You Need Pain Medicine? Why?

We’d like to believe that medicine is a hard science, unaffected by something so, well, unscientific as culture. In reality, culture exerts massive influence over how equally-intelligent doctors and healthcare professionals think about and practice their craft. The day my youngest was born gave us some rather unforgettable illustrations of this truth.

When my wife was pregnant with our third child we were hoping for a natural birth and planning to have the baby in our adopted Central Asian city. But very few doctors here are experienced now with natural birth and most vastly prefer C-sections. Still, we were hopeful as we planned for the birth at one of the premier private hospitals in the country. Then we found out that the cord was wrapped around the little guy’s neck. This and other unexpected developments meant we needed to change our minds in the middle of the night and prepare for a C-section. At this point they told me that I needed to go be prepared in case something went wrong in the surgery and my wife lost a lot of blood. They told me to go down to the lab with a slip of paper. At that lab I would be given a cooler full of ice. Then I would need to leave my wife alone (in stalled labor) to trek across the city with my cooler to the blood bank, pick up two units of blood from the blood bank, and bring them back to the hospital. I remember asking, “Wait, you don’t store blood here at this hospital? How can that be? What about emergencies?” They assured me the twenty-four-hour blood bank would be open (it was 3 a.m.), and no, they didn’t have any blood at the hospital. And no, they didn’t have a phone number for the blood bank.

I called up a local believer who worked as a policeman and was often awake all night. Thankfully, he came to our rescue and went to the blood bank on our behalf. Turns out the twenty-four-hour blood bank was shut down for the night. So our wonderful friend spent the night in the hospital parking lot and then went back and banged on the blood bank gate at the hour they were supposed to open. They didn’t have my wife’s blood type on hand. “Go tell them to call their relatives to come and donate the blood for them.” At this point my friend had had it and basically threatened to bring the wrath of the police down on their heads if they didn’t produce the needed blood ASAP. And somehow they were able to suddenly scrounge up one unit from somewhere. He rushed it back to the hospital and made the hand-off. I delivered the blood and worriedly told the nurse that they only had one unit. She replied with a strangely cheerful, “Well, Inshallah she won’t need it!” All I can say is, Praise God she didn’t.

Later on that day, the little guy already born through a successful C-section, the doctor paid my wife a visit. By this point, my wife was in quite a bit of pain from the surgery. She asked for some pain medicine. The doctor cocked her head and in all earnestness said, “You need pain medicine? Why?” And then prescribed a couple of Tylenol. We learned very quickly that the locals don’t really use heavy duty pain meds. In fact, they often send women home on the same day that they’ve given birth. This is super normal to them and they discharge women with their IVs still attached, who then hobble down the street and are likely buy some fresh flatbread on their way home. Our local friends and the hospital staff were quite bemused at the strange foreigners that opted to spend three nights in the hospital. “Nobody does that!” We were quite stunned ourselves both at the pain tolerance of the local mamas and the lack of any meds stronger than an ibuprofen in one of the best hospitals in the country.

We went home just as my wife started to develop severe debilitating pain in her neck. The outer layer of the spinal cord had been punctured too severely by the epidural shots and too much spinal fluid had leaked out, meaning she couldn’t sit up without incredible pain. She spent the next four or five days completely bed-ridden while I played nurse and hosted all of our local friends who had come to congratulate us and bring my wife a special post-birth recovery mash of flour, sugar, and oil.

The amazing thing about all of this is that our third-born turned out to be the most easy-going, sweet baby that we’ve had. To this day we marvel at his perceptive and kind nature (He’s a two year old now, and a cute curly-haired little ewok). Our other two were born much angrier, angstier babies. And yet he had, by far, the most traumatic birth experience of the three of them. We shrug our shoulders and attribute his easy-going nature to him being the only one to enjoy the delicious local diet while in the womb.

When it comes to the local medical system, we’ve had our fair share of shock and surprise, both in this situation, and later, when our daughter was hospitalized with new-onset type-1 diabetes. But in spite of the cultural differences, we do really thank God for the doctors and nurses in this country. There are some things we will always scratch our heads about. Sometimes we can see clearly how their culture has canceled out sound medical practice. But at the end of the day, they are a common grace from God. They’ve saved the life of one of my children and potentially of my wife and youngest as well. And to be honest, I’m sure we also have our own cultural blind-spots in the West that get in the way of good medicine.

And now I know. If local surgery is required, best to beforehand round up a crew of “relatives” with the right blood type just in case the only blood bank has run out. Forewarned is forearmed. I may still feel it is a very badly designed blood bank system, but as long as you know what to expect, even bad systems become, well, somewhat normal.

Photo by Christian Bowen on Unsplash