GIFT (a guest post by my dad)

 “Do these parents write about anything other than medical dramas?”

“Oh, just read it, Eleanor.”

December 18, 2021 Pretoria, South Africa

It is not yet 4 AM and I am wide awake at the cozy quirky Brooklyn Guest House in the dark in our room behind the Alice in Wonderland door with its thigh high key hole, on the second floor landing with thigh high painting a foot by foot square and mirrors facing mirrors across the chandelier dangling beaded lines of pink plastic jewels.

Being here was not in the cards even three. Now, Drew and I are medical tourists in Pretoria, South Africa at the height of its omicron variant fueled COVID-19 wave. At 6AM, we’re scheduled to report to Mediclinic Medforum Hospital for Drew’s surgery for what has (finally) been properly diagnosed as ethmoidal sinusitis with an abscess that has swollen his left eye nearly shut. Over the past three weeks, it has gotten more and more purple and puffy with a firm mass just below the surface radiating the heat of a growing infection. To the touch, it feels like one of those large marbles, just below the surface of his skin.

Across the room in a nook with the smaller of the two beds in our room, Drew is out cold, his breathing calm and steady. I get up to check on him and in the moonlight see he’s on his back, with one knee up in the air and the ankle of his other leg resting on his knee, like he is thinking a thoughtful thought or listening close to a tale.

But as for me - I can’t sleep any more.

Google isn’t helping - at least not to calm me down. As I scroll in the dark on my phone, I learn more about his condition, about the procedure, about the risks of surgery so close to his ocular nerve and brain, and I learn what I can about his surgeons. Who are these two South African Afrikaans-speaking men? 

Can I trust them with our precious boy? 

Or do I trust that the churning feeling in my gut is a sign that what I should really do right now is overcome the pull of momentum, of train-has-left-the-station plan going into effect, and (the hardest part for me)  the pull of wanting to trust and defer to the counsel of highly trained, highly experienced, competent and confident professionals. 

But what if I don’t share their confidence? Should I pull the plug? Should I scramble the jets even now and orchestrate a different and somehow better plan, a different location, and a new team who would vanquish all my doubts?

Is that what a good dad would do? Is that what Ashley would do if she were here instead of me?

What if I don’t and then it all goes sideways?

Over the previous three weeks, we’d gotten advice and counter advice from a gathering horde of nurses and doctors local and global. Some we have always and will always trust, and it is by their counsel we have made our way here. Others left us scratching our heads, anxiety mounting, as Drew’s condition kept getting worse and wose. The diagnosis kept changing. It was a blocked tear duct that just needed over-the-counter eye drops and a warm compress. It was an allergic reaction to COVID masks that needed more frequent changing, and he needed different drops and an ointment, and don’t worry it will clear up in two days. It was an infection and blockage of his lacrimal glands, needing oral antibiotics and more drops and keep up with the compress. It was none of these things. And none of the remedies was working.

Finally, four days ago, Ashley took Drew in to one of Lusaka’s best private hospitals for an MRI. It was not easy for a ten year old to hold so still for so long in such a tight space. The technician was kind, but grew increasingly frustrated, as Drew grew increasingly hot, sweaty, dizzy, squirmy, overwhelmed and scared. In the end, Ashley joined his side and talked him through the final push. When it was finally over, it had taken over two hours and Drew was in tears.

The next day, after the radiologist reviewed the images the hospital doctor delivered a diagnosis of an abscess that needed to be drained - a “minor surgery” he called it, requiring general because he was so young, and because it would be painful.

OK, we said, and sat with that for an hour or two, until it became obvious to us both that we needed to pause and ask around before signing Drew up for surgery.

One of our first asks was to a doctor friend and fellow parent, who had spent a decade practicing medicine in Zambia, and was now home in the States. “No. No. No!” he said, “Absolutely not in Lusaka. You need to get Drew to South Africa.”

None of our most trusted people disputed that counsel. No one said, “He’ll be fine. It’s nothing complicated. It’s only his eye. And doesn’t he have two?” 

So we shifted gears and scrambled the jets. We collected recommendations, scoured websites, figured out how to make international calls on Google Voice, and made one after another. 4:30 PM on an afternoon before a Holiday, we kept getting vacation messages. Place after place was shutting down for the “Festive Season” wishing us well and sharing their reopening date a month from now. One of the messages included a doctor’s name and “in case of emergencies” number. I called it, and the line seemed to connect - I could see the seconds counting up on Google Voice. But I couldn’t hear anything. I tried the number again and it didn’t go through at all. And then again, and it was the same thing. After more dead ends with other closed or fully booked eye care places, I typed the in-case-of-emergencies doctor’s number into WhatsApp and, when the little green check mark appeared confirming she was on the platform, I typed a desperate note to her. 10 minutes later she wrote back asking for a picture of Drew’s eye. I sent one from that morning. She called me right back via WhatsApp full of questions about Drew’s condition, how it was evolving, and what medications he’d been on. Within an hour she wrote to say that she had lined up a surgeon ready to see Drew and operate, if need be, as soon as the day after next. Could we get there tomorrow? I started a WhatsApp group chat for me and this doctor and the surgeon.

Meanwhile, Ashley had gotten through by email then phone to a pediatric eye specialist who was heading off on vacation but kept answering emails, and Ashley caught her by phone. She knew of an eye doctor in Pretoria, who was 1) wonderful and 2) available. Ashley managed to speak to him, to share the MRI report and image files, and talk through Drew’s history. His competence and caring were so clear. So was his kindness. He offered to pick Drew and I up at the airport if we weren’t comfortable navigating our way to Pretoria from the airport. 

How to choose which of these was the right one? We submitted ourselves to the counsel of the vacationing pediatric eye specialist, who kept returning all of our emails. We told her about the two possible directions. Pretoria, she said. And that’s what we decided to do.

The medical tourists almost wheels up. 

Then there were COVID tests and plane tickets purchased for tomorrow, and a return to the Lusaka hospital to collect a travel certificate with the Zambian Ministry of Health seal and stamp on our negative results, and the DVD of Drew’s MRI. I also wanted to pass a message to Drew’s doctor there, to do him the courtesy of letting him know Drew would not be coming in for surgery, that we were going to South Africa. But the ophthalmology floor was empty of patients and the receptionist ushered me in to his office, where whatever words I used, no matter how much I wanted to convey respect and generosity and kindness, I knew the subtext was clear. “We don’t trust you,” I said without saying. “We don’t think that you or your hospital or the quality of care available in this entire country are good enough for our child.” 

Setting off for surgery before 6AM from the Brooklyn Guest House

Standing there and saying that and squirming in the disrespect and privilege and entitlement of it, I recalled advice from my boss at home about making people happy - it’s not the point. You can’t always do it. And you can’t let it sway you from the course you believe is the right one.

This doctor in front of me was not happy at all. “You’re getting advice from all these different doctors,” he said, “And you are second-guessing every one of them. You need to listen to one and only one and allow them to see their course of treatment through.”

“It’s true,” I said.

“And what was that about last night?” he asked, “I got a call. It woke me up after 11 o’clock.” 

That call came because we were already going gangbusters against his advice. He’d said to stop giving Drew his antibiotics. But then our doctors from home and from South Africa team all agreed that was nuts, and that Drew needed to be on (different) antibiotics to manage his obvious infection. So, Ashley and Drew set off on a late night odyssey from hospital to hospital to 24-hour pharmacy, trying to get a drip, then pills, which the pharmacist wouldn’t provide them without a doctor’s prescription.

“Uhh, that was…” I started to explain, when my phone rang. It was Ashley.

“I’m sorry, I need to take this,” I said. “I need to go.” And I did.

The next day, Drew and I boarded a plane for Johannesburg. We Ubered our way to Pretoria and the Brooklyn Guest House. The next morning, we walked around the corner for Drew to see his eye doctor, who then drove us downtown to see a highly experienced Ear Nose & Throat surgeon he’d recruited to join him in the operating room (the “theatre” they call it here). Evaluating Drew and reviewing the MRI images from the disc I’d carried with us, our new team confirmed that Drew not only had a mass below his eye that needed to be drained, but infection in his ethmoidal sinuses that was the source of all his troubles, now presenting as orbital cellulitis. If the sinuses were left unaddressed, the swelling would almost certainly reoccur. Surgery on the mass alone would have been for naught, and it would have cost us valuable time as the infection spread and spread.

“What surprises could there be?” I asked in the car with the eye doctor as he drove us back to the Brooklyn Guest House, after our ENT visit and pre-admission visit to the Mediclinic Medforum Hospital (which looked modern and clean and professional and so new there were circular saws screaming as construction continued around the corner from where I completed form after form after form). 

“What could you find when you’re in there that you couldn’t see on the MRI? What could go wrong?” I asked. “And how confident are you in this ENT?”

“This is one of the most common surgeries,” he said. “And the only surprise will be how much of that mass is pus or blood and solid matter. You have no reason to worry. Drew will do very well.”

But now, at 4 AM, two hours before we are meant to report at the hospital, my reasons to worry are mounting. The ENT is very experienced, yes. But to be completely honest and agist, is he too experienced? If he were a decade younger, it would be easier to trust him.

And why did he have to mention going in for carpal tunnel surgery in three days? “It’s not my working hand,” he assured me when I asked what impact that would have on his work on Drew. “None,” he said.

And, then there are those two and only two Google reviews - a 5-star rating that called him the “Best ENT ever.” And a 1-star rating and complaints about a nose job that didn’t meet someone’s expectations.

Is that even relevant? Is that the red flag that should spur me into action?

At 4:03 AM, I wrote a WhatsApp message to the other South African ENT - the one we’d taken a pass on going with, the one who would be the lead if I scrambled the jets right now. I told him the diagnosis, the plan, and who was on the team.

He wrote me back right away. “No need to worry,” he said and extended his prayers to me and my family.

“I am getting medical and spiritual support from all over the world,” Drew had said over dinner last night at a restaurant called Peaches, with his rain jacket on with the hood up and under his Africa hat throughout our last supper (no food or drink allowed after midnight) against the surprising cold of the evening. 

And I know that, at this very moment, we are held in the thoughts and prayers of so many, and that prayer might be the only thing, right now, to settle my swirling, troubled mind and spirit.

I set my phone down. I swing my legs over the side of the bed and set my bare feet on the floor. I close my eyes and breathe deep.

And in that silence I am set upon by a single world, like a shout, like a message in ALL CAPS and 14 point font and blue.

The word is: GIFT.

And I am utterly undone by it.

What a gift he is. 

Every single day that he is.

A total and complete gift. 

No matter what today or tomorrow holds, he is a gift beyond measure.

Drew was less nervous than I was before they rolled him into the Theatre

A gift undeserved.

At 5AM, I woke Drew up. At 6 we were at the hospital. At 8, he was in his little blue hospital gown, lying in his hospital bed, squeezing my hand.

“I love you, buddy,” I said, as they wheeled him away and into the theatre.

“I can relate,” he said, in his distinctive Drew way.

And then he was out of sight. And I was alone in the empty waiting area. And it all went on for so much longer than I had understood it was supposed to take - my mind aswirl with all the things that could go wrong, leaving precious Drew forever changed, or even gone.

When the surgical team finally emerged, all smiles and good news and reports about “What a champ he was,” I was a mess.

“In five minutes,” they said, “They’ll wheel him out and you can join him to the pediatric ward.”

As five minutes became ten, became an hour, became two, my mind got to swirling again. Something had gone wrong. It had all gone sideways.

But no - they had just forgotten about me. And then, when they remembered and were trying to track me down, my Zambian phone couldn’t receive their South African calls or the SMS text message I needed to link up to the hospital WiFi.

So, I wasn’t there as I’d promised I would be and wanted so much to be, when we woke up from the anesthesia. 

He did it!

But I got there eventually. And after a long and boring day and night in our hospital room with a view of Pretoria’s green and rolling hills, and with a TV suspended from the ceiling that could not be turned off or covered, or the volume turned on, or the channels changed (it was 24-7 Nickelodeon - Spongebob and Smurfs and teen superheroes), and a lunch, dinner, and breakfast on white sectioned trays, our ENT stopped by and gave Drew the green light to be discharged. The next morning, there was a post op visit and green light to fly home.

Then it all became a glorious, joyful father-and-son adventure. “Maya is going to be so jealous,” Drew kept saying, at each new and unexpected turn - like finding a bowling alley, minigolf course, video arcade, and Krispy Kreme Donuts at the nearby Menlyn Mall, or the high ropes course and zipline just out of town.

Drew on the high wire

What a time it was. What a gift to savor and celebrate and share each and every moment with our precious son, Drew.

As Master Oogway, the wise and kind and unhurried old turtle from Kung Fu Panda says to his young and floundering, despairing charge,

Yesterday is history.

Tomorrow is a mystery.

But today is a gift.

That’s why they call it, “the present.”

This Christmas, it is the best present of all.