A Quick Delivery

It was Sunday afternoon as I walked on to Labor & Delivery to check several patients.  The nurses were concerned about a newborn that had been born prior to arriving at the hospital.

We’ll call the mother Harriett.  This was her 4th child and she had been at home when the labor pains became rather intense.  She lives in a house on stilts with a surrounding veranda just a short drive from our hospital.  As she hurried across the veranda to the stairs, the baby was born.  Baby of Harriet dropped from the birth canal and fell from the edge of the porch.  The sudden jolt severed the placenta and the baby plunged 1.5 meters, impacting on a plank walkway and then  rolled into the dirt.  Harriett then scooped her child up and raced to the hospital where the staff delivered the placenta.  The nurses cleaned the little baby boy who had dirt everywhere.  He still had a little dirt in his ears when I came for the examination.  Other than that he looked pretty healthy.

After an afternoon of observation Baby of Harriett finally started nursing and we all took a sigh of relief.  On Monday he and Harriett were both doing well.  I hear and see many things in PNG I have not seen elsewhere.  This was a first.  A newborn trying to bungee jump.

The Lucky Few

Recently, I read a book entitled The Lucky Few by Heather Avis.  If you are interested in adoption or know someone going through the adoption process, it is a great book to read.  Or if you know someone who is living with disability and walking through medical needs, it also is a good book to give you a glimpse into their life.

Heather and her husband adopted three kids, two of whom have Down syndrome (Ds).  And while parts of their story is different than ours, parts of it were similar.  It was encouraging to hear from a mom who struggled with living life attached to a tube (an oxygen tube for her daughter and a feeding tube for our daughter).  She made some of the same mistakes I did and had similar emotions.

I got to read how another family navigates going out in public as a family with mixed abilities and mixed ethnicities.  There are both positive and negative aspects to how conspicuous a family becomes with those dynamics.

Heather spoke about the moments leading up surgery as she entrusted her daughter to the heart surgeon to repair the hole in her heart.  This part struck me in a way I didn’t expect, because I have recently met two mothers who will never experience the hopefully anxiety that comes with open heart surgery.  Two mothers of children with Down syndrome who will not watch their children grow much past infancy or toddlerhood.  Two little boys whose hearts are working over time to keep up with the demands of their little bodies.

Heart surgery takes special training and specialization equipment.  Our general surgeons perform surgeries far beyond the scope of a general surgeon in the USA, but heart surgery is simply not something our hospital can offer.  Had these two mothers been pregnant in the States . . .

. . . they would have had doctors who could refer their boys to a cardiologist and pulmonologist and whatever other -ologist they would have needed to fix their tiny bodies.  But had they been pregnant it the States, they likely would have had an OB/GYN who told them that a life with Down syndrome is not a life worth living.  That there were other options they could choose before these little boys were born.  Their little lives could be terminated when they were most vulnerable.  In a culture where it’s not okay to judge the life of another person, it is okay to judge that another life is not worth living.

How do I reconcile a world where the lack of resources in one country will bring about the death of children while in another country that is rich in resources, the lack of value brings about the death of other children?

At times I want to despair in these injustices, but I am reminded of the hope we have.  That God, through Jesus, is reconciling (restoring) all things to himself (Colossians 1:20).  That He has reconciled me “if [I] continue in [my] faith, established and firm, not moved from the hope held out in the gospel.”  (Col. 1:23)  As I become a servant of the good news of Christ’s restoration, He uses me in these very areas of injustice that weigh on my heart.  And He refines me, helping to strip away my selfishness and desire for ease and comfort.  And despite my fumblings, He can use my obedience to bring restoration and reconciliation in the lives of other.  He has called Nathan and I to be a part of His restoration by providing medical care where there is little available and to welcome children into our family who are so easily disposed of by cultures around the world.  It’s not always comfortable or easy, but there are blessings that come only through obedience.  Blessings we would have missed if we had chosen to walk in fear of the unknown.

“I believe that at some point in our lives each of us has the opportunity to leave our comfortable path and head into the wilderness [with God].  Each of us will at some point hold a ‘yes pebble’ in our hands.  My hope and prayer for all of us is that we will be willing to toss those pebbles into the murky waters and get our fancy shoes dirty in the mud.  My hope is that as we say yes, the ripples of our decisions will begin to form wonderful waves.  Waves, my friends, cannot be ignored.”  Heather Avis, The Lucky Few.


One of the things I enjoy about Family Medicine is the variety.  There is always something new to see, do, or learn.  In PNG this is very true.  Most days I see something that I have rarely dealt with or is completely new.  I have learned to adopt a “can-do” attitude.

The first x-ray

I was working in the outpatient department (OPD) when a middle aged male came in.  He had fallen two days before and had pain over his thumb.  His thumb was deformed and he could not flex it.  I sent him for an X-ray and he came back with a film showing dislocation of his distal phalangy.  Well, I’ve never fixed one of these before but thought it should be simple enough.  I injected lidocaine around the base of his  finger (digital block) making his thumb numb.  As I held his hand in place, I gave the tip of his thumb a firm, steady pull.  Pop!  Like magic his thumb popped back in place,  looked normal and was moving normally.  Post procedure film was normal as well.

After popping it back in place

Nursery Reflections

One night in July:

I had come to the hospital to evaluate a young mother with appendicitis.  After finishing in the ER I walked into Labor & Delivery to check in before going home to bed.  I peeked in the nursery.  The Baby of M is having apnic spells.  The child is already on 2 IV antibiotics, IV fluids, and medications to stimulate breathing.  His mom is gently rubbing his jaundiced hand as the photo light casts a blue glow on his tiny body.  The bag and mask sits near the warmer ready for use.  My heart sinks.  What more can we do?  It’s an all to familiar story in PNG.  Respirations go  down and we slowly lose the child.  Of all the things I saw and did today this got to me the most.  Not the 2 C-sections with floppy kids that turned up all right or the multiple broken bones or lacerations.  Even the hand amputation I took in stride but looking at a little helpless child in a nursery warmer breaks my heart.  What more can I do?  Pray.  And so we did.  I left the nursery with a grateful mother who knows we are doing all we can and that we care.  A mother who knows we do our jobs because we love Christ.   As I walk home through the cool night air many questions race through my brain.

This morning as I rounded on Pediatrics, bed 9 was empty, the little 7 day old child had died in the night.  Bed 29 had an episode of respiratory arrest in the early hours of the morning. Her situation is guarded  Does our work matter?  We keep losing patients.  But as I looked down the Ward there were many more kids who were improving.  Some were going home today healed.  Its easy to get down with the losses but without Nazarene General Hospital and its staff many more would die.  And so one week ends and a new one begins. IMG_0540


There are a lot of comings and goings on a mission station.  Volunteers come for a few weeks to a few months.  Missionary kids visit for a few months and return for college (they get one trip paid for by the church during college).  Family comes to visit.  Long term missionaries leave for home assignment and new missionaries arrive.

This coming week we are expecting the return of Dr. Erin.  She has been serving here for over ten years and after arriving in the US for home assignment in the spring, she was diagnosed with a brain tumor.  It was uncertain if she’d be able return in August as originally planned.  Many people prayed for her, not knowing what God’s plan was, but trusting Him in the process.  Thankfully, the tumor responded well to treatment over the summer and she is able to return as planned.

The Miller family will be arriving along with Erin.  They are a new missionary family that will join us for the next couple of years.  Justin works in IT, Stephanie will be helping at the MK elementary school and their daughter will be entering first grade.  Our family has been eagerly anticipating their arrival for several months.  They are just days away from moving, so are in the middle of the last minute chaos and emotions that accompany this transition.  I know they’d appreciate your prayers during this time.