Nothing but good times to show, I'm on my way

I wanted to used the lyric New friends and new places to see as the title of this post. Though there is truth in that statement, I write this blog post from my couch in Charlottesville, Virginia. A place that I had come to call home before leaving for Mercy Ships a year ago.

This summer was filled with traveling to visit friends I hadn't seen since leaving last August, hanging out with the family, reunions with ship friends, "working" as the camp nurse at high school youth camp, and figuring out what would follow this past year of change.

          
         
  
Through a series of fortunate events, my friend I met on the ship, Karyn, and I applied for a travel nurse assignment at UVA, in the Pediatric ICU where I had started this journey 3 years ago. Each assignment lasts 13 weeks, so we will be here until just before Thanksgiving.

This transition back to life and work here has been interesting. I'm excited to be back in a familiar place and to catch up with friends who I have missed. There are moments where I slide back into old routines and friendships so easily. And then there are moments where nothing feels the same. My drive to work is the same, but my heart is in a different place. It's with the patients who became friends on the ship. It's with the friends on the ship, waiting to learn where they will go next, as Ebola ravages West Africa.

And all I can do is be here. In Charlottesville. Be here for the easy, fun moments. Be here for the surprisingly difficult moments. Be here to share the stories and the experiences. Be here to listen and to learn. Be here, now.



Did I mention that I am excited to be cooking again? Because I definitely am. A life update would not be complete without sharing a couple of the new recipes I have tried since being back. Another of my favorite parts about Charlottesville is the farmer's markets. Wednesday I picked up some homemade tortillas that I had been wanting to try and a few tomatillos. Enchiladas and homemade salsa verde were on the menu :)

Roasted Tomatilla Salsa Verde

- 1 pound tomatillos
- 2 jalepeno peppers
- 1/2 medium onion, quartered, plus 1/4 cup finely chopped onion
- 2 cloves garlic, peeled
- 1 C chopped cilantro
- 1/3 - 1/2 C water
- salt, pepper, and cumin- to taste


1. Remove tomatillos from husks. Rinse fruit well to remove sap.

2. Cut the stemmed tops off the jalapeños then split them in half. Scrape away the seeds. (For a hotter salsa, leave peppers whole.)

3. Roast tomatillos (whole), jalapenos, onions, and garlic at 450* until slightly charred and tomatillo juices are seeping out. The peppers, onions, and garlic will soften and char the fastest (5-8 minutes). Remove to bowl. Continue roasting the tomatillos for another 5-8

minutes.

 

4. Allow to cool a few minutes then add ⅓ cup of water. Use a blender (or immersion blender) to puree until desired consistency. Add more water if a thinner consistency is desired.

5. Pour into a bowl, add salt, pepper, and cumin to taste. (Cayenne pepper can be added for heat, if wanted)

6. Stir in the cilantro and the chopped onions. Puree if you don't like chunky salsa. I left mine finely chopped in the salsa for texture. 

7. Chill or serve at room temperature.

 

Best eaten while preparing chicken enchiladas :) Recipe coming soon.





"On My Way" - Phil Collins 

It was nothing like I'd planned

Three weeks ago, I sat in a small café across from the airport with two of my favorites from the ship, waiting until the last possible moment to walk out of the African sun for the last time. On this trip at least. The good-byes were harder than expected, people I had come to love as family over these past 10 months. People who, whether they knew it or not, were the reason I stayed.

"How was Africa?" 
I apologize if you have asked me this question in the past 3 weeks and I have looked at you, seemingly blankly and a little confused. In my head, my thoughts are going a million miles a minute. What do you want to hear? How much do you really want to know? What can I say to make you reach the deepest level of understanding possible, this side of the ocean? How much time do you have to listen? How do I put these thoughts into words?

Africa was difficult.
I was challenged in ways that I never anticipated. Personally, living and working with the same people, all day, every day is difficult. I know- these people all made incredible sacrifices to be here, they love Jesus with their life, not just their words. They are good people. The best people actually. In the midst of all these people, there were lonely days. Days I longed for someone to understand how I felt. 

Africa was full of learning.
Some days the work was challenging. In the beginning, it wasn't what I wanted to do. I wasn't using the specialized skills I had, and no one cared! Because that is not what they needed. And that's not what I was called there to do. I was challenged to find confidence when I doubted myself. To feel valued. To find perspective when politics and differing opinions on what was the best treatment for the patient caused frustration. To find grace when I had a small and selfish mindset. To find deeper compassion for those who have suffered.

Africa was wearisome.
There were disappointments. For every life we changed, there was one we couldn't help. There were short-cuts we had to take. There were cases we didn't win. We left with patients still in the midst of difficult healing processes. Patients will need more surgeries and more follow-up that we will not be there to do.

Africa was home. 
Our friend Josh explains it beautifully on his blog- how leaving these friends creates an ache deep within. They get it, they understand what it's like to leave the place we called home for the last 9 months. A place unlike anywhere else.

Africa was where I found joy.
How do I describe the depth of the joy I felt when Mahamadou, usually reserved and somewhat aloof, joins in friendly competition with the other patients? Or how hard it is to hide the sadness in my eyes when I see Flo's wound not healing, knowing what this means, but not wanting to steal any of the hope she has? Or how I can't help but break into a smile when a Deborah's mama gladly hands her over to me and gives me permission to take Debo with me wherever I go, even to America? What about how funny it was to watch Jonah joke with Habiba about how hungry she always was? And how I knew she, Flo, and Bijou would envelope Karyn in hugs after I left the ship?

These are the things weighing on my heart as I come back. And even these words do not suffice, they don't explain how I left a piece of my heart in that country with each of those patients, who loved us as their own.

"How was Africa?" It was more than I could have hoped for.

Part of the great team we worked with

Vincent

Habiba! 

Flo

Sanate

Josue

"That's Where It Is" - Carrie Underwood

Pieces of my heart, pieces of my soul

Pieces, the good and the bad
Pieces, the happy and sad
Pieces, the wrong and the right
Pieces, that's my life
 
Last weekend, I got an invitation to go with a friend from the ship to visit Rovel. I've written about him before- of watching him turn from a shy boy who covers his face to one who hides behind corners and jumps out to scare you.

 

He had noma. It is a bacteria that eats a hole in your face. So we took some skin from his shoulder and attached it to his face (while still attached to his shoulder). Put your left ear on your left shoulder. That's how he walked around for 3 weeks. He was not pleased. That was over Christmas break.

 

Each day for 3 weeks I went to the hospital for an hour to change his dressing. We watched Elf, I introduced him to Timber and Pitbull, we watched Never Back Down, and Iron Man. Lots of movies and music. Some days he was really discouraged about how his wound looked. The best days were when he looked in the mirror and said "Yeah!" gave me a high five, and said "Thank you" in English. He was a fan of running ahead of you, hiding behind a corner, and scaring you. He thought he was 23. He was probably only 13-14. He closes his eyes during kissing scenes, I mean how old can you be?

 

He stayed with us for a long time because his wound didn't heal. He was finally able to go home in February. I saw him at outpatients appointments a couple times, but hadn't seen him since he had been discharged from the ship's care .

 

Saturday after yhe orphanage, Ryan, Charissa, and I went to visit his village. Rovel didn't know I was coming. It was one of those hugs where I really thought I was going to be knocked over. We got to meet his mom (who hadn't been on the ship with him), see where he lives, take some pictures, meet some  of his friends, have a dance party, let him walk us through his village. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Then, in true African fashion, I sat in a taxi for the next 2 hours with the most passive taxi driver in all of Congo trying to get back to the ship. But it was there that I realized that these days were what it is about. It is what makes this place special.

 

I am able to walk down to the ward on my way to my room to check in on patients and no one gives you a second glance. It's about more than just our patients receiving physical healing. It's about showing them that they are loved, regardless of their physical condition. I wonder what it is like for the mommas to bring in their babies all wrapped up because their lips are gaping instead of perfect baby lips and for the nurses to scoop up that baby in their arms and smother them with kisses? Or for a man who had his nose shot off years ago to be greeted with smiles, hand shakes, and laughter from patients in various physical conditions around him?

 

I have two weeks left on the ship. What does that mean? Where do I go from here? Great questions. My life seems to be segmented into small pieces where I am having to ask these questions over and over again. And I don't know the answers yet.

 

For the next two weeks I get to love each of these patients, care for these patients; patients that, probably without knowing it, take a little piece of my heart as they make their way into mine. And that is enough for today.

 

"Pieces" - Gary Allan

 

Just take my hand...

We'd spent our morning sneaking around the hospital, shooting unexpected crew with the "Sock Monkey Shooter" (a hit from one of Mom's packages!), watching Lion King, then playing baseball with the clipboard and foam balls. At 2:30 when it was time to go outside, Josue's dressing over his wound had come off. "No, mon ami, deck 7!" he repeated over and over when I told him we had to redress it. "S'il vous plait, Becky, deck 7..." But he took my hand and walked down the hallway to the dressing room. Where he proceeded to dramatically flop himself on the bed and take control of the music my phone was playing. A short time later, the dressing was done and we were on our way to deck 7 with the rest of the patients.

My shifts over the past few weeks has been so full of laughter and "Things that never happen at home" moments. I work in a hospital where people stop and put their hands up when a 12-year-old points a sock monkey at them. Then they proceed to play dead when he shoots them with a foam ball. 

One Sunday night, the ward was full of kids, teenagers, and adults with lots of energy. A couple of my friends had stopped by to say hi and our surgeon's teenage son had come to play Connect 4 with Josue. None of the nurses were too busy, and one semi-jokingly suggested we play hide and seek. So of course, I instruct all the patients to get out of bed and for the day crew to explain to them the boundaries. Our ward and two other empty wards, if they were caught elsewhere it was soft diet for a week! (a cruel punishment according the patients- no one cares for soft diet, which consists of- soft foods)

All the nurses turned their backs and started counting, while the patients took off to hide. Josue was ecstatic, even when he was quickly found, because his friend Wesley had stayed to play. The little girls with bandages around their heads hid behind curtains hanging from the ceilings. As the nurses rounded up all the patients, we did a quick head count. Missing one. The new girl, Stephanie (who I have since nicknamed "Stepheeee" but you have to drag the e's out). She'd been here about 4 hours and we had already lost her. After a small moment of panic and a quick search, all were accounted for.

 

Next it was the nurses turn to hide. We told the patients to count to a million and then took off to hide. My plan was to hide under a bed with all the sheets down to cover me. (Things I would never do at home- get on the hospital floor to hide. Things I might never do again- get on the hospital floor to hide...) Karyn was heading to hide by the linen cart behind a curtain. But really, why hide behind a curtain when you can fit in the linen cart??

So she crawled in the cage and one of the caregivers immediately took to covering her with sheets, then proceeded to sit in front of the cart for the remainder of the game. 'Find the nurses' took a little longer than 'find the patients,' but eventually we were all accounted for, with the exception of Karyn . One of our long term patients, Angelique, kept turning to me with her hands up, a 'where is she?' look on her face. "Keep searching," I motioned.

As she approached the linen cart, Bed 10's father continues to read his book with a straight face. She opens the door and ruffles through the linen without seeing her. Then we hear "Kareen! Kareen!" and a burst of giggles. She calls all the patients and day crew into the room to see Karyn hiding in the linen cart. The patients get closer, not believing Angelique, stoop to see her and start to laugh. The papa who assisted in hiding could not hold it together any longer and was all laughs. This never happens at home.  

Our final round was Sardines, where one person hides and every person searches. When they find you, they join you in the hiding place. I took one of the girls to a hiding place suggested by another nurse. An exam bench against a wall with curtains in front of it, so if your knees are pulled up, they cannot see you. Josue was the first to find us, then Jasmine with the other 9-year-old girl. Josue gets the giggles, the hands-over-his-mouth/holding- his- nose/ shoulder-shaking giggles, which gives us away to Stephee and Angelique. We're pretty crowded, children in all our laps and Josue laying behind us against the wall. Finally Amy and baby Samme join. He's quiet until the last two nurses come in the room, then he giggles. Stephanie shakes her head, but it's such a cute baby giggle we couldn't be mad. 11 people, nurses and patients with various dressings and tubes, all squished on small tables. Things that never happen at home.

I could go on and on about with these stories. Patients with malformations we never see at home. With courage and determination so strong and rare. Stories that are hard to believe, but at the same time, so easy to believe because of where I work. These are the things and the days that make this place unlike any other and a place that I will miss.

But it's not over yet, 4 more weeks of surgeries, stories, and countless hours of baby holding, Connect 4 playing, and Lion King watching.

PS. I promise I do actually provide nursing care here. But Mom always said "If you get all your work done first, then you can go play with your friends!"


"I'm Gonna Love You Through It" - Martina McBride

And return as we must...

I've been back on the ship for 3 weeks; I think that means a Uganda recap is overdue...

The first thing I noticed was the smell. I stepped off the plane onto the tarmac next to Lake Victoria and inhaled deeply. It was not the stench of the port or of the day's catch from the fishing boats next to the ship. The air was fresh and the smells so familiar that if I closed my eyes I was walking through Bumwalukani to the clinic once again. How was it that scent of the air I haven't breathed in four years can bring back memories that strong? Here, this is the Africa I first loved.

 

Outside of the airport, I was greeted by the familiar face of Dr. Joel, a pediatric intensivist from UVA, and the hour car ride into Kampala was spent catching up on the last many months of living life serving the people of Africa, each in our own setting so different, but the calling the same- love God, love people.

Let me set the stage for this little holiday from the ship and reunion in Kampala. A team from UVA has joined with a team from DC Children's for the past couple years for 2 weeks at Mulago Heart Institute in Kampala to do pediatric congenital heart defect repairs. Last year when the team went, I mentioned that I would love to do something like that. This year, I just happened to be a couple countries to the west and maybe volunteered to Dr. Joel (who has moved with his family to Kampala for 2 years to serve with Samaritan's Purse) that I could get leave from the ship and would love to come. Graciously, I was allowed to join.

The first week of surgeries were done in the cath lab. The majority of these were PDA closures and diagnostic cath procedures for children with VSDs. The first days were spent organizing and setting up the ICU, getting used to working 12 hour shifts again (I know I'm spoiled here...), getting to know the Ugandan nurses we were working with, and playing with lots of cute kids :)




Prescious, dancing to the music and coloring!

Christian

That first weekend, I got to babysit Joel and Kristy's kids for a night and spend some time with their family, hearing about their life in Kampala. It was encouraging and refreshing for me, to hear people committed to their calling, but honest about the struggles that come with it.

That weekend also brought the arrival of two more friends from UVA, a fancy dinner from Samaritan's Purse, and the kick off to the surgical week.

Ross, Me, Dr. Joel, Dr. Jeannean

The week focused on VSD closures and Tetralogy of Fallot repairs. Though it wasn't without its setbacks (a whole day of cancelled surgery due to a power outage) and frustrations, the week concluded with 8 successfully repaired children!

Note the bowtie...

 

Going into those 2 weeks, I had no idea what heart surgery in Africa looked like. At the end of the 2 weeks, my heart and my mind were left reeling. Is pediatric heart surgery in Africa possible? Are the limitations we have greater than the potential for these people? Is the loss we suffer justifiable by the progress we are making and the amazing outcomes we have? Having seen these two weeks, I think that at least to a degree, it is possible.

And my answer to "How was Uganda?" despite the frustrations and sadness that you inevitably experience when you practice medicine here, is always that I would do it again.

Not just because being brought back to Uganda filled me more than I would have imagined. I love watching the shock that people experience the first time they step into this reality slowly melt into a compassion that I'm not even sure they knew they had the capacity for.

It's also not because my bathroom for the week was bigger than the bunk space I 've shared for many months. Or because I could eat real bacon every morning, along with the most delicious fresh fruit. Or even that I could walk outside in the fresh air to the gym next door and use the elliptical out on the balcony. Then grab a coffee on the way back to the hotel and shower for more than 2 minutes. Then go to work with the people who taught me how to be a real nurse, how to critically think and how to care deeply for my patients.

 

 

It was not even because after the day's work was through, I gathered around a table to eat delicious food with fascinating new friends. To share about my life here on the ship, and be reminded constantly of how blessed I am to be here.

It is because I believe in helping to bring a better quality of life to the people here.

It is because at the end of the day, regardless of the outcome, we were able to touch these families' lives forever. To be even given a chance at hope is more than they have ever had and to know that their child was valued and fought for, these things they do not forget.

 

"Hello" - Sugarland

All that matters after all

Small.

His small dark hand reaches toward my face and strokes my cheek. What have I done to deserve this affection? Nothing more than squatting down to his level on the floor and offering a smile. Small.

I've spent a fair amount of my time here fighting to not feel small. For what I am doing to not be insignificant. I want the difference I am making to be anything but small.

I am learning that small things can make all the difference. Dying head bandages different colors. Drawing faces on balloons. Cutting a door and windows in a large cardboard box then serving brothers water through the window of their fort. 

Actually, I've spent a lot of my life not wanting to feel small. I wondered if these small things are enough. So I took off to Kampala, Uganda to do pediatric heart surgeries with a team from home for two weeks. (Many stories for another post, another day) And there I realized just how small I actually am.

I thought that something more intense and life-saving would make my impact bigger. That's where I was wrong; it's not about me, or anything I am doing. I was faced again with the limitations of medicine in a third-world country. Where small things we take for granted (fresh blood in the blood bank, electricity, routine medications, diapers) can make significant impact on the outcome of the patient.

I was reminded that it doesn't matter what I am doing, or where I am doing it for that matter, that all the small things I have been called to are to point to the One who is not small. The One who has not created insignificant people or insignificant tasks.

Before Him I long to be small. And when I become weary from the small tasks or my heart is heavy with the accumulation of small despairs, I do know His grace and love know no limits, He has promised to renew and restore us, to strengthen us when we are weary and give grace to us when we fall short.

"Who shall stand before Him? Our works, alas, are all in vain, in much the best life faileth. No man can glory in your sight, all must alike confess your might." Psalm 130 

Before Him I am small.

"So Small" - Carrie Underwood

Something that matters

I was gently reminded yesterday that it has been a little while since I have blogged....and by gently I mean a Facebook post that read "Write again." 

I love New Year's. Not necessarily the staying-up-late celebration part- let's face it, I would really rather be in bed much earlier than midnight- but what it represents. It is a clean slate, a time of reflection, a fresh perspective.

I love to read back over my journaling from the past year; to be reminded of where I have been, the lessons I have learned/am learning, what plans have come full circle, and what plans did not come to be, every time for my good. Looking at resolutions from the last year and seeing which were accomplished, which ones I can put on the list again this year, and often seeing how different my goals for this coming year are.

Call me sentimental and idealistic. I was really excited to come up with resolutions for this year. I found it much harder than before, because I have no idea what comes after June. As opposed to last year when I knew exactly what I was doing for the year...."get a dog" worked out really well :)

The new year in the hospital has been full of both great moments and hard moments- but mostly good!

New babies to love on.
                                               

Old friends, back for second surgeries, looking great!

New patients we have the opportunity to help- as frustrating as their road to healing can be. Read Angelique's story here on Deb's blog.
                                                 
                                            

And perhaps my favorite moment of 2014: seeing Rovel's wounds heal enough that he could go home.

The night he got back from surgery, he hopped off the stretcher and walked himself to his bed. Not without stopping to show us that he could turn his head every direction, as his shoulder-to-face flap had been removed.

That evening, he also insisted that he needed a haircut. His head had been wrapped in daily dressings for weeks and this was necessary. The special thing about this place is I can call my friend Jasmine, the hairdresser, and she comes down to the ward with clippers for a haircutting party, not minding that it is 8pm on her night off.

To see him smile at his going away party when multiple people told stories of how he hid around corners and jumped out to scare them. To watch his eyes light up when he realized the balloons in the bag I had were full of water. To hear him cackle and declare Junior and himself "Champions!" when they escaped completely dry. (Grace and I on the other hand were pretty soaked). 

 

 

To gather on the dock as he and his grandmother give hugs to all who had come to see him off. This is why we are here. These are the moments I long to never forget.

Outside of work, this year has been full of lessons in grace and loving people, as we continue to navigate friendships and life 24/7 community.

"Renewed hope for the future" a friend called it. This is where my excitement for the new year is rooted. Deep down inside, I know it will be good. For each of us is right where we need to be to do something that matters.



"I Was Here" - Lady Antebellum