Sunday, March 16, 2014

Lucy Elizabeth

Lucy Elizabeth

On Thursday March 13th, Esther and I welcomed Lucy Elizabeth to our family.  Dr. Bill was worried that Esther's water broke without her going into labor, which could lead to infection for her or the baby.  Until that point, our baby had done very well and was only a few days away from her due date so Uncle Bill gave Esther a medicine to induce her labor.

This experience differed greatly from our past births, in some good ways and some bad ways.  Esther was induced at home and we were able to have dinner and take a walk with the kids through the garden in her early phase.  Bill came to check on her shortly after dinner and though she was only three centimeters dilated, suggested we go to the hospital as he felt "this might go pretty quickly."  Turns out he was right, because less than an hour later, after just ten minutes and a few contractions in the labor room, our little girl was born.

Dr. Bill and Staci Rutledge were superb in helping with the delivery and we were back home in just a few hours.

Dr Bill attends the next generation of Crouch births

It sounds picturesque, doesn't it?  Laboring at home, going to the hospital for a few hours to make sure mom and baby are safe, then coming home to start the process of bringing this little life into our family.  In some ways it is.

But what if it weren't?  I would by lying if I didn't confess a good deal of anxiety leading up to this delivery, and some remaining as we wait for Lucy to feed well and regain weight while she suffers from a little jaundice.

 The reality here remains that most moms and babies do well, no matter what we do for them.  But for those who suffer severe complications, the risks are great.  Newborn asphyxia, respiratory problems, prolonged labor and neonatal infections killed six babies in my first few weeks here.  Separating my little Lucy from any of those fates is God's grace.

  Coming to Kudjip while Esther was pregnant challenged me to trust that God would provide for our safety.  I also came to terms with the idea that I didn't control the outcome for Esther or our baby - and that my obedience in coming here was more important than what that outcome might actually be.

"Surely in whatever place my lord the king shall be, whether in death or life, even there also your servant will be."  -2 Samuel 15:21

Gratefully God blesses us with good things most of the time.  But as His servants, our willingness to follow Him shouldn't really depend on what good things we get.  Our commitment walking in Christ's footsteps should be as servants, whether in life or death.  Even as I write that, my heart skips a beat knowing that as yet, I've not faced a great sacrifice in my family for His service.  

I pray that He would give me strength and that His favor would continue to bring us life and blessings.

Thank you for your thoughts and prayers toward us in this time, and praise God with us that Lucy is here!


Happy St. Patrick's day


Tuesday, March 11, 2014


Next week will begin a difficult stretch of time at Kudjip.  Dr. Bill McCoy, who has served here nearly twenty years, will be going back to the States on a four-month home assignment.  When I (or nearly anyone else here) gets stumped by a patient we usually go to Bill for advice and direction.  For the next few months we won't get to use this resource.  Beyond that, Esther and I depend on he and his wife Marsha for mentoring in our role as a new missionary family here.

Bill walks me through an X-ray on my first day

Our prayer is that Bill gets to deliver our new baby in the next eight days before he heads back home.  Esther feels that the time is close.  It means big changes in our house, of course, but we appreciate the love and support of our new friends here at Kudjip and the thoughts and prayers of friends and family back home for our newest treasure.

St Patrick's Day baby?

This week I'm covering the Surgery ward for our surgeon Dr. Jim Radcliffe, who enjoys a well-deserved vacation for Spring Break.  I enjoy surgery, but I am certainly not a surgeon.  So far, the patients have done well without complications and Dr. Scot Pringle (visiting Gynecologist) helps with surgical patients and cases in Jim's absence.  My time at Kudjip stretches me professionally to say the least.  The risks, losses and rewards are great.

I wrote previously about a man who suffered several wounds from a suspicious relative.  He continues to recover and I pray for him, his son Tony and their entire family line who have fallen into a tribal conflict.

Koki doing well

There have been more than a few miracles around here lately as well.  Haddie, a young girl who suffered from Pigbel and spent months in the hospital is home!  She began eating on her own and though she is still weak, she's back to the care of her family to return for occasional checkups here.  Most of the doctors and staff here felt that Haddie wouldn't survive, but God had other plans.  Another one of my premature babies is doing well, has gained weight and is almost entirely breast feeding meaning that home is just around the corner.  Pray for Kepis when she takes this little one home to a house where she already looks after four other children.

Kepis and the still unnamed newborn, now 2000g!

I love seeing God's grace on patients here, but of course there are some that don't thrive or even survive.  Dr. Jim counseled me the the other day that we can probably really help about 60-80% of the people we see here.  But the others we must try to show Christ's love even if we have nothing material or medical to offer them.

My last night of call pushed my limits a bit.  It seemed every thirty minutes the phone rang for something.  About one o'clock in the morning I was called to our pediatric "A" ward for a child that was gasping for breath and listless, nearly unconscious.  When I arrived my heart sank.  Two-year-old Resley came to the clinic the day before for recurrent bouts of diarrhea and vomiting for nearly a year, but particularly bad the past two weeks.  I admitted him worried about dehydration and severe malnutrition as he hadn't gained any weight since he was twelve months old.  Resley also suffered from hypoglycemia.  I gave him some sugar, started his fluids and admitted him to the ward.  Now, about twelve hours later, his blood sugar was extremely high.  I changed his fluids, gave him oxygen and prayed with his father, Taman.

In the early morning, about five o'clock, when the sun had just crested the hills and roosters were warming up, I got called back to A ward.  My heart sank as I made my way to the hospital, knowing that this must be Resley.  He had quit breathing and had no pulse.  We resuscitated him to the best of our ability but without success.  Taman wept - he had nine children: eight girls and Resley, his only son.

I still don't know what happened to Resley - I suspect he had a glucose metabolism disorder which might explain his failure to thrive since weaning from breast-milk and poor ability to tolerate solid foods.

That day I went back through Resley's illness, trying to figure out if there might have been something I missed or managed incorrectly.  He was certainly ill, but I took it hard that he didn't last the night.  Then a mother brought me her thirteen-month-old daughter who was malnourished and dehydrated and I admitted her to hospital.  I struggled with the paperwork, going through my orders with a fine-toothed-comb and had Bill double check me.  He could tell I was accepting too much blame for Resley's death and told me as much.

Perhaps I made a mistake.  Perhaps there was something I missed.  Or perhaps, in God's providence, Resley's life and death will make an impact that I'll never understand or appreciate.  I see now that while our efforts here are mixed with God's grace, there are things that we still cannot do or cannot do well.  Whatever happened to Resley, his life and death taught me to accept that though redeemed, I am still flawed.  In spite of my flaws, God can make my efforts fruitful for those that he brings under my care.  Even if it is only 60-80% of the time.

Do I dare to dream
of a Kingdom where I'm not King.
Of a richness without dollars
and my life belongs to others
and I would gladly be the least of these.

-Brooke Williams

Sunday, March 2, 2014

Walk Away

Some moments I want to go back to the States where I can drive a car whenever I want, take Esther on a date and escape to a cafe or watch football with my brothers.  I want to take Anna and Levi to the Oklahoma Aquarium and then to Chik-Fil-A before a walk through Turkey Mountain ("Urban Wilderness").  I want to give my patients the best un-expired medicines available, use the most important diagnostic tests for them and get the opinion of a specialist on their illnesses.  In essence, I want to walk away.  Away from an unending stream of poor, broken and needy people and the job of tending to them with my limited skills and a small variety of testing, technology and medicines.
Deborah delivered her baby at home in a remote area because she couldn't get access to an aid post, health center or hospital.  In the first couple of days her baby girl couldn't breast-feed.  Most likely that is because Deborah was only about seven months pregnant when she delivered her.  Her baby weighed just one and a half kilos or so (3 pounds, 5 ounces).

Deborah put her baby in a bilum (bag), strapped it over her head and hiked over the mountains to catch a public motor vehicle up the Highlands Highway to Kudjip.  Thankfully, a doctor named Bill McCoy decided thirty years ago that he would spend his medical career tending the poor, broken and needy people overseas.  Bill promptly gave the infant intravenous fluids carefully calculated out for its small size and treated it with antibiotics for neonatal sepsis.  About twelve hours later, Deborah and her baby came under my medical stewardship.
Fast-forward two weeks.  Deborah's baby lost weight, down to 1.19 kg (2 pounds 10 ounces).  However, she rebounded, finished her antibiotics, started eating and miraculously hasn't experienced any breathing trouble.  In fact, Deborah has started breast-feeding her and she has gained nearly 10 ounces. 

What will happen next?  Around here is anyone's guess.  But I pray every morning for Deborah, Kepis, Amanda and Moreen whose tiny babies have been under my care, some for an entire month.  Their mothers echo my "Amen" as I leave the nursery and head to the wards, the ER and our outpatient department to face more of the needy peoples of Papua New Guinea.

Twelve years ago I went to Newcastle, England to begin a training program that would change my life.  During my time working with MercyShips I felt that God called me to medical missions.  In the last twelve years I haven't given up on that, but now that I'm here I need even more of that same perseverance.
I love that my faith follows in a rich legacy of endurance, particularly in its call to take care of those who have been forgotten.  Solomon, the wisest ruler the world has ever known, recognized that God made a point of acting on their behalf.
My last night on call I treated several men who were involved in a tribal fight.  I stitched a couple of them but one suffered a wound in his arm that put a small tear in the tissue surrounding his brachial artery.  Another millimeter deeper and this wound would have cost this man, Jack, his arm and probably his life.  Our surgeon Dr. Jim graciously came late at night to assist me in stabilizing his injury.  I didn't sleep much that night and missed what might have been a family night at home. 

"For He will deliver the needy when he cries, the poor also, and him who has no helper.  He will spare the poor and needy, and will save the souls of the needy.  He will redeem their life from oppression and violence; and precious shall be their blood in His sight."
Psalm 72:12-14
The precious blood of the needy sounds so poetic when I sit in a comfortable chair reading about it with a cup of coffee.  But when I get called to the emergency room at midnight and see the floor literally covered with the blood of our latest bush-knife victim, poetry is the last thing on my mind.  In that moment, the things I need most are strength and perseverance from the One who will spare them, save their souls and redeem their lives. 
I don't wanna be someone who walks away so easily
I'm here to stay and make the difference that I can make
I had to learn what I've got, and what I'm not, and who I am.