rotating header

Sunday, August 30, 2015

Sabbatical, Furlough, HMA. . . or what in the world are the Myhres doing?

Sabbatical, a term which seems to exist only for college professors and missionaries, which makes me feel a twinge of guilt.  But it has a strong biblical basis.  In Leviticus 25, the farmers were instructed to let their fields lie fallow every 7th year, a rest for the land, and God promised to make their sixth-year produce last until the eighth. Furlough, a leave-of-absence particularly for military personnel, a temporary stepping back from the battle.  In Serge-speak, we are on a year of "Home Ministry Assignment", which traditionally comprised one year in every five.  The concepts of sabbatical, furlough, and HMA are related but not identical.  Sabbatical implies sabbath which implies rest which implies faith.  Yes, faith.  To cease from the struggle, for a limited time, requires faith in God's provision and work.  Which may be why the failure to observe sabbath is such an oft-mentioned sin.  Furlough implies a break from intensity, for sanity, for survival, or taking care of other aspects of life.  Both of these recognize the fruitfulness of recharging.  HMA implies more shift of focus, from ministry cross-culturally to ministry on the home front for a limited time period.  The purpose then is not just for the worker who is taking leave, but for the home supporters who will benefit (in theory!) from their return and report and encouragement.

This is our second year-long sabbatical in our 22 years in Africa.  The first was a university-type sabbatical, a year we used away from our normal work to pursue further study, getting a Masters  in Public Health degree.  We've had numerous short furloughs or HMA's, where we visited churches and family, often in times of need or for specific purposes, a month here and a few months there.  But this year is something new for us, what I would call a true biblical sabbatical.  Fallow land, letting grow what will, ceasing from most of our usual labor, waiting.  A year of faith.

This sabbatical carries a strong theme of rest.  Hebrews 4 kind of rest, where we follow Jesus into a sabbath of pause, of work-completed.  It is not a passive rest, we are told we must be diligent to enter it, that we must hold fast to our confession and boldly to Jesus.

The concept of entering rest and coming home will find their fulfilment ultimately in the new heavens and new earth, in the all-things-right world that we labor towards.  But we get tastes of that rest and that home now, and for us that taste is coming in a place appropriately labeled "almost Heaven". Yes, West Virginia.  As a pilgrim and wanderer since age 18, this spot of ground holds the most consistent peace for me of any on earth.  My ancestors were born here, my parents met here, I spent childhood summers and weekends here, and my Dad left us some property here.  The 100-year-old farmhouse he had intermittently rented out, but in the last decade it had deteriorated with disuse.  My mom agreed to deed it over to us and we spent a good bit of our savings in the last year or so on a new roof and floor and finishing a room addition my Dad had started.

Which means that for the first time in our entire adult life, we own a house (and a car too!).  A house which carries a touch of our ideas, and ties into the hand-me-down furniture from our childhoods and some gracious presents from our long-ago wedding.  What a gift, what a revelation to find that rest and home tie so strongly together, that as embodied humans our souls breathe differently in this geography than in another.

We are in Sago, tucked into a fold of old hills, with meadows and forest sheltering from behind and a river flowing by in front.  We walk a few minutes to the best swimming hole, deep and cold right before the river bends onto shallow laughing rocks.  Four deer step nervously from the forest edge; hawks circle in the high clouds; a bee-sized humming-bird sips from the flowers by the kitchen door; an owl calls in the bright full moon.  We clean and organize, put in outlets and shelves, spread our quilts on beds and arrange our books in shelves.  Our kids seem a little disappointed that our first full empty-nest week milestone tonight did not find us collapsed in boredom or sadness.  We miss them.  But we'd be fools to shun this gift, this 28-years-later honeymoon, this space to process and settle.  Frankly, I can't remember the last time I went two weeks without watching someone die.

Pray for us.  I still find the most frightening verse of the Bible to be Psalm 106:13, where God gives the whining Israelites what they think they are desperate for but sends leanness into their souls.  Perhaps the decades of living in mission-housing, living by borrowing, makes us wary of the wonder of a home.  Pray we find the kind of rest for which sabbath-sabbatical were designed:  a deep dependence upon God the creator and provider, a sense of perspective as the world tilts on without us waking up at all hours of the night, a stillness and clarity as we listen and wait upon the Lord.  Pray we would do some home-ministry, we would thank and bless all of you on our support team.  Pray we would be ready to plunge into frontline medical missions again in a year.

Lest you think this sabbatical is too much fun . . . here's where what we have planned for the Fall, in addition to recertifying exams, study, spending time with family, writing, etc.  Hope to see many of you in these places.
Sep 3-19 Spain/North Africa for Serge Meeting (Area Directors with Mission Leadership, then visiting some work in the area)
Sep 20 speaking at Grace OPC in Vienna, VA, our main supporting church (combined Sunday School hour)
Oct 4-6 in Philadelphia, speaking to Serge Board
?Oct 24-25 speak at Trinity Presbyterian, Charlottesville . . TBD
Oct 27-Nov 1 speak at Serge's Vision Summit in Florida
Nov 5-7 speak in seminar at Global Health Missions Conference in Louisville, KY
Dec 27-31 speaking in two seminars at Inter-Varsity's Urbana Missions Conference in St. Louis, MO
Baltimore, Cincinnati, Chicago, Half Moon Bay, Colorado Springs, to be scheduled still!

Pray we would have God's words for His people in these places.
And pray we would rest well in between.

Thursday, August 27, 2015

America, we're back

Oh, America

Here you are in all your splendor.  We, the peripatetic children of this land, meet you once again after a long absence that brings both the clarity of a fresh look and the bewilderment of being out-of-sync.

So here are some thoughts on the first weeks back.

Friendliness.  This is one good rep that America has in the world, and deserves.  I noticed it as soon as we boarded the United flight in Amsterdam.  Our stewardess served our meals with such cheer, greeted us with such warmth.  The Atlanta airport, even in immigration, exuded can-do hearty welcome.  Strangers smiled at us. And I noticed that most of this good will came from African-Americans (we landed in the South), which is remarkable given the state of tension and injustice we are reading about. 

Rural life.  We are based this year in rural West Virginia, and an extension of the point above is the friendliness of the Baptist itinerant pastor down the road recalling stories from MY childhood in his sermon as we were spotted in the pew, and insisting we stay for the potluck lunch, held in tension with the natural suspicion of mountain folk.  Sago is for me a soul-anchor of the familiar, the birthplace of my ancestors, the site of many of the best memories of my childhood.  It is also a foreign land, and I know more about rural Bundibugyo than rural West Virginia at this point, but I’m learning. We have had our neighbors for lunch, and had long conversations with the mail-carrier, the UPS man, the Southern-states gas tank trucker, the guys who maintain the electric right-of-way, the water co-op . . it's small-town and wonderful.


Recycling.  Recycling is big.  The rules are obscure and local.  In our new home we can separate plastic, cardboard, paper, cans, and garbage.  But there’s no place for glass.  Who knew something like trash could come with such a heavy set of expectations?  If you want to be helpful in someone’s home, you have to ask for directions.

Sweet Potatoes.  Sweet potatoes are IN.  And personally I think sweet potato fries are a triumph of the 21rst century.  I could live on them.

Ice.  I don’t think I’ve seen a fridge yet, besides our own, that doesn’t dispense ice right from the door.  In the short forays into the heat between air-conditioned car and air-conditioned building, we survive on ice.  Everyone has huge cups with straws.  There is a mass fear of dehydration; a drink must be always within arm’s reach, and tap water is suspect.  Vitamins, flavors, fizz, packaging all make the water special.  And it’s gluten-free.  I am not making this up, water is labeled as such.

The doggy aisle.  Throwing this one in for fun . .We stopped in REI and were perplexed by this display.  Then realized it is rain coats and winter boots. For DOGS.

The Moral Majority.  To me this conjured images of self-righteous politically-conservative so-called Christians, desperately laying claim to their birthright of dominating the culture.  For some good causes like speaking for the unborn, but mostly not really Jesus’ agenda of justice and mercy so much as protecting privilege.  A democracy only stays Christian in value if the majority of people agree, and in America the mainstream has flowed on.  We landed in the midst of major shifts in marriage legality for same-sex partners, controversy over the use of fetal tissue obtained from Planned Parenthood, and shocked horror over the killing of Cecil the lion.  The media buzzed with opinions.  We just listened.  Not so much to who is right and who is wrong, but to the Moral-Majority tone of the discourse.  Ever since the Puritans pushed out the American Indians, our tone of voice hasn’t changed.  Scathing shame heaped on those who step out of line, which most recently would be a dentist who paid for a hunting permit, or anything the majority finds deviant or unacceptable.  Yesterday’s Salem Witch trials are today’s Twitter explosions.

Exhaustion.  This is a tired country.  If you come at life with the same passion for right and wrong as our heritage embraced, but with no agreed upon text to draw the lines, life becomes a very tiring process of figuring out what to be incensed about.  When everything is up for grabs, when there are no givens, it takes a lot of energy to organize a life.  Perhaps the college/20’s crowd feels this most acutely, leaving whatever rules their home or high school enforced and (except for Caleb) entering institutions that pride themselves upon anything-goes, then finding out the hard way it doesn’t.

Violence.  The friendliest nation, and the most armed one.  What an American paradox.  We have actually seen people carrying guns in the grocery store.  Yesterday a disgruntled employee shot a reporter and cameraman from his former station, on the air, not far from us.  Increasingly, the friction of human life sparks into fatality.   We have lived overseas with rebels, war, terrorism, but those countries have clear lines between the illegal gun-toting bad guys and the rest of the citizens.  In America, anyone can be armed and dangerous.

Generosity.  We are here, after all, to thank our supporters, who do not fall into that strident shame-flinging social media frenzy, nor the gun-toting vigilantes.  American individuals give, and give, to people they have never met.  They are willing to sacrifice, and we are thankful.

Roads.  Enough said. The roads are awesome.

Safety.  Yes, America is still safety-obsessed and risk-averse, and the culture of blame and liability drives a lot of our behavior.  Some warnings are helpful.  Some are laughable.  Don’t drop this toaster on your toe.  Don’t try to eat this packaging.  On the other hand, Julia's defunct phone slipped in under warranty so we got a free new one at the Apple store.  Yeah.

Absurdity.  To end on a lighter note, this is my favorite so far.  The microwavable potato.  As if all potatoes are not microwavable, now you can buy them individually wrapped in plastic.

Sunday, August 23, 2015

College Drop-Offs and Clouded Glory

A hazy sun burns through wispy clouds as we  drive north though Carolina pines and tobacco fields, away from two of our children.   ‘Tis the season of college drop-offs, an American ritual.  Parents have scoured the shelves of Target and Bed, Bath, and Beyond for pencils and pillows and microwaves, loaded station-wagons and U-haul trailers with couches and bikes, heaved boxes and suitcases up stairways, attended receptions and given hugs.  The grand launching of a generation.

I think of the dozen kids we sent to school in Uganda.  Everything they owned fit into a small bag, the most expensive back-to-school item was a mattress, the school-approved list of packing items included toilet paper and drinking water, and they boarded public buses to brave the big city on their own.  I felt some of the same guilt and angst, wondering if they would be OK. 

But now it’s my baby, which takes the whole good-bye thing to a new level.

Don’t get me wrong, Duke is a rare combination of elite opportunity, southern graciousness, and generous aid.  Leaving two kids at the SAME school gives us courage for both.  The web of missionary connections stretches to include some fantastically supportive people in Durham.  We have spent the week shaking hands with professors, absorbing information and atmosphere, sampling cuisine including corn-on-the-cob, shrimp and grits, hushpuppies, barbecue, iced tea . .  . but we had to say goodbye nonetheless.  Had to give hugs with quiet tears. Had to walk away.

And though I know that my youngest two think this is NOT a good thing, and though my own heart questions it, I know the deep Truth that IT IS GOOD.

I know that the doors God opened to put them here had a purpose; there are fingerprints of the divine all over this, glimpses of providence.  I know that these are two young adults, ages 17 and 18, who will shine.  They will be curious learners, they will forge connections between problems and possibilities that we could not, they will be answers to other parents’ prayers as voices of reason and faith in other kids’ lives, they will grow in their bond with each other and find community.

I also know that to do all of that, we need to get out of the way. 

It will not seem that way when they are sick, or injured, or struggling in a class, or confused about how to buy textbooks or use health insurance or budget food money.  It will not seem that way when their dorm friends are throwing up after drinking binges, or when they don’t have a place to go for a holiday (not this year since we’re in the USA!), or when they wake up feeling that pit of lonely.  It will not seem that way as they make the transition not only from home to college, but from Africa to America, jumping too many times across major cultural gaps.

But right now let us stand on the foundational truth that it is.  

And let us stand there because we see the same pattern in God’s loving, parental shepherding of our own souls.  We want presence, assurance, and help, and yet what we encounter is often a sense of distance.  We want independence with an escape clause, we want next-door rescue at any time.  Which in a sense God gives, but the Throne is obscured by clouds, the King seems perpetually on a journey, the earth-melting power of God remains veiled.  God hides the reality enough to call out our faith and action.  If Jesus walked tangibly through our days, what need for our paltry efforts to teach and heal?  So he gives us the space to draw out our gifts and our courage.

I hope that is what we are doing this morning, driving north.  Giving space that will be filled with the glory of two souls-in-the forming.  Following the example of God-Our-Father, with the same ache of longing for reunion.  Holding onto love by prayer.

Tuesday, July 14, 2015

Jack Preacher

The RVA Sunday Worship Service this past week was led by the Class of 2015.  They call it "Senior Sunday.

The Seniors lead the 700 attendees in worship, prayer, and biblical teaching.  Jack was one of three senior guys who preached "sermonettes" - 10 minute pieces of teaching and encouragement.

Click here to watch Jack's 10 minutes on Fear and Isaiah 43.

Sunday, July 05, 2015

Dr. Seuss, margin, sorrow, and who's writing this story?

Two weeks ago I came off my last night of call, and entered into the transition zone. One of the things I have learned from my 30-something-year-old colleagues is the value of margin.  Scott actually negotiated finishing at Kijabe June 1rst so he could focus on his AD leadership job, and travel to Uganda.  I asked to finish June 21rst as one of our regular short-term docs arrived, so we could clean and sort and say farewells well and pack and plan.  Margin, sounds wise, right?

But that night I got sick, and we've been reeling from a series of punches ever since.  It took me two rounds of antibiotics after initial improvement and relapse to emerge from the first sickness, and then we both got slammed with a flu-like virus (fevers, chills, aches, and head-exploding congestion) this past week.  Meanwhile Scott had surgery on his eye, Jack had surgery to remove four impacted wisdom teeth, and this weekend Luke seriously injured his knee playing soccer in Rwanda and is heading to Kijabe tomorrow for diagnosis and care.  Scott threw his back out a week ago as well.  In short we're a sorry bunch, limping through days of cleaning and packing and sorting at a very slow pace.  Not what I expected this time to look like.

It's making me a little suspicious of margin.  You give yourself some space that looks wise, and suddenly it gets filled with things you don't choose.

In fact a lot about this ending here is not unfolding the way I would have written the story.  Jack's last Rugby game was not the triumph we hoped to watch, and though he scored a try he didn't have the ending we would have loved to see.  We got to go to his end-of year sports banquet, and in spite of being only one of two senior boys that played all three of the most competitive sports, and one of 3 or 4 who had played the most varsity seasons in their RVA career (7 for him, 7 or 8 for the others) he didn't get any recognitions (though he had a good attitude and was happy for his friends).  We would not have chosen to leave for furlough with two of four countries we supervise in complete political meltdown with teams evacuated, and the other two under threat.  Contingencies and grief abound.  Then our hearts ache for Luke right now, with his bruised and swollen and painful knee that reminds us of Caleb's.  Our plan had been to hike the Rwenzoris after graduation.  Sort of like margin, a TCK-guru Dave Pollock advised us when our kids were very small to grab those transition times between one place and the next, and do something memorable as a family.  Take a few days on the way from here to there.  We are grateful that we have been able to do that a number of times.   This year now is looking challenging.  We set out one week before flying to the US for our furlough when all of us but Caleb could do the climb, but now we can't.  And we have been trying to get a week in the US in early August when all six of us could overlap, but due to an Air Force change of rules Caleb's leave has been hard to arrange and short, so even with Luke skipping two days of class and Caleb begging for a 96-hour pass it may be that we wrest only 24-48 hours all together.  While we've had wonderful closure with our departments and friends, there have been some disappointing sorrows in the last two weeks too.  And even the good stuff is emotionally draining.  Sorting photos and books and handmade pottery.  Hosting the last Caring community, last Thursday Lunch, last Sunday school; the Lower Station farewell for graduates, the Serge team grad appreciation lunch.  Attending the RVA staff appreciation tea.  Good stuff, but sad.

In the midst of all this angst, I had a birthday.  This was June 25, before this last knee disaster and in between major illnesses.  Luke flew up for the weekend from Rwanda as a surprise, and kick-started our packing.  The whole day was full of team and fellowship, and as we prayed together after our team dinner it popped into my head why "53 years" sounded familiar.  It was my Grinch birthday!

"Why for 53 years he'd put up with it now.  He must stop this Christmas from coming, but how?"

Now anyone who knows me knows I am the antithesis of the Grinch when it comes to Christmas.  I'm all for tinsel, noise, parties, special events, music, cookies, the whole shebang.  It's my favorite time of year.  But I do wonder if 53 is a risky time for Grinchiness in general.  As I look at some disappointments and losses my kids face, I don't like it.  I would choose to wreck my own knee if I could save Luke's. I don't like packing or transition.  I don't like not knowing how the year in the States will unfold, or what God is calling us to do next.  We have a list of potential places to serve in Africa in 2016, but we are waiting for the way to be clear.  I don't like letting go of most of our possessions, paring down to the essentials (well, I DO like decluttering when it's done, but the process is hard).  I can see myself as that old self-pitying Grinch, plotting on how to make everything work out my way.

But when the Grinch's plans were unsuccessful, his heart grew two sizes.

Transition, loss, disappointment, lack of control, the unknown: this is the stuff of heart-expansion.

Pray for us this year, that God would grow our hearts.  That we would trust His goodness with our kids even when knees blow.  That we would trust his authorship of our story, even when we don't know what's going to be written on the next page.  That as we move through goodbyes and sorrow, our hearts would not shrink into stone but soften and blossom.  That 53 years would lead to love.

(Here are some photos of closure and celebration . . )

Tuesday, June 23, 2015

Advice for Young Doctors, Gleaned from Goodbyes

This morning's farewell was a breakfast party (complete with chocolate cake, above, as all breakfasts should be) with our Paeds team, including nursing staff from the BKKH floor, the Family Clinic, the nursery, the ICU . . the many places around the hospital where Paeds patients are seen.  I am grateful for the steady pace of closure, the ebenezer-opportunities to reflect on God's grace, to be thankful for friends, to say goodbyes in the truest sense of "God Be With Ye".

As I reflect on what people say at these events, I realize that the things I tend to think make a great doctor, and the things which truly do, are two different lists.  Not one person in now four parties has mentioned a dramatic story or clever diagnosis.  A certain level of competence is essential, but brilliance is overrated.  I remember the baby who was dead post-exchange transfusion, and nothing brought him to life until I pushed calcium, and he literally resurrected, and a year later I saw him in clinic a normal toddler.  Or the infant born with such severe swelling (hydrops) she looked inhuman, and after a long ICU stay being told "this is the last chest tube we have", and praying, and against extreme odds she survived and mom sent me pictures on her first birthday.  That kind of wonder.  But those are like peaks of mountains, rarely seen, and not commonly traversed; occasionally beautiful, but not where most of us live.

So here are the basic essentials that nurses and trainees and administrators and colleagues notice and remember:

1.  Come when you're called.  It's that simple.  Keep your pager by your bed, keep your phone ringer turned up, and answer.  When someone wants you to see a patient, show up.  Don't make excuses.  Don't complain.  Don't make people feel bad for calling you, even if it was silly.  Just show up.  It's probably the #1 thing I've heard in the last two weeks.  Your nursing colleagues want to know you have their back, you won't leave them to manage alone.

2.  Listen to the nurse.  You might be covering 50 kids on four services scattered all over, she (or he, but mostly she here) is watching 2 or 8 or 10 closely within arm's reach.  She notices when breathing changes, or feeds aren't actually going so well.  If you're thinking of making a change in management, ask her what she thinks, and take her opinion seriously.  She knows if the endotracheal tube is still necessary because lung secretions are too thick.  If she tells you the patient is worse, listen.

3.  Be clear and definitive in a crisis.  When the kid is coding, then everyone needs the confidence of a leader who assigns roles by name, who orders the sequence of treatment, who has a plan and communicates it.  Listen 95% of the time, but when someone is dying, be ready to take action and responsibility.

4.  Stay organized.  Keep up with the details.  Your team wants to know that you're paying attention.

5.  Let your heart shine through.  People are watching, and they take encouragement when you sit and counsel a family, when you pray, when you go an extra step and care.  You can't fix every problem, you can't even fix most of them.  But you can show compassion for every patient.  Be willing to raise funds for those who can't pay.  Be willing to weep sometimes over a poignant sorrow. Invest in relationships around you.

Medical school is fascinating, but most of the above I learned from my parents long before.  Come, and listen.  Take charge in chaos.  Pay attention.  Be kind.

These are the characteristics of a doctor that nurses want to work with, and that is who you want to be.

If any students or trainees are reading this, let me end with the testimony I shared this morning.  There's nothing like goodbyes to make you realize the treasure you've been given.  This was the prayer guide for my mom's prayer group this week:

Give them a strong sense of purpose so that they are led to the right occupation and are always in the job or position that is Your will for their life.  Speak to them about what they were created to do, so that they never wander from job to job without a purpose.  Help them find great purpose in every job they do.

And as I prayed it, I realized how it had been answered for me.  This job, being a missionary doctor, is what I was created to do.  It's impossibly straining and wonderfully fun, both at the same time.  Hang in there, because this is the best job in the world, and so worth it.