week in review

Julia and the Varsity Girls' Football team, with Coach Dahlman. They had their first game this week, a loss to the Swedish girls. In spite of the 1 to 0 score, our team played well. And Julia played awesomely. Highlight of the week: Miss Larissa of South Sudan has stayed with us since Wednesday. It has been delightful to have her in the house, to feel like "team" again. You can see how happy Acacia is. I am thankful for her company, ideas, service, cheer, and general presence. Brielle sports her CPAP (continuous pressure oxygen circuit) which is held in place by the little pink knit hat. Charming parents anxious but happy, unstoppable labor, an active little preemie with a reasonable weight and a good prognosis. Hoping she will fight on through. Jack, exhausted with cheering, sinks to the floor in relief when Man U pulls out a victory over Man City. It hasn't been an easy couple of weeks for avid Man U fans, and the losses have taken their toll. Caleb's last step (??) in college apps, the ROTC physical fitness test. He did 57 pushups in one minute and then ran a mile and a half around the grass field in 9 min 6 sec, which is pretty good at this altitude. Here he is smiling with Coach Davis after the run. Miracle baby Wangari. Keep her in your prayers. No baby with gastroschisis has yet survived here, though we've tried to help many. The others have been born elsewhere, languish a few days with their intestines hanging out a hole in the abdominal wall, become infected and dehydrated and can not be rescued by the time they arrive. This baby was born here, and in spite of a harrowing first few minutes when we couldn't get her to breathe . . has done well. Her intestines are now back inside, and starting to work. I taught a conference on her case this week, and reflected on Psalm 139. Rugby tryouts have started a whole term early. Because the varsity team did not do so well last year, they have to play a relegation match this term, so the coaches are training with about 40 boys daily. Rugby is THE sport at RVA . . here is Jack, with the talented Howorth brothers, coming to eat pizza covered with mud . . Some of Caleb's senior guy friends (Titus and Aneurin are our guardees, plus Joop who is just fun) join us for pizza making at the end of the week. One of our other guardees . . Anna Rich . . also joins the party. It rained for hours and then cleared just as we were ready to cook, for a very fun evening. The power has been off most nights for random blocks of time. Caleb has mastered dish washing by candlelight. Sort of nice, you can't see the mess. Fridays the students gather outside during their chapel time for flag raising. Larissa and I went up to see the choir sing the national anthem in Swahili . . I tried to post the video but no deal. It was lovely. Perhaps you can make out Julia and Acacia singing alto, and imagine Caleb singing base int he back. This weekend Scott and I are both on call. Last night I sat with a tiny preemie who was dying, praying with his mom and watching his little heart slowly tick down to nothing. We had been rescuing him with less and less success all day, and by 2 am he had signs of brain death. Meanwhile Scott was doing two C sections. We both got home at the same time, 3 am . . And were both called from church this morning for this little pumpkin, a 33-week preemie whose mom was deteriorating dangerously. Scott did a C section and I whisked her off to be revived. Only she didn't need reviving, in spite of weighing 1.4 kg she was the most active, wailing baby I've seen all week. These two cuties were surprise twins--their mom delivered the one on the left and the paeds team was taking him to nursery when lo and behold another one came out. They share a cot warmer and are twice as cute as one alone. So another week goes by: death watches and celebrations, rescues and cheering, sweat and struggle, meals and messes. Amen.

Occupational Hazards...

One of the inherent risks of doing surgery is potential exposure to patients' blood and body fluids. The Cesarean delivery is one of the bloodiest of all surgeries.

As Scott attempted to extract the placenta from HIV+ mother during a C-section this week, the cord tore and blood splashed up onto his mask and glasses.

Thankfully... -- it was cord blood which should be virus-free -- he doesn't think he got any fluid in his eyes -- the mom is on treatment so she should have very low virus in the blood.

However, please feel free to shoot a prayer up for his continuing HIV-free status if you think of it!

Mt. Kenya

Between Christmas and New Year's our family hiked up Mt. Kenya. We reached Pt. Lenana, 16,300 feet, one of a cluster of craggy bare-rock pinnacles. Batian is a few hundred feet higher, but not accessible to non-technical climbers like us. Our route took us from the Northwest slopes, ascending the Sirimon path through the Mackinder Valley to the central peaks, then back down the eastern side on the Chogoria route past Lake Michaelson. We spent four nights on the mountain, three in simple wooden shelters with bunk beds, and one in tents at 14,000 feet of COLD. On our summit day we woke at 2 am for tea and biscuits, then hiked too fast so we reached Pt. Lenana almost an hour BEFORE the sun rose and waited shivering in the shelter of rocky crags until the light broke. That morning the clouds were below us, and nothing but brilliant stars above.

Four nights in the wilderness refreshes the soul, five days of strenuous hiking in the thin air of equatorial altitude hones the body, a week of family togetherness completely cut off from the world (no phone, no fb, no email) builds memories and togetherness. We went with a budget outfit of Kenyan guides and porters which turned out to be perfect. We drank mugs of hot sweet tea morning, noon, and night, and sometimes in between, which seems to be how Africans handle the low temps and high altitude. We marveled at the wildflowers, jumped over boulders, teetered on the edge of precipitous panoramas (I was later thankful that we ascended the final peak in the dark so I couldn't see most of the danger until the way down), laughed at the fat unafraid rock hyraxes, fed our crumbs to the mountain chats, shivered in our sleeping bags and ended up with sunburned faces and hands. The last morning we watched an elephant drinking from a watering hole near our cabin, while monkeys chattered in the trees.

Mt. Kenya is one massive rise, not the long convoluted range of the Rwenzoris. There were few bogs, and almost no mud, long spectacular views, more dry open scrub and a lot less jungle. There were also MANY more people. In a week in the Rwenzoris we hardly had contact with any other campers, unlike the couple of dozen at each campsite on Mt. Kenya. In the evenings we read aloud from "No Picnic on Mount Kenya", the true story of an Italian POW interned in Kenya in WWII who escaped the camp to climb the mountain and then turned himself back in.

It was a lovely way to spend the holiday. God often calls people up on the mountain when He wants to meet with them, wants their undivided attention. There is something to be said for the inaccessibility, the juxtaposition of danger and beauty, the rewarding effort, the perspective on life below, that makes mountain climbing an apt metaphor for a spiritual journey as well as an appropriate real physical location for divine encounter.

As we have turned the corner of our second year at Kijabe, passing our one-year anniversary on the 1rst of January, I hope I can hold on to the memory of the stark splendor and clarity of Mt. Kenya back down here in the Rift Valley of normal life.

Thanking my faithful and generous friends

Luke stuffed his luggage on the way to Kenya with beanie babies. 162 of them, to be exact. And he brought me lots of cards from people who sent them. Vicky B, John, Susan, Ellie and Hannah P, Sarah E, Susan and Paul M, Elaine M, Sally V, Amy S, Debbie H, Dan, Erika, Daniel and Katerina C, I thank all of you. I found email addresses for some of you, but let me say thanks on this forum as well. And to whoever sent packages that Luke did not manage to keep the cards from. Yesterday we scoured craft markets for cute beaded baskets made by Maasai ladies. Tomorrow we start assembling the Valentine baskets which will encourage the students here at RVA as their parents will be able to send them, with notes. Fun stuffed animals, candy ferried by many of the doctor-visitors here, locally made African baskets, and a few fun goodies from the Nairobi grocery stores . . should be great. Thanks to the dozens of people who made this happen.

While I'm thanking, Heidi L and Julie S sent us packages (YEAH! Trader Joe's peppermint Joe's, and a puzzle!!) and Becky T sent a hand-made craft, and my mom's neighbors Victoria and Scott sent us a book and CD . . thanks so much for mailing and thinking ahead to bless us. And we had visitors from Baltimore by way of China, who brought Chinese oreos and cards and friendship and a New Year's Eve celebration. Grateful for their visit!

And I can't even begin to mention our families whose generosity made our trips to Samburu and Mt. Kenya possible.

I thought I'd get nice cards to send back with Luke to mail. I thought I'd write out lovely notes to everyone. But the truth is I didn't, and even if I had I don't have handy addresses for most of you. So please let this serve as a heartfelt thanks.

Below is Luke at the airport yesterday. I miss him so much already. This is a hard day here at Kijabe for me, some disappointments and just the heavy sorrow of another goodbye. So I'm obeying the Psalms and being thankful, hoping it lifts my heart (and if 162 stuffed animals and pounds of chocolate can't do that, I don't know what will!).

Strangers and Aliens and the End of Gloom

There is a light. No matter how dark it might become, there is a radiance that will not be denied, that cannot be ignored. Prepare yourself for the coming of this luminous Presence. Get ready for the end of gloom. Is 42:16 http://www.d365.org/followingthestar/

If you know me you know that I love Christmas. It is a month-long tangible spirituality, anticipation and holiness, colors and tastes and music and memories. Over almost two decades we have developed a rhythm of traditions, from our families and from Bundibugyo and from Scripture and from experience. For me, at least, it was a blessing. But Christmas, the real Christmas, is a story about interrupted lives. Mary, interrupted by a turn-life-upside-down pregnancy. Joseph, interrupted by doubt and scandal. Their known world, interrupted by the chaos of a census, movement, displacement. The shepherds, interrupted from their duties by light and wonder. The wise men, interrupted by a quest, foreign intrigue, danger. Herod, interrupted by the threat of a new king. This was the theme of our sermon in church yesterday. For the first time I can remember, the Sunday School's presentation of the Christmas Pageant included soldiers marching in formation to genocide, and the main characters running out the side door, which African kids know too well. Our hearts keep trying to make order, safety, ritual, and yet the story is one of upheaval.

As newcomers to Kijabe, I felt this acutely. Trying to hold on to some of the things we "always" do, but in a new setting, with new people. A lot of that was good, and meaningful, and fun. Having advent with new colleagues, Kenyan and American and otherwise. Inviting friends for our White Dinner. Pulling out the old decorations in new arrangements. Less obligation, in some ways, brought more freedom. But in the few days before Christmas, a lot of that was hard too, and I felt the alienation of not being "home" in Bundi. In my old life our family would have taken little gifts to all the kids still admitted on the 23rd or 24th in the hospital, but here a major organized party went on the ward while I was stuck in the ICU struggling for a baby's life, and I didn't even know until I found all the balloons and stuffed animals that had been give out when I was on the ward that afternoon. In my old life we would have gone caroling as a team, but here we didn't find out about the caroling plan until a couple of hours before and it was too late as we had invited friends for dinner. In our old life we took beans and basins and practical gifts to each of a half-dozen neighbors and visited on Christmas Eve, so here I signed up to distribute Christmas gift baskets organized by RVA but our family inadvertently got dropped from the list (we could have just gone I know, but it threw us off, and it just wasn't the same as taking it to people we had known for years). All of the timing was just a little off, the services too early, the meals hard to work in. We ate our Christmas dinner with a family we had never met until that afternoon, at someone else's house. None of this is wrong or bad, people here were uniformly gracious, it is just the reality of uprooting and entering a place that has its own ways of doing things. Of moving from being the center of planning and instigating and creating, to being on the periphery of not-quite-keeping up with the established program. Compounded by working most of those days in a hospital where acutely ill children keep showing up regardless of the holiday, and being on antibiotics for a minor infection that I couldn't quite shake off.

So the words of Isaiah in the advent devotion called for faith, in a way that might not have been possible in a more comfortable setting. Get ready for the end of gloom. For a new thing God will do. For gifts He will send.

The real story is one of aliens and strangers and interrupted lives and making do. But also one of unexpected blessings, of inversion of expectations, of beauty in the strangeness.

So here are a few snapshots of Christmas, of moments that came as gifts.

Julia decided to make a wreath herself.

Christmas Eve dinner table, with the plates I found in a duka in Fort Portal once, who would have thought, all the way from China to Uganda to make an American table beautiful.

A fireplace, for the first time ever.

Best moment of Christmas: up on the soccer field at sunset, kicking a ball around, as rain swept over the valley and the dust and droplets lent a golden glow.

By Christmas evening there were four paediatric patients in the casualty department needing admission. After working with the intern and evaluating all of them, I went to do a final check on the ward, and thought I'd pop in and say Merry Christmas to my favorite little patient, Ryan, pictured above last week when he was feeling perkier. He has TB and his heart has not kept up with the damage to his lungs. He's moved from near death to pretty much alive over the last month. Only Christmas night I found him irritable and struggling to breathe. What!?! My greeting turned into an alarmed exam, and I found his heart much worse. A review of his medicine chart showed one of his essential meds had been mistakenly canceled. I got the nurse and we gave an emergency dose. It is a Christmas highlight because I think the Spirit sent me to his room that night, and I'm so glad, I doubt he would have made it much longer.

Second favorite moment: this morning, I went out to hang the laundry early, up because of various calls from the ward. And a flock of about 30 red-fronted parrots landed in our tree! They chattered and squawked, their beaks clacking as they fed on the tiny green berries. They've been here much of the morning. Luke set up the spotting scope so we could see their bright green feathers and red faces in exquisite detail. Christmas birds.

This is the bright red pullover and the silver cross Scott brought me back from his trip to America. I love both.

The Lion and Lamb

In Samburu National Reserve, a Kenyan game sanctuary, the prophecy of Isaiah 11:6 was fulfilled about ten years ago. Jesus' reign is not complete, but in this instance a lioness adopted a young gazelle and raised it. Twice. What better place to spend a day or two before Christmas? But I get ahead of my story. What better way to really experience the anticipation of ADVENT than waiting an extra two hours for Luke to make his way off a late flight, last in line at customs from row 63 on the plane, and then talking his way through customs with a refurbished guitar in a box stuffed full of donated beanie babies? Here he is moments after arrival Monday morning: From there it was a couple of hours through snarled, agonizing, choking Nairobi traffic until we hit the open road and drove north to Samburu. All of our parents gave us generous gifts this Christmas, and this was how we spent some of it: 48 hours together, away from the rest of life, re-bonding and refreshing. Unlike our usual rough-it camping experience, we splurged on a tented camp recommended by our friends Anand and Sophia. We knew this was not a normal Myhre vacation when . . . We were following the rough trek to our camp, pausing to watch a group of elephants cross the shallow river, and around the bend we came upon a welcoming committee. Chairs, cool towels to wipe off the dust, cold drinks, all set up on the river bank where we could stop and watch the sunset before proceeding to the camp. Luke surprised us with a new safari accompaniment: the spotting scope. Binoculars on steroids. Luke can look at a distant horizon and pick out an animal, but the rest of us mere mortals need him to focus the scope to see much detail. It was a great gift! Here Julia tries it out on the veranda of the tent in the afternoon. Meanwhile Jack is cooling off in the heat of the day in a small dipping pool of COLD water. We went on the chilly early morning and late afternoon/evening drive, but mid day the temperatures soared. So each tent comes with it's on opposite-of-a-hot-tub. And our family all had good books to delve into in the heat of the afternoon. Lovely. Our final meal, breakfast this morning, on the river bank again. Any time you have four teens at a buffet you feel like you're getting your money's worth. We did actually see some beautiful views and animals, but those photos have to come from Scott. I only snapped phone shots at meals. A parting shot: Luke shows me that I can get in my own photos. We were only in the park a little over 36 hours, so we debated hiring a guide for game driving since our explore time was limited. But I realized that's not really our style. We aren't really out there to tally up the sightings. We're out there for the experience of wilderness and beauty. For the wind blowing in our faces as we ride out on top of the roof rack. For the way the sun lights up the post-rain grasses. For the spring of the spindly-legged gerenuk and the stately gaze of the oryx. For the family memories, the banter, the meals, the suspended time of being away and together. For all this I'm grateful. Tomorrow morning starts a stretch where we are "on" almost continuously 3 of the next 4 days, including 2 calls, one of which is Christmas. So this trip was a precious gift.

Christmas Prayer Letter for Downloading

Merry Christmas from the Myhres and World Harvest Mission!

Some of you will receive a hard copy of this letter in your mailboxes in the coming week...

For those of you not on our mailing list or for any who would like to see the pictures in the letter in color...

Click HERE!!

Thanks for your prayers and parternship.

Kijabe pre-Kristmas News

Moneys are browsing in the tree a few feet from my porch, the rain is drizzling down incessantly, the kids gave up on waiting for sun and went to play soccer anyway, Scott is on call but post-strike he has an INTERN, plus the rest of the world is not transferring patients our way left and right, so it's been relatively quiet. It's good to be home after several long hours sorting out both nursery and the regular paeds service this morning. One thing I do love about rounding on EVERYONE (OK I'm looking for a bright side here) is seeing the very baby who I despaired of living, now thriving. So nice to greet Dancun and his mom today. He's out of the incubator and starting to breast feed, happy and growing, and a few weeks ago I didn't believe he'd survive the night. We have a whole room of little oxygen-dependent heart-defect babies who are hoping for surgical sponsorship from a German charity (see http://steeres.com/ "A tale of Two Hearts" and http://www.helpachild.de/de/hilfsprojekte-/medsoforthilfe). Our ICU baby is coming back to life too, and his neighbor is much better once we figures out his severe electrolyte deficits. Now I have been plowing through a month or more of flagged emails, the up side of being made immobile by having my hair braided. If it turns out I'll post a picture.

Most relieving news of the last few days: Caleb has officially completed his college applications. He hit the submit button. From our human perspective, it is done, and all goes into the black box of God's will and human random choice and the beating of butterfly wings in China that will somehow determine the next phase of his life.

Most exciting news: Julia got to fulfill her goal of learning to ride a motorcycle, thanks to the cheerful can-do kindness of another station family, who took her with a handful of boys out to the airstrip to practice.

And most meaningful news, we had a lovely evening with our Medical Officer Interns. We had planned a pizza evening for them on the 16th but with the strike we weren't sure it would really happen. I think it was God's timing to bring us all back together. Six of the seven were able to come (one didn't get away from call at the hospital). I realized once again what a great group they are. Intelligent, game, hopeful, curious, seeking. I have to say they made some very good pizza, catching on quickly. They were, of course, rather late so it was dark as we finished. Then they came up with a couple of very active laughing dancing sort of games, almost giddy with the freedom of a night off, lots of food, the end of the year in sight, rest from their ten days of strike. We lit advent candles and focused on Zechariah 4, not by our might but by the Spirit, God bringing victory from the day of small things, very appropriate to our work. The evening ended with mutual thanks. I guess we're old enough to be their parents which was how they categorized us, and I was complimented by that. As we miss Bundibugyo, these evenings with our colleagues at Kijabe are very sweet to me.

And most anticipated news: Luke is, even now, in his organic chemistry final exam. In a few hours he'll be DONE with the first semester of his sophomore year, and boarding a plane for Africa.

Snickerdoodles and CPR

That could be the title of my life, I guess. In the last 24 hours (I am not making this up) our life has included the following disparate moments, often within the same hour.

Bedside with Ryan, a nearly two-year old twin whose TB-filled lungs caused his heart to fail and nearly cost him his life. After a month in the hospital he is smiling, reaches out to shake hands, precarious, his spindly legs splayed out, not yet catching up to his largish head. Tremendous progress, but he is still oxygen dependent. Sympathizing with his patient mother, who cares for him day and night, we begin to discuss plans for home oxygen. I mention, as a last minute thought, that the oxygen can't be in a room with a flame, so they will have to keep Ryan separate from the kitchen. Oh, wait, she begins to balk, in Swahili. It turns out that this lady, her husband, and her four children all live in one room. They cook and sleep and exist in it. She can't cook outside, because the wind causes the fire to burn down too quickly, wasting precious fuel. She decides that since her husband has taken the other three kids up-country to the grandparents for Christmas, she really doesn't need to get home until it's time for the older children to go back to school, so she'll stay as an inpatient praying for Ryan's improvement. What an impossible dilemma: breathing or eating, one twin or the other.

And then I'm home for a couple of hours, making Snickerdoodles in my safe and efficient oven, in my 8-room house for six people, with my thriving healthy kids. Mixing brilliant red and green food color, rolling in the cinnamon sugar, fighting off snitchers.

Because yesterday evening, the annual Kijabe women's cookie exchange occurred. I had kind of been feeling like we were among the only ones left here, but last night one of the dorm apartments was packed with RVA women and girls, all bearing plates of every variety of cookie, sipping coffee and juice, greeting. I think it is the first time I've ever been to one of these, and as one might expect this event has a long tradition and a specific sequence and plan. You basically take home as many cookies as you bring, but an assortment. It was a good thing I brought Julia because just when it was time to collect on the goods, I got paged back to the hospital.

And a few patients later, only an hour after the cheery companionable atmosphere of women in red sweaters, a buzz of chatter over the strains of Christmas music . . I was kneeling on the floor of maternity responding to a complete cardiorespiratory arrest in a post-partum woman. I happened to be closer than Scott so got there just as the nurses were realizing that the springy mattress made resuscitation impossible and we all pulled the heavy lady, thin mattress and all, onto the floor. Just as I was wondering what the adult dose of epinephrine was and how long my arms could keep up the chest compressions, lo and behold, an INTERN showed up. The strike was CALLED OFF AGAIN and unlike 99% of the doctors she was not waiting for the morning but came straight in to take call. We took turns ventilating and compressing until Scott arrived and intubated the lady, but in spite of everything we were unable to bring her back. So there we were on the floor, kneeling around the body of this woman, in a crowded passageway in full view of a handful of other patients. She was unmarried, had delivered a baby with severe malformations who came to Kijabe for surgical care, and while here she developed what was probably a pulmonary embolus. Scott had to go tell her hysterical sister who was caring for the baby. Tragic.

I was home a few hours somewhere between midnight and 4, replenished my energy on Christmas cookies and tried to sleep a little, though we both got numerous pages. Our spastically blinking blue tree lights are a beacon in the dark when running back and forth in the wee hours. Scott left for an emergency C section (his third of the day I think) a while before I was called back to see a shriveled jaundiced little baby I had admitted a few hours earlier who was basically dying. I spent the rest of the night trying to stop that process, as it turns out, unsuccessfully. Intubation, bagging, xrays, labs, fluid bolus, an epinephrine AND a dopamine drip, ICU, but he still didn't make it. He was also a twin, the firstborn in a hospital without a handy doctor, he was born unattended and probably suffered some damage even then. A week later he was infected and gasping and his heart just gave out. He was another victim of the strike perhaps, both at his birth and in the many hours visiting three hospitals before finding care at Kijabe.

Back home (hooray for Thursday and Mardi!!) I make tea, notice the milk is sour, know my kids and Scott are about to wake up hungry, and remember a great oatmeal muffin we used to make from the Jane Brody wedding-present-cookbook-before-I-could-cook-anything era of food in our lives. I find the recipe on line, use the sour milk and oats and dried blueberries to make a double 24-muffin batch that three teens completely consume within two hours. We linger at the counter together, spreading on butter and locally made jam. Big treat of the morning: the annual Schubert Christmas package. Julie grew up as an MK and she gets it. She finds a puzzle for us every year, and sends it in time to reach before Christmas. Something about the continuity and thoughtfulness of that is so reassuring.

Meanwhile Scott is up and out and back on the ward while I stumble through a Swahili lesson. He checks on his middle-of-the-night C-section patient, who was HIV positive, which always makes surgery a bit more risky and tense for the surgeon. As they chat he asks the baby's name. Shekinah. Intrigued he asks her how she chose that name. And then has one of those "you aren't in Bundibugyo anymore moments". She replies, doctor, don't you know that's Hebrew for the transcendent presence of the Glory of God. He asks her where to find that in the Bible and she replies, google it. Really.

The afternoon is devoted, at long last, to Caleb. Who is one essay away from finishing and submitting applications to 8 universities for Engineering programs, in case he does not get into the Air Force Academy. Scott, Caleb, and I all sit by his computer as he uploads answer after answer that he's been working on for weeks, checking through one last time for spelling and commas and missing data. Caleb's humor in the whole process has us laughing a lot, which is remarkable in our sleep deprived state, I think with every step closer to done his burden feels a little lighter. He's a remarkable kid, with some very solid and meaningful statements about life. Each school looks better than the last. Soon it will be out of our hands, and in God's alone. I notice that the more he writes, the better it gets, the later essays being the best, which makes me a bit more of a believer in English classes.

Back to the hospital one more time at dusk, to visit my house-worker's sister-in-law who burnt both legs badly when she accidentally spilled a jiko full of burning charcoal on them. I am wearing loose running pants and tennis shoes and have my hair in pigtails. No white coat, no stethoscope. I truly think for a moment as I walk in the gate, no one will recognize me, I look just like all the other visitors. Oh, then I remember, I'm white. So much for blending in.

Patients and packages, death and muffins, hospital and family. All mixed together hour by hour in a messy paradox of life. Snickerdoodles and CPR.