Tuesday, March 19, 2013

What will it cost?

The cost of following – the strange thing is that you don’t know what that actually is going to mean. When God first pricks a heart, awakening it to the needs so deep, yet previously unknown, He whispers (or sometimes is quite loud) that they should follow. Some turn away, wanting to make their own way and shape their own future. But dotted around the globe are those who sense that this call is the one they have waited for their whole life. Ears hear, faces turn, and then the whole body and life move to follow.

We don’t know in that moment what it will cost. Some don’t even consider it well. Some come to know Christ and their road still seems easy. Others struggle with great loss and great pain. But when the hardest of times come we remember that no matter where He leads us, we stay close behind. When it is so dark and stormy that we can’t make sense of what is around us, that is when we are most aware of the Lord’s presence with us.

In the course of a week, I’ve seen what it looks like in the lives of others to suffer. Two similar circumstances with the loss of a child, but two very different experiences. I saw each only from a distance. Both appeared quite difficult, both had some confusion, both wondered where to go next, but grief was worlds apart between them. One family stood their as the child lay dying, desperate and without hope. Thoughts turned to “what will people think of us”. Life turned to fumbling, purposelessness, and uncertainty. There had never been more than this life to think of, and so even in such a moment, there was still no room to consider the greatest of questions. There was pain with no aspect of rest or hope. The second family too had a sharp, cutting loss. But they cried out to and rested in the arms that they had known many times before. In the midst of weeping, they trusted God enough to know that His plan had not failed. Even as the child died, they could whisper to her to run into the arms of Jesus. They knew that the little girl was going somewhere amazing, even into the everlasting, outstretched arms of God.

Both families realized that being in the developing world had risk, but they were willing to take those chances. Their purposes though were very different. One family came just to wander, the other came to follow after Christ. The first is lost, still wandering, but in the midst of pain and suffering greater than they imagined. The second has some of the same pains, but they still follow with purpose and vision. Their vision may be clouded by some tears, but they dimly can see the Savior just in front of them. They realized that the cost of following could be great, but the shelter beneath His wings is unimaginably better.

To follow God has always cost. Saints of old have shown us the cost with their lives. Even as Jesus passed through and bid for those to come after Him we see that they left much. Houses, family, jobs, stability, riches, social standing – all left for the uncertainty of walking with Him. But Peter may have put it best, when the disciples were asked if they wanted to turn away from Him. He replied, “To whom shall we go, You have the words of eternal life”. Whatever the world offered apart from Him could not provide what was most needed. No matter the price, Jesus was worthy of their lives. 

Monday, March 11, 2013

Recent Patient Stories

In the Gynecology Operating Room
Her story was partly sad, partly interesting. I got to fix her complication from some other surgery at an outside hospital. Seven months ago she had “appendicitis” and was taken to surgery. However, upon looking inside her abdomen during surgery here, what she actually had was both ovaries and tubes along with her uterus and appendix removed. No one ever told her about the complete removal of all of her female organs in addition to her appendix. She just knew that she hadn't had a period since. Huh? Where else would that happen? She is just over 20 years of age and someone basically made her menopausal with no hope to ever bear children, and didn’t even tell her. But worse than that, and the reason she came to my attention, was because of a big swollen belly with a pelvic mass. Since I hadn’t known that she already had her ovaries removed, I was thinking perhaps an ovarian tumor (likely cancer, though rare in this age group). Upon inspecting her organs during surgery, I realized that not only had the prior surgery done the things mentioned above, but also had injured part of her urinary system. Her body had found a way to sort of wall off a large collection of urine, but over the months, it was collecting as well in the entire abdominal cavity, making it swell. She had amazingly been able to filter some of that urine back into her system (somewhat like peritoneal dialysis, for those medical people out there), and so had remained relatively healthy in spite of it. So upon opening her belly,  out poured over 7 liters of urine that had been collecting into her belly. After much dissection, we were able to reconnect her urinary system the way it was supposed to be to provide proper function. It was very satisfying to go in thinking that some young woman may have terrible cancer, and then to come out (a loooong time later)  having fixed a treatable problem. Daily we cared for her, and daily she improved. She heard the gospel, and hopefully saw it, day after day. She was happy to be healthy again and prepared to leave the hospital with a future ahead of her, a hope that some normal life awaited her. Although we couldn’t do anything to improve her fertility issues, at least she could be healthy again.As I gave her discharge instructions, I told her the routine precautions. But I told her something else too, something that I had begun to think of while I cared for her. I told her of how important it was for her to stay in school and to continue her education. This was one of the most important things she needed to understand. You see, for an infertile woman, the world here would tell them that they have little value. She will likely never find a man who will marry her, knowing that she cannot produce children. This will affect her financially, socially, and emotionally. She knows, in a vague sense, what her condition means, but in the future it will become very, very practical. Many struggles are yet to come, a whole lifetime of them. I pray that she will face them knowing the value that she has in the eyes of God, for the world here will likely offer her much opportunity for discouragement.

A Few Halls Down, In Labor and Delivery
I had just walked in the door from rounding Sunday morning. I was thinking of the upcoming surgery of which I had just notified the OR. The phone rang as I was shutting the door behind me. The voice was familiar, it was a midwife from the maternity ward. “Double footling breech with feet in the vagina”, she said. I grabbed the set of special delivery forceps that were sitting on my dresser and rushed out. It was as I had been told. The mother was pushing with all of her might. I had to choose – a cesarean or vaginal delivery. Emergencies are managed much more slowly here, I knew that by the time we got to the OR and ready for surgery, the baby would likely already be out. So I told her to push with all of her heart. The water broke a moment later, and into my hand fell a long loop of umbilical cord. I pushed past it to grasp both feet. They came down fine, we were making progress – until the mid abdomen. Then the baby just stopped coming. I cut an episiotomy to give more room for the manuevers which I knew may have to be performed  (though the old scissors really chewed an episiotomy instead of cut one). I gently put traction on the hip bones, but still progress was slow. Finally the arms. But they were still a bit higher than I wanted, and it was so difficult. I felt the pop of a bone as my finger finally swept it outward. I felt the first arm come down. The nurses stood beside me. We struggled with the second arm. I heard the nurses praying as they worked, and they heard me pleading with Him for help. It had been minutes, the umbilical cord had been squeezed off by the weight of the babies body as it fit through the narrow canal. The body just hung there, half out. As I worked, sweat rolling now, I thought to myself “we may lose this one”, which added a quick breath of momentary panic before again my hands continued with the necessary movements. Finally, both arms were out. The head, usually the most difficult part, was yet to come. I maneuvered that head exactly as it should have been, but it wasn’t coming. I asked for the forceps, and applied them. Just as the second one was fitting in place, the head began to come. Limp, pale, lifeless, and nonresponsive, the child was finally released. I instructed to begin oxygen (though we don’t have an oxygen tank, we can concentrate oxygen from the air) and begin compressions. Within a few minutes, a glimpse of a tiny movement brought encouragement. Another series of long seconds passed, and then a cry came. Plenty of cries followed, and then our own voices joined to rise up with praises to God from all around the delivery room. From the mother, to the woman with the mop, we all rejoiced together. We looked around at one another. There was a sheet of blood dripping off of both my arms, reaching the whole way up to my shoulder. The nurses white gowns were spotted with dark red. But we looked like the happiest, most delighted people in the world. I fixed the tear on her bottom, and then wrote the delivery note. I found myself stopping every couple of minutes to catch my breath, and then with it to thank the Lord again. 

Friday, March 8, 2013

Reinforcements Have Arrived

The rainy season has started. Oh the joys of putting on a rainsuit and rainboots - it makes you 20 years younger. It's also pretty refreshing to lie in the cool evening breeze and listen to the rain on the tin roof. The rhythmic sound beckons to something deep inside, calling me to a deep, sound sleep.

But it's not nearly as refreshing as having my family come visit. My mom and stepdad have piled up in my little house for just over a week. I stored up on a bunch of good stuff in the city 5 hours away when I went to pick them up from the airport. I bought things that had never been in my house before - cheese, napkins, paper towels, crackers, a toilet bowl sanitizer/deoderizer, etc. They are living the life of luxury, but they don't really know it. I'm kind of enjoying the fancy stuff too, even every flush of the toilet brings a lovely mountain fresh scent.

But, the high life is only part of the story. Besides that, they've been put to work. Sean is working with the orthopedic team and helping to teach some students. The first day on the job he saw "more pathology that all the rest of my career". I had him assist me in a C-section, and believe that soon he will be wooed to the world of Ob/Gyn. In his off time, I have him finding ways to block the lizard from crawling up into my washing machine drainage pipe, fixing the shower, etc. Mom is providing anesthesia, and teaching anesthesia students. It's nice to see her up there at the head of the table, I realize that the patient is in good hands. In her time off, I have her cleaning up the yard and managing the garden. It is also her responsibility to debone the chicken for dinners. She says that she misses chic-fil-a where the chickens don't have names and come properly cut up.  When they finish their respective chores, I have them put on their hiking clothes and conquer mountains. Though sometimes the mountains conquer us instead.

Sunday they were allowed a bit of rest. They experienced church like they never had before. Everyone was dancing and swaying - everyone except them. Again, they confirmed to the Africans that white people can't dance. I guess it takes a bit of getting used to in order to really let loose. I loved to watch everyone dance their offerings up to the basket in the church - the old, hobbling woman with the cane, the man with the shriveled useless hand, a child, a wealthy woman from the community, an impoverished man, and then each of us. I always enjoy watching everyone join together to worship, and I'm glad that they could experience it with me. 

It's funny to watch them and listen. "Did you see that?", "Take a picture of this", "I can't believe that". The sights, the smells - they are much more intense here. There are constantly cultural and medical differences along the way that amaze them. Sometimes I forget how different it is, so it is kind of fun to have them remind me.

But, alas, while we live on the earth, all good things must come to an end. By the time I post this, they will likely be flying back over the big lake. My house will be quiet again. I'll be fighting off the bugs and critters all by myself. But I'm glad they have come and given of themselves by their work in the hospital. They have been refreshing and entertaining. I'm so thankful for their presence.

Bye Mom and Sean! It's been a pleasure having you. I'm sending some love back with you. Spread it abroad.

Monday, March 4, 2013

Stumbling Follower

What is different about a Christian doctor compared to any other doctor? The world would say nothing really. But I think that truly it is everything. It’s the same that sets apart a Christian plumber, or teacher, or lawyer, or politician, or mother, or any other job or title description that comes behind it. God has changed us. Everything is different.

And yet, I struggle with this many times. There are times I completely fail. I’m not very different in some situations than any other doctor would be. There are times when I don’t love well, don’t respond well, times when I am overcome by circumstance rather than seeing that God has a plan in the midst of the circumstance.

Christians are supposed to wake up in the morning, realizing that His mercies are new. When we view the world around us, we should see from a view more clearly distinguishing purpose and value. When we work, we ought to do it with all the strength within us. Eating, playing, loving, giving – everything should look different.

And yet, we don't live perfect lives apart from the struggles that all other humans face. Every day it is not easy to see where God’s hands have been at work. Our flaws are still quite noticeable, and we are full of failures day in and day out. But in the middle of it all, the Christian looks up to trust a God unseen. One who calls us His children. He has displayed His love for us through Christ, and has forgiven us based on His own righteousness. But now He calls us to come out, to be separate from the rest of the world. To follow after Him. We struggle, we stumble, but we follow.

As we struggle in the midst of all the hard times in life, we sometimes feel like His hand isn’t there sheltering us. But if we could only see, that it is then shaping us more than in the easy times. That He is in the middle of molding us into something that actually does look like Him and reflect Him into the world. It hurts to be shaped and refined. Often we would rather stay just like we are than take the pain of His improvements. But we are His, and His plans for us are better than to let us stay impure and rough. He is making something that will actually show His glory.

If it is His hand that hurts as it shapes us, then let us delight to receive from Him.
Lord, create in us something that makes You smile.