Christmas in the NICU

It's Christmas time in the city. Like the old classic carol, the tree is up in the foyer and garlands climb the stairwells, sprinkled with bells and golden ornaments and scarlet poinsettias. It's beautiful, despite the fact that outside the huge glass windows is a cold, wintry desert rather than a snowy landscape aglow. I miss the snow so much at Christmas time.

While the OR picks up speed into the New Year, each shift grows longer and faster than the previous. Minutes, hours, days blur by in a streak of blood stains, sterile gowns and bright lights. People shuffle with heads down, bellies hungry from missed meals, shoulders tired with the weight of so much illness and injury. It's easy to forget that outside the walls is a world of merriment, parades, hot chocolate and holiday gift shopping.

So this Christmas, as I am alone, it is hard to fight the melancholy of the season. But I don't want to let it slip by unobserved, either.

So to answer this, I decided to do what I always do when I am feeling alone and sad and forgotten- I focus on someone less fortunate. Like the orphans in Malawi, I have my own troupe of pediatric waifers desperate for some attention and holiday cheer. The NICU.

The idea came to me as my wonderful boss and CVOR manager was showing me recipes for holiday cookies. Would I like to spend an afternoon with her baking? It sounded like fun. But since I am now on a strict diet and all alone, it also sounded like it could trigger some holiday depression. With whom would I share my wondrous baking treats? Baking and home and family warmth all went hand in hand to my upbringing.

After agreeing, I laid awake that night wondering why I had said yes. What would I do with the cookies? It seemed silly to leave them all to her family and friends, when I had put in long hours and elbow grease and love.

Then the idea hit me - the family in the NICU. As dreary and cold as the hospital walls could be to me, who chose it as my home, I could hardly imagine how they must be to a family marooned in the specialty zones for Christmas. Especially the tiny, innocent little preemie babies, fighting bravely for life.

I would bake cookies for them.

The idea settled upon me and filled my heart with an instant flood of warmth and excitement. What holiday cheer this could bring!

My basket of Christmas treats had been shipped off to my boyfriend's family, and my box of gifts to my family far away across the ocean - but now I could turn my attention to a gift that would have no return expectation. A true gift, perfect for the holiday.

How many babies could there be? I imagined between 5-10. Surely no more than a dozen. But I was shocked when I got off the phone with the NICU senior nursing manager. This Christmas week we have 38 babies! That's almost half of a hundred!

I quickly reevaluated how many hundreds of cookies I would have to roll out to make boxes of a dozen cookies for each family. Somewhere over 500. I lost count in the math. It was crazy, for one little scrub to take on such a task.

But then again, it was quite perfect. I called my manager and told her I would be going to the wholesale market to get larger quantities of ingredients. This was going to be a week-long project, rather than a single afternoon, but I was so happy.

Christmas cookies for Christmas babies!

Maybe that's why they named me Noelle.

Baby Trauma Scrub

I walked into the hospital this morning at 6:15. It was Monday, and I was right on time. My Nectar lunch bag was full of perfectly portioned, prepped meals for today and I had my gym clothes in my backpack for after my shift. There are a lot of unknowns in my job, and today was going to go however it went, but at least I would start the day prepared. I swiped through security into the surgical Scrubex hall and dialed in my code for a pair of powder blue scrubs. Between the walls of NICU and ICU and CVICU is the surgical wing. Labor and Delivery is around the corner, and the other hall faces the hospital library and main entrance. A direct elevator would take me to the ER one floor below my feet.

It was Monday, and I am a heart scrub. So I changed into my surgical dress, pulled slip covers over my tennis shoes and a bouffant over my hair. I clipped on my access badge, lined my pockets with pens and slips of sterile paper. I logged into my Volcera radio, and put my cell phone in my back pocket.

It was 6:25 when I stowed my food into the lounge and took a glass of water to start the morning. We didn't have any heart cases pending, and that typically meant I would end up as resource personnel for the day.

But today, it meant I was the trauma scrub. I was handed the trauma pager and a checklist for the trauma surgical suite. There hadn't been any traumas the night before, but I still went through the operating room inch by inch, lying out my sterile gloves and gowns, verifying every piece of equipment was present, functioning, and on standby; meticulously combing the equipment lockers and spreading my case cart for whatever the day would bring.

But it was hardly 6:35 when the alarms sounded and my first trauma red came in. I'd never had such a fast start. It was too early for rush hour traffic and too late for drinkers. What kind of trauma awaited us on a Monday morning at dawn?

It was a crush victim. Male. 50. Pinned between two dump trucks; coding on the field. ETA five minutes out.

I found my trauma nurse and we were buddies for the day, so together we took that direct elevator ride down into the ER silver zone, trauma bay one. Staff were responding from multiple departments - emergency room, radiology, anesthesia. Everyone donned PPE - lead suits, face splash guards, masks, latex-free gloves. This could be a blood bath.

Then we waited.

The trauma surgeon on call was three hours from the end of his 24-hour shift, and he looked it. Rough from being woken from sleep, barefoot in his leather shoes, rubbing his tired eyes. There were a dozen people in the bay, but only two of them mattered to me - the charge Paramedic, and my Trauma Surgeon. The first would give me information on the complications we would encounter on my sterile operating table. The second would give me direction on which route to proceed. The rest of the information was just background noise.

Except we didn't make it to the OR. We never made it to the theatre of sterility and perfection. The paramedics brought in the stretcher and put the patient on the bed and we took over the chest compressions they had initiated almost 30 minutes ago. His chest was nonexistent; the crepitus and fragmented ribs giving away like butter to the firm, relentless surges of CPR. Free flowing blood billowed like waves on the ocean under his skin, flowing from chest into the distended abdomen and then back into the chest again and again, no skeleton frame to stop it, organs shredded to pulp.

It was strange because my field is a beautiful landscape of blood. But there was not blood here. Just a body on a table. Bruised, broken, but unopened.

We continued CPR for ten minutes and two rounds of epinephrine, but it was only a heroic effort in intention. He had died pinned between those dump trucks, and his soul was long gone.

We were released from the ER to go back to our home upstairs. The body would be bagged and taken to the morgue. But I watched the Paramedic and Charge Nurse go through his wallet looking for information on who to call. He was wearing a wedding band. He had decals as a veteran Marine Corps on the leather folds of his wallet. He had probably kissed his wife good morning and drove to work not even an hour before, and she had no idea he was dead yet.

I felt the tears fall as I walked back upstairs.

What a crappy start to this week. What a crappy first hour on shift, on a Monday morning. What a crappy failure to save a life.

On the TV in the hallway, the news was just breaking of the accident but didn't have any information on the condition of the victim that was rushed to the hospital. I knew; but knowledge didn't bring any relief. It just brought sadness.

I'm a trauma scrub today, and I walked to the lounge to make myself a cup of coffee and take a moment to refocus, hoping my pager didn't go off before I got the chance. My job is about being strong and focused and flawless. And I'm very good at my job. I love it.

All the pain, all the victories, all the losses. Did I say it was easy? It's only 7:45am. Another ten hours on this shift, another hundred chances to try again. Someday, I want to be a lady surgeon. Someday, I want to be the one calling the shots to save that life. But for now, I'm a surgeon's right hand. I'm the scrub nurse, the assistant, the one learning and perfecting and preparing.
It's Monday morning, and someone died already. We can't control our time to go. But we can make the most of the time we are given. That was my thought this morning, that followed me into my next cases. How can I make the most of the time I'm given this week? How can I really matter to something bigger than myself? The only way to find out is to try.

EuroMaidan: From Tanks to Torture

The revolution in Ukraine continues to rage. The internet and phone lines have been down off and on and should continue to do so as the government struggles to control what communications go out regarding the conflict. It was with a great deal of dread I woke up to check the news. Not knowing doesn't help, but knowing isn't easy, either. I am just so glad to know that in this horrible, unbelievable time, God is more than in control. He is with all my friends, my family, my church and all the missionaries in Ukraine. How could one go through this without God? I do not know.


From the limited research I've been able to find from western sources, here are some overviews of the current struggle.

A very long and thorough read of the events can be found at http://www.kyivpost.com/content/ukraine/standoff-remains-today-after-jan-22-clashes-kill-five-protesters-injure-more-than-300-335387.html

After President Yanukovich passed laws to begin colonization laws to merge Ukraine under the sovereignty of former dictator Russia, the citizens of free Ukraine have continued to assemble, protest, and even fight for their freedom. The country is clearly divided over whether they want to remain free or dissolve back into Communism. For the sake of the gospel and freedom, I pray that the people of Ukraine will remain united and free.

Several leaders of the opposition for freedom have been executed, both in Kiev (the capitol) and prominent southern city, Odessa. As of today, the mayor of Lviv, the most prominent western city, has resigned. Citizens assembling for their freedom have not only been killed, beaten, but as of today stripped naked in the subfreezing snow and tortured publically under the protection of the Special Forces Berkuit, approved by the Presidency. I opted not the post the public photos of these victims. Other innocent and unarmed citizens like seventeen-year-old Mikhailo Niskoguz have been arrested, tortured, and beaten without due process of law. In the case of Niskoguz, he was left to bleed for over four hours before medical attention was called by the Berkuit.


To quote the commentary of western sources watching the revolution........
"This is not a war of radicals. This the war of middle class and civil society, freelancers. journalists, NGOs, IT workers, artists, students and old people, who have nothing to lose."


"Military tanks have reached Maidan Nezalezhnosti – the central square of Kiev, the capital city of Ukraine."


President Yanukovych released the statement, "As long as I run Ukraine, no one can divide it."


"The talks on settling the political crisis in Ukraine between the authorities and the opposition must be attended by the president as the guarantor of the constitution and the person responsible for everything that takes place in the country, UDAR Party Leader Vitaliy Klitschko said."


"State-sanctioned homicide is no stranger to Ukraine: In the Holodomor, the Ukrainian terror famine of 1932–33, as many as 8 million Ukrainians were deliberately starved to death in a genocide planned and executed by the Soviet leadership in Moscow and enforced by Stalin’s satraps in Ukraine. In that sense, death-by-sniper-bullet is cleaner. But it is no less murder, and no less state-sanctioned murder, when the bullets are fired by internal security forces and police at the behest of the democratically elected (but certainly no longer “democratic”) government of Ukrainian president Viktor Yanukovych."


"The European Union is considering sending two of its most senior officials to Ukraine over the next week as it ratchets up pressure on Ukrainian authorities to reverse current policies, EU diplomats said late Wednesday."


These and other sources can be followed on kyivpost.com, bbcnews.com, euronews.com and others.
Here are some images of the war continuing today. Please, please pray for Ukraine.

Of the pictures posted, there is some of Klitchko, former pro-boxer and now political leader for the freedom movement. I love the one of him in between the police & civilians, he is so tall! And the picture of the journalists trying to capture the historic events.... one man wearing a strainer on his head in place of a helmet. Oh, Ukraine. Only Ukraine.

Euromaidan: World on Fire

Watching what is going on back home, begin so far away... there aren't really any words. I was fifteen during the Orange Revolution, when the political heart of the country exploded into a stand for freedom and westernization. Just a few years later, and Russia has slowly crept back onto the scene through the power of its ability to appoint leaders in Ukrainian government willing to give back up their freedom. Like Yanukovich, our president right now who has signed into law colonization laws against the protest of millions of citizens across the country. In a world very different from the one where I grew up in, the cobblestone streets are slick not only with ice but also blood and ash from fires as the people stand up against the standing army of Berkuit soldiers. One of the last statues of Lenin was torn down by the people. The Parlament broke into a brawl among the leaders themselves, leaving bloody hands that may represent more than just their own blood, too. Millions gather to form barricades throughout the capitol and protest the loss of constitutional freedom that include the right to assemble and the freedom of speech. Leaders of the opposition are disappearing, and journalists covering the Euromaidan revolution imprisoned. Both the US and the European Union had spoken against the violence and sent in diplomats with little results. The timeless streets of my beautiful capitol have become a war zone, with no end in sight as of yet. Regardless of political agenda, the loss of Ukrainian freedom will result in the loss of freedom for the gospel and will affect missionaries across the country, my friends, my family. Please be in prayer. It is so hard to be so far away. I wish I were home, I would be there with a flag, too.

 

Please, pray for Ukraine.

Drivethru Life

Because 100% of Americans spend 90% of their lives in the drivethru. Or at least, that's what I feel suspicious about nowadays. I find myself parking and going inside just to defy the lifestyle. Or maybe it was being stuck in line for 45 minutes one horrible mistake of a day. I learned my lesson after listening to 6 songs on the radio and getting a luke-warm cinnamin dolce latte. Yupp, I'll just go inside next time! But while I was waiting, I had the thrill of seeing this little sparrow peeping around in some pretty little wildflowers. Just thinking about how God cares for me and that little sparrow changed the whole experience. In fact, it made my day.

A Glimpse of Autumn Glory

Most of Oklahoma City is still green and defiant of the upcoming cold, but this particular road is lined with trees who have taken a bold approach to the holiday air. I was stunned by their brilliant scarlet beauty beginning to appear. What perfection! If only the trees could speak, what would these say of the chilly nights and frosty mornings?

Sunsets on the Heartland

These are real photographs from different nights that I've taken with my camera while driving around the countryside southwest of Oklahoma City. I've been singing to the bedridden at a nursing home there all summer long, and I love that ministry. It does my soul good to see their smiles and the joy in their precious, feeble eyes. While I drive back and forth, I have been captivated by the beautiful countryside. The vast fields of corn and wheat are landmarked by silent giants, the oil rigs moving up and down in timeless rhythm. Almost every week, I pull the car off the busy 70-mile-and-hour highway and turn into a random field where I can sit among the thistles and wild black-eyed susan flowers and watch the fiery sun kiss the fearless horizon. It's breathtaking. The peace in the air, silent and still, far from the pressure of every day life in the city, is such a wonder for me, a girl who was raised in the heart of a teeming multi-million person metropolis. I hope these pictures help convey the beauty that graces Oklahoma just before twilight wraps it into slumber.  What an unprecedented artist is the Creator of this world, to effortlessly spread his masterpiece across the wide western sky with such ease and splendor.