Caribbean Luminescent

Friday, many emotions were paired with an uneasy fear that a man might die because the local resources were limited and he had, perhaps, moments left until his last breath. Dread, doubt, and sadness pulled at me. I found myself strangely escaping into the luminescence of the Caribbean on the boat ride back home. Visibility was next to nothing at 9:00 pm but I trusted in Horman, our captain. Squalls were rough and, still two days later, I feel the brutality in my lower back. The events, which lead to me rocketing through water in darkness, provided enough adrenaline to make it half way home. But only that much. The letdown of cortisol is great when needed but there is no encore and it abandoned me to deal with the emotions while in strange tides. It’s at this point that I notice there were green glowing things in the water below just where the boat breaks smoothness in the otherwise clear, salty sea. I’m ignorant to the processes that caused the bio-luminescence, however, I was aware that God had, yet again, provided me a temporary escape from reality when it was needed most. Rather than bathing in the overwhelming fear, that there wasn’t more that could be done, I sat in wonder and awe of His unfailing provision and majesty. 

 

Cassie and I had just finished celebrating our 16 year anniversary a few days late. The children stayed back on Helene while we spent time together on the beaches of West Bay, Roatan. It was gorgeous, to say the least. At the end of our romantic getaway we met Larry, Shelia, and the kids at the airport to say farewell to our new friend, Britt. When down island, time is of the essence and each trips cost is high so we scurry to accomplish much to get our money’s worth. Larry and Sheila broke away to do the grocery shopping as we, the Riley’s, went to lunch and then tried getting internet connection issues resolved. Just your ordinary trip to the store in Honduras, until it was time to load up the boat and head home.

As I was corralling four young and wild Riley kids, I noticed an antiquated fire truck pulling into the docking area. I couldn’t help but admire the retro lime green paint job. It was almost as though the first of many vehicles were arriving for an unannounced classic car show. I stood gazing at the beauty of a time of old until I realized there was a reason it had joined us at the dock. In the blur of it all, I can’t exactly remember who came and hailed me to assist the paramedics, but suddenly I found myself in charge of a dozen people, all trying to help Mr.R, a 50 year old man from my island of Helene. He had been found down at his home, and unable to move. It took a few large men to even get him out of the boat and into a vehicle.

Realizing the paramedics were limited in their supplies and training I stepped in and quickly assessed my friend. Chest pain, weakness, sudden sweating, and a blood pressure high enough to launch the space shuttle from Cape Canaveral; Mr.R was most likely having a heart attack. I turned to Collins, the Roatan EMS. He didn’t speak English but understood my request for Nitroglycerin and an IV. He had neither. Because the ambulance had not arrived we decided to get him in a near by van and start towards the hospital. Maybe we could hit a Pharmacy en route.

Moments later God provided! I launched myself from the van to meet the pharmacist who, though she too did not speak English, was able to gather IV supplies and the life-saving medication that would dilate Mr.R's cardiac vessels and give him time that he desperately needed. Starting an IV inside a vehicle going 50 mph is not easy however, God gave me grace and Mr.R's fluids were running after my first attempt. Three doses of Nitro into our 45 minute drive across the island and his blood pressure had dropped from 280/120 to 180/100. Still high but significantly better. At least he was talking to me now.

Looking back, I’m not sure what I expected exactly. My first encounter of a third world hospital was humbling. In the alleyway and surrounding corners leading to the ER doors shadows lined more than the light illuminated. Wards and units stood alone, disconnected from other parts of the facility. It had not been painted in years. Maintenance must have been done strictly on an as needed basis. Benches, partitions, and doors operated haphazardly. The emergency department spared minimal standing room and the beds lacked linens while sitting only a foot apart from one another. Entrances and exits were adorned with bars, gates, and armed security. Neighboring buildings fostered a collage of shops selling anything from an umbrella to, what us typical Americans would call, a fish filled Spanish Hotpocket. The streets were peppered with children just getting out of school as well as a few nefarious characters who appeared to be looking for weakness and folly in those sauntering by. I felt eyes from all directions. I stood out, obviously. Perhaps I was the only gringo within a few blocks. I felt exposed but I had little time to worry about my own safety. Mr.R was only 50 feet away fighting for his life. 

Rain had been falling for the better part of the afternoon. In order to use the restroom I had to carefully balance on a fifteen foot long 2"x 4" board then, treading lightly from cinder block to cinder block, I had to leap into a dark concrete room haphazardly lit with a bulb dangling from uncovered wires. Because of the poorly covered areas around the ER, lingering family and ailing Hondurans wore shrouds of damp clothing and I couldn't fight the feeling of being blessed beyond measure.

While waiting to hear how my friend was doing, I met a young man named Jonathan. Our conversation was casual but I learned, from my new friend, that it would only be "a matter of time before someone hurt me”. After my declaration of a great love for Honduras and its people, I can only hope that my reply, "God would give me the grace to continue loving his people and his home even if pain or suffering were my only reward", would leave a lasting impression on his soul.

It was thirty minutes into my wait when one of the nurses came looking for me. By this point, in the states, a patient with chest pain and signs of myocardial infarction would have had two IV’s, an electrocardiogram, and the first of many labs would have started trickling in. Mr.R had yet to have any of these things done. The nurse was only now asking me to clarify the medication that I had given him en route. I returned to speak to the doctor. After explaining, for a second time, all that I had done and assessed, he shared that his resources were limited and Mr.R would likely be released that very evening. In that moment, I was preparing for my own heart to skip a beat or two.

Management of his hypertension was their first priority. Once his pressure was stabilized they would draw blood for his lab work then send him home with the results so I could read them and treat him accordingly. The nurse brought Hydralazine, an IV blood pressure medication. While re-positioning the IV, which I had established on the way, she accidentally pulled it out prolonging the time it would take for Mr.R to get this potentially lifesaving medication. To her credit, her ability and skill at starting an IV was amazing. Before long, he had his first dose.

The doctor decided to fill me in on the amount of Mr.R's med and the dose of meds he would be sent home with in order to manage the hypertensive crisis. My history in the field, and Mr.R's weight, suggested that the dose would not be adequate. I found myself in a strange place. Rather than arrogantly telling the physician to give a larger dose I simply made a suggestion that a second, larger, dose be prepared in the event that he needed a larger dose to reach the desired therapeutic effect. He listened and subsequent doses eventually moved Mr.R from immediate danger to stability.

Darkness began to fall. Keep in mind, there is a steady level of manageable danger for a white man in the heart of Roatan. I have been told to always be aware of my surroundings while down island during the day and, if at all possible, don’t get stuck there at night. I have a profound, God given, love for my new community but I am not naive. I was alone. Mr.R's sisters had arrived and were focused on his care. I called Larry, the director of the mission that we are serving at, to find out how I would now get home. He had already sent a ride for me. Matilday came with the van but needed to return to the taxi station to get his personal truck so I would wait another hour before starting my 2 hour trip back to Helene.

Miss E, Mr.R's sister, decided to return with the two of us. We received regular phone calls updating us on his status as we drove through the city of Roatan. As far as I know, Mr.R is alive and recovering but it remains to be seen if he was experiencing a heart attack. I prayed with him on the way to the hospital and continue to do so. There are options for him to go to main land Honduras and have tests done that any American would receive at the simplest corner clinics. Life is not as simple as in the States. Money, time, and benefit by association play a much bigger role for the members of my new community.

Obscurity and Blackness concealed the twenty foot vessel that would shuttle me home. Adrenalin still pulsed through my veins as I boarded. The 45 minute drive from the hospital to the pier left little time for me to process all that had occurred. Tears remained confined. Fear ruled my subconscious and I was merely finishing the terrifying night going through the mindless motions of getting in a boat, staring into the water, and, eventually, finding my bed to rest my weary head and broken heart.

Five days after the ordeal and I am still trying to process it all. I hope to refine procedures in the clinic to avoid some of the nights pitfalls if, Lord forbid, someone comes to me with a similar illness. Please pray for Mr.R. Please pray that those of us involved can find and learn from the moments that Jesus was showing us. Please pray that I can have the fortitude to continue encountering my island with His grace and the skill, wisdom, and insight that God has given me, and then some. Please pray that He protects and/or uses my emotional well being when I simply can’t do more.  

I know this post was long. Perhaps a few might read it. I guess if there is anything to take away from my ramblings, if a nugget of enlightenment may be attained, I would hope that you have learned that the sea of the Caribbean is enchanting at night and God’s majesty is visible even in the most frightful of situations and, while the struggles of missionary life are real and show no sign of slowing, He is mighty, He is good. He is peace and tranquility, even when the air is anything but calm. 

Blessings.  

Levi