Hope Without Healing
When questions are unanswerable, can we still trust?
By Olen Netteburg
Day 1 I knew from the moment I saw him that he would die. I wasn’t going to get attached.
Emmanuel was 8 years old. His brother had accidentally dumped boiling porridge on him. A quantity large enough to feed the whole family. He was orphaned some years ago, semi-adopted by a semi-family. They call themselves Aunt and Uncle, but they aren’t really. Now he’s a burned orphan. I’m not getting attached.
A TRADITION OF MISSION
I’m an emergency medicine physician. A child with second- and third-degree burns over 10 percent of their body has the odds stacked against them in the best burn center in the world. Béré Adventist Hospital is not the best burn center in the world, and Emmanuel has 40 percent third-degree burns. I’m not getting attached.
I look at him. I touch him. I talk to him. He’s alive. He’s breathing. He’s thinking. He’s moving. He’s talking. What am I supposed to do?
The only thing I can do is treat him. That’s what I’m trained to do. That’s why I’m a doctor. A patient comes in. I give treatment. The patient gets better. I feel good about myself. I remember to give credit to God. Sometimes.
I can’t treat him partially. I need to treat him fully. It’s expensive. His semi-family can’t pay for it. Luckily the government mandates we treat the poor for free. They allocate to us the medicines and other supplies to use for indigent cases; we provide the care. I order fluids, antibiotics, cimetidine, a clean sheet, and clean bandages. Oh, and of course, pain medications: Tylenol and Motrin. That’s what we have here at the best burn center in “Nowheresville,” Tchad.
I leave the hospital and walk the 50 yards through the mango trees to our home. I’m not going to get attached to Emmanuel. (I’ve got to stop using his name!) He’s just another patient. Just another kid who’s going to die in Tchad.
Day 2 Emmanuel looks pretty uncomfortable. I suppose I can use his name and stay unattached.
HOSPITAL STAFF: The entire hospital staff at 70-bed Béré Hospital in TchadDay 4 He’s still alive. Well, he probably won’t die from pulmonary/airway problems.
Day 7 I start to think, Maybe he’ll pull through. Nah, I’m fooling myself! Forty percent third-degree burns. He’s going to die. Even if he lives, he’ll be horrifically deformed. He’ll have terrible contractures. He’ll never be able to use his hands. He’ll need to have his skin cut continually just so he can continue to grow. That scar (if it ever forms) won’t let the skin stretch and grow. He won’t live. He’s going to die. And I’m not getting attached.
Day 12 I keep hearing words like “miracle.” I even catch myself using it once. But a miracle would be letting this kid die. He’s suffering terribly, crying nonstop—whenever he has the energy.
Day 19 Somebody has the idea to bring a bucket of water to the bedside to wash him. We try to tell the staff that it’s not necessary, but what do we know? He cries every time they put him in the water. I can’t imagine his pain. He thinks washing is what’s good for him, so he bravely scrubs away at his body where he has no skin. He whimpers while inflicting pain on himself. He’s so brave. No, I’m not getting attached to Emmanuel. I can’t.
Day 25 The hospital runs out of government-supplied products for Emmanuel. The family can’t pay. Benzaki, an administrator at our hospital, starts paying the bill himself. What’s wrong with this man? He doesn’t earn $300 in a month! How can he sink all his money into this hopeless case?
Day 34 This morning Benzaki drags me to Emmanuel’s bedside. He’s barely breathing. They still want everything done. I sit down on the bed across from him and notice how pale he is. I scribble on a piece of paper the orders for an IV, dextrose, a blood transfusion, quinine, ampicillin, gentamicin, metronidazole, and cimetidine.
Mr. and Mrs. Benzaki mourn the loss of Emmanuel, whom they had planned to adopt.The nurses can’t find a vein. I
go to my office and return with an intraosseous needle* and five grams of magnesium. I recognize the risk
of respiratory depression, but give him the magnesium intramuscularly anyway. I then set about manually screwing a long metal needle into
I get my needle into the bone marrow before the nurses get theirs into a vein. We start the medication. I need to leave before this becomes personal. I’m not getting attached to Emmanuel. Not to this hopeless case.
I’m in the office later doing ultrasounds. I hear a wail. I know what’s happened. I walk outside. Benzaki, that very same foolish administrator who never gave up, comes over. We walk to the patient’s bedside together.
Emmanuel’s already lying on a stretcher, covered by a sheet, ready to be carried to his semi-family’s home.
I ask them to stop and put him back down. I want to look at him again. I want to pull back the sheet. I want to say goodbye to this boy who didn’t speak a word of the English or French that I can speak. I am attached.
A nurse prays in the local language. I have no clue what he says, but my vision is blurry when I open my eyes.
STAFF WORSHIP: The hospital staff meets under the mango trees every morning for worship. The site then becomes the waiting room for the hospital, and later in the evening is used as a sleeping space for patient relatives.I can’t tell them it’s OK to pick him up and walk out.
I know the words
in French. I even mouth them. But I know my voice will betray me if I try to make a sound. They understand. They take him away.
Benzaki and I walk outside. His wife is sitting under the mango trees, on the concrete slab we treat as a waiting bench. She too had taken an unusual liking to this boy. She’s crying.
I sit down beside her, unaware that she’s about to pummel me with questions I’m unprepared and unable to answer.
“Tell me, Dr. Olen. Tell me, why did he have to die? What is the purpose in his suffering? What is God trying to tell me?”
The story comes out. The Benzakis had agreed to adopt this boy in December. They had already been paying for his schooling. In their 40s and without the children that make you a person of worth in this culture, his story came to them. After much prayerful consideration, they decided to adopt him. They had never thought about adoption before. They signed the papers and were about to take custody.
Then Emmanuel was burned. They visited him every day. They paid for his medical expenses. They drove on their motorcycle long distances to find the medications for him. They showed Emmanuel what the love of a parent is, something he had never known before.
And this morning, after waking up early to finish preparing his room for the day when he might be able to come home, Mrs. Benzaki visited her future son, took his hand, and listened to him call her “Mama” for the first time. And then he died.
THE MOST VULNERABLE: Dr. Olen Netteburg treats countless babies in a country that has one of the highest infant mortality rates in the world.“Tell me, Dr. Olen. Tell me why. We agreed to adopt him in his perfect form. And after he was so badly burned, we still wanted him. We didn’t care how deformed or ugly he might be. He would still be our son. Why, Dr. Olen? Please tell me why.”
I wanted to shout, “Don’t you get it? It was hopeless! He was a lost cause! Can’t you rejoice that his suffering is finished? And don’t you know that you’ll see him again in heaven, with his brand-new, perfect, heavenly skin? I don’t know what God’s reasons are. The rules that govern the battle between good and evil are things that I don’t understand. Maybe God in fairness allows the devil a little more leeway than we would. And all we think to do is tell God that He isn’t fair.”
I wanted to shout, not so much at her as at the whole world, this world I’m attached to, this world that seems addicted to pain and suffering.
But I don’t shout out. I remember that God came to this earth in human flesh. I remember that one part of God watched as another part of God suffered. The one part of God could have intervened, but He was unwilling to risk all of humanity in order to save that other part, that God-man. God never gave up on a race that the rest of the universe deemed unworthy, hopeless, ugly, deformed.
So I don’t shout at Mrs. Benzaki. Instead I hug her. And together we cry under the mango trees.
*An intraosseous needle is injected through the bone’s hard cortex and into the soft marrow interior, which allows immediate access to the vascular system.
Olen Netteburg and his wife, Danae, are the physicians at Béré Hospital in Tchad, Africa. Their family includes two sons, Lyol and Zane. This article is adapted from their blog. To read more of their experiences, visit www.missionarydoctors.blogsport.com.