I'll call her Courage

There's a little girl that comes to the clinic. I'll call her Courage because that's what she is to me. She's 7 years old. Ill. HIV +. Lacking spunk and vitality. She comes every week with her mom. When she walks into the clinic my heart aches. I could hardly stand to see her walk, no bounce in her step because she's being robbed from her childhood by the most disgusting disease I have ever seen. Her legs are swollen with fluid, causing her to limp. Some days her face is ballooned up, full of fluid. Even her forearms have been puffy with fluid retention. One day I heard her talk. Once. When she saw some bread that she thought would quench the hunger inside of her.

I hadn't seen her smile. Not at all. Until...

The day when I had her in my chair and I pulled out a dress to give her. Nede had been going through her clothes and had found a beautiful white, red and black dress that she was no longer wearing. She said, "Mom, can I give this dress to someone who needs it?" Immediately I thought of Courage. Then Nede started asking me some question about her. I told her that she was about her age and she was sick with a disease, her legs hurt and she couldn't run and play like most 7 year olds should. Nede thought it was a great idea to give Courage the dress.

So, on Thursday when Courage came to the clinic she sat at my desk. She was unwell. Very unwell. As usual her mother had taken her to the hospital-- doing all she could. The treatment? Amoxicillian-- an antibiotic for a chest infection. And Tylenol. Again, I wanted to scream. Yell and scream. This little one, struggling to breath, coughing, gaining weight due to fluid retention alone, not because of added nutritional support. She needs a diuretic, a water pill. Her little heart is failing her so she's not excreting fluid as she should.

I never went to medical school so I don't really know what's wrong with her but I do know she has a heart and/or kidney condition. She needs a diagnosis and treatment. I can't make that diagnosis. I don't have the skill. Neither does anyone in our area. And if we did have the diagnosis, would we have the treatment available? Unlikely.

What kills me the most is my 5 years of working as a hospice nurse, knowing and believing in a philosophy that says you don't have to suffer. Death is difficult enough, I believe that one should not, and is not meant to suffer through the dying process.

What could I do for Courage? Well, I told her about my daughter. I told her that she had this dress that she wanted to give to her. I showed her a picture of Nede on my camera. I said, "My family and I are thinking about you. We're going to be praying for you. My daughter is about your age and she would love to play with you. How about next week when you come on Thursday I'll bring my daughter here with me so you can meet her?"

Upon hearing those words it was the closest thing I had ever seen on Courage's face that approached upon a sparkle and little bit of zeal, a bit of joy.

"Would you like to meet my daughter?"

Indeed.

So, the following Thursday after missing work at the clinic all week because Chad and I had both been in bed with malaria, we made a plan to go to the clinic to see Courage. Nede would soon be returning to school and not be able to come with me to the clinic. Nede brought a stuffed giraffe along with 3 strawberry candies to share with her friend that she had been praying for. We waited at the clinic for sometime but Courage and her mother never showed up. We stayed in the area so we could quickly run back if Courage and her mom arrived. They never did.

Up until this point Courage's mom had been quite dependable about going to the hospital when we asked her to. She typically would return to us with medicines and paperwork so we would know what the treatment plan was for Courage. Days passed, still no Courage.

I had a sinking feeling each day that slipped by. Again, I didn't know what to do. I wanted to go looking for Courage but, I myself not feeling well, didn't go. Another one of the nurses did-- she checked 2 hospitals to see if Courage had been admitted. No.

I asked our colleague to try to check in on her, she promised to get her mother's phone number. I felt like I was doing what I could but really it was nothing and in the deepest part of my heart I knew it wasn't enough. I felt convicted.

And then Friday, when I was again unwell and laying on my bed I got the message. A small girl had been sent to our colleagues house at 5am to bring the news. On Saturday, January 18, Courage had died.

I wept. I cried and cried for this little one. I wanted to remain in my fetal position because I was so angry. I was maddened that a child had to die like this. Not just die but likely suffer in the process. Nede didn't get to give her her giraffe or give her a hug.

I hoped Nede wouldn't ask about her.

Fat chance. Nede's in tune. Nede's heart is one of compassion. She asked, shortly after coming home from school, she asked, "Mommy, did Courage come to the clinic today?"

"Lord Jesus help me to know how to talk to my little girl about this!" I crumbled to the floor, wrapped her in my arms as she said, "What Mommy, what? What is it?"

"Nede, Courage died last week."

Silence. Aching. Pain so deep I wanted to run to my happy place of dancing in a field of daisies, forgetting about HIV and children dying.

Then Nede, in her sweetest voice of deepest concern said, "Mommy, I wish I could have met Courage and been able to help her before she died, then maybe she could have been healthy."

"Oh, sweet girl, you did all that you could, you prayed for her and you opened your heart up and loved her. You did all you could and I'm so proud of you and now it hurts badly, doesn't it?"

"Mommy, do you think she wore her dress?"

"I'm sure she did Love! I'm sure she was so happy when she did!"

Throughout the weekend we had several tears for Courage. My heart is sore again. Through God's grace I'm not a broken mess all the time, if I were I wouldn't make it here very long. For some reason this one embedded herself into the deepest chamber of my heart and I, along with Nede, am grieving the injustice. Thankfully I take comfort, and shared with Nede, that I believe Courage is dancing in that field of daisies, with her red, white and black dress on, holding Jesus's hand, smiling and laughing with more vitality than she ever felt on this earth. She finally gets to be a child and isn't sick. This brings me much peace.

But...

I ache that she got there through deep suffering.