rotating header

Thursday, November 29, 2012

of Love and Long Distance and Writing

I'm not sure how I found this book, but it was a good read, the tale of humanitarian/missionary 30-somethings who find each other by blogs and emails and fall in love.  One of my favorite real-life stories, which has been repeated a handful of times even in Bundibugyo.  Here is the author's site.    Enjoy.

And here is my favorite quote:
". . That I started writing the essays largely because it was fun, but I kept writing them even when it wasn't nearly as much fun because I sensed that it was an important discipline for me to cultivate-that in the face of a constant kaleidoscope of airports and faces it would serve me well to learn to narrow my focus to a moment.  To take that moment for what it was and to think carefully about what else it could be.
  That over time, without my even really noticing, writing had become a spiritual discipline -one way for me to snatch breaths from beneath the waterfall of life.
  That now, like the chemicals on a photographic negative, it is the keyboard that helps me define my experiences.  On my best days, a jumble of moments, like so many bright pixels, coalesce into something vibrant and evocative as I type.   Often I feel as if I have not understood anything of waht an experience has really meant to me until I have anchored it in text.  "

Yes.  That's writing.

And as a person who anchors in text, and who spent four years in a long-distance writing relationship with the love of my life before we got married, I resonated with this book.

The End of the Road, or a Tale of Two Viruses

The end of the road:  this was the literal translation we were given for Bundibugyo.  So you'd think I'd be used to living there.

But I'm not.

Because the end of the road where I've been camping out lately is called the ICU.  This is a 5-bed unit shared by adult and paediatric medicine, with the most directed nursing care in the hospital, the best monitors, the only ventilators, the most space, and the smartest doctors.  Well, on the medicine side anyway.  I am a bit of a stretch, an intensivist-imposter.  Which is rather tricky because lately the paeds patients have outnumbered the adults.  One day this week I had 4 of the 5 beds and had a baby waiting to move into the 5th.  This is a room that beeps and bustles, where lights flash and IV pumps smoothly push and ventilators sigh, where we rally to the emergency and ponder the best plans.  But it is also a room where a lot of people die.

The problem with the end of the road is this:  100% of the people we bring in would die in the next few minutes, hours, or at most days, without this care.  We generally can achieve at least a 50% survival, which is really a remarkable thing.  But that's hard to remember when half your patients die.  That much death gets pretty discouraging.

The last couple weeks I've had two girls in side-by-side beds with very similar presentations:  high fevers, seizures, incoherent speech, weakness, and rapid deterioration.  The 11 year old girl in bed 3 we think has Herpes Simplex Encephalitis, a viral inflammation of the brain.  And she's the happy side of that 50% story.  After an initial touch-and-go period, she responded to acyclovir which we have to give in a tube to her stomach since we don't have an IV form.  She's waking up, following me with her eyes, lifting her fingers when I tell her to.  The excellent physical therapy and nursing care just may carry her through.  

But the 3 year old in bed 4 came to the real end of her road on this earth on Tuesday.  "S" was a little Maasai girl, who suddenly developed fevers and seizures, an inexplicable downward course.  Her grandmother and I tried to communicate in Swahili which neither of us speak well, this wizened lady with her stretched beaded earlobes and bald head, me with my white coat and desperate questions.  The night she was admitted I was frantically reading about viral encephalitis because of her neighbor in bed 3, when the word "rabies" jumped out at me. "S" was hyper-salivating, foaming at the mouth.  She was hot, hypertensive, smiling and singing inappropriately at first, incomprehensible, and going downhill fast.  The next morning her father came in.  Had "S" ever been bit by a dog, I asked?  Oh, yes, he replied, about 3 months ago.  What happened to the dog?  They killed it, because it was a stray, aggressive, behaving strangely, and they feared it would bite others.  Oh dear.  Over the next ten days we watched "S" get worse and worse.  When she couldn't breathe on her own anymore we intubated her.  We tried to find a way to make a diagnosis, and sent samples out that will take weeks to be analyzed, hoped that it was something else, something survivable, something temporary.

And over those days, as we reluctantly drew closer and closer to the end of the road, I spoke often with "S"'s father.  Unlike many parents, he was unfazed by the ICU atmosphere.  He stood tall, like a man who was used to planning things, to being heard.  He asked questions, really good insightful ones.  He wanted data.  He remembered what I said.  He sat and stroked his daughter, talked, looked for signs of life. (His wife with her regal green beaded necklaces was sent home after a brief visit, to care for the baby.)  I could imagine this father unbowed by the challenges of fighting a lion with a spear.  On the last day of her life, we held a conference in our side room, with this father, his brother, the chaplains, the nurses, and me.  "S" was no longer responding to pain, no longer taking breaths at all.  She was gone, I believed, and it was time to withdraw the ventilator.  We talked and prayed and agreed, and then all stood around "S"'s bedside.  I removed the tube and held her hand, while the pastor prayed.  Children's hearts can sometimes beat on for a long time without oxygen, but "S" died quickly, without a flicker of motion or struggle.  I let go of that little palm.

Then there was the flurry of papers to sign, and questions about the body, about the bill.  But before they walked out, I shook hands with this Maasai father, and said sorry.  He gripped my hand so tightly, and started to cry.  Thank you, he said in Swahili, I know you did everything you could.  

There was something so poignant and real in that moment.  This tall thin man of the savannah, defeated by a disease we could not treat, grieving, struggling, the first crack in his authoritative control.  Yet in his moment of sorrow, holding on across a chasm of culture and education and everything, to say thanks for our effort in spite of our failure.

The end of the road is like that.  An emotional journey up hills and through quagmires, sometimes an unexpected turn, and then the abrupt, inevitable end.  Emotionally exhausting.  After two patients this week for whom I had to have those "this is the end of the road" conversations with their families, and one more who came abruptly from the theatre where he had bled profusely and arrested and was pulseless and unrevivalbe, well, that's a lot of death in a few days.  I'm spent.  

But the gripping hand of a parent who knows that we were in the struggle with them, the walking-alongside that occurs at the end of the road, is still a beautiful moment.  I suppose that's why I'll go back tomorrow, and the next day and the next, and keep beating my head against the end of this road, with a glimmer of hope that the path stretches on into eternity.

Sunday, November 25, 2012

Two pictures of community

This is the Paediatric team at Kijabe, or at least those we could gather Thursday for Thanksgiving.  Paeds surgery, neurosurgery, orthopedic surgery, and Paeds medicine, doctors and clinical officers, spouses and kids.  Plus a pathologist and a teacher for good measure, 41 souls whose existence here serves to bring excellent care to the marginalized.  And they can cook to boot.  Very thankful to be part of this team.
And this is baby C being shy for the camera, a few minutes old, one of the great pleasures (and terrors) of being missionaries at Kijabe.  13 months ago Scott and I stood in this room trying to save the life of his mother, who was going into shock after his tiny precious fetal sister had died.  Today there was great redemption and rejoicing as he was born, strapping and healthy, wailing and moving and sucking his fingers.  We've both been up half the night here but we're smiling with relief and gladness.

Two pictures of community, sharing lives, rejoicing and weeping, eating and praying.  

Friday, November 23, 2012

There and back...again!

On short notice (just having returned from Uganda), I (Scott) was invited and agreed to attend the Planning Retreat of the South Sudan Team on the shores of Lake Victoria near Kampala.  One flight, four taxi rides, and an outboard motorboat ride later (next time I'll try to work in the camel), I found the South Sudan Team, hard at work - thinking through complicated questions of strategic planning for the coming year(s).  Again, I came to listen, observe, represent, and chime in on issues of policy and experience.    This is a team which living in a remote, harsh, and hot (!) place striving to serve a new nation with a fantastic diversity of skills.  Engineers dominate the team, but they are engineers adept at teaching the Bible, playing the guitar, or discussing ethics in addition to their obvious skills in making stuff work.  Others are investing their lives in health, education, and agriculture.  The challenges of living in South Sudan (Mundri) boggle the mind.  No grid electricity.  Only solar.  So, no air conditioning despite the consistent temps over 100 F.  Drinking water from a water bottle left on the kitchen table tastes like it has come out of the hot water tap.  It's not uncommon to hear any of five languages spoken in the market: Arabic, Moru, Swahili, English, or Somali.  Most of the men on the team study Arabic, while a few of the women study Moru.  

This team has been on the ground in Mundri for just under four years and what progress they've made.  They have a fruitful trusting relationship with their host denomination, the Episcopal Church of Sudan (ECS). They have tasteful housing, welcoming friends, vibrant church homes, appreciative partner schools (primary, secondary, theological), many new and refurbished water sources developed for the community…and a thriving volleyball league!   But they want more.  They want to develop public health interventions,  develop computer science centers, train more teachers, provide more medicine, raise up and sponsor students for professional training….it's exciting.  And it's very, very hard.
The South Sudan Team 
They need much more money.  For more housing (the Sudan Housing Fund) - currently in a puddle of red ink.  For infrastructure (like Internet service - the Sudan Operation Fund) - currently in a LAKE of red ink.  For a vehicle for the Bishop of the Mundri Diocese of the ECS…for computer training, sponsorship of students, short-term loans for small business start-ups, for drilling more water boreholes…there is so much which needs to be done….

And while one could feel despair at the enormity of the need, I feel thankful for this amazing team 

our dorm at the retreat

dinner with the team

There and back...

Three weeks ago, I (Scott) made a last-minute trip to Bundibugyo (Uganda) in order to attend a year-end review with the leadership of Christ School - Bundibugyo. 

There is something about the familiar which is so comforting, so relaxing.  Not that Entebbe is a particularly friendly airport, but I just breathe a sigh of relief after I touch down in Uganda.  I know the place, the rules, the prices, some language. It was once home and still feels that way.  After a brief one hour commercial flight from Nairobi to Entebbe,  I connect with friends from Mission Aviation Fellowship (MAF) and squeeze into the Cessna 206 with a pilot's yoke in my lap and scads of dials and meters in my face.  We end up spending nearly an hour and a half in flight because we need to divert around, above, and beneath various storms, but finally touch down on the soft earth of the Bundibugyo grass airstrip.  The door snaps open and the the hot, humid air fills the cabin.  
MAF Cessna 206 at Entebbe airport
Nyahuka from the air (CSB in foreground)
Bundibugyo airstrip and the gathering crowd
Guys from the team, beaming with smiles, welcome me.  Ahh, to know and be known.

Bundibugyo has changed.  From the air, the wide swath of destruction and construction which is the new tarmac road has reached Bundibugyo Town.  Only 12 more kilometers and the pavement will reach Nyahuka and WHM.  Not sure when exactly, but it will definitely be 2013.  While I had been warned that Nyahuka has changed - more people, more buildings, more development -  it seems that there is more that is the same than different.  The place is still lush green everywhere, the rutted dirt road is filled with motorbikes loaded with 2 and 3 passengers weaving around women pack-mules loaded with water and firewood.  As we reach the Mission, the greetings begin.  Faithful friends, despite the lack of foreknowledge of my trip, somehow discover me.  Students, neighbors, former workers, church members.  It's good.

Richard, Basime, and Kadima
Bamparana and Caleb
Asta and Buligi
Isingoma, Michael, and Travis
But this is a working trip.  I come as the East AFrica Field Director, to listen and provide counsel about Christ School's future.  The school is in capable hands: Isingoma Edward, my colleague since 1993, is now Head Teacher.  He's ably assisted by Michael and Travis who represent "the founding body."  We've come a long way since 1998.  Our senior secondary boarding school is now ranked in the top 12% of the more than 1000 secondary schools in Uganda!   No small miracle for a school that is just entering it's second decade, a veritable adolescent in a district which just 20 years ago ranked dead last in the entire country.   I soaked in the stories of the dramatic and tense football season which extended all the way to the National Tournament - as well as the more mundane struggles of preparing meals for 350, of keeping water flowing in the taps, and of collapsing latrines (yuck!).  
CSB and new cell tower adjacent

CSB students and Isingoma
The purpose of this Christ School "Summit" is to make "the way forward" (as they like to say in Uganda).  We had a budget crisis this year.  Cocoa, the main cash crop of Bundibugyo, didn't come in and the price per kilo was low.  By the end of Term 2, we were swimming in red ink.  With the help of many friends of CSB, we weathered the storm.  But we want to avoid these situations which seem to happen almost every year - for one reason or another.  So…budget slashing was the overall theme of the meeting.  Tough, tough decisions…about enrollment, staffing, and curriculum.   We have a plan and we have committed it to God, trusting that He is the One who guides our steps.

My trip was short.  Three nights.  Sunday was full.  I preached at Christ School and Bundimulinga New Life Church.  Watched the Manchester United game with the Christ School staff.   And I saw Johah's wife who continues to amaze.  Her private primary school - Alpha - now has 19 teaching staff.  Unfortunately she faces the same struggles as we do at CSB.  Parents who don't pay school fees and a fixed payroll to meet.  Baby Jonah is almost five and apart from his mom and attending school in Kasese.   The life of a single mother who manages a school and four homes is taking its toll.   She needs prayer.
On Monday, I almost don't make it out because the pilot is hesitant to land on the soggy airstrip.  He does come, but too late for me to make my commercial flight from Entebbe to Nairobi.  I'm bumped to a later flight and finally stumble in the door at Kijabe just before midnight, thankful for traveling mercies.  A mercy that I have not died on that crazy trans-African highway, the A104. 

Cocoa drying in the market

Josh and his new ride
Bundi Team Meeting

the pizza place
these buildings will all be demolished by the new road

Bundimulinga New Life church

New gas pump in Nyahuka

Thursday, November 22, 2012

Give Thanks

Today I am thankful for this verse
James 4:5:  BUT HE GIVES MORE GRACE.  No matter what is happening there is more grace.  Enough for the whole human race.

I am thankful for Scott returning from Uganda, energized by the great South Sudan team, meetings and prayer and hope.

I'm thankful for my kids making it to the end of exams, only one more half-day of school in the term.  Yeah!  Jack, Julia, and Acacia are ready to crash.  And Luke and Caleb already have, thankful for Scott's parents who are feeding them and providing beds, quiet, mountain bikes, and an ocean view in CA.  And my sister who is enfolding my mom into her celebration.  If we can't all be together, it is good to know that we're in groups together.

And thankful for our Paeds team, especially Amanda Hansen who is providing the venue for the Thanksgiving-Dinner-for-Forty-One that I've been trying to organize this month.  One more hour, the turkey is out of the oven, the stuffing is baking, the tables are set, and we're almost ready to roll.


 Thankful for patience, and Patience.  Two-month birthday on the left, 3-month on the right as this tiny preemie and her mom moved out of nursery onto the maternity floor for a few days to be sure that she was ready for discharge.  She had tripled her birthweight.  Her mom brought US cake, bought blankets for the next five preemies, and took OUR photos.  Celebrating this fruit of patient care.

And this little family miracle, much improved.  He and his mom nearly both died as she bled and he was premature, but they have emerged from their side-by-side ICU beds to the point of hope.

Tis the season of parties.

Thankful for the Kindergarten class who came to visit and sing carols for the hospitalized kids.
Thankful for friends.  This family faithfully sends us a Christmas package EVERY year, with a puzzle that we can spend hours of relaxing family time putting together.  It has become part of our yearly tradition, and the consistency of this package finding us here at Kijabe just made my day.
Thankful for this friend, who sent HIMSELF to Kijabe to work in pathology.  Ron G has been a friend since he and Scott went to med school together.  He was a groomsman in our wedding.  He is a supporter in the best sense of the all-around financial and prayerful and concerned friend.  He came to Kijabe for short term trips long before we did, and we're privileged to both be here together this year.
I'm thankful for our jobs here which involve intensive care of the sickest children, teaching the next generation of African physicians and clinical officers and nurses, research and data gathering, being stretched to work on difficult diagnoses (like possibly rabies this week!), sitting down to chat and encourage coworkers, learning from people much smarter than me, prayer around bedsides, and long term dreaming of excellence and mercy.

And that brings us back to grace, which is always MORE, more than the deaths and sadnesses and stresses and challenges, always available, always deeper than every trial.

Happy Thanksgiving to you too.

Monday, November 19, 2012

Not well, but . .

The world goes not well, but the Kingdom comes.  Today our staff at the hospital gathered and prayed for recent violence in Nairobi.  A grenade was thrown on a matatu killing ten people, and sparking riots between the predominantly ethnic S-li people of that neighborhood and other Kenyans and police ( and  Our WHM colleagues work in this neighborhood.  And many from there come out to Kijabe for care.  Then there was news that the M23 rebels of Eastern Congo are about to advance on Goma, the third wave of revolution to sweep from the border west since we've lived nearby (  There's also a simmering ebola outbreak in Luwero, relatively minor on the ebola-scale with two deaths and lots of panic (  The evidence mounts for the world's not-well-ness.

But the Kingdom comes.  As you pray from now through Thanksgiving please pray for our teams in East Africa.  Scott flew to Uganda tonight to meet with the South Sudan team as they work through a planning retreat this week.  Pray they would seek God's face and follow His spirit as they draw alongside that Kingdom-coming activity in Mundri.  Pray they would be united in their teamwork, their diversity of gifts melding to bless the people of South Sudan.  Pray for Scott to have supernatural wisdom (as in not just his own, but insight from God) to offer as he participates. He'll fly home Thursday and then our Uganda and South Sudan teams will shift to a lovely restful hotel for a spiritual/physical refreshment retreat together.  Pray that they would encourage each other, and be blessed by those they've invited to lead them.  The Burundi team perseveres in language study, and we look forward to some friends landing at Kijabe next week after teaching at Hope Africa University.  The Kenya team is dealing with the terrorism mentioned above.  All can use your prayers.

Sunday, November 18, 2012

It was the best of times . . .

. . as exam week approaches, goodbyes loom, anxiety mounts, there is a bit of worst-of-times seeping in.  And other aspects of community and school can be tough.  So here's a best-of-times tribute to RVA on a pre-Thanksgiving weekend.  Pinewood Derby, a masterpiece of logistics, and literally hundreds of races are run in an orchestrated computer-timed video-enhanced sports-announced production.  The entire school community seems to gather.  Cheering.  Conversations.  Some really good music by Mr. Peifer.  And really bad.  Excited kids, prizes, creative cars, occasional wrecks.  Julia and Savvy were doing a car together, which mostly meant Julia provided moral support and Savvy did the work, on a rhino car with a red mohawk.  Because both girls were in soccer tryouts Jack ended up spending a brotherly couple hours in the final touches and registration so he put his name on too.  So the three of them had a blast and made it to semifinals in their age group, but nowhere near fastest.  Just fun. It was a good time to eat and visit. And best of all Jane M with her mom Ann, our very own WHM-ites, won the women's category!  I love the empowerment that comes from a stadium of cheers when you're six (or any age).

Then today, Baptism Sunday, where eleven students gave testimonies, had favorite scriptures read, were baptized and prayed for.  In multiple languages, from many different countries, all desiring to identify personally with faith in Jesus.  Singing and guitars, outdoor amphitheater, overcast sky, families involved.  

But the best thing about both days was sort of the same.  A single mom here whose husband died in the course of missionary service.  Watching staff men who helped her young sons build and race their cars, and who mentored one of them as he made his profession of faith and baptism today.  What a great thing, to see solid men stepping into the gap where a comrade fell, showering love upon these boys.  Then add to that tonight's band and choir concert, four groups, about two dozen pieces all related to Christmas, all wrested from kids who have learned to play and sing and cooperate in the last few months.  And essentially that is RVA, at its best, a community of dedicated people pouring attention and skill and concern and challenge and love out onto other peoples' kids.  Because being a missionary kid, or any kid, carries so many losses, from the tragedy of a father killed to the subtlety of not quite fitting in to a new culture, and everything in between.  So thankful in particular that our very own Bethany F has been here to counsel and encourage kids this term.  It's a good thing for a place like this.

So to dorm parents, teachers, choir directors, counselors, administrators, cooks, coaches, librarians, secretaries, launderers, nurses, maintenance experts, and all the other diversely gifted people who make up a school like this, thanks.  Happy Thanksgiving.

Friday, November 16, 2012

Victories, mostly

Not all of the last week has been alienating (see below).  In fact there have been some true celebrations.
First and foremost, Scott's Birthday.  Another year, another dozen roles and abilities.  His capacity for being diversely gifted and wise in doctoring, fixing, mentoring, scoring goals, cooking, creating (won the WHM Christmas photo contest too!), building, writing, organizing, fixing again, saving, listening, deciding . . . is exceeded only by his capacity for putting up with me and Africa and the whole mess of life.
Luke's Football Club of Yale University went to finals in the Ivy League tournament, won their conference, and placed respectably in regionals.  He had a great season of friendship and football, the essential outlet for Yale survival.  Caleb's Thunderbird Squadron 27 intramural team also went to finals (40 squadrons) at the US Air Force Academy.  Another essential outlet for survival.  Jack's RVA Varsity Football team also went to finals, their first defeat in a great season. So all three boys enjoyed solid season finishes in the #2 position, all as wings mostly, fast, running, defense, shots, and camaraderie.  And in the family theme, Acacia's JV basketball also finished 2nd, losing by the narrowest of margins in the finals.  And Julia's tennis team made it to semi-finals, so I guess they were 3rd or 4th in the league.  All these sports have been great fun to watch and cheer (from afar for Luke and Caleb, but field/courtside for the younger ones).  I'm grateful to coaches.  Grateful for exercise and confidence and opportunity.  And on pins and needles as the RVA three go through tryouts for the next season, I believe/help my unbelief, trying not to be the mother who asks for right-hand-seats-glory for her kids (Matt 20:21) (others seem to pray for this and then their kid scores the goal), but to trust that the teams will prove to be blessings to my own and to others.  But I can't help hoping the kid who got cut last year won't have that happen again.  So if you have more faith than I, pray for that.
And lastly, on the theme of birthdays, parenting, and victories, here is baby L on the day she was discharged, snuggling up with a very happy Mom.  The next ICU-save baby, baby F, also made it off the ventilator and back down to the nursery this week.  Thankful for life being stronger than death in these two.

Add to all that an unexpected gift of a visit from Karen, walks with friends including neighbor Sheri who had been traveling and is back, a movie with Bethany, days of sunshine and dry clothes on the line, cream cheese frosting as a rare grocery bounty in town, huevos rancheros at Java house after the alien debacle, prayer with fellow moms, and an all-hospital all-out party to celebrate the new Maternal and Child Health (now called Family Health) clinic, the new about-to-be-turned-on CT scanner, the new palliative care building, and the cornerstone-laying for the new BKKH paediatric wing . . . well it has been a celebratory week.

Thankful for the moments that give a glimpse of belonging and thriving, even if not all is victorious in this fallen world.

Rule-weary, and Confessions of Lovelessness

"If every human being had the capacity to do the right thing every minute of every day, humankind would have no need of laws.

But since all of us have the capacity for both hatred and love, we are compelled to make rules that provide our best judgment for how to live together in peace and justice. Laws alone cannot ensure our well-being, however. The stories of our very best human selves are the stories of our love for one another — the stories where laws and social norms are trumped by hearts that love and people who follow their hearts and act on that love.

Consider now how love can help us be our best selves."

This quote comes from http://www.d365.organ on-line devotion we read as a family at breakfast in the mornings.  And I've gone back to read it several times recently.  It's been one of those rule-weary cross-cultural stretches.  A boarding school is a rule factory.  A missionary station is a diverse community, and every passing month seems to generate more rules or protocols or meetings or structures.  A foreign country has its own laws and makes it clear that we don't always fit in.  So as a missionary/doctor/mom/class sponsor/community member in Africa, there are a multitude of overlapping cultural lines that one must tread carefully.   In the last couple weeks I've showed up twice to events to which I thought I was included, only to be excluded with unintentional harshness.  And as a final straw, Kenya has declined for the time being to register us as aliens, having lost our paperwork.  The only thing more alienating than being an alien is being an alien who can't even have an alien registration card.  

So I admit, I've felt a little sorry for myself after some of these interactions, and tempted to throw in the proverbial towel.  But that very thought points out the real issue. " Towel" may be a boxing metaphor, but it is also a Gospel symbol of community.  Jesus washed feet and wiped them and called His followers to be servants not lords.  My capacity for hatred and judgement and exclusion is greater than my capacity for washing grime and tenderly wiping.  I'd like to imagine that without so many rules I'd be a sensitive neighbor and kind doctor and generous friend and sacrificing parent.  However the truth is that the same selfishness the laws are designed to protect our community from fills my own heart too.  So even as I sigh clinging (literally at one point this week) to the outside of the fence, instead of wishing it away I need to learn to live in the bounds of this community, extending grace.  

I'd like to trump rules with love.  Which does not happen by pointing out the absurdity of the rules, but by acting consistently in love, day in day out, until those who are trying to protect themselves and their community with ever-more-detailed laws relax in the fear-casting surety of love.  Which I suppose won't happen until the all-things-new of eternity.  When we finally won't be aliens any more.

Wednesday, November 07, 2012

Paeds Team

This is the great group of people with whom I work, at our monthly meeting.  So thankful for the wisdom and dedication of Mardi, Lillian, Mary, Erika, Ima, Bob, SarahG, Rick, and especially (not pictured due to hold-up in immigration this morning) SarahM!

Addicted to Resurrection

Jesus said, I am making all things new.

The privilege of working right down in the nitty gritty of that is pretty astonishing. The last couple of weeks I've seen it up close. Baby L, whom I've written about before, is now able to rest in her mother's arms and feed. Almost anyplace within a thousand miles she'd been born would have meant a lifespan of about one minute for her, but now she's edging towards the possibility of discharge. Her mother thanks you for your prayers, and said we could show her smile.

This week it was baby H. His mother arrived as a transfer from another hospital with a hemoglobin of 5 (that's almost too low to survive) and a blood pressure of 60/24 (that's also just a shade from demise), bleeding profusely, her life and her baby's draining out of a placenta in the wrong position. Our OB team rushed her to the theatre and our Paeds team received the baby whose heart still beat, but he was limp and blue. I found him being resuscitated, and spent the next two days and one night basically within a few yards of his cot. There is something very intimate about intubating a baby's trachea, putting an intravenous line into the umbilical vein, listening, watching, examining, calculating drips and fluids and meds, fiddling with our ancient ventilators, watching the monitors. And texting Dr. Erika our 6-month short-term neonatologist, about thirty times, because this baby was as sick as they come and way beyond my expertise. With great advice from Erika though and every medical therapy we could muster he's dramatically improved. Not out of the woods, or even out of the ICU, but not dead either and definitely trending towards recovery.

I am thankful to be a paediatrician. But that night I got a little taste of Family Medicine as I pulled for not just one ICU bed but two, to save the mother as well as the baby. As I struggled with his poor lungs and low blood pressure, I kept looking at his mom's numbers too. She's out of the ICU now and well on the way to being healed. She and her husband are small farmers with no margin for disaster. We will end up once again paying for a good portion of Baby H's care from our emergency Needy Children's Fund. Both babies were vigorous in their own ways, fighters, with little eyes that flutter open and just LOOK at you as you're trying to help them, faces that grimace in a soundless cry around the endotracheal tube, legs that kick. It's hard NOT to keep struggling for a baby that looks at you like that.

In Mel Gibson's movie about Jesus' passion, the all-things-new quote is placed on the walk to the cross. Which is an important juxtaposition, one that I tend to gloss over. Resurrection comes at a cost. For Jesus, the real maker of all things new, his life. For us, his apprentices, mere inconveniences like a bit of lost sleep, or discouragement, or mistakes, or weariness. Perhaps that is necessary, because this resurrecting business could become addictive.