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Monday, July 07, 2014

Blessing and Favor

Yesterday I spent time in a sober meeting, discussing hour by hour the management of a mother who came into our hospital in labor, and delivered a very stressed and depressed baby.  The infant died about 12 hours later in spite of maximal intensive care.  We examine these cases in detail, review all the vital signs and monitor outputs, clarify what could have been done differently.  It is responsible and helpful, but frankly we aren't in control of every outcome.

So it was particularly encouraging that one of our interns sent us this picture from clinic that afternoon:
This is the mother who was getting CPR WHILE Scott performed surgery to remove her twins.  All 3 would have died 99% of places in Africa.  But the team rallied, OB and Anesthesia, Theatre and ICU, Paeds and Medicine.  And mostly, miraculous intervention by God.  When the mom finally turned the corner towards living, and woke up a couple days later, a nurse and I took her babies up to the High Dependency Unit.  She named them Blessing and Favor.  I wrote about that in a blog a few weeks ago.  Here they are for a check-up, a smiling and grateful and intact family, a dramatic story of rescue.

So much of our days are like that.  A party for Julia while we're on the phone with teams making tough decisions about evacuation.  A child who was in a coma wakes up, another who I thought was going to fully recover from a treatable infection slips into seizures and coma.
It is easy to see God's blessing, and His favor, in the dramatic healings.  It is more challenging to believe in those things during the loss and grief.  And yet we walk through the valley of the shadow of death to a richly prepared table.  Feasting and mourning, juxtaposed, throughout this life.




Sunday, July 06, 2014

And Give you Peace

Juxtaposed with blessing today, chaos.  I chose Numbers 6 for the blessing for Julia:
May the LORD bless you and keep you
May the LORD make his face to shine upon you and be gracious unto you
May the LORD lift up the light of his countenance upon you
And give you peace.

This was the blessing that my pastor growing up, Pastor Vail, pronounced upon our congregation weekly.

And give you peace.

Poignant, today, because we are in a swirling epi-center of NON peace.

Here in Kenya, 29 people were killed in another round of attacks on the northern coast.  Tomorrow is "saba-saba", or 7/7 in Swahili, a day with political significance chosen for protest.  Tensions are mounting, people are being warned to stay home, the opposition (mostly from the west) versus the current administration (mostly central).  In South Sudan, our team is pondering whether to continue with plans to return at the end of the month because of newly increasing violence and tribal tensions.  In Uganda, the embassy sent out a very specific warning of an attack planned on the airport this week.  Our boarding school had a stressful exhausting week as a letter purportedly from some parents was read on the radio accusing the administration of all sorts of things, then students went on a hunger strike, rocks were thrown, police brought in.  Just as this was simmering and being sorted, in the last 24 hours five coordinated attacks in three western Ugandan districts have left over 50 people dead.  No one is quite sure what is going on, but the official line is that this is internal tribal conflict as well.  Some of the gunfire and violence took place near our team.  Visitors heading into the district were turned back by machete-wielding youth.  Our team is safe but bunkered down; our school has closed.  I talked to Melen and my heart goes out to her as she makes decisions about her school, her teachers, and her own children, all alone.  She is from the minority tribe, and if things get out of control that could be bad for her.

At least Burundi is plugging on ahead, working and building and teaching.  We just talked to Luke who passed through Kibuye on his East Africa road-trip circuit last night, and we are super-thankful for their hospitality.  No war, but he did come upon a wrecked vehicle and so showed up at the team's hospital with a bleeding child in the back seat.

You don't appreciate peace until it is, quite suddenly, not there.  The familiar pit in your stomach, the uncertainty, the rumors, the limited mobility, the hyper-alertness, the taking-nothing-for-granted view that is blocked only a few hours or days ahead.

Please pray for God's peace in East Africa.  Meaning real peace, real dealing with fear, protective reprisals, greed, hate.  Kenya, South Sudan, and Uganda all need the Gospel that breaks down dividing walls of hostility, that gives people true harmony in diversity as the many tribes reflect God's infinite complexity and yet also God's trinitarian unity.

Celebrating Julia







Today we invited all of "lower station" (hospital and Bible college staff) to an open house to celebrate our seven collective RVA soon-to-be graduates.  




Celebration and community are an essential combination in life, sharing milestones together.  Before we cut the cake, the seven stood and each set of parents spoke a blessing to their graduate and said a prayer. Raising children is a shared affair, and we are blessed by the many friends who came around today to acknowledge that reality.

And by those of you who read this blog from afar, and pray.  

Here is the letter we sent to our supporters, as we prepare to see Julia graduate:

Dear Praying Friends:                                                                                        12 May 2014

Julia is our Jewel, a precious gem of a soul, multifaceted, shining under pressure, sharp and strong.  And you have been a part of her journey from the beginning, when she was a fetus in Uganda, when she was born in Virginia, when she was an infant being carried through a war zone and evacuated by helicopter, when she was a toddler living in displacement, through all her school years growing in grace and favor with God and man.  She has been tough enough to survive Ugandan school, caring enough to draw friends into her life from many languages and cultures, smart enough to keep up with three brothers, fast and agile enough to join the first-ever girls’ football team from Bundibugyo participating in national tournaments and then to play and captain multiple varsity sports at RVA.   She was voted “Most Encouraging” in the senior class, an apt title for someone who prioritizes prayer and relationship. You would be hard-pressed to find a 17 year old girl more responsible, more independent, less influenced by fleeting opinions, more fun and adventurous, more comfortable with dairy cows and computer programing and motorcycles, or more beautiful.  And all of this rests on the prayers you have prayed, the sustenance and counsel and assistance you have given our family.  So as we approach her graduation, we want to take this opportunity to say “Thank YOU.”  To invite you to reflect on God’s mercy to all of us as you receive this announcement, to sense our gratefulness for the ways you have blessed us.

Julia will attend Duke University in Durham, NC, beginning in mid-August.  She is a gifted young woman with a heart sold out to God and we look forward to seeing what direction He will lead in her life. 

We will be in the States for the month of August as we help her get ready for college and attend orientation, as well as visiting my Mom who is recovering from serious back surgery.  Luke will also be starting medical school that month.  He graduates from Yale on May 19th with a bachelor’s degree in African Studies and a concentration in Global Health.  God has opened doors for him with scholarships and financial aid and it looks like he will head back to the very place where we met and began this journey, Charlottesville, to attend UVA’s Medical School.  Caleb is finishing a grueling second year at the US Air Force Academy, slowly recovering from his devastating knee injury, majoring in mechanical engineering.  Jack will begin his senior year at RVA in September.  These kids have survived on your prayers, and are potentially a quadrupling of sacrificial Kingdom blessing pouring back to the neediest corners of creation where their hearts remain as they study.  We continue our crazy, demanding, fantastic jobs:  working as doctors at Kijabe Hospital, teaching a new generation of Kenyan doctors and nurses, encouraging and bolstering six teams in four East African countries, caring for missionary kids at RVA.  We plan a “real” Home Ministry Assignment (year of furlough) after Jack graduates in 2015, to meet you face to face, and prayerfully seek God’s next steps for us in Africa with Serge (the new name of World Harvest Mission).

May God continue to bring Julia to your hearts to pray for her during this transition.  And for all of us, who will be grieving her absence as we press on.   

With love,
Jennifer, Scott, Luke, Caleb, Julia and Jack
c: +254 706 060 813  
e: drs.myhre@gmail.com                            
m: Box 20, Kijabe 00220 Kenya

                   

















Sunday, June 29, 2014

Another week, another year

This week began in a feverish haze of flu, shaking under a mountain of covers while my temperature edged up near 103.  In that zone, I found myself hearing the World Cup in the next room and briefly believing that the cheering was for the battle of my cells against the virus, and I remember floating over my body.  This particular pathogen eventually ripped through our whole family, with Julia also missing three days of school with chills and fever, and all of us settling into hacking productive coughs.  Thankfully we have emerged on the other side as the illness ebbs away, but we are exhausted.  I'm on call this weekend, fairly typical:  in and out of the hospital all day Saturday, evaluating multiple kids in the emergency room in the early evening, a trip in at 2:30 am, a 999 code in the early morning, two deaths, back home in time to go to Sunday school and church. That level of work this weekend, though, has left me absolutely wasted instead of just plain tired.

Physically, and emotionally.  On Thursday evening, I checked in maternity to chat with a newly admitted mom whose baby had a prenatal diagnosis of spina bifida.  When I picked up her chart though I nearly cried. Her seventh pregnancy, and all the previous six had ended in death.  Not one living child to show for time after time.  There she sat, with the paler middle-east look of the Somali-border people, wrapped in a headscarf, patient, uncomplaining.  I asked her if I could pray, and we did.  Her baby was born the next day, premature and massive-headed, pink and struggling.  Her spinal cord did not form, her brain is pressed by fluid, and she is not likely to survive long.  Which is why I gladly walked in at 2:30 am when there was a problem, to give this woman the courtesy of all my attention and explanation and communication out of respect for her suffering.  The same day she delivered, our team received a dead baby they were unable to revive.  A 13 year old school girl, too alarmed and ashamed to tell anyone she was pregnant, went out to the school shamba and delivered on her own.  The school found her and brought her with her baby, but the infant she carried in was dead.  And a preemie whom my colleague had struggled over for several weeks in ICU with ventilators and chest tubes finally gave up his tiny struggle.  This morning it was a 2-year-old whom we had admitted umpteen times for respiratory illnesses, he had severe brain damage from something previous and so a difficult time handling his swallowing and feeding, and was constantly sick.  When we admitted him he was no worse than usual, and had a good set of vital signs at 6 am but was found dead before 7.  In spite of an all-out code, we got no response.  You would never know from his well-kept well-nourished body, or from his mother's desperate cries, that this was not a perfect child.  He was loved.  I found myself supporting this woman for quite a while, reading 1 Corinthians 15 to her, and praying.  As often happens, Kijabe is a place where she spent a good portion of his two years of life, and a place where she received attention and care and hope.  Even in her tears this morning she could be thankful for that.  From there I went back to nursery where a very abnormal little baby had stopped breathing.  She had intestines protruding from the front, a heart on the wrong side, infection in her brain, lots of extra fingers and toes, a small head and deep jaundice.  We had already counseled the parents about her poor prognosis, and we stood together around her again and prayed and agreed to let her go.  No one can prepare for what he or she will be like in these life-and-death moments, so the faith of Kenyans never ceases to amaze me.  Job-like, the dad prayed in worship, and the mom affirmed thanks.  We kept a short death vigil of comfort, and then she was gone. That's four deaths and one more expected death in the last few days.  All represented the frontiers of what we can do, the margins of where we can save.  All strike home the way that evil takes its toll on the bodies of babies, in the process of birth becoming death and loss.

And in between the fevers and the losses, right in the middle of this exhausting week, I had a birthday.  I was barely moving and eating, but Scott got up to make a special breakfast of cinnamon rolls, friends brought over flowers and pie and chocolate and a necklace and a beverage.  Our quarantined family ate together and crashed by the fire and the World Cup.  I read my hundred greetings on facebook from around the world and through the years.  It was a good day.  A spot of sunshine and life-goes-on, of another year punctuating the reality that not everyone survives these flues and I am thankful for my family and this place, my work and this life.

My mom manages to get cards here on time for special occasions.

My favorite celebratory group.

The sky.  Actually saw it after weeks of cold clouds, on my birthday

Jack made me this bowl in pottery class

And Scott made his own creations

After being sick so long they were happy I emerged on my Birthday to pay a little attention to them.

How we spend cold June evenings

Birthday cheer that reminds me I have great friends.

Our lovely garden

Former neighbor Anna Rich back for a visit.  

The day Julia got out of bed, classmates came to cheer her up.

My traditional bday apple pie, courtesy of Karen.

Last Caring Community.  Sniff.


Visiting doctors on my Birthday, and it turned out the cardiologist on the right and I were actually in training together in Chicago 23 years ago.

Sunday, June 22, 2014

Occupational Hazards

My second flat-out-take-down illness in less than 3 weeks, chills and fevers over 102.  Bleaaahhh.  I think 25 years in this profession gave me the false assurance that I had developed great immunity.  But I am way less invulnerable than I think, and this weekend of shivering under blankets and coughing until I pulled a rib muscle proves that.

Scott's hazard was of a different nature, physically and technically demanding.  Friday was his fourth call for the week, the other three were mercifully reasonable to get him ready for this doozy.  Just at 5 pm a woman presented in labor with her baby transverse, meaning the baby's back (not head or bottom) was across the cervix.  It is not possible to deliver that way, and without surgery the baby and mother would die.  Even with a Cesarean it is a difficult extraction, but he was able to make an incision without rupturing the membranes and turn the baby around inside the amniotic sac for a safe entrance into the world.  He made it home for dinner and to help us set up for Senior Class night (we're still sponsors) then got called for one emergency after another, in the operating theatre from 10 pm to 6:30 am.  A lady with a ruptured ectopic pregnancy, which had to be removed to save the mother.  A lady who was bleeding to death from a cervical laceration.  A lady with a placental abruption, meaning the placenta separated from the uterus with the baby still inside, which would have led to both baby and mom bleeding to death.  A woman with previous scars who presented too far dilated to wait for morning for an elective CS.  There were some delays because the Paeds surgery team was stitching up the severed trachea of a 15 year old boy who had supposedly been attacked by a baboon in a nearby town.  The point is, he accepts the all-nighter for the satisfaction of eight lives saved (and one lost, the ectopic fetus, but that was not possible to save).  And having lived in the "bush" we know that most of those would have died most places in Africa.

In John 16, Jesus says that we endure pain as we wait for him, as we work for the Kingdom, but when we see Him we will forget all the suffering just like a mother who is in labor for a baby.  I resonate with that analogy.  The suffering is real, the scars are palpable, but the worst of it becomes a dim memory in the joy of the outcome.

And some of that joy, for us, is the privilege of living here where we can see our kids and participate in their lives.  So we close with a few photos of the weekend:
Missing Caleb.  Sigh.

Julia and Katie, baristas!

Coffee, donuts, and hot chocolate for class night (remember it is winter here below the equator at 7200 feet, chilly and damp and grey)

Julia's senior singing group leads worship this am.

"Small Group", the senior choir, performing

More World Cup with RVA kids, Germany vs. Ghana