6: Lip Service

6: Lip Service

From Chicken Soup for the Soul: Inspiration for Nurses

Lip Service

Dear children, let us not love with words or speech, but with actions and in truth.

~1 John 3:18

She walked into the exam room holding her mother’s hand tightly. Compared to the dozens of other children we had triaged that sweltering tropical morning at the South American mission hospital, she was quite overdressed. Instead of the expected T-shirt and shorts, she wore a frilly pink dress. Instead of flip-flops, she wore Mary Janes on that wet cement floor that reeked of bleach. A shock of springy curls bounced off her shoulders when she plopped down on a chair before us. Even though she covered her mouth with a rag, the sparkle in her mischievous brown eyes told of a hidden smile.

“Well, hello! What is your name?” Dr. G asked.

I translated the question.

In a voice muffled by the fabric she said, “Maria.” Her nasal twang was distinctive of an uncorrected cleft defect.

Dr. G asked, “May I examine you, Maria?” He pulled a penlight from his lab coat pocket. I handed him a tongue depressor.

Maria shuffled around on her chair. “My mom says if you fix me I can go to school.” With the rag still firmly pressed over her mouth she asked, “It’s true?”

The mother searched our faces, her eyes filled with hope. We could hear the desperation in her voice when she asked, “Can you help my girl?” With trembling hands she smoothed Maria’s hair. “All she wants is to go to school… to play like other children.” Lowering her voice she continued, “Children are afraid of her. Some call her very bad names.”

A fan hummed next to an open window, pushing the humid air around. Fragments of conversations, children’s laughter, and infant’s cries drifted inside the room. Outside, parents waited in line for hours hoping their children would be selected for surgery.

“Well, let’s have the doctor take a look then, okay?” Gently I moved the rag away from the girl’s face. The severe cleft defect split from her upper lip through the base of her nose. Since birth the child had never had treatments. However we had seen many other patients with even worse defects. Some had deformities that included the gum line, whether unilateral or bilateral, and their teeth grew in grotesque angles from protruding gums. Others had palate defects only, and many had a combination of unilateral or bilateral fissures including cleft palates.

Dr. G shone the light into the gaping hole in the girl’s face. “Palate’s intact. Fissure’s on the right.”

I noted Dr. G’s assessments on the surgery scheduling form.

Dr. G clicked off the penlight, winked at Maria and said, “We’ll see you in a couple of days then, young lady.”

Before I had a chance to finish translating Dr. G’s sentence, the mother embraced me, crying out, “Thank you, thank you!”

Clapping with excitement, Maria laughed. This made the gap between her upper-lip widen and lobes of pink tissue dangled at each side of her mouth. Instantly she covered it with the rag.

We continued to see patients throughout the day, from infants and toddlers to school aged children, to teenagers and young adults, and even a fifty-six-year-old woman. There were multiple types and severity levels of maxillofacial deformities. And it was with careful consideration that Dr. G, the anesthesia provider, and the local medical team made the difficult decisions about which patients would be selected for surgery and which would be turned away.

Thirty-one patients were selected and scheduled for surgery. Maria and her mother arrived almost an hour early on the day of her operation. It was my teenage daughter’s first mission trip. Since her job was to distribute toys and play with the children, she and Maria soon became friends, coloring pictures and playing with the other children in the pre-operative area.

When the time came to wheel Maria’s stretcher toward the OR, she waved a groggy goodbye to her inconsolable mother, all the while keeping the rag over her lips.

We lifted the child onto the OR table. The anesthetist gently removed the rag from her face and placed the oxygen mask over her mouth and nose. Her long eyelashes fluttered as medication was administered through her IV. Her skin was prepped, and sterile green towels were placed around her head and face. Disposable drapes covered her tiny frame. Dr. G adjusted the overhead lights and began the operation, then finally connected both sides of the lip like two perfectly aligned puzzle pieces.

When Maria was wheeled into the recovery room, her mother rushed to meet us. With both hands covering her face she sobbed. “My girl, Maria. You are beautiful!”

Maria was still sedated, but awake enough when I placed a hand-held mirror before her face. “Look, Maria. What do you think?”

With glassy eyes she took the mirror from my hand. For several seconds she stared at her image. Suddenly, with a gasp, she said, “I can go to school now.”

Many days later, on the last day of the mission trip, exhausted but elated, we packed our equipment and supplies. All we wanted was some food, a shower, and rest before our eight-hour-plus flight home the following day. But instead we were invited by one of the nurses to visit her church service. We politely attempted to beg off, but she refused to accept any of our excuses. Sweaty and hungry, we reluctantly put on our lab coats over our scrubs, and followed her to a waiting van.

The church was packed when we arrived, but there was a reserved pew in front for the medical team. To our surprise the service had been planned by the community to thank us.

The pastor prayed over our team, and then came the altar call. We bowed our heads to a familiar hymn sung in the congregation’s native tongue. A large crowd gathered at the altar. Suddenly from within the group, a blur of pink satin and bouncing curls rushed toward us. I pulled at Dr. G’s sleeve, and he opened his eyes. Maria stood before him with arms wide open, her perfect smile marred only by a blue suture line. Overcome with emotion, Dr. G swooped up the child in his arms. This moment brought the entire trip into perspective for all of us.

Our mission was to bless the underprivileged with surgery, or so we thought.

But in reality God blessed us through the humbleness and faithfulness of that poor, but joyous, community.

Everything else was just lip service.

~Ivani Martucci Greppi

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