Sunday, April 20, 2014

Afraid of the Weeping

Been in the room too many times when the cancer is diagnosed, when the baby is lost, when the marriage is over. Tears and snot running down faces too beautiful to be puffy from hopeless weeping. Daughters and sons, husbands, friends – the awkward moments leave silence and space between relationships. Who knows what to say?

Most often everyone steps back. The pain is uneasy, tense. Our comfort is at risk. This is a time for the pastor to step in. The family to step in. The doctor to step in. The counselor to step in. Someone else. Not us. We aren’t trained or prepared. They write whole books on how to deal with this stuff. We feel foolish. Can’t fix it, and that is what we want to be able to do.

I remember times of pain, some near, others long ago and forgotten by others.Sitting in a purple plaid chair in the hospital lobby, alone, tears streaming down my face. That day as he died, I knew what loss felt like. Another time, fear and pain consumed me. I was just a child, lying in the hospital bed alone. The medications given into my arm were supposed to make me better, but also had side effects of making me hallucinate, the terror was so real. Such confusion in the midst of hurting so badly. And then again, when their marriage broke down, so lonely, such despair. Whose was I? Not theirs, so hers? Or his? In heartbreak. In despair. A thousand times I have had reason to cry.

David cries out to God in the midst of his distress – “Reproach has broken my heart and I am so sick. And I looked for sympathy, but there was none, and for comforters, but I found none.” So sad to cry out, and hear no one answer.

Who hasn’t bled, who hasn’t cried, who hasn’t lost. Each member of the body of Christ has been through circumstances that have pain us, shaped us, sometimes scarred us. Each has some compassion to share, a shoulder to lend. But we don’t want to share or lend. When the uncomfortable times of grief, or pain, or confusion come we want to draw away. But maybe God has been training us just for that moment, to step in. To try, knowing we may fail. To offer silence, or words. Provision, or even only presence.

The Word says “Rejoice with those who rejoice, and weep with those who weep”, and later regarding the body of Christ, “And if one member suffers, all the members suffer with it; if one member is honored, all the members rejoice with it”. We were meant for this. It is part of our life together.

Christ left the example for us. He didn’t just find Himself in the midst of the needy, He went out to be among them. He stepped into the world of dust and filth. He saw the Samaritan woman at the well, thirsty and tired. But he met her not exalted as He deserved, but dirty, thirsty, and tired Himself. He multiplied bread for the multitudes, knowing hunger Himself. He took Judas’s foul kiss, feeling the knife in His back, stabbed by betrayal. He watched His mother weep, as her heart was broken. He cried out to the Father for relief on that dreadful day, feeling His abandonment for the first time. He looked in Peter’s eyes as the rooster crowed, knowing that his best friend had been too ashamed to claim Him. He bled. He cried. He lost. And because of this He understands our trials and our pain. He also understands our weaknesses, sympathizes with us, and provides mercy and grace for our times of need. We are to be His, imaging Him into the broken places and broken lives, not just the easy, comfortable situations. May we have boldness and compassion to walk toward those in pain rather than walk away. He has trained us through our own trials, for times such as these.

Sunday, April 13, 2014

The Search For Aisha Kelly

The story began long before I arrived. A young couple looked at their premature newborn, 28 weeks of gestational age (way too early). The village elders, several old Fulani men, came and told the doctor, Dr Kelly, that they were just going to take the baby home. They had no hope for it. Against all cultural norms, she stood against them. She told them that no, they weren’t going to take the baby girl out of the hospital. She would not relent. Cultures collided – Muslim Fulanis and the Christian medical doctor were at odds. The doctor won, believing that there was hope for the small, frail life.

The child was eventually discharged from the hospital, healthy and normal. And she bore the name Aisha Kelly, the latter obviously in honor of the pediatrician who cared for her. Relationships were not only restored, but flourished. The whole village came to know of the tiny baby, and the strong-willed doctor.

Now, a year later, Dr Kelly was going to the village to see the child. This seems like a simple concept, but the practicalities were more involved. It is best to travel with a second person, especially as a single woman in the developing world. So, she needed somebody to accompany her. I didn’t know the language, or the location, but I was somebody. So, the plan was made, and off we went.

We walked half an hour to the edge of the nearest town. Two motos (mopeds) were arranged as she bargained on the price. The ideal moto driver is a bit older and a bit fatter, as this generally indicates a lower testosterone level and safer ride. The last key is to pick one with a helmet on, since at least he appears to have some concern for safety. Mine had no helmet, was young, and skinny. But, such it was, so I just prayed as I put on the helmet I had brought and jumped on. As light raindrops fell, we were off. Further and further from town, down dusty dirt roads, out into the bush we went. Dust particles covered us, even grinding between my teeth.

The cell phone for the family we were visiting wasn’t working, nor had we actual directions to where they lived, and lastly, the family name couldn’t be recalled. We only knew the name of the nearest village. But we were determined. The family is from a aforementioned tribe called the Fulani, cow herders who previously were completely nomadic. The group that we were going to see has two camps, hours apart. We were hoping that they would be at the one near the village that we were heading toward.

We arrived at the village market. Most of the villagers didn’t speak French, so we wandered around until we found a man who did. Then the three of us wandered around more, initially in what appeared to be an aimless fashion. Within an hour, though, we had found an elder from the Fulani tribe, who spoke neither French, nor the predominant local language. He was one of the men who had come to the hospital, demanding the child a year ago. Immediately upon seeing Dr Kelly, he smiled and laughed as he rushed to greet her. She had won his respect over the intervening time. There were four languages that were being translated amidst all the people in order to figure out where to go to find the husband, wife, and little girl. Finally, after much ado and the formation of an entourage of translators mixed with moto drivers, we were again off.

A few miles down the road, and off the path, to where the path narrowed. I could tell we were getting close. There were several women bearing large loads atop their heads, with fewer clothes, more skin, and dense brightly colored beads. The decorations seemed to grow heavier and heavier with each subsequent woman, signs of beauty and prosperity, shiny glimmers covering necks, chests, ears, wrists, and ankles. Their appearance showed that they were obviously Fulani. Finally, the motos stopped, though there was no trail, or obvious camp. We began walking through the bush until we saw the small domed houses, covered in plastic tarping. These structures even have the appearance of the nomadic, temporal lifestyle, easily picked up and carried off to whatever place is next necessary for the grazing of the cattle.

Finally, we had found them. The grandmother came out, with little Aisha Kelly wrapped on her back. Another family’s child also peered out at us, obviously stricken with some condition limiting his mobility, nearly crippling him. Then came the young father and mother. I watched the mutual delight of Dr Kelly and the family. The little girl locked my eyes, at first scared of the white skin, but intrigued as well. Again translation ensued through many people, the long task of communication.

It turned out that the wife was pregnant again, which allowed for encouraging her to come to the clinic for care. Any woman who has had a prior preterm baby is at risk for having a similar outcome, and needs to be watched carefully and given some special medicines to try to prevent a repeat of the prior early delivery. So, Dr Kelly pushed me forward, indicating that I was the mom-baby doctor, and she needed to see me. I was glad that I was there, as she would be much more likely to actually come for and accept care within an established relationship.

We enjoyed the time, took some photos, and eventually said goodbye, mounting the motos again and heading back out the path to eat more dust. Furthering relationships here almost always requires a bit of adventure, stepping out into the unknown, risking something. But I suppose that life worth living requires those things. Life lived today. 
Displaying photo.JPG
A typical fulani house

Displaying photo.JPG
They are taught not to smile in pictures, it isn't that they were scared to death of Kelly
Displaying photo.JPG
Mom and little Kelly

Saturday, April 12, 2014

Worth Running For

I finished with the lady in clinic. Her problem list included high blood pressure, thyroid disease, obesity, and medication exposures that can cause damage to a developing baby. Ugghh. High risk pregnancies are difficult to manage even in the developed world with fancy tests and monitoring. Here, “high risk” just brings a sigh and a sense of helplessness. Too weighty for limited resource settings. I headed off to the house to grab some lunch, glad to have closed her chart for the moment.

I was about 2/3 finished with my bowl of macaroni noodles when I heard the noise. Like a circus clown horn, with a high pitched honk-honk. I had heard rumors of such a horn, and was sad that I hadn’t ever heard it here. So, I jumped up from the table, leaving my fork in my lunch bowl, and ran for it. The only problem was that the hospital compound is on a circle. As I approached the road it hit me that if I went the wrong way, I may miss it all together. So, I just started yelling “Fan Milk? Fan Milk? Fan Milk?” There was no reply, sadly.

I saw one of the missionaries heading across the grass. “Mr Teusink! Have you seen the Fan Milk man?” To my delight, he directed me in the way. A few moments later, I rounded the corner of a house, and found him. There he was, looking glorious, the ice cream man. He rides his bicycle around tooting the little horn on the handlebar, selling ice cream in little sachets. I put in my order. “Five?”, he questioned. My reply “I’m hungry” as I smiled and rubbed my belly for emphasis. I smiled as I walked away, carrying my bag of goodies.

Finishing my bowl of room temperature noodles, I grasped one of the cold plastic bags, tore the corner off with my teeth, and squished all the ice cream up through the little hole. Delightful. A new, and wonderful addition to my life. The ice cream man might become one of the more important men in my life. He definitely brought joy to my day. In those few moments, I went from sigh of helplessness in the face of medical problems, to sigh of satisfaction and happiness. Ice cream makes my heart beat fast in delight.

Phone rings, it’s a retained placenta. So, I’m off. But I’ve been refreshed, ready for the next thing. Thank God for life’s small pleasures amidst normal needs and tasks of life. 

Sunday, April 6, 2014

Looking in the rear view

It’s a Toyota hatchback. Always a hatchback it seems. Me and seven others. Seven “healthy” others (aka obese). Children don’t count, so more can fit if kids are piled inside. Thick hips and thighs crush together, one sits forward and three sit back. Armpit at my head, one arm thrown behind the next passenger too. No one needs to know anatomy to realize that there is a nerve on the outside of the calf. Pressed firmly against the door, or the neighbor’s leg, every time the one leg is numb when we finally arrive. Today is no exception to the norms.

The driver hangs out the window to allow one more passenger (or obtain one more fare). He swerves around potholes and people, beeps his horn. Oftentimes, though not today, he is obviously inebriated, as the odor of alcohol wafts toward us through the wind blowing through the open window. We pass police check, one after the next. He gives them a coin so they turn their eyes from the long list of obvious illegalities. And then we pass on through.

He drops us at the taxi area, where we scatter, each into another hatchback or mini-bus. It is the same routine. Finally, I get dropped at the bus station. My ticket says “VIP, 8:30am”. But VIP may be misleading. It means you have an assigned seat, and the bus should leave on time. “On time” is sometime before 9am, and it is much better than the non-VIP bus, which only leaves after every single crevice and crack is filled with human cargo.

I’m in seat 3. Seat 2 has a skinny guy, but yet he leans halfway over into my seat. My thigh, my shoulder, they each touch his. I lean deeply into the window. “Thank You God for the window”. Seat 2 only shifts more, making himself more comfortable. I am the only passenger who recognizes the idea of personal space. So, I silence any complaint, knowing that the culture here currently rules over my own preferences. I’ve come to find that the inner thigh is really the only place that one can call their own on public transport. Every other place is public. Buttocks are shifted, one person on the next, babies are halfway on your lap, pushing against your breasts. Feet are entangled. Yep, the only part that I get to keep is my inner thigh. But thank God I get at least one part.

The bus moves slowly, up the winding hills. In spite of the uncomfortable seating, the driver is safe and cautious, partially because the bus’s steady, slow limit of acceleration. I listen to music, singing out the window, finding opportunity to worship with the engine muffling the sound of my words. Deep, thick black smoke blows on us from the unmaintained semi-truck, painfully pulling its load in front of us. The bellows out of the engine rush into the window, and I cease my song for a moment.

After a while, we come to a stop. Suddenly swarms of hands shove bananas, plantains, roasted corn, coke bottles (filled with something that is not any official coke product), bush meat creatures – resembling armadillos, furry rats with long tails, and sometimes a small deer or monkey. The sellers envelop the bus, each passenger buys the desired items, and the bus begins to move. As the tires roll dangerously close, the sellers are forced to retreat from the hope of a day’s wages. I smell the curled, dried fish that some passenger bought, and it pushes me further out the window.

But no matter. I smile, grateful for the chance to ride. The smoke and fish, the drawn out slow pull up the hills, the uncomfortable skin on skin – they are all noticed but not concerning. My eyes are set ahead, looking forward to the hope of coming things. Glad to see the rearview mirror looking at the past, things truly behind. Last time I took this one-way trip with a paid hospital car, I received a bill for $450. That was on the day that I arrived. Today, I return for a $10 charge. Lessons learned along the way (many important ones - one just practical one was how to save about $450). Eyes now wide open to realities, some of which were much more romantic while hidden. And yet, also opened to the graciousness and provision of God seen both personally and through my patients.

I praised Him through the difficult days on those beautiful, hard mountains with the hospital nestled between them. I praise Him now on this windy road, uncomfortable, but hopeful. And I am learning to praise Him at all times, though perfection of that may be beyond sight, far off in the distant haze. I am reminded of the constancy of God in the midst of varying circumstances, of time and place. He calls for heart worship through them all. And the worthiness of the One who calls is constant and unchanging. 

Tuesday, April 1, 2014

Goodbyes and Hellos

I knew that it was time to walk away. The moment I turned my mind toward leaving, it was as if a big cement block was removed from my shoulders. I physically felt some sort of strange freedom.

But I do hate goodbyes. I had several good friends, and knew it would be hard. But I wouldn’t cry. I knew it. My missionary friends from the next city down were sad, just as I was to be leaving them. But we always knew it wouldn’t be for the long term. They had seen my through some hard times, heavy laden, and dark. And we had enjoyed many times of fellowship together. As we drove down the road for the last time, my friend noted the mood simply with “this sucks”. When he stopped and stepped out to get gas, I was left only with Kindle, one fittingly named for the fire and warmth she provides. She has been a  bright spot of laughter and joy that I had the privilege of walking these roads with. We often found ourselves reveling in giddy drunkenness, brought merely from the intoxicating humors of life. She only said, “I don’t do goodbyes well, you already know I’ll miss you. Lets keep it at that”. I replied, “You already know how much you mean to me”. That was it. Short, sweet, the way I like it.

But then came Anna. I knew she could bring me to tears in a moment. She worked in my house 2 half days per week. Plucking chickens and grinding flour, and other such things that I wouldn’t ever get time to do without her. But it wasn’t like she really worked for me. When we were together, we just fooled around, laughed, cooked, ate. Life was brighter on her days. Literally, she always opened the curtains. But more than that, she left my heart more alive. She was the only Cameroonian who really knew me inside. She didn’t require cultural sensitivity, or a fake smile, or a special greeting. I’d smack her on the butt as I left for the hospital, retreating quickly before she had the chance to swat me back. She was the closest thing I had to family during that time and in that place. “Bye ma”, I’d laugh as I fled. She would smile, “bye daughter”. I stopped to pray for her just before I put my bags on my shoulder. She just stood there. And I knew that this would be the one time for me, the first time in many, many hard months, that the tears would flow. She grabbed me and just held on. Her sobs heaved into my chest as she said, “I’ll never see you again”. I felt the weight of her soul leaning into me. I could only hold her, and tell her the best of truths. I would see her again, if only on the other side. And it would be wonderful. I spoke of the thing that I knew for sure, and whispered instruction “Love the Lord with all of your heart, mind, soul, and strength – in this He will be pleased”. I told her that I loved her. She finally let go and lifted her head from my chest. I put my bags on, and she watched as I walked away to the road.

My current season is full of comings and goings. “Hello” and “goodbye”. I am thankful for those who have passed through life, stayed a while, had a seat. We’ve shared joys and pain. Let’s not forget those who have made our paths brighter, those who have provided shelter in the storms. And let’s not forget to do the same for others who walk along through our lives. 

Moving Along

After a year and a half, I knew for sure that the hospital where I had initially been assigned was not a place that I would call home. Trustworthy people who had walked these paths before I came advised me some time ago to consider another place. I lingered, wanting to make sure that I had done my part and tried to honor my commitment. It has become clear that I have fulfilled my obligations to the best of my ability, and am able to move on to something else.

As my two year term is drawing nearer and nearer to a close, I've decided that it is time to volunteer at another location to see what differences may be found in another mission hospital setting. The organization that I work for (Samaritan's Purse) has been constantly supportive and gracious, and has agreed that I am able to explore other options for the last months of my service.

So, bags are packed and I'm heading off on another journey. I am going to a hospital in Togo, West Africa (a few centimeters up on the globe, but pretty far away in reality). There I will be on a team with some other doctors who are trained in obstetrics. I'm excited to see differences within practice patterns and medical care between hospitals. I'm also looking forward to working within the community of believers there (of whom I already know a few people).

I'm refreshed and encouraged as I step into a new place and new phase. I'm looking ahead to see what God has in store. And I am thankful that it is He who holds my hand and leads through it all. Thanks for your prayers as I transition. I'll try to keep the stories coming.