The young woman with “jumped facets” was placed in a “halo” with hopes that her cervical spine would be stable enough to allow healing over the next few months. However, as I read from my orthopedic textbooks, the recurrence of dislocation is approximately 50% even with a halo in place; and should that happen, the proper treatment is a spinal fusion. As a young, inexperienced surgeon with NO plans for spine surgery anywhere in the near future, my worst fears were confirmed on follow-up x-rays of her cervical spine. “Well, I’ve done all I can by putting her in a halo,” I thought to myself. “I’ll just have to refer her to a spine surgeon in Nairobi.” Thinking that I had devised a good, safe “out” (for myself), I ran my plan by Dr. Russ White, chief of surgery. “That’s fine,” he said, “but without money, no surgeon from Nairobi would ever agree to see her…you’ll just have to do the surgery yourself.” Easy words coming from a seasoned missionary general surgeon known to do everything (even some orthopedic spine surgery). “What are you doing tomorrow?” I asked calmly (on the outside) but with a certain amount of desperation (on the inside). Thankfully Russ was available in the afternoon.
In the US, prior to a surgical fusion for jumped facets, an MRI would be obtained (to evaluate for a herniated disc, which if present, could paralyze the patient). Additionally, spinal cord monitoring would be used during surgery to alert the surgeon of an impending spinal cord injury. Of course, neither are available in a rural Kenyan hospital. Surgery on patients with a spinal cord injury is usually less stressful (strangely comforting to a surgeon with the knowledge that neurologically, you cannot make the patient worse). However, our patient never had any neurological injury, and without a prior MRI or spinal cord monitoring, I kept praying during surgery, “God, let her remain that way.” Thankfully, the surgery went well, and despite our lack of technology, and my lack of experience, the patient awoke from anesthesia moving all four limbs and feeling every touch.
It is amazing how God desires to push us all beyond the edge of our abilities. When we get to the end of what we have to offer, to the end of our experience, our education, our means, our talents and gifts, to the very end of ourselves, the only thing that remains is God. Oddly, according to scripture, this is God’s design, so that Jesus Christ is glorified and His Kingdom is advanced. As John the Baptist replied to those taunting him that Jesus was drawing greater crowds and baptizing more people: "A man can receive only what is given him from heaven….He must become greater; I must become less.” And as Jesus replied to his disciples who were arguing amongst themselves as to who was the greatest: "If anyone wants to be first, he must be the very last, and the servant of all." Dependence on God, serving rather than being served, becoming nothing so that He can become everything, this is the paradoxical design for all our lives. May our eyes be opened this Christmas season to the inexpressible treasure of Jesus Christ and the true joy that can only be found when He is more, and we are less.
Child Life Specialists at Kibuye
5 days ago