It had already been a long day seeing our usual overload of patients at Bangkla Baptist Hospital in rural eastern Thailand when the nurse notified me that there a patient waiting in ER that had just arrived from another hospital in the provincial capital. The 18 yo girl had been diagnosed with a rare clotting disorder that had now caused clotting of the main artery supplying her small intestine. She had been admitted at the government hospital for 2 days while the doctors had considered her diagnosis and treatment and decided she was too sick to survive a life saving procedure and so let her family know she was going to die. The family immediately brought her to Bangkla Baptist Hospital, about 45 minutes from the other hospital. When she arrived she was very ill. She was running a fever, her breathing was becoming labored and her pulse was barely detectable. It was clear that she was near death. Our fine general surgeon, Dr Jirachat was already seeing her when I arrived there. He read the note from the doctor at the provincial hospital and shook his head. He told the family that it was very grave and that he did not want to operate on the girl since she would almost assuredly die in surgery. Maybe had she come a day or two earlier, he would have tried, but now its too late. In Thailand, it is considered a bad mark or "face losing" situation to have an intraoperative death even in the case of a very sick patient. I also examined the young lady and spoke with their family. It was clear how critical the situation had become and the family begged me to help somehow. I was torn between wanting to help but also the seeming hopelessness of the situation. I was unsure of what to do. But in our small emergency area and outpatient department was a big sign left by one of our long term missionary doctors, Al Hood. It was Jeremiah 33:3 which says: ‘Call to me and I will answer you and tell you great and unsearchable things you do not know. I prayed for wisdom and God gave me the courage to go forward. I echoed that the situation was very grave and that she had a significant chance of death in surgery, especially considering we are a small hospital without a full ICU or critical care capacity. But I also let them know that I was not worried about my own reputation, because we give all the credit for our success to God. I told them that the main purpose of our hospital was to give the people of rural Thailand HOPE. Hope for medical treatment sure, but also hope for eternal life through faith in Christ. I told them that I was a family physician and not a residency training surgeon. But that through the years with the mentoring of a number of missionary surgeons, I had learned to do a wide selection of surgery and that I was willing to operate on their daughter. They understood the risks and the dire conditions, and still begged me to proceed. I agreed and asked them to pray with me over their sick daughter. I prayed for the wisdom and skill to do best possible care, but asked God for the miracle I knew she needed to survive.
After praying again in the O.R., my wife, Linda, CRNA, put her to sleep with a minimum of anesthesia since her BP was low and her condition was so frail. Upon entering the abdomen, I was immediately hit with the smell of dead bowl and dark fluid that was surrounding her blackened small intestine. Virtually her entire small bowel was now necrotic and not viable. I found that about a foot or two of the end of her small bowel looked a little less dusky and was perhaps viable. I removed all the dead bowel and joined her duodenum to the distal ileum with a very small residual bowel. Her condition remained critical, but now her BP and pulse stengthened and we were able to reduce the support of her blood pressure with dopamine. By that time, Dr Jirachat came in to see what I was doing. He was very skeptical of the viability of the remaining intestine but grudgingly agreed I had done the right thing to try. I think he felt a bit ashamed of his reluctance to try, but remained convinced she would die.
She had a rocky recovery and needed lots of care and prayer over the next several days. I had some donated intravenous feedings from the U.S. that we gave her to help support her nutrition and healing. By one week, she was eating small amounts of food and water and was then a few days later, able to continue to recover without IV support. When we let her go home after 2 weeks, her family was ecstatic that she had survived and I reminded them that this was truly a miracle from God. While she lost weight over the next few weeks, eventually her weight stabilized and she was able to lead a relatively normal life. The girl and her family recognized the true author of her healing and became members of God's family and of the local church where they lived.
We were constantly amazed at our little rural hospital in Thailand of how God took care of our patients and how He honored His name even faced with what seemed insurmountable odds as long as we were willing to serve Him and the precious people he brought to our door. Please continue with us to pray that the wonderful people of Thailand would seek the counsel and healing of the Great Physician as we all remember that we can treat, but only Jesus can heal ! John Gibson, MD
After praying again in the O.R., my wife, Linda, CRNA, put her to sleep with a minimum of anesthesia since her BP was low and her condition was so frail. Upon entering the abdomen, I was immediately hit with the smell of dead bowl and dark fluid that was surrounding her blackened small intestine. Virtually her entire small bowel was now necrotic and not viable. I found that about a foot or two of the end of her small bowel looked a little less dusky and was perhaps viable. I removed all the dead bowel and joined her duodenum to the distal ileum with a very small residual bowel. Her condition remained critical, but now her BP and pulse stengthened and we were able to reduce the support of her blood pressure with dopamine. By that time, Dr Jirachat came in to see what I was doing. He was very skeptical of the viability of the remaining intestine but grudgingly agreed I had done the right thing to try. I think he felt a bit ashamed of his reluctance to try, but remained convinced she would die.
She had a rocky recovery and needed lots of care and prayer over the next several days. I had some donated intravenous feedings from the U.S. that we gave her to help support her nutrition and healing. By one week, she was eating small amounts of food and water and was then a few days later, able to continue to recover without IV support. When we let her go home after 2 weeks, her family was ecstatic that she had survived and I reminded them that this was truly a miracle from God. While she lost weight over the next few weeks, eventually her weight stabilized and she was able to lead a relatively normal life. The girl and her family recognized the true author of her healing and became members of God's family and of the local church where they lived.
We were constantly amazed at our little rural hospital in Thailand of how God took care of our patients and how He honored His name even faced with what seemed insurmountable odds as long as we were willing to serve Him and the precious people he brought to our door. Please continue with us to pray that the wonderful people of Thailand would seek the counsel and healing of the Great Physician as we all remember that we can treat, but only Jesus can heal ! John Gibson, MD
