Off-Kilter

I'm not sure if KILTER is a physical part of the brain, or a quality of the soul, or an achievement of community, or all of the above.  Perhaps the Hebrew is shalom.  One of those things that you can take for granted until it is missing.

This is a week (month . . year?) in which the kilter is askew.  Monday, instead of working, I was in the car.  ALL DAY.  Reading a good book (Allah, a Christian Perspective, by Miroslav Volf) and doing some computer work, but confined to the car nonetheless.  Leaving half our family (Luke and Caleb) behind on the coast, and hurtling back towards responsibility.  Because of that, and some staffing issues, I worked T/W/R instead of M/T/W in the hospital, which meant that my usual R things like Swahili lessons and prayer meeting and RVA clinic had to be juggled alongside of patient care.  The week was also kilter-imbalanced because the interns were pulled off their rotations for trauma training, and my only remaining partner, a clinical officer, was feeling sick.  Scott and I had staggered calls instead of the same night.  I had two patients die in ICU.  In both cases I poured my all into their care for a day or more, and had glimmers of hope, but in both cases their brains could not recover.  Both had lovely caring pairs of parents.  People that hugged ME and reassured ME that I had done everything possible, people that thanked ME for the care that ended in their child dying.  That, and the sobbing, always get me.  

Some of the off-kilter comes when bumping against good things, too, like having a delightful kid stay with us for the week, or a visit from potential new long-term Kijabe doctors, a pediatric plastic surgeon and his pediatrician wife.  The surgeon was my medical student in Chicago when I was a resident.  Just over twenty years ago now, he was a bright, committed, helpful, competent student who was also a Christian, and we kept in touch as he even supported us over the ensuing decades.  Now he gave a phenomenal talk about the cleft lip surgery program he helped establish in Ethiopia and the way God had used that to concretely demonstrate love to some very resistant unreached people groups.  We're hoping to get them to Kijabe in order to train others.

Then there is the usual fact that our front-line friends have their own off-kilter experiences, week in and week out.  Which mostly affects Scott, who is working very hard.

And did I mention the three-hour sophomore class sponsor meeting?   The guilty anxiety that we're not going to pull off our part of the class project?

Work and sleeplessness and death and loose ends and visitors and cooking are part of life.  The real reason it all felt so . . .well, I should just say it, STRESSFUL . . . was that the background of this week is the looming end-of-this-chapter of our family's life.  The dispersal of the fellowship once again.  A week from today Caleb will have a mini-graduation recognition at chapel, and then over the weekend we'll fly out.  He and Luke already said goodbye.  Reality is hitting, hard, that the days our family can spend together are precious, that we can't see them or count on them from here.  We'll have Luke in a summer Swahili Language program at the coast, Jack and Julia and Acacia finishing the term at RVA, Scott working, and Caleb will be suffering through basic training.  My heart aches, already.  I don't know when we'll be together again.

In a perfect world, such as the one that we are promised, shalom will be the air we breathe, all will be on-kilter.  But in the meantime, I think the jarring imbalance of these sorrows and even joys keeps us living by faith.  Off-kilter can be a state of grace.  A gift.  

At one point this week, I rushed home to pull leftovers out for the kids for lunch and then rushed back in response to a page about a critically ill baby.  When that was settled I had a half hour before RVA clinic so I decided to just plow through some charts in the outpatient clinic, since there are no interns to see them.  I pulled out the first two:  malnutrition, sounding dire.  Depressing, complicated, no-quick-fix, and I admit to feeling resentful and stuck.  When I called the name, it took me a while to reconcile the smiling plump baby with the chart.  It was C, the orphan from Sudan, and his fellow-abandoned-child S.  The Kenyan NGO worker who had been hired by the American group to manage the project in South Sudan had been keeping C and S at his own home in Nairobi for the month since we had discharged them.  He decided that his wife needed to get involved.  And she did.  Those children had each gained 1.2 kg.  C had now doubled his weight since we first started.  They were playful, relaxed, loved-looking kids, with grandparently-type well-educated Kenyan caregivers.  He plans to return them to South Sudan with their siblings but not until next month, when his wife can also go and spend some weeks supervising the care and teaching the orphanage-workers about feeding and nutrition.  

I was almost "too busy" to see these kids, and if I had protected my kilter from one more interruption, I would have missed a real treat.  A reminder that God can mix things up a bit, for good.  Move kids across borders and families, involve multiple people and agencies, push us a little harder but bring out new life.  A reminder that the loss I grieve may be hidden gain and glory.

(above, 3.7 kg, day 3 of admission, to the right 6.2 kg, yesterday)