One Nurse at a Time

All eyes watched the fine crimson streak following the surgeon's scalpel as he traced it across the woman's swollen belly. Immediately, the Finnish nurse said the opening was not big enough to pull a mouse through, much less a baby. He carved a beautiful line. After all, the 75-year-old doctor was a plastic surgeon, not an obstetrician.

The moment had the makings of a bad joke: a retired plastic surgeon, general practitioner, anesthesiologist and three nurses traveled to Guatemala for a facial reconstruction mission and ended up doing a C-section. In the punch line there would be a talking duck.

After 14 brutal, bone rattling hours of driving, in the mist of the far northern highlands, we reached the small town called Barillas. Our unpacking could wait until morning. Our aching bodies needed a warm shower and soft bed, but the door opened and a small woman walked in.

"She is the local midwife," I translated. "She wants us to deliver a baby by C-section." The town's only doctor had left months ago and never returned. "Doctor," she said, smiling and pointing to the two tired men, who looked at each other with concern.

The GP whispered he hadn't seen a delivery since med school, twenty years prior. The Plastic Surgeon let out a nervous laugh, "Multiply that by two and a half for me!" One nurse specialized in geriatrics, the other an OR director. And me, as a typical ER nurse, I would rather walk barefoot across burning coals than face a pregnant woman who says she needs to push. But the moment we saw the girl drenched in sweat, panting through a contraction, we forgot our own fears.

We let her labor during the night and hoped with crossed fingers and toes that nature would take its proper course. But the knock on the door came before the roosters had a chance to crow.

"Susanna," the midwife said to me. "She needs help." Her membranes ruptured, she had been in hard labor for three hours, contractions were two minutes apart, but the baby wasn't coming.

There was no delivery suite, only a bare 8 X 10 foot concrete room. A steel gurney, antique by our standards, would be our delivery bed. The anesthesiologist introduced a catheter for spinal anesthesia. She didn't flinch when I started the IV and placed a catheter to drain her bladder. A liter of urine filled the catheter bag. Perhaps her full bladder had impeded labor.

The plastic surgeon entered the room with the GP at his side. A drape blocked the girl from seeing the first, gentle cut of the scalpel.

"You can't even pull a mouse out of that," the Finnish nurse said, pulling off the clamps the GP had meticulously placed to stop oozing. "She's not going to bleed to death - you'll never get a baby out with these on!"

When the incision was wide enough, the surgeon tentatively slid his gloved hand into the girl's belly, shaking his head. The Finnish nurse grabbed his hand and pushed it in deeper.
"Cradle the baby in your hand," she said. "Then you scoop it out like a melon ball."

The surgeon tugged but nothing budged. The baby's head was engaged deep in the pelvis. The surgeon looked over his mask at the GP, who looked at the Finnish nurse who looked at me. I looked at the girl's trusting brown eyes. The GP placed his fist in the birth canal and pushed. The baby popped out into the surgeon's cupped hands and began to wail. A six pound five ounce girl.

We swaddled and warmed the infant beneath a goose necked lamp. Ladies of the community streamed in to visit. The surgeon went happily back to his comfort zone of repairing cleft lips and palates. I held kids as they woke up from their surgeries and passed them to nervous parents praising God for miracles. Checking on my obstetrical patient, conversations stopped and laughter ceased as all eyes stared at me. The people of Barillas have lived in isolation for generations: descendants of the Mayans, coarse black hair framing round faces, short in stature. My five foot nine-inch frame towered over them and with my fair skin, blue eyes and long blonde hair; I must have looked like something out of a story book.

The new mother passed her squirming bundle to me. I held her little brown face beside mine.
"Look!" I proclaimed. "She looks just like me!"

The room erupted in laughter. The dark-eyed, black-haired baby was the spitting imagine of the tall blonde American nurse. I asked what they were going to name the child. Mama held the baby next to me. "She looks like you. Her name is 'Susy.'"

Three years passed before I returned to Barillas to screen patients for another surgical mission. Little had changed in the village and news of "Gringas" caused a stir. On the second day of our work, the midwife invited us for lunch.

The living area was filled with relatives and neighbors. I instantly recognized the young mother, who pulled down her skirt to show me her C-section scar. Only two inches long, it was barely noticeable.

"The other women are jealous. They want that doctor to come back for when they have babies." I doubted the surgeon, now nearing eighty, would be interested in revitalizing his career in Obstetrics.

Sleepily, a little girl appeared in the doorway, rubbing her eyes with her hands. Amid a room filled with black-haired, brown-eyed, bronze relatives, stood a fair-skinned little moppet of blond curls and blue-green eyes - Susy. She ran over to me, put her warm hand in mine, looked up and smiled.


I have lived a charmed life. I was born in a time and place that fosters independence, education and freedom for women. I believe it to be my responsibility to give of myself for the many gifts that I have received through no merit of my own. The non-profit that I co-founded, One Nurse At A Time, grew out of frequent inquiries by others "How can I get involved and do what you do?" Our goal is to make it easier for nurses to use their skills to help people around the world, to lower the entry barriers, to increase public awareness of the role and contribution nurses make in the humanitarian world. I truly believe we CAN change the world.