Saturday, November 16, 2013
I work part-time in the emergency department of a hospital nearby, to cover our expenses so that everything donated to our WGM account will only be used when we're en route to Chogoria. I was working in that local ER a few days ago, taking care of a fellow who was quite sick and becoming sicker. He had a whole-body infection, termed 'sepsis,' and his blood pressure was dropping. He needed a large IV in his jugular vein to give fluids and check internal pressures and give powerful blood-pressure-supporting medications. This IV procedure isn't surgical, but is somewhat complex, requiring multiple needles, a scalpel, wires, sutures, and other devices. Because the procedure carries some increased risk to the patient, including collapsing a lung, injury to the carotid artery and infection, we took extra precautions. We prepared the area carefully and used large sterile drapes, and I suited up with sterile gown, mask, and gloves. I also used ultrasound to visualize the vein and artery during the procedure, and was glad to have ultrasound available, because this patient's anatomy was somewhat different and I would have to insert the needles at an atypical angle.
I found his vein with the ultrasound, injected anesthetic, used the large-bore needle to enter the vein, threaded a wire through the needle, removed the needle, used a scalpel to open the skin around the wire, inserted a dilator and removed it, and threaded the IV catheter over the wire. Then I pulled out the wire and used a syringe to pull out some blood to confirm placement. All was going well. Then, while holding the catheter and reaching for the suture needle, I felt a prick on my finger. The bloody scalpel had fallen into a cavity of the tray and was lying blade-up. I had cut my finger with the scalpel.
I paused to consider risk of contagion. And my thoughts were not reassuring. This fellow's medical record included many past visits to treat STDs. And his white blood cell count had been low for the last couple of years, which could be a sign of HIV infection.
I finished the procedure, suturing the catheter in place, and cleaning up my mess, including policing up the needles and scalpel and other 'sharps' so our superb nurses and technicians wouldn't be injured by them. Then off to the sink to wash as best I could, and then I reported the 'needle stick' to the charge nurse. She and the rest of the staff were very good, completing lots of paperwork and drawing lots of blood from me and from our patient to check for hepatitis and HIV and other concerns. All of this is routine procedure for a 'needle stick.'
The more difficult part followed - waiting the few days for the test results, and ruminating about my foolishness. The stick had occurred at about 1:00 in the morning. I was tired and was sloppy with my 'sharps.' I should have been much more deliberate with every piece of equipment that had touched my patient's skin. What if he had HIV? And what if he had hepatitis C? That was actually the main risk, based on his history. Hepatitis C could be very debilitating, even fatal. Surely the Lord would not allow those infections, especially as we're preparing to go to the mission field.
On the other hand, we recently had the profound privilege to hear the story of a friend already on the field who had been raped and subsequently had a positive HIV test. This friend's story of faith and deliverance is truly remarkable and miraculous. Perhaps we can tell it someday. But I could hardly claim some sort of right to protect me from those infections when I knew our friend's story.
Isn't blood interesting? Life-giving. The Bible says life is in the blood. Lose too much and you die. Astoundingly complex, containing proteins, clotting factors, antibodies, inflammatory mediators, infection-fighting and cancer-fighting cells, electrolytes, hormones, cellular fuels, buffers, and cells that carry oxygen and carbon dioxide, among hundreds of other things. And sometimes infectious viruses. When it carries those, blood can be death-giving. What is profoundly good by design can be exceptionally dangerous when tainted. Symbolic of all creation, I suppose.
Martha took the news well. She prayed and I prayed. I might have lost a little sleep about it, but not much. My favorite verse is Isaiah 26:3. "You will keep in perfect peace him whose mind is steadfast, for he trusts in you. Trust the Lord forever, for the Lord, the Lord is the rock eternal." I am very grateful for that peace.
And then came the phone calls from the very kind Occupational Health nurse. First, about HIV. Our patient's test was negative. (So was mine, in case you were wondering.) And, last night, the second phone call. His hepatitis tests were negative, too. Hallelujah.
I am very grateful for this event. In prayer, I feel that I have received fair warning. Or at least an important reminder to be much more careful. We're going to a place with a very high incidence of HIV and hepatitis and parasites and other dangers. I cannot be sloppy with my 'sharps' or with similar procedures, and must insist on my students' diligence as well, for their protection. We can go with the best of intentions and unfortunately still make a mess of it, both for ourselves and others. But we desperately don't want to do that. We will still engage as best we can, but we will make ourselves diligent. As innocent as doves and as shrewd as serpents. Thank you, Lord, for the very kind reminder.