Dear Dad and Mom…

Warning: The following story may prompt incredulous laughter and children to ask uncomfortable questions.

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Dear Dad,

Maybe I should have followed in your footsteps and become a better baseball player, you know, to make me a better doctor.

Nevertheless, I am happy to report that the secret playroom kickball matches that Jerod and I played allowed me to develop the skills necessary to become a competent physician. You see, just a few weeks ago, as I started my morning rounds, my very unpracticed sliding-into-homeplate manuever was put to the test:

I heard a yell in the hallway leading to surgery and went to investigate.

Arriving there I saw a pregnant woman, waddling towards me. Her eyes were wide with the shock and terror of a person betrayed by their own body. And as I ran forward to assess the situation I quickly saw the reason; upon seeing my querying expression she hiked up her hospital gown to reveal her baby crowning.

Her family and a few nurses were trying desperately to help her get to our labor and delivery room. But I determined this baby was going to come before we could possibly get her to a bed.

“We’re going to need to deliver the baby here,” I said with authority.

With relief the mom stopped trying to move forward and immediately began to sink to the floor. Fortunately her family members promptly stepped up to support her as she began sitting back. Unfortunately, as soon as her knees bent and she began to squat, her baby took advantage of the more open pelvic outlet as well as the increased abdominal pressure generated by her squat.

Noting this, I dove forward, my arms reaching out to catch the slowly falling baby and mother. The amniotic fluid on the tile floor helped me to slide easily into position at the mom’s feet. With my right hand I worked to catch the baby that was slipping rapidly out for a head first dive. And with my left hand I tried to push up and away on the mom’s buttocks that was coming down to land on top of her baby.

When the proverbial dust settled, we’d managed to all land safely in a somewhat slippery and slightly bloody pile, with a joyfully screaming little baby cradled in my arm connected by his umbilical cord to his mom who was slightly shocked and somewhat on top of me.

All we needed was an umpire to stare down at our strange pile and then after a pregnant pause, dramatically yell, “Safe!”

Love, your son,
Dr. Nate

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Dear Mom,

Remember one New Year you asked Dad, Jerod, and I to each tell about a miracle that we’d seen. Ultimately that led to a discussion about miracles, because for you, every day was filled with miracles: from rainbows to children to happenstance meetings- you saw Divine fingerprints everywhere; for Dad, Jerod, and I the world was a significantly less miraculous place. We weren’t sure we’d ever seen God reach down and definitively perform a miracle.

Well, I’ve decided that your view of the world is the better one, and I would like to tell you about a miracle I recently witnessed.

You see, the little baby that I caught in the story above (Yes, the story above is totally true, and yes Jerod and I did secretly play kick ball in our playroom, frequently, and without ever breaking a window), that baby started to turn yellow 12 hours after he was born. Now that’s not too uncommon, he was jaundiced, and we can treat that. We put him under some blue lights that convert the yellow, problematic bilirubin to a form that can be disposed of by most any liver.

I say, “most any,” because on rare occasions the drainage system of a liver is incompletely formed or the infant’s liver cells are genetically incapable of doing some basic function that causes excess production or diminished disposal.

I say all that because, after we put the baby under lights, instead of turning a beautiful Honduran brown and going home, he turned green. He turned green because his liver had one of the two problems detailed above.

When I investigate what could be done to help this little fellow, I found myself running into dead ends (grim pun intended). In Honduras, you do not want to be a green baby. Most likely you are stuck looking for an expensive, risky surgery that only a handful of hard to get to surgeons can do (to repair your drainage system). The other, equally tragic etiology, for our low resource patients, is that this disorder could arise from a super rare genetic problem that will be almost impossible to diagnose and likely will be equally untreatable.

As I often find myself doing, I first explained the poor medical prognosis. In this case I explained to baby’s mom that from strictly a medical perspective her baby had a serious and life-threatening problem. As stated above, the most likely cause was a problem with the liver’s drainage system. Untreated, this often results in death after a few months. So we would do further investigation and begin reaching out to arrange for treatment if necessary and possible. (We would also be reaching out for help from our donors because just the trip to see the surgeon in the big city would have been cost prohibitive)

Then, I concluded with your perspective, mom. I reminded this mother that we believe in a God who is all powerful and can do miracles. So even as we do everything we can medically, we also pray. The mom and I prayed for healing multiple times, specifically for God to allow this little boy’s bilirubin to get out of his system.

I have prayed many such prayers, and most of the time God either answers those prayers through the medical care being provided or the patient dies. But, occasionally, Divine fingerprints are a little more overt. Like this time, where visit by visit the little boy’s color, weight, and labs improved with no treatment beyond earnest prayers of hope and thanksgiving. A few days ago he came in for a check up and was totally normal.

Whether this was God directly altering the baby’s physiology or not, I do not know. But one thing I do know, he was a sickly-appearing, green baby and now he is healthy and brown.

And at that visit I praised God with his mother for the miracle of her son’s life.

Love, your son,
Nate