Life and Death Decisions

I love this ministry. It is the most challenging and demanding work that I have ever done, but I would not trade what I do now for anything that this world has to offer. If you could list every job in the world and offer me my pick I would still choose this life and this ministry.

Having said that, there are still days when I want to quit. I know…that sounds like a contradiction, doesn’t it? Maybe it is. But there are times when I feel like the decisions that are necessary to run a ministry like this are just too far above my head. Someone else could do it better. Someone else has more wisdom. Someone else should be the Director, and I should just go do the grunt work.

Never have I felt more over my head than when we face the life and death decisions of this ministry. And we are facing once such decision this week.

Little Emily is eighteen months old and has hydrocephalus. This condition results from excess cerebral fluid surrounding her brain which creates tremendous pressure, damaging her brain and causing her head to grow to an abnormally large size. Normally when a child is born with hydrocephalus they would have immediate surgery to install a cerebral shunt that would drain off excess fluid from the child’s cranium to their abdomen. In the US this would have been done regardless of the family’s economic situation, but here things are different. Emily’s mom is very poor and cannot afford a doctor or the surgery. So the pressure on her little brain continues to increase. Already she has experienced permanent brain damage that has greatly limited her development.

We entered her life a few weeks ago when we were down in Sipicate. We were contacted by the local health department and told that she and her mom needed emergency transportation from Sipicate to the free clinic in La Gomera (because they could not afford to pay for an ambulance). We had just wrapped up our work for the day, so we readily agreed to give them a ride.

As we traveled my heart broke for both this mother and her child. The mother was desperate to help her child and Emily was clearly suffering. When we arrived in La Gomera the doctor took one look at her and took her straight back to a room in front of the dozens who were awaiting treatment. In addition to the pressure on her brain she was also diagnosed as having an impacted bowel. The clinic arranged to transport her to the national hospital, and we left to head home.

Last week we received a call from her mother in which she told us that the national hospital examined Emily and then sent her away without treatment. She wanted to know if we could help. We contacted the health center in Sipicate and they arranged to send her to the national hospital in Guatemala City. That hospital is better than most other national hospitals, and I know the neurosurgeon that works there. He is an excellent doctor and surgeon. However, they will still need to pay for the surgery. And therein lies the rub.

What should we do? From past experiences I know that I could request money on this blog and the many wonderful readers such as you would respond. You have done it many times before, and I am confident that you would again. I have no doubt that within 24 hours we could raise the $3500 we would need, and she could have the surgery. But should I do that?

Every day we face a long line of medical needs, and often those needs are life and death in nature. As a small ministry with limited resources, we have to ask not only “Can we help?” but also “Should we help?” In other words, is this the best way to use our limited resources?

In Emily’s situation, she is already severely brain damaged. By paying for this surgery, we can extend her life indefinitely, but we cannot reverse the damage or significantly improve her quality of life. She is suffering. So, should we make her comfortable and allow Jesus to bring her perfect healing sooner rather than later? Or should we intervene with the surgery?

This is not a sanctity of life issue. Of course Emily’s life is sacred and valuable, and I would never say that it is not. Every life is valuable and precious from the womb to the tomb. But we are dealing with hard facts here which include the following:

• In Guatemala if you cannot afford the treatment you do not receive it, regardless of how critical that treatment might be.
• People die everyday due to their inability to pay for necessary treatment.
• With our limited resources we are, at times, forced to choose who we will allow to die and who we will save.
• A part of that decision-making process has to include the long-term quality of life for the person we save.
• No, I am not qualified to make these decisions.
• Yes, it does feel like we are playing God at times. (And I hate it.)

For those of you who would like to write and set me straight, I welcome the correction under the following condition: Offer me real solutions and not just clichés. If you think I am doing it wrong you are welcome to move here and run this ministry. I will do the grunt work and you can make these hard decisions. You probably will do a better job and I can be free of the emotional and spiritual turmoil.

I will also say this…now is not a good time to complain to me about the US health care system.

I beg for your prayers. We are facing numerous life and death decisions in our ministry right now. We understand that we cannot save them all. For some our role is to simply stand with families and love them as Jesus does while they say goodbye and mourn. For others, we must intervene with medical care. But always we need the wisdom of God to determine which role we should pray in each situation.

Thanks for allowing me to pour out my heart. Now, back to work…

Blessings from Guatemala!

Daryl, Wanda and the Crew