I was sitting peacefully at home when the nurse first came to call.
"A young pregnant woman just arrived in a coma. Her blood pressure is high, she has a fever and we can't find the baby's heartbeat."
I gave some instructions for further tests and things to examine, put her on a quinine drip and hoped it wasn't pre-eclampsia.
The next morning, I saw her during rounds and she was writhing around in bed with four people trying to hold her down. We got the results for the tests for pre-eclampsia and they were negative. She had a little malaria but not that much. I continued her on the quinine, checked the fetal heartbeat myself and confirmed that the baby was already dead. I then ordered the nurses to provoke labor and deliver the child.
All day long she moaned and thrashed and screamed.
That evening the nurse came to get me again. The woman was in the delivery room lying half naked on the table with her mom and aunt holding her arms and legs and the nurse keeping her from pulling out her IV. She was crying as if being tortured and it was all we could do to keep her from biting her hands and arms and falling to the floor. She wasn't having good enough contractions so I adjusted the Oxytocin drip. The thoughts that started to come into my mind I tried to ignore but finally couldn't.
"I think she's being bothered by evil spirits." I blurted out.
The nurse, Gilbert, translated into Ngambai for the family and we started to discuss what that meant and how the only treatment was prayer because no amount of IV drips, medications or even surgery can exorcise a demon (yes, we had to explain that!)
Finally, Gilbert prayed long and hard in Ngambai and I finished with a prayer in French begging God to keep his promise in Luke 4 that he came to deliver the prisoners and set the captives free. A few minutes later she was calm and snoring. I left to go home.
Now I find myself back in the same room with an even wilder patient. She has delivered the still-born and now the placenta has been stuck for 45 minutes. She is stiffening her legs, lolling her head and wildly waving her arms as we try to hold onto that slippery, bloody mess.
I put on some gloves and try to reach inside to pull out the placenta but she clamps her legs together. The women are shouting at her in Ngambai and I'm trying to pry her leg apart with one arm as I try to grab the placenta with the other. Finally, frustrated, I reach up and grab her chin and shake her while screaming, "Let me help you!" She calms a little letting me get my hand in the uterus, grab the placenta and pull it out before all hell breaks loose again.
Now she starts to bleed heavily. I'm calling for meds as Liz and Sonya rush to get them and try to hold on to her as the blood coursing from within makes her more and more slippery. The thrashing as covered her legs and back and belly. I try to massage her ritually and ornamentally scarred abdomen but her powerful rectus muscles are contracted as she resists with all her might. Without time to think and scared that this demon is trying to kill her by keeping me from stopping the bleeding I reach up and slap her face and shake her again while pleading with her to let me help. She calms a little and starts asking "Khalas? Khalas?" (Is it finished? Is is over?) I'm able to massage her uterus and it starts to firm up a little but I'm forced to press my fist down between her rectal muscles as to keep pressure on it as she starts to contract and thrash again.
Liz comes back with the Methergine and Oxytocin but the intramuscular shots start an even crazier bout of thrashing. Finally, we give her some Chlorpromazine to try and calm her. At last, the bleeding slows down. It's 3:30am and I've been with her for 45 minutes. I come back to the house, plug in some quiet music as I feel like Martin Luther having fought the devil physically.
I"m drained but not discouraged.
The next day, Gilbert tells me that they've finally discovered why she was possessed. Apparently, even though she never went to the Marabout, her relatives went to the witch doctor to find out why she was sick and were told that someone had put a fetish curse on her. I referred her to Noel, our chaplain.
A day later and much prayer later, she is sitting up in bed.
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