From the dirt

"Circumstance often changes the way that I see"

-Sarah Sparks

 

I stepped out the back of the police Land Cruiser with a million other things on my mind, but I knew I would soon need to process what I had seen.

My resident and I were managing a mass casualty incident in our Emergency Room - in which nearly a dozen people had been injured when a PMV (public motor vehicle) rolled over not far from Kudjip.  Some experienced only minor injuries while others lay in a critical condition awaiting our stabilizing procedures or advanced surgery.  A policeman got my attention and informed me that I needed to confirm a fatality before they could take the body away - the body of a young girl who suffered a severe head injury and died at the scene.  

I walked just outside the doors for a brief moment and crawled a short way into the back of the truck - enough to confirm that a young victim lay there, clearly lifeless.  Thirty seconds later I had completed the paperwork, given it to the officer-in-charge, and returned to assisting my resident.  

Several other people received life-saving treatment in the space of a few short hours - but my mind lingered on the young girl who couldn't make it to us in time, as it so often does when we lose children.  

Though I know there was nothing else that I could have done in that circumstance, the reality that I need to pronounce the end of so many young lives weighed upon me.

Fast forward a couple months.

I've just finished teaching an obstetrics course to several PNG doctors alongside a friend visiting from the US.  I'm on call the next day and Matt agrees to work with me.  After a full clinic day, we are summoned to the ER to attend a young girl we will call Mara who is confused and disoriented with a head injury after being struck by a bus.  A wire of energy and anxiety go through me, recalling that tragically similar scenario, as we prepare to stabilize her.  

After administering an anesthetic her confused thrashings abate and we get to work.  A gaping head wound needs vigorous cleaning and scrubbing after filling with dirt from the roadside.  The dirt is removed.  The skull and underlying tissues are cleaned thoroughly.  Many stitches are placed and drains are sewn into the wound.  I write orders for some basic supportive care - IV fluids, medications to prevent seizures, antibiotics to prevent infection, and instructions for the nurses to provide suction as needed.  While the wound seems adequately treated, it is difficult to know how much damage may lurk beneath the bones and only time on our ward will show us whether she can survive.

While we have enjoyed furloughs at least every two years, we are now blessed with the chance to take a Sabbatical.  Two months of time completely separate from the responsibilities of our ministry - a ministry which escalated this year as Esther took on a full-time teaching assignment and I navigated being the senior missionary doctor for some months.  At first I struggled feeling that this time would be "wasted" - though I knew I needed a break from the stresses of Kudjip.  Through some painful emotions and times with God, I came to appreciate the chance for some deliberate time away.  I have managed to find new connections with my family and reflect on my ministry in a way that helps me prepare to resume it.  In a sense, I have been given a chance to see new life coming from the dirt of a difficult season.

A few days after my visiting colleague leaves to return to the US, I am feeling a bit overwhelmed as I leave the hospital.  I am headed to our missionary prayer room, but I pull up short on the walkway outside the paediatrics ward.  A man and his daughter are carrying their things down the ramp and I realize it is Mara - not only alive but awake, alert, walking, and speaking normally.  Her father grins at the surprised look on my face.  I give them each a hug, take a quick picture, say a silent "Thanks" to the Lord and make my way to the prayer room - where I fill several tissues and receive an encouraging time of prayer from one of my fellow missionary doctors.

 

 

 

"Surely I have calmed and quieted my soul" -Psalm 131:2

I have found myself genuinely struggling with appreciating God's goodness in light of the difficult things we encounter so often.  In the past, I have consistently been able to walk into those situations and feel His presence through them.  After a difficult year of ministry, my reserves for those encounters felt like they were running dry.

But then the Lord provides something that helps me remember His plans will be completed.  His work in the world, in His ways, on His time.  Though I cannot understand Him, He can understand me and He knows the hurts that still need relief - both for me and through me.

 

"You complete your plans with our broken hands, you have shown.

I have seen your work: raising life up from the dirt.

This I know -

See that thread of sin seamlessly woven in

This I know - 

See the lion, see the lamb, You complete Your plans - this I know."

Anywhere

"There's a shadow at my back saying, 'Everything's broken'

So I pointed to a star saying, 'That's where I'm going'"

-Gray Havens

 

For a couple months I have struggled to put this story together.  Bear with me if it gets disjointed or heavy.

I stared at the papers in front of me as a way of avoiding the very real suffering of a young woman on our paediatrics ward.  Inwardly I fought the temptation to leave - to walk away from that bedside and the heartbreak it held.  I wanted to escape.

"Kay" had walked into my clinic room about a week earlier bearing two baby bilums carrying her twins.  For a variety of reasons, including many outside of Kay's control, they struggled to find stability in their home and did not feed or grow well.  When I unwrapped those precious bundles two sets of weak eyes looked at me from wasted frames.  We went to the emergency room to prepare their admission to the hospital.

Over the next few days I struggled to adjust fluids, medicines, and feeds in an effort to save their lives.  But on this particular morning I approached the bed where a weeping mother sat on the floor cradling a baby in her lap as tears dropped onto its face.  Only one patient chart remained.

We dutifully and tearfully went through the medical ritual of morning rounds: "Any vomiting or diarrhea?  Was there any blood in it?  Fevers?  Did she take the feeds we gave?"  But we both struggled to put our hearts in it, dwelling instead on the ghost of that little life now missing among us.

I got through that encounter and got away quickly.

I changed departments soon after.  Several weeks passed and I no longer saw "Kay" or her baby around the hospital.  I assumed the worst and moved on.  

"Just take me anywhere - anywhere - anywhere but here"

 

Ten years serving in a mission hospital in one of the more remote parts of the world have taken me through some things I would never wish on anybody.  Losing so many patients.  Not losing others.  Performing procedures I never dreamed I would have to.  Running a treadmill clinic sometimes just to get to the end of the day.  Working seemingly endless shifts during a global pandemic when we had four doctors for half a million people.  Watching my son gasp for breath in a hospital with no ventilators. Wondering what kind of tropical fever could be afflicting my daughter.  Talking honestly with my teenager about why it is sometimes both great and awful to be a missionary.  Feeling torn between my call and my family.  Losing connections that I thought would last.

In our early years the solution to the most difficult times felt like it should be to escape them.  If only I weren't here - If only God had called somebody else to do this - I wouldn't have these challenges.  My relationships would be "happy and healthy" and I would be earning an income that allowed me to get a little more rest and recreation.

 

 

I have meditated a lot lately on Jesus' words, 

"Come to me, all who labor and are heavy laden, and I will give you rest.  Take my yoke upon you, and learn from me, for I am gentle and lowly in heart and you will find rest for your souls.  For my yoke is easy, and my burden is light." (Matthew 11:28-30).

Before and after this passage Jesus admonishes: 

"Go and learn what this means, 'I desire mercy and not sacrifice'" (9:13; 12:7).

 

Our family prepared to walk home as we concluded the weekly missionary prayer meeting on a Thursday night.  I felt a nudge in my spirit that I should return to the hospital to check on a patient, so I told Esther I would catch up back at the house.

Our newest resident had discussed her with me that morning and it was clear that she was very ill.  A tropical fever with renal failure at just about thirty-two weeks pregnant.  Regretfully I look back and see that, while I listened attentively and made some helpful suggestions, I was inwardly avoiding the thing that I knew would be the most painful: to go, sit with her, hear her story, and see a face that I may have to say goodbye to soon.  After suggesting some orders, I had gone to clinic, seen heaps of patients, and gone home thinking, "maybe tomorrow." 

But apparently the Lord felt it couldn't wait until morning, and the gravel now crunched beneath my shoes on the way back to the hospital.  I tried to imagine what I would say or do that might help.  My resident had done it all.  What was I adding?  Should I just turn home and avoid this heartache?

She joined me in the delivery room where I repeated her ultrasound to provide a "reason" for this late visit. 

And then it happened.  For the next thirty minutes she told me things she had never shared with another soul.  I mostly listened for a long while to the unfolding of a tragically familiar story, almost dreading every next turn in the tale. 

 

"But it just feels like pain, it doesn't feel like progress ..."

 

Yet slowly, miraculously, that dread ebbed away and was soon gone.  I felt a comfort and peace that could only be Divine - and knew that the middle of this pain and struggle was exactly where I was meant to be.  The tears that rimmed her eyes spoke of guilt, fear, and shame - but the tenderness of the moment promised restoration.  Jesus filled up that space not because it was good and joyful, but because it was painful and sad.  A fitting place for a rescuer.  When I shared with her about His love for us, she immediately wanted to sense it and prayed for Him to join her life.

Her physical condition did not change - but a new sense of peace visited both of us as I said goodnight, hoping against the odds that I would be able to see her again in the morning.  

 

I know I have a tendency toward being sacrificial - working hard and enduring much as a way to "prove" my own commitment or strength.  I must guard against it.  But in those moments of pressing, when I know that I am overburdened and I want to go find something easy and light, I am discovering that Christ's comfort to me is not to remove the pressure.  His solution is much better.  My yoke becomes easy, and my burden light, not because He changes it - but because He is in it.  Joined to Him I don't have to endure - but to receive mercy.  The weight lifts.  The heaviness makes me not a sacrificial martyr, but an apprentice - being formed more and more into the likeness of the One who toils alongside me.  And my soul rests, trusting that my transformed self on the other side will be a better reflection of Him to those around me.

 

 

 

One morning I called for the next patient in our clinic to join me.  I looked at the pictures drawn by my children in their younger days adorning the walls - now sun-faded.  I briefly reflected on the thousands of patients I have tended over the last decade in those walls - with a mixture of joy and sadness.  A heavy burden attempted to creep up on me.

But Jesus walked in again - disguised as Kay and her surviving baby, now gaining weight and growing. 

And I was grateful that the One who joins me to his yoke in those dying moments is just as present in the new and living ones.  

 

"So bring me to a place where I don't chase escape,

somewhere I could finally say,

'Don't take me anywhere - anywhere - anywhere but here'"