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Saturday, March 31, 2018

Honoring Dr. Jonah Kule: Easter Saturday and Aching Liminality

Ten years ago, our dear friend and colleague died in an Ebola epidemic that struck our area as we worked together.  We did not.  So today Scott was invited to address the Federation of Ugandan Medical Student Associations at their annual general assembly at Makerere University, to give a memorial lecture challenging students to follow Dr. Jonah’s footsteps of service and sacrifice.  
pre-lecture, with Biira (center) and Masika (right), Jonah's two oldest daughters

His two oldest daughters, who were 12 and 15 at the time of his death, attended with us, along with two of our “kids” John Balitebiya who grew up as our next-door neighbor, and Dr. Katuramu Tadeo whom we embraced when he was Luke’s classmate at Christ School.  We had an absolutely lovely dinner with the handful of our young people from Bundi who are still in Kampala area in school the night before, a real vision of the Kingdom of Jesus coming to earth as these former orphans grow into their roles as doctor, nurse, business administrator, accountant, banker, lawyer, development director.

Dinner celebrating some of our favorite 20-somethings

John and Dr. Katuramu joined Jonah's daughters and us for the lecture

The leadership of the medical student association intentionally wanted to bring a message of outreach and integrity to their fellow students.  And we were grateful for the opportunity to address about 150 student leaders from multiple schools across the country.
soon-to-be doctor student leader Meddy thanking Scott for coming with a certificate of appreciation

Scott taught a bit about the biology of Ebola and the reality of an epidemic response, detailing the way the epidemic unfolded, the investigation, the published results.

But the bulk of the talk was about remembering Dr. Jonah, about his character, about his story, about his faith.  Scott talked about how we as doctors handle such a tragedy, and how we interpret God's work through a lens of faith.  He ended with Micah 6:8:  do justice, love mercy, and walk humbly with your God, a life guide for all these future doctors.

Though we’re all smiling in this pre-lecture photo, the memories of the day were poignant, and some quiet tears were shed on our supportive front row.  Afterwards we sat with the four from Bundibugyo having tea and continuing to remember their father and mentor with more stories, stories they barely remembered as children but appreciate now as young adults.

And as we said goodbye, Scott read aloud today's devotion's last paragraph: “On the way from death to life, there is Saturday. Sabbath day. Rest. How do you rest when your world falls apart? You rest in the restlessness. I know that's demanding; more demanding than we'd like. But that's the nature of living along the aching liminality of Holy Saturday. Our transition from death to life, through the breath-taking disorientation of Holy Saturday, into the shocking gasp of hope on Resurrection Sunday.”

So appropriate that this lecture and this visit occurred today, on the achingly liminal Saturday that represents all of history between Jesus and Heaven.  Our worlds fell apart ten years ago, yet we live in the shocking hope that tomorrow’s resurrection will redeem us all.

Friday, March 30, 2018

Good Friday

This Tissot watercolor, Son of the Vineyard (featured a few days ago on the Biola site) questions the "good" in Good Friday.  The grey death tint of the body thrown outside the wall onto a heap of stones matches the somber sky.  The perpetrators hustle away, climbing like thieves back over the wall.  It is a snapshot of apparent defeat for all that is good.  

The naked vulnerability of the sprawled murdered form is, in that moment, accomplishing what millennia of religion and power and rules and laws and rituals could not.  A substitute broken by evil that not only pays behind all the wrong ever done, but pays it forward in actual transformation.  The Jesus-figure's body blends with the stones, hinting of the unseen reality: this rejected body will be the cornerstone of an all-things-new dimension. The drained blood will blossom in the sterile vineyard behind, bringing life and joy. And not just for a few deserving folk.  For all of us, all of us running away and climbing over walls.

But today, we consider the shocking hour when God entered into death itself.

And even before we see the grapes bursting with wine on the fruitful vines, even before we see life breaking out of the stones, we hold onto the Goodness of Good Friday by faith. The goodness of that love, that comes to us as the crushed body and bleeding side.

For in this hour when the dying night lingers
Unwilling to surrender its waking darkness
Over your face and fevered brow, my torn fingers
Will stray bringing such comfort
As may claim your doubting heart.
(Abioseh Nicol, African Easter: Good Friday)

Thursday, March 29, 2018

Walking away from the meal: thoughts on Passover and Judas

Today we remember the Jewish passover, the ancient tradition instituted by God through Moses, in which the story of the descendants of Abraham as slaves in Egypt freed by miraculous intervention is told and retold.  And because we are learners who live in bodies, this story comes with props, bitter herbs and pierced flatbread and cups of wine.  This is the very meal Jesus was celebrating with his twelve disciples on the night he was betrayed.  And though the meal is meant to create community, a common story, a redemptive framework upon generations of suffering, an assurance of things hoped for . . . Judas walked out that night.  This was the painting featured in today's Biola Lent devotion:
The background is a scene of sustenance. Food, wine, readings, prayer, talking, laughing.  Friends.  Yet Judas is glancing back for one last glimpse of that light as he heads into the shadow.

Which is an important detail.  This moment sets in motion the entire arrest and crucifixion, yes.  But this moment also encapsulates God's choice to effect history through humans.  So often when we look at the mess we've made, we wonder why God doesn't immediately zap out all the tears and straighten everything up right now.  But Jesus let Judas walk away.  And ever since, redemption comes quietly, one man dying and rising, and two millennia of followers doing the same. Billions of daily choices, to embrace the light, to sit at the table, to raise a glass to Jesus.  Or to turn away from the feast, to slip into the dark shadows of hate and greed and jealousy and violence.  We will never fully understand the mystery of that plan, of how God's goodness and love win the universe over to wholeness in a sure and inevitable plan that still lurches along asking humans to participate. Once for all on Easter weekend, then seeping out to the frayed edges every second since.

The nation freed at Passover turned back from freedom repeatedly.  They remembered Egypt with rose-colored longing whenever the going got too tough (and it was tough).  And we daily devalue the bread and the wine set out for us as we cram all kinds of empty calories that cannot satisfy.  

The blog has been quiet as we traveled to the Christian Medical and Dental Association biannual meeting for continuing medical education for health care providers all over Africa, the Middle East, central Asia.  Over 900 doctors, nurses, therapists, parents, kids, professors, program directors, board members, etc assembled for nine days of an overwhelmingly rich meal.  Seven lectures a day x 4-8 choices per time slot x 9 days of programming, plus morning preaching and evening extras . . it was a feast, for sure.  We were challenged to some big-picture strategic thinking and updated on the science of medicine.  We had numerous meals with younger (mostly!) medical families, hoping to encourage them.  We cheered on the Sergers giving presentations . . . after almost two decades of coming to these meetings as the only doctors our Serge area, we had a solid team of co-workers at this one, and most of them in teaching roles! The conference is like the table in the background of the painting, rich with fellowship and content.  But now we and others have the choice to embrace and continue, or turn and walk away.  Praying that we will stay with the table even when it's hard to see Jesus there, and not be fooled by the shadows.
Another rich table, Rodger B instructing me on intubation skills at a workshop at the conference, photo by Ari

we had a full day off and hiked up a small mountain in a protected area along the coast, which for us is an invitation to God's feast of beauty in nature

In that same spirit, prayers appreciated for Scott as we head to Uganda tomorrow.  He's invited to speak at a weekend conference for Ugandan medical students, in memory of Dr. Jonah Kule.  We'd like to challenge them and point them by faith to sit at the table of service with Jesus, and not go chasing unsatisfying wealth and comfort.  

Blessings to your Easter weekends.  Here's the Passover Guide we like though I'm sure there are many, and again the Biola link for the Scripture-poetry-art-music-devotional thought-prayer each day.

Sunday, March 11, 2018

A blanket, a mirror, and a gift

Scott preached at our church today, the wrap-up sermon of 1 Peter as we have been working our way through the book, a sermon that aptly addresses this season of approaching the cross.  So here is a brief summary of what he said from one listener, me.  1 Peter is a book written to believers who were suffering, countering the false idea that trials cease when faith enters.  Chapter 5, the final chapter, gives them three ways to persevere in the midst of suffering.  A blanket, a mirror, and a gift.

First, we are called to a path of humility, which is contrasted to a life of anxiety (5:6-7).  The cares of the world we often wrap around ourselves like a blanket.  Success, jobs, the future, financial security, popularity, admiration, look like they will comfort, but instead they distract and choke.  If we throw off that false security blanket, cast our cares on God, then we relinquish illusions of control and embrace a humble dependence on God's goodness.  In humility we surrender our will to seek the good of others and the glory of God, which paradoxically bolsters our perseverance.

Second, we are called to be alert (5:8).  Scott reminded us that we are in a battle, in a world broken by evil where that very breaking, where our own sin, where the deceiving prowling lion of personal spiritual forces, where the discipline of the Creator's merciful order, all mysteriously embattle us in troubles.  So we hold up the mirror of truth to examine our own hearts and to look behind us for the ill-intentioned devil ready to pounce.  Like real soldiers (even the one in our own family!), lethargy and denial can be deadly.  To persevere, we need situational awareness.

Finally, chapter 5 ends with the reality of grace in the fray of suffering (5:10-11).  Being humble and being alert are not states we dredge up by sheer will power, they are states of being we receive as gifts from a merciful Father. God works with purpose through all this hard life to strengthen and purify and transform us for our own good (v10), and for the glorious growing reality of God's putting the universe to rights (v11).  Or as we say in Serge, the world's good and God's glory.

Well, we're preaching to ourselves, so hopefully these thoughts from Scott encourage you too.  Throw off that red woolen blanket, hold up that little yellow plastic hand mirror, and accept that lovely gift bag.  Don't be surprised when trials come (I know I always am), but sink deeper into trust in the One who holds us all.

Thursday, March 08, 2018

Direction: Death, a Path of Mercy and Truth

(3 babies squeezed onto one resuscitaire bed this morning, two were dead by this evening)

 (note neighborhood name on this file .. "Jesus Winner", still pushing the Gospel of Triumph)

One of my Lent devotions this week contained this paragraph: 

Therefore, let no confusion remain. Lent is not self-improvement. Lent is not self-denial for the sake of some moral gratification. At its most basic, Lent is about awaiting death. It is the uncomfortable and unwelcome reminder that we will grieve and we will die. For this reason, we can embrace the pain rather than avoid it. We can lead one another in lament over death’s temporary reign.

Jesus' disciples in the 40 days prior to his crucifixion certainly were not, for the most part, anticipating a march towards death.  They were still expecting the angel calvary, the miraculous zap to all enemies, the dramatic vindication.  Even as Jesus talked about losing your life to save it, taking up the cross, being a servant . . . they were arguing about seating arrangements in the palace.  That is me, too.  Lament and embracing inevitable pain all sound noble in a devotion.  But the actual determination to keep moving into areas of suffering, to keep facing death without fear, well, that's another story.  Just when I think we are faithful, it becomes excruciatingly hard.

For us, the walk towards death occurs every morning when we get up and go to another day at the hospital.  There is literal death, sometimes way too many.  Yesterday I lost four patients, today so far two.  Women arrive hourly with preterm twins, with a baby delivered on a bus still attached by her cord, with a convulsing lethargic infant, with an unconscious one-year-old deflated by diarrhea.  There's no screening here, no shielding, the raw effects of poverty and stress and physical labor and not-enough-to-eat just wash up on this doorstep over and over and over.  Yesterday as we tried to round and review the 38 babies we already had admitted in Newborn Unit, a nurse from radiology walked in with a rough wool blanket, inside was a 885 gram 26-week grey-blue limp newborn with no sign of life except a barely perceptible slow pulse.  The mom had been sent for an ultrasound because of abdominal pain, surprise, that was labor and this was a baby.  While I got the heart rate up and some response and breathing initiated the prognosis was very poor, and I had to decide to just leave this one on oxygen by pressure in an incubator while I ran to the operating theatre where Scott was delivering another 985 gram very small-for-age 32-week baby to save the life of the mother.  I literally walked in as the baby came out, and that one also needed a lot of resuscitation, and by the time I got him stabilized on his airway the other baby was dead.  And so it went.  We lost a 1-week old readmitted who had meningitis, and another baby with severe lung damage from a too-slow too-stressed birth with meconium, and a 29-week baby who delivered at home and was brought in infected and jaundiced.  And then 25-week twins, whose mother worked hard manual labor on farms.

(the very small-for-gestation baby delivered early to save his mom's life, so far still fighting)

But the walk towards death occurs in subtle ways, too. When we walk into that hospital, we never know what the staffing will be (38 babies, one senior nurse and one brand new one brought over from a dispensary to help on NBU, 50-some kids on the ward with two nurses as well).  The patient with asthma is just not improving . . only to find out no treatments had been given.  There is always something:  your colleague has to go to a meeting, pick up a document, appear in a court case.  The government is fighting with the university and interns are delayed in posting.  We're out of almost every antibiotic, or none of the labs are done because the machine is broken.  There are no gloves, or no IV cannulas.  Or bigger picture, there are protests in Nairobi, or roads closed, or political uncertainties.  There are wipe-you-out issues with people you care about.  There are rebel threats on borders, or potentially fatal illnesses. 

And death comes to certain dreams, or hopes.  Like not being with your med student son when he has surgery, or your soldier son on his pre-deployment vacation, or ever seeing your youngest son playing sports, or being able to reassure your graduating yet-to-be employed daughter that she can always live with you for a while (she can, but it's a long journey!).  Never having seen the rooms/homes/dorms of 3 of the 4 kids.  Moms who we never spend a birthday with.  Sisters who do almost all the attention for our mothers.  Planning that needs to happen but keeps getting pushed off to late evenings, funds that need raising.

I guess this week I've just been reflecting that the determination to keep going back into that fray, to keep plugging on in hard places, wears one down.  In my head I do believe that's what Jesus calls us to.  OK some people glorify God by being stars, speakers, well-known, moving in circles of the powerful, but that's not really our jam.  God asked us, we believe, to go to very dysfunctional places where injustice skews the outcomes, where every. single. day. something new doesn't work.  

So later in the week, in another devotional time, this verse popped out in Psalm 25 (v 10):  All the paths of the LORD are mercy and truth . . .David wrote that, David who suffered hunger, who suffered betrayal, who committed adultery and murder, who lost and regained his Kingdom, whose heart was broken by his son.  David wrote about humility, and then asked to be taught God's ways. 

So the Lent rubber meets the road, day after day, in our lives.  Can we accept that the quiet plod of faithfulness in the dirty corners of the world, even when it is frustrating and exhausting and unrewarding and costly, is a path of mercy and truth?  That being called to borders, to refugees, to cities, to isolated rural areas, to places where people are suspicious or hostile or demanding or incessantly persistently needy, is the very place where God pours out that mercy on us, and shows us the truth of who God is?

Let's lament the 6 babies who slipped away from life here in the last day and a half, and the uncounted others all around us.  Let's lament the broken jagged edges that centuries of sinful unjust choices have created.  Let's support each other as we call out the false Gospels of continuous triumph, always winning, comfort and ease as our birthrights.  Let's challenge each other to keep walking towards the margins.  Let's look for hints of mercy and truth, even as we walk straight into shadow, truly believing that this movement towards death paradoxically leads us to life.  

(another peri-natal collaboration between Scott and me, this one had a rough start but is peacefully anticipating discharge tomorrow)

(In honor of International Women's Day, with my two interns at lunch as I gave them a talk on TB.  These are two hard-working, unperturbed, non-complaining women and teach me to walk into challenge)

Friday, March 02, 2018

Jack Myhre, a 20 year journey

Twenty years ago today, God gave us one of the greatest gifts of our life.  We had evacuated from war in Uganda, and were taking refuge working at Kijabe.  Scott was my OB (not our preference but choices were limited) and after months of displacement, illness, terror, uncertainty . . a healthy big baby boy joined our lives.
(The weight of responsibility seems to be sinking in for big brother Luke. . )
Back in Uganda, his baptism party descended into a tribal conflict, his first birthday party Scott missed because he had a potentially fatal infection, and we spent the next few years of his life trying to hold on in spite of frequent temporary evacuations.

Grammy and Grampy came to visit

The "balongo" (twins) . . these two have stuck together through thick and thin for 20 years.
And so he grew up, playing football every day, fiercely determined to do anything his big siblings did, riding a bike with no hands and running miles and reading everything in sight.  He said the deepest things, big thoughts, tender heart, a "great dane who thinks he's a lap dog" a friend once said and that summed him up.

Fearless and funny, loud and boisterous, a "one-man tomato".  Until one day he was taller than the rest of us and playing three varsity sports and debating in MUN and surrounded by a diverse group of great friends from all over the world.

And then he was graduating and heading out of Africa to go to school in America for the first time.

God's last-minute provision of an amazing scholarship allowed him to join Julia at Duke, for which we are ever grateful.  More sports with club football and rugby, more studies with engineering, more fun with intramurals and motorsports and Cameron Craziness, more friends and fellowship.

Which brings us up to this 20th birthday.  This is a young man who is . . . . 
A scholar and a gentleman
A gifted artist
A creative cook and barista
An athlete playing in a rugby tournament today (praying for MY birthday gift, no injuries please!)
A loyal loving little brother

And a delightful son to us his parents and to the many others who have helped us raise him.

As you can tell from all the photos, another birthday apart makes us miss him even more.  Today he'll be playing on the Duke men's club rugby 7's team in a tournament, and serving as the official Duke yearbook photographer at the Duke-UNC basketball game.  Happy Birthday Jack.  We love you.

Watch out world.  Here he comes.