Thursday 1 September 2022

Consent by Laura Alexander, green tea

 Li Jing unconsciously fingered the large opening in her upper lip. She reread the crumpled newspaper clipping describing the team of healthcare workers due to arrive to the city of Linyi to perform cleft lip and palate surgeries. Putting the paper in the back pocket of her tattered shorts she climbed out of her bedroom window just as the moon rose into the night sky. To keep herself moving she imagined herself as a rabbit running through the forest making as much progress as possible before sunrise. Ushi would be out looking for her as soon as she found Li Jing’s empty bed. Ushi had never considered allowing her to have the surgery as it was her deformity that prompted the tourists to toss a multitude of coins in her direction. Tomorrow she would do no begging for Ushi.


     The health care workers pulled up to the hospital and were greeted with dragon dancers and drummers but also the anxious and desperate crowd of parents waiting hopefully with their children. The surgery they were offering could change a child’s life because many of them, as well as their families, were ostracized by their communities. Some of the children had been abandoned by the side of the road only to be picked up by a loving family willing to take them in.  All of these parents wished only to give their children the chance at a normal life.   


     As the healthcare workers set up their clinic the families gathered their belongings and tried to calm their hot and tired children. The halls of the hospital had the pungent odor of urine and sweat but the physicians and nurses barely noticed as they set up to work. They weighed, measured and took medical histories. The surgeons evaluated the extent of the children’s disability, their age and their general health. They chose the younger, the healthier, the ones who had some kind of support at home for those were the ones who had the best chance of having no complications from the surgery.  Reluctantly the healthcare workers gave the regrettable news to the parents of the older children who it was too late to help, the sickly children who were too much of a risk. The difficult choices they had to make weighed heavily on their collective consciousness. The seventy five chosen children were settled into the pre-operative area of the hospital and the next day the surgeries would begin. 


     Over the next three days and nights Li Jing hiked through the dark woods and down the dusty roads trying to avoid detection. She foraged what she could to keep up her energy. The few hours she allowed for sleep were spent tossing and turning. She always woke anxious and afraid that Ushi would find her. She calmed herself by imagining a life that did not include the pitying stares of the tourists and Ushi’s relentless demands.   


     The surgeries were to be performed two at a time, overseen by Rosie, the Director of Nursing, a small woman with a big heart who no one dared to cross. Rosie did her morning rounds starting with a review of the notes on all of the children, once again assessing their health and putting them at ease with her quick smile. She then turned to the OR checking and double checking the equipment necessary for the surgeries and consulting with the physicians. She spoke to the parents of each child individually, reassuring the families with her soft voice and gentle, reassuring touch. She took her job, to  leave the city of Linyi with no complications, no infections, no child harmed, very seriously and her team felt lucky to have someone as conscientious as her to lead them. 


     On the third day of the mission trip a small child of questionable age walked into the clinic.  Li Jing was barefoot and covered from head to toe in the dust of the city. Her hair was matted against her head and she gave the nurses a cautious smile when she approached. She appeared hungry and dehydrated but her eyes showed intelligence and determination.  “I have walked for three days,” Li Jing explained through an interpreter.  “I want to get my face fixed. I have no family, no one.  Please can you help me?” 


     Over the next couple of days Li Jing hung around the hospital doing everything she could to help the workers. She bathed the younger children getting ready for surgery. She sponged them down tenderly and gave them hugs of reassurance. She sang to the ones who could not sleep. Everyone fell in love with this little girl’s spunk and determination but knew their hands were tied unless they could find someone to consent to her surgery. 


     Two days before they were to leave, the hospital’s elevator door opened and a woman stormed toward Li Jing pushing through anyone in her path. They all watched in horror as the angry woman grabbed Li Jing by the hair and dragged her toward the stairwell throwing punches at Li Jing’s face. One of the surgeons grabbed Li Jing and pulled her to safety. The woman was escorted downstairs by security where they determined that she was Ushi, Li Jing’s guardian.  Ushi was ordered to leave the hospital but they knew she would be back. Rosie may be unable to give Li Jing the surgery she requested but she could at least feed her and keep her safe for the next couple of days while they were in town. The physicians and nurses all pleaded with Rosie to let them do the surgery for Li Jing but now that she knew the Ushi was Li Jing’s guardian Rosie could not agree without Ushi’s consent. 


     That evening Rosie walked down the deserted hallway shoulders sagging, dragging her tired feet. She noticed light coming from the operating room. She opened the door and found one of the surgeons at the head of the bed, a nurse and an anesthesiologist at his side, a small form asleep before them.  It was Li Jing.  Rosie looked at the surgeon with confusion and asked “Who gave consent for this surgery?” The surgeon did not even look up from his work. “God did.”  


About the author

 Laura Alexander is just starting her writing career at the age of 65. She has been a nurse for 41 years and raised four sons which has given her plenty of ideas for her writing. You can find her work at
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