Blessings

Doreen is 18 years old. She gave birth to Dalitso on the operating table on November 3, 2005. That was the last night shift I worked. Like my other nights spent at Bottom, it was an exercise in suffering - watching women in true agony without being able to assit them; my own tailor fit version of hell. I have such a clear image of Doreen, restless, in the fourth bed on the left side of the room, an IV line attached to her left arm, crying inconsolably, pleading for help, tormented hour after hour by strong contractions which failed to dilate her cervix past seven centimeters or move her baby down through her pelvis. Even by generous standards, her labor had already arrested by 4:30pm on the 2nd when I arrived, but Bottom only has one operating theatre and there was a woman with a ruptured uterus, ruptured bladder, and a dead baby ahead of her. Considering that Bottom occasionally shares one anesthetist with Central Hospital and that both the urologist and the consultant had to be called in from home, the first surgery took several hours. Unfortunately for Doreen, during that time a hemorrhaging pregnant woman arrived, bumping her once again to the back of the line.

There was nothing I could do. Every so often I would go and listen to the baby's heart, the quiet contender in the difficult battle. And, I would place a hand on her belly, feel it rise up - a stone under a thin layer of skin - as it ceaselessly tried to remove the now unwanted person from her small body. Finally, sometime after 4am, the theatre staff summoned Doreen. I went with her to receive the baby but when everyone was scrubbed and ready to begin, someone noticed that the baby's head was beginning to crown. Almost instantaneously, the theatre was vacated, leaving me alone to attend the delivery, resuscitate the baby, deliver the placenta, and suture Doreen's tear. I was annoyed by everyone's disappearance while I resuscitated the baby and Doreen lay unattended on the table. I was annoyed when I thought of them sleeping while I searched for everything needed for suturing. But, when the tasks were complete, I was grateful for their absence. I was grateful for the quiet; grateful for the uninterrupted opportunity to witness a woman falling instantly and deeply in love with her baby.

Doreen's transformation was complete. She entered theatre as a woman approaching death and left in a state of pure radiance. While it was just the three of us, Doreen smiled and talked to me rapidly in Chichewa - not at all bothered by the fact that I only understood ten percent of what she was saying. I did understand that she wanted me to name her baby and so with my foggy 4am mind, I rattled off all the Chewa names I could remember. She considered them thoughtfully and continued talking. After a while I took her and her baby boy back to the labor ward. She asked for my phone number, which I happily gave her, laughing to myself as I wondered how we would communicate without the aid of sign language. And then the work resumed. The night continued with all the expected and unexpected difficulties but every once in a while I'd look across the room and Doreen would flash me an enormous white smile.

On Thanksgiving, an appropriate day, Doreen called me. Luckily I was near a bilingual Malawian and with his help we agreed that we would meet the following Tuesday at Bottoam and that she would take me to her home. And so we did. We met at Bottom, me little Doreen, and chubby Dalitso. When I asked what Dalitso means, she said in English, "Blessings, don't you remember? You named him?" We got in my car and she directed me through familiar and unfamiliar parts of Lilongwe, arriving at last at the house where she lives with 7 people and a handful of children. On the way I learned that her parents died when she was 12, that Dalitso's father is completely out of the picture, and that she still wants to finish secondary school but lacks money for school fees.

It was wonderful to spend the afternoon with Doreen, Dalitso, and their family in the place that envelopes much of their unfolding stories. It is difficult to describe what an honor it is when someone brings me home, introduces me to their family, lets me hold their baby, feeds me, tells me I am welcome, and does it all with joy and pride. It approaches divine. I will certainly return to visit and the school fees . . . covered.