.supposed

There are some things that just aren't supposed to happen.
There are some things you just aren't supposed to do. 

There are some things that are unprecedented, uninvited, unmapped.
There are some things that are still firsts in the vast millenia of repeated epiphanies.

There are some things you aren't supposed to prepare yourself for.
There are some things you shouldn't have to make sense of afterward.

If you are Julie:

You aren't supposed to find your friend unconscious, unresponsive.
You aren't supposed to go running across the ragged soccer field to get the nurse, purple skirt flying in the wind behind you.
You aren't supposed to try to wake Minnie up - to shake her - to scream her name - to feel the mounting panic when she doesn't open her eyes.
You aren't supposed to learn to take her vitals and spend sleepless vigils with the nurse - anxiously monitoring blood pressure and counting respirations on for a full minute from your phone.
You aren't supposed to see the one person that was nicest to you - the person that cooked for and with you every warm village evening - the person that you always went to the nutrition
center with - the person that never failed to ask you if you were okay, that always cared about the response - to see that person looking through you, not understanding that you are there any more, not knowing how badly your heart is tearing.
You aren't supposed to be called in at 10:30 pm from an exhausting day of worrying - the nurse on the other end of the line explaining how she needed to go pack up her hut, and could you just come in for 2 hours? 
You aren't supposed to get up out of bed when you barely went to sleep, already sick and exhausted.
You aren't supposed to be told - "I'll be right back - if she starts seizing - just call me and I'll run back and give diazepam." 
You aren't supposed to be left with a message like that. 
You aren't supposed to be left alone in that room without a nurse there too.
You aren't supposed to be left to take and interpret the vitals by yourself when you are a nutritionist - when you don't have experience with critical care. 
You aren't supposed to be told, "she is sleeping - we just turned her so she should be comfortable there for 2 hours," and then see the door shut leaving you alone.
You aren't supposed to go over to the bed, puzzled, realizing that the breathing was deeper, more irregular, feeling mounting dread as you stand there and count respirations.
You aren't supposed to see that its only 10 per minute instead of the usual 20. 
You aren't supposed to frantically dial the number of the nurse, you aren't supposed to say "You need to get back here - she isn't breathing well."
You aren't supposed to stand there - taking vital signs because you don't know what else to do - watching the breathing slow and become more labored, wishing you understood, wishing you could stop it, wishing that door would open and you wouldn't be alone anymore. 
You aren't supposed to watch helplessly, hysterically, as the breathing grew more ragged, until the door burst open, and the events started spiraling blurmotion out of control.
You aren't supposed to hold the IV fluid up high, to become the IV pole so the lines would reach the floor.
You aren't supposed to wish you could do more, wish you knew what to do, wonder if you had done everything or anything right those past 10 minutes. 

If you are Bronwyn:

You aren't supposed to lose the best friend that you had in Tchad - the only other long-termer - the only other one that wasn't going to leave after putting in their year.
You aren't supposed to lose the person that understood you on the level that doesn't need words. 
You aren't supposed to be worried and frazzled and already over-worked, scrambling for someone to work your shifts so you could spend extra time with Minnie.
You aren't supposed to lean over her and pray with her and give her the kind of support that none of the rest of us could offer.
You aren't supposed to decide whether or not you can accompany Minnie to Nairobi, whether or not you are the best person for that.
You aren't supposed to be asked to pack up her entire world before the life-flight.
You aren't supposed to run back and find her dying - to listen to her heart and hear nothing.
You aren't supposed to kneel over her, crying and pleading, breathe Minnie, breathe.
You aren't supposed to press your lips to Minnie's, firmly and fervently giving everything you have in your lungs.
You aren't supposed to taste the death of your best friend.
You aren't supposed to be the one who starts CPR on your best friend.
You aren't supposed to feel her ribs cracking beneath your hands.
You aren't supposed to keep pushing, over and over, a perfect rhythmic cadence of love grit and endurance.
You aren't supposed to be the one that stops CPR.
You aren't supposed to feel the Doctor's hands over yours, gently telling you that that was the last push.
You aren't supposed to pick out Minnie's best outfit, and make her look beautiful, and brush her hair away from her face.
You aren't supposed to lay the same Bible that you read to her hours earlier on her chest.
You aren't supposed to leave her there, to walk away, to have to snap into action borne of no other recourse and be the one to lead the others in organizing her belongings.
You aren't supposed to fly with Minnie to NDJ - to because of space spend the flight with her feet in your lap - to be told to be prepared if they shifted slightly in your hands due to the elevation.
You aren't supposed to be expected to carry on as if none of this ever happened.
You aren't supposed to feel more alone than you ever have in your life.
You aren't supposed to realize that the one person you want to talk to about all of this isn't here anymore.

If you are Marci:

You aren't supposed to bathe your colleague.
You aren't supposed to be the one that helps the nurse wash her with warm pleasantly steaming water from Tammy's kitchen. 
You aren't supposed to be the only other one that worked as a CNA which therefore makes you the most qualified. 
You aren't supposed to help turn Minnie every 2 hours - placing folded swaths of sleeping bag behind her back and gently floating her heels off pillows. 
You aren't supposed to wash her after death - to remove the IVs and gently scrub the blood away.
You aren't supposed to fold the plastic over her, taking a corner and lifting her into the plane. 
You aren't supposed to be the strong one when your friends are completely falling apart around you. 
You aren't supposed to have to store Minnie's things in your office - to walk around them, trip over them, and work among them until one day you feel like you can sort and organize.
You aren't supposed to have to organize her funeral in the church.
You aren't supposed to have make the slide show for her funeral - to pull pictures off yours and everyone else's computers and pick a song to play she would have loved.
You aren't supposed to have tell the community what happened, to have to field questions when everyone wonders why you partner in Project 21 isn't coming out to the village anymore.
You aren't supposed to smile and shake hands and explain over and over and over the same circumstances.
You aren't supposed to have that burden fall completely on you when all you want to do is talk to no one. 
You aren't supposed to receive a delegation of chieftains in the church - all coming to say I'm sorry - to say how much Minnie meant to them. 
You aren't supposed to not be able to pause or rest but instead continue on with Project 21 - the huge public health initiative for the district of Bere that was originally inspired by Minnie.


If you are Olen:

You aren't supposed to be the Doctor for your friend. 
You aren't supposed to be at home sick with malaria - get up to answer the knock on the door, and hear through the quinine-induced ringing in your ears that the volunteer you are already treating with the strongest and best malaria medicine was just found unconscious. 
You aren't supposed to have to mentally tick through the options of what could be causing the coma - and realize that since its not hypoglycemia her malaria is now cerebral.
You aren't supposed to be the first one to really comprehend the seriousness of the situation - because you know what the others don't - that once an adult's malaria goes cerebral they rarely ever come back intact. 
You aren't supposed to rack your brain and search your medical books and literature for anything that might offer an improved prognosis. 
You aren't supposed to be solely responsible the whole hospital, responsible for the health of all the volunteers, responsible for all the current projects, responsible for keeping your family safe and intact, responsible for maintaining the reputation of the mission both locally and globally
You aren't supposed to try to make yourself be objective - to focus on the fact that you are the doctor and this is your patient - despite the fact that this is not your patient, this is your friend, this is your volunteer, this is the person you have lived and worked with for over a year.
You aren't supposed to have a sick volunteer in a hospital in the middle of one of the poorest countries in the world, in a hospital that has no oxygen, that has no ventilator, that has no local nurses trained to provide critical care or life support. 
You aren't supposed to be unable transfer her to the ICU, or consult with Infection Disease, or to share the decisions about her care with a group of your colleagues. 
You aren't supposed to have the decision about where she goes when she is life-flighted out of your hands - despite the fact that you are responsible, despite the fact that you understand through experience what the "experts" do not - that IV quinine may be the only medicine strong enough to save her life - that the falciparum strain endemic to this area often only responds to IV quinine although the literature suggests otherwise - that if she goes to Europe or America, they will not give her quinine.
You aren't supposed to know that her best chance for survival may in fact be in your hospital - yet with the impossible flip side that your hospital also cannot provide sustained life support. 
You aren't supposed to give clear orders to the nurse and know that even though it isn't enough, there is nothing more to be done.
You aren't supposed to have to call her brother - to tell him that his sister is gravely ill - to have to be the one to explain to a desperate family the particulars of her illness. 
You aren't supposed to have to be the one with all the answers, the one that has to be strong for everyone else.
You aren't supposed to spend the entire day and evening on the phone with family members and medical evacuation insurance companies and interruptions and then finally fall exhausted into bed.
You aren't supposed to be woken up minutes later by frantic and desperate phone call from your nurse - telling you that Minnie's 02sat is in the 40's and falling, telling you to come now. 
You aren't supposed to run through the night towards this surreal situation - knowing better than anyone else the odds rapidly stacking up against her survival - yet deciding to fight with all you have no matter what.
You aren't supposed to arrive to see CPR already being started on the floor, to have to instantly transition into ER doctor mode, to clinically distance yourself despite the fact that everything about this situation is personal.
You aren't supposed to be the Doctor running the code on your friend.
You aren't supposed to have to be the rock, to be the calm one.
You aren't supposed to have a code team that is wearing pajamas instead of scrubs.
You aren't supposed to look around at all the faces of the ex-pats and realize that you have to keep this code going just as much for them as for Minnie.
You aren't supposed to run the code from the head of the patient while being completely responsible for her airway, not having Respiratory Therapy there to take over for you.
You aren't supposed to see the minute hand wind its way around the clock - to realize that even after 3 ampules of Atropine,  9  ampules of Epi, after re-starting her heart twice and losing it twice, after dextrose and mannitol and an epi drip and another line and suction and strong perfect CPR, that your monitor still showed Asystole.
You aren't supposed to have to say "Give one more amp of Epi - we will continue CPR and respirations for 2 more minutes."
You aren't supposed to have to say "‘Unless anybody has any other ideas or any objections, we’re stopping."
You aren't supposed to be the Doctor telling a roomful of your friends to stop the code on their friend. 
You aren't supposed to have to say "12:45, time of death."
You aren't supposed to have run a code for a full hour exactly. 
You aren't supposed to have to call Minnie's family to tell them that their loved one is dead.
You aren't supposed to immediately have to start working on all the arrangements for repatriation without having time to process any of it. 
You aren't supposed to go back after her sunrise funeral and have to see a hospital full of patients. 
You aren't supposed to be the one that has to be there for your volunteers, for a hospital staff and grieving community of Tchadians, for your friends, for your family, while having to work just as hard as before with no option of a break. 
You aren't supposed to have been the Doctor for your friend.

There are some things that just aren't supposed to happen.
There are some things you just aren't supposed to do. 

If you are Janna:

You aren't supposed to be the nurse for your friend. 
You aren't supposed to be be medically responsible for the life of someone you are close to.
You aren't supposed to say goodbye in the morning, after a night of checking the quinine drip and making her promise to tell you if she needed anything, to tell her Julie would be by every hour, to make her promise to keep sipping the guava juice, not realizing its the last conversation you would ever have. 
You aren't supposed to see Julie running towards you - feeling something old and cold in the pit of your stomach when you learn that Minnie slipped into a coma.
You aren't supposed to interrupt a surgery in the OR to tell Danae that the patient isn't responding.
You aren't supposed to call them a patient when its really your friend.
You aren't supposed to give a sternal rub that barely elicits a response - to quickly take the vitals - to order a hemoglobin and glucose test - to realize with a sinking dread that the coma isn't due to hypoglycemia because the blood sugar is 201 and not below 60, that this is probably cerebral malaria. 
You aren't supposed to find Olen coming in already, to tell him rapid-fire the vitals and what has already been done - to watch as he tries to get her to wake up - respond to painful stimulus. 
You aren't supposed to realize that you are completely out of your element yet it is you who is the most qualified of the nurses to be with her. 
You aren't supposed to realize she needs the best care and that has to come from you because there is no one else who has even remotely worked in critical care. 
You aren't supposed to start one hour vitals just because you don't know what else to do. 
You aren't supposed to look up from the mat on the floor, to see the muscles contracting, to go over to the bed, to try decide if she is seizing, posturing, or are her muscles just contracting? 
You aren't supposed to give diazepam 13 times in one night - dancing the delicate line between stopping her seizures and not compromising respirations. 
You aren't supposed to turn your friend on her side so she wouldn't aspirate because she was too weak to vomit - to kick everyone out of the room to put an NGT in, to see the forest green serous bile slowly snaking down the tubing and into the bag. 
You aren't supposed to be trusted this much - to try to be worthy of that trust by taking accurate I/O's, hourly vitals, replacing ml for ml the NGT output, counting and analyzing trends.
You aren't supposed to run a mini ICU in the same room where rats run in and out at night and mosquitoes clings to the walls with nurses who think code blue is a color
You aren't supposed to wonder why you don't try this hard for everybody.
You aren't supposed to leave your patient. 
You aren't supposed to leave her to pack up her hut in preparation for a life-flight to Nairobi - to listen to Minnie's lungs multiple times before you left, to look at that last set of vitals, to decide that she was resting and was stable. 
You aren't supposed to get a call saying that 10 minutes after you decided that, that the breathing had changed.
You aren't supposed to run into the room, to see that the person you have known your entire year here has stopped breathing, to take the 02 sat and realize its 47%, to frantically dial the doctor, to tell him to get here now.
You aren't supposed to see your friend as your patient - to realize that the patient's heart stopped beating
You aren't supposed to throw Minnie on the floor because there isn't a backboard for good compressions - to start Bronwyn and Julie on CPR - to run barefoot to the pharmacy for the Mannitol and Dextrose Olen ordered, to run back and see your friend Bronwyn doing mouth to mouth on Minnie - her best friend here.
You aren't supposed to feel hysterical and responsible and shaking all over.
You aren't supposed to have to be told by the doctor who walked into the scene to calm down, that rushing won't help Minnie.
You aren't supposed to call Danae and tell her -  Olen says run to the OR now and set up suction, we are coding Minnie.
You aren't supposed to start coding your friend
You aren't supposed to see strong and perfect chest compressions being done as sweat and tears rolled off Jamie and Marci and Bronwyn's faces.
You aren't supposed to have to give Epi and Atropine to your friend the first time you have ever done it - raising her arm every time because you vaguely remember that's how you did it when you took ACLS.
You aren't supposed to realize that you forgot ACLS.
You aren't supposed to be one of 9 expats in an OR room in the middle of the night in Tchad, Africa, being part of a desperate, determined, loving breaking, unbelievably competent team of your friends, all trying in their own way and in their own role to do every single thing possible.
You aren't supposed to see the flat line of Asystole, to desperately hope to get the heart back - to watch the numbers on the screen, mentally hoping and screaming and praying for them to stabilize.
You aren't supposed to hear the warm calm voice of Olen, cutting through the fog - "we will continue for 2 more minutes."
You aren't supposed to give that last Epi.
You aren't supposed to see that last chest compression.
You aren't supposed to stop coding your friend.
You aren't supposed to ever stop.
You aren't supposed to look at the clock on the wall and see that it has been a full hour - and that now it is over.
You aren't supposed to walk out of the room, jaw set, grim and blind with the guilt crushing you and pinning you against a wall of nothingness
You aren't supposed to ignore the doctors when they tell you you are a good nurse, to walk right past them into the night, telling yourself that it isn't true.
You aren't supposed to be hit with a parade of crystal clear moments - clear points where you can see in hindsight all the things you could of done, should have done, must have missed.
You aren't supposed to break down walking in aimless circles, believing that you were that last person on earth that should have been trusted to take care of her. 
You aren't supposed to feel like you betrayed everyone at the exact time when it mattered the most.
You aren't supposed to not be able to help the others prepare her body.
You aren't supposed to have three hours to with your friends sort, organize, and clean her hut, to make snap decisions about what goes and what stays, to be in the position of wondering what would the family want to have, what would Minnie have wanted to leave behind, who would she wanted to have left it to.
You aren't supposed to roll and tuck and place someone's entire life into suitcases and snap them shut. 
You aren't supposed to make public the cherished belongings of the most private person you know. 
You aren't supposed to find bump along the rugged road to Bendele, splashing over puddles, Minnie in the back, alive in the front.
You aren't supposed to sing hymns at sunrise, breaking down because you want to slap every hopeful joyous note in the face.
You aren't supposed to watch your friend being lovingly wrapped in plastic and placed in a tiny airplane.
You aren't supposed to watch that airplane fly away and then keep looking at the sky seeing only puffy unconcerned clouds - clouds that say they don't know when you ask them where God is.
You aren't supposed to have to write to your friends, past and present volunteers, telling what they no doubt have already been hearing, that Minnie is dead.
You aren't supposed to try to wrap your mind around the surreal and horrific events of the last 12 hours.
You aren't supposed to live in a world where something as simple and preventable as malaria could take the life of a warm and loving person who had so much left to give. 
You aren't supposed to spend the day curled up in the dental chair - surrounded by piles and boxes of Minnie's things - unable to move or think or function or sleep or imagine a time when you won't feel as completely wrecked as you do right now. 
You aren't supposed to wake up at 10:30 pm in Tammy Parker's house - and start crying hysterically because it was dark and Marci and Julie had left you, and you didn't know where they were, and you didn't know what to do. 
You aren't supposed to let Marci sleep on her floor because you can't spend the night alone.
You aren't supposed to spend the next week replaying the last 2 hours of her life and your role in it over and over and over again.
You aren't supposed to keep playing this movie every waking moment, crushed by the guilt of supposed hindsight, tears spilling out of your eyes feeling that you never should have been so completely trusted, that you never should have left that room.
You aren't supposed to feel professionally devastated, to wonder if you can even trust your own gut anymore, to wonder if you should even be a nurse, to wonder if you can ever be confident in your abilities again.
You aren't supposed to feel this guilty about something that wasn't your fault.
You aren't supposed to skip work the next day, not telling anyone you weren't coming in, just because you couldn't do it. 
You aren't supposed to spend the day instead "death-proofing" your hut, your computer, your journal - sluggishly arranging and writing and encrypting and cleaning so just in case are gored by a bull or don't come back one day no one will wonder what to do with the remnants of your life.
You aren't supposed to see your friend wake up - a wild look in her eyes - saying, "do you want me to take one hour vitals?  Where is Minnie?"
You aren't supposed to go back to work the day after - to be expected to do just as much work as before - yet to feel completely weary and uncaring. 
You aren't supposed to see everyone cracking around you - to see the various stages of grief and anger and numbness and denial and try to find something to say that means anything at all.
You aren't supposed to make this about you when you are the one still living and breathing and loving. 
You aren't supposed to to wake up one day and realize that you are okay, that weeks later the guilt has subsided and the sun still shines and children still smile and jump up and down and scream "Nasara! Lapia!" in squealing frantic little voices. 
You aren't supposed to write a blog like this. 
You aren't supposed to post it.
You aren't supposed to have been the nurse for your friend.

There are some things that just aren't supposed to happen.
There are some things you just aren't supposed to do. 

If you are her family:

You aren't supposed to have to read this about the person that you love and cherish. 

There are some things that just aren't supposed to happen.
There are some things you just aren't supposed to do.

**Photo:  Janna, Bronwyn, Minnie