Smile

I don’t know his story, but I hear that he fell out of a tree. His name is Jeremiah, and he is only seven years old. Now his left femur is fractured as well as his left arm. He will be immobilized in traction for six to eight weeks.

I watch him, laying motionless in his bed. At least six weeks! I think to myself. I first think about the boredom. He has no TV, no Gameboy, no ipod, not even a book to read. Today, I make it my goal to entertain him.I want to make him smile.

Then, I begin to think about his health and strength. Six weeks of complete bed rest will cause significant loss of strength. In the United States, one of the nurse’s job for a patient like this would be to perform range of motion for the unaffected extremities. This means moving the right arm and leg in all directions to keep them mobile, flexible, and strong. I made this, too, one of my goals, although I wondered how exactly I would do it. I felt a little uncomfortable since he did not know me and I could not speak a lick of Swahili.

I stand at the bedside and introduce myself using the only Swahili phrase I know. I spot a weakly filled, slightly deflated green balloon at the head of the bed, so I pick it up and bop it at him. He turns his head and uses his arm to find the balloon and throw it back. I bop it again, only my aim is not very good, so it falls way above his head. Reaching and stretching over his head, he found the balloon and tossed it back.

Extension! I realized. He just extended his arm! I tossed it again, only this time a little more towards the foot of the bed. He reached down to find the green toy. Flexion! The next time, I bopped the balloon so that it landed on his left side. Reaching across his chest with his right hand, he continued playing our game. Adduction!

Depending on where I hit the balloon, I could get my friend Jeremiah to go through complete active range of motion with his arm. I could even get him to use his leg if the balloon landed towards the foot of the bed.  I couldn’t believe it! We found a way to perform range of motion while playing a fun game at the same time.

For the first time, Jeremiah smiled. His white teeth beautifully lit up his dark-skinned face. His beautiful white and brown eyes opened wide with delight. The joy I found in accomplishing my nursing skill in a fun way did not compare to the joy I found in simply seeing Jeremiah smile. I saw Jesus in that smile today, and I hope Jeremiah saw Jesus in my smile, too.

Life is in the Blood

My stomach began to feel slightly weak at the sight of the operating table where Luja lay. I could not see her face, only her body resting in a pool of her own blood. There was so much.

When she came to the hospital earlier that day, she was admitted to the OB ward and instructed to undress and lie on the table. Her skirt was saturated with dark blood, and it trickled down her legs. She continued to bleed for the next several hours until she was called into the operating room for an emergency C-section.

Now here she was, losing even more blood.

As the minutes passed slowly, I could hold it in no longer. I wouldn’t normally do this, but I interrupted the surgeon. “Will she need blood?”

Through his mask, I heard a muffled, “Yes.” He looked at me. “You go find blood.”

I rushed out of the operating room and ran to the lab, feeling as if time was ticking underneath my watch. Not knowing her blood type, a lab worker walked with me to the operating room to get a sample of her blood. Her unhurried steps frustrated me, and I wanted to grab her hand and pull her, saying, “Have you seen how much blood she has lost? Hurry up!”

Back in the lab, her blood type was determined to be O+. “We only have A and B in the blood bank,” the lab worker said to me. Without hesitating, I stuck out my finger. “Test me.”

My heart beat faster and faster as I waited for my blood to agglutinate in the test kit.

“She is very lucky." The nurse paused as I tried to interpret what she meant. "You are O+.”

I have never been eligible to give blood in the United States because I go out of the country so frequently. Here in Africa, there is an emergency down the hall, so no questions are even asked.  Luja needs blood, so I volunteer my veins. As soon as the bag is full, I put my shoes back on and walk down to the OB ward, where they are transferring Luja from a stretcher onto a bed. I hang my own blood and watch it drip into her veins.

“It is still warm,” the nurse tells me as he looks at the bag of blood. “Asante sana,” he says slowly with a respectful nod. It means “thank you very much”, and I knew he meant it.

Without a doubt, if Luja had not come to the hospital to give birth, she would have died. She would have bled to death in her own home. And I don’t really know,  but if I had not been there to give my blood, she may have bled to death right there in the hospital.

My blood gave Luja a shot at life again. My blood runs through her veins. A part of me is within her. 

Life is in the blood.

I hear God say it in the Old Testament, “Life is in the blood.” I, too, live because of the sharing of blood – even the spilling of blood. I was left to die, but my Savior shed His blood on the cross to bring me life. To bring us life.  His blood gives us a chance at life again. When we let His blood run through our veins,  a part of Him is within us. Our very lives are saved by His blood.

I watched my blood drip, drip, drip, as it replaced what was once lost. I saw Jesus' blood drip, drip, drip, as it ran down the wooden cross. I listened to Luja’s heart, and then I felt my own heart beating in my chest. “There is life in the blood, Luja,” my heart whispers. Nothing but the blood of Jesus.

A Twenty-First Birthday Gift

They say you will always remember your twenty-first birthday. I have no doubt that I will always remember mine. But what I will really remember about this day is not that it was my twenty-first birthday, but that it was her first. 

When we were called down to the delivery room after dinner, we found Rehema laboring. She was fully dilated, but the baby’s position was still too high. When the water broke, it was full of green meconium. We knew the baby was already at risk, so we got ready for a C-section.

In the major theatre (AKA the operating room), I readied myself to catch the baby in my arms. However, the baby was so stuck that the surgeon and even the scrub nurse were working to maneuver it out of the womb. They tried to push and pull for what seemed to be way too long before the baby finally sprawled out on the operating table. It was limp and lifeless.  My heart started beating faster and faster.

The doctor placed the baby in the blanket in my arms. “This is one depressed baby,” he said with fear. I could here the severity in his voice and see the intensity in his eyes.  I placed her on the counter where Meghan was waiting. She suctioned the baby’s mouth and nose and placed her on oxygen while I listened to the heart rate. A normal heart rate for a newborn is 120 – 160. Hers was 70.  She was not breathing, and she was blue. I immediately began compressions while Meghan started giving respirations with the ambu bag. I counted, “One, two, three…” while pressing on the baby’s chest with my thumbs. I then paused for Meghan to fill the tiny lungs with air. “One, two, three, breathe. One, two, three, breathe…”

We rhythmically performed CPR for two minutes before stopping to reevaluate the baby. By this time, the heart rate was up to 140, but the baby was still not breathing. “Come on, little girl!” Meghan and I cheered her on as we continued to give her breathes and pat her feet. After the ten minutes that seemed like an eternity, she choked up a tiny cough. That was all it took for her legs and arms  to flex and her lungs to inflate on their own. “That’s it!” We congratulated her and let out a sigh of relief. We even began to laugh. 

I swaddled her in a simple blanket and took her back to the OB ward, where we weighed her in at 2.75 kg. I used to cringe at the sound of a baby’s cry, but now it is music to my ears. She hollered and kicked as I weighed her on the cold scale, but I grinned with delight because I knew her lungs were working. Against many odds, she lived. Later, the doctor told me he never thought the baby would make it. For my twenty-first birthday, I saw a miracle.

As I held her in my arms, I whispered in her ear, “Hey baby girl, we have the same birthday!” I kissed her on the cheek and played with her tiny nose. “Do you know that Jesus loves you?”

Meghan and I prayed over her, that she would come to know and love Jesus with all her heart. Then we passed her over to her proud grandmother. A gigantic one-toothed smile spread across her face at the sight of that baby girl.

The best gift I received on my twenty-first birthday was the gift of a new life. In spite of great life-threatening opposition, a healthy mama holds a healthy baby in her arms tonight. Now, whenever I celebrate my birthday, I know that another precious little girl celebrates hers at almost the exact same time. (Within two hours anyway!) Jesus used my hands to bring her into the world, but it was His breath that gave her life. 

They say you will always remember your twenty-first birthday, but what I am going to remember is that it was her first.

Even Cups of Cold Water

(This is an entry from my first day in Tanzania. Sorry for the break in chronology, but I forgot to post this earlier! It is dated May 21, 2012)

When I am asked what kind of nursing I want to do, I often respond by telling people that I don’t really know. “That’s okay,” they will respond, “because you won’t really know until you get into the clinical setting. When you find your niche, you will just know it.” For  some people, that happens during the pediatric rotation. “I never thought I would work with kids until I took pediatrics!” they say. For others, it happens when they help deliver their first baby in the obstetrics unit. For me, it happens when I step foot in a third-world country. It happened today when I worked in the Chimala mission hospital for the first time as a medical missionary nurse. This is my field. This is my specialty. This is where I belong. They were right; it is something you just feel and know when you are actually there, living it and experiencing it.

I was assigned to the obstetrics ward where one woman was laboring. Oh boy! I thought to myself. It’s the first day and I am gonna deliver a baby! As the day continued; however, she did not progress quickly and I spent most of the day waiting...and waiting. When I heard that one of my peers was giving blood and hanging it for her patient, I thought, I wish I could do that. I thought the same thing when I heard that my friends were starting IVs and inserting catheters. I wanted to do something big, but instead I was trying to find ways to fill my time. I wandered to the men’s ward, where Alaina introduced me to two young boys who were immobilized by fractures. They were looking quite bored, so we took them some colorings sheets and crayons and showed them how to color. I took a mental snapshot of their faces as we broke the ice and brought smiles across their cheeks. I have a feeling that they probably hadn’t smiled in a while.

After observing a paracentesis procedure, a group of us girls prayed and sang for the lady and all the other women in the ward. 

During rounds after supper, I met some young mothers and their babies. We smiled and laughed  at each other as we tried to communicate in broken Swahili and English, but we also brought light and joy into a dark room full of sick children. 

And today I learned how to say “God be with you” in Swahili, which became the phrase of the day that I shared with all my patients.

At the end of the day, the only nursing skill I performed was bedmaking. No IVs, catheters, injections, blood draws, or delivered. Not really very exciting when you think of it that way. But then I remembered my prayer this morning.

Lord, show me where you are working today. Open my eyes to see you. I want to do what you call me to do.

So today, He didn’t ask me to give blood or deliver a baby. He asked me to color, sing, and pray. I may not have done anything impressive as a nurse, but I did love the patients and people that I encountered, and I did so with all my heart.

Jesus said that the cups of cold water given in His name make a difference, and that is what the Lord reminded me today. May we never ever forget.

Life and Loss

I parted the curtain that separated the delivery room from the rest of the ward. An additional bed had been dragged from outside and squeezed into the delivery room in order to accommodate our newest admit, who became our fourth laboring patient. All four women, separated by dingy curtains, rested two or three apart from one another on metal tables covered in plastic – their birthing beds.

Every five minutes or so, the delivery room would echo with one of the laboring women’s cries. These were groans of pain and pressure unaccompanied by epidurals, injections, and medications that we use in the United States to ease the distress. Occasionally, two or three of the women would have contractions at the same time, filling the room with multiple cries.

As soon as I arrived in the delivery room, I found the newest patient resting from her last contraction. I introduced myself just in time to witness and assess her next contraction. Amy, one of my team members, was watching her from the end of the table. “Ladies, I see a head!” I heard her say with urgency. I grabbed a pair of gloves, quickly popped them on my hands, and ran to the bedside where the Tanzanian nurse was waiting. With only one push from the mother, a baby girl entered the world. I quickly wrapped the newborn in a Kitenge (multi-use cloth) that the mother brought from home, drying and stimulating her until we heard the first precious cry. After assessing and weighing the baby girl, I wrapped her tightly and took her to her mother.  A bright smile beamed from her sweaty face, and I saw a new surge of energy and pride overwhelm her tired body.

While I was still soaking in the emotions of assisting my first delivery in Tanzania, the second mother began to deliver. With a little more time to spare this round, I found some more gloves, gathered supplies, and prepared the table for the next birth. This time, the Tanzanian nurse gave me the look saying that said, this time it is your turn. As the nurse instructed her to push, I caught the head, pulled out the wet pink body, and laid the fresh baby on a clean Kitenge. I clamped and cut the cord, then stayed with the mother to deliver the placenta while my teammate, Kellum, took care of the baby.

For the first time in my life, I felt like the nurse. I just delivered a baby – a healthy, breathing, 3.2 kilogram baby Tanzanian girl. I patted the mother and smiled at her, and it was probably the biggest I have ever smiled in my whole life.

With two women still left in the delivery room, I turned my attention to our third patient, Luja, who was also getting ready to deliver. We went to check the fetal heart tones, only to find an eerie static sound in the spot where we had previously heard the heart beating. We wheeled Luja to the ultrasound room, my heart beating fast. Surely it was a mistake; we just couldn’t find the heart tones. But I watched the doctor find the heart and point to it on the ultrasound screen. It was still, silent. “We must do a C-section right now,” said the doctor, “or we will lose the mama, too.”

I followed Luja into the operating room. I watched the C-section, the blood pooling on the table and dripping onto the concrete floor, the stealing and wrapping of a stillborn baby. I wanted to feel something, but “psychiatric numbness” held me together…for the moment.

When our fourth mother, named Bahati, was ready for her delivery, I was right there by her side. She struggled to deliver, and it became quickly apparent that the baby was not breathing. A doctor on our team, one of my peers, and the nurses on the ward began CPR immediately. As I watched the tiny chest rise and fall with rapid compression, I held Bahati’s hand and prayed aloud for her and our team of medical professionals as they worked so intently. Even after the “amen”, I prayed constantly in my heart.  Thirty minutes later, we had tried everything we knew to do. The heart would not beat and spontaneous respirations would not begin. I watched the doctors and nurses slowly let go of the baby, and my heart broke.

The mother cradled her baby, trying to hold back the tears stoically. The nurse wrapped the baby tightly and placed her on the cold ground under a table in the corner. It took all of my being to refrain from snatching up the tiny bundle. I wanted to steal it from the cold concrete floor, from the dirt that would soon cover it,  and hold it in my arms in attempt to somehow pray life back into its lungs.  I watched Bahati and her mother walk past the curtain that divides the delivery room from the rest of the ward. Bahati was placed in a bed between two young mothers nursing their newborn babies.

With the delivery room quiet, empty, and still, I sat down on a dusty trunk and cried.

I cannot tell you what it feels like to watch a mother bleed and sweat for six hours only to hold a breathless baby in her arms. She carried that life in her womb for nine months, then labored on a metal table in a dirty hospital with no medicine whatsoever only to leave empty handed. I cannot tell you what it sounds like to hear static in the place of a beating baby’s heart. There are no words, not even understanding.

At the same time, I cannot express the relief and joy I feel at the sound of a baby’s first cry as I hold it in my hands, knowing that I helped bring this life into the world. I also cannot explain what it feels like to catch the newborn, wrap it in clothes, and then hand it to the happy mother.

These two drastically different emotions existed side by side and occurred within moments of each other. I wish I had the words to explain, words to tell.

But there is one thing that I can explain, that I can tell.  As I sat on the trunk and cried, I reminded God of Isaiah 66:9 where He says, “I will not cause pain without bringing to the point of delivery.” Lord, what about that promise?

In response, He reminded me of Job. “The Lord gives and the Lord takes away. Blessed be the name of the Lord.” He said to me, “My ways are not your ways.” I will admit that I do not understand why mothers have to labor and babies have to die, but I do know that God is the giver, sustainer, and even taker of life.

Through the intense roller-coaster of emotions I experienced, God taught me that I am not the one who gets to decide what is good and what is bad. That is where His ways are higher than my ways. We as humans tend to quickly judge our circumstances based on our perspective of what we think is good or what is bad. We decide and we label, but it is all based on our own limited perception, which is so different from the Lord’s vast perspective. What we see is not the same thing that God sees. Who am I to label my circumstances when I can only see through blurry tear-stained eyes?

I trust that as I cry on my truck and mothers cry in their beds, God is in control. He, the maker and sustainer of breath and heartbeats, is sovereign and completely trustworthy. Tonight, he holds two new babies – baby Luja and baby Bahati - in His loving arms.

Although I will never understand, I will always trust. I will always believe that God’s ways are higher than my own and that His understanding and wisdom transcend mine. Knowing that my perspective is limited to human eyesight, I choose to rise above the circumstances and my own temptation to label the situation as either good or bad.  Ultimately God knows and works for the good of those who love Him.  So my response is to be thankful in all circumstances.

Thank you, God, for allowing me to deliver two beautiful, healthy babies into your world today. And thank you for holding two new babies in heaven tonight. Thank you for giving and taking breath. Thank you for working all things together for our good. Thank you for teaching me to trust your sovereignty and surrender my perspective to you.

The day after these events, I read an entry from Jesus Calling that hit home. "I have already been working to prepare the path that will get you through this day. There are hidden treasures strategically placed along the way. Some of the treasures are trials, designed to shake you free from earth-shackles. Others are blessings that reveal my Presence: sunshine, flowers, birds, friendships, answered prayer. I have not abandoned this sin-wracked world; I am still richly present in it. 

Blessed be the name of the Lord.  

Sparklers and Sunsets

After at least twenty-four hours of airplanes and airports, it felt wonderful to step foot on ground – Tanzanian ground at that! One breath of the hot, humid air of Dar Es Salaam, Tanzania, and I felt right at home. I closed my eyes and almost convinced myself that I was in Managua, Nicaragua, in the country that first stole my heart for kingdom mission work. The atmosphere reminded just enough of previous mission experiences to allow me to exhale slowly and feel like I belonged there, but at the same time, there was the distinct smell of Africa in the air. I knew that this adventure would be new and fresh. Yes, this experience would build on everything I have already come to know about God and the church through mission work in Latin America, but I also knew it would bring new challenges and lessons that will cause me to grow in ways that will definitely exceed my expectations.

We continued to travel by bus on the scenic highway across Tanzania to Chimala where we will be spending the next four weeks working in a mission hospital. On the way there, we passed through a game park. Staring out the window, I asked God to reveal His glory to us through the animals He created. I was just hoping to get a glimpse of a giraffe or something, but of course, the Lord exceeded my expectations.

First, a whole family of baboons crossed the road right in front of us. We had to almost stop to keep from hitting them! Next, we saw a long neck stretching up to the trees in the distance.  I thought the vehicle slowed down so that we could get a longer look at the giraffe, but then I realized it slowed down because there were about fifteen giraffes on the side of the road right in front of us. I was so excited to see the far-away giraffe that I can’t imagine what my face looked like when I saw so many right out my window! To top it all off, we saw zebras, elephants, warthogs, buffalo, impala, and wildabeasts. It was practically a safari.

This is why I have abandoned expectations. God always exceeds them. I have abandoned the pursuit of expectations in pursuit of God Himself, trusting that reckless abandonment to the God of the Nations is a greater joy.

Once we finally arrived at the Chimala hospital, the sun was setting. As I watched my first African sunset, I felt like a little girl holding a sparkler on the fourth of July. As the sky fades and darkness settles in, you light a sparkler and find fascination and wonder in the tiny spraying sparks. You know the fireworks show is yet to come, which will be greater by far, but part of the magic is found in the anticipation. In the sparkler.

As I prayed a silent prayer, I invited God to come with us all our days here in Chimala. Then I quickly corrected myself. God doesn’t need an invitation. He is already here. Instead of inviting Him, I welcomed Him. In response, I felt Him welcome me. This is His people, His nation, His realm, His heart. He returned the invitation, inviting me and our team to join Him in what He is already doing.

Let the sparks fly. The fireworks are coming. God is good.

Making Memories

My mom's face fell as she told me the weather forecast for Saturday. "It's going to be rainy. My plan is not going to work." I frowned a little, too, because I could see the disappointment on her face. I didn't know the plan for Saturday because it was supposed to be a surpise for my twenty-first birthday, but apparently it wasn't going to happen as my mom had hoped and planned.

As it turned out, she had been scheming to take my sister and I to Magic Springs, an amusement and water park about an hour away. But without the sunshine, no water park. And with the rain, no roller coasters. My mom was so disheartened as she explained, "I just wanted to make a memory for your twenty-first birthday."

Instead, we just hung around the house on Saturday, just like we have been doing the past two weeks that I have been home.

I biked with dad on the tandem, and we hit forty-two miles per hour going down hill with a speed limit 30 sign. "Hey dad, do traffic laws apply to cyclists, too?" He answered, "Yep, and if I ever got a speeding ticket on a bicycle, I'd frame it!"

I walked on the golf course at sunset with mom. We talked about anything and everything as we watched the sun go down in beautiful color, the sky turn dark, and the lightning bugs come out.

I played the old wooden piano in our living room for hours, learning new songs and repeating old ones. The weighed keys and full wooden tone rang much more richly compared to the short keyboard with only 61 keys that I usually played in the dorm. It sounded like home, especially when my mom snuck up behind me and sang along.

I tied my blue apron with yellow ducks around my waist and helped Mom cook dinner almost every night. After dinner, the four in our family lounged on the floor for a game of dominoes. We can't be together very long without laughing, so soon the whole house filled with the playful sound of joy.

My sister and I spent several days making a Mothers' Day video for mom, and it is pretty hilarious, but I promised her I would not show anyone except our family. It might be blackmail material, but we had the time of our lives making it.

Even though we didn't go to Magic Springs on Saturday, we were making memories. Sometimes it is not the big things that make the best memories. Sometimes it is the simple things, like bikes and aprons and dominoes and silly videos. These are the moments that I will never forget.

I hung my hammock in the backyard and swung in it every morning as I read my Bible. I asked God to teach me something new about Himself in these two weeks between the end of school and my departure for Tanzania.

God faithfully answered my request, but it wasn't the firework-type answer that I was expecting. God's answers aren't always big. Sometimes it is the simple, small things about the Lord that are the things I will never forget. Just like I don't need roller coasters to make a memory on my twenty-first birthday, I don't need something like fireworks to teach me about God. Just a hammock and quiet mornings.

Instead of teaching me something entirely new about Himself, He gently reminded me of something very old and precious. He reminded me that His presence is peace. 

I am so used to the fast-paced college life with Harding devotionals every other night of the week, chapel every day, and Bible class three times a week. I am used to my relationship with God being like a speeding higway where every new turn brings rapid spiritual growth. And I love that kind of wild ride with the Lord.

But I also love swinging in my hammock, slowly back and forth, breathing God's love in and out like time does not exist. I whisper to Him and He whispers back, My presence is what you are seeking, what you are needing, what you are breathing. And in His simple presence, I find joy. It is these simple moments with simple reminders that I will never forget.

Forget Magic Springs and fireworks from God. I don't need a big event or a roller coaster ride to make a memory. I don't need a big event or a roller coaster ride to find God. I am learning the simple way. Making memories is about family. And knowing God is about stillness. Both so simple, but both I will never forget.