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Saturday, May 31, 2014

Repenting of Jet-Lag-Righteousness

A certain person in our family coined the phrase:  "I don't do jet lag".

Of course he didn't do sleep either, at least not as much as other kids.  And yet his general jump-in ignore-sleepiness and just-go attitude does seem to help him adjust quickly, and he goes back and forth between continents pretty regularly.

When we flew to CT a couple weeks ago, and then back to Kenya, I felt like I was embracing his mantra.  I stayed awake in the daylight and slept hard at night.  I did wake up early in America, and I was a bit tired back in Kenya, but the combination of call nights prior to departure and then delayed flights on the way back made me tired enough to just jump into the new rhythm.  I thought I was doing great.  I felt a little sorry for Scott who was waking up in the night.  I felt a little righteous about being able to travel so well.

Then Friday I felt a little tinge of indigestion, and thought, that's odd, but I guess I ate too much pizza and this is how people feel who can't deal with pizza.  Hope that isn't becoming me.  It is my admin day so after a 7 am meeting I came home and had coffee, but I wasn't too hungry.  I was feeling more and more draggy but forced myself to take the dogs for a jog because I'd had no exercise all week (it is so hard to fit in!).  The jog slowed to a walk, I threw up twice, and then got goosebumps.  This is not normal.  I barely stumbled home in time to shower and fall into bed.

Shaking chills, aching bones, semi-conscious, unable to eat or drink or think, I laid there all day long.  Scott came home and took a blood test from me for malaria since we went to Uganda recently.  Negative.  Before I got sick I had been communicating with our Bundi team, which is perhaps why when my temp topped 40 (102) I morphed our mosquito net hanging above my head into an angel who then turned into Lucy W (sweet little girl on that team) who was showing me a large glazed donut and admonishing me never to waste money on such pastries because they had holes in them.  It was some fever.  About 10 pm it broke, and I ate a bit to stomach some ibuprofen and then sleep again all night.

I feel WAY better today, and am thankful for Mardi taking my rounds and call.

No idea what that mystery fever was, but I suspect that a time-change turn-around of a week, work, call, school activities, and the emotional drain of goodbyes, all played a part in giving me zero margin.

I think next time I'll do a little jet lag instead.

Monday, May 26, 2014

Remembering Memorial Day

Memorial day takes on a new meaning with a soldier son.

I have seven uncles who fought in WW2--five in Europe and two in the Pacific.  All came home alive but the scars of that war stayed with them throughout their lives, rarely mentioned.  I visited one of them briefly on this last trip.  His generation is passing quietly away, the men who did what they had to do without complaint, who spent lifetimes of generosity, common sense, practical know-how, hard work.  We also visited my father's grave.  He was in the army for two years in a clerical job in Fort Knox, KY. I grew up among patriotic people, who decorated with American flags and believed implicitly in the goodness of the American brand of freedom.  Memorial day was about parades and picnics and the beginning of summer, vaguely about feeling proud for being from the USA.

Our kids have a different background, a bit more world-aware, a desire for service and justice, for putting right, for doing the hard things, for sacrifice, that is not fueled by an America-is-always-right opinion.  They saw real war, real bad-guy rebels, real good-guy soldiers who were actively saving our lives.  They have lived (and still do) next to refugee camps, in the vicinity of bombs.  So the fact that one of them is headed to a deployment on a base in the Middle East and will be studying in a language intensive in North Africa should not come as a surprise.  Yet it is not an easy walk for him or for any of them, to hold onto ideals that are not quite politically-correct in liberal or conservative circles, that are their own.

Memorial day to me is now about the reality of sacrifice.  The stakes are real.  To change this world, and to stand against evil, costs lives.  This is the cross.  And that puts my stomach in a knot.

It hit me last weekend at Yale's graduation.  We came out of the Baccalaureate service and Scott and Caleb went to find a restroom, leaving me in a marble hallway.  I started noticing that the walls were engraved with names.  Hundreds, thousands of names.  So I looked more closely. They were the names of Yale grads who died in WW2 and other wars.  Young men, class of 1940 or 1943, death in 1941 or 1945.  Pilots.  Kids, in other words, exactly like mine.

So today is a sobering day to remember that a world amok is only put right by a cost, and it is often our young men and women who pay that cost with their lives.

Sunday, May 25, 2014

You know you're back home when . . .

First, it was no easy process to get home.  Our flight took off from Virginia after an idle hour on the runway.  Which was just enough time that when we ran pell-mell through the airport in Zurich, practically stomping on elderly ladies, we reached our gate for the Kenya connection after the doors had been shut.  The plane was there.  The agents were immovable.  This is Switzerland, land of rules and schedules.  They preferred to have all of us stand in an hours-long line at the transfer desk and laboriously and expensively dole us out to other airlines.  Thankfully by agreeing to go to Frankfurt and then fly on a no-name budget airline called "Condor" (don't, enough said) we still made it to Nairobi by 5-ish am on Saturday morning.  Sure, we lost a planned night of sleep.  But we did walk around Zurich, happen upon a medieval street fair, drink coffee and view the alps.  And we did make it into Nairobi as shops opened, do our grocery shopping, fuel up on more coffee, and go straight to Blackrock.

 So the first sign of being home:  going to the biggest sporting-event day of the year at St. Mary's school in Nairobi, the annual Rugby tournament.  Slathering sunscreen, finding our kids, hugs, anticipating, waiting, cheering until we were hoarse, as Jack's RVA Varsity team won the whole tournament.  This is RVA's first time to win it all since 2007.  Jack played very well, smart plays, fast running, strong tackles, multiple scores.  It was so fun to be outside, to chat and relax with hundred (s) of RVA fans, to witness the victories.  Not a single try was scored against our team the whole day.  Our JV boys also did well making it to semi-finals in the second tier.  (Also I should explain that school tradition dictates that all the Varsity team boys shave their heads for this day.  So they look a bit like a prison team, which is intimidating I guess.)

After a full day we pulled back into home at dusk, so sign two of being back:  thrilled dogs, shaking and barking and groveling and celebrating.  Piles of produce from the grocery, spilling suitcases, telling stories, having a workable phone again, and staying up til after midnight to watch an exciting Champion's League final.

And then there's the jet lag sign of being back.  I'm normally a morning person.  But I had no problem watching soccer at midnight, and then could barely get out of bed at 9 for Sunday School.  Still there's nothing like severe sleep deprivation to ease one through jet lag.  It was pretty easy to sleep Saturday night when the last time we'd seen a bed was Weds night.

You also know you're back home when . . .  the girls came to Sunday School breathless with the news that a leopard was prowling around the dorms.  It turned out to be a caracal, another wild cat, which was removed by the Maasai guards.  Earlier this month it was 4 buffalo that had everyone local afraid to walk on the well-trod paths through the woods.

And to feel really at home, we agreed some time back that today (Sunday) was the only possible time to have the tennis team over while their coach was still here so instead of unpacking this afternoon we were making mounds of dough and cutting up toppings and stoking the fires to prepare.  The tennis team is a great group of kids and we enjoyed hosting them.

So pizza, wild animals, rugby, sleep, community and worship.  It is good to be home.

Wednesday, May 21, 2014

Yale Graduation, Part Two

Sunday and Monday the marathon of festivities continued.  Sunday is known as "Class Day", for speeches and awards.  Monday is the actual "Commencement", the parade of professors and graduates and the conferring of degrees, using formal language, scepters, bands, and flags.  These two events are massive, thousands of students and even more spectators filling the large grassy center of the Old Campus, surrounded by those ivy-covered buildings, row upon row upon row of plastic folding chairs, sunshine, shady trees, jumbotron screens, loudspeakers.  These mass events are followed by receptions and ceremonies in each of the residential colleges, which is part of the brilliance and appeal of Yale.  Six thousand students are divided into 12 colleges, each with its own square of dormitories, library, dining hall, grassy quad; each with its own master and dean who know the students by name. I suppose it is a mercy that the entire graduation event is partitioned, since each huge group ceremony takes a couple of hours, as does the individual residential college ceremony.  In Africa we would power through six or eight hours of speeches and song and dance, all in the blazing sun and hungry.  And we would save the most prestigious speech for last.  And the guest of honor would be hours late.  But not so in America.  The most important speech was first; the events ran like clockwork; there were tables where free bottled water was being distributed; there was plenty of seating.  

So a brief recap of each event.  Class Day is a curious mix of tradition and fun.  The students enter in their gowns, but instead of traditional mortar-board graduation caps they wear their own choice of hat.  Some are outlandish creations of flowers, sculptures, ribbons, colors.  Some are just meaningful.  Luke wore a Kenyan cap.  The main speaker was Secretary of State John Kerry.  He was funny and engaging.  The class speaker who beat Luke in the final selection was a 40-something single mom who had a moving story of overcoming fear to come back to school.  She was lovely and inspiring but personally I thought Luke's speech was better and more relevant to 99% of the graduates.  His and several other student writings were published in a "Graduation Anthology" handout.  We arrived early and had fantastic seats.  Afterwards the thousands of people churned through a few archways to receptions at each Master's house, a shuffling line of dressed-up parents shaking hands and smiling and vying for fruit and cheese.  We took Luke and a friend out to dinner and then left him to party and pack.  

Commencement on Monday began earlier.  Each undergraduate college marched in with their own banners and regalia, then each group of graduate students with their color-coded hoods and tassels.  This ceremony was more ancient, more structured.  The band led the way, there was an ornate scepter and a formal wording of the conferral of each group's degrees.  Twelve honorary doctorates were handed out to fascinating people including the INVENTOR of the World Wide Web, the neurobiologist who discovered the cause of Rett's disease, a musician whose banjo-bluegrass style has epitomized American music (he wrote "A man of constant sorrows" featured in Oh Brother Where Art Thou).  

After the group commencement we re-sorted ourselves under tents in the quad of each of the residential colleges.  Luke's college, Davenport, had the unprecedented honor of winning the triple-crown of Yale undergraduate life:  three competitions for highest average GPA, highest science GPA, and best intra-mural sports record.  Luke did his part in all three.  There were hugs and pictures, milling families, smiles and congratulations.  Then we sat and clapped as each student's name was read and they received their degrees.  They did not know ahead of time where the Summa, Magna, and Cum Laude grade cut-offs would be set since they are based on honoring a certain small percentage (about 5 each of the 120 kids graduating)  and not an absolute standard.  We were very proud of Luke as "magna cum laude" was announced after his degree.  Another dozen or more kids had this award and that award for specific achievements or future plans, including a Rhodes scholarship for one of his friends.  We teased Luke that if they gave an award for being sociable, and having amazing friends, he would win it!

Being parents who did not plan ahead, we were delighted when Luke's room mate's family included us in their post-graduation lunch.  We joined them in a private dining room in one of the nicest local restaurants, toasting our two sons. Jhamatt's father was a Singaporian diplomat who met and married his New York mother, and he grew up between the two places.  He is a brilliant, serious, wise kid who walks his own path and heads from here on a fellowship to perfect his Chinese, which includes some sort of culinary school in Taiwan.

We spent the later afternoon packing up the rest of what Luke wanted to save and loading it into the car, then drove back to Westport for a lovely celebratory dinner with the Gendells.  I can't say enough about their hospitality. I wish upon every slightly dazed and displaced missionary family such gracious friends.  They had champagne and crab claws ready, the grill fired up for steaks, warm congratulations and conversation, all topped off with a cake with Luke's name on it.  It was a perfect end to the weekend.  Caleb drove Luke to the train station to head back up to Yale, where he probably didn't sleep at all before his 4 am departure to Utah for a week of backpacking with friends.  We packed all of Luke's worldly goods (3 cardboard boxes of books and the espresso machine and sacred objects, a trunk holding his charcoal grill, a plastic bin of clothes, and a guitar) into our Volvo with our own suitcases and Caleb's and then slept until 5 am when we headed out to La Guardia to drop Caleb off for his flight back to the Air Force Academy.  And from there we drove about ten hours to Sago, West Virginia, but that's another story.

Perhaps a day and hundreds of miles are useful for perspective on all the Pomp and Circumstance which is graduation.  A few parting thoughts.  First, wonder.  Wonder that our kids, who sat on benches in mud-floored classrooms, who read books shipped on containers and passed down from family to family, who were little pale faces in a sometimes hostile crowd, have been able to stride into this world of privilege and sharpness and survive.  More than survive.  They have held their own with the best students in the world.  Literally Yale is a polyglot place, one is surrounded by families from around the world, and the Air Force academy draws the best from each of the states. They have found that they have what it takes.  Second, admiration.  Luke figured out how to make friends.  He entered the global health world and took advantage of fellowships and seminars. He chose his classes and learned from the best.  He pulled off good grades with decent effort (he described his experience at one point this weekend as breezing through college which is probably a bit optimistic but he knows he will have to work harder in the next phase) without being consumed by it.  We missed the final dinner for Gospel Choir, the final practice for Club Soccer, places where he invested time and leadership and where the kids reflected back to him thanks for the impact he had on their lives.  Caleb has also formed solid friendships and poured himself into Officer's Christian Fellowship, and works very hard on his studies (he is already pushing himself to the limits in a way that Luke anticipates in med school).  I admire their choices, their consistency, their independence of thought, their loyalty to relationship.  I admire the way that the large and small losses in their lives are working an eternal weight of maturity and hope.

And thirdly, grief.  Grief for a phase completed.  Grief for the brevity of the weekend.  Grief that our main glimpse into Luke's life comes as this chapter closes.  Grief that he had to navigate the competition, the intensity of people who are promoting themselves and launching careers of wealth and fame.  In fact that is one of the main surprises for us in spending time with our boys this weekend.  They are both immersed in cultures of success on a level that we do not remember.  When we were in college, we spent a summer working at a summer camp because it was fun and we made some pocket money.  We spent summers in Africa because we believed in what we were doing.  I don't think either of us had the resume pressure that kids feel now.  When some of the awards were read out, they could not have sounded any more extreme if they were parodies than if they were real.  So-and-so basically published new research, cured cancer, saved the world in their spare time while earning perfect grades and performing piano professionally for royalty. I applaud my kids for their sincere effort to cling to what is real, to step into experience for the sake of knowledge and goodness and to try to resist the culture of promoting their own stars.  It is a fine line.  They must wrestle with learning and accomplishing without being driven by perfection.  With serving without being driven by earning points.  With friendships that are not tainted by networking.  Luke was one of the only kids in his social groups that did not join a "society".  He decided that he could not afford the considerable fees or the time which he spent on work-study jobs to earn income instead.  Still these are difficult decisions, difficult lines to discern and walk.

Ironically my Bible reading (and commentary by Eugene Peterson) this morning was Jesus' spontaneous outburst of praise that the Kingdom is not revealed to the wise.  The Kingdom is an undercurrent, a transformation, an unexpected way of working.  It comes to Yale and the Air Force Academy; it comes to alley-ways and farmhouses and islands and hearts.  It comes in success of graduations and it comes even more clearly in the painful daily grind of trusting and holding on that makes a weekend like this possible.  It comes in the supportive community that carried us along and in the deep friendships across time and culture.  It comes in diplomas, but even more so in the scars of survival and faith.  For all of this we are thankful, and though another goodbye tears our hearts again, we believe it is not forever.

Sunday, May 18, 2014

Yale Graduation, Part One: Parties and Baccalaureate

Yale's graduation is a marathon event, a three-day stretch of three major cap-and-gown events, interspersed with hors d'oeuvres, music, art, walking, dinners, greeting, and packing.

 As soon as we arrived on Thursday night, we were picked up by Luke and a good friend and whisked up to New Haven, chatting and getting to know a couple of kids.  It is fun to put faces with the names we heard often over the last four years, and to see the same boys and parents we met on that first weekend when we dropped all our sons off into the suite at Davenport.  There was a reception at an art gallery, a reminder of the rich culture of this place, from historic paintings to obscure detailed wildlife sketches, all the while bumping into seniors whom Luke admired for their intense interests and skills.  Then we got a precious hour alone with Luke, clustered in a booth at a local restaurant with burning spicy Thai curry.  Hearing about the end of the year, exams, the Gospel Choir farewell dinner, the last Club Soccer practice. Reflecting on the richness of relationship, the way he has forged a path, learned, grown.  This is the essence of coming, to open the door to our understanding his experience, the joy and wonder of our taste now mingled with the sadness of missing most of it.

On Friday he came down to Westport where we are staying with Scott's friends from high school.  Dave and Laurie have been our lifeline to Connecticut.  They nursed Luke through a rough wisdom tooth extraction, invited him for boat outings and meals, stored his stuff, took him to the airport, and were a home base and source of wisdom over the last four years.  Their home has been ours when we drop through, and we have enjoyed the renewed friendship with someone whom Scott went to school with from Kindergarten through 12th grade.  After a gourmet dinner together we drove back up to New Haven for a lovely reception put on by two sets of parents from Luke's residential college for the dozen kids in the two adjacent suites who became fast friends over the four years.  They are off to med school, banking in New York, cooking and Chinese study in Taiwan, physics research, teaching in city schools, a Rhodes scholarship at Oxford.  And as their days at Yale draw to a close they are celebrating the ties they forged.  We dropped in on another party with Luke's research partner who had spent a summer with us in Kenya, meeting her parents.

Caleb flew in late Friday night, which with flight delays turned into early Saturday morning.  It was a battle against jet lag to force our eyes open and keep in touch waiting for his shuttle to arrive in the rain at 1:20 . . but then we were wide awake with reunion, hugs, coffee cake, stories.

Saturday Luke wanted Caleb and two guitars and his friend Evie to all spend the morning by a lake while Scott and I had our own lovely breakfast in town.  Then the Baccalaureate, which is a more intimate and religiously-based service held in a historic hall vibrating with the glory of a 12-thousand pipe organ. Scripture, hymns, speeches, and most amazingly, the Yale Glee Club singing a choral Hallelujah.  The president of the University spoke eloquently about gratitude, a humble acknowledgement of the communal effort that put the graduates here, the connection of recognizing and thanking those involved.  It was actually quite solid, and impressive, the first of the three cap-and-gown formal events, ending in the organ's mighty rendition of Pomp and Circumstance which was actually composed for Yale in 1905 and premiered in that very hall.  The 12 residential colleges are divided into 3 services, each followed by a reception for parents and guests.  Today's and tomorrow's events will be all-inclusive, involving a couple thousand graduates instead of a few hundred. We ended the day back in Westport for dinner overlooking the sound, a gesture of thanks to our hosts.

So the weekend is now half over, speeding too fast.  Sunshine.  Handshakes.  A spare hour spent packing boxes in Luke's now-chaotic dorm room.  Walking and more walking.  The stone walls, the carillon bells.  Smiles and hugs and introductions.  Delicious food.  Stories spilling out when least anticipated, from Caleb and from Luke.  Driving back and forth in traffic.  Cappuccino.  Talking.

We are so grateful to be here, yet also feeling the ever-present jarring reality of being outsiders.  We aren't the parents who thought of planning a reception.  We are dressed in borrowed clothes and shoes, as if we really mixed in these circles.  We are reveling in the crisp air and blooming dogwood, yet the reality of life-and-death patient encounters lurks on the edge of our consciousness.  We are so proud of our boys and thankful to be with them, but miss Jack and Julia back at home in Kenya.  We are so grateful for this pleasant home and welcoming friends, but vaguely guilty that we are always on the receiving end.  It is a different world, one we step into and then back out of.  One we gladly embrace and yet as we do we feel the slight rub of disconnection that our kids deal with all their life.

Stay tuned for part two . . . 

Wednesday, May 14, 2014

And we're off

Only an hour left of May 14 and by midnight we will be out of this stuffy departure lounge and high in the sky.

So so so so excited to be heading towards a long weekend with Luke and Caleb. And the graduation festivities will be fun too. Only wish that two hellos were not paid for in two goodbyes. That fracturing of the heart, always.

So it was a smile from God that in the middle of a busy post-call day that included being called to the bedside of someone else's patient, finding the child dead, reviving a bit of life ( CPR never gets old) ... Making week-ahead plans on 28 babies... Managing patients in Icu ... Teaching ...

I found myself in the normal delivery room at the request of the OB team who requested Paeds be present for the delivery of a baby they thought might not do well. The mom had been Laboring all night. She was finally ready to push but she had no energy left.

So there she was in the very bed where I delivered jack 16 years ago. And I was probably the only person in the room who had actually HAD a baby. She grabbed my hand and I turned from paediatrician to labour coach. I prayed for her. We breathed. She wanted to quit. I coaxed. She pushed. Scott helped the OB intern and I helped the mom. At one point she dug her fingernails into my hand so hard she made me bleed. But in less than an hour she, by sheer force of will, pushed out a squalling healthy 3.8 kg baby girl.

Afterwards she was so thankful and happy she held onto me again and asked my name. Which she then gave to her new daughter.

Baby Jennifer probably has more of my hair and shape than my own children do.

It was a tender and blesses moment made possible by intersecting paths and common pain. And a reminder that I am also thankful to the many who have coached and coaxed me all the way to having a 21 year old graduating from university.

Tuesday, May 13, 2014

Bragging on Kijabe Hospital

In less than 24 hours we fly out to the US for Luke's graduation.  We leave about 30 minutes shy of Thursday and leave the US again on Thursday.  It's a short turn-around.  And like many of our trips, we're working full speed up to the last moment.  So today was a somewhat typical day, and impending absence may be inspiring nostalgia, but I'm really proud of Kijabe Hospital today.  The morning started with a call during rounds that the OB team was taking a mother for an emergency C Section due to cord prolapse.  That means the baby's umbilical cord was coming out ahead of the baby, which would result in the baby dying.  A midwife had her fingers up the mother's vagina to keep the baby's head from smashing his own blood supply and cutting it off, and they were wheeled together (midwife and mother) into the theatre for a rapid extraction.  The baby (who also happened to be premature and HIV-exposed . . ) was a star.  She is lovely and perfect, crying and active.  A truly dramatic save, happy ending to what could have been a disaster.  (The photo is from a later CS this evening with Scott.  That baby was also one that would have probably died many places, with a cord-around-the-neck very distressed infant).

Mid-day, we got a call that another hospital wanted to send us a baby with gastroschisis, a defect in the abdominal wall so that all the intestines are spilling out and exposed to air.  Bad news.  However it was a nearby hospital, and this was the baby's first day of life, and they were coming with an ambulance transport, so it all sounded good.  Even though we had 31 babies (WAY over capacity) at the time I said yes, because we have the only gastroschisis survivors in Kenya (4 so far I think).  This baby rolled in with a temperature of 34 (that's COLD), unmeasurably low blood sugar, in shock, blue.  And again I was so proud of our team.  Within fifteen minutes we had that baby warm, sugars up, fluids pushed, bowel decompressed and covered, pink, on oxygen, and 100% improved.  We were able to send him up to ICU for the night, and the Paeds surgeons will be managing his extruded bowel, slowly pushing it into his abdomen.  He went from almost-dead to possibly-surviving . . . a complicated baby that got fast and effective care.

This is baby K on the day he was born with a severe skin condition called ichthyosis (we think), and today.  He's been with us for just about two weeks.  We really thought his condition was probably fatal but decided to give it our best try to keep him alive and see if we could help him.  The change is remarkable.  Just as we were settling the little one above, baby K's mom called that he had stopped breathing after a trip to the OR for a biopsy .. but he was quickly stimulated and OK.  It's amazing to see that good nursing care, fluids, antibiotics, moisture, feeding have allowed such a dramatic transformation.

The preemie with the Rh-negative mom is alive and kicking, after three exchange transfusions he is doing very well, with relieved and thankful parents.  Again, there are very few places in Africa where a 1.3 kg premature baby with dangerous and severe jaundice could emerge alive and well.

This little guy was brought to us starving from South Sudan after his mother died, and he's finally putting on a little weight and settling from his fevers.  So sweet.  And a little connection with our Mundri team (who is, at the moment, only Scott Will plugging away in the danger zone) and a way to connect and contribute to a place that has been dragged down by war again.
Perhaps not as cute, but something to be proud of, this growth chart on a 27 week preemie who has been with us for about two months.  This is what is supposed to happen.  Yeah. 
 I am looking forward to the break from the daily (and all day all night) demands of this service, chaotic with crying babies, anxious moms, overworked nurses and interns, unpredictable crises, occasional disaster.  But I also realize it is hard to walk away from these little ones whom I'm pouring my soul out for.  And I'm thankful to be part of a great team on a dramatic day of rescues like this one.

Sunday, May 11, 2014

127 Years

We used to say in Bundibugyo that time was compressed, kind of like "dog years."  We lived fuller, more complicated lives there.  More life, more death.  It was a complex web.  More happened in a given year than in the parallel lives of our friends elsewhere.  So 17 years in Bundibugyo (times 7) plus another ten outside the Twilight Zone... we've been married roughly 127 years.

On this Mother's Day as I pondered the life of the amazing mother of my children, I revisited my favorite wedding anniversary poem which Jennifer penned on our 20th.  The themes are poignant - sorrow, grief, pain - but like all of her favorite stories ultimately redemptive.   The ties strengthen with time, the hopes solidify, our bonds refined by fire….and our love paradoxically secured.

For Scott, on May 9, 2007

Twenty-year strong bond,
Forged by fire
Today celebrate firmness 
Found in mire
Bless bog's central solid ground:
This rock admire.

Intangible substance binds 
Us more sure
Than ring or name or contract-
Love pure,
The only cord whose weight 
Can life endure.

Liquid ecstasy one link
But weak,
Fouler fluids (pus, blood, tears)
Pool and reek
The truth of twenty-year trek
Through lands bleak.

Grief the furnace of our 
Resilient tie.
Losses: children, father, home
Some dreams die
Yet behind each a resurrected hope

This union of twenty years
Unyielding binds
The unseen years ahead where 
Time winds
Our thread through sorrows 
Yet to find.

Sorrows not yet seen, nor faith
Still undeterred
Wearing this fire-forged fetter of 
Freedom conferred
A paradox of pain and gain, by mournful
Bonds our love secured

Mothers to Mothers

On this day we honor motherhood.  I taught my Sunday School class this morning on Ruth 1, using Paul Miller's excellent now book A Loving Life: In a World of Broken Relationships.  Naomi and Ruth embody the courage of love, giving up everything for the good of another.  This is the essence of motherhood and why these relationships are where we first and best learn of the essence of God's nature.  A life put on the line for us.  So today, a tribute to the mothers who put me here, and to the way that extends forward, on and on, life for life.

First, my own mother, who lost her father at age 4 and her own mother at age 21, but threw her whole energy into building a life with my Dad, creating a home, helping run a business, taking us to piano lessons and cheering a soccer games, leading in pioneer girls and Sunday School, teaching and loving and providing.  Her passion for history and an artful order are seen in this photo taken in Williamsburg, VA, a few years ago.  Pray for her now, recovering from back surgery and a blood clot in her leg, the combination of which will mean she misses her planned trip to Luke's graduation next week.

Then, Scott's mom Ruth, the best mother-in-law a girl could hope for, kind and encouraging and serving. With a master's in home economics she sounds intimidating, but she taught me to make a pie crust and scandanavian treats and never, ever made me feel inadequate.  She is the glue of the Myhre clan, caring for our kids and planning vacations and drawing in the scattered cousins for Thanksgiving and giving us wise advice.

From these two women, I have received the privilege of being a mother myself.  

This photo is from this morning, I got Julia and me matching batik wrap-around-skirts from the Maasai Market on Friday.  It is by far the greatest privilege and joy of my life to have been able to marry Scott and together parent these amazing children, who are witty and fun and strong and faithful and in all ways an improvement upon the raw material from which they came.   Whatever they do in this world, as parents or doctors or pilots or engineers or nurses or teachers or politicians or builders or cooks or artists or preachers or whatever path they take, they will be an impact and a blessing.

And with them, the friendship that comes from raising children with other women, both my fellow moms and my friends like Bethany who mother my kids and many others.  

And last but not least, my job means that I have a role in supporting motherhood every day.  Literally.  In the last week I have been in the delivery room holding onto crying mothers who were anxious and in pain, praying with them.  Giving them good news and hard news.  Pouring the hours of my life into the survival of that most precious to them, their babies.  Lines and blood transfusions, calculations, listening, inspecting xrays, making decisions.  

Baby Victor's mom lost her first child, then arrived at Kijabe as preterm labor overwhelmed her.  Within the hour she delivered her tiny infant son.  And now we have transfused his little 1.3 kilogram body in 3 double-volume sessions, meaning 6 times his blood volume, in and out.  His life still hangs in the balance, his mother's prayers and our work pulling for him to survive.
Emmanuel was our sickest baby for most of last week, struggling to breathe.  His mom has lost three previous children.  She was anxious, hovering, hoping, crying.  I felt the burden of her need, the difficulty of his survival.  Here she is on the day he turned the corner, tenderly touching him, having taped a Bible verse there by his head.

And one of our youngest survivors, 26 weeks, Mariah snuggles against her mother's chest, content and ready to go home.

So from Victor, Emmanuel, Mariah, from all of us at Kijabe and in our family, a happy mother's day to all.  A day to ponder the blood and determination and grit that brought each of us life, and to purpose to share that with others.

Tuesday, May 06, 2014

Serge Internships: not for the faint of heart

Every summer our mission brings young people who are on their holiday from college, or recently graduated, and places them with teams around the world.  Our kids always looked forward to "the interns", who were generally way more fun and hip than the old parents.  They helped with nutrition programs or taught in schools, coached, distributed goats and led Bible clubs (oh, and once helped us carry kids as we ran for our lives from rebels, but that's another story).  Now that we're in Kijabe we are focused on Kenyan medical interns and have less exposure to American college students.  But it turned out this year that one of the Nairobi interns was arriving a week or so ahead of the rest of her group, and as an aspiring premed student wanted to visit Kijabe.  So Mae Mae caught a ride out to our rural hospital and is spending a couple of nights.

On rounds this morning, we plugged along seeing our patients, until we came to baby I.  He was born precipitously the night before on Scott's call, and we were glad to see that in spite of being only 32 weeks gestational age (out of 40) and 1.3 kg he was breathing well and active.  He was also, however, yellow.  His mother is B- (negative for the Rh antigen on her blood cells), and he inherited O+ blood from his dad.  His mother had lost her previous baby shortly after birth because of jaundice.  So her body was primed to recognize and react to those + markers on his blood cells, and her womb became a dangerous place for him.

God, however, had plans for his life it seems.  For no known reason his mom went into labor so fast and hard last night that Scott and team had no way to attempt to stop his early delivery, and out he came.  His hematocrit was about a third of the normal at birth, showing that he had been breaking down his blood cells in utero.  If he had continued to term, he probably would have died of heart failure.  But when we rounded this morning the whole story came out, and we saw we would need to do an exchange transfusion to save his life.  This involves taking his blood out a teaspoon or two at a time, and putting someone else's blood back in, blood that matches and is less likely to break down.  This removes the dangerous levels of bilirubin that cause not only yellow skin but permanent brain damage.

Only to do this, we need just the right O- (neg) blood, to match him AND his mom.  And it has to be fresh.  So as I was trying to figure all this out and see our 24 critically ill babies and get up to my weekly RVA clinic, Mae Mae our visiting intern mentioned, oh, I have O- blood. What?  Really?  It is a precious and relatively uncommon type.  Within ten minutes she was in our lab donating.  Meanwhile I walked our new Kenyan medical intern Beatrice through putting in a special umbilical IV line that is used for the blood drawing and transfusing.  Then we sat and pulled blood out an pushed blood in, 10 cc in, 10 cc out, 22 times.

Baby I's mother hovered close by, moving from distraught to smiling with hope.  We prayed over her baby with her and she watched us painstakingly spend the hours this procedure takes.  How amazing is it that her 2-month-early baby popped out in the exact 48-hour space when we had a willing and able donor to save his life?  Or that God sent this young woman around the world for just such a time as this?  That a Serge intern's blood will live on in a tiny Kenyan infant? 

Baby I still has a long way to go.  We may need to repeat the procedure in the middle of the night tonight.  He will risk infection and bleeding and take weeks or even months to recover.  Mae Mae has a long summer ahead too, learning Swahili and delving into Kenyan culture and loving kids through football coaching, all while working on med school applications.  But for today their stories intersected in a way that blessed baby I with life and intern Mae Mae with purpose and the privilege of loving.

Stay tuned for more internship stories from around our East Africa region.