Friday, September 26, 2014

Co-laborers

"I beseech you therefore, brethren, by the mercies of God, that you present your bodies a living sacrifice, holy, acceptable to God, which is your reasonable service."
-Romans 12:1

When I first came to faith I used to imagine myself like one of the ancient martyrs.  Losing my life for the faith of Christ seems, to most, the pinnacle of service to God.  Not until several years later did I realize the importance of this verse in Romans.

God indeed calls some to lay down their earthly lives for Him.  However, I realize now He calls each of us to give up our lives, even if we enjoy many ongoing years on this earth.  Why should I be confident that I would lay down my life and die for my faith if I'm not willing to lay it down and live for it?

At Kudjip I enjoy the privilege of working with incredible physicians who live their lives in a sacrificial service.  Having met, learned from and loved them - I want to share them with you.  I can never put enough words to the testimonies that their lives represent to me, but I will try to give you a glimpse into how they've affected me.





Dr. Jim Radcliffe currently recovers from open heart surgery in the US, but plans to return in about three months and resume caring for the sick and needy as a surgeon at Kudjip - a position he's filled like nobody else could for the past thirty years.  He life and ministry, praying with all of his patients, speaks to his endurance.




Dr. Bill McCoy I cannot say enough about.  Bill attended my birth in Tulsa, Oklahoma thirty two years ago and has remained close to our family.  He is a large part of the reason our family moved to Kudjip and his mentorship and now friendship, along with his wife Marsha, has smoothed our transition here in humbling ways.




Dr. Susan Myers left practice in the United States and moved to Kudjip with a young family over a decade ago.  She now serves as the director of medical services and her patience with me as I learn to function in the Kudjip system reassures me in times that I wonder if I can continue here.  She has a special ministry for our children with congenital heart disease.




Dr. Andy Bennett loves on his patients and gets to know them outside of their illness.  He also works every week to correct club-feet in young PNG children who would otherwise spend their entire lives crippled.  If you need help remembering the fourth verse of an old hymn, ask Andy.  Andy's heart-felt care and encouragements remind me of my dad.




Dr. Scott Dooley runs the whole show.  I don't get to work with him much in the hospital, but it is great to have a fellow "visionary" to discuss grandiose and entirely speculative ideas with.  I'm very pleased my neighbor is back from his home assignment.




Dr. Erin Meier never let an eye-lid droop while she watched over Levi in our scariest time since moving here.  Erin works hard, plays hard and lives on purpose and I enjoyed having her as my stand-in mentor during Bill's absence.  She also sees about half of the patients at the hospital on any given day which makes for the occasional early afternoon off - thanks Erin!




Dr. Imelda Assaigo has the best smile on station.  She works toward a Master's degree in rural medicine and seamlessly became an integral part of the team here, even though she is technically still "in traning"  She also keeps me honest in my Tok Pijin.




Dr. Scot Pringle and his wife Tyronza have been here for 4 of the 9 months that we have.  He retired from OB/Gyn practice in the states and comes at least once a year to Kudjip and takes OB call every third night, relieving the pressure on the rest of us.  Scot makes me laugh and Tyronza perpetually hosts people in their home, often making us classic home-cooked meals!





Dr. Ted Henderson arrived in the last week.  I've already enjoyed a hearty basketball and soccer game with Ted.  I blog-stalked Ted before he came and in a way he has felt like a part of our team for a while.  It's great to have he and his wife Rachel as new neighbors.




Dr. Ben Radcliffe, a surgeon and Jim's son, and his wife Dr. Katherine will be here in January.  Ben and Katherine received the same Steury scholarship that Esther and I did in medical school.  Though I've not met them yet, what I know of their family and their hearts makes me think there couldn't be a better recipient.  Ben and Katherine and their young family will become our newest neighbors, rounding out station life on the "north end" and putting a couple more playful boys down here in the middle of all the girls.


Monday, September 1, 2014

A moment of hard grace

"I’m tired I’m worn
My heart is heavy
From the work it takes
To keep on breathing
I’ve made mistakes
I’ve let my hope fail
My soul feels crushed
By the weight of this world

And I know that you can give me rest
So I cry out with all that I have left" 

Imagine that your wife nearly dies after a complicated surgery to deliver your unborn child.  Imagine that you lose that child in its first weeks of life.  How would you approach the doctor that cared for them?  How would you feel about going back to the hospital where it all happened?

Imagine that you are a young doctor in a foreign land taking care of diseases you've never seen before.  You have witnessed more suffering in just a few months working there than your last eight years of medical training.  Imagine that you've delivered three small babies in the last four weeks for the same nearly fatal problem in their mothers.  All three have died despite your best efforts - the last after nearly two weeks of fighting for life, buffeted by your prayers and tears.  How would you feel looking that child's father in the eyes?



Moreen came to Kudjip about three weeks ago with placenta previa, the third patient I saw for the same problem in as many weeks.  She bled heavily, nearly losing her life and that of the child inside of her.  She was only seven-and-a-half months pregnant.

Moreen, like Dambo and Grace before her, got blood, steroids and tocolytics to keep her uterus from contracting.  She stayed in the hospital a few days.  Then she began bleeding again and her baby girl was delivered by Cesarean section to protect her mother's life.

Dambo and Grace's babies came under my care in the same circumstances and within a week they both died.  As I listened to Moreen's baby, I struggled to control myself, wondering if I could emotionally tolerate losing another tiny baby to this malady.  This little baby's heart sounded wrong - a strong murmur, potentially a sign of congenital heart disease.  For a day or two she did well enough and I thought she could breastfeed.


Then Moreen got measles.  She never looked good after surgery and had fevers that didn't respond to antibiotics.  On her third post-operative day her eyes turned bright red and an extensive rash appeared on her face and chest.  I had to move her to another ward to protect the babies around her, and she never established breastfeeding for her tiny baby.

Over the next ten days, her baby's weight plateaued - and she struggled to breath while also suffering jaundice.  I gave her all six things I had to offer (IV fluids, IV antibiotics, Oxygen, Phototherapy, Nasogastric Tube feeds and IV aminophylline to protect her breathing)

Two days ago she lost her fight.  When I found out, I felt dead inside and my inadequacies as a doctor stared me in the face.





This morning a man came to see me in the clinic, bringing his three year old son with him.  The son fell and hurt his elbow.  When I took a second glance at them I asked the father, "Where have I seen him before"

The man said, "A couple weeks ago we came here and you took care of his mother.  She had surgery.  Our little baby died two days ago and when I went back to my village I found my son had fallen so we are back."

"Her name was Moreen"

"Yes, that's us"

I wanted to leave the room.  I thought this man would surely want another doctor.  His wife struggled to survive, his baby died under my care and now he brought his remaining child to me.  But we both stayed in that moment for a short time and he smiled at me.

Isaac had indeed broken his elbow.  I gave him an anesthetic.  I pulled on his arm, attempting to straighten the bone and then put a splint on.  The father looked at me without contempt.  Indeed, if I saw anything on his face it was gratitude - even affection towards me.  He smiled several times.  

Did he know how conflicted my heart was at that moment?  That I wanted to make his entire family well, but also wanted to run away and hide from my failure as their doctor?

I left the room, gathered my things and headed home.  Twenty meters out the door I stopped.  The only thing I could feel was overwhelming love from this man, and I had no idea his name.  His wife nearly died under my care, he lost his child despite my trying everything I could to save her.  Yet all he gave me were looks and words of thanks.

I turned around and went to their bedside.  Isaac lay still with a new splint, sleeping under his anesthetic.  

"What is your name?"

"Kikiow - or just call me John" he said and smiled again.

"Can I pray with you?"

"Yes, please"

I prayed and he said "Amen" and then "thank you."

I walked home, avoiding looks from passers-by.  I changed clothes and literally ran into the jungle.  I ran past the station, past the reservoir, past the grass huts and up the river in the mountains.  I added tears to the water passing by for a few minutes, remembering Moreen, her baby, her son Isaac and her amazingly tender and gracious husband, Kikiow.



What a mysterious opportunity our lives are.  I never asked him if he felt I did the right things for his wife and child or if he was upset.  I could see in his face that he didn't blame me.  In this moment, when a father could have let loose his anger or frustration at me, he chose instead to show kindness and grace.  A powerful grace not to comfort me, but to teach me something.  Perhaps the moment of hardest grace in my life.  A "severe mercy" as Sheldon Vanauken might say.  A grace I felt I didn't deserve, could never earn and had no means to repay what he had lost.

What minister or saint can show the kind of grace that Kikiow showed to me today?  But there won't be any remembrances put in religious calendars for his child, nor feasts named after him.  He and his family's hardship might go unnoticed by all but a handful of people.

Yet his example of grace just might change one person's life forever.  His story might endure.  And tomorrow, that suffering might be just as real for another needy patient.  And the hard grace that goes with it might be brought to bear on the broken doctor caring for them.




"Let me see redemption win
Let me know the struggle ends
That you can mend a heart
That’s frail and torn
I wanna know a song can rise
From the ashes of a broken life
And all that’s dead inside can be reborn
Cause I’m worn"

-Worn, Tenth Avenue North