“My life is Yours. My hope is in You only.
My heart You hold; because You made this sinner Holy.”
I flipped through the hand-written notes in my patient’s medical record or “scale book.” She had been evaluated in a couple of hospitals over the past six months due to irregular bleeding. At one she had undergone a biopsy for a “lesion” in her birth canal. After awaiting the result of this test unsuccessfully for months, she returned to her home province of Jiwaka in the highlands to seek care at Kudjip. She had a young child and looked about thirty-five years old to me.
I summoned our clerk as a chaperone and examined her with a terribly un-surprising result. A tumor growing from her cervix encroached on the surrounding tissues. Because of her age, I still hoped that perhaps the cancer hadn’t spread beyond the higher portion of birth canal. I told her and her “was-meri” that I wanted to perform a scan to determine the extent of her illness, but that I was worried this might be a cancer that is beyond our treatment. “Dispela sik I look olsem sik nogut I stap, tasol I gat lik-lik chance we mipela inap ken rausim yet.”
Before we could get to the ultrasound a nursing student knocked on the door and called from the other side, without opening it, “Dokta Mark – Dokta Angeline I nidim yu long D-ward hariap.”
I have been working with our newest PNG doctor in training for the past few weeks on the maternity service. It has been a privilege and a joy to see her embrace caring for the women of Jiwaka and expand her obstetrical knowledge and skills.
As I entered delivery room number three, a vigorous but small baby lay in the basinet next to the bed. Usually this would be the point at which the room relaxes a bit, but there was still a tension in the air as Dr. Angeline gowned up and approached our laboring mother. While the nursing students started an IV drip, the midwife informed me, “Second baby I kam breech.”
I looked around Angeline’s shoulder and saw a distinct gluteal cleft approaching the perineum with mom’s contractions and pushing efforts. I quickly asked, “How many breech deliveries have you done?” With what I imagined was a nervous smile beneath the surgical mask, Angeline said, “None.”
I gently rotated the emerging baby’s pelvis to keep the back of the baby up, then placed Angeline’s hands on the sacrum. The legs delivered and baby emerged to the umbilicus, at which point Angeline guided her hands over the baby’s back and along the arms to fold the elbows and bring the arms out. The moment of truth had arrived – the largest part of the baby, the head, now needed to be flexed through the birth canal. As Angeline performed the needed maneuver, mom gave a final push, and her second baby made its entrance into this world with a mighty and healthy cry.
As the baby nestled onto mom’s abdomen, Angeline and I exchanged a gloved fist-bump while she prepared to conclude the delivery. I have a passion for teaching medicine, so my heart glowed a bit as I de-gloved listening to the cries of two healthy newborns and watching my registrar competently care for her patient.
In my excitement, I had forgotten who waited in my exam room.
About thirty minutes after my abrupt departure, my patient and I made our way to the ultrasound machine. The scan confirmed that the tumor had indeed spread to involve multiple internal organs rendering it inoperable. The warm glow in my heart felt like it had cold water poured over it.
We returned to my exam room and I shared the diagnosis and prognosis with her and her guardian. After answering a few questions, I wrote medicines to help with the symptoms she was currently experiencing, prayed for healing and comfort with them, and escorted them to the chaplain’s room for further counseling.
“For everything there is a season, and a time for every matter under heaven:
A time to be born, and a time to die”
Ecclesiastes 3:1-2
Some of our newer doctors recently took a much-deserved break to recharge and the clinical work of the hospital increased. Each day wore on the next and the call nights seemed to come thick and fast. The never-ending stream of patients transformed from an opportunity to share Christ’s love and hope to a bit of an obligation. My temper shortened and my thoughts dwelled on all the “bad” – bad outcomes, bad news, and bad sleep. The good continued – but I saw less of it than I wanted (or needed).
In our first weekend in PNG I accompanied my language tutor, Gabriel, on a walk around a nearby village. We stopped by a “haus-kapa” with a water tank just as I asked, “Gabriel – are there seasons in Papua New Guinea? Is there a rainy season?” He walked over to the water tank and pounded it in a few different places, discovering that the water was near the bottom and pronounced, “Yes – it is dry season.”
There are no daily weather reports in our Waghi Valley. No constant measurements of temperature and rainfall nor predictions about storms to come. It is difficult to appreciate what kind of season we are in unless a deliberate pause is made to reflect upon it.
After nearly nine years of serving in the highland jungles of Papua New Guinea, I have discovered the same is often true about the seasons God brings to me in the work of serving my family, my patients, and my community. While many days feel the same, there are changes I might notice if I took the time to do so. Our latest season has been one of heavier work in the hospital and more demands on my time.
But God’s provision is not less in those moments simply because I do not feel Him as acutely. In fact, it may be given in a greater share than at times I feel more composed or relaxed. If I am willing to recognize that a season of difficulty is something ordained with a purpose, I can learn to dwell there without constantly looking for an exit. That season can be something I endure and, one day, even embrace rather than escape. Because there is another season coming that is ordained for refreshing and life-giving waters. Waters made all the better because of the thirsty and dry ground they land on.
I called to the front of our outpatient queue for another patient to join me in my room. As a young man rose and made his way toward me, a smile broke out on his face that gave me pause. He entered and said, “Doctor, before I tell you about my illness, I want to share a story.”
As one of a handful of doctors working in the referral hospital for a population of 400,000 people, my margin for listening to stories is normally low and I’ve been known to interrupt patients before getting there. But at times I bite my tongue and decided to on this occasion.
“About a year ago I brought my father to you, and he was very sick. In fact, you said that he wouldn’t live. You prayed with us. I took him to another hospital to look for more treatment, but they were not able to help him, and he passed away shortly after. But I never forgot that prayer. I’m not a church-man, but I will never forget it. Thank you for praying for us.”
“Your glory is so beautiful; I fall onto my knees in awe.
And the heartbeat of my life is to worship in your light.
Because Your Glory is so beautiful”
Mark, thank you for sharing. I pray God gives you the grace to persevere in a dry season, and that waters of refreshing flow from his hand. Thank you for your example of faithfulness. I look forward to learning a lot from you in PNG!
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