Last Friday our community gathered together for morning prayer and worship. We spent most of our meeting praying on behalf of baby Aro, still lying in ICU with his chest open. The hospital called in the midst of this to inform us that he was about to receive full support from the heart machineâ€”discouraging news we were hoping not to hear. We had barely absorbed this new information, and only a few minutes had passed since our prayers had finished, when the hospital called again to say that Aro had gone into cardiac arrest and passed away. Because of the order of events, it is probable that the doctors were in the midst of fighting for his life, administering CPR and a defibrillator while we had been praying. Baby Aro and his mother had only arrived in Israel five days prior. Everything just happened so fastâ€”arrival, surgery, ICU, death--that the jolting news of a life over so soon was the hardest to handle. Even in that short week, our volunteers had poured out much love on them both. We prayed, and cried, and clung to each other.
Aro was my final thought as I drifted off to sleep last night and the first thing on my mind when I woke up the next morning. "Spare his life Lord! Be merciful to him," I found myself praying again and again. The urgency to intercede in this way felt as natural as breathing. An hour later, with the Scriptures opened on my lap, I read the story of Lazarus in the gospel of John. It was here that Messiah spoke the profoundly powerful statement, "This sickness is not unto death, but for the glory of God, that the Son of God may be glorified through it." As though emblazoned on the page, these words spoke directly to my heart: "Yes, Lord! This is exactly what I ask for Aro!" Donna found me in the garden soon after, and I could tell she had good news to share. Aro had made it through the night without needing the Echmo (heart & lung machine) to support his fragile body. We rejoiced together as a community for the way God heard and answered our cries.
This afternoon, I couldn't help but feel a bit hesitant as I stood waiting outside the door of Wolfson's ICU. What would I find on the other side? I took a breath and stepped in. Aro's bed lay directly in front of me. He looked miniscule on the hospital gurney, his body mostly covered, save his face and one tiny hand and foot exposed. The ventilator regulating his oxygen and respirations caused his whole frame to shake with constant vibration. His heart raced at 200 beats per minute. Even as a nurse who has seen many children in the ICU, I was still taken aback. And so I prayed. Initially, I said, "Lord, please be faithful to Aro," then realized, "Lord, You are always faithful. I don't need to ask this of You because that's who You are." Instead, I spoke over this precious baby the promise I had read this morning: "This sickness is not unto death, but for the glory of God, that the Son of God may be glorified through it," trusting that in Messiah's name, there is life.
His nurse then came to my side, and we exchanged thoughts on Aro. "He's so small," I noted. "Yes, but he is strong," she replied. As she asked questions about Aro's family and about Shevet Achim, I saw compassion in her eyes. She listened intently as I shared our hope for new life for this baby. I was thankful she was the one caring for Aro today. After expressing appreciation for all of her hard work, she paused, then responded with, "Um, how do you say it? God bless you?" "Yes," I said. "God bless you too!"
ICU specialists Dr. Houri and Dr. Cohen are also on constant watch for Aro's life. Donna and I had a chance to speak with both of them as well during our visit to the ICU. Dr. Houri told me that while last night had been frightening, Aro was doing slightly better. He also emphasized the fact that being in this precarious position was normal for this surgery's degree of complexity. Dr. Cohen shared with Donna that he believed Aro "will be okay," and that his chest may be closed as early as next week. We took each hopeful word, however small or tentative it may be, with thankful hearts.
Aro's mother, though sometimes weary and heartbroken at the sight of her baby, is trying hard to be brave. "The greatest gift for me," she shared, "is the life of my son Aro." We agreed that his life was, indeed, a precious gift and that we were all praying for this. Would you join with us in interceding for Aro and his mother? Every breath is an expression of God's relentless love. May He be glorified through the redemption of Aro's life one heartbeat at a time.
If today could be summed up in a word, I believe that word would be â€œintense.â€
We arrived at the hospital this morning before six o'clock to find tiny Aro alone in the ICU, where everything was still quiet, as though waiting for the floodgates of activity to open and pour forth the day's challenges and victories. Within minutes his mother came in to greet us, sharing that the nurses and doctors encouraged her to get some rest before Aro's surgery began. She was grateful to see us, and looking into her eyes, it seemed to me she was both very vulnerable and very strong at that moment. She was vulnerable in the focused intensity of a mother's love which would soon painfully let go of her precious infant, yet strong in her determination to do this "letting go", employing the dynamic reality of hope in pursuit of the life-saving help Aro needed.
For the next hour, she stayed at his side, caressing his head and body with her touch and her prayers. Concurrently, ICU staff began detaching IV lines and moving into place all the equipment needed to move Aro from the ICU to the operating theater downstairs. Around seven-fifteen a team from downstairs appeared, took their places around the gurney, and invited us to follow as they quickly and efficiently guided their precious charge to the elevator. Once downstairs, since Aro was already intubated, there was a brief pause only so that his mother could sign the anesthesia consent form, and then Aro was rolled into the operating room and into the capable hands of Wolfson's pediatric cardiology surgical team. At this moment, Aro's mom buried her head on my shoulder and broke into deep sobs.
Soon she was composed enough to go back upstairs, where the long wait for Aro's return would begin. Understandably melancholy at first, Aro's mom found comfort in the fellowship of Arin's and Hero's mothers, and drew strength from our presence as well. These mothers were able to enjoy mutually supporting one another.
They shared some small snacks, laughter and serious discussion during the wait for Aro's return to the ICU. Only after about 4.5 hours did Aro's mom's stress overflow in tears of fearful concern.
Around the 5.5 hour mark the surgical team wheeled Aro back into the ICU. I was in the ICU at the time, and was immediately relieved that he had survived his risky surgery. Within seconds all the ICU staff surrounded Aro's bed, and moments later the ECMO machine (heart-lung machine which provides both cardiac and respiratory support) was wheeled in. I understood that the need for the ECMO meant Aro's heart and lungs could not function on their own yet, and prayed fervently as the next ten or fifteen minutes passed. At that point the surgical team dispersed, and as the ICU team remained busy tending to Aro, Dr. Sasson, the surgeon, came in. I continued waiting and watching, and after five or ten more minutes, he came to the bedside to address my questions. He said it was a good surgery, but as we knew, Aro came â€œlateâ€ for the needed repair, and he hoped the surgery would "hold.â€ In other words, he was saying that he hoped Aro's body would accept the repair his heart needed, and begin functioning with the proper oxygenation. As he left the area, I observed the activity around Aro's bed a little longer, but wanted to go quickly to his mother.
I found Aro's mom outside with Ruth, Kelsey and Tabea. I shared the news of the good repair, but also that things were still difficult, and that the doctors were watching very closely to see that the surgery was still â€œholding.â€ After a phone call to her family, we went to lunch while the ICU staff stabilized Aro. My next opportunity to see Aro came an hour later, and just as I was entering, Dr. Sasson was coming into the ICU as well. I asked if the surgery was still good, and he said yes, so far it was still good. But again he stressed the importance of waiting to be sure Aro continued to be stable. I shared this news with his mother, and as we talked, the ICU director came to ask that we not gather around Aro's bed for our discussion, since his heart was left open in case there was a need to go back in for further repair. Aroâ€™s mother and I thanked God together that Aro was still stable, and bade each other loving farewells until tomorrow.
As I've written this blog, I've continued to feel the intercessory burden for the life of this tiny boy and his family. I called the ICU to check on him and found him unstable, with doctors carefully observing and on the brink of deciding whether to transfer the work of the heart and lungs to the ECMO machine. We've gathered again here to pray for Aro, and ask that you do the same.
"O Sovereign LORD, you have only begun to show your greatness and the strength of your hand to me, your servant. Is there any god in heaven or on earth who can perform such great and mighty deeds as you do?" Deuteronomy 3:24
â€œI wonder why Aro and his mother just went into the ICU?â€ Kristina wondered aloud to herself. Yousif replied in Hebrew, â€œThe doctor came. They are preparing Aro for surgery.â€ â€œThat is strange,â€ Kristina said, â€œBecause the only reason Aro would be taken in the afternoon is in preparation for an unusual surgery time.â€
And that was the case. In a move that surprised all of us, doctors at Wolfson Hospital are intending to begin operating on this little child at 7am sharp tomorrow morning. The above picture is in the ICU, where Aro is now sedated. His whole little organism is being stabilized and dialed-in for what tomorrow holds.
Jonathanâ€™s first blog described the medical risk of Aroâ€™s operation. A heart will only respond to this surgery if it is less than one month old. Aro is six weeks old. But there is One who has made the heart, and he is the same who has given to humankind to work with skill and compassion.
More tomorrow. Please pray in the meanwhile.
Despite his rapidly rising and falling chest, baby Aro is easily contented. While his mother spent the day in the ER for various symptoms (pain, vomiting) I spent the day playing mom. For the first hour or so he didn't even stir. Eventually some crying led to a bottle, some burping, and a new diaper. I cherished his dark eyes that studied me while I fed him. His oxygen level bounced up and down quite a bit, as high as 70%, then gradually dropping to as low as 45%. The nurse warned me to alert her if it dropped to the 30s, but it never did and eventually steadied out in the 60s â€“ still dangerously low for an infant who needs oxygen to grow and thrive.
My precious alone time with this sweet baby was made even sweeter with much prayer and singing in my heart. His tiny heart is working so hard to keep him alive, and I prayed for God to sustain him and heal him. I also read over Aro the prophecy of John the Baptist's father, Zacharias: "Because of the tender mercy of our God, with which the Sunrise from on high will visit us to shine upon those who sit in darkness and the shadow of death, to guide our feet into the way of peace."
Because of the urgency of his condition, baby Aro and his mother Maryam flew into Jordan Saturday evening without a visa to enter the country. We had received a verbal commitment from the Interior Ministry to allow them to enter, but I expected a bureaucratic battle of a few hours. Instead, by the time I reached passport control inside the airport the clerks were showing the finest of Jordanian hospitality and just putting the final stamp on Aro's passport.
Baby Aro looked remarkably well when we reached our Amman way station. His heart defect (transposition of the great arteries) is a life-and-death emergency, since it leaves the heart pumping unoxygenated blue blood out to the body instead of the oxygen-rich red blood. But by God's grace a second defect, a hole between the atria of Aro's heart, is keeping him alive by allowing the red and blue blood to mix while still inside the heart. Aro slept peacefully most of the time, even while my wife Michelle took a turn holding him for his tired mother.
We set out for Israel before dawn, catching the Sunday sunrise in the Jordan valley as a reminder of Messiah's resurrection and triumph over death on Aro's behalf, and on ours. By 10:30 we reached the hospital where a team of doctors and Donna, Ruth and Kristina from the Jerusalem community were waiting.
Kristina's gloved finger helped pacify baby Aro as Dr. Livia confirmed the diagnosis by echocardiogram.
Then the moment of decision. A full repair of Aro's defect--switching the arteries back to their normal places--is normally possible only during the first month of life. Today Aro turned six weeks old. Had we reached Israel in time?
Chief cardiologist Akiva Tamir told us the echo findings were borderline--but after consulting with surgeon Lior Sasson they decided to go for the full repair, despite an estimated 10% risk from surgery to Aro's life. Aro's mother broke into tears at this news, perhaps more from fear than relief, and our coworkers came alongside her with hugs and encouragement.
Tonight Aro and mother are resting in the hospital, and the Shevet Achim community is already in prayer for Aro, his mother, and the doctors as Wednesday's surgery approaches.
One-month-old baby Aro was born to a family with connection to our Muslim-background friends who follow Jesus in northern Iraq. His condition, transposition of the great arteries, can be surgically corrected in the first weeks of life in order to restore a normal heart.
We have applied for an emergency visa for Aro and his mother and hope to have them in Israel within one week.