ADAM

The moon has gone down. I walk in the dark with only the stars and the promises
of yore to light my way. I make my way past the silent benches that all day
held crowds singing in French and Nangjere as the drums pounded out their
mournful beat. My body is as limp as the pillow I carry. Every last tear has
been wrung from my eyes. I make my quiet pilgrimage to the site of my greatest
sorrow. I enter the room that holds so many memories. As I open the rickety
lock I remember locking that same door from inside as I cared for two little
African babies struggling for their lives while outside men fought to end each
others. The faint odor of bat guano greets my nostrils and makes me think of
the time the winged mammal hit the fan and landed on the face of the baby
fighting for breathe in the clutches of an asthma attack. I shine my light on
the IV slowly dripping into the arm of my sweet little daughter, Miriam, as she
tosses and turns in a fitful slumber. Sarah lies by her side in the mosquito
net softly comforting her one remaining child. It seems like an eternity
already since the morning when two babies wiggled and squirmed and flipped and
grinned and giggled and squealed together in that same tent.

Sarah woke me up less than 24 hours ago. "The twins are really active and I'm
having a hard time. Can you come over?" I arrived to see Adam staring at me
with a silly grin right before flipping off the mattress between it and the net
and letting off a howl of frustration.

"You should have seen them. They both woke up, looked across the mat, grinned
and tried desperately to crawl to each other," said Sarah.

We'd arrived in Bere the day before. Thursday night, Adam had a fever of 104.
We were in N'Djamena and I bought a rapid malaria test. It was negative. I
wasn't convinced. I opened a capsule of Artemesia, poured it on his mashed
sweet potatoes and fed him despite his obvious preference for medicine-less
food. The next morning, I fed him another dose and we loaded up the scalded dog
and were on our way to Bere by 6:30am. By 2:30pm, both Adam and Miriam had been
diagnosed with Falciparum malaria and started on IV Quinine. Through the night,
they each got two of the every 8 hour doses.

I start Miriam's next IV perfusion and turn to Adam. I let 150 mL of 10%
glucose solution run from the IV bottle into the pediatric reservoir on his IV
tubing. The tubing has special air traps to avoid any accidental entry of air
into Adam's veins. I pull out 0.5mL to flush his IV and then carefully measur
90mg (0.3mL) of quinine and inject it into the top of the reservoir of 150mL. I
open up the IV, see that it was running well and slow it down to a drip.

I turn to look at Miriam and talk to Sarah.

"Is that a seizure?" Sarah interrupts our conversation and we turn to look at
Adam. He's not breathing. We start CPR. I run and get some 50% glucose
solution, afraid of low blood sugar. I text Olen who is there in minutes.
Still no breathing. Olen confirms a heartbeat, slow and irregular, but there.
Olen gets a bag valve mask and starts breathing for him while I do chest
compressions and Sarah continues to give glucose. Anatole arrives and checks
the blood sugar. It's high from all the glucose we've been giving him. We try
Adrenaline in ever increasing doses. His heartbeat never picks up. Every once
in a while he grimaces, groans, struggles for a couple breathes, giving us hope.
We work on him for over an hour. His heartbeat disappears. His pupils are
fixed and dilated. I'm praying desperately for a miracle. We stop.

Deja vu.

How many years ago did the same thing happen to my friend Gary and his little
boy Caleb?

It's 8:00 am and my life has suddenly changed for the worse. Sarah and I hold
Adam's still warm body. I desperately kiss his neck, my tears know no bounds.
My cries echo across the campus to join the thousands of others I've heard over
the years in this corner of Africa. Will I never again see his tongue half
hanging out of his silly grin? Will he never again wrap his legs around my
arms, brining my fingers to his mouth as he softly coos? Will he never again
thrash his arms in legs while staring at me with a look of pride and joy? Will
he never again take up the airplane position looking around for confirmation of
his abilities? Not in this life.

A day long ritual of African mourning begins as the news spreads like wildfire
through the village. People come to offer their condolences. Miriam becomes
agitated with all the visitors. I wrap Adam's body in my green and black
checked Arabic head scarf and carry him over to the house where friends have
arranged to let the mourners come in and visit. All day long the songs sung in
rhythmic Nangjere drift in as people make their way to where I am sitting on a
thin Nigerian mattress. So many people, so much collective pain and loss.
Salomon comes in and hugs me. A flood of tears bursts forth as I remember him
holding Adam so many times as we ate together in Moundou, enjoying one of his
famous sauces. Frederic kneels down and holds my hand long and hard in an
undulating shake of sympathy. Just last year I was at his house as he held his
son who had just died. The mother of the boy across the street who fell down a
well and died crouches and holds my hand as we share tears of sorrow and she
offers words of comfort and hope.

The steady stream of people brings me a steady stream of tears as I shake and
hold the black calloused hands of so many people who's lives have been filled
with loss. The strength of the grip and the power of the muscular arms of both
men and women combined with their roughened feet tell a thousand tales of woe.
Their is no awkwardness. They've done this before a thousand times. Tears come
from faces I've never seen before. But we now have a common bond of tragedy.
The only ones who seem uncomfortable are some of the westerners, but their warm
embraces make up for the lack of familiarity with death.

Gary and Wendy fly in from Zakouma just in time for the English portion of the
day long wake. Hymns of hope sung gently and powerfully by the many musicians
in our group of Nasaras warm my soul as Sarah holds Adam's now cold and
stiffening body.

"When the trumpet of the Lord shall sound and time shall be no more...when the
roll is called up yonder I'll be there." The rollicking song brings bursts of
tears from Gary, Wendy, Sarah and I as we remember Caleb's favorite song and the
other little foreigner buried in Bere what seems like ages ago. Now it's time
for last good byes. Sarah and I bring Adam's long little body into the house
and place it gently in the casket made by Jamie just this morning. I kiss his
cold brow one last time and we put on the lid.

The pathfinders are outside to carry the body to the grave site. Under a little
tree in front of our old house in Bere lies a volcanic stone with a little
plaque that says "Dinah Bindesboll Appel". Next to it is a deep, rectangular
hole waiting for our second child to return to the African dust. Noel gives a
stirring eulogy reminding us of the day when God will say "Viens" to both death
and the devil and both will be done away with forever. Then God will turn to
Sarah and James and say, "Here's Adam." And to Gary and Wendy, "Here's Caleb."
And the innocents will be restored to their rightful place.

But for now, we miss him terribly...

RIP Adam, June 25-December 31, 2011

MERRY CHRISTMAS

"For unto us a child is born, unto us a son is given:
and the government shall be upon his shoulder:
and his name shall be called Wonderful, Counselor,
The mighty God, The everlasting Father,
he Prince of Peace."

Isaiah 9:6

6 PAC

I always love when the Christmas season arrives each year. The lights, the beautiful decorations, the yummy smells, greetings from friends far and near and getting together with family just warms my heart. I have barely started my shopping but had better finish quickly because most of the gifts have to be mailed this year.

Tonight I should be working on figuring out just what I will get everyone but instead I am considering joining the 6 Piece Winter Collection that runs from November through January. Kinda crazy to start at this late date, but so fun to plan.

The requirements for this sew are as follows:

Winter coat - neutral
Overlayer top, jacket, cardigan - neutral
Overlayer top, jacket, cardigan - color
Underlayer top - neutral
Underlayer top - color
Trousers - neutral

Seems pretty doable so I looked until I found patterns I thought would work for each category.



The only pattern that I have made before is the top right jean jacket. I had to spend some time getting it to fit and although not perfect I made it out of a cotton stretch material that I just love. I will tweak it a little and make it out of a white corduroy that should go with quite a number of garments.

My closet is filled with lots of black and white so to change things up a bit I thought I would have my main neutral be navy. The only down side for me was figuring out what color of shoes I would need to wear with navy. The last time I was shoe shopping I did not see any navy shoes so having a navy wardrobe didn't seem like a really smart idea.

So I did some research on the internet to see if there was another acceptable color to wear if you didn't have navy shoes because I was taught that black was never worn with navy. To my surprise the dress code in 2011 allows for black shoes to be worn with navy as are brown and cordovan .

I think I'm going to like this.

Cabazon

There's nothing like a trip to Cabazon Outlets to get a person thinking about sewing again. My daughter and I decided to meet at the outlets and see what fun clothes were waiting for us. Oh, my, what a disappointment! Things are bad when you would rather look at the purses and shoes that anything that was folded on a table or hanging on a hanger.

Is it my imagination or are stores carrying less merchandise that they used to? Ann Taylor had a small selection, Liz Claiborne - closed, Ralph Lauren - a darling white blouse with bias ruffles and our favorite - Tahari. Of all of the stores and merchandise we looked at, the dresses and jackets at Tahari were to die for. The workmanship and details on each of the pieces were beautiful making the garment look stunning on us regular people. But other than that stop the trip was a bust.

It may be next week before I get around to it, but it looks like I will be looking through my skirt patterns and coming up with a few possibilities so I can eventually find one to be my TNT.

The shopping trip might not have been such a bad thing after all!

No Sewing

What was to be at the longest just a month stay in Tennessee to work on our store has turned out to be four months and counting. In this present economical climate that is so unsure we weren't quite sure what to do to make our store competitive so we turned everything upside down and have redone about everything...starting with painting every piece of wood furniture, then remodeling the furniture to serve other functions and adding beadboard to the backs of all of the wood shelving. We had to use oil based paint so that the paint wouldn't chip but the smell just about knocked me out. As bad as it was to complete this project while we still had the store open and were doing business I am thrilled that we did it. It looks clean and neat and it's a pleasure to go to work now. Monday we add deli items and until we can hire a good cook I will be spending my day doing the menu and cooking.

So......no sewing.....yet! Well, almost none - I brought my coverstitch maching and was able to get it to work sewing binding on an apron. It was so much fun and I can hardly wait to have more time to spend playing with it.

I found this video and video two on you tube that showed a method of making bias binding that I had never seen before. I tried it and was really pleased with how it turned out and how much I was able to get from a yard of fabric.

The good thing about being here in Tennessee is that I am getting to spend lots of time after work with the grandchildren so I can't complain at all.

Poop

From James:

Silently the man slips stealthily through the shadows of a dark Chadian night. The Bere Adventist Hospital has become his temporary domain. His child is hospitalized for severe malaria and a blood transfusion is slowly dripping life back into his fever wracked body. The man has sinister motives. He really needs to go.

The hospital has had trouble for years with patients relieving themselves in piles on the ground in the tradition of the African bush. Despite the availability of latrines, the smell and foreignness of the cement structures is revolting to someone used to the pleasant peacefulness of natural surroundings and soft grass or sand. In the 90's a resourceful night watchman named Jairus made successful war on the perpetrators by taking the pile in a rubber gloved hand and moving from bed to bed wiping some of the stool on each bed until someone confessed or turned in the guilty party who then had to go out and bury the leftover turds.

The problem only got worse with the building of a fence around the hospital in 2004.

Now, this evening, maybe the tide will turn as our unknown man makes his way quietly past the operating theater to the outside water faucet. Taking a comfortable position squatting flexing and stretching his thigh muscles the man pulls down his pants and stretches out his hands to get a firm grip on the metal water pipe coming out of the cement slab he has chosen as his receptacle. Suffering from a common Chadian ailment, his knuckles turn white as he strains to force out the poop hardened in his dehydrated and constipated colon. A sigh of relief accompanies the success of his mission until a bright light suddenly blinds him and a harsh cry of "Ca c'est quoi?!!" brings to an end his devious deed.

Literally caught with his pants down the man hurriedly tries to cover his naked manhood as Jean-Jacques, our vigilant gatekeeper hauls him roughly to his feet. It's a little after midnight but our new administrator, Augustin, comes immediately from home.

Punishment is swift. The gendarmes are called. The man is forced to pick up his ca-ca and stuff it in his pocket before being escorted off to prison. He was last seen weeding the flower garden in front of the jail.

Moonlight

Life has been hectic and there has not been any time to sew - haven't even really been able to try out my coverstitch machine! Two weeks of showing my dad and his wife the sights of SoCal and then hopefully I will be back producing something to wear!



From James:

I could never have imagined that things would turn out they did.

As I stare out into the moonlight filtering through the flamboyant tree branches casting shifting shadows with every breath of wind, as I hear the soft shuffle and breathing of our sweat-flecked horses outside the stable, as I draw my gaze back to the pile of pineapple carvings in front of the cutting board and bring the ice-cold pineapple to my mouth and slowly savor crunching into the juicy morsel, as I think back over the past few days I find it incredible to think of how this afternoon ended...I can only call it an unexpected grace, a surprising joy, a metaphysical moment when all things good come together out of the midst of all things wrong.

As I gallop through the forest, grasping Pepper's mane as fiercely as I hold to the reins; as I stand up in the stirrups and hug my body to the horse's powerful neck; as the leaves slap my face and a branch rips through the skin of my shoulder; as the full moon lights up the sandy trail like a river of silver stretching lazily out before me through the dark shadows of the trees; as my sweat soaked shirt clings to my back; as I am surrounded by the silence of an African evening in the bush I find myself carried way beyond the horrors, sorrows and sufferings of the last few days.

I can hardly remember the strong features of the handsome Arab man staring steadfastly upward with a look of incomprehensible peace as he is lugged up the ramp to the operating room in a vinyl stretcher with wooden handles held firmly in the grips of a dozen turbaned comrades his mangled body wrapped in a blood soaked turban in stark contrast to the serenity of his gaze. I almost forget the hours of working on his bilateral open fibula and tibia fractures uncovered on his right by a flap of skin running from his heel and achilles tendon up his calf and across the top of his foot revealing the anatomy of the muscles, tendons, ligaments and bones as I can only barely remember from Anatomy lab in medical school. The almost can't bring up the vague memory of him calmly complaining of neck pain since he can't move or feel the rest of his body is a silent grace to him allowing us to work on his tattered limbs without anesthesia after framing his chiseled face in a cervical collar. I thought I'd never survive the emotional roller coaster of the myriads of swishing robed, turbaned men and brightly wrapped head scarved women that filed incessantly in and out, many of the men leaving with tears unashamedly rolling down their cheeks as I had to console them to leave all in Allah's hands as only He can know the day of our death and we should trust Him. The memories flood in of fighting my way through crowds and over colorful mats and rugs to try and do his complicated dressings after spending what seemed like ages of emotional energy trying to get the swarming family and friends to respect visiting hours and hospital policies. When his paralysis didn't get better after three days I was almost relieved when the nurse came to get me yesterday morning to say "Ca ne va pas" and I arrived in time to see his unconscious, but still dignified face take it's last shallow breaths and feel his heart beat in his neck slow down and become weak. He was bound for a long road of suffering in this environment as a quadriplegic and it was certainly God's mercy that laid him to sleep.

As I stand on the bank of the river, looking down on the swirling eddies of the brown, engorged river; as I see the sun slowly set behind the great branching trees of the African plain; as I turn around and see the full moon rising through a circle made by two rounded trees and a small hill; as I watch the slow transformation of the day into moonlit night; as I feel the wet of the river slowly drying on my body; as I watch Stefan desperately trying to capture the moment on film; as Eddie slowly makes his way upstream against the current; as I pull on my jeans over my moist swimming suit and prepare for the ride home; as untangle Pepper from the bush I've tied him to I am amazed at how quickly depression and overwhelming burnout can be replaced by wonder and marvel and ecstasy.

Can it be that only this morning I found myself deep in a belly under the ribs carefully cauterizing a gallstone filled gallbladder from the liver of an elderly, lighter-skinned Muslim man? Is it possible that yesterday I was about to throw up and finally gave in and started taking malaria treatment only to go out immediately and take out an ovarian tumor stuck to all the intestines, omentum and uterus? Is it possible that only two days ago I didn't think I'd make it through the morning much less the weak because of fatigue I refused to believe was another bout of Plasmodium falciparum destroying my blood cells? Is it possible that only three days ago the hospital was full to overflowing while we spent all of a Sunday afternoon filling it up with sick babies needing blood transfusions and malaria treatment? Is it possible that only four days ago I spent all Saturday in the OR with two motorcycle accidents needing emergent orthopedic intervention? Is it possible considering how things later turned out?

I come back from work almost collapsing. It's been another day of neverending hospital rounds, complicated surgeries, ER patients, ultrasounds all pleasantly muffled with the ringing of Quinine in my ears. I feel a little nauseated and drink some cold water. I sit down and finish reading "Flying Doctor of the Philippines". I just want to sleep, but decide I better go out and feed the horses to keep my wife happy. The next thing I know I'm in the saddle trotting past the mud huts of Bere, around the pond, through the forest and onto the river road mounted on Pepper while Stefan rides Bob and Eddie rides Libby. Out into the open Stefan and Eddie cluck their horses into a gallop. I can feel Pepper tensing beneath me and I give him the releasing cry and squeeze and he quickly closes the gap and passes the others through a mud puddle as Bob goes left and Libby goes right around it. We're in the open now and I slow down. We arrive quickly at the river ride down the ridges gauged out by the rain leading to the cattle crossing and then climb up the hill next to it. A quick assessment confirms the possibilities and Eddie and I strip down and race off the cliff arms and legs flailing wildly before crashing into the swift moving current below. It's not enough for Eddie, so we find ourselves pulling our reluctant bodies up the bank using exposed tree roots before climbing up the tree as high as possible with still a path clear of branches to the rushing waters below. I crouch on two diverging limbs my hands in front as I propel myself through the gap, past the other branches below and into the welcoming arms of the cool, refreshing liquid beneath. I'm glad there are no crocs and lions in this part of Africa.

As Eddie and I climb up the bank for the last time after multiple jumps from different levels, Stefan's face is glowing. It's hard to believe just last night he was talking about maybe wanting to leave. Now all he says is, "the only thing that could make this better would be a little ice cream."

Later as I walk through the cool of the moonlit evening from my house to his carrying the plate of chilled fruit I think to myself, "well, cold pineapple could arguably be as good or better..."

Then the clapping comes again...it's Salomon...

"There's an old man peeing blood since this morning..."

And I'm off to the hospital as the moonlight leads the way.