Please don’t read this if you are sensitive. I imagine this account will upset some of my friends. It wasn’t easy for me to write.

A week after her birthday party, Shakeenah came down with a stomach bug. She started vomiting even from just drinking her mother’s milk or water, and by the second day had lost nearly half a kilo in weight. We took her to the pediatrician, who felt it was a virus that would soon pass and prescribed anti-vomiting medication and rehydration.

Instead of returning home, we rested at an empty apartment that some foreigners in the city use for meetings and language classes. It’s just upstairs from Aslam’s own apartment. Peregrine gave Shakeenah a bath, and I went use the toilet.

I heard Shakeenah cry and Peregrine yelled for me. She told me later that Shakeenah (just starting to walk) had tottled across the bathroom and slipped, hitting the back of her head on the tile floor. At first Shakeenah had cried like normal and reached out to be held, and that’s when Peregrine called for me to get her.

I grabbed a towel and came in to pick her up. As I reached down her eyes suddenly rolled around erratically and her head started twitching. Rosey and I both screamed and I grabbed my little baby. My immediate, very strong thought was that my baby’s brains were scrambled and she was going to die.

I ran full speed downstairs (no shoes, no phone, no wallet) and yelled out to Aslam to take us to the hospital. He rushed out and we jumped on his motorcycle. The ride was horrible. I’m looking at Shakeenah and her arms and head are having little fits. I’m just supporting her head/neck in a safe position and praying desperately to God with everything in me to save her life. In my mind I’m imagining her dying, imagining what life is going to be like with her gone.

Aslam pulled his motorcycle up to the door of the trauma center and told people to clear the way, I rushed in with Shakeenah and yelled out to the first doctors I saw.

It is impossible for someone who hasn’t been in a trauma center like ours to adequately envision it. A room crammed full of stretchers, overloaded to the point there are a dozen or more people OUTSIDE the room on stretchers, and many of them look like they’re dying. Only a few doctors moving around the room, less than one for every ten patients. Patients are being tended by friends/family rather than by nursing staff.

The doctor sends me to a vacated stretcher and has me lay Shakeenah on her back. The nurse hooks a pulse monitor to her big toe. She’s not moving as much now as she was before. The doctor states that she is stable and they walk away. I’m staring at the monitors, not knowing what “normal” is supposed to be and scared about everything. After a few more minutes Shakeenah stops moving and falls asleep or unconscious, though the monitors report basically the same.

Aslam is out completing the requisite paperwork for admittance. Every other time I’ve taken someone to trauma, I’m the one who takes care of everything. Now I’m just next to my baby. I’m alone, waiting for the doctors to come back, waiting for Peregrine to arrive. I have no idea what will come next.

A man standing next to my stretcher asks me what happened. I explain that she slipped and hit her head, and he says, “She only slipped? Don’t worry, she will be fine, she will be fine. See that boy over there? He fell two stories.” He is pointing to a 3 or 4 year old boy lying unconscious on the next stretcher. You can tell that my new friend is honestly optimistic about Shakeenah’s chances. It does comfort me a little.

I realize the boy is his son. I tell him about my friend whose 5-year-old boy fell 10 feet and hit his head, and how he was in a coma for three days and a bad state for a week but ended up fully recovering and is perfectly fine now. My own attempt to comfort seems to work a little. But I am terrified for his boy and feel like he’s not going to make it.

While we wait, people are getting wheeled in in the most horrible states. Later I will see at least two patients fail to exit the room alive. Aslam returns and tells me he’s spoken to the doctors and she needs an x-ray, a CT scan, and an ultrasound. I use his phone to call Peregrine and tell her that Shakeenah is unconscious, to bring all our paperwork and not to forget my sandals. Aslam leaves again to arrange the scans.

About five minutes after she fell unconscious, Shakeenah wakes and sits up in one motion. She’s not in a good way and starts crying. A nurse comes over and checks her vitals, the heart monitor falls off, Shakeenah is too upset to get it back on securely. I’m worried that she’ll hurt herself further. The nurse signals that I can pick her up and I do. I try to hold my tiny daughter in a stabilizing position without hurting her head and begin pacing next to the bed.

A nurse and doctor insert a catheter into Shakeenah’s arm so that they can give her injections or IV later. I thank God that she has such visible veins, but her hand looks tiny and vulnerable. They complete it well, then leave. Once again I am alone. But Shakeenah waking up and sitting up and crying was so good, the first normal movements I’d seen her make. I have real hope. I continue praying incessantly.

At some point our Indian teammate shows up with a friend from the slum. He’d been assisting her inside the same hospital. Peregrine arrives with Aslam’s wife. Shadia and her roommate make it over from the other side of town (this is back when she was working a hotel job and staying in staff housing), and Shadia’s boyfriend pulls up on his motorcycle. It was really helpful to have all of them there, Aslam in charge sending everyone out for various tasks. My only job was to hold and comfort Shakeenah.

I could share about the x-ray, the CT scan, the ultrasound, but you can imagine. Through the course of it all I’m overreacting to every bad sign, little moments of terror, invariably followed by moments of relief. Shakeenah had to be partially sedated for the scans, leading to more opportunities for fear.

At some point we hear that the CT checks out as normal. The best news of my life. Slowly I’m becoming more optimistic that things will be okay.

We wait outside in the hallways now, all of us. Shakeenah is very drowsy and still out of it but the sedation is starting to wear off. On a whim I lift my hand in a high-5 gesture. She gives me a high-5 and breaks into a huge grin. It’s her first smile! Everyone else high-5s her and gets grins too. But she still looks like she’s suffering.

Eventually we move up to the neurology department to show the doctor the test charts and get a consultation. He tells us that there was a minor brain injury but no major injury – no fracture, no internal bleeding. He labels it a concussion. They consider admitting Shakeenah overnight but decide against it. I am disappointed because I don’t want to be alone with the responsibility. We are prescribed an anti-vomiting medication to stop the vomiting from the stomach illness, and paracetamol for pain, and told what to watch for (seizures, uncontrolled vomiting, bleeding from any orifices). Four hours after we entered the hospital, Shakeenah is discharged.

She falls asleep on my chest soon after we exit. We take public transport home, the road is in terrible condition and I hate every bump. We get home and make a perfect bed for her on the floor. Over the phone a nurse we know tells me to wake Shakeenah every two hours, make sure she opens both eyes, test the pushing strength in both arms. She sleeps deeply through the night. waking only when I force her to for the tests. She is drowsy but passes her tests, and just wants to nurse from Peregrine and go back to sleep. I do not sleep all night.

In the morning she wakes up and starts crawling around. She’s WAY out of it, has trouble standing normally but does stand up and walk eventually. All day we keep stimulation low. She does her activities at low intensity and keeps going back to sleep. She throws up twice. I get a recommendation for a neurologist and go to visit by myself without Shakeenah. He listens well, seems very competent, says he thinks the situation is okay, that the vomiting is due to the preexisting illness, and tells me what signs to look out for over the coming week. When I get home it feels like she is already doing better than when I left. The second night is somewhat more normal than the first. I still hardly sleep if at all.

The second recovery day she is still drowsy, low key. My sister, a P.A., tells us that Shakeenah’s brain is tired and needs time to recover. Thankfully, she hasn’t thrown up since the previous morning. In the afternoon, about 48 hours after the incident, she suddenly “wakes up” in a new way and starts acting more normal than before. We toe the line between keeping her occupied and not overexerting her. And she’s very hungry. By evening she has a more normal bowel movement than before, our first clear sign that she’s recovering from the stomach bug. I don’t fall asleep until after 6am.

Over the following days Shakeenah continues to show recovery. I recover more slowly. I avoid emails, avoid personal or vulnerable conversation, only tell a few people what had happened. I have a trauma reaction when I hear a noise that sounds like someone falling, and am constantly afraid that she’ll hit her head again. We use a tied-on panda cap as her “safety helmet” whenever she’s on a hard surface, just to give us peace of mind.

Over time I begin to put the pieces together in my head more accurately. Why did she respond so seriously to what should have been a minor fall? Dehydration has a impact on the brain, decreasing brain tissue fluid among other things. I believe the dehydration from her stomach virus made her brain more vulnerable than usual. I also realize that all the symptoms I had seen – the eyes rolling about, the seizures and arm/head movements – were things I had seen in other people with concussions. Concussions which they recovered from fine with no problem. It’s just so much more terrifying to see those symptoms in your baby.

The trauma of the incident, along with the ongoing concerns about Shakeenah having possibly contracted tuberculosis several months earlier, affect me for months. I become moodier, less willing to expend energy, less willing to talk to people. I go through the motions to complete my daily obligations like teaching, but tend to do the minimum rather than searching to go above and beyond. At some point I stop blogging or writing email updates to my friends, feeling like the emotional investment was too hard. In free time I escape into current events and internet discussions, but interact with a short fuse. I often found it impossible to fall asleep before 3am or even later. Only playing with Shakeenah gives me actual joy, but the slightest mishap brings back traumatic feelings.

Over time, over months, we’ve all slowly improved. Shakeenah is an active, healthy baby who shows no lasting effects from her concussion. I’ve been able to engage in somewhat more personal emails and discussions, and am expending more energy with more enthusiasm. As I mentioned back in March, at some point during lockdown I really began to feel more energy to engage fully in life again.

But I still startle whenever I hear a bump and fear that she has fallen.