipedia.) Imagine my sheer joy when I found this site. Contained in that little corner of the internet is enough to make a language-lover's heart pretty much explode on contact. There are vocabulary lists, grammar lessons, and even audio files for learning pronunciation. I was planning on trying to spell out what I learned today. Instead, I'm just going to link to the files, and you can hear for yourself.

We'll start with, Did you wake up well? (A standard greeting, used much like, How are you?) : A fon gangi a? The response is Eeen, un fon gangi.

From there, the greetings usually go on for a while, since West Africans never like to get straight to the point. After finding out if you've woken up well, you might be asked whether or not you've done something. This is a rather random question, but it's a nice space-filler, since, unless you're dead, the answer is most likely going to be yes! A blo kpede a? The answer isn't on the site, but it's just the same thing without the a at the end.

And it's not on the website, but I can now calm a crying baby using the Beninoise equivalents of the Liberian no ma now and sorry yeah? (Evo, evo and Dede, dede, respectively.)

I'm going to be spending a lot of time on that website in the future, learning how to talk to my patients, how to get into their lives just a little bit.

And let's be honest here; who doesn't want to learn a language where the word for star literally means child of the moon?

When cranky children head into the OR, we have a little trick up our sleeves, one that helps to take the edge off the experience for them. Its called a premed, and it involves dosing the kiddo up with a small portion of any of a number of lovely drugs. The favourite choice is a benzodiazepine, a drug that will not only make the child sleepy, but also acts to help them forget what we're about to put them through.

If there was ever a child in need of a premed, that child was Fred.

Let's consider, for a moment, the fact that this little man's name is Fred. If you're anything like me, you know that just hearing that name attached to a small West African boy would make you immediately want to be Fred's friend. We all do. Unfortunately, Fred, aside from his true medical problems, also suffers from a lesser-known condition known as Yovophobia. You'll notice that, contrary to form, I haven't included the link to the Wikipedia article on Yovophobia. I haven't quite gotten it approved yet; it turns out that an irrational and often screaming terror in the presence of white people isn't really a widely-recognized diagnosis. For Fred, at only two years of age, this problem is crippling.

It means that, whenever one of the nurses comes near to take his temperature, a procedure that we all agree is painless when done using the Mercy Ships approved under-the-arm method, Fred immediately starts to cry. And heaven forbid we should do anything with his surgical incision; if you have white skin and come at Fred with anything resembling a bandage, he straight-up loses his mind.

Today, Fred needed another surgery.

The wise anesthetist stopped by the wards about an hour before Fred was due in the operating room, whipped out his pen and wrote the magic words. Lorazepam 5mg PO on call. That might not mean anything to a non-medical person, but in my little Yovo heart I knew it meant that Fred had the chance to go to the OR without a complete meltdown.

In due time, the call came and little Fred received his premed, screaming the entire time. I steered clear for a while, waiting for the calming effects of the drug to kick in, and when I figured it had had enough time to work, I decided to test the waters. Fred's mama was holding him, his little head bobbing back and forth as he fought the inevitable sleep. I came up beside him, put my incredibly white face next to his and waited for the screams. They never came.

Fred bobbed his head in my direction and puckered up his two year-old lips with all the gravity of a judge. With the next loll of his head, he planted them firmly on my cheek, and then he let his head fall back again, grinning at me from behind half-closed eyes, looking for all the world like a drunken old man in a tiny little body.

Fred kissed me. This, my friends, is the magic of a premed.