There are so many things I would like to convey through words, yet it’s impossible. Experiences, thoughts and feelings are all connected with one person: Lya.
I want to voice my affection and the impact she made in me, yet every time I’m left speechless. The only thing I could do was stand in silence and weep when I had to say goodbye.
Throughout my life I’ve had to say goodbye to many people because of moving around from country to country. It has become harder every time and I have never gotten used to it. To find comfort I opened up my Bible and the first thing I read was Psalm 137:1 “By the rivers of
I can remember the first time she sat in my lap after her operation and I had unintentionally put my hand on her chest to hold her. She became still for a minute and I could feel her intense heartbeat against my hand. I never realized how amazed I would be at this living miracle. This was the source of her life.
The night before Lya and her mother were leaving for
God works in miraculous and mysterious ways. Not only had He chosen to use the time she was here in
How grateful I am that God brought her to
I’m still not exactly sure what it is about small children that causes even the most eloquent and austere of adults to turn to behavior which includes (but is not limited to): baby talk, silly faces, overly dramatic expressions and general goofball-ery. I don’t count myself notably eloquent, and I’m fairly certain no one would describe me as austere, but when it comes to children, I follow the typical adult pattern and inexplicably turn into a huge goof. And if you fit this goof description like me, you know that some children will give you a look like “you’re crazy, please stop”, some will join you and some do you one better by unreservedly serving a main course of weird right back (with a side dish of adorable, of course). Our little Lya here fits this latter description perfectly. And I’ve come to love this wonderful whimsical personality of hers. I guess you could say that our friendship revolves around this quote by Charles Lamb: “Tis the privilege of friendship to talk nonsense, and to have her nonsense respected.” And I was reminded of how much I’m going to miss this friendship I’ve made with Lya when we took her into the WolfsonHospitaltoday for her last echocardiogram.
Based off of her recent history with doctors or nurses coming toward her with, well, anything, I was expecting today’s appointment to be extremely stressful. But little Lya seems to have gotten the hang of the hospital routine and the procedure was quick and relatively tear-free. The results were good too. Lya’s heart has healed well, with the only hiccup being that she is still suffering from a small residual VSD. In other words, she still has a small hole between the ventricles of her heart. This may sound severe, but her doctors did not seem too concerned about it. Because of the hole’s tiny size, it’s more likely that she will experience no loss of quality of life at all. However, doctors still need to confirm and confer with the senior cardiologist about the residual VSD and Lya’s current state of health before they give her the clearance to return home. We are hopeful that this clearance will be given to her and her mother very soon.
After her echo we celebrated by heading to the beach. As we crested the hill in the van and she got her first overlook of the Mediterranean, she squealed and clapped her hands in delight. She continued with this enthusiasm in the vehicle, but once the door was rolled open she took on a rather different attitude. Her tiny grin vanished and was replaced with a look of concern. And as we took our steps ever closer to that vast expanse of sea and sand, she turned around to look at all of us with a look which seemed to say, “Okay guys, I don’t know what kind of fancy contraption this is, but I’m not buying it.” She stopped short of where the concrete ended and where the sand began and refused to take a step further. Kristina and I had to run out onto the sand and start kicking it around to show her that it wasn’t in fact hot lava, but obviously something to have fun with.
This first impression the sand made on Lya must have been strong, because for the rest of our visit she was much more enamored with the sand than with the water. She ran around yelling with joy with sand clenched in her tiny fists and screeched (more with terror than joy) occasionally when she ran too close to the water lapping up on shore. Overall, I think our precocious Lya enjoyed the beach thoroughly even though she and her mother were unable to grasp some of it’s quirks like the excessive amounts of churning loud water coming (they might say) threateningly toward them.
In the end, we were gifted with one of the most spectacular sunsets I’ve seen the Mediterranean offer. And I couldn’t help but draw the analogy that the sun is also setting on Lya’s time here in Israeland she moves one day closer to a completely healed heart.
I am a visitor to Shevet Achim from Colorado. Today I was invited to go to the hospital with Lya, her mother, another child and mom, and three volunteers. We did not have to wait long to get in for Lya´s echo. The echo technician was very nice and joked about whether Lya would cry again. Lya did cry, and the doctor tried to reassure her while doing the procedure.
The results of Lya´s test were good. There is still some water around her heart, but nothing to worry about. A next echo is scheduled for Monday. We were at the hospital for a couple of hours checking on two other children who were in the hospital. I had time to play with the children and get to know their mothers. Lya loves to turn the pages of books. Even though we can’t speak each other’s language we were able to communicate. It was a very special day.
Today was a long day for sweet little Lya. Her first follow-up echo was scheduled at Wolfson Hospital, but before we left for the hospital, we had lunch with many guests from the United States. LyaÂ´s mother helped with the preparations, while Lya enjoyed playing with Mohammed and Sophie. When our guests arrived, Lya felt most secure in the arms of her mother or a familiar volunteer, watching attentively from there.
On our way to the hospital Lya fell asleep and woke just as we had passed the security guard at the entrance. While Sophie took Mohammed and Lya to the Echo Department, I went to the childrenâ€™s ward to get their files. When I returned, Lya was already in one of the echo rooms. I did not need to ask which room she was in, because she made it known through her crying. Sophie was with her, comforting and entertaining her. It worked for short periods, but for most of the time Lya continued crying. The doctors took it well and were able to complete the echo. The more a child is crying and moving, the harder it usually is.
The echo revealed some fluids around Lyaâ€™s heart, which the cardiologists want to reexamine on Thursday. LyaÂ´s mother received this news not so well, as she is worried about what this means for Lya, and also for their return to Kurdistan. Would you please continue to lift up precious Lya and her mother, as they wait to be cleared to leave for home?
Our sweet Lya returned to Jerusalem this evening just eight days after open heart surgery. Her wispy curls, chocolate brown eyes, and laughter have surely been missed around here. And if I could speak for Lya, I believe she would say the feeling is mutual. She met me with outstretched arms today and cried every time I needed to set her down. In good humor, her mother explained that Lya was bored with her and needed new company. I was happy to oblige.
Today's echo confirmed that Lya's heart is mending well and strong enough to leave the hospital. No post-surgical fluid exists around her heart or lungs, and only two medications are needed to keep the situation as such. Lya is not quite her sprightly self yet, but give her time and we'll soon be chasing after her. I continue to be amazed at how quickly children rebound after such a life-altering experience. It is quite possible that within the next three weeks, Lya will be on a plane bound for Kurdistan!
While waiting for final discharge instructions, I had the pleasure of giving Lya a very special gift. As you may recall, her surgery date happened to fall on her second birthday. When this was made known to friends of Shevet, one of Lya's sponsors sent her and her mother a package that arrived just yesterday. Both mother and daughter seemed delighted when a lovely scarf, hand-made card, and plush teddy bear were presented to them. Lya was especially taken with the card. Its bright colors caught her attention, and she contentedly opened and closed it over and over again. Since the Kurdish culture doesn't typically emphasize birthday celebrations, this expression of love was even more significant.
Our hope and prayer for Lya is that she lives to see many more years, finding increasing joy in God's gift of grace.
The last time that I saw Lya, she was intubated and wasnâ€™t even awake. Today was a very different story. She was awake, highly attentive and there were no tubes. We brought with us some new toys that had been purchased especially for the children staying at the hospital right now. One of them was a squidgy orange duck that Lya loved to hold against her face and wait for the opposite side she was pressing to expand. Then sheâ€™d giggle as she realized how funny she was.
But every time a nurse would walk into the room she would automatically start crying, even though none of them touched her. She was just so afraid of the pain. But the promise God gives us in His Word is that â€œwe know that all things work together for good to them that love God, to them who are the called according to his purposeâ€ (Rom. 8:28). We might not be able to understand the temporary pain or affliction we are experiencing, but God promises us that even those things will be used ultimately for our good. I pray that Lya will one day understand and come to know that this operation, despite all the pain and healing she has to go through, will eventually lead to her good. As we were leaving she started crying and it felt awful to leave her, a new found friend, but at least she had her new toys to entertain her until weâ€™d meet again.
Today's visit to Lya brought good news: She'd been moved to the secondary ICU last evening! After visiting Rozhgar and her mother, we went to find Lya. Her mother greeted us from the bedside, and little Lya was lying serenely in her bed. We learned that she hadn't eaten much at all today, and her mother was worried. Yesterday however, she overate, and was sick to her stomach. Otherwise, Lya is doing very well, praise God! Her activity consisted of holding her mother's hand off and on for most of our stay, that is, until the final few minutes. Lya's mother walked over to tell us goodbye, thus momentarily disappearing from Lya's view. Suddenly Lya was sitting up in bed looking around to find the most significant person in her world, and finding her quickly, refrained from tears even in this traumatic moment. We left mother and daughter doing well and hoping to move to the regular ward soon. Will you keep praying for this beautiful little girl as she heals, along with her family in Iraq?
This afternoon we saw a beautiful, fast-healing little girl in the Wolfson ICU. Lyaâ€™s breathing tube was successfully removed this morning and perhaps a few of us are breathing easier now as well. Itâ€™s only been two days since Kelsey watched the life-changing procedure on her tiny friend.
When we arrived, she was fussy and crying â€“ she was in pain. However, within minutes of the nurses changing her dressing and bedding, we saw the above picture of perfect rest, healing, and peace, at least for this little angel.
Today her mother was tired, her back was hurting, and she wants her baby to be well. But she was relieved that Lya was awake and breathing on her own. And smiling down on them both was the vital signs monitor, showing 100% oxygen saturation, confirming the success of todayâ€™s extubation.
When I see someone breathing well, it reminds me that every breath is a miracle, a kind of continuing creation by the Creator. Truly, every breath in this little girl is a new gift of life from the One who designed and sustains her. And us.
Iâ€™ve started to notice that the days which contain the some of the most significant moments in my life start out exactly the same: I have no idea what Iâ€™m getting myself into. And today this was indeed the case when I was granted the privilege to observe the proceedings of Lyaâ€™s heart surgery.
The day at the hospital started out being rather upsetting for Lya and her mother. As the hours ticked down to her operation, she was crying frequently for the water and food she was not allowed to have. And when the time came for her to be taken to the ICU to begin the first stages of preparation for her surgery, it seemed as if Lya had had enough. She loudly howled at the slightest touch from any doctor, even if it was only one extended as a gesture of comfort. She was soon given some sedative medication, and it was at this time that Lyaâ€™s mother and I were asked to leave. Lyaâ€™s mother broke down emotionally once outside the ICU, and I tried my best to comfort her.
Some time later Lya was wheeled out of the ICU and down the halls toward the elevators leading to the operating room. Lyaâ€™s mother and I quickly jumped up to meet her and the entourage of medical staff. I then had to make the extremely rough transition from source of emotional comfort for a distraught mother to pre-medical student. So trotting along after the bed Lya was being wheeled away in, I spluttered out my goodbyes and awkwardly waved to her mother.
As one of my favorite songs as of late quips, Iâ€™ve effectively â€œpacked my bags and given the academy a raincheckâ€ since coming over to Israel. I had had enough of the torturous hamster wheel of unhealthy competition, rankings, endless assignments and pressure to preform that enveloped me as an undergraduate student. Deciding to defer medical school for an undetermined period of time in favor of volunteering with Shevet, Iâ€™ve relished in the intensely relational aspects of working with these families in a hospital setting without actually working at a hospital. But I donâ€™t think I realized just how emotionally invested and attached I was to these families until today when I saw my friend Lya stretched out in front of me on an operating table. This was not just some textbook procedure you abstractly read about being impersonally preformed on a nameless person. This was Lya. A girl who has consistently referred to me as â€œDadaâ€ (â€œBig Sisterâ€ in Kurdish) since the day I met her. Someone who greets me when I come to see her and her mother by running up to me arms flung wide. Someone Iâ€™ve spent countless hours playing, laughing, and sometimes crying with. This was real. And I found myself very nervous, unable to contextualize or rationalize the situation and on the verge of tears once I entered the operating room.
But because of how much she means to her family, the rest of our staff at Shevet and others around the world whom she has never met, I wanted to do my best to document this momentous event in her life. Today was even her second birthday. And the symbolic significance of her receiving the gift of a new heart on this day was not lost on any of us.
The surgery started smoothly. After sterilizing their â€œwork areaâ€, the doctors made the first incision into her chest. I had to step back for a few moments to allow more doctors to flutter over her so they could use a saw to open up her chest cavity. After stepping back into my viewing position at the head of the table, an odd smell crept my my nostrils. At first I thought it might be my stale breath but after refocusing my attention I realized it most certainly was not my breath. It was the smell of Lyaâ€™s flesh and capillaries being cauterized. Upon this realization, I quite honestly wanted to leave. But the reassuringly calm demeanors and quiet conversations of the surgeons hemmed me back in. This part of the surgery was small time compared to what was to come.
A clamp was inserted into her chest, the pericardium pulled back along with various tissues and then I had my first look at the miracle of Lyaâ€™s heart beating within her chest.
Mesmerized by itâ€™s rhythmic pumping, I made the observation at the surgeons prompting of her pulmonary artery and aorta. Lyaâ€™s pulmonary artery was almost twice the size of her aorta, a physiological consequence of her VSD (ventricular septa defect). For Lyaâ€™s life thus far, much of the oxygenated blood coming from her lungs and emptying into the left ventricle has been crossing into her right ventricle through several small holes in the septum of her heart. This large amount of blood coming into her right ventricle has been inducing a harmful amount of pressure on the chamberâ€™s place of release from the heart, the pulmonary artery. In other words, there is a disproportionately large amount of blood being forced out of her right ventricle into her pulmonary artery back to her lungs. Much of the blood being sent back to her lungs should instead be going to the rest of her body. If she did not receive treatment to â€œpatchâ€ these holes in her heart, the pressure on her pulmonary artery would have increased with age to the point where her condition would have been inoperable.
The surgeon then made several calculated incisions and cleverly inserted several small tubes around the entry and exit points of her heart to where the blood flow in her body was completely diverted from the heart. Instead, her blood was oxygenated for her and pumped back into her body via a machine about as big as the operating table she was on. It was an incredible juxtaposition to witness: the fragile, tiny organ which meekly preforms the same task mankind can only begin to replicate with a whirring, behemoth machine. With her bodyâ€™s blood diverted from her heart, the surgeons then made an incision into her right atria and did another incredible thing: they stopped Lyaâ€™s heart from beating (cardioplegia) with some wonder medication of modern medicine called Custodiol. With these things done, the actual repair could begin.
Several incisions and more prodding revealed the heart defect which could have ended her life if left untreated; two holes about as big as the eraser tip end of a pencil. One hole was decidedly larger than the other, and it was this that the surgeons repaired first. A piece of gortex fabric was literally sewed into this larger hole. The same was done for the second hole. However, repairing this second hole was much more of a delicate task than the first because the two holes were very close to one another with a extremely narrow band of tissue separating them. The head surgeon worried that if the repair of the smaller hole wasnâ€™t handled with enough finesse, the narrow band of tissue separating the two could become damaged to the point where it caused AV (atrioventricular) block. In simplest terms this would mean that the electrical connection and coordination between her atria and ventricles would be compromised, leaving her with a possibly irregular heart rate. Fortunately, these are some of the most skilled cardiac surgeons in Israel and they repaired the holes between Lyaâ€™s ventricles beautifully.
Watching three (sometimes four) pairs of hands gracefully working in perfect compliment to one another over this small exposed section of Lyaâ€™s chest, I became immersed and excited over all of the heart physiology I had studied not long ago. It was incredible to see the real schematics of a functioning heart which could never be adequately captured by a simple diagram on paper. Feeling myself be drawn into this medical and scientific world, I found it hard to remind myself that my friend Lya was under all these coverings. But one thought back to her mother in the waiting room brought the reality of Lyaâ€™s personhood crashing back down on me. I began to pray for the rest of the surgery to proceed as smoothly as the first part had. And thanks to God and the brilliant surgeons in the operating room, that was exactly what took place.
Lyaâ€™s chest was closed with the surgeons taking special care to stitch her in such a way as to minimize any scarring she will have. She was eventually wheeled back down into the ICU where her mother was able to see her, touch her and kiss her. I looked on at them with a dazed sort of feeling. It was hard to try and process or reconcile the events I had seen from walking between two very different worlds that day. In one world I was able to share in the gut wrenching emotional uncertainty with Lyaâ€™s mother as she waited for her child to go into surgery and then stabilize after it. In the other, I was able to witness the modern miracles of science and surgery as it was preformed on a dear child and friend. I praise God for all of it. And I praise Him for bringing Lya so smoothly through surgery in such skilled hands. Currently, Lya is stable and intubated in the ICU at Wolfson. Her mother is in good spirits and contented by the presence of the other Kurdish mothers there. Let us continue to pray for the complete healing of Lyaâ€™s heart as she now journeys down the road of recovery in itâ€™s post operational phase.
Lya and her mother left our building in Jerusalem this afternoon for the Wolfson Medical Center. She has since been admitted for her heart surgery which is scheduled for tomorrow afternoon. Please remember to keep this exuberant and preciously precocious child in your prayers as she takes another step closer to a healthy and healed heart.