We had just finished our outpatient clinic, and I was getting ready to go home. Our medical superintendent found me as I was headed down the hill. He had received word from a small hospital about an hour away that one of our staff members had been injured, and the hospital wanted to transfer him to us.
It sounded bad. Andrew had been injured while riding a boda boda, a small motorbike that is the backbone of the transportation system here. Unfortunately, we see far too many accidents and injuries related to them.
We sent one of our surgical chief residents with the ambulance to pick him up. Here, an ambulance is really a transport system. Little medical care occurs during the transfer. So they simply went to the hospital, picked him up, and brought him back.
When Andrew arrived at emergency room, things indeed looked grim. While the fact that he survived long enough to make it to Tenwek meant he likely didn’t have any immediately life-threatening injuries, his initial assessment was not reassuring. He clearly had suffered a head injury as evidenced by a large defect over the right part of his head and wasn’t responsive.
With traumas, we have a way of evaluating an injured person’s degree of responsiveness or level of consciousness. This helps to measure how severe a head injury is and even helps us assess outcomes and the likelihood of survival. In this scoring system, a score of less than eight is considered comatose and indicative of severe brain injury. Andrew’s initial score was five.
This was also worrisome because people with severe brain injuries often need support to breathe correctly and should have a breathing tube placed very quickly to allow the brain to get the oxygen it needs in order to not worsen the damage. Andrew had now gone for hours after the injury without any breathing support.
The initial evaluation didn’t reveal any other injuries. By exam alone, it was clear that Andrew had a depressed skull fracture, meaning that the pieces of broken skull had been pushed inward by the impact. This can cause compression of the underlying soft brain and therefore needs to be managed with surgery.
Also because the overlying skin was cut, creating a direct route for road debris and germs into the brain, the injury would need to be thoroughly cleaned and closed. Prior to surgery, Andrew was taken for an emergent CT scan. This would show us if there were any pockets of blood within the skull that needed to be drained in order to relieve pressure. If there was a collection of blood that could be drained, it might explain some of Andrew’s condition and could help improve the situation.
However, the initial CT scan showed only a shattered skull, some areas of bleeding within the brain, and the beginning of brain swelling. It also showed a broken neck. His neck now stabilized in a brace, we took Andrew for surgery to wash the debris out of the wound and lift the bone fragments off of the underlying brain as much as possible. With nothing more in the way of surgical options available, we could only support Andrew’s body, provide medical treatment to minimize further brain swelling, and pray for healing.
The Power of Prayer
Andrew is one of the longest-serving members of Tenwek’s staff. He coordinates the outpatient clinics and ensures smooth flow for patients. He is also a lay pastor. He was going to pick up a sick church member for treatment at Tenwek when he lost control of his bike.
I had my first of many discussions with Andrew’s family that night. His wife, Lily, and several brothers were there. I explained the critical nature of Andrew’s condition and the plan of treatment. A severe brain injury of the nature of Andrew’s carries with it a high rate of death. Even if a patient survives, the likelihood of significant disability is high. Only about 15 to 20 percent of those in his situation would be expected to have a good recovery. His family was amazingly at peace. We prayed together and committed Andrew’s outcome to God.
About a week after his accident, Andrew took a turn for the worse. He started to have fevers and low blood pressure, sure signs of infection. For many trauma patients, it’s an infection after the initial accident that causes death. I questioned the wisdom of continuing care. We determined that he had meningitis, an infection of the covering of the brain, which is common after an injury like Andrew’s. He was started on antibiotics, and we continued to wait.
During this seemingly interminable period, God began to teach me a lesson about His sovereignty. There is this sense in my mind that things will turn out better if there is something I can do. I need to be able to fix, to work, to make right. Prayer is too often an afterthought, like a reluctant admission of my own inabilities. While God uses me and has given me talents and opportunities that He uses for His purpose, He does not need me to bring about His purpose.
To the community, it didn’t matter who Andrew’s caretakers were. God was in control, and their responsibility was to pray. So, they prayed without ceasing. They planned prayer meetings. They prayed as families. And while they prayed for healing, their primary prayer was that God’s will would be done and that He would be glorified and known in Andrew’s life or death. It was amazing to witness.
A Miraculous Recovery
Over the next few weeks, Andrew began to show some improvement as his body responded to the antibiotics. The family began to tell me that he was moving his right hand spontaneously and that he seemed to be opening his eyes a bit in response to their voices. Soon, all of us were seeing the movement, and it did seem to be purposeful!
Initially limited to his right side, his movements improved. When asked to greet one of us, Andrew would offer his right hand, complete with a thumbs up—his signature way of greeting. Therapists began to work on helping Andrew regain his strength and motion, eventually sitting at the side of the bed, then getting into a wheelchair, and then working on standing for brief periods. Andrew remained paralyzed on his left side and was unable to talk due to a tracheostomy tube. However, during this time, he began writing. In his first sentence, he asked how his daughter was.
His recovery was nothing short of miraculous during the next several weeks. We were able to remove the tube, and he began singing and then talking. He was able to start eating and drinking on his own. The function returned to his left side. He was able to walk with a walker.
After nine weeks in the hospital, he was ready for his family to take him home. While still using a walker and requiring the brace for his healing neck fracture, he seemed to have recovered most of his pre-accident mental faculties and abilities.
Andrew continued coming to the outpatient clinic for visits, and each visit showed some improvement. He was able to switch from a walker to a cane, and, eventually, he was able to walk completely on his own. After three months in a brace, his neck had healed.
In January, he was able to return to work in his previous role, first part time and now full time.
He is back to serving God and the patients of Tenwek Hospital, preaching and pastoring his church. He returned with many celebrations and opportunities for testimony of the healing of God in his life. And I am certain God is not through using Andrew’s story.
There is no question that his recovery was miraculous. While God didn’t need any of us to work a miracle, He used a vast network of us, from the local community that was joined in prayer, to the nurses and hospital staff who cared so diligently for him, to medical experts thousands of miles away who looked at CT scans and helped advise. I still don’t understand the nature of prayer or miracles, but I do know that a loving God beautifully orchestrated an intersection of faith and science to bring about healing for Andrew.