Sunday, October 28, 2012

Recent Photos

A child, happy to offer a photo

The break room, with all of the staff asleep in it

Hiking the whole way up and feeling like you are on top of the world, until you look the other way and see more above you

That little red dot is a beautiful little girl, sneaking a peak around the corner of the house

Ready for action in the operating room!


Sunday, October 21, 2012

This is a view from where we call half-dome. Who knows what the real name is. The last thing in the video is a view of the hospital compound, way off down in the valley.

Touching Worlds Apart

My world is small. I live life between a couple dirt roads surrounding the hospital here. Once in a while I branch out on a hiking trail, or rarely take a taxi to town (a very high risk ride). I have no TV, don't get much news. If there's a catastrophe or great event, I never knew it happened. I only know when someone emails me an update.

It makes me think of how far away worlds can be.  As the fall comes at home, I have no idea if my family is breaking out their jackets. When winter sets in, who knows if the snow comes and the children get out of school to play.

Here the rains start, and then the rains end, and then harmattan sets in. None of it usually means anything to another unless they are walking through the rain or dust on this side of the world.

That is the way it is. We are almost always consumed by whatever we see around us. Our circumstances dictate reality for us. If it is raining on us, then it is raining. No one considers that in some other place it is snowing, and in another people are bathing in the sun. That is, unless we love someone who is apart from us. Then, we wonder, "what are they doing now?", "what's the weather like there?", "are they sleeping or awake?". Our mind wanders to something beyond ourselves, to try to grasp what another's life may be. Once in a while it happens in terrible circumstances - tsunamis, earthquakes, famine, war. Our hearts are touched by the position and circumstance of others. But it is much easier to forget about all that is beyond our sight, and so we most often don't consider what is beyond our front door, or work area, or circle of friends.

But for those who follow Christ, He calls us to remember. We reach out across those miles through a God who is outside of and beyond the limitations of space and distance. He has called us to intercede on behalf of others, even those on the other side of the earth. It still can be hard to imagine, sometimes hard to know exactly what to pray. But God is always listening to the cares and pleadings of His people, and He is changing circumstance on account of the prayers of His saints. I am so thankful for those who lift me up before the Father regularly. The people who don't really understand what life is like here, or exactly what the needs are, but who keep praying anyways. I see God move on behalf of your prayers. I see better outcomes than I should have in my daily work. People who should have died walk out of the hospital alive, as if nothing was ever wrong. So, thank you for praying.

To those who don't pray much, I would ask why not. When there is Someone who is all powerful, and who  cares so much about all the things that you care about, why not ask Him to move. We are like idiots with the things we chose to pray for. You feel your stomach start churning, and begin to pray with all of your might, "Lord please help me make it to the bathroom, please let me make it, help me hold out, oh please.." We come closer to Him in our GI upset than in the actual greatest needs of our souls. He isn't expecting eloquent speeches and persuading words, He is just wanting hearts that long to know and trust Him more. His heart is already inclined toward those who seek Him.

Better Hands

Here a handshake can last forever. Offering a hand to greet is constant. Over and over and over again. It is deep in the culture. And the hand holding. So different than what I am used to. Though I have spent a good deal of time in Africa, this has never been natural for me. Walking to the market, someone grabs my hand. It would be okay if it were just for a moment, but no, they keep holding on. If it were up to me, I would pull away after a gentle touch that made sure they knew that I cared. But it's not up to me. So hand in hand we walk swinging our arms together. Men do it even more frequently. I laugh to think of what my male friends at home would do when another man slipped his hand into a firm grasp and held on tight. Young fellows in their twenties, old men with grey hair,  all with hands clasped together in friendship. It is awkward for me. When their hand tangle in mine, I always consider which way to break free - a fake cough, or pretend a sneeze is coming, or act as if I have to move my hand to shift the load I carry... There are just precious few people with whom I want to hold hands.

But His hands are wonderful to me. His hands are perfect to rest in. Perfect to hide in. They hold us up when we are weak, and guide us when the path is rough. So often we are found wringing our own hands, not realizing that He offers His. We get busy with our own lives, our own walk, our own stumbling, and forget that we can hold the hand of someone who can steady us through life. Like a toddler, we pull away to go on our own, only to land on our tush shortly thereafter. Oh to remember His presence and to slip my small hand into His large one. I want to instinctively cling to His hand, just as a small child does to the Father she adores.

The steps of a man are established by the Lord, and he delights in his way. When he falls, he will not be hurled headlong, because the Lord is the One who holds his hand. Psalm 37: 23, 24

Sunday, October 14, 2012

Poorly Fitted to be a Missionary

I’m not such a good missionary. I mean, I’ve never really fit the mold for the missionary woman. Number one, missionary women are supposed to be kind of reserved, sweet, mild ladies, and I’m not too much of that stuff. And they really do wear missionary woman dresses. I wear scrubs because it is like getting to wear pajamas out in public. I don’t have a husband, while almost every other woman is a “missionary wife” (perhaps that’s due to my constant pajama wearing in public, or some of my other similar attributes). I don’t like playing card or board games, and all the real missionaries love some of that. Who even knew that there were so many of these crazy games? They keep thinking they can teach me how to play and I’ll like it, but it holds no pleasure for me. I just go to “game night” for the snacks and fellowship. Thankfully, those missionary wives do make good snacks.

I’m not even a very good missionary doctor. I find myself often frustrated by all the stuff around me, sometimes consumed by it. I teach the general surgery residents and think, “surely I was not this hard to teach, surely not”. I try to have patience with the nursing staff, but this week one of my nurse midwives thought that preterm pregnancy was anything before 40 weeks. Huh? Every day it is something. Sometimes it feels like every moment is something. Patient care sometimes has huge mistakes and I find myself overwhelmed by waves of irritation by near misses, and often complete failures. I’m fine with seeing patients in clinic, but what about when they show up at the door of my house and I don’t know what to do with them. Today one came wanting me to do a vaginal exam. Really??? Do I need to clarify that I don’t do those at my house on Sundays? And those things are all outside of me. Inside, I find inadequacies of knowledge, skill that is lacking compared to the cases before me, and a restless spirit that gets consumed by all of the circumstances around me.

The other day I had been grumpy inside for quite some time. I realized the pattern of frequent frustration and I thought to myself, I am going to start every introduction to a new person with an apology – “I’m sorry I didn’t meet you earlier in life when I was really fun…sorry you only got to know the new me that is not really much fun at all”.  And that got me thinking about who I want to be and how I want to see life around me. I can’t fix all the knowledge deficits in myself or the staff. I can’t be the perfect doctor to every patient who comes in. I can’t know what the right thing is to do for every person who shows up at my house. But somehow I have to learn to rely on God through every success and every failure. I can see how He is glorified by success, but so often I can’t imagine that he can be gloried even by our brokenness and  mistakes.

One day last week I finally saw a glimpse of it in a tangible way. I was operating, just about to open the last layers of the belly wall, when I thought, "that looks like a big full bladder poking out at me". Hiding the frustration inside me, I asked if the patient had a catheter in. I mean, every patient, every case needs that catheter. I knew that someone had forgotten, just like they had forgotten the antibiotics until I asked just before beginning the case. I could feel the irritation rising inside me. But then I realized, had that bladder not been bulging out at me, tremendously full, I would probably have damaged it entering the abdomen. Only with it so distended could I really see how amazingly high up it was stuck to the underlying structures. Their error actually helped me. So instead of feeling my heart beat fast from yet another irritation, I thanked God for providing for me through it.
In 2 Corinthians it speaks of how we carry about the treasure of the gospel in “earthen vessels” so that the power will be seen to be from God and not from ourselves. He could've chosen golden vessels, or fine crystal vessels, but He chose earthen vessels so that the glory that was displayed by them would not be due to their own attributes. And in multiple places within the Word, God speaks of His people being like clay, and He like the potter molding them just as He desires. To think on it makes me wonder at the goodness of God. If I was making something and it kept having a defect in it, I would just say “well, that’s a defective clump of clay, throw it out and get another”. But God so often shows His patience and kindness to us, even when we are grumpy or irritated or imperfect in a thousand other ways. He keeps shaping and molding us, He keeps His hands on us. He is making us to be vessels that can carry great treasures. But we don’t carry our own precious cargo, we carry the greatest of worth – the gospel of Christ. Who would have thought that God would trust that to be carried by the flesh of marred men? And yet, that is how He has seen fit to make Himself known. Not through perfect, strong, wise specimens of humanity, but through the broken, weak, and weary who follow after Him. All He requires is that they be His. He is big enough to mold them into what He wants them to be from there. 

Friday, October 5, 2012

More Odd Things

I took communion for the first time this week. The church in America could learn a thing or two about the Lord’s supper from these guys. They use the equivalent to graham crackers and orange kool-aid. I felt like I wanted to keep going back through the line. It was like kindergarten snack time. I was reverent and somber until I put those things in my mouth, then I started feeling a like I was living on some more thrilling fringe of Christianity. It was just a big surprise I guess compared to choking down that dull cracker (which I do adore and always look forward to, but only because it represents the body and blood of Christ). Much more exciting taste to it than at home. I'm not sure if communion should be so thrilling. :)

My house is not far from market. It is always a bustling place. So if I am home from work, I hear somewhat annoying music blaring from the speakers there for most of the day. And then once in a while Dolly Parton comes on. Where in the world did she come from? It’s always the same song. I can’t hear the words well enough to know which one, but I know for sure it is her. Always amuses me.

Something else amusing was my patient today. I was kind of excited about getting to treat a nun. You know, it’s something about that thing on her head. That is what sets her apart. There are many of us who follow God with all of our lives (though certainly ours are different), but the rest of us don’t get to wear that. Anyhow, while treating her I was having a good rolling laugh inside. I had to give her birth control pills – not for the purpose of birth control, but for other gynecologic problems. I told her while chuckling, “You are going to have some explaining to do to the sisters at the convent as to why you are on these”. 

And the last thing I've found funny - circumcision. Three mornings a week I see them abducting the boy babies out of their mothers arms and lining them up on a stretcher. Their mothers wrap them like it is deep winter in the frigid north all the time, so they look like fat little rolled baby tortillas. They are all lined up right alongside one another. Most are crying - I would be too, had I the same parts and destined for the same purpose. They seem to know that they are in danger. I heard the nurse today gently say to one, "Stop crying baby". I told her, "You'd cry too if someone did to you what you are doing to him!" And then they were off, rolling down the hall to surgery clinic. 

The Broken

The world is full of brokenness. I see it every day in my clinic. Advanced cervical cancer again and again. It’s getting young women with children and families, older women widowed and raising grandhchildren. The cancer doesn’t care who they are. It just grows and consumes them. I’ve gotta look them in the eyes and give them “the talk”. Infertility again and again. Didn’t know that those times of pleasure then would cause them so much pain now. But sexual diseases have scarred the tubes shut and I can’t fix them. I can’t give them a baby. I’ve gotta look her in the eyes too, and give her “the talk”. Mothers, or women who want to be mothers, pregnant so many times, but lost them all. Stillborn twice, three died within a week of birth, the only one that lived died at age of five. I’ve gotta look her in the eyes, and here comes “the talk”. It varies a bit to fit the need of the moment, but the beginning of the talk is always starting from the same point – hopelessness. And the end of it is leading to something that often seems out of grasp – hope. Maybe circumstances haven’t led you to that point of having been drained of expectation of any good, or of any joy. But they likely will. So let me tell you the introduction for what you are going to need to know on that day. Maybe you can remember and reflect. I don’t know why bad things happen like this. I mean, theologically, I do know. But sometimes you just can’t make sense of it. This is a hard day. You are hearing hard things. And it seems like there is no hope left. But I want to tell you that on the very best days and on the very worst days, there is hope. There is a God who can be trusted no matter what the circumstance is. He is able to be trusted with the circumstances of this world, and with all that is to come when this life is over. He sent His Son down to show us who He is, and to bring hope to the desperate. He Himself lived a life of sorrow, and He can comfort you in your sorrow. You need to understand who Christ is, He is the only hope…

Really, that is the most important conversation that I have. And sometimes it feels so helpless, like you wish you could do something more, but you can’t. Ultimately we all need a bigger, better hope than this limited world has to offer. Life is going to let us down. It’s going to ask us for more than we want to give, take more than we ever would have allowed, and sometimes pour on more than we can bear. But there’s something better to come. Where brokenness is made whole, healing is complete, joy comes without sorrow, and life does not end in death. In fact, life there does not end at all. There we will see for the first time since generations and generations ago, what creation looks like without the mar of sin. The worries of this life will be but distant memories, wisps too small to be remembered in light of the One who will satisfy and sustain us in full. Let every broken moment make us long and yearn for that day. 

The clucking box

I’m officially a chicken farmer. Just got my chicken house finished up at the carpentry workshop. All the Africans chuckled to watch me walking down the road with a loud, big, fluttering cardboard box full of feathered friends. Well, I guess they are friends, at least for a while. I’ve named them – Breakfast, Lunch, Dinner, Snacky, Noodle Soup, Carolina BBQ Chick, Tender Clucker, Finger-lickin Chicken, Roasty Toasty, and Kentucky Fried. There are some problems, like that fact that I don’t really know much about chickens. I mean, our family had chickens when I was growing up, but I don’t remember any of the important stuff. I do remember that chicken coop smelled so bad. It was eerie and dark. Sometimes snakes would get in and eat the eggs. I hated having to shoo those chickens away to collect the eggs, they would try to peck at me as I did it. But here there aren’t many snakes, and I put the chickens somewhat far away so I can’t smell them. They are for meat, so won’t be around long enough to make eggs. Plus, they are going to serve multiple purposes. Chicken poop is supposed to be awesome fertilizer, so my garden is about to be amazing. And they are going to eat all my leftover vegetable scraps so I have less trash to throw away. The more I think of this, it is a great idea! Actually, I initially decided to get the chickens because I am cheap. Anyone who knows me would say that. My sister prefers the term “tightwad”. I’m not cheap toward others, just myself. I don’t waste money. So, when I wanted a chicken and it was going to cost over $10, I said, “heck no, I’ll raise my own darn chickens!”. And so, that’s where it started. Within an hour or so I had found someone to make my chicken house. And now they are all snuggled up together holding out until morning when I will feed them again.