My Life in the Biathlon

We are watching the Olympics, at least little snatches of them when we can.  The graceful ice dancers twirling in unison, the bird-like flights of the petite ski jumpers, the dangerously fast luge, the brutal bounce and spins of the free-style moguls.  But if I were an olympic athlete, I would enter the biathlon.  That's the cross-country ski endurance race punctuated by rifle shooting.  Scott and I actually did have cross country skis when we were newlyweds in Chicago.  Thanks to his Norwegian roots, we inherited them from his parents and used them on the Lake Chicago trails.  And as much as I deplore gun violence in America, I did grow up with guns.  From my first pellet gun to 22's to gauge shot guns, I was a decent shot.  Many cans jumped off the railroad track where we set them up, and clay pigeons burst into shards when we shot skeet.  So the idea of being strong enough to slog through the snow on skis, and sharp enough to hold a gun steady and shoot, appeals to me.

Mom and patient in ICU 

A panel of Kenya's leading paediatricians as we debate improving infant survival 

Our Caring Community learning Scottish Dancing for an evening activity

The orthopedic surgeon from Charlotte NC who operated on my mom two weeks prior, doing a teaching/surgical trip to Kenyatta the same day I was there for neonatal survival meetings.  How crazy is that?????

Because my life is a biathlon.  Most days are a cross-country endurance race through slippery and hazardous conditions.  Up in the dark, prayer and maybe exercise, breakfast and plans for the day, devotions with kids.  Day in and out at the hospital, covering rounds, checking labs, teaching.  Sorting out call schedules, meeting with my team, mentoring younger docs.  Covering RVA student health, appointments, immunization policies, working with students, projects.  Laundry.  Emails, planning WHM conferences, answering questions, accounting.  Prayer meeting times, communication.  Cooking dinner, creating atmosphere and wholeness.  Cheering at games, thinking, reading, learning.  Meetings. The marathon continues, day after day, striding through and over, pushing back against the path of least resistance.

Birthday for Jack's classmate

Sunday morning pre-Valentine treats 

First-place Basketball tournament 

Colleagues reporting on their trip to a Paeds conference in Germany 

Kenyan Raspberries, which are being off-loaded at Kijabe 

New surgical residents-note Erik second from left, who brought his daughter here for treatment from Congo and developed relationship and trust here and is now staying for his own residency 

My "Banquet Ask" at our Student Health Clinic

Then the beeper goes off, and it is time to shoot.  In the war against disease, in the covert effort to save the lives of children, one has to go on the offensive.  No matter how weary, to take a deep breath and line up the gun, to carefully but boldly pull the trigger.  This week it was baby B, another gastroschisis, plummeting down.  We were so close to our fourth save; he had been doing so well.  But when the pager went off at church, I went into shooting mode, intubating, changing therapies, xrays, antibiotics, move to ICU.  He stabilized temporarily, but then he needed blood.  Fresh blood.  And I was the only handy compatible donor, so another round of shooting, this time in the lab's blood donor room.  Perhaps these shots were off target.  Bahati died that night.  Or perhaps they were on target, the target of showing love to this family, giving these parents the assurance that they and we had done everything possible.

More cross-country endurance, normal life, then boom, time to lift the gun.  Our friend E.N., who took care of our family almost 16 years ago when Jack was born here, was having her baby.  She's a little older than the average first-time mom, after many years of working for others, finally she has her own husband, a hard-fought struggle for pregnancy with many complications.  But the day had arrived for delivery, and I went in to comfort, to wait, to celebrate, to be the one to receive her baby, from Scott who was doing her C-section, no easy matter.  Baby M.J. was vigorous, crying even before he was fully "out".  But my heart sank as I dried him off.  Down Syndrome.  Almost 14 years ago I was in the same situation, at my sister's delivery for moral support.  Only when her sweet Micah was delivered, I knew he was not quite alright.  Just like MJ, unexpected but certain subtle signs.  I found myself once again comforting the mourning loss of the expected baby, but enjoining her to be thankful and anticipate blessing in the unique and loving baby she did get.

 So that is the biathlon- straining on, sweating, muscles tired, rhythms, pull, the constant background of effort.  Then the beeper, the call, the all-out push to defeat, to pull off victory.  Ski, ski, ski, ski, shoot.  Ski some more.  Never quite balanced.

When the women finish this event, they fall over into the snow, and gasp and cry.  That's how I feel some weeks.  Stretched by the pace of a normal day, then energized by the adrenaline-rush-demands of a dehydrated burned baby coming to life as we push fluids into an emergency needle into his bone.  Or challenged to come up with a plan for a nearly-dying patient.  Then back to the steady pace of normal life, thinking about what we can pull together for a meal.

Maybe one day I'll have skis and a gun again.  Or maybe for now, it will be pots and pans, and a stethoscope and a needle.

Building in Bundibugyo?

World Harvest Mission short-term-trip-leader and construction-guru-with-decades-of-experience Brad Wallace is planning a construction trip to Bundibugyo May 9-25.  He has four people signed up and could use 4 to 5 more to help on building projects at Christ School.  This is the first time in AGES that we've had an opportunity like this for handy construction-oriented people to bless Bundibugyo.

If you are interested please contact Brad.  703.969.5309 or bwallace@whm.org.  

Our children studied in these classrooms.  Our friends are the teachers who still faithfully bring the Kingdom of God to Bundibugyo one child at a time.  Our team mentors young people, coaches sports, helps with the farms, leads studies.  Our Ugandan boys have found Jesus here, have received the foundations for their lives.  The buildings are not just buildings, they are the the venue for real change in real peoples' lives.

Thanks for considering!

21!

21 years ago today Luke Aylestock Myhre made his entrance into the world, a month early (but not three months early which he had been threatening), after a difficult labor that nearly ended in a C-section, on a snowy day in Baltimore.  He was beautiful and perfect but a little early and punky, so whisked off to the nursery in an incubator.  21 years later he was back in Baltimore to interview for medical school on another snowy day.  He's approximately thirty times the size he started and finally sleeps a bit longer, but most things haven't changed significantly.  We still revel to watch the new steps with wonder and hope, still find our hearts wrapped in his flesh, still banter our points of view, still enjoy his company more than just about any other in the world.  But now we have to do that from seven thousand miles away.  We sent postcards and a few fun things in the mail weeks ago.  That's how we have to do Birthdays, right?  I thought that was fine.

Then this morning, a bustle to get Jack out to a basketball tournament, breakfast, laundry on the line, be at rounds by 8.  I started writing a note on a baby and wrote down the date:  8/2.  8th of February, hit me like a punch in the gut.

Our firstborn son is an official adult today.  It's another milestone we'll miss.

He'll be fine, with friends and work and hopefully a good dinner.  We'll be fine too, distracted by most of the last 8 hours in the hospital on call.  But it's another little shift in our family.  And while we celebrate survival, celebrate independence, celebrate the beginning of a future, we also grieve.  As all parents do, who look away from the incubator to blink and find that the little person inside is riding a bike and reading, is making slingshots and climbing trees and falling out, is writing poems and scoring goals, is climbing mountains and solving equations, is flying across continents and learning new languages, is leading groups and captaining teams.

Because he is his own person.  A person we are proud to know, a person whom God has gifted in a hundred unique ways, a person who will cut to the core, see the problem creatively, live to the fullest, invest in his friends, and not lose sight of the real and the important.  A person we believe in, no matter how many miles or months separate us.

It's been a while . . .

Perhaps part of the recovery phase of a terribly crazy October through early January, short staffed, strikes, terribly sick patients, family visits, heart-wrenching goodbyes.  Perhaps the insanity of RVA meshing (or more to the point, NOT meshing) with Kijabe and World Harvest as the new term started.  Perhaps Scott being gone two weeks for meetings in America, and connecting with his parents.  Perhaps sensing God calling for silence, meditation, grounding, thoughtfulness.  But for whatever reasons, this blog has been unusually quiet.

And the pressure of resuming with something profound to make sense of the silence is too much.  So I'll just list a few happenings and praises and flow-of-consciousness information.

Patients.  Gift, whom we all prayed for throughout the last two months, went home.  He is the third survivor ever in Kijabe and probably all of Kenya of his serious bowel malformation.  He had overwhelming bacterial infections, and once completely died but was revived.  He had a persistent heart issue that slowly healed, and in the last week we thought he might have had a second life-threatening abnormality of his liver.  But he didn't, and he got better, and he went home to the coast on Friday.  Along with Daudi, who hopped a ride on an ambulance from the opposite side of the country one terrible night when I had kids coding in ICU and nursery at the same time.  He had a massively swollen belly because no one had noticed his lack of anal opening, being distracted by his obvious cleft lip and palate.  Again, thanks to partnership with our Paeds surgeons, he went home rescued and functional, with hope for more procedures soon.  It's been a pretty good month on the NICU service, lots of surviving preemies and slow improvements, lots of moms who battled discouragement and hung on, lots of victories and a bit of heartache too.  Both Gift and Daudi were majorly helped by our Needy Children's Fund as well as other funding through the surgical arm of our hospital.  It is good to work in a place where Jesus' healing power can be extended to the least of these.











RVA.  The new term is in full swing.  Which means early Saturday mornings for Senior Store coffee.  Caring communities.  Class night preparations.  Clinics.  Games.  The flurry of activity and anticipation that occurs for Banquet, the major social event of the year for Juniors and Seniors (sort of like a prom, but no dancing, so more of a dinner theatre evening).  The girls helped Jack pull off a wonderfully romantic "ask" with lots of chocolate, roses, word-smithing and atmosphere, and each of them had fun with clues and notes and surprise askers themselves.  And Friday was a parent open house day, where I got to watch Julia in her pottery class, and think about poetry and physics and Swahili.  It is a privilege I will never take for granted after two kids boarding, to be here and to participate.  I try to remember that when every night seems to be crazy busy with something scheduled.

Women's Retreat.  And in the midst of single-parenting and new terms and homework and scholarship applications and lectures to prepare and middle-of-the-night emergencies and phone calls and dinner to make and administrative scheduling and just too much of life . . the AIM mission had a women's retreat which they opened up to all of us.  Our World Harvest contingent of Ann, Bethany, and me was joined by Pat visiting from Uganda for a wonderfully refreshing weekend.

We roomed together and had a blast.  But the worship and teaching were also solid, and just to be away and quiet was priceless.  God had been drawing our attention to Psalm 1 and the tree, so when I was able to go early to the retreat and spend a day in silence and prayer, I wandered into the nearby forest and sensed the refreshment of God's presence.

Family.  Prayers would be appreciated for my mom, who underwent MAJOR back surgery two weeks ago.  She had rods put in to help with a severe kyphosis (hunching over) that would have progressed to respiratory compromise.  The recovery has been slow and painful.  She is in a rehab facility. Today she sounded brighter, and was able to get out of bed with help and take 120 steps.  But she has a long way to go.  And Caleb will have surgery on Tuesday to remove a screw from his knee that is working its way out of the bone and irritating him where his brace rubs.  He has finally, after a year, just started to run a bit.  Luke heads into February with five interviews for medical school to be completed.  That's a lot of travel, and no small amount of stress and uncertainty.  Pray that God would prepare a place for him.

That's the news for tonight, thanks for hanging in there with us, and for your prayers.

A Rooted Pilgrim

Last weekend our pastor preached on Psalm 1, and the entire idea of meditating on Scripture.  So the main idea that has stood out for me in this chapter is rootedness.

Perhaps that is because the missionary life often feels so uprooted.  Right now I have a husband sitting in an airport in Qatar, a son in CT, a son in CO, my sister and mother in NC, my inlaws in CA and Norway.  Today I was on long and short phone calls with team in Uganda and boys there who were our neighbors, talking to my mom in the US, emailing with team in Burundi, and others formerly South Sudan now in limbo, and texting with team who moved from Bundibugyo to America.  While I was talking to Scott in the Doha airport, a text came in from our embassy here warning us that an IED had been exploded in the airport in Nairobi.  It sounded small, but not exactly encouraging a few hours before a loved one travels through.  My mom is preparing to have back surgery on Monday. My heart is diffused by the dispersion of those I care about and the threats they face without me, and that can lead to a sense of being disconnected from any particular place or time.

But Psalm one contrasts the people who are like chaff, blown away, with the ones who are like trees, planted and firm.

And the difference is in where a person seeks their wisdom, counsel, thoughts.  In the passing fads of our philosophies and fashion, or in the ever-flowing river of the Spirit?  It seems that it is possible to be a mobile tree, a rooted exile, a pilgrim with connections.  A centering occurs in meditating on the Word of God that gives roots strong enough to bear distant fruit.

So to start 2014, I am praying for that rootedness.  And I know it requires space, discipline, time, desire.  Which led to another epiphany this week.  I am a person who works until the job is done, not until time is up.  That is the nature of motherhood and medicine.  Task not time oriented.  No particular limits.  A baby has to be held, a meal has to be prepared, and patients have to be seen even if there are 30 instead of 15, or if they show up dying at the last minute.  But that seeps into all of life, so that if it is 10 or 11 pm and I still have a lot of administrative work to do, I plow on.  This year I would like to develop habits and limits and boundaries in the areas of life where they are possible.  Not necessarily in patient care, but definitely in computer time.  I've practiced this week turning off before the work is done.  Freeing, but unsettling too.  The requests for schedules or evaluations or plans pile up.

But to stay rooted requires day and night focus on the Word, and to do that requires ceasing from some other words.  Pray for discipline to make the space to meditate, and survive.

A Gift Update

Gift lives.  It was touch and go for weeks, but he came out of the ICU in early January and is doing his best to turn into the kind of baby you don't expect to die every minute.  His surgical wound is nearly healed.  He still needs oxygen, so we were able to get a cardiologist out to confirm the pressures in his pulmonary blood vessels are too high, and recommend a medication.  He is mostly fed through his tube still, but starting to swallow from a syringe and even attempt the breast.  His infection is gone.  But the days and weeks stretch on and his mom is getting a bit discouraged.  I try to remind her how far we've come.  Would you please pray once again that Gift could go home?  To do that he needs to be able to breathe without oxygen and feed without tubes.  God has miraculously preserved his life . . I am reminded of Romans 8 . . how shall he not also, with him, graciously give us all things (v 32).  Thanks.

All our incubators are full, and nursery is popping.  Lots of stories, some as dramatic as Gift's, some simpler.  Baby D arrived in a veritable bus-like ambulance from Western Kenya one night.  I had agreed to accept a transfer of a premature baby with meningomyelocele, since this is the best place in Kenya for such a child to receive care.  Only it turned out he was a twin, so both preemies were put in, and since they were coming, the threw in a bigger term baby with the vague diagnosis of "anomalies and distended stomach".  This baby had a cleft lip and palate, problems that paled in comparison to his tense and grossly inflated abdomen, a big jaundiced balloon laced with distended veins.  Since the original referral baby arrived dead, and we tried for some time to revive him, it was about half an hour before I could look at baby D.  One look at him and I checked for an anus.  Not there.  Well, that explains a lot.  No opening for his GI tract, so all that air and stool and secretions and food just kept blowing up.  Our surgeon rushed him to the operating theatre, and he's a thousand percent better now and nearly ready to go home.

I love working in this nursery. Yes, it's HOT and crowded, and there are hourly ethical dilemmas, who to move when the next preemie arrives unannounced and all our incubators are full, how to share 7 monitors among 20 or 30 babies.  Yes, it can be heartbreaking when we lose one.  Last week we spent several days almost constantly at the bedside of a baby with very very very sick lungs, and then she died.  But these are balanced by the preponderance of infants for whom we can offer life-saving assistance.  Wednesday I stood by and watched and coached and cheered for six babies being born, all doing well, even the 3 pound one.

So pray for Gift and his mom Dorcas to have a happy ending too!

Motherhood, the battle

A month or so ago I witnessed the mother ibis, who had built a nest in a tree in our yard, successfully defend her eggs from an onslaught of monkeys.  She raised a racket, extended her wings, hissed and jabbed with her beak, and the dozens of monkeys who were scampering through the branches finally gave up and went on to scavenge easier prey.  It was impressive, this glossy squawky ungainly bird holding off much larger and more agile mammals.  I've been rooting for her ever since.  Three eggs hatched, and one of the small birds died when he fell out of the nest early on (or after he fell out, not sure, but found the carcass).  The other two have been making noise, venturing out a bit, over the past weeks.  Saturday morning I was awakened by a ruckus of the dogs going crazy.  That can mean that our neighbors are on a walk, or the world is ending, hard to tell.  By the time I walked out I found that the monkey troupe was chasing through the trees and over the roof, and another baby ibis was injured but alive in the yard, and the mama ibis was flapping and screaming and berserk.  I let the dogs off to chase the monkeys, and kept an eye on the young bird.  Our dogs obediently left it alone.  The mother circled for a while.  But the hours went by and it didn't get up.  Mid day I moved it into the tree, but it couldn't hold on.  So I placed it carefully in the flowerbed beneath its nest, and brought water which I poured gently into its beak.  It swallowed, rapidly, gulping.  I could feel the fluttering heart, the warmth under the feathers.  It opened its eyes, then closed them, wearily.

Just before we piled in the car to go the the airport, I checked it again.  It was dead.  This morning the parent ibis pair perched on a branch above the body of the infant bird, crying out.  I later moved the carcass to the compost pit.  

And if all that drama had not occurred the day I was putting Luke on the airplane back to the US, I might not have been so emotionally involved.

Last day bitter lemons after a picki ride

But the truth is that motherhood requires a spirit of battle.  No matter how strong and great these kids get, there is always a troupe of evil ready to swoop down and wreak havoc.  Applications rejected, ligaments torn, fevers escalating, hearts bruised, homes lost.  One got back to school last week and spent this weekend in bed with a fever and sore throat, coughing, and alone.  Vacation days are times of sweet vulnerability and connection, which makes the partings harder.  The future is blatantly uncertain.  

Yes, mothering is not for the faint of heart.  I identify with the ungainly ibis, relatively powerless, but ready to squawk.  Mourning loss.  I went for the first long walk I've had in ages on Friday, and I was not ten steps down the path before I started sobbing.  Scott is in America for WHM meetings, gone two weeks.  Son 2 had left and son 1 was about to, and South Sudan is falling apart and changes are ahead.  Sometimes it is just all too much.

Yet when I feel the pain of another goodbye, I also feel the thanks that I'm here to say those goodbyes.  This month we're helping host two different families where the missionary mom died of breast cancer.  One is a fantastic young mom herself now, with her mother's poise and practicality.  I'm hoping she and her husband come back long term.

Betty and Denise were courageous women, who struggled for their kids and for the Kingdom.  It is a holy honor to see their families thriving in the midst of grief.  

So I will battle for my kids, and battle my own heart's self-pity, with a dose of thankfulness.