51 minutes

is how long I have left to type another blog entry on this funky French keyboard. I just got home from catching baby number three, which was such an easy birth that I actually felt ripped off afterward. A nice change of pace, however, from the bigger things Ive seen and done since being here.

Im feeling a lot better than I was yesterday. After dinner last night I couldnt be upright any longer. I felt like I was never going to feel better and so, even though I couldnt breathe lying down, I finally just surrendered to the sickness and lay helpless in bed until sleep took over. When I fell asleep, the ranch was bustling with activity but when I awoke at dawn with the call to prayer, everything was dark and silent around me. Its always disconcerting when that happens --when you never realize you are falling asleep and wake to a changed world. I was still too immobile by sickness to do anything but feebly rub crusted snot from around my nose and mouth and fall back to sleep for another couple hours before being woken up by the phone ringing and Heather talking to a midwife at one of the clinics that twins were being born! TWINS!! We hustled out of bed and I realized my sore throat was gone and the cold has moved to my chest: fine, I can deal with that. We called the other ladies who had spent the night at a nearby clinic and they picked us up and off we went, arriving just in time to see a single baby be placed under the lights the clinics use as a warmer. Never shy at a birth in Africa, I went over to the baby and looked back at the woman on the table. Only one cord --the other baby must not be born yet. She looked awful small for twins... turns out there was only one baby being born. Maybe Heather was half asleep when she answered the phone, but no twins were coming at this moment. The post partum wasnt uncomplicated however: the baby on the table sounded gurgley and the midwife who brought him to the table walked away, as often happens here when we attend a birth. I have mixed feelings about it --on one hand, great I can run the show. On the other hand, I dont expect to be handed the keys to the castle and it makes me slightly uncomfortable that theyre SO accommodating about it. Anyway, this baby needed a little help and this midwife clearly was expecting me to give it to him so I got a glove on quickly and turned him on his side to help him spit up the fluid he was choking on. Nicole saw me struggling to care for baby with a single gloved hand and helped me get another one on and then she went to attend to the placenta. An hour later, the placenta still hadnt come. Tara left the room to look for our preceptor to check in with her about a dose of pitocin wed decided to try to help the placenta detach when suddenly, there was the placenta with about a cup and a half of blood behind it. Fuck, I said. Pitocin. Now! No one had it, so I put down the baby and ran for supplies, drew up the shot and gave it to the mom and the bleeding stopped. Exciting 60 seconds!

After Tara and Nicole shared duties repairing a nice second degree tear, we were on our way with Serguy playing Take It Easy by the Eagles on his cassette player in the ambulance. So awesome... That song is so appropriate for this trip: take it easy, take it easy, dont let the sound of your own wheels make you craaazzzzzyyyyy. We stopped by the market for the usual Senegalese adventure of trying to find eggs, cheese, bread and yogurt. Money here is SUPER confusing. After a 30 minute trip (which, I kid you not, included a quick stop by the car junk yard as we searched for bread) that should have taken 5 minutes, we went home for breakfast of scrambled eggs and fresh baguette with cheese and black coffee. SO GOOD after an exciting few hours. After breakfast Heather and I headed off to Mboro 2 to see what was going on there and I showed her how to do a vaginal exam to assess dilation, we labor sat for a while, went home for lunch, and returned in time for me to catch this womans NINTH baby. This is very, very common in Senegal -- 35 year old women who have already had 10 babies. Crazy.

Im feeling really good about my skills, though a little disappointed I havent seen anything that really challenges me yet, just because Im here to get a real sense of what Im good at and what Im bad at and I KNOW I cant be good at everything yet. The easy births (someone here calls them "butter births") are nice, for sure, but I really want to learn some hard skills. Give me bleeding uteruses, babies not breathing, give me deep tears in need of suture. Maybe Ill eat my words later but I did not leave the comforts of my own home to squat over holes in the ground, to miss COLD drinking water so much I want to cry, to miss my family and friends and Chris so much it feels like drowning sometimes, to just have babies fall out. And they havent all fallen out, in truth. This week began with two hard births and two very sad experiences and Ill try to get into that next time, but for now Ill just say that Im good, kicking ass, getting along with everyone, feeling like Im on the mend, and ready for what comes next.

Write me love notes because I miss you like a fat kid misses seeing his pecker. Or like I miss an apostrophe on a keyboard.

xoxoxox L