Nathan’s Notes – Thank you!

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The end of March I was on the Internal Medicine ward with Dr. Bill McCoy and Dr. Erin Meier.  Erin walked on the ward a few minutes after Bill and I had started to review our patients.  She was preparing to go home for 3 months of home assignment.  Erin asked if any of the patients would like to send a thank you to those in the USA who pray for our work and help partner with the hospital.  Hands went up all over the ward as patients and staff eagerly jumped at the chance to say thank you to all of you for your prayers and support.  Here are just few face.

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A hospital could to function without its nursing staff

 

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Creepy Crawlies – Beautiful Blue Butterfly

The best I can tell, this butterfly is a papilio ulysses or Blue Mountain Swallowtail.  The big boys and I were out for a walk and saw it flitting around the Thompson’s driveway, barely sitting still long enough for a picture.  I told it that resting for a moment so I could get a picture would be a lovely thing to do.  When it started to fly off, I let it know that there were still many flowers along the driveway it had not yet visited.  It briefly came back and then flew off in the other direction.  “Come back,” I called, but my boys informed me that it probably was gone for good this time.  They didn’t seem to think it strange to follow me up and down the driveway while talking to a butterfly.  But it may have seemed odd to the security guard sitting down the road . . .

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This was the best picture I could get of the very busy butterfly

The Secret Garden

The oldest three kids have been exploring the station with their friends and frequently come home insisting we accompany them to see the latest discovery.  The most recent outing we went on was to a garden area.  At first they called it the prayer garden and then the secret garden.  I’m not sure if has an official name, but it is beautiful whatever it’s called.

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There were two ways to the garden . . . two ways if you’re a child.  After some debate they decided we would get to the gardens by way of the stairs.  It’s a somewhat steep climb down, but lined with banana trees on one side and flowers and bushes of different sorts on the other.

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This was on the way back up since I was too busy watching my footing on the way down

Rock paths meander throughout the main part of the garden and on the other side of one fence is a big white cow.  It was quite important that we see the cow, but he was a bit hard to get a picture of.

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And instead of dainty potted plants, the poinsettias are beautiful bushes.

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We had company bringing us dinner that night, so it was soon time to head home.  Since we entered the garden by way of the stairs it was decided that we needed to exit through the other path.

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“Wait a minute,” I said as our pikinini (children) started climbing over a metal fence.  “How hard is this path to climb?”

“Oh, it’s not bad,” they assured me.  And they would have been right . . . had I been two feet shorter, not juggling a baby on one hip and been part billy goat.  Not bad at all.  But, we made it over the fallen down banana trees, up the slippery mud slope and to the top of the hill (slightly out of breath) without (much) incident.  The view on top was beautiful.  It’s what all our friends on the other side of the station see out their windows everyday.  Everywhere on station has beautiful views, whether looking out over a valley like this or the amazing vegetation that surrounds everyday life.

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We will see what other discoveries the kids will show us next.

Creepy Crawlies – Preying Mantis

It was their cousins that first got the kids interested in preying mantises.  Last summer the cousins brought one as a gift and we watched it for quite a long time.  It ended up being a female and laying an egg case.  That brought all kinds of excitement to the house!  After that, my bug boy found them all all over place, which was amazing.  They were little brown creatures sitting quietly in brown grass and he still spotted them.

This one he’s holding was found here in PNG.

Preying mantises are in abundant supply in PNG.  The heads seem to be smaller than the ones that the kids caught in the States and they like to randomly jump.  I may or may not have squealed when the little one below jumped at me while taking the picture.  And I may have made the baby cry.  It was just so surprising to see him jump at the camera.  So anyway . . .

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It was important for the cousins to see this spot on the leg of the mantis, especially since the oldest cousin is somewhat of a mantis expert.  Do you know what this spot means SW?

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And while I tried to get a side shot of this tiny one, he kept following the camera round, keeping a close eye on it.  I was waiting for it to jump at me too.

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Nathan’s Notes – Christ is Risen

I walked briskly up the dark gravel road dodging mud puddles heading toward the hospital from our home.  My mind was racing over the scenarios I would find on arrival at B ward.  Minutes before I had received a phone call asking me to come quickly to the internal medicine ward, they were doing CPR on a patient and needed me.  There really is only one way to prepare for this kind of emergency,  to pray.  My pace did not slow down but my mind calmed as I talked with God   With 50 feet left to my destination I could hear the loud wails and knew there was nothing more I could do, the patient had passed away.

I slackened my pace and calmly walked onto the medicine ward.  One of the nursing staff met me at the door and filled me in on what had happened.  Mrs. K, 70y/o female, was admitted earlier that day for an obstructed small bowel.  She then aspirated and fell into respiratory failure and the staff had valiantly attempted CPR.  Despite their care she slipped away.  Would I talk to the family please?

After briefly reviewing her chart I met with the family and explained what had happened to their mother.  Next I asked the family if Mrs K had give her life to Christ and trusted him.  There were affirmative nods all round the large group gathered round her bed.  We talked about how we were sad she had passed away but glad she was now with Christ and that she had no more sickness, or pain, and was happy in the presence of Christ. My heart ached for the family’s loss.  They had not had time to say goodbye given the sudden parting of there mother.  In PNG culture it is very important to say good bye and mend any hurts.  I then prayed with the family in Pidgin and English.

I left the family, signed the death certificate and left the hospital with a heavy heart.  As I walked home alone down the dark road I continued to wrestle with the events of the last half hour.  I didn’t know Mrs. K, but it still hurts to lose someone under your care.

After completing my night’s work I had some time off the next morning.  I was listening to Matt Maher’s song Christ is Risen and reflecting on Mrs K’s story.

Christ is risen from the dead,

We are one with Him again,

Come awake, Come awake,

Come and rise up from the grave.

O death, where is your sting?

O hell, where is your victory,

O church, come stand in the light,

Our God is not dead, He’s alive, He’s alive!

 

O death, where is your sting?  The heaviness was replaced with joy.  In the midst of pain and death, there is hope.  Our God is not dead, he is alive!  He’s Alive!   Happy Easter.

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Sunset at the hospital

Nathan’s Notes – Mr. J

 

On my first day rounding for internal medicine service I met Mr. J.  Mr. J had an ascending paralysis.  This left him unable to move his arms or legs and he could only sit up with the help of his watchman (a family member who comes to the hospital and helps the patient with their needs while in the hospital).  Dr. Bill and I are pretty sure he has GBS.  It is thought that GBS is a rare side effect of some viruses.  The problem is that if the paralysis extends to the muscles of the chest the patient will not be able to breath and then would require a ventilator.  Kudjip does not have a ventilator.  We were quite concerned.   Despite Mr. J’s dire situation he always has had a huge infectious smile.

After 5 days rounding with no change we stopped to talk with Mr. J.  He could move his little finger and raise his hand off the bed.  There is no easy way in Pidgin to explain such a complex illness.  Dr. Bill began to share our earlier fears, that his lungs would stop working.  That it was as if God had drawn a line across his body and told the paralysis to stop there and go no further.  The smile on Mr. J’s face grew bigger as he more deeply grasped the situation and the goodness of God.

This weekend I had the opportunity to see Mr. J again.  He smiled as I walked onto the ward and showed me he could lift a foot and his hand.  There is no mediation to treat GBS.  All you can do is support, provide oxygen, and pray.  We serve a big God.  Please pray for Mr. J that he will continue to regain his strength and be able to walk out of the hospital soon.

Creepy Crawlies – Giant snails

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This one was found climbing the side of a building

Snails and slugs are a common nuisance of gardens in Oregon.  Nathan would set out bait and the next day we would marvel at the size of some that found their way into the bowls.

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It’s a little longer than her hand

I was trying to think of an adjective to describe the snails the kids have found here in PNG.  Huge? Giant?  Enormous? Jumbo?  Colossal? Monstrous?  All of the the above?  These guys are pretty impressive.  When Nathan gets the garden put in we’ll see if these adjectives could also apply to the destruction they bring.  Not to fear!  My kids will happily pluck them out of the garden.

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Our language teacher would bring her daughter to play while we studied

 

Nathan’s Notes – Day 1

It was a beautiful March morning in 2017 as I entered B ward of Kudjip Nazarene Hospital.  The sun was softly streaming through giant windows.  The walls were a clean white.  On the nurses station was a sign “We treat, Jesus Heals.”  Thirty some patients were patiently waiting to see one of the two teams of doctors.  Today was my first day on the ward and I was working with Dr. Bill, a long time physician at Kudjip.  We began examining patients and talking about their treatment plans and progress.

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Our first patient had altered mental status with episodic fevers.  His presumed diagnosis is Typhoid with improving encephalopathy (infection of the brain).  We are encouraged as family has noticed he is acting more like himself.  My mind is racing.  “Typhoid?  I think the last time I read much on this was medical school 11 years ago.”

The 2nd patient has a diabetic foot ulcer after stepping on a nail.  Looks like he needs further surgical detriment to remove the dead tissue around the wound.   Okay, I’ve seen a lot of this in rural Oregon, but how do I counsel a low sugar diet in a country that is totally carb based?

The 3rd patient has fever of unknown origin.  We think typhoid but the test we have to confirm this is very unreliable, only slightly better than a flip of a coin.  She is possibly improving.  We will check a blood test and get a follow up chest X-ray and reevaluate later.

Forth, another possible typhoid and, no, typhoid is not an epidemic, this is typical life in the highlands.

Fifth, liver cancer.  We are trying to make him comfortable and get him home.  We will talk with the chaplain later today.

The sixth patient has ascending weakness.  We think post viral.  Could be Tb of the brain but we have no CT machine to evaluate this.

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In spite of challenges, he greets Nathan with a smile every morning

Next, the seventh patient has HIV and dysentery (bloody diarrhea).  Presumed opportunistic infection.  Symptoms slowly improving.  Hopefully we can get her well enough to get on some meds for her HIV.

The eighth patient has TB  and seizures.  Unclear if the seizures are from his TB or his medications or both.  Seems to be doing better on his new anti seizure medicine so we will monitor a little longer.

And the ninth has weight loss, with presumed adrenal insufficiency and TB.

I glance at my watch its only 9:30AM.  Most of the problems I’ve seen are rare in the USA and would not cross my mind in evaluating a sick person in Oregon.  And so the day went, one new problem after another.  “We Treat, Jesus Heals.”  We do our best to help each patient and share the love and hope we have in Jesus Christ.  Some patients will get physically better and others won’t.  We pray all learn of and see the love of Jesus.  Only in Him can we hope to truly heal the broken.

Handy Man

Cooking with an open flame on a gas stove made me nervous with little ones running around.  Especially with a little guy who learns by touching . . . absolutely everything within reach.  In one of the boxes that was sent ahead, we included a baby gate to block off the kitchen to help keep curious little hands safely away from the hot stove.  The gate, though, ended up being far too short for the doorway of the kitchen.  Not to fear, my handy husband came to the rescue.

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Standing with Daddy by the safety gate

After finishing medical school and residency he actually had time to think about hobbies and one that he took up was woodworking.  He was always coming up with ideas to help around the house or ways to repurpose old wood.

Woodworking was one of the things he knew he’d have to give up when moving to PNG   . . . or maybe not.  Turns out there is a workshop here to help with all the maintenance that goes into the keeping up the houses and hospital.  Moving around the world has now given him the opportunity to use woodworking equipment he never would have had in our garage in the States.  And the project ideas are flowing.

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One of my favorite of Nathan’s creations and is proudly hanging on our wall here

 

PNG Eats – Experiencing a Mumu

The week of March13-18 was a celebration of the 50th Anniversary of Kudjip Nazarene Hospital.  One important part of the celebration was a mumu, which is basically a giant BBQ.  This particular mumu was the largest that some of the missionaries remember, with over 30 pigs cooked along with many chickens.

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Gathering the food

The preparations that we saw began on Thursday with the digging of giant pits that would hold all the food.   Later that day food was brought in by various groups: maintenance staff, x-ray staff, nurses, pastors, Bible college students, etc.  The delivery of food was a ceremony in itself.

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Each stick with flowers represents one donated pig from this group

 

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Notice the chickens on the left and the Coca Cola near the middle

 

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This big guy will become dinner

Early Friday, around 4am, the pits were prepared and the animals butchered.  Rocks were heated and placed in the ground with layers of banana leaves meat, kaukau (like a sweet potato and a staple of the diet here), cooking bananas and other food that I’m still learning about.

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The mumu pit

There were six places around the station that were involved in cooking the food.  An e-mail was sent out letting everyone know where the mumus would take place.  Being new, I wasn’t sure where these houses were, but while out walking Friday morning the smoke from each one made them easy to spot.

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The mumu near our house

All day long people gather to help with the cooking.  A mumu is an important social event, but the focus is on the preparation and cooking.  Once the food is ready it is separated out for each family and they go home to eat the meal.  Because most PNG families do not have refrigeration, all of the food will be consumed that evening.  From what we hear, there will be many more mumus to experience in the future.

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Banana leaves used to separate out the food for each family