Thursday, April 29, 2021

Foundation and Calling

 Hi friends and family,

Sorry for the long gap in writing. Life here has been busy and every time I have tried to sit down and write I have lacked the inspiration and energy. Initially I had planned a much different blog post, but that changed.


Pictures from a recent hike up to Mt Tapi



Life here is settling into more of a pattern. I am now moved into my permanent house that the construction team had been hard at work on to prepare for me. It’s nice to have a space that I can make more my own knowing that I will be in it for the next two years.


And yet, it still feels hard to find consistency. Call shifts can range from easy shifts with only a couple of phone calls to my last Thursday call shift where I was at the hospital for most of the night taking care of machete wounds, a patient with liver failure, two vacuum deliveries, a C-section and a repair of a third-degree tear. We also have a large number of people leaving in the next couple of weeks-volunteers returning home, families going for home assignment and a long-term family leaving permanently-even as we welcome a few new and experienced faces. I definitely feel some sadness and a sense of transience with these transitions.



One of my Peds patients who came in with burns from cooking oil-improved a lot from admission


Part way through a recent busy call shift I found myself dreading being called for something for which I was unprepared (any number of things really-trauma, complicated OB cases, anything in the eye…). I longed to be completely competent, ready to answer any call, or, on the other hand, to always have quiet calls with conditions that I was more than capable of handling. I wanted to have arrived, to be able to coast down through the rest of my work, not being ruffled or showing my vulnerabilities. Being exposed by difficult cases made me feel unsettled.


It’s easy for me, particularly as a physician, to find a lot of my identity in my work. When things go well, I feel on top of the world, glowing with a sense of competence and agency. However, when things are difficult or don’t go well, I often blame myself, feeling inadequate and uncertain.


My initial plan was to write this blogpost as a case study about a patient I was caring for on the Pediatric Ward. He was an 8-month-old that presented with shortness of breath and sores over his body. I cared for him for 2 and a half weeks, discovering his diagnosis and starting him on appropriate therapies. He seemed to be slowly moving in the right direction, until the weekend when I heard that he has passed away. I was stunned. Initially he had been so sick I would not have been surprised if he had died, but he had seemed to start to respond to treatment and had been there every morning as I came to round. My heart sank as I remembered his eyes looking at me as I would listen to his heart and lungs every morning and the deep sadness that was always in the eyes of his mother. I also felt the weight and doubt of the physician who has lost a patient, especially a child. The next day on rounds the empty bed bored into me with its silence.



I’m currently slowly working through a book called Walking with the Poor by Bryant Myers. A wealth of ideas about what poverty actually is and the complexity of doing development work well, it has challenged me deeply about my work here. Last night I read a sentence that hit home in regard to what I had been feeling, “An agent of transformation who is not also being transformed is capable of doing more harm than good” (sorry no page number-Kindle edition). Coasting through is not our calling.


A good friend recently asked me how I had changed since being here and I didn’t have a good answer. But I think that as I have become more proficient in the language, seen more deeply the ebb and flow of life here, I have found slowly growing in me a more profound love for my patients, a greater willingness to listen to stories and to see. I’m also being forced to find my identity and stability in something beyond my abilities and the outcome of my work. As Easter reminded me, in Jesus and the cross we have the perfect model as well as the perfect foundation.



1 Year Update

This weekend I was able to get away up into the mountains around Mount Hagen. I had time to rest and reflect on the almost full year that I ...