Wednesday, May 31, 2017

One forsaken grave

“So give me hope in the darkness
that I will see the light
'Cause oh, you gave me such a fright.
But I will hold as long as you like,
just promise me we'll be alright.”
Most people who read this blog know that I am a twin. My brother, Luke, and I were numbers four and five, separated from our older siblings by at least eight years. We are very close to this day, and even as kids I can remember only one or two instances where punches might have been thrown. I love the connection we have and I believe it is unique.

In 2010, Esther and I suffered our first miscarriage. I remember the heartache of not getting to meet our child. Then in 2011, while Esther was pregnant with Levi we had another scare. Our doctor called with some test results and thought a medicine might help. I raced to the pharmacy while praying furiously. Few people know that Levi had a twin sibling in the womb, and as it turned out we lost one child but one survived. I sometimes wonder about that – if he somehow knows there is a twin brother or sister waiting to meet him one day.

It was nearly midnight when my phone rang and woke me up from the couch where I sleep when I'm on call – to try and spare Esther and baby Gabriel more disturbances in the night. A visiting family medicine resident named Christie from the US needed me to see a patient in the hospital. When I arrived, I saw Delma gasping for breath, barely conscious.

I recently cared for Delma and her twin sister Elma on the ward for severe breathing trouble. I remember the confusion each morning as these 8-month old twins often got switched around in the bed and it took a few moments for their mother to sort out who was who. But they improved and went home. The respite wouldn't last, though, and both fell ill with breathing complications again.

As soon as I arrived I knew Delma was in trouble. The nurses couldn't get intravenous access to give fluids or drugs and a nebulizer aggressively pumped “gas-maracin” into her face, trying to open her constricted airways. Delma was slowly suffocating. It brought back harrowing memories of Levi's illness a couple years ago.

I got adrenaline from our drug cabinet and injected it into Delma's skin, then placed a special needle directly into the bone of her leg and gave a powerful respiratory medication through the intra-osseous line. She seemed to relax some, but I knew she needed to climb a big hill to recover. Christie and I grabbed the hands of her mother and prayed for her. All the while, her sister Elma watched on, mostly oblivious to Delma's obvious distress.

The next day our staff gave every possible treatment to Delma. Sadly, her breathing wore out and she succumbed to the constriction in her lungs. Elma watched passively as their mother cried over her lost twin sister.

Recently in our nursery, we lost two babies to prematurity. Each had a twin that survives them and are doing well. Those babies are a blessing to their grieving mothers. I love the strength of these women who can love on their living children, but know that a tinge of sadness lingers as they consider the departed siblings – ghosts that we all knew.

I worry that I don't have the right words for the families here when they lose children under our care.  

As a medical missionary, I feel those moments are precisely why I wanted to come to a place like Kudjip.  I believe doctors have a special connection to their patients - encountering their moments of greatest vulnerability and triumph.  As a follower of Christ, I see the opportunity to present the love of God in those circumstances.  So why am I so paralyzed?

Perhaps I struggle to find something to say because, in those moments, I am simply trusting in the persevering hope we share in Christ.  Hope in the darkness.

For every child we lose to malnutrition, pneumonia, diarrhea, pre-maturity or one of the other myriad illnesses we might see here, we probably send five home to their families - to life.  As they gather their belongings from the bed preparing to leave for the village, I take a moment and appreciate that they have been restored.  That a grave meant for them remains empty.  I want that same paralysis to grip me - grateful that their recovery, like those we lose, represents something truly beyond me.

"Our wayside planet, carrying land and wave,
Love and life multiplied, and pain and bliss,
Bears, as chief treasure, one forsaken grave."
-Alice Meynell

Tuesday, May 23, 2017

Beyond reach

"Today, we live in a media-saturated, Internet-connected, cell phone-equipped world in which everything that happens anywhere is instantly available everywhere ... We now have the opportunity not only to see those in extreme poverty but also to help them."  -Richard Stearns

For many of the people who read this blog, it might be difficult to imagine what things are like on the ground.  What is the hospital like?  What are the conditions like?  What challenges do the people face?  Perhaps the stories and pictures from this blog have painted a virtual picture for you.  But the amount of stories, information, and pictures coming into the typical western home every day are staggering - often stories about hard-hit places in the world where help is desperately needed.  Nothing can quite compare to experiencing PNG on the ground

From the enjoyable fireside at my home in Tulsa, Oklahoma, Papua New Guinea felt like a million miles away.  I remember spending a month here as a resident, and then running through the rest of my training wondering if I were called to come back.  Back to 'those' stony roads, 'those' hospital wards, 'those' sick and hurting in the middle of the Pacific.

Not quite a million ...

One thing I love about being here is how supportive our families are toward the mission we feel like God has given us to reach out to the suffering patients of Jiwaka.  We are so grateful that they are willing to spend years at a time away from us and grandchildren, nieces, nephews and cousins.  Many of them actively support our work - through their thoughts, prayers and gifts.

A few months ago, my brother Luke and nephew Anson were able to get bruised and bloodied on the ground in PNG.  While they mostly came to see the kids, spend time with us and help with some chores around the home, they got to see first-hand what the country is like and how we fit in here.  Before they came, I arranged a day to get them into the true village and bush experience of PNG that so many of our patients encounter every day.  In particular, I wanted to look into a specific valley - where my twin brother Luke and I each have a namesake child running around the jungle because of our efforts at Kudjip to treat their mother.  During their visit, we summited Mount Kulpope, which lies on the range north of our station, looking down into one of the most remote places of the world - the Jimi valley.

Anson, Luke & I on Mt. Kulpop


We are not the “world travelers” of the family. Before this trip, Anson had been to Canada exactly once. And Luke sometimes gets home-sick on his way to the office. We’re both used to our comfortable American lifestyles.
Even reading this blog is a jolt - Papua New Guinea seems unreal. It's much easier to read whatever stories & pictures our Facebook feeds and reddit put in front of us.
So we're very thankful to Papa & Mimi for encouraging us, and supporting our trip. We had a chance to spend time together, and to experience PNG for real. (After a quick day full of banter in Sydney)


First, we filled 20 hours of travel and a day in Sydney, Australia with some Crouch banter. Then we flew from Sydney into Port Moresby. The airport is modern, but small. We made a short walk outside from international to domestic terminals. A local "pikinini" pinched Anson's (white) leg. A lady in the airport asked Luke if he was a doctor at Kudjip.

We landed in Mt. Hagen's new terminal, complete with a real baggage carousel. Mark, Esther, and all the kids came to pick us up! And we got one of the first “real” PNG experiences that doesn't appear much on this blog - the "roads" of PNG.

The US Army Corps of Engineers developed the "Pavement Condition Index." It's a number between 0 (worst) and 100 (best) that indicates general condition of pavement. It includes distress types from "alligator cracking" to "bleeding." I assume the PNG Army Corp of Engineers’ scale goes from 0 to negative 100 and includes “bus-sized sink-holes”.

But, we did arrive at the Nazarene Hospital station.

I noticed immediately how much the station felt like a monastery. I’ve visited the Abbey of Clear Creek in Oklahoma dozens of times. There’s something about places of enduring intentional community. They are quiet, and there are few frills; opposite to most modern Western environments.


We started with a hospital & station tour. This blog doesn’t describe the amazing gardens - especially fruit - at Kudjip. Almost every house on the station has a large garden (by American standards). And every plant in every garden is always bearing fruit. We also saw some of the station operations. We met Jordan who builds and repairs many of the facilities.

That night, we played the board games that we brought for the family. Levi beat us all with "the dream" draw in Carcassonne.

The next day, we “helped” paint Lucy’s new school desk, and Anson got to teach the elementary kids in Anna’s PE class (soccer, of course). We joined Mark for a “swim” in the "station canal". Where "swim" means "harrowing death-race against the current." And where "station canal" means "10-meter fork of water between death-by-waterfall or death-by-grinding-in-the-hydro-power-generator."

Anson strikes the post in the kids' PE class

"Warning!  All adults must look after kids in this area!"

Since that was so much fun, we also visited the Kudjip dam. At least there were signs warning of death. And yet we saw many PNG pikininis doing back-flips into the reservoir inches away from a 12-foot fall. We played a game of volleyball with many station docs, and finished the day with dinner with the McCoys.

The next day, we joined Brandon Zimmerman - a professor from the Good Shepherd Seminary - for a hike up Mount Kulpop to try to get a view into the Jimi Valley, which you may have read about on this blog before. Brandon arranged for a guide, but by the time we reached the foot of the mountain, we had at least 4 guides. We wore hiking boots and high-tops; a few of our guides were bare-footed. Brandon suggested we were 4 of only 50 white people to ever hike up the mountain. It was the hardest thing either of us has ever done. But we saw some kid's homework on the trail - now THAT'S a hard walk to school! (Luke: When someone complains about box-jumps at CrossFit, I now say "Somewhere in Papua New Guinea there's an 8-year girl doing 100 box-jumps on her way to school.)

That night, Mark & Esther hosted a board game night for many of the station docs & staff. We got to share a couple of our games with them, and they showed us "Colt Express" - which we now play back at home.

Our last day was slow and quiet. So of course we invented a new dumb game called "honor" - a completely despicable variant of soccer to make your opponent run as far as possible as fast as possible. We packed our bags and watched The Lion, the Witch, and the Wardrobe to finish the night.

We left the station in the morning for the Mt. Hagen airport and our return flight to Sydney. We ate breakfast at a restaurant near the airport, said our last good-byes, and were back in cozy hotel beds by sun-down.


I can’t get over how much the Kudjip station feels like a monastery. The trip was absolutely a spiritual retreat for me …

Years ago, I struggled with an episode of depression with a strong spiritual dryness - a crisis of faith and a dark night of the soul. Since then, I keep my faith and spirituality deeply to myself. (Maybe I’m afraid of triggering a relapse?) While becoming Catholic, I studied theology intensely. After my depression, I resolved to study the faith less and “to live real life with real people” more.

At my Easter Vigil Confirmation, my pastor - Fr. Joe - spoke about the Resurrection, and the many ways we experience the risen Jesus. But that “the best evidence of the resurrection is you: you are the Body of Jesus alive in, to, and for the world.”

I have never experience the truth of that statement more deeply than this trip to Kudjip. The real people at Kudjip saving real lives.

Even having been there, now that I’m back in my American home and routine, Kudjip and Papua New Guinea are already starting to feel exotic and remote again. (It doesn’t help that it took us 5 months to write this down!) It makes me sad that our culture seems to make real meaningful and spiritual life experiences so hard, and after we have them, it crowds them out with noise.

But I have no doubt that Papua New Guinea will be with me the rest of my life. I’m so thankful for everyone who made our trip possible. And when I do get some quiet moments, remembering the people of Kudjip is my new favorite way to remember how real Jesus is in the world.