My whole body aches. We've just come back from a horseback ride to the river. I rode Libby across to the island and than left her to munch grass while Matt, Daniel and I waded and swam to the far shore. Now I'm back home and feeling the fact that I haven't exercised in weeks. So I'm lying on a mat on the back porch staring at the tin roofing...and I'm missing Adam. I miss him snuggling up to me when he's really tired. I miss his gnawing my finger to comfort himself. I miss massaging his chest as his head wags back and forth as he fights sleep. I miss his cooing and clutching my fingers. I miss his snorts as he realizes lunch is about to be served. I miss hearing him attack Sarah's breast taking in more air than milk. I miss his drunken look as he emerges after a feeding and stares around dazed and happy. I miss his series of three crescendoing burps after eating. I miss watching him startle himself with an extra loud belch.
I miss his cries of frustration as he wants to crawl but can't just quite coordinate it all yet. I miss his pushing up on his back legs and flopping forward in a vain attempt to capture whatever object is before him. I miss his lunging onto Miriam in a playful brawl that she doesn't appreciate as well.
I miss him sitting and staring at Miriam while playing with her hand. I miss him looking across the mat, seeing his sister and smiling his dorky grin.
I miss that grin. The full open mouth with the tongue stuck straight out and the eyes bright. I miss his chortle as I tickle him. I miss him not knowing whether to laugh or cry as I try to entertain him when he's tired. I miss his staring into my face and rapidly extending both arms and legs and letting them drop on the floor as he looks to me for approval. I miss him doing something and looking my way and smiling shyly when he realizes I'm watching and cheering him on.
I miss his surprised look as his whole body tenses when the first water of his bucket bath hits his head. I miss him pretending to want his mashed sweet potatoes only to swirl them around in his mouth, mix them with his saliva and either let it drool out slowly or spit it out with a pleased look in his eye. I miss his fast moves to knock the spoon out of my hand or grab the bowl and smear sweet potatoes all over his face, hands and feet. I miss him grabbing his feet and putting his toes in his mouth so he can suck his big toe. I miss my dreams for him. I miss the fact I'll never know what his hair color will really be. Will it be curly or straight? Will his eyes change or stay blue? What will his first words be? Dada? Mama? I miss seeing him crawl, stand, walk, run, jump, play, sing, make up stories, shoot hoops, learn languages, travel in the vanagon, listen to tales from the Bible, learn to read himself...I miss all the things I planned to do with my firstborn son. I miss having him hang around the operating room. I miss having him tag along in clinic. I miss taking him to the river. I miss bringing him his first pony. I miss it all.
Yeah, I miss Adam a lot. In the words of a song I wrote when my twin brother, David, was killed in a car accident 10 years ago: "But I miss you, I want you back right now,...to hear you laugh out loud. My tears flow uncontrollably, so fast, I cannot even see. But still I know...I'll see you again. No matter how long that may be. I'll see you again. Though right now, it all seems a dream. The Lord and His promises are sure. He's faithful, our hope is secure. I'll see you again."
by James Appel on Tuesday, January 3, 2012 at 4:26pm
There is no meaning in it all, and yet my mind struggles to find some answers and explanations. Of course, they will all fail, but I must try anyway or drown in hopelessness. Maybe that's why I wake up so early and can't sleep. I'm searching for some consolation, for some meaning. My body is tense and needs release. But the tears are dried up...until they spring forth at some memory, for some reason. I lay Miriam to sleep last night. She's exhausted. She's had malaria for God's sake. She was swamped by visitors trying to console her parents. She was surrounded by sobbing and wailing and tears. She couldn't sleep in all that. So now we're in a familiar setting. Her crib and mosquito tent are unchanged. She has the quiet of her corner. So I lay her down to sleep, to rest in peace. She's unafraid. She knows I'll wake her up in the morning. She knows she's safe. She knows I'll be there. She drifts into silence. She knows nothing of what I'm suffering all through the night as I think of my little boy, pale and cold in that box surrounded by the damp, African soil.
He was on borrowed time. He shouldn't have even been born. Sarah and I have had unexplained infertility for years. Thanks to modern science, Adam came to us after sitting in a freezer for months. Then his little body developed in the womb of his mother. But the enemy was already at work. Through his wild movements we have come to know so well, he managed to wrap his umbilical cord into a true knot that if pulled tight would cut off his precious supply of oxygen coursing through his mother's blood, crossing the placenta and entering his body through those umbilical blood vessels.
Sarah went into active labor a month early. Then her labor stopped. If she had gone till term, in all Adam's wiggling and kicking he may have pulled that knot tight and been stillborn. Or if her labor had progressed, as he was squeezed out the birth canal, the knot may have tightened and killed him or given him brain damage. But God intervened and stopped Sarah's labor progression and Adam and Miriam were born by c-section, healthy, screaming and eyes wide open.
His life was a miracle, a gift. He was on borrowed time the whole six months of his precious life. "The Lord giveth and the Lord taketh away, blessed be the name of the Lord." (Job 1:21) Is God really so cruel if he's just a Father putting his child to sleep for the night only to wake him in the morning? "For his anger is but for a moment; his favor is for a life-time: weeping may tarry for the night, but joy cometh in the morning." (Psalms 30:5)
"Brothers, we do not want you to be ignorant about those who fall asleep, or to grieve like the rest of men who have no hope...for the Lord Himself will come down from heaven...and the dead...will rise first. After that, we who are still alive...will be caught up together with them..." (1 Thessalonians 4:13-17) Unfortunately, it's still night where I'm at...
I'm lying flat on my back on the veranda. Dusk has settled. The stars are not out in force yet, but the half moon and it's bright under star are straight over head. Among the dark tangled branches a few fruit bats flap silently across the clearing, temporarily blocking out the moon. Darkness settles in as I feel a gnawing in my gut and the need to release my anguish. But the tears won't come. My mind wanders to a million memories. It's only Monday but Friday already seems a lifetime ago.
I've already started to feel the waves of grief mixed with a calm peace that ebb and flow like the tides that Tchad has never seen. A few incidents stick out.
I'm in the tiny office off the waiting room with Sarah and Miriam. Miriam is half-way through her treatment. She has just finished an hour of cooing, flopping, half-crawling and wrapping herself in her IV tubing. Now, she's sleeping, her legs hanging off the edge of the mattress face down and slightly turned to the side away from the her left arm which is encased in tape, an armboard and an elastic wrap to keep that precious IV access going.
I hear the sounds of French with an Arabic accent outside.
"I just want to see James and give him my condolences."
"He's at the house," replies an unknown informant.
Through the broken slats and ragged curtain on the window I see a couple of Muslim hats on top of well-known faces as they turn to head in the wrong direction. I take the route through the waiting room and from the door yell out, catching the two men's attention.
"AS SALAAM ALEKUM!" The two muslims turn and smiles light up their faces as they give the traditional reply: "Wa alekum as salaam." One is a contractor who remodeled the Bere Hospital ER and built some staff housing. The other is the local imam.
The Imam is dressed in a light blue robe with embroidery on the chest. He has a white, flat topped hat on his head and a checkered middle eastern scarf around his neck. One eye is blind and almost shut and a scraggly white beard graces his chin as a smile crinkles up his lined face.
"This is the way of the world," the imam continues in Arabic after we have shook hands and exchanged the appropriate long greetings. "This is the way of the world. Only Allah knows why these things happen. Only He knows."
"Al hamdullilah," I reply.
"My heart hurts with your heart," the imam continues, first touching his chest and then moving his hand out pointing at my chest. "My heart grieves with your heart. Only Allah knows why. May Allah be praised."
"Mashallah," I intone my head down as I shake and hold the Muslim leader's outstretched hand.
"Where's Sarah?" the imam asks.
"Inside. Come." We walk back together as both men offer me more words of encouragement and condolences. Inside, I check and find Sarah is sleeping.
"Don't worry," says the imam with a smile. "Allah will give you more children. This is the world. There is loss. Allah gives and Allah takes away. Let's pray."
Both Muslims stand with their hands outstretched to receive Allah's blessings as the imam leads us in a prayer of praise and consecration. When he has finished we all bring our hands to our faces to accept the blessings from God.
That evening, my uncle, a Christian pastor calls me on the phone also offering his encouragement and condolences. He also ends with prayer. During the prayer I realize that this is a rare moment. I have been blessed by both Isaac and Ishmael. For an instant, around a tragedy, the two brothers have stopped fighting and helped the hurting. I am moved to tears, which is quite easy these days.
The next morning, Miriam's 3 days of IV Quinine are finished. She has no fever and is back to her normal self. We pack up the van in truly Tchadian style with baggage to the ceiling, three American volunteers, one Tchadian patient and his two family members (plus small child), one Tchadian nursing student, one Tchadian cook, our two Tchadian adopted daughters (Yahdang et Djongyahbo), Sarah, MIriam and I. Before getting in, the three of us make a final pilgrimage to the two graves under the red flowered tree.
Then we head out in an eery fog. The whole country seems to be mourning with us as a white haze drifts in and out of the dried grasses, half burned fields and cracked clay. Passing a lake, some massive rounded backs rise out of the mist, nostrils flaring as a herd of cattle is driven by. The chill lasts until we are safely back in Moundou wondering what do we do now?
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.
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 David Bindesboll Appel, June 25-December 31, 2011