Reflection on 2024

 

The longer I go between posts, the harder it is for me to find the words to start a new post. So much has happened over the course of the last year that I have unfortunately not been able to communicate with you. But I do want you to know that I appreciate you all very much. The short emails or texts of encouragement, the prayer, the financial support help me to continue in the work. So, thank you.

 

I am currently back in the US for home assignment and will be here until mid-May. I would love to connect with you so feel free to shoot me an email or text.

 

First, I wanted to share a video made by one of our volunteers that gives a much better idea than I can of what the hospital and its work look like. It is too big to attach here so it is included in the email I sent. If you didn't receive this and would like to see it, please let me know.

 

 

Second, I wanted to give a few highlights from the last term that didn’t make it into previous updates. God has been so faithful and I continue to be amazed at the incredible work of my PNG colleagues.

·      Rural clinic opening at Tsingaropa: Our rural clinic in the Jimi valley had to close last year due to staffing shortages and some small problems in the community. In August, the clinic was reopened with an incredible young nurse named Simon as the officer in charge. The celebration in the community was amazing.

 

·      Helping Babies Breathe: I participated in a training with some of our other doctors that we can now use to help train our hospital staff as well as the staff at our rural clinics. We are hoping to run this out with some new CPAP and T-piece resuscitator machines donated to the hospital starting this year.

 

·      Visit to Omae clinic: In September I was able to visit our clinic in Southern Highlands Province to see patients and do education with the staff. It was an incredible trip, and I stayed busy, seeing many patients from the surrounding communities and teaching basic neonatal resuscitation and obstetric care.

 

·      Congenital Heart Screening: Dr Kirk and his team returned last year, and we did echocardiography screening for more pediatric patients. We identified some more possible candidates for surgical intervention.

·      Christian Health Services (CHS) conference: While covering for Dr Ben in the DMS role, I attended the national CHS conference. It was cool to praise God with healthcare workers from across PNG.

 

·      Doctor’s Friday meetings: This year we have altered our doctors’ meetings to give more space for growing in our spiritual walks with time for prayer, sharing and lament for difficult cases. It has helped us to grow closer as a team and to seek God in our work.

 

·      Hike to Mt Wilhelm: I climbed Mt Wilhelm for the second time with a new group. Jake made a cool video of the trip, which you can check out here: https://www.youtube.com/watch?v=iWObFvj7bio

·      Hike to the lakes: Since coming to PNG and hearing the story of Drs Jim and Bill hiking to the lakes up in the mountains to the south of the hospital, I have wanted to climb there. I finally got the chance to go. It was one of the hardest hikes that I have ever done (very steep, overgrown and muddy), but it was awesome to get to the top and look out over the Waghi valley.

 

·      Visit from my parents: My parents were able to come for their second visit to PNG and meet Stella as well as see my work at the hospital.

 

 

Lastly, I wanted to give an update about the future and to request prayer. I will be heading back to Papua New Guinea in the middle of May for my next term (likely 2 years). I will be taking over the position of Director of Medical Services when I return. In this role I will be a part of the administrative team and responsible for the staff, and breadth and quality of the services provided by the hospital.  I will be doing more administrative work, although most of my time will still be clinical.

 

Prayer requests:

·      Grace to manage my time well and to know what responsibilities to take and to which to say no

·      Wisdom in how to best serve the hospital staff

·      Close friendships and brothers (two of my close friends and running buddies have left or are leaving Kudjip this year)

·      Consistent funding for the hospital

·      Smooth transitions for new doctors and staff joining our team

 

Merry Christmas!

 

Merry Christmas!

 

 

Over the last few weeks as Christmas has approached, I have found myself amazed as I ponder the truth behind what we celebrate. One night, I was called in to help with a delivery in which the baby was coming out the wrong way, feet first instead of head. It wasn’t her first baby, thankfully, and she was close to delivering. I called in the team to be ready for a C-section, but she wanted to try for a vaginal delivery, so I said that we could try. After pushing for a while, we hadn’t made much progress so I went over to the Operating Theater to get the team ready. A nurse came running over a minute later saying that the baby was part of the way out. I ran back to the delivery room to see most of baby visible with the head still yet to be delivered. My heart raced as I went to help the midwife and I prayed a quick prayer. With the next push, the baby’s head delivered. While he was initially a little stunned, he soon gave a big cry.

 

 

Coming into this world can be a harrowing process, especially when you do not have the help or the resources that you need. And even after you arrive, there are a lot of things that can happen in the first few days. A significant part of my work here is trying to keep mothers and babies safe and healthy.  And yet, God chose to enter the world this way-through pain and blood and uncertainty into abject poverty.

 

The Magnificat, or Mary’s Song in Luke 1, has resonated with my heart this year.

“My soul glorifies the Lord
⁴⁷     and my spirit rejoices in God my Savior,
⁴⁸ for he has been mindful
    of the humble state of his servant.
From now on all generations will call me blessed,
⁴⁹     for the Mighty One has done great things for me—
    holy is his name.
⁵⁰ His mercy extends to those who fear him,
    from generation to generation.
⁵¹ He has performed mighty deeds with his arm;
    he has scattered those who are proud in their inmost thoughts.
⁵² He has brought down rulers from their thrones
    but has lifted up the humble.
⁵³ He has filled the hungry with good things
    but has sent the rich away empty.
⁵⁴ He has helped his servant Israel,
    remembering to be merciful
⁵⁵ to Abraham and his descendants forever,
    just as he promised our ancestors.”

God, through the manner in which He gave His Son, has revealed to us the way He operates in the world. He has scattered the proud and sent the rich away empty, but he has lifted up the humble and filled the hungry with good things.

 

 One of my favorite parts of Christmas here at Kudjip is the nativity play put on by the children at the church. They have a moment at the end of the play where all the shepherds, wisemen and extras come to where Joseph and Mary are with Jesus in the stable. But they don’t just walk in to see Jesus and finish up the play. They come dancing through the church with joy and a simplicity of heart. Every time I feel my heart swelling like the grinch and tears come to my eyes at this earnest response to Jesus.

 

 

 

May you be able to meet Jesus with joy and simplicity of heart this Christmas.

 

 

How can I keep from singing?

My apologies for my long delay in writing for my blog. I could easily write about the many activities that have filled the last few months, and I might eventually, but I instead want to reflect on some of the stories from the past few months.

 

At a laity retreat recently, I sat down at the back of the tent knowing that I would need to leave shortly for a night call shift. I came with the desire to support the community, not necessarily expecting much before I had to leave. As the tent started to fill up, a group of young men filled up the row in front of me. Within the highlands of Papua New Guinea there is a crisis currently among the young men. So many are being led into harmful addictions to drugs and alcohol by slightly older role models. For the many who are unable to finish school (for many different reasons including family instability, lack of school fees, not passing entrance examinations, etc), there is very little to look forward to in the future. There is a generation of young men with little hope, full of anger and disillusionment. My heart has often broken for this group. However, as the music began for the retreat, the group of young men in front of me began to sing, and not just to sing, but to worship with fervor and life. I found myself weeping, unable to sing, moved by the faithfulness of these young men. They had found life in the midst of the darkness.

 

 

My life flows on in endless song;

Above earth’s lamentation,

I hear the sweet, though far-off hymn

That hails a new creation

Through all the tumult and the strife,

I hear that music ringing

It finds an echo in my soul

How can I keep from singing?

 

I held her shoulder as she softly broke into tears, her hand stretching towards but not reaching her dead baby. He had come early and struggled to breathe right from the beginning. We had tried all that we were able, antibiotics, oxygen, IV sugar solution and medication to try to help him keep breathing. When he had stopped breathing, the nurses called me and we had tried CPR, to no avail. My words failed as I squeezed her shoulder, trying to convey my sorrow and support. I learned from the nurses that she had lost her last child as well. I mourned with her at the side of the warmer.

 

 

What though my joys and comforts die?

I know my Savior liveth

What though the darkness gather round?

Songs in the night he giveth

No storm can shake my inmost calm

While to that refuge clinging

Since Christ is Lord of heaven and earth

How can I keep from singing?

 

A few days later in that same nursery, I congratulated a young mother on the growth of her baby. The baby had been in the nursery a while but was finally big enough to go outside and sleep with her. The young mother next to her reached over a gave her a fist bump, a recognition of her hard work and the solidarity of the mothers working side by side to help their little ones. My heart lifted at the encouragement from this impromptu community.

 

 

I lift my eyes, the cloud grows thin

I see the blue above it

And day by day this pathway smooths,

Since fist I learned to love it,

The peace of Christ makes fresh my heart

A fountain ever springing

For all things are mine since I am his

How can I keep from singing?

 

 

Through hard times, God has continued to be present. Through an immense workload, He has continued to provide just enough energy and strength. Through others, He has provided encouragement at the right times. How can I keep from singing?

New Life

 

He is Risen! This week as I have been reflecting on the new life and hope found in the resurrection of our Lord, I have been thankful for the ways that I have seen God move and work here.

 

 

One day in clinic, Dr Angeline, one of my PNG colleagues, asked me to come see a little boy in her clinic. As I walked into the room, I was amazed at the transformation of the figure I saw before me. A month and a half before, Jacob (name changed) had some into the hospital with complete paralysis of the right side of his body. He suffered from a double-outlet right ventricle, a congenital heart defect that caused him to be chronically short of oxygen. We weren’t sure if he had developed a clot in his poorly functioning heart that had then broken off and gone to his brain or if he had some type of infection in his brain causing the symptoms. Without neuroimaging it was impossible to confirm the diagnosis, but we started him on TB medications and strong antibiotics and prayed for his recovery. I took care of him for a couple of weeks and saw some marginal improvements before I was moved to another ward. Now, he was greeting me with an almost straight smile and a firm handshake. He had walked into clinic by himself. I smiled and laughed with him and his mom and we prayed again, thanking God for the healing.

 

 

 

When Dr Susan, our only Pediatrican at the time, left, I was handed the work she had been doing with our congenital heart disease children. Although I was trained to take care of children, I am certainly not a Pediatric Cardiologist. But over time I have slowly improved my ability to identify and diagnose some of these children. With the help of a visiting team of Pediatric Cardiologists from the US we have been able to do better screenings and identify some children for treatment. Last year I helped to arranged transportation for 9 children to go for screenings in Port Moresby and 2 received procedures, one to help open up a stenotic valve and one to close a small hole. Last month I put in a lot of extra work to help one patient get all the paperwork needed to fly to the Mayo Clinic in Rochester, Minnesota where he was able to have open heart surgery (for Ebstein anomaly). He is continuing to recover in the US from his surgery before he will return to PNG. This is truly life changing for him and his family.

 

 

A few months ago, a young man came into my clinic room looking miserable and tired. He had clearly been sick for quite some time. He related that he had gotten medications repeatedly at different hospitals but continued to get worse. He had large skin lesions on his face and swelling of his left leg. In consultation with a colleague, I ordered a test I almost never check, a skin slide looking for Mycobacterium leprae, the bacteria that causes leprosy. His slide showed the presence of some of these bacteria, and he was able to start treatment for this curable disease.

 

 

 

 

A few updates outside of the hospital. I help serve on the Spiritual Life Team here on station. Easter morning we put on a Sunrise Service for our missionaries, a time of reflection on Jesus’ work on the cross. Our men’s bible study continues to meet at my house and has been a great encouragement and support to me and many of the other guys. 

 

 

Stella is doing well and has been enjoying our newfound activity of hiking on the weekends. We have to go early before it gets too hot.

 

Dr Ben, our current Director of Medical Services, is leaving for home assignment. I will be taking over his role while he is back in the US. Please be praying for me with the new responsibilities.

 

 

The Father's Love

 

The overwhelming wave of realization slowly crested and came crashing down on the young man. He slowly folded inward as his strength to hold up a strong front crumbled. But then he turned into the embrace of his father who was kneeling next to the bench he sat on. The new diagnosis of HIV had shattered him, three months into his new marriage, both with what it meant for his future and the shame he felt. Like two figures carved form the same block of wood, the young man turned into his father’s chest, tears flowing down his old blue jacket. His father stared out, like the mother from Dorothea Lange’s famous photo. I sat for a few minutes, a stranger on the outside of this intimate scene.

 

 

She was carried into the ER in his strong arms, the blood flowing down his bare arms. She had been hit by a car and it was apparent that she was not going to be with us much longer. Blood streamed from her ears, nose, and mouth. We started to try to stabilize her, protecting her airway and obtaining intravenous access, but we knew that there was nothing we could do to halt the process that had begun. Her father, sensing what was happening, anxiously followed each breath. As they began to slow, he cried out again and again, “Lewa, no can lusim mi,” “My heart, don’t leave me.”

 

In the love of these two earthly fathers, I glimpsed the smallest picture of what our Father’s love is like for us. These two fathers would have done anything for their children, gladly taken their place. In Isaiah 49:15-17a, God is speaking to Zion, answering their complaints of feeling forgotten: “Can a mother forget the baby at her breast and have no compassion on the child she has borne? Though she may forget, I will not forget you! See, I have engraved you on the palms of my hands…”

 

 

As we enter this season of Lent, I pray that you would know and feel the love of the Father for you. Even in the midst of darkness and suffering, He is with us.

Approaching Advent in the Dark

 

My grandmother on my mother’s side was a true southern lady. She had a certain sense of propriety about the way things were done. She could cook mean collard greens and black-eyed peas. But she also had a saucy side and a bag full of sayings that she would love to pull out, “Y’all eat like birds. Next time I’m making birdseed!” Towards the end of her life when she would have to visit the doctor, she would put on her nicest clothes and make sure that her hair had been done at the hairdresser.

 

The old lady sitting in my office had a smile missing several teeth and the pearl necklace around her neck was obviously fake, however it was clear that she had put on her best clothes for the visit. She didn’t speak Pidgin, but her eyes lit up when I said hello with the “Kawi” of her local Tok Place. She wrapped me in a tight, encompassing hug taking me back to the ones my grandmother used to give and a feeling I didn’t know that I had missed.

 

She had been feeling some abdominal pain for a few months and had blood in her stool, something that was becoming increasingly harder to do. Her daughter had brought her in out of concern, a concern that had developed not through the patient’s complaints about her symptoms but out of the daughter’s careful observation of her mother.

 

As we moved into the ultrasound room and the picture of her illness began to become clear, I began to seek a way to break the news to them. Tears brimmed my eyes as I saw understanding alight in the daughter’s eyes. But as the heaviness settled in the room, it didn’t seem to touch the patient. Even as her daughter explained the cancer that had grown in her pelvis, she reached out to me and her. She was at peace.

 

 

Rita comes every Wednesday to clean my house and help me with some of the housework that gets neglected while I am at the hospital. I hadn’t seen her for several weeks because of vacation and a difficulty that had come up in her family. She and her husband had faithfully cared for his mother over the last few months as she navigated one after another health crises. When she passed away the rest of the family became very angry, threatening Rita and her husband with violence and destroying her pineapple garden, the product of lots of time and money and the main source of income to help cover expenses like school fees for the children.

As Rita was telling me the story over our weekly Maggi noodles, I felt myself fuming inside desiring justice to be done. I couldn’t believe that people would act that way and felt my anger ignite. But then Rita stunned me with a simple sentence, “Mi lusim rong bilong ol” or literally I lost their wrongs. She had forgiven those family members who had so unjustly hurt her. And I felt immediately humbled at this lesson in forgiveness and love. Rita showed me what Christ-like forgiveness looked like that day.

 

 

Looking through the NY Times pictures from the year, I was struck by the incredible violence and pain across the world. I saw a picture of a number of premature infants being prepared to transfer from a hospital in Gaza to Egypt, and the advent phrase, ‘there was no room for them’ played through my mind.

 

As we prepare for Christmas this year, in the midst of the brokenness of sin and hate, may the light of Jesus, his redeeming blood and forgiving love, move us to help those around us, to be lights of peace and forgiveness to our needy world. As he came in vulnerability and weakness to us, may we find the strength to choose the way of surrender, the way of our Savior.

 

A Long Expected Blog

The last few months have run past me with only brief moments for me to catch my breath. I apologize for the long gap since my last blog. I do frequently think of my friends and family in the US and am so thankful for the support that you provide.

 

The longer I go between blogs the more daunting the task feels to try to write a new one. I will give a few highlights from the last several months and hopefully in a couple weeks I will be able to reflect in more detail.

 

Shortly after my last blog, our missionary doctor team met to make schedule changes to try to decrease our burnout rates. It was a powerful time of vulnerability and sharing. Our new schedule is an attempt to allow everyone to fully use their gifts while having space for rest and other God-given responsibilities. In this time of life, I have been blessed with greater freedom and time, and so I am now trying to help support my teammates with families and children. I also picked up the new responsibility of Medical Education Coordinator. In this role I serve as a supervisor to all of the residents and students that come to work with us at Kudjip. I have enjoyed getting to work more closely with these students. I have also enjoyed reorganizing our Friday lecture times as doctors to provide time for spiritual development in addition to increasing our medical knowledge. In this process we also get to model to our trainees what it looks like to be doctors who love and follow Jesus.

 

Top: Spencer and I on PNG Independence Day. Bottom: Our awesome team of doctors

 

In September, I was able to celebrate several baptisms at our local church. It was powerful to see people that I work and live with and some of their children being baptized into Christ’s body.

 

Also in September, I traveled to a leadership conference for the Nazarene Church in Papua New Guinea. I met many leaders in the church here in Papua New Guinea as well as leaders in  the colleges run by the church. I gained a deeper appreciation for what God is doing in PNG and the many challenges that our faced here. It is humbling to meet the ministers of Christ who are working with next to nothing in the rural areas of PNG, walking miles every day to go to different villages to share the love of Jesus.

Top: Leadership Conference; Bottom: Sepik-style Stations of the Cross at conference center

 

At the beginning of November I arranged for transportation of 10 pediatric patients with heart disease to go down to Port Moresby to be seen by Pediatric Cardiologists from the United States who were visiting for the week. Two patients had operations, a mitral valvuloplasty and a PDA closure. The others now have plans for their care, although several will need surgical intervention outside of PNG.

Here are a few clinical cases from the last few months for my healthcare friends.

Top 2 pictures: 40yo M with cervical vertebral compression fracture secondary to either TB or metastatic cancer  Bottom: MRSA sepsis in a 13yo F from a pyomyositis leading to bilateral pneumothoraces

 

Finally, a donor provided some funds for vacations for the doctors at our hospital. I used this to go to New Zealand (hence the blog title for LOTR fans) for the last week and a half. It was a much-needed break in a beautiful part of the world.