The Death of Carlita

Disclaimer: if you are very sensitive, easily upset, or offended by frank observations, please be advised that the following post may be hard to read. It's long, but I am documenting the following events as a sort of therapy session and also to give a glimpse into this culture. This is very long, but, I believe, worth the read.

It started on Sunday morning at about 10:00 as I was about to brush my teeth to leave for church. We had a couple from the CAM board here with us from the US to see Guatemala, to see our ministry, and to have their board meeting. We were going to take them to church, take them out to eat, and then Brandon was going to drive them back to the city. All this got interrupted with a phone call.

Brandon walked into the bathroom with all color drained from his face. He said “first of all, our family is fine…Carmen’s baby died.”

Carmen is the 16 year old daughter of Gladys, our housekeeper and friend. Gladys is at our house from 8-3 or 4 Mon.-Fri. and 9-12 on Saturday. She cleans our house, helps me cook, helps me with the kids, and has been our practical Spanish tutor. Carmen got pregnant last summer and had a beautiful baby girl (Carlita) in May. She was 4 months younger than our babyK. Carmen had a very hard labor and birthed Carlita alone because Gladys wasn’t allowed in the hospital with her. She had a very difficult time nursing at the beginning and spent some time over here while I helped her learn to nurse.

After Brandon gave me the news, I called Gladys on her cell. She was hysterical, crying “my baby, my baby is gone, my baby is gone.” I asked her where she was and rushed to the public hospital emergency room to meet her. At this hospital, the emergency room waiting area is outside of the doors on the street. Everyone has to sort of move out of the way when an ambulance approaches so they can transport someone inside.

Gladys was sitting outside with friends. She was frantic. Crying uncontrollably. I sat with her for a moment and found out what had happened. That morning, around 8:20, Gladys woke up and went to make some coffee when she heard Carmen scream “THE BABY’S NOT BREATHING!” Gladys ran into the room, picked up the still warm Carlita and realized that she was unconscious…looking like she was sleeping but not breathing and not waking. She wasn’t blue or anything. The baby was already dead.

They (after putting on pants and shoes at lightning speed) ran a significant distance to the street with the baby where Gladys ran in front of a passing car to stop it. The driver took them the 5 minutes to the hospital emergency room. When they arrived, a doctor examined the body and pronounced her dead. No resuscitation efforts were attempted.

After sitting with Gladys for a moment, her questions started flowing: “Why Señito (what she calls me)?” “Why did God take my baby?” “She was healthy, why did she leave?” My answers through tears: “I don’t know, my friend.” “I don’t know.” “I am so sorry.”

I then headed inside to see Carmen. They had her in a corner next to a crib in a space that may have been 18inches wide not including the crib. There was a partition on her right, and the dead baby laying in the crib on her left. She was standing, and had been that way for 2 hours since she arrived at 8:30. This emergency room is just a series of cribs and examination tables circling the 20 x 20ft room. Her little area was the only one partitioned and that only on one side. Directly in front of her lay a newborn crying with fever. There were sounds of children and babies crying from fevers, injuries, injections. There was (from what I could see) 1 doctor, 3 nurses, and a couple of lab techs working among the 10+ sick children. Carmen and her baby had been forgotten.

I loved on Carmen a moment and asked the friend that was there if there was a chair for Carmen. “No” I was told. “They’re all occupied.” So I went to the doctor and asked “Excuse me, I know you are busy, but the young girl over there who just lost her baby has been standing up with no rest. Is there a chair for her?” The doctor promptly took the chair from the nurses “station” (a small desk with some file folders on it) to give to Carmen. Carmen was not speaking. “Are you hot? Are you cold? Do you need a drink? Can I get you a chair? Do you want your mom in here?” That last one got a nod so I left to get Gladys.

Outside Gladys was still sobbing. I told her that her daughter needed her and that she needed to pull herself together a little bit to be there for Carmen. Carmen wasn’t grieving yet. She was in shock. She was in shock, standing next to her covered dead baby girl with crying children all around her. Gladys did as I asked her. When Gladys returned, we found out from the administration that in order to avoid an autopsy (everyone wanted to avoid that) they needed a doctor who would sign cause of death on the death certificate. One problem: the night before, Carmen and Gladys had given Carlita some cough medicine that a doctor from the hospital had given them the week before at the well-baby visit, “Just in case - It is coming on flu season, and if the baby starts getting stuffy, give the baby this medicine.” I don’t know what the prescription said. I don’t know if they even had one. I don’t know if they followed the doctor’s instructions or if they dosed her themselves. I don’t know any of that, but they gave a 4 month old 15lb baby girl 4ml of this medicine. To my very untrained eye, that is a lot. We give babyK, an 8 month old 18+lb baby boy, half that amount in cold medicine prescribed by the doctor. Only God knows what happened to that baby. We won’t know this side of eternity. It could have been SIDS, a hidden heart defect, a hidden metabolic disorder, too much medicine, too many blankets at night. The questions bother me, although I don’t know if any answers would make a difference. Maybe they would give me closure, but they wouldn’t bring Carlita back to Carmen’s arms or back to her breast.

No one in the hospital would sign cause of death because she arrived deceased. They had 15 minutes to get a doctor that would sign off, or they would have to call the police and ministerio publico to do an autopsy. I tried calling my kids pediatrician and my friend from church who is a doctor. Gladys ex-boyfriend was driving around trying to locate a particular doctor to come. As I was leaving to go home to nurse BabyK, they located a doctor who agreed to come and sign the death certificate.

An hour later, I took Gladys Q1000 ($125) to pay for the doctor who signed the cause of death and to pay for the casket and funeral director’s services. Although they weren’t going to have a funeral, they needed to pay for the director to help get the paperwork done and to bring the casket and transport the body and the family back to Gladys’s house and they didn’t have the money.

I left there and went to eat lunch with our house guests before Brandon had to leave to take them to Guatemala City. By 2:30 Brandon was gone and the neighbor was getting ready to come to my house to take care of the kids so that I could go to Glady’s house. Right before I left at 3:15, Gladys called to say that they were still at the hospital waiting for a signature from someone from the ministerio publico so that the body could be released. So I headed back up to the hospital.

Let me interject to tell you what I saw while sitting outside the hospital, and what I saw while inside. There were a couple of elderly people driven by loved ones who had to be led inside. There was the girl carried by her father with her foot wrapped in a blood soaked rag with gelatinous blood dripping a trail from the car to inside the hospital. There was the young man with an obvious broken leg being transported on a collapsed gurney rolling along the completely uneven ground screaming at every bump while the paramedic said “Calm down, calm down.” There was the drunken guy with gashes and wounds all over his face and torso that refused to enter the hospital for help and just walked around outside asking for coins to use the payphone. No one would help him. I only had one coin and gave it to him, but he was really too drunk to use the phone. Inside there was the newborn that was having blood drawn by a tech with no gloves on, who was also receiving an injection to lower her fever, which the doctor stated was the most important thing. This newborn was wearing 2-3 layers of clothing and was wrapped in a blanket. No one was suggesting that they remove some of her clothes. There was another little toddler fussing in her daddy’s arms, red cheeked and sweating from fever. She was also wearing her shirt, undershirt, and jacket.

Anyway, when I returned to the hospital later that afternoon, Carmen and Gladys were both sitting outside. Carmen’s grandmother was inside with the baby. You see, someone had to sit with the body because the hospital personnel kept trying to take the baby to the morgue and we were still awaiting the signature from the doctor to release Carlita home in place of an autopsy. The chair that Carmen had been using had been removed. After a while, Lupe (the grandmother) came out for a break, and it was my job to head back in and stand with the body. So I did. I stood…only for 20 minutes (they had been doing it all day) next to the tiny body of 4 month old Carlita. I know that it was just a shell. I knew that at the time. I know that Carlita wasn’t there under the receiving blanket. But every time I looked over at that tiny figure, I couldn’t help but think about how beautiful she was. How happy she was and how she was growing strong and gaining weight and how nursing was going so well (finally) for Carmen. I thought about Carmen waking up and finding her baby girl gone and a limp, lifeless body left. I thought about Carmen never seeing her first tooth. Never seeing her first roll over, crawl, or take her first steps. I thought about the empty arms of Carmen and how never again would they be filled with that wriggly precious gift. All that time, curious Guatemalans, seeing me cry, came over and frankly asked “Where are you from? What happened to your baby?” I had the luxury of answering that it wasn’t my baby. Poor Carmen didn’t.

I went back outside after a while to sit with Carmen and Gladys. Soon after we got word that all paperwork had been signed and that the funeral director was on his way. Everyone was fine until the casket arrived. This little tiny box covered in white gathered satin was carried into the hospital, and was soon carried out by Lupe, Carmen’s grandmother. I had to basically carry Carmen and Gladys to funeral director’s van. They were weeping and getting them to walk was a challenge. They went home and so did I.

This was now 5:30pm and I made it home to nurse the baby and heat up some leftovers for the 2 big kids. I had them in bed by 7:15 and I was looking forward to sitting on the couch, eating a cookie and milk, and watching some T.V. I called Gladys at this point to find out when the service was going to be the next morning. Gladys answered and let me know that the service was going on right then. So…I called the next door neighbor back over and headed out to Gladys house. I arrived at about the time that the service was ending, but I got to sit with Gladys and Carmen for a minute. The casket was sitting closed on a table in the middle of their kitchen/living room. Soon after, a group of young believers (young in age, not in faith) came and very kindly said that they were curious to know if it is the will of God that Carlita be raised from the dead. I would like to mention here that Carmen and Gladys had not been attending any church although they are professing Christians. These were members from a neighborhood church where a neighbor attends. After asking Carmen for permission, they opened the casket, laid hands on the corpse, and began praying for her resurrection. I could see that Carmen was beginning to panic. This was too much for her. She whispered to me that she did not want to be there, so I let her out of the room and into her bedroom where we sat on her bed and cried and prayed. I don’t think I have ever prayed so hard for anything in my life. I wanted so badly for God Who Is Able to bring life back to that tiny body. For Carmen’s sake. For Gladys’s sake. For God’s Glory. He didn’t do it. It wasn’t His will.

After everyone had left I stayed with them for a while crying with them and just listening. I just kept wondering how on earth they were going to live with out their baby girl. They were asking that same question. I had no answers. There are none that I know of.

I went home and slept fitfully. The next morning the neighbor came back over and helped the kids finish breakfast while I took beans, drink mix, water, and pitchers over to their house. I sat there with them for quite a while. At this point the casket was open and little Carlita was just laying there looking asleep except for the cotton pieces stuffed in her nose and ears. They don’t embalm here. People kept coming in and un-wrapping her and stroking her hands, repositioning her legs, and just examining her. For me, it was very unnerving. It was for Carmen also. She couldn’t stand to be in the room with the casket open. No one was really hugging, touching, or holding Carmen or Gladys. So I did. I don’t know if this was culturally relevant, but when I would hug them, they would both just collapse into me and cry. I had to leave again to go feed the baby.

Brandon had gotten home from Guatemala City while I was out. It was so good to have him home. I was so tired. That morning I had to put ice packs on my eyes because they were so swollen from crying and I couldn’t open them enough to see. Just to share the burden a little bit with him was amazing. We ordered a pizza for the family and my friend came over who has a daughter the same age as BoyD. The burial was scheduled for 2pm, so we took BabyK with us (I didn’t want to have to leave again to feed him) and left the big kids with my friend.

In true Guatemalan fashion, we had to wait for a couple of hours for a signature before we could bury the baby. It was after 3:30 when we got word that it was o.k. for us to precede. I have to say, although it is morbid and gross, that it was very hot in the living room. We had to keep moving the casket so the sun didn’t hit it directly from the window. They had to close the casket because the body was beginning to darken. The smell was overwhelming: similar to rotten meat that gets left out, or the smell if a rodent that has died in the wall. It had been about 30 hours since she had died. Poor Carmen. During this entire time, Brandon had BabyK in the sling and walked around the outside of the house with him where it was cooler.

Finally, the pastor arrived and we had a short prayer and Bible reading before heading out. Two of the men in the family carried the casket out to the back of the truck. Carmen wanted to walk (as opposed to ride in the truck) so all the little kids piled in the back of the truck with the body to hold the flowers upright. We began the 2 mile or so walk to the cemetery. The grave was dug earlier that morning by a neighbor. Thankfully Carmen’s dad supported her during the long walk and Gladys’s son did the same for her.

The grave site was almost unbearable. After a short word from the pastor and from Brandon, Brandon had to climb into the grave to receive the body and set her down inside. This was the hardest moment for everyone. She had been “asleep” on the living room table all day and now they were laying her in the ground. Brandon climbed out and two men began covering her with dirt. Shovel after shovel. The dirt was littered with trash and old floral arrangements. It didn’t matter. They just shoveled it all on top of her. Carmen watched in horror as her 4 month old baby was buried forever (we know that it really isn’t forever, but that perspective isn’t dominant at the moment) under 5 feet of earth. Right next to her was the ruined grave of another child. Caving in and rotting with old flowers. Carmen wailed and held on tightly to her father; finally giving herself over to the grief. We sat there crying until the flowers had been arranged by a couple of friends and placed on the grave mound. Then came the walk back to the truck. Carmen’s dad and brother were not available so I held her as we walked back, trying to support her weight. We all climbed in the back of the truck and drove the 2 miles back to the house. Brandon took BabyK and loaded him into our car while I helped carry in one of the other babies. I left Carmen laying on her bed looking as though she had been beat up and left for dead. It was more than sadness. More than grief. It was the grief of a mother who has lost her only child.

Carmen and Gladys and her mom and brother came over last night just to get out of the house. We sat and talked and cried and laughed. They are alive, grieving and carrying on. One day at a time.