Taste and See that the Lord is good!

Intern Year

2011-08-03T12:49:00.000-07:00

Intern year ended a little over a month ago and already I'm caught up in the bustle and newness of being a junior resident. I had intended to write some reflections on the year earlier, but am just now finding the time to sit down and really reflect on the importance of what has happened to me over the last year. Briefly summarized, I have seen over the last year that the time for me to grow up has finally come.

I entered residency cautiously confident, believing that I had been adequately prepared, that I had much to learn and that I would do the right things at the right times. Over the course of a year, through poor decisions, false perceptions and inadequate knowledge, I have learned that the complexities and intricacies of dealing with sick people are beyond me. The year was a cycle of gaining ability and confidence only to be forcibly reminded of my inability by sobering mistakes.

The need for help
Self-deprecation is not my goal in writing, for I sincerely believe that I will develop into a capable, even possibly excellent, surgeon and doctor; however, I have not yet arrived. Despite my constant desire to question the edicts dispatched by my superiors, I now trust that I need their guidance and teaching more than ever. Many of my mistakes could have been avoided if I had asked for help sooner rather than later.

The need for caution
I sincerely believe that things will turn out for the best in all circumstances. Whether this is a byproduct of my upbringing, a facet of my faith in God, or simply a hopeful desire, I do not know, but while a joyful and good character trait, it can predispose to danger. The truth is that things don't always turn out for the best, particularly when dealing with sick people. Sometimes they take a turn for the worst possible outcome and my work is to guard against that possibility, even while hoping for the best.

The need for discipline
Now this is what I mean by growing up: Not giving up joyfulness and excitement and adventure, but by recognizing the proper time and place for such things. My last post hints at this, but explicitly, I can't achieve excellence on talent alone. To truly love my patients requires sacrifice. To truly love God requires sacrifice. To that end, there are days when I will want to go play, but when duty necessitates discipline and study. There are countless mornings when I want 10 more minutes of sleep but when dedication to God demands that I get my butt out of bed and spend some time in prayer and in the Word before I am ready to face the day.

The need for humility
All the above culminate in a concerted effort to take myself out of the middle. The tendency toward an attitude of self-preservation is so strong in residency that it can overwhelm all other desires and dreams, but it is not an unconquerable urge. When I stop trying to take care of myself, every controversy above resolves and the need for sustained effort transitions seamlessly to an outpouring of other-centered goodness. The only way I can practically achieve this in my mind and in my life is to be fully confident that in neglecting myself, God will provide. In fact, this is the challenge to believers for generations past and will continue to challenge us for as long as the war between selfish desire rages against love.

Therefore if there is any encouragement in Christ, if there is any consolation of love, if there is any fellowship of the Spirit, if any affection and compassion, make my joy complete by being of the same mind, maintaining the same love, united in spirit, intent on one purpose.

Do nothing from selfishness or empty conceit, but with humility of mind regard one another as more important than yourselves; do not merely look out for your own personal interests, but also for the interests of others. Have this attitude in yourselves which was also in Christ Jesus, who, although He existed in the form of God, did not regard equality with God a thing to be grasped, but emptied Himself, taking the form of a bond-servant, and being made in the likeness of men. Being found in appearance as a man, He humbled Himself by becoming obedient to the point of death, even death on a cross.

For this reason also, God highly exalted Him, and bestowed on Him the name which is above every name, so that at the name of Jesus EVERY KNEE WILL BOW, of those who are in heaven and on earth and under the earth, and that every tongue will confess that Jesus Christ is Lord, to the glory of God the Father.

The Next Step

2010-09-26T12:24:00.000-07:00

It's been a pensive day. Lots of things have converged lately prompting me to take a census of what's going on with me, God and life. And it's been good. Real good. I don't really write on here anymore, but today was one of those days when I felt like writing.

If you haven't been around, my journey for the last several years has been centered around the realization that God is among us, active and hopeful that we will lift our eyes from our own lives and join in the story that He is writing in the paths that we walk. That prompted some reevaluation of my spiritual beliefs and practices resulted in the exploration of true freedom, relationship and service to others. It has been a joy to discover new ways to glorify God, to feel myself slowly unburdened from the legalism that so often accompanies religion and to see prayers answered, whispers of God in all things and meet others in whom Christ so obviously dwells.

In the midst of that learning, I was learning to experience God through enjoying good things in life. Now unfortunately, I may have associated things like skiing, rock climbing, good music, food and beer with carrying out the simple call of Christ a little too strongly. All beautiful things to enjoy, but lifeless in and of themselves and missing pivotal elements of the life of Christ. I still can and will enjoy all those things in life that God has gifted to us, but those things can't be at the center. I don't know what it was today, but I was reminded of my first steps toward a life lived fully with God. Back then, I was miserable but found simple joy in working for the happiness of others. It happened in Guatemala and continued in Texas and then Alaska and so forth.

A lot of people ask me how I like living in New York. Those from Alaska (including myself) sometimes have a hard time understanding how I can be happy somewhere so far from home. The truth is, my happiness, my joy, even when I was there, was never about the mountains, the wilderness, or the exhilaration of extreme sports. Rather, the joy I experienced occurred secondarily to taking myself out of the center and using my life to build up others. Even good things can become idols. It is the recognition of where God is moving and joining in that brings joy, not in recreating the specific context of where or how He has acted in the past.

I've learned well over the last few years how to live, how to love myself. I see this as a dangerous destination if viewed as such, but as a necessary precursor to the next step. To love your neighbor as yourself, you necessarily must love yourself first by understanding the great love that God has for you. I am here in New York not only to live life to the fullest for me and for God, but to live fully and to share that richness with all those around me in simple acts of service.

"Teacher, which is the most important commandment in the law of Moses?"
Jesus replied, "'You must love the Lord your God with all your heart, all your soul, and all your mind.' This is the first and greatest commandment. A second is equally important: 'Love your neighbor as yourself.' All the other commandments and all the demands of the prophets are based on these two commandments."

Leaving Peru

2010-03-29T13:33:00.000-07:00

As a rule, I hate leaving. Maybe it's just me, but I think at some level, we realize that we were not meant to be apart from those we love. Yet another little cue that points my eyes toward God. All that to say, there are some really wonderful people that I will miss having left Peru. I love the diversity and unique personalities that you encounter when outside your element. I also love friendships that grow quickly and the ability to create lasting bonds in such short time.

Early in my trip, I started compiling some unique things about Peru, some serious, some not so much. This is what I came up with:

Everything means something else/is innuendo
I realized quickly that I had to be really careful what I said here. Almost every word in Spanish means multiple things. Sometimes, this only creates a sense of confusion for the gringo that doesn't understance the nuances of the language. Other times, it creates for particularly embarrassing circumstances.

Not all parts of speech are mandatory
Now this may be true in English also, but I found it particularly challenging that a sentence could contain neither a verb or a subject and everyone else in the room would understand exactly what was going on. Not me. A simple prepositional phrase is not sufficient. But toward the end of my trip, I started doing it too.

Peru is not a poor country
There are some incredibly poor people here, but I was struck by the diversity of agriculture (read POTATOES), commerce and industry here. This place is rich with resources and has fairly decent infrastructure. It also has room for development, which I think we will see in the coming years. Unfortunately, Lima has had a HUGE influx of indigents and there is a real need in the surrounding areas.

Oompa loompas are real
I couldn't resist a dig a this, just because it cracked me up and made me happy so frequently. One of the first sights I saw arriving in Peru was a VERY SMALL person cleaning the sidewalk. As time went by, I adapted to the fact that it is very common for indigenous Peruvians to work in city improvement, but I SWEAR that they hire the smallest people they can find for the street sweepers.

The sun really is hotter higher up
Oh the burning. THE BURNING!!

Latin Americans really can dance
I'm sorry, but what we do in the U.S. just isn't dancing when you compare it with Latin America. I had a ton of fun not only trying to not move like a gringo, but just watching the people dance here. They manage to be really smooth and sensual without being hypersexual (if that makes sense). Not to say that everyone at the clubs was a Puritan, but the mood was different for the most part.

Plans don't count for a lot
I found it was quite possible to agree to a course of action with some one else, only to find out in hindsight that they really weren't totally serious. I never quite figured this one out, but it seemed like sometimes you made plans and they happened, and sometimes, they just didn't count.

In medicine, sometimes less is more
I can't contest the fact that the U.S. has amazing health care for those that receive it. What amazed me here is that everyone gets treated at least to some extent. The ugly side of U.S. medicine that most people don't have the privilege of seeing are those patients with potentially curable diseases that are working to make ends meet as it is, and then get diagnosed with something terrible. While that can still be devastating here, it somehow seems more recoverable. There is clearly a lower level of care delivered to the working class here, but rarely is some one simply denied treatment.

God is always moving, you just have to look
While I didn't have a particularly moving spiritual experience here, there were definitely some sweet times of communion with God in a very unique part of His Creation. There were chance encounters with folks doing their small part to demonstrate that God loves all people, not just those with money, and a lot of wonderful relationships formed here. I know that leaving Peru, I feel closer to God and more in tune with His plans and wishes for my life. It has been a sweet time and I am excited to see what Costa Rica will bring.

A case or two

2010-03-24T21:20:00.000-07:00

I can't stress enough how strange and interesting are the cases I see here every day. Probably kind of boring for most folks, but I wanted a record of what I had seen. Here's a brief run-through of a few patients on our ward right now.

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Typical TB patient being treated for about 3 weeks turns yellow, gets nauseous and shows up at the hospital. Lab tests confirmed our suspicion of a drug reaction, so all TB meds were stopped and we're waiting for his symptoms to improve before restarting.
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26 year old with fever & chills off and on for about a month. Enlarged liver & spleen. Initially responded to treatment for malaria despite a negative blood smear, but fevers returned every couple days. CT of the abdomen was bland. We still don't really know what's going on with him, but are suspicious for malaria resistant to chloroquines.
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Snake-bite patient came in, but other than a little pain, he's done well. No massive necrosis or infection.
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A 16 year old kid supposedly kicked a soccer ball a week or two ago and developed an ulcer and subsequently and necrotizing skin infection. My friend working in the lab cultured out Pseudomonas, a bacteria that is really rare in healthy patients. This kid's foot looks pretty bad now, but it should be getting better over the next couple days.
===
We have a couple patients with HIV & some type of secondary infection. One is a 22 year old with Kaposi sarcoma and meningitis. Another, a middle-aged guy with cryptococcal encephalitis that isn't doing so hot. The third is actually comatose and found down by the police. We're presuming he has meningoencephalitis tuberculosis. Tragic patients to work with really.
===
Also had a fascinating/terrible case of leptospirosis with scleral hemorrhage, liver failure, kidney failure, hypocalcemic contractures and ridiculous amounts of jaundice. With this severity, it's called Weil's syndrome. He's actually doing better now too.

===
Occasionally we get consults from other departments, this time it was peds. The patient was a 24 day old baby born in a village to a mom with malaria. She became deathly ill and was taken to the hospital while the baby stayed at home with grandma. Mom got better, but at 21 days, the baby caught fever, his blood pressure dropped and he was taken to the hospital. The typical test for malaria here is a blood smear, which is rated on a scale of 1 to 4 pluses. This kid had a 4 plus blood smear, a ridiculous amount. With the timing and the level of parasite load, it is almost a guaranteed case of congenital malaria, an incredibly rare occurrence. My attending had never seen such high levels and will be submitting a paper to describe the case, as it is rare even with low levels. They have designed a treatment regimen here that seems to be working and the baby was much better today.

Fin de semana #6 - Man Versus Wild

2010-03-22T16:52:00.000-07:00

Okay, so my Amazon jungle experience wasn't quite that hardcore seeing as I had a guide and a roof over my head, but despite not being totally swarmed by mosquitoes or almost dying, it was a pretty amazing experience. I heard about my guide from the girl from Holland at my hospital. He works for Ecoexplorers which is owned and operated by Carlos Grande, not to be confused with my GUIDE Carlos, or ME when I go by Carlos down here. (people have a hard time with Ross, and my first name translated is Carlos).

So I met up with Carlos and Carlos Saturday morning at 7:15 to catch a rapido (fast boat) downriver to Santa Maria de Fatima. Despite the mouthful, it's a tiny village of thatched roof, open-air huts spread out sparsely in the jungle next to the Amazon. Carlos is friends with a family there that is always happy to host and cook for tourists, so we based our weekend adventures out of their place.

First was a stroll through the jungle to check out whatever we could find. Mostly trees. My guide had studied a lot of traditional medicine so was full of information about all the plants and their medicinal uses. Pretty cool stuff. I also got to try my hand at playing Tarzan: climbing trees, swinging from vines and the like. Really, just being in the middle of the jungle swinging a machete was pretty neato.

We headed back to the hut for lunch and to escape the midday heat. As afternoon rolled around, we hopped in a motorized canoe and headed upriver to fish. The poles were nothing more than a line tied to the end of a bamboo rod. The fish were all pretty small, but made for good eating later that night. We didn't catch a ton, but managed to pull in a few piranhas and catfish. After fishing, we cruised around until we found some freshwater pink dolphins to watch for a while. I went for a swim off the side of the boat, which was a little unnerving, but totally refreshing. As evening rolled around, we hung out on the Amazon watching the sun set before returning to cook up our catch and spend the night in mosquito-net hammocks.

It strikes me that while all this was really cool, this post is getting kinda long so here's a summary of day 2:
- breakfast of giant snails we found the day before
- hike to a reserve for monkeys
- discover my camera batteries no longer work
- play with monkeys, tucans, anaconda, sloths and prehistoric turtle
- get a monkey tongue up my nose
- try some jungle-brew whiskey/mead
- head back for lunch
- swim in the river, throw local kids off the side of a boat, watch soccer
- climb a tree & get eaten by ants inhabiting the tree
- join a local volleyball game & win 3 soles
- die from overheating, use 3 soles to revive myself with cool beverage
- watch a fierce competition between the local soccer team and a visiting team from another pueblo; rejoice at our victory
- cruise back to Iquitos at dusk watch the jungle fade to black and the lightening flash in the distance
- Praise God for an amazing weekend.

Cooperstown

2010-03-21T21:10:00.000-07:00

I'll be living in Cooperstown, New York for the next five years. In case you haven't heard, it's home to the baseball Hall of Fame and approximately 2,000 people in central-ish New York on Lake Otsego, about 4 hours from New York City. More pertinent to this post, it is home to Mary Imogene Bassett Hospital and the Bassett surgery residency program. Additionally, the Mithoefer Center for Rural Surgery is a part of the Bassett program. It is basically an institute geared toward the idea of rural surgery as an entity somewhat separate and unique from mainstream general surgery.

Essentially, this all means that I will be training in a rural town, learning a particularly broad spectrum of surgery and working with other residents who have interest in rural/international surgery.

Learning about my match went down like this. I took a little bit longer lunch break last Thursday, Match Day, to head down to the riverbank and brought my laptop along. I spent some time in prayer and hung out with a local kid who was trying to sell me bracelets before cranking up the computer and learning of my fate. It was a beautiful backdrop for receiving the news and I read the words with some excitement. I ordered some grilled fish, avocado & yucca fries at a restaurant by the river before heading back to work for the evening. That night, I met up with a couple of the residents from the hospital, the two expat girls and one of their boyfriends for some barbecue at The Yellow Rose of Texas, a local restaurant owned by a guy from Texas. It was a great way to celebrate some really great news!

While I had some good options on the West Coast, I can honestly say that none of them have training equivalent to Cooperstown for rural surgery. The skiing won't be quite as good from what I hear, but there are all kinds of amazing recreational opportunities right out the back door. They even have an outdoor hockey rink!

The major downside of living in such a cool place is that it is a ways away from the most important people in my life. In fact, it's about 1-1.5 hours from a large airport. However, I'll be working around 80 hours a week, not leaving a whole lot of time for social engagements. I'm planning to use my time off to head back to Alaska whenever I can though. Overall, I'm pretty darn excited to start residency!!

Iquitos

2010-03-17T21:43:00.000-07:00

The two things I consistently heard about Iquitos when I mentioned I was going there next:
1. The girls are really hot there and they will try to put pills in your drink and rob you.
2. The weather is really hot.

So far I've avoided being robbed, but everything else seems pretty accurate.

Iquitos definitely has its own personality, but also has a lot in common with your typical South American city. Instead of taxis, here they have motos, 3 wheel vehicles with a covered seat behind for passengers. It feels more touristy than Huancayo and it's much more common to see gringos walking the streets. The locals are a little more forward here and I made a couple of new friends my first night in town who were supposedly just wanting to practice their English. Who knows. It's also much more common to get hit up by beggars, disabled folks and hungry street kids. I try to help when I can but sometimes there are just too many. No clue how Jesus did it...

Cool random fact: about 5 hours away on the river is the leper colony where Che Guvara hung out in Motorcycle Diaries. I thought about going there, but apparently no one lives there anymore.

(warning, it gets gross here. no, really.)
The hospital here is great. Rounds in the morning are very educational and the cases are fascinating. I can add to my repertoire now dengue, malaria, leptospirosis, TB (with and without HIV) as well as your garden variety parasite infections. I also saw probably the most interesting/grossest case of an acute abdomen and surgery that I've ever seen. This guy came in with peritoneal signs and was taken to the OR for presumed appendicitis. Turns out he had an intestinal perforation in the duodenum... from an ascaris... that they found swimming in his abdominal cavity with a buddy. Apparently it's not unheard of, but quite rare. Also ran into a French fellow who was being seen for leishmaniasis and is here as part of a sanitation project for Belen, the floating shanty town a few blocks from my hotel. He was quite a character and we may run into him again to see what he's working on.

I was reading about leptospirosis on UpToDate today and found that the major study on the topic was actually done here in Iquitos. Random. Speaking of research, the two other white folks at the hospital here are doing some cool projects. One is researching malaria transmission from humans to mosquitoes in hopes of finding a vaccine and the other is researching tropical skin infections. She has a lab set up to do cultures and sensitivies and it was kinda fun to see how all that stuff works. It's usually just something that gets ordered and forgotten until the results come back. It's quite a process though.

Tomorrow is match day. I'm kind of excited needless to say, and have spent some good quality time hanging out with God today in preparation. It's all in His hands!

Change of plans

2010-03-14T13:15:00.000-07:00

The thing I hate about putting off blogging is that I can't type everything that I want to. Lots of cool stuff this past week but the most interesting and pressing is this:

I have left Huancayo and just bought my plane ticket for Iquitos, a port on the Amazon River in the middle of the jungle.

Yeah, I'm pretty stoked, but it was hard to leave. It's always hard to leave. I met some really great folks in Huancayo including my expat crowd, the doctors and interns, my host family and newly met friends that I never got to know well enough.

This week in the hospital I finally got to see a few surgeries for hydatid cysts which was pretty interesting. One was in a kid of about 11 years old who had two hard-to-access liver cysts. Pretty interesting surgery, but straightforward. I got to do a little more suturing this week on skin, but other than that, it was a pretty typical week of watching surgeries, attending rounds in the mornings and hanging out in the ER in my downtime.

Outside the hospital this week, I took off to play soccer with the surgeons at a doctors' pavilion for recreation. I played goalie and had a few nice saves, but let in a lot of goals too. They ended up hanging out for hours afterward passing around bottle after bottle of Cusquena and telling stories. Not my favorite post-game activity, but later I was invited to a doctor's house for a fantastic meal.

I also ended up over at the expat house one night for crepes courtesy of our French-English friend and met up with my friend from the disco a few nights this week for late-night snacks and conversation. Dr. Montano gave me a great send-off by inviting me over to listen to music and drink some wine. He presented me with a surgery manual in English that he had from training in Cuba... quite a gift!

My host family and I went out for dinner at La Lena (there are about a million of these, but the one on Brena is the best) where I had one more amazing steak before heading out. The next day they prepared an awesome lunch of basically fajita steak, onions and tomatoes and homemade chocolate pudding for dessert!

I met up with Joseph the Peruvian with my backpacks in tow to head out to obtain passage to Lima. I ended up booking with a car instead of a bus because the bus was really expensive during the day and driving in a car is much faster (supposedly) but one broken fan belt later found me sitting on the side of the road between Huancayo and Lima hanging out with my newfound friends, the other passengers in the car, one of whom was a policeman from Lima. Good times.

We finally arrived and I met up with Mario and a big group of his amigas to close the night out with karaoke.

Redeeming a bad Monday (2/2)

2010-03-09T20:02:00.001-08:00

Fresh out of the hospital after an unspeakably frustrating morning, I took a long walk home to chill out a little. I spent some time relaxing at the house before calling up a friend to meet up in the park (the Jesus-lovin' gal I met at the discoteca). There was a crowd at the park watching a heated volleyball match and when I asked, it was a team of "maricones" that was dominating. Now there are about a billion words for homosexual in Peru, but maricon (merry-CONE) is the most widely accepted.

My friend and I went for a walk and talked for a while at a juice stand where they basically blend up whatever fresh fruit you want and dump it in a glass. Delish. She had some wise things to say that helped redirect my angst and we discussed our life goals and stuff. Good times. She had to cruise to class that evening and I headed back to the park to try my hand at volleyball.

I watched the conclusion of a match where the maricones again kicked some major butt. It seemed that the winner of the match kept the court and took on challengers. So I hopped down onto the court to see if I could join the next group of challengers. However, as soon as I stepped up, the whole crowd started cheering. Apparently, gringos don't show up to play volleyball a whole lot. As our team slowly formed, one of the reigning champs told me to join their team, as they were one down. If I thought the cheering was loud when I walked on, it was doubled when I stepped onto the other side of the court.

We ended up playing a pretty close match and some really good volleyball. Man, those guys can play. There were definitely a few pretty hilarious moments like when one guy set the ball for me to hit and simultaneously called out "Mi amor!" I'm used to getting teased about the girls here liking me, so it really wasn't that much different and everyone was just out to have fun and joke around. We ended up winning, and apparently there was some money on the game because I came away 1 sol richer. I wasn't a standout player and made my share of mistakes, but also got a few nice spikes in. They invited me back at least...

Afterward I met up with my gringo crew at a pizza joint downtown for some good times and okay pizza. My friend finished her classes and took me to a bar with live Peruvian music and colchitas (kind of like spiced rum) for a nightcap before I tucked in for the night.

It was a long day and the stark contrast between my morning and my afternoon still surprises me a bit, but I'm thankful that the pain of my lesson in humility from that morning was far outshone by the richness and the fullness of engaging in the lives of the beautiful diversity of people that God has made.

Lessons in Humility strike again (1/2)

2010-03-09T19:14:00.000-08:00

Ever have those days when you know what you're supposed to learn from the hard things you're facing, but you just don't care and you want it to be made right??

Welcome to Monday. Having been here for 3 weeks, I assumed I would be given a bit more liberty in the OR and much to my delight, I was offered the opportunity to assist on thoracic cases... on Monday.

Up to this point, I've gotten to assist only a couple times, with the majority of my time being spent watching and leaning over the surgeon to help retract. Reminiscent of shadowing a physician during my 1st year of med school. In contrast, during my surgery rotations this year, I've done a below-the-knee amputation myself and assisted on neck dissections, opening the chest for heart surgery and multiple thoracic surgeries, not to mention doing a fair amount suturing upon closure for most cases. Coming to Peru, I was hoping to get even more hands-on experience while learning about endemic diseases.

So I showed up, on Monday, ready to get my hands a little dirty, but when I walked into the OR, the patient wasn't in the room. When I check again, they still were there... 30 minutes... 45 minutes... an hour... hour and a half and no patient. In fact, the surgeon that I'd met and was planning to operate with was nowhere to be seen either. I finally got up and sought out the anesthesiologists. They essentially told me that all of the thoracic cases were canceled for the day. Upon further inquiry, they informed me that thoracic cases are complex and they should have two real surgeons operating for all of them.

I wanted to scream in their faces that I have assisted on thoracic cases at the Oregon Health Sciences University Hospital and if I was good enough there, I should be good enough in Huancayo, Peru.

I managed to keep cool for the most part, but when one of the interns graciously offered to let me watch another laparoscopic gallbladder surgery, I should have said thank you and scrubbed for the surgery. But I told him, instead, that at this point, I don't have the humility to stay and watch anymore. He understood the situation. I left.

In speaking with my attending about the situation later, he explained that allowing me to assist is not necessarily illegal, but is borderline, and he believes that there was some concern about litigation. Still. It stung.

Fin de semana #4 - R&R vs R&B

2010-03-07T17:52:00.000-08:00

I had planned to stay in Huancayo anyway, but when fever struck Thursday night, thoughts of fleeing the city for the weekend vanished. I was bummed to call in sick on Friday because a pancreas specialist was visiting for the weekend, events to include a dinner on Friday, rounds on Saturday and some teaching on the subject. So instead, I spent Friday sleeping/watching movies/sleeping and trying to pretend like I wasn't there. My host family finally discovered me late in the day and did their best to coddle me, which I resisted only half-heartedly.

Saturday saw much improvement and having reassured myself that I didn't have anything scary like TB or malaria, I headed over to my attending's house for lunch... or so I thought. As it turns out, he's somewhat of a gourmet and I arrived to find pork glazed in honey smoking in a homemade contraption in the back yard. His house is beautiful, with a garden in front and back with all kinds of interesting, edible plants that I can't begin to remember the names of.

However, for him, being at home on Saturday does not necessarily mean not working. Across his back lawn is the back entrance to a clinic that he shares with his wife, a dermatologist. Throughout the afternoon, patients would drop by for appointments or check-ups and he would duck out for a few minutes. Later in the day, he told me to come with him and we wound up in a private clinic doing a hernia operation on Saturday afternoon.

As I was watching, it gave me room for pause. My ideal career consists of working really hard some times and playing really hard at others, hopefully helping people along the way. His life is nigh consumed by surgery and patients, even in his free time. When I questioned how he manages this, he replied that he does what is necessary to support his family both here and in Cuba. It was quite sobering.

Saturday evening, I headed over to a gathering of a bunch of expats at the house of my friends from the jungle trip. It was a great night of hanging out, drinking wine (Romanian pinot?), eating lasagna made by my British rockstar friend (to be fair, he hasn't made it yet, but his music is fantastic) and hearing stories from all over the world. We had folks from France, Bermuda, England, Ireland, the U.S. and Peru all converging over dinner. Excellent.

Nighttime found us trying out a new discoteca, La Noche, which was a flop so we moved on to familiar haunts, a discoteca they frequent frequently and I'd been to once, Taj Mahal. In addition to a great night of dancing, later on, I was recruited to meet a couple of Peruvian gals with my British buddy. As is prone to happen, the girl I danced with asked why I was single, but when I started talking about my faith, instead of a blank stare, her eyes lit up. We ended up talking quite a bit and we have pretty similar stories and love for God.

Not that such coincidences are unheard of, but it is rare to meet some one in Peru that loves God but can still go out dancing and have a glass of wine or two. Anyway, it was super great to meet some one had a genuine love for God and was excited to talk about it! God must have known that my Monday was going to be really frustrating and I'd need some encouragement. More on that later.

Sunday I slept in and then headed back over to Dr. Montano's house for a lesson in making ceviche, a Peruvian delicacy. We hit up the market to buy supplies and that was an experience itself. He had fewer patients on Sunday and I slipped out a little early to spend time with the expat crowd. They'd had a barbeque that was winding down when I got there, but the music was winding up. I was treated to live performances by my British friend, the gal from Bermuda who sings some mean blues without accompaniment and the local on guitar and wooden flute, which is in a lot of Peruvian music.

I winded down the night with a walk to the central plaza. Snagged a burger and fries and sat down to eat and think and pray. Got accosted by a group of Peruvian gals on vacation who all wanted pictures with a gringo. Back to prayer & meditation. Reenergized. Back to the casa for a conference call with my college roommates over Skype to finish off the night and me.

The Daily Grind

2010-03-04T18:32:00.000-08:00

The alarm clock is set for 7 a.m. (which means I roll out of bed at about 7:20) and breakfast is waiting downstairs. The initial offerings included fruit, eggs and avocado, but the family I'm staying with has since realized that I really only eat a piece of bread and drink a cup of coffee (instant coffee, sugar, milk & hot water). If I'm feeling ravenous, I'll stack on some jelly or a piece of cheese. I'm out the door at 7:45 and walk less than a block to the main road through Tambo. Huancayo proper is actually a bit to the south of my place. It usually takes a couple minutes to spot a legit taxi looking for a fare. The price to the hospital is 3 soles, which equates to about a dollar.

Five minutes later I'm at the entrance to the hospital, greeting the security guards at the gate, walking through the courtyard and I head to my daily work. Since obtaining my white coat from Dr. Montano, none of the guards have really questioned my right to be there and give me confused looks when they ask my last name, but let me by.

Mondays, Wednesdays and Fridays I'm in the OR all day with the general surgeons. Occasionally I'll check out other surgeries. This week I stepped in on an emergency GYN surgery for a ruptured ectopic pregnancy (lots of internal bleeding) and a revision of a nasty tibia fracture. I don't do anything, just watch. Wednesdays I scrub in with the pediatric surgeons and usually get to help out a bit. This week we removed a 10 pound ovarian tumor from a 13 year old. It was ugly.

I suppose it was the arrogant American in me that assumed I would walk in and get to operate or have a pretty active role in the OR, but there are usually two surgeons on all general surgeries and they work 12 hour days doing nothing but operating. I share 2nd assist duties with the interns here. On simple surgeries, I sometimes first assist and actually got to head up removing a fatty tumor from a guy this week. It has tested my patience to sit and watch surgeries that I've seen a lot of already, but I will be there soon enough.

Tuesdays and Thursdays I generally tag along for morning rounds with the surgeon of the day and the intern covering the surgery floor. After rounds I help with dressing changes, wound care and sometimes head down to the ER to hang out with a doc down there. Dr. Carlos is a medicine doc that is pretty proficient in English and enjoys the chance to practice, so I've been hanging out with him in the ER when he's on. I actually learn quite a bit of medical Spanish from him as well.

I'm usually out the door before 5 on non-OR days and today I came home for a nap, which wiped me out for the rest of the day. I walked downtown to see if I could catch a movie at the mall, but the one I wanted to see was in Spanish rather than in English with subtitles. Sometimes I just need a break from stumbling through Spanish.

So instead, I ate dinner at the mall food court and then headed to the central plaza/park and just hung out. This may sound kinda corny, but tonight was kind of a date with God. I haven't been doing so hot on spending time with Him lately and tonight was a great chance to just relax and enjoy the presence of my Creator.

This weekend is looking like it will be full even though I'm probably staying in Huancayo. I'm okay with that, especially considering that I have a potential grand adventure in the works...

Fin de semana #3 - Welcome to the Jungle

2010-03-02T14:25:00.000-08:00

La Merced was the destination. The group consisted of 3 girls I'd run into in a restaurant while out with the doctory type, a Huancayino and an English rockstar. The girls were from Maryland, N. Carolina and France/England and are here volunteering at an orphanage. After a quiet Friday night at home for me, we met up at the bus terminal on Saturday a.m. to commence our journey.

The rest of the crew was wiped out from dancing until 4:30 in the morning, but somehow managed to rally for an 8 a.m. bus ride. I was so proud. So we talked briefly before most of the crew passed out on the bus. I enjoyed the beautiful scenery between Huancayo and La Merced and tried to sleep when the turns got a little too twisty.

Upon arrival in La Merced, we snacked (a popular pastime with this group), they slept, I visited a local hospital and we embarked on a beautiful hike through the jungle to a waterfall. We made it back that night in time to eat and experience a small amount of the city life before tucking in for the night.

We arranged for a guided tour on Sunday, which I will admit I was not a huge fan of, but I was following the crowd. It turned out pretty great. We learned about local history, agriculture, native groups and such. We even visited an "authentic native village" where we were greeted with traditional clothing, a story, dancing and exotic animals. Afterward, we were expected to buy souvenirs and stuff, but I didn't. I did pay 50 cents to have my picture taken with an exotic rodent (pacarana) eating an ice cream though.

Finally, we got down to business and headed way out of town to hike up to another waterfall that was pretty spectacular. We went swimming despite the coolish temperatures and I got a great massage from the cascading water. I also managed to take a fall off a boulder that I was climbing, but our guide, Jesus (hey-SOOSE), was there to catch me and I wasn't hurt a bit. Anyone care to comment on this irony???

There was tons more that happened over the weekend, but it was little stuff, like getting yelled at about nutritional supplements on the bus, riding on the back of a moto taxi, trying to make animal-shaped balloons in the pub, countless jokes with new friends about American vs British culture, eating giant rodents, finding obscure bands in common with people from across the pond, driving through a river on a cliff and hoping the bus wouldn't slip and planning our next escapade. Believe me, it's in the works, and it very well may involve snacking.

Work, work

2010-02-26T15:32:00.000-08:00

After a weekend full of excitement, it's been a busy week in the hospital. I set a new record for number of surgeries in one day one Monday with 8, then subsequently one-upped myself on Wednesday with 9. These were no more than 12 hour shifts too, I might add.

It's a little different here than the states, needless to say, and I've found myself a little frustrated with some of the differences and a little relieved at some of the others. I've come across some interesting cases here including a fluke inhabiting the bile duct, a set of triplets today, a horrible necrotic reaction to an NSAID injection and a horrible case of necrotizing fasciitis following a hematoma caused by a fairly innocuous fall against a table. (my apologies to the non-medical folks)

I was expecting to be doing a little more hands-on work, but there are a good number of other students and residents around in this hospital. Occasionally I'll get to first-assist in a surgery, but there's a lot of watching, cutting sutures and retracting while some one else is doing the real work. All in good time I suppose. The other students are really nice and pleasant to work with. I usually take a little time to help them with dressing changes on the wards, but don't really have a whole lot to offer.

I spent Wednesday and Thursday with the pediatric surgeon and saw a few good cases. The most common stuff here in kids includes hernias, ankyloglossia, cryptorchidism and hydatid cysts from parasites. We operated on the former three and saw the latter a few times as a consult. It was a nice change of pace seeing kids in clinic. The pediatric surgeon gets teased for being not only a surgeon who operates on children, but a surgeon close to the size of his patients, but he takes it well and is overall a really great guy. One of the most important qualities for an attending is a willingness to teach and he excels at this.

I met up with an American kid last night whom I had met last weekend at the discoteca. I didn't know much about him, but it turns out he's a seriously committed Christian but has a much different path than mine. He had a pretty great story of coming to Christ and encouraged me in a lot of ways. We share a lot of similar beliefs and both have a desire/calling to do our small part to bring a little more love into the world, particularly the developing world. It was kind of funny because earlier in the day I had spoken with a good friend who mentioned he was praying that I would find community.

I'm currently waiting for a call from a group of expats who are here volunteering at an orphanage. We're planning to probably go out dancing tonight and then head out to the jungle town of San Ramon for the weekend. More on the later.

Fin de semana #2 - Huancayo & Inginio

2010-02-22T19:07:00.000-08:00

After 4 days back at work, it was time for a little R&R. My friend Mario came in from Lima (as a reminder, a Peruvian neurologist I met in Seattle) and we decided to hit the town. We met up with two Peruvian gals, the daughter of my landlord and her cousin and commenced with the revelry. This included karaoke (I bust out a mean Bon Jovi), live music and dancing until the wee hours of the morning. Come to find out, the cousin is actually a dance instructor! Major bonus... not to mention that she was "Miss Huancayo" for two years running. Some ridiculous luck I have.

We managed to get up in time to finish breakfast by noon at Mario's family's restaurant a few miles from my place. Restaurant may be a slight misnomer as it's more of an outdoor cafe, but the food was great if not your typical breakfast: sopa verde and cau cau (a kind of potato soup and a dish with cow stomach, potatoes and rice). That afternoon we had a nice walk around his old neighborhood, made friends with a little girl who showed us how to get past the gate down the river and generally goofed around along the Rio Mantaro. Later that day I fell asleep on the riverbank of another river close to town where people were bringing in a huge carrot harvest. We closed out Saturday by heading to La Cabana for dinner and internet.

Sunday was amazing. Mario and I had heard about a good place to visit in the mountains on Saturday from a guy by the river, so we headed out to see if we could find "Arco Iris." We took a shared-ride taxi out to Juaja (hoo-huh) and then hired a taxi to take us to a little more remote area. We ended up outside Inginio, a fairly touristy spot for expats and locals alike. Green mountains, a clear stream and lots of parks tucked in the valley. We arrived next to a park with a family playing volleyball and asked if we could join. They ended up inviting us for lunch too: pan-fried truche (true-cha) with red chili fired in a pan over a camp fire. IT WAS DELICIOUS. Supposedly truche is a small, imported salmon, but whatever it is, it was amazing. The family was celebrating one of the girls' birthdays, so Mario and I made sure to sing Happy Birthday in English. Her little brother was hilarious, a 3 year old named "Peidrito." We also took a few moments for a hike up a valley before being turned back by the approaching rain.

Instead of paying our way back to Huancayo, we snagged a ride with the family and treated them to ice cream from a local creamery (fresh milk!) on the way home. Back in Huancayo, we got caught in a "chaperon," a fierce, but brief, downpour. As it broke, we left our shelter on the side of the street and passed through the Sunday market. I snagged an alpaca sweater for 10 bucks... not bad, not bad.

We rounded out the day with a church service with Mario's mom followed by another trip to La Cabana for good food, wine and an incredibly uplifting conversation with Mario's mom. She exudes a sense of warmth and joy and was able to speak some really powerful truth to me about trusting in God and how ridiculous it is to doubt Him.

After this weekend, I can't say a word to disagree with her.

A lost stethoscope saves the day!

2010-02-18T16:48:00.000-08:00

Not that today was bad, it was pretty enjoyable actually, but there were no surgeries scheduled and I spent most of the day seeing post-op patients with one of the other surgeons and hanging out with people... not a lot going on. I was about to head out early for the day when I realized I had left my stethoscope in the locker room the day before. I went to the OR locker room, and it was nowhere to be seen.

Now losing a stethoscope shouldn't be that big a deal, except that mine was given to me the summer before med school by my cousin who is a pediatrician and taught me during my 3rd year. It has sentimental value. And it's a nice stethoscope.

So I inquired to multiple people including surgeons, cleaners and nurses and finally they told me to talk to the chief of surgery. Within a minute or two, he had one of the cleaners bring it from the lost and found, a huge relief. I thanked the surgeon who referred me to the chief and as we were talking, he asked if I was busy. Well, not really, no. I was about to go home actually. He invited me into watch a pediatric surgery and I hastily accepted.

It was a 13 year old girl with fluid in her chest from tuberculosis. I ended up as the first assistant rather than a spectator and actually got to help quite a bit. They even let me help close. I tried pretty hard to skin the skin closure done well as this girl will have a pretty sizable scar on her back/side for the rest of her life. It was pretty sad to see someone so young so sick, but the nice thing about kids is they get better pretty fast.

On another note, I was praying about residency last night, wanting to make the best choice and was asking for wisdom. The idea to read Jeremiah 27, which I don't really know much about, popped into my head and so I did. It discusses the Israelites being sent away from their home, the places they loved and the land they were connected to, to live in Babylon. For them, it was a strange foreign city and they had set their hope on an imminent return. However, Jeremiah told them to invest in that city and work for its good, that their fates were tied to the city they were sent to and that they could prosper there, even away from home, if they chose.

I thought it a pretty awesome answer to prayer. Not that I'm 100% sure of where I'll end up (I think I know), but that God is working to bless wherever I go for residency and I can choose to be a part of that.

A new rotation begins

2010-02-17T17:39:00.000-08:00

For the non-medical students in the audience, clinical rotations go something like this: Enter a new place with new people and new systems, awkwardly stumble through the first week, gradually gain more grace and feel like your at the top of your game and actually learning medicine by about week 3-4. Rinse, wash, repeat every 4-6 weeks.

So, here I go again, except this rendition has a twist, as it's in a foreign language. Que bueno.

I met Dr. Montano outside my humble abode at 8 in the morning and he ferried me to the hospital where I proceeded to sit and watch for the rest of the day. Actually, it wasn't that bad, but he did tell me I'd have to watch for a while.

-WARNING, DORKINESS FOLLOWS, IF NOT MEDICALLY INCLINED, FEEL FREE TO SKIP-

Such cool consults to start the day: a lady with sepsis who needed a laparotomy, classic appendicitis and cholecystitis (positive Murphey's sign and McBurney's point with Rovsing's sign and rebound) and to top it off, a strangulated hernia. Neato mosquito. Of course, my attending did all of these surgeries with another doctor while I watched, but he did all of them OPEN, which I never see in the U.S. So cool. I actually skipped the hernia repair to do a couple chest tubes on the medicine ward (I butchered both of them, but got the job done). Super great first day, medically speaking.

-DORKINESS ENDS, KIND OF-

My attending is a classic surgeon. Serious and professional when necessary, a little crude and hilarious when in the right atmosphere. I wish that I could understand Spanish a little better because he is quite entertaining from the little that I do gather. He is also a great teacher and will take time to explain things to me that he deems important, as slow as the process is with my comprehension. One thing that stuck with me from my first day was his interest in the etymology (Sp?) of the word for surgery. It comes from a Greek word for hands, which translates to doing something with your hands. I didn't quite get the finer points of his monologue, but I got a sense that he feels a great deal of respect for work with the hands.

After work I met up with Mario and hit up La Cabaña, the author's recommendation in Lonely Planet - Peru. Great food, great music, great atmosphere. We had a great conversation and enjoyed telling stories and laughing, alternating in English and Spanish. The tone become more serious as he told me of the sudden, unexplained death of his 18 year old brother. I want to respect his privacy and won't go into detail, but it was an emotional conversation for both of us. It made me realize how much I have and how grateful I should be to have such a wonderful family and group of friends. I truly love all of you more than I express, or can express.

As a kind of preview, I am gathering a list of things that I find amusing or odd about Peruvian culture which I will publish at a later date. Stay tuned!

And because I'm not sure if I'll write about it later, I spent today with an anesthesiologist (a Christian) and went 1 for 3 on intubations. He and a couple other surgeons took me out for a steak dinner tonight which was AMAZING. Three bottles of wine later, we were all friends and I was invited to spend the weekend with one of the surgeons maybe doing a little fishing (I had to decline numerous attempts to refill my glass - moderation my friends, moderation). We'll see. I also ran into a few expats at dinner who I will try to meet up with later. Good times in Peru!! Peace!

Huancayo

2010-02-16T19:35:00.000-08:00

Before diving into my first day at the hospital, I have to reflect briefly on my trip to San Andres with Mario, Guillermo, Claudia and Dr. Montano (the sister of the surgeon I am working with). Talk about accomplished! She has worn more hats than that one guy in the children´s book that wore a lot of hats, including being the Minister of Health and the director of the Peruvian police. To boot, she owns one rockin´ house in a remote oasis, about 2 hours south of Lima.

We piled into her car and commenced a weekend of eating homemade pizza, steaks, chorizo and whatever else we could get our hands on, lazing around the pool, playing games and checking out the local trees and horses. Suffice it to say, it was wonderful.

After being thoroughly burned despite prodigious application of sunscreen, we left and almost immediately hopped a midnight bus to Huancayo. It was a luxury cruiser of a bus, definitely no chickens attached. I slept for most of the 7 hour ride and only woke to see the bus going further and further up, peaking at over 16,000 feet before descending into the San Mandero valley and Huancayo.

We headed to my host home which I´ll write about later to rest briefly before hitting the hospital. We were treated to a circus of an entrance, having to traverse the outside of the hospital several times before ending up where we started and meeting the hospital director. I won´t emphasize this a lot, but I could if I wanted to: the man can talk.

I´m getting kicked out of the internet cafe, so I´ll finish this later... Peace!

First days

2010-02-13T08:06:00.000-08:00

One of my longtime goals has been to dance like a Latino. Now, genetically speaking, I have some built-in limitations that I have been furiously working to overcome the last 3 nights. Miraflores is a upscale district in Lima that has an alley called La Calle de los Pizzas (Pizza Street) where the Pizza isn't so great according to Mario. The dancing, on the other hand, is superb. It is the young Peruano (Peruvian) crowd and music ranging from salsa to electronic to meringue, reggaton, cumbia, musica negra and 80s ballads. They even mixed in a little "Greased Lightning" last night.

It is typical to hago horas (hang out) in Pisco bars before hitting the clubs. Pisco is a grape-based liquor that is popular in Peru and is pretty similar to vodka. Mario has lots of friends and it's been great to pick up some Spanish and then proceed to work on my dances moves until late into the night. We also went to a district called Barranca which Mario and company frequent. We spent part of a night in a classy pub there listening to a live singer and his guitar.

Yesterday, I met up with Helanie, a friend from Alaska that I had met in Portland. She is here working with orphans that she supports year-round but only can visit occasionally. Her main mission this trip was to find her "Lost Girl," who had run away from the orphanage to check on her family and had been sexually abused on the road. She found her at a detention center and said the meeting was incredibly emotional, a more tragic version of the story of the prodigal son is what I pictured. The reunion was nothing if not filled with mutual love.

Today (Saturday), Mario and I are going to help Helanie's group feed orphans and then get ready to go to San Andres for a party on Sunday. Mario's attending/boss, a preeminent neurologist and former Minister of Health in Peru has invited him and the other residents to her house there as kind of a retreat. I finagled an invitation and it should be a good time.

She also took us on a tour of his hospital a couple days ago. It is 310 years old officially and began with a miracle known as the "Pobre Cristo." The story goes that a priest stopped to help a beggar at this location, a former trash heap, and the beggar turned out to be Christ, who admonished the priest to care for others like he had cared for him. So they started a combination convent/hospital in the 1600s. Pretty cool stuff. Also, it was a great honor to learn this from such an important woman. The hospital has an entire room full of human brains with different disease processes visible which was pretty creepy but impressive all the same. Apparently it wasn't illegal to return a body to the family missing a few important, but non-visible pieces back in the day. (my apologies to the feint-of-stomach)

All that is not to mention walking on the beach, seeing cathedrals, palaces and other important buildings, hanging out with Mario's dad, eating good food, going for long walks through the city in search of electronics and taking taxis and buses all over the place. It has been a very full 3 days.

I also started my residency match list today. If you're the praying type, I could definitely use a little help there. Love you all!

On to Peru!!

2010-02-10T08:40:00.000-08:00

By way of introduction, this blog is now serving as the official receptacle for all thoughts and ponderings of my voyage to Peru for the purpose of learning general surgery from a physician in Huancayo, Peru. Huancayo is a town of about 300,000 at 10,700 feet in the Andes Mountains east of Lima. I arrived here in Lima last night.

After an uneventful flight and passage through customs,
(How long will you stay? -47 days.- *stamp* Welcome to Peru. -Gracias.-)
(I'm not sure if I was supposed to get my luggage searched, but no one stopped me)
I was greeted by Omar, a friendly taxi driver who has somehow arranged to pick up all the medical students that visit Lima through my contact here. We had a great conversation, by which I mean I spoke slowly and awkwardly and he filled in the gaps, and took a drive down the coast to Hostale Pukara.

It looks like most of the houses here, but had a lobby, warm shower, clean beds, free internet and complimentary breakfast. After partaking in all three, I am now sitting in said lobby awaiting my friend Mario who I met on my neurology rotation at Harborview. He is (thanks God!) from Huancayo and is vacationing from neurology residency. I think we may travel together this week.

So I'm excited, getting back into international travel mode and ready to take on all that God has to offer here in Peru (hoping for a little less adventure than my last trip). I should be writing quite a bit more frequently now, so stay tuned! Love all you guys!

(also, check out my last post, as I just put that one up this morning too. I'll try to take a break and reflect on the interview trail at some point here too.)

Is there a doctor on board?

2010-01-10T20:41:00.000-08:00

So this is my first post from Peru, but I actually had a blog that I didn't finish that I'm going to post first as it seems fitting.

Flying back from Alaska after Thanksgiving break, I was enjoying some solo time on board the airplane. Flying for me is not hours wasted in boredom, but a beautiful reprieve from duty, conversation and the pursuit of recreation, all good things, but all good things to take a break from as well.

Shattering my solace and simultaneously revving up and relocating my heart to somewhere around my stomach, a voice came on the PA: "Is there a doctor on board? One of our passengers at the front of the aircraft is unconscious and needs assistance." Banish the thoughts of heroics that you see on TV and now imagine a medieval page training with a wooden sword and shield being sent off to face the dragon.

Naturally, I instinctively ducked my head, peering around the seat to see... no one in the aisle. I braced myself for a few seconds, praying that I was not the most qualified person on board and then unbuckled and started to walk up the aisle.

"Are you a doctor?" the flight attendant inquired, fittingly so as I was in "Alaska mode," a.k.a. unshaven and in comfortable clothes.

"No, but I am a 4th year medical student," I replied. I'm not sure how I missed it, perhaps the whole hiding incident, but she pointed out to me that a REAL doctor was already with the would-be patient. At this point I was committed, however, and still crept up to peer over his shoulder. All I could see of the patient was an arm, which was moving in a very non-seizuresque fashion. My ABCs ran through my head (Airway, Breathing and Circulation) and I realized that if any of those were missing, that arm would not be moving. Whew.

I offered my assistance to the doctor, who tacitly ignored me. I returned to my seat relieved. I may not have saved the day, but I DID later score a free cheeseburger from the grateful flight attendant.

(The patient turned out okay too)

Healing

2009-11-06T16:22:00.001-08:00

Late summer in Alaska means that it starts getting dark-ish and the air cools off substantially in the evenings. That's why I was shivering as my friend and I prayed together down by the Kenai River that night in 2006. I was getting ready to start medical school and he was blessing me before I started. Now before I go on, realize that I had spent months and years leading up to a fairly new-to-me belief in the supernatural, stemming from examples of regular people doing incredible things through the name of Christ all throughout history even up to some events that summer that I had seen for myself. I know it's a stretch for those that don't believe in miracles, but I was preparing myself for a lifetime of seeing and being a part of the divine and miraculous.

My friend had the gift of seeing and speaking truth, so when he told me that night that I would not have the gift of healing, I was more than a bit disappointed. However, he quickly added that spiritual healing would be mine to share with those around me. What that meant at the time, I didn't really know. As I have come to understand medicine, however, it makes sense. Doctors really just remove obstacles so that the body can heal itself. The actual healing takes place over hours to days to months to years as the slow, intricate process restores normality. Spiritual healing, on the other hand, is both an active and passive process involving confrontation of lies believed, encouragement of truth known deeply and faith in the redeemability of any circumstance.

Today was a day I recommitted to experiencing Christ in my life. Something I've done somewhere between 100 and 10,000 times, probably closer to 10,000. Seems I can't ever stay on track, but I keep going for it anyway... So when I saw my patient's husband reading her the Bible this morning, I offered to pray with them. As I said, "Amen," he looked at me and said something to the effect of the following:

"You are an answer to prayer. We have people all over the country praying for her," and went on to describe miraculous healing that he had been a part of and continued, "God wants to use your hands to heal people, but more than that, he wants to use you for spiritual healing. He wants to pour out these things through you if you are willing and have the boldness to follow."

He didn't know my story. He didn't know that I would be using my hands in surgery or that years ago, my friend had spoken very similar words to me. I ascribe glory to God for looking at me and seeing that even with my tendency to veer off in all kinds of directions, He would make use of such a broken and fallible tool.

To top things off, just last Sunday I had whispered a prayer that I almost had forgotten, "God, please send some one to show me that I am still walking your path."

P.S. I apologize to those of you who didn't know I put faith in such weird stuff. You don't know because I'm scared to share some of the things I believe in, but this is me and I'm in love with God.

I love crazy people

2009-10-16T22:43:00.001-07:00

I have lots of good blog-worthy material saved up from my excellent moose hunting/camping trip to my Chicago-South Dakota-Texas roadtrip with Daniel to the emotional rollercoaster that is living in Seattle, but what inspires me tonight are the crazy people of Harborview.

It's been kind of rough working in the ER... long hours, difficult patients... a lot of unrewarding medicine interspersed with some really great chances to help people. So two nights ago I was hanging out in ED Green (read: the least sick patients in the ED) when somehow, a slew of crazy patients ended up in there all at once.

The most consistent of them wasn't actually crazy, but a teenager who had ingested a few too many 'shrooms and no matter how persistent we were, would not believe that he was still alive. I say consistent because every 3 seconds or so, he would loudly question: "AM I DEAD?!?!?!?" Which we answered in the negative the first few times, but after around number 50, we just let it go. Some one may have even tried convincing him that he WAS indeed dead, but that didn't pacify him either.

Next to him was a good old boy (if you've ever seen Strange Brew, think Dave Thomas's character) who just randomly shouted funny things. I can't remember most of them, but a lot of them made me laugh... none so much as a simply shouted, "ONE TIME! I SURVIVED FOR A WHOLE MONTH ON NOTHING BUT APPLE JUICE!" He was definitely my favorite because he was funny and completely harmless, and only piped up every so often.

And next to HIM, was a guy who was MAD. He stayed quiet mostly, but every once in a while he would get riled up and start cussing at anyone he could: the kid shouting about being dead, the pleasantly crazy guy next door, his nurse walking by, the doctors hanging around... And man, this guy could swear. He was practiced, no doubt and even had my ears burning a little.

The last guy was across the room from the others, but it didn't seem to bother him. He let loose with the eeriest, crazy laughter at the strangest times and would kind of mumble to himself and occasionally yell at nurses. But mostly, he contributed the creepy laugh. He actually was in the ED two nights in a row and was my patient the 2nd night... Pretty entertaining guy.

So it may not sound that funny from the outside, I dunno, maybe it does... but after working for 11 hours and having all 4 of them piping up at once:
Young Guy: "AM I DEAD??!! AM I F***ING DEAD?!?! SOME ONE ANSWER ME! AM I DEAD??"
Happy Guy: "Sometimes tomatoes are PURPLE!"
Mad Guy: "SHUT THE $%@!* UP YOU PIECE OF $%$#@ing *#%@!!!!"
Laughing Guy: "EEEEEEEEHAAHAHHHAHHAAHAAAA!!!!!"
Young Guy: "AM I DEAD?!?!!!"

You get the point. I couldn't fill out charts. I just sat there at my desk and laughed. Good ol' Harborview...

Duck hunting

2009-09-11T21:21:00.000-07:00

Just to catch up a bit, since May, I've finished 3rd year of med school, done two surgery rotations at the VA Hospital in Seattle, took a few weeks off and am now back in Seattle for my ER rotation.

My break started by going back home. My dad, 2 dogs and I flew across Cook Inlet in his plane for opening day of duck season. We started duck hunting over there together when I was in 5th or 6th grade so it was a pretty nostalgic trip. We stayed in a luxury duck shack complete with a stove, table, porch and separate room for bunk beds. Opening day found us swatting swarms of mosquitoes in the twilight hunkered down behind a pile of driftwood fashioned into a duck blind. There had been some ducks on the pond in front of us prior to shooting time that acted as live decoys to give those we'd put out a hint of authenticity.

It's hard to describe the following hours in a way to paint the taking of birds in a majestic light but there were picturesque moments, freeze frames where every contributing factor summed to etch an indelible snapshot in my mind. After a morning of birds flaring into our decoys, birds from the far side of the pond responding in curiosity to our calls and dogs finally realizing their inborn drive fulfilled, my dad and I decided to take a walk and jump shoot before heading back to the shack for breakfast.

We had already put down 14 out of a 16 bird limit and were both wanting to prolong the day, but still felt compelled to seek out those final 2. We walked through the grass and marsh without seeing much for a while, the dogs trotting along tired from a long morning. I spotted two heads peeking up among the tall grass and signaled to my dad their location. We crouched, crept forward quietly until in a burst of sound and motion, they rose into the air. A pause. Eyes tracking, guns rising, a moment of calculation. Simultaneous shots forming one loud BOOM and both birds fell synchronized from the sky. The dogs, Chipper and Darby, alerted to the action bolted to find the fallen ducks in the grass.

It was the perfect ending to a morning unparalleled in all the duck hunts I have been on. It wasn't so much the hunting as it was the plane parked in the blowing grass with the mountains stretched skyward in the background. It was the plate of chips and onions and cheese and chili the night before. It was walking through the tall grass in silence with my dad and the dogs and the occasional hawk riding the air currents. It was the moment of anticipation, of hearing the wings overhead and briefly tensing before reacting quickly.

It's hard to describe without having been there, but it was one of the ways I felt a reawakening during my time off. It was a chance to sit quietly and experience the fullness of the life that God has given me and be thankful.

Birthday(s) 2009

2009-09-11T21:19:00.000-07:00

It's always hard to come back after being gone for so long. The occasion this time is a 6 hour flight from Anchorage to Chicago. I didn't bring much to read and have had some time to reflect and eventually realized I could write without the distractions of the internet.

A couple days from June rise to the top when I think about blog-worthy events in my life lately. The first was my birthday. Prince of Wales Island is in Southeast Alaska, a large island home to around 5,000 people. I spent my birthday week out there with a family doc from Wrangell putting on clinics at various small towns. I awoke on my 27^th birthday in a vacation cabin overlooking a lake and spent some time in prayer preparing for the coming year and reflecting on the last. My doc wished me happy birthday and after a hearty breakfast of oatmeal, we headed to work at the Whale Pass library, which was hosting the day's clinic.

Most of the patients were of the run-of-the-mill primary care variety, but about midway through, we were informed that there was a man in the parking lot with a large laceration that would not come in for some reason. I went out and discovered that he was concerned about the cost. After looking at his injury and persuading him that he shouldn't let cost be a barrier, I found myself repairing the injury. I casually mentioned that it was quite an interesting thing to be doing on your birthday and he replied that he would be celebrating his the next day.

We closed up shop and headed out to Naukati for an afternoon clinic, finally ending up at Rosie's, a seaside restaurant in Craig, for a birthday dinner of halibut oscar. It had been an amazing day.

Except it wasn't my birthday. I was a day off. I had called my parents from the lone hill in Naukati where cell phones get reception, expecting birthday wishes, but as the conversation drifted on, I ended up asking, “Aren't you going to wish me happy birthday??” Oops. Fortunately I hadn't missed it, but would get to have my 27^th birthday... again.

I spent my actual birthday, June 4^th, in Koffman Cove and woke up on a church floor, not quite as picturesque. Clinic wasn't quite as interesting, but I had an excellent steak dinner with an older couple after paying them a house call. From their beach front, I watched whales spouting, played in the tide pools and reveled in the surrounding beauty with my God. Following dinner, we went for a hike through massive cypress trees to a waterfall and then a drive through the woods of Prince of Wales Island... a perfect end to my birthday(s).

A great weekend

2009-05-05T22:58:00.000-07:00

A post I wrote during my last weeks in Anchorage... from a weekend on the Kenai River.

Friday: My doc has come to trust me quite a bit in the OR. I think that bodes well for my hopeful future as a surgeon, but regardless, Friday morning found me holding the scalpel over two patients: one, a young woman with questionable health, the other, an infant who had yet to see the light of day. I cannot describe the sensation of the moment, but it intertwined the weight of responsibility afforded by breaching the natural surfaces of the human body with the light-hearted elation of being the first to experience fresh, new life. Some element of self-preservation resonated as well, akin to the feeling of clinging to a rock wall high above the ground with only my fingers and toes as purchase, although my life was not the one at stake. Upon throwing the last stitch, the tension resolved and I was left with a great sense of satisfaction and, admittedly, relief.

Later in the day found me working with laparoscopic instruments in the recesses of another patient, shaky, yet excited to be operating. Surgeries I may never perform even as a general surgeon, but within my grasp thanks to a trusting, confident and gracious physician.

Later still in the day found me at a charity walk and let me highlight to you the joy afforded by finding that your delicious chili has STEAK PIECES in it. And that your entry ticket also buys you unlimited chocolate-covered strawberries, cotton candy, sno cones, corn fritters and fabulous prizes. Top that off with downtown statue-climbing utilizing the jump-lock-pull method to ascend said statue and hanging out on the sun, watching the sunset followed by a top-floor oceanside deck hangout to watch the sunset AGAIN and you have the right combination for a fantastic Friday.

Saturday: 70 degrees. Drift boats floating down the upper Kenai River with my dad and a buddy. Moose roast sandwiches for lunch on a gravel bar and a long nap reclined on a log in the sunshine. A puppy finding satisfaction in a prize fishhead. A brown bear frolicking on the shore not 30 feet away. Revisiting a place of youthful memories and sitting on a mountainside with the Lord. A welcome reception at home with food only a mother could make. Walking on the beach and then finally resting peacefully.

Sunday: You can't beat waking up to homemade blueberry muffins made with berries you picked on a venture into the wild in search of a bull moose. Unless maybe you count spending time with your sister and nephews and parents and worshipping with numerous friends and church family. Then again, there's a lot to be said for a relaxing afternoon catching up on school work on a comfortable couch. The drive home was beautiful.

The weekend was beautiful.

Life choices

2009-04-21T16:12:00.000-07:00

I've lately been pondering the direction of my life. Mostly because I have to make some major decisions about it in the next few months. While I don't have any great wisdom or insight into what's making me do what I do, I have had a great deal of peace and reassurance lately.

I want to be a general surgeon, or maybe a pediatric surgeon. Or maybe a river rafting guide or a million other things (that's the subject for another post: wow I hate closing doors). But as I've struggled through giving up things that are exquisitely important to me: time spent with friends, time spent in the outdoors, living in the place that I love, I have come to a peaceful resolution. My life was never intended to be lived as a container for pleasure and self-indulgence. It was meant to be lived as a container to be filled with love and poured out on a hurting world. I'm rediscovering that trusting in God to provide a constant flow of love is the only way to keep that container full. When I try to fill it up, it's amazing how many holes start popping up.

On a similar note, I'm realizing my own inability to meet my goals. I set goals like: be a good friend to these 5 people, and subsequently ignore, put off and occasionally offend those 5 people. I set goals like: pour everything I have into doing well on my surgery rotation, and miss my lofty target by inches, but that's enough that the fall really hurts. I make goals like: get enough sleep and find myself awake at 11pm playing frisbee golf with my cousin in the twilight.

Maybe I should stop trying to set and achieve goals and live life in all its fullness right now, thanking God for the peace that rests in my heart when I realize I'm incompetent, but so loved. And there's no way I can mess things up bad enough to lose that.

So I'm going to keep struggling through my failures, as prideful and unrealistic as those failures may be, and be content to be just another messed-up guy walking with a God who redeems messed-up guys.

If - Rudyard Kipling

2009-04-21T16:02:00.000-07:00

If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too;
If you can wait and not be tired by waiting,
Or, being lied about, don't deal in lies,
Or, being hated, don't give way to hating,
And yet don't look too good, nor talk too wise;

If you can dream - and not make dreams your master;
If you can think - and not make thoughts your aim;
If you can meet with triumph and disaster
And treat those two imposters just the same;
If you can bear to hear the truth you've spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to broken,
And stoop and build 'em up with wornout tools;

If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breath a word about your loss;
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: "Hold on";

If you can talk with crowds and keep your virtue,
Or walk with kings - nor lose the common touch;
If neither foes nor loving friends can hurt you;
If all men count with you, but none too much;
If you can fill the unforgiving minute
With sixty seconds' worth of distance run -
Yours is the Earth and everything that's in it,
And - which is more - you'll be a Man my son!

Kotzebue

2009-02-05T21:29:00.001-08:00

Apparently, API flies students all over Alaska to experience mental health in a setting other than a big-city psych ward. I'd heard I was going somewhere "rural" during my psych rotation at Alaska Psychiatric Institute for a while, but when I told them I wanted to go to Kotzebue a few weeks ago, I didn't really know why. Still don't, but wow. Awesome experience there.

I found out, officially, that my trip to Kotzebue had been approved last Friday, and concomitantly heard that I would not be allowed to see any patients during my trip out there. What?! That's what I DO. That's my JOB: See patients and tell doctors about them. But it was too late to line something up somewhere else, so I resigned myself to several days of doing nothing in a really cold place. Here are some things I saw out there:

- Negative 81 degrees (windchill factor, I know, I know, doesn't totally count)

- A med-peds doctor from San Diego with cerebral palsy.
His disease basically incapacitates him physically. He can walk, albeit very awkwardly, and talk, loudly and awkwardly, and write, with childlike scrawl, but the amazing thing is that he's made it through medical school, residency and fellowship and practices a sub-specialty in Kotzebue, Alaska. Incredible guy and very inspiring and upbeat.

- The heart of rural medicine, Noorvik, Alaska.
A nurse practitioner from Anchorage. One clinic. 5 health aides. The things they did to keep the clinic running were back woods. The facilities minimal by modern standards, but they kept trucking along providing health care to around 5 villages ranging from 100 to 800 people each. It was more common to see a snowmobile or a 4 wheeler running up and down the streets than a car or truck. People walked around with "parkies" with fur trimming provided by a successful hunt by the guy across the street.

- Totally awesome chili pepper chicken.
Didn't expect to find great food in Kotzebue, but was pleasantly surprised. Holy smokes. If you ever get a chance to eat at the Empress, it's worth the trip AND the high prices.

- Revival and healing in rural Alaska.
Went to church Wednesday day night at "Friends Church" in Kotzebue. Inupiaq after Inupiaq got up to talk about the darkness they had come from and the great love for the Lord that they now have. The hope, the joy and the love that they expressed openly spoke volumes of the transformation they had experienced. I heard stories of abuse, addiction and suicide attempts from folks who had smiles lighting up their faces as they contrasted life without hope with life in Christ. I left that meeting after being prayed over and blessed by 3 Inupiaq elders in an awesome conclusion to my trip.

I Still Think About You Sometimes

2009-01-19T18:16:00.000-08:00

I'm not going to sit here and pretend like I've been blogging all along, but I am going to jump right back into what's now going on, which is what this is all about. I think my lack of blogging has actually been pretty reflective of my mindset this year.

So many good things to do. So little time. So much wasted time that could have been spent doing MORE good things. This is my life.

Adolescent psychiatry has offered me a rare insight into the minds of not just kids, but myself. I see in my patients many of my own thoughts, attitudes and desires amplified and mirrored back to me. It is always humbling to see a caricature of myself and realize it's probably closer to reality than is comfortable.

One of them thinks he has everything figured out. A young, athletic, good-looking guy who made some bad choices and ended up suffering the consequences. Rather than listening and taking the advice of those outside his situation though, he's just trying to plow through and make things work out the best he can. I feel for him, and really hope he makes it. He's still not making the best choices, but he has this air of confidence in himself and optimism that make you want to believe he's right. I'm not even making this up.

What am I learning from him? That I'm in the same spot. I've had my fair share of ups and probably fewer downs that I deserve, but the point here, I think, is that I would do well to heed the advice of those with an outside perspective, not quite so invested in my personal view of things. Anyway, kind of a tangent.

I probably won't post again for months, so if I don't, I've loved being back in Anchorage, have felt incredibly renewed since being here and am learning to walk by faith again. I believe that this will be a year of strength for me and am excited to embrace all that God has to offer in 2009. Peace.

A few words on medicine

2008-10-27T23:20:00.000-07:00

Needless to say, this last month or so has been an experience. Another step in a series of life-altering events that, when the dust clears, will leave me with my head spinning and the tools of a physician at the tips of my fingers. How does such a thing happen? I actually wasn't sure it would, or at least didn't see how. But things are becoming clearer... one patient at a time.

For all the books, lectures and clever mnemonics, nothing compares with a living, breathing, feeling illustration of disease. And while that may sound like a morbid perspective of a human life, it is the stark truth that there are many names that may fade from my memory, but processes of illness that are indelibly etched in my mind for having known the face bearing the disease.

Another morbid truth I have come to accept is that intimacy with death highlights certain people in my mind. I could spend days upon days getting to know a patient, but my recollection of them is now dim in comparison with the vividness of one known briefly who is no longer among us. A code called last night found me in a line of people waiting to be the next to pump a heart that had stopped beating. As I compressed his chest, I briefly closed my eyes to connect with our Father, the one who made and knows intimately both me and the dying man beneath me, asking for His protection over both of us. Moments later, a pulse returned on the monitors and the resuscitation continued. In short, success, at least temporarily.

I don't mean for this all to come across as dark, it's just that the most profound moments are the ones that leave a lasting impression. Overall I've had an absolute blast on this rotation. My team has been wonderful and I will miss them when I come back to Alaska. I have less than two weeks left now and intend to make the most of them. While I don't anticipate a future in internal medicine, what I am doing right now is a joy.

Refreshment

2008-09-23T12:14:00.000-07:00

I started this a while ago and never finished it, so now I'm finishing it.

After spending 10 days out on the Alaska Peninsula trying to gun down a moose or a caribou, I'm back in the civilized world counting down the days 'til I leave for Seattle to start my Internal Medicine rotation. I wasn't sure I would be able to say this with confidence when I reached this point, but after recent events, I'm ready to go back to work.

I think the reality of beginning a real profession was hard for me to adjust to at first and taking some time off allowed me to come to terms with the fact that my free time was becoming scarce as a rule. I'm actually pretty okay with the idea of not having a vacation for a while and buckling down to get some real learning done. A quick rundown of my 6 weeks of freedom:

Seattle: a few days to see friends, revisit some of my favorite places, do a little climbing and tie up a few loose ends before heading to Alaska. I quickly realized that hanging around Seattle with all my friends there busy with rotations would not be profitable.

Anchorage: (see: "Seattle" addend "and work and school" to "rotations") I also got to see some great live music courtesy of Marijke and Paul.

being back in both places was excellent, but it's not quite the same being there with nothing to do.

Kenai: Stacey needed some attention, so I spent several days in Kenai attending to her needs, several days basking in the glory of doing nothing and some time preparing for the hunting trips. It was great being back at church and seeing everyone. I heard some great truth that helped realign me with the fact that life isn't always about just basking in the love of God, but that there are times of that, and times where we endure and times where we must seek.

West Forelands: I grew up duck hunting with my dad, it was one of those father-son things that was really special for me. I hadn't been since possibly high school and possibly middle school, and getting back out on the duck flats was a high priority for my time in Alaska. My shooting wasn't what you would call stellar, but I managed to bring a few birds home. That wasn't really the point anyway, but if you've never had wild duck, you're missing out. It was a beautiful trip and an awesome time.

Alaska Peninsula: The big moose/caribou/black bear hunt. My dad has friends who live on Lake Clark in the middle of the Alaska Range and run a flight charter service. They picked us up and dropped us off on a lake out about 40-50 miles from the proposed Pebble Mine. It's rolling hills and spruce forests with willow thickets in the low places. Blueberries galore. Our hunt turned into a camping trip where we spent a good bit of time waiting out storms under shelter. We had steaks, burgers and blueberry pancakes to help us pass the time and I think I finished more novels that the previous 4 years combined. Despite not getting anything, it was great hanging out with my dad and brothers-in-law.

Port Alsworth: As we were unloading the float plane and preparing to hop the plane home, Glen Alsworth Jr. mentioned that if I had time, they could drop me off at a bear camp where they were picking up hunters and try to get a caribou. I jumped at the opportunity obviously and got to spend some great time in Port Alsworth, one of the most beautiful places in the world. The highlight was probably hanging out with the ground crew, an awesome group of 20-somethings who were tons of fun, but more importantly, really encouraged me in my faith and attitude toward God.

Alaska Peninsula: Two days of drenching rains, howling winds and rugged country. No trees out here. One of the ground crew guys, Micah, came out with me to do some small game hunting. Despite the weather, we got out and hiked quite a bit, but only glimpsed a caribou herd from across the valley. By the time we had stalked them and made it to where they had been, they were long gone. It was nice to see something though. I had a lot of time for reflection and prayer out there in the open country and started feeling more like myself than I had in a while. The morning the plane was coming, I got within 400 yards of a lone caribou, but we were on an open plain together and as soon as I began edging closer for a reasonable shot, he sensed danger and was long gone. They're usually not so skittish, but there had been wolves in the area.
Kenai/Anchorage: A few goodbyes and some more awesome truth from the home church and I was ready for Seattle. Truly ready.

I should probably write something

2008-08-25T16:52:00.000-07:00

Back in Alaska. In between rotations. Six weeks of pursuits designed to provide pleasure, good company and all that. As we would say in our progress notes for "interim history": no major events. Spent some good time with family, made some vehicle improvements, climbed a mountain, saw friends perform some killer music... good times.

You know, deep thoughts are nice and they have to be confronted at times, but sometimes, it's just pretty nice to enjoy life.

Two Rights Don't Make A Right

2008-08-06T20:39:00.000-07:00

I see my life as a series of seasons, each with its own themes, decorations, sounds and thoughts. Entering this season, I prayed that I would truly come to learn, understand and embrace humility. Now part of that is learning to look at myself in an honest light, thinking neither too highly or too lowly of me. In fact, I think it's more about learning to think of me less.

Learning humility takes on many forms, but in my case, it has involved realizing that my own talents and efforts are not always sufficient. Sometimes, no matter how hard I try and how well-equipped I may be, I fail. I think I tend to withhold effort in most of my endeavors so that I always have the mental excuse that I could have avoided failure "if I'd REALLY tried." Sad to say, I have discovered that I can REALLY try, and still come up short.

Along this road, I have begun to take joy in being content in my weakness. If I allowed myself reign to condemn and punish myself for every shortcoming, I would quickly become miserable, yet through failure, I am learning to base my joy in things other than strictly defined "success."

Part of being a third-year medical student is acquiring new skills and knowledge through experience. Clearly, some experiences present themselves frequently while others are more rare and difficult to obtain. It is normal to desire fairness and equality in the distribution of these experiences. In fact, many would say that they have the right to experience the same procedures as every other medical student, and if some one else gets to do something they don't, it is unfair and justifiably unjust.

And just as I'm experiencing this, the voice of God breaks through (in the form of a book called The Shack) and announces to me the ridiculosity of this concept we have of "rights."

We have essentially taken things that we should receive out of love and fashioned rules that we can collapse upon in the event that we are not loved. What a tragedy that such efforts have been made in the past to simply claim what should be freely given. Rights to freedom, rights to a voice, rights to peace. And yet these rules do not and cannot replace what was missing in the first place, instead imposing a rigid framework devoid of warmth with only a token nod affirming that yes, you probably should get this.

How bold and daring we may be should we willingly give up this frantic pursuit of love for ourselves, in both big and small ways, in exchange for the knowledge and security that we are loved already and that the one who loves us is already working for our good. Humility is choosing to stop demanding love and start accepting love on its own terms.

Defervescing

2008-07-19T21:51:00.000-07:00

Not only is defervescing one of my new favorite words, but it's actually pretty descriptive for my life right now. Since my last post, things have settled down a little here in Pocatello. I'm starting to catch on to the rotation and getting more comfortable operating as a 3rd year medical student. I still screw up on a daily basis, you know, the kinda thing where as soon as you open your mouth, you realize the words coming out of it don't actually make sense. But all in all, things are feeling just a little less feverish.

I'm a little more settled into a routine and getting used to 6-7 hours of sleep. This was a slower week, which wasn't great for learning, but allowed me a chance to get my feet back under me after a long run of not being really settled. Hey, I even went rock climbing!

In the neonatal intensive care unit (NICU), we have a status for babies who are in the clear and developing as they should be. They're called "Feeder/Growers" and that's a good thing. It means all their systems are working right, and the only thing they have to do is keep eating, digesting and storing away energy as they develop. Yep, that sounds familiar. Lovin' it.

Laying Down My Life

2008-07-12T12:55:00.000-07:00

On the receding end of one of the most intense weeks of my life, I, needless to say, have a few things I've been thinking that I'd like to get into words. The last few months have felt a little like sitting in a sauna where some one kept turning the heat up a little bit at a time, culminating with taking boards.

Hitting the hospital/clinic this week was my analogous experience to jumping into a huge pile of snow after sweating in the sauna for a few hours.

It was exhilarating. It was unexpected. It was really freakin' hard. I kind of want to do it again.

I'm not much of a morning person, but we start our day around 7, which might not sound THAT early, but it is. I actually got up at 5:30am one day this week for the first time that didn't involve fun in I don't know how long. I'm used to getting lots of sleep and on my 2 call days this week I didn't get home from work until 11 or 12. You do the math. I actually did pretty okay with the sleepiness cause everything was new and exciting and REAL.

Talking about patients specifically is not ok, but I do want to share a cross-section of the kind of stuff I'm seeing. I'm working on a pediatrics rotation, so none of the patients I've seen have been 18 or older, so it's little kids and young teens I've been seeing. I've seen cases of possible pregnant teens having to weigh the moral consequences of the morning-after pill against the possibility of having a child before graduating high school. I've seen children hearing that they have a life-threatening illness and won't get to be normal kids for years to come. I've seen brand new babies with life-threatening illness that I can't confidently say whether they still live as I write this.

There's more, but it's hard to share without giving too many details. As I finally caught my breath this weekend, I started to ask myself the natural questions, like "What am I doing?" "Am I even competent to do this?" "Do I really want to spend the majority of my life indoors?" "Do I really want to live like this?"

The answer came to me on my knees in the shower this morning. As I contrasted the life that I could pursue of adventure, recreation, travel and self-indulgence with a life of a physician, I realized that the one is focused on self, while the latter is focused on others. When I was called to this profession, it was not because it would bring me fulfillment, but because it would ease the suffering of others. And through that, I would find fulfillment and peace with God.

We studied the story of the rich young ruler (Matthew 19) on a Wednesday night when I was home in Kenai. He asked what he must do to be perfect and Jesus told him to sell everything and give to the poor. While we can never life up to perfection, walking with God involves taking steps toward him, and at this point in my life, I've realized that laying down myself and trusting God is the step. I'm not doing this because it makes the most sense or because I think right now it will make my life the easiest. But I know without a doubt that I will be burdened in this life and the burden that I am going to choose will be the light one that Christ offers rather than the unbearable weight of attempting to hang on to my life and wring the last drops of joy out of every experience. I will be content in what is before me and be full because I am allowing God to fill me by walking with Him rather than attempting to forge my own road.

When I truly submit to Him, there is no room for jealousy or cynicism or regret and all the room in the world for love and joy.

Friday night found me at my cousin's house in Blackfoot, a 30 minute drive from Pocatello, watching Pierce Pettis soulfully hypnotize the audience and myself with songs of honesty as he and his guitar spoke the truth about what they have seen and heard in this life. It was one of those moments that transcends our daily experience and reminds us of those other connected times that dance on the periphery of our memory waiting to be recalled. For me, those times have been centered on and surrounded by and saturated with the presence of God and reflecting His glory back to Him with the knowledge that you are exactly in the right place, doing exactly what you've always known you were meant for. So now, I can't wait for Monday.

Independence

2008-07-04T10:37:00.001-07:00

Quite fitting that on July 4th, I finally feel like I am yet again independent... kind of.

Quick summary of what my last month has consisted of:

Early June: cramming parts together in some semblance of a vegetable oil burning conversion for Stacey, trying to pack up, get everything NOT being packed disposed of and trying to be a decent human being at the same time.

Less-early June: leaving a few things behind, JR and I jumped in Stacey and began the trek through Canada to the homeland. The link is JR's account of the adventure w/pictures.

Junish: There were rumors of my presence in Anchorage and Girdwood for a few days, then I disappeared from society for two weeks. Some surmise that I was inventing a toaster oven that never burns toast, but in reality I was cramming information into my head at alarming rates. I took a brief break when I realized that my graduating class had reinvaded Kenai for the weekend:

Early July: D-Day. Both the day of Step 1 of the United States Medical Licensing Exam and the 1 year anniversay of Daniel getting shot in Ecuador. A wry irony. The next day, I packed my bag in Kenai, tied up a few loose ends and headed out for Seattle and Idaho.

I'm now in Seattle, finally relaxing. Ahhhhh.

Being back in Alaska was AWESOME. And I love it a ton. I always forget how great it is being there until I get back. No place like it.

Since being alone and back home, I've been doing a lot of remembering. Remembering who I am, who I have been and who I've wanted to grow into. It involved some checking in with myself to see if I'm living up to the man that I was hoping to be at this point. In some ways, yes, in some ways, no. I believe that God is steering me down the right paths right now and that His grace is enough to get me through the rough patches. I felt his presense with me strongly taking my giant test and was reminded that the only thing keeping me from that assurance all the time is my own attentiveness. So I'm ready to enter the wards of 3rd year with full confidence in the God who has brough me this far. He has been faithful and kept His promises and I LOVE Him for it.

Before signing off, I would be no kind of uncle if I didn't show off a couple pictures of my NEW NEPHEWS!!! I present to you: Carson Richard Hawes

and Jeffrey Dane Hultberg:
They're WAY cuter in real life, but these were the only shots I had handy. I am incredibly blessed.

Catching up: A Birthday Extravaganza

2008-06-09T10:10:00.000-07:00

I'm sitting in a hotel room in Fort Nelson, Canada and have no restraints on my time right now because Stacey is across the street waiting to get her exhaust leak fixed. Ahh, the joys of owning an old vehicle. At least the ride from here on out should be quieter. I've been meaning to write about my birthday since... my birthday... because it was awesome.

I woke up to a soft knock followed by a soft voice and a slow opening of my bedroom door. Attached to that knock was a hand now carrying a tray full of morning goodness. Scrambled eggs with onions, bacon, fresh tomato and avocado cut over the top, sourdough french toast with real maple syrup, bacon and a whole grapefruit just for me. A quiet happy birthday singing greeted me, some couple-y words and I was left to eat my breakfast in bed. Truly royal treatment. Apparently, it's tradition in her family's household that the birthday recipient gets mandatory breakfast in bed. That's a good tradition.

So I got to spend part of my morning with an amazing girl, a treat in and of itself. She took off about her day and I got down to business. I had a mission. Stacey waited patiently in the driveway and I set to her with a fury known to few men, those who undertake working on their own vehicles in a time crunch. By lunchtime, I was ready for a break, and was pleasantly picked up by my friend Teja. She brought me over to Sage Cottage, a home I have come to dearly love, where Xavi awaited me with an amazing chocolate cake baked with Fair Trade chocolate. Sarah Reed, I salute you and simultaneously get flying-hugged (I owe you one or six for the cake).

They graciously took me by the auto parts store as I was rideless before going to lunch at Nana's and getting some more deliciousness in the form of grilled sandwiches (we ate cake before lunch cause it was MY BIRTHDAY). They dropped me off and I was back at it, with plans to look nice and meet up with the Alaska crew by 7pm. Well, 7pm rolled around and I was still grubbing around in the car with Greta looking exceptionally cute and ready to go. I ran inside, scrubbed up real quick and made it out to Chandler's Crabshack on Lake Union just late enough to be annoying, but not so late that everyone left. We had a spectacular dinner overlooking Lake Union as the sun was going down. The windows in the room opened up the whole view to me from my seat. I again got my hands grubby, but this time breaking apart crab and mussels and all kinds of good things. Dinner was great and the company was better. Capped off with a glass of Cote du Rhone syrah and a chocolatey, gooey birthday cake.

We made a final stop at the Duchess to grab after-party drinks and meet up with a couple more friends... and have cake one more time. What a day. Driving home, I couldn't remember a better birthday... everything that I had wanted and more. Good friends, good food and time for doing exactly what I wanted to. Thank you, God, for an amazing birthday.

Exploding Little Men

2008-05-15T10:18:00.000-07:00

There's a little man in our backyard right now, and I'm a little worried that he's going to blow up any minute now. This isn't some kind of euphemism or anything like that. He's mowing our yard. And I have two open gas tanks sitting back there.

I don't really know where he came from or WHY he's mowing our yard in particular... maybe he works for the realtor? He's wearing one of those bucket hats that were all so popular in late middle school/early high school. I kind of wonder how he got to be where he is and all that, but I'm mostly just concerned that he doesn't blow up. I also recently (aka this morning before he started mowing back there) dumped gasoline on some weeds to kill them. Just thought I'd share.

Back to studying/working on Stacey.

Hurdles

2008-05-12T10:11:00.000-07:00

Just finished my OCP... that's Oral Case Presentation to the layman. I'm sitting in an art-deco meets preschool 5th floor lounge set aside for the few, the proud, the classroom-bound medical students. I should be reworking my pharm cases, but I wanted to blog.

Hurdles. Hurdles define this year for me. I only actually tried running hurdles once or twice in middle school, but from what I remember, it goes something like this:

1. start running as fast as you can
2. realized there is a big metal thing in your way
3. awkwardly jump over it and try not to wipe out on the landing
4. realize you're still alive, upright and still propelling forward
5. repeat

As much as anyone enjoys running hurdles, everyone has a breaking point where they wear out. You have to stop, catch your breath, reflect, refresh and possibly regurgitate, before starting the next race. I mostly have felt this year that I was in the middle of the race: sprint, leap, land, repeat without much of a chance to catch my breath. Some of the hurdles were great: Spring Break skiing, a plethora of live musical performances, dinner with friends, parties, church... all good things... still hurdles.

I cherish the moments when I can lose myself in the moment and embrace the vigor of the race as lively and intense. Hanging from a rock wall, exploding a pocket of powder, absorbing full auditory and visual stimulation, savoring an exquisite taste... Flashes of full engagement. But even more do I enjoy the moments when I can look the next hurdle in the face with nonsensical peace and calmly engage in this path that has been chosen. I lost that feeling for a while this year, but was then reminded of the incredible power I have when I fall to the ground with my hands lifted up to my most gracious Father. Thank you.

The Gospel of the Birdcall of 9

2008-05-02T13:38:00.000-07:00

Let me introduce this post in the most appropriate of post-introducing ways:

KA-REEEEER!!!!!

If you have no idea what that means, I'm sorry, for I feel that I have failed both you and those who have gone before me in the way of the Gospel of the Birdcall of 9. Please forgive me. For those who know EXACTLY what that means and all that it entails, I beg your forgiveness as well, for I have forgotten my past and that which has molded me.

I was riding my bike along the Burke-Gilman trail as I was on my way to class this morning. I spied, on the other side of Sand Point Way, a parallel friend strolling on her way to class. I wanted to get her attention and simultaneously tell her that I appreciated her as a friend and that seeing her makes me happy. The noise of the cars on the road, the fleeting nature of the moment and my own hesitation prevented the interaction, thus nipping in the bud the joy that could have been added to the day.

And that's when I remembered. I remembered how life used to be.

Flash back to Texas. It's a beautiful day, the sun is shining, the college students are swarming out of Chapel. And all of a sudden, it comes cracking through the din like a bolt slung by Thor: KA-REEER!!! and you turn, ka-reering in return, before your eyes even make contact, and then they do, and you smile, laugh and go on your way if you're busy, or perhaps stroll over and share the latest on the way to the Bean (school cafeteria).

Coming to a new place, leaving behind friends near and dear, the Way of the Birdcall has faded. But today, today I made a new commitment to share with others the Gospel of the Way of the Birdcall. I've told others of the joy of the Birdcall, I've convinced them of its beauty and authenticity at times. At other times, they've merely blown me off, not believing that something so noble could exist, or perhaps twisting the message in their minds and dismissing it as something childish and irrelevant in today's culture.

No longer will I settle for merely speaking of the Birdcall. No longer will I withhold a due birdcall in shame. I must show others the joy of living with the Birdcall. So today, as I crossed over the pedestrian overpass and looked up the street to see the picketers blowing their whistles and waving their signs, I encouraged them with a hearty sound. The man on his cell phone looked at me askance, but I detected a hint of smile in his eyes and knew that his day was better for having been a part of that moment.

I guess you could take this as a spiritual metaphor or whatever. To that, all I have to say is:

KAAAAAAAAA-REEEEEEEERRRRRRRRRR!!!!!!

Chasing Cars

2008-05-02T12:41:00.000-07:00

Mom - you might, cancel that, you definitely, won't enjoy reading this one and will have a happier life if you just close the window now.

That warning also goes for the rest of you who don't believe that I am actually James Bond in disguise.

With that said, man, sometimes my life explodes in momentary bursts of awesomeness. Usually, not intentionally. Wednesday was just a typical day... met some random guy on the street in the U district to buy car speakers (woo hoo!), went to my tropical medicine class, sat through repro and path... blah blah blah... attended a training class so we can give free sports physicals to low-income middle-school kids, then hit up the climbing gym for a little while. It was when I realized that I had a 30 minute bike ride to complete and only 15 minutes before I had to be at Bethany Community Church that the trouble started.

I booked it up the Ave on my bike, snagged a left on Ravenna and was making good time. As I cruised up to the various stop signs, I would time myself so that I wouldn't have to actually stop, but could just ride in the shadow of a car that happened to be crossing the intersection at the same time as me. Make sense? I cross at the same time as a car, rather than trying to compete with everyone else for my turn at the stop sign.

So I was cruising up to the 5-way stop at Green-Lake that has lots of diagonals and weird turning patterns. It's confusing as heck. So I was more than happy to jump on the tail of a car in my lane that was just ahead of me. It was probably a little too far ahead of me in retrospect, but it seemed like a great idea at the time. So I was pedaling hard, trying to catch up to that car when my eyes got big and I saw the oncoming car turning right behind the car ahead of me... and accelerating.

I kept waiting for him to brake, to show some sign that he was acknowledging my presence on the road, but no, he was intent on getting through that hellish intersection at top speed. Neither slowing down nor speeding up was an option for me, so I elevated my center of gravity and prepared for impact.

It was spectacular. A brilliant crash swept my bike out from under me and threw me onto the hood of the speeding car, rolling me over before depositing me on the ground with a few more departing rolls for good measure. After taking a quick self-survey, I assessed that I was indeed still alive, and confirmed that my health had not rapidly deteriorated, information which I relayed to the concerned driver of the vehicle. Ensuring that all of my bodily parts were still intact, I straightened the handlebars on my bike, which had been thrown all out of whack, briefly looked for any debilitating deformations and hopped back on, determined not to miss my deadline.

I was stopped by a horde (two or three) of concerned passersby. They demanded that I must be injured after such an explosive interaction, but I assured them I was fine, wearing a helmet and that my training as a soccer goalie has indwelled me with sufficient falling skills to land on all the right parts.

I made it to my final destination on time and safely transported my passengers from downtown to their evening abode. Mission accomplished.

Piety

2008-04-29T00:37:00.000-07:00

When it comes to life, I've got it more than pretty good. I don't need to sit here and tell you how great everything is for me, but suffice it to say that my idea of a rough week is one where I don't get to do something exceedingly fun with exceptional people. A life lived in such a fashion has notable potential to produce a whole lot of guilt regarding the people whose rough week is one where they don't eat.

This is not a new struggle, but one that has haunted me since I first really started engaging God and seeking to understand His purpose in my life and more generally, the world. I've definitely felt the tug to sell everything, give my money away and go squat under a bridge. At least then I wouldn't feel guilty. That's a lie. I would have replaced the previous guilt with the guilt of having squandered irreplaceable resources.

This year has been somewhat of an experiment. I've honestly felt the call to put aside piety and just enjoy what was before me. And it's great! Seattle has a ton to offer!! Skiing, climbing, hiking, famous musicians, rising stars, plays, professional sports, exotic food, more varieties of beer than I could taste in a lifetime. All these things at my fingertips. And yet, handing over a 20 dollar bill for a night of entertainment, I sometimes cringe realizing what that money could buy in Cambodia. Literally, it could feed a family for a week.

This Sunday, my preacher clarified the confusion with a simple admonition: "Don't attempt to be more pious than God."

In short, it is not our work to deprive ourselves of everything in a reckless attempt to fix the world. Neither is it our place to live lives of endless pleasure-seeking that never satisfies. It is our place to enjoy the work that God has put before us, and the fruit of that work and in doing so, loving ourselves. It is only with that framework that we can begin to love our neighbors in the same way we love ourselves. There's a whole lot I could say about that, but the final piece for me was realizing who my neighbor is.

The Good Samaritan is the quintessential example of being a good neighbor. He wasn't out there feeding the homeless or starting new charities. He had some business to attend to. Then something interrupted his life, but rather than seeing it as an interruption, he saw it as an opportunity to alleviate suffering, so he laid down his desires and plans temporarily, and loved some one as he would have loved himself in the same circumstances, then continued about his business. No huge missions, no crusades, nothing worth waving banners around, just simple life, seeing the needs in the proximal context and using the available resources to patch something together.

I don't need to, in fact shouldn't, make my life hell so that people halfway across the world can eat. The number of people who are going to die is too overwhelming for me to start counting pennies... or twenties. But I would be hugely remiss to think that nothing is required of me either. I intend to more forward in alleviating the suffering around me while enjoying the heck out of life and my work, with a huge smile on my face.

That's a good start.

Studying

2008-04-23T10:05:00.000-07:00

I'm in my tropical medicine elective, which is rad, but I'm studying for my midterm in systemic pathology. I keep forgetting these diseases, so I'm just going to write them down. Thought you'd be interested. Ha.

Wegener's granulomatosis - vasculitis affecting lungs, kidneys & others; ANCA positive -> causes neutrophil degranulation; small-medium size vessels; can lead to lots of H&E symptoms, glomerulonephritis, skin nodules, lung "coin" lesions, cavitations & hemoptysis. Thanks Wiki.

Primary Biliary Cirrhosis (PBC) - progressive destruction of interlobular bile ducts w/florid duct lesions; most common in middle-aged women; eventual cirrhosis

Primary Sclerosing Cholangitis (PSC) - fibroinflammatory destruction of bile ducts w/"onion skin" lesions; most common in young men; eventual cirrhosis

Wilson's Disease - accumulation of copper in organs, esp. liver, brain & eye; autosomal recessive disorder of copper metabolism; Kayser-Fleisher rings; presents w/acute hepatitis & nonspecific findings (i.e. mallory bodies - purple blobs)

Time just ran out... gotta go take a test. Why are there so many weird liver things?? And all this on the coat tails of a post about using this blog for more noble purposes. I repeat: sheesh.

Refocusing

2008-04-22T00:14:00.000-07:00

Lately this web-writing thing has been kind of scattered. I started this so that people who love me would know what was going on in my life. Rather than sending out mass emails about my summer travels, I thought, "Hey, why not just broadcast what I'm about for the world to see? Maybe I'll inspire some one!" That's what I want this to be about. I want people to laugh more and be more intentional about living. Living actively rather than responsively. I want to share the best things, the most admirable things, the worthy things that I contact because this world does not shed light on such things enough. I started this so that God would be glorified. Lately though, I've been doing some thinking about how to take the next step into being a part of what is admirable. It start with a healthy understanding of

Stupidity…

…is often associated with impaired reasoning, lack of knowledge or misperception of the outside world. Yet none of those need be present for stupidity to rear its head. In what context then? In the context of relationship. In the context of forcibly placing your own wishes and perspectives and interpretations in the path of some one else, leaving them no alternative but to dive through your twisted web of past experience, beliefs and preferences. Why would we do such things? Why impose? I have no reasonable response; reason has little to do with it. Yet we persist in casting forth our webs to trap and hold those around us in the patterns that we create for them. Can satisfaction be taken in such actions? I can imagine so, but only with relentless self-confidence spurred on by a paternalistic mindset and an individual dedicated to the idea that their own vision for the world rings with absolute clarity and goodness.

It hurts every time.

Why stupidity? Pride.

When, oh when, will I exchange this stupidity for humility?

I must become less that Christ may increase.

A few good bands

2008-04-17T13:26:00.001-07:00

I've been to more live shows this year than in the rest of my life combined. It would be a travesty to forget these. So in an attempt to add an element of usefulness to the reader while selfishly immortalizing the good times I've had, I present to you:

The Stratified Subjective Subjugation of Sweet Seattle Sounds

Lame

Project 86
Wyclef Jean - lame because I DIDN'T GO. Sheesh, what the crap was I THINKING??
Talbot Tagora
Cold War Kids

Tolerable

Jesse Sykes
Presidents of the United States of America

Enjoyable

Moneta
Soljibe (New Year's at Schweitzer)
Metro Station
PWRFL Power
Maritime
Mae

Sweet

The Everybodyfields
Tristan Prettyman
Whitley
Sherwood
Motion City Soundtrack
Ted Leo & the Pharmacists (Neumos <>Totally SweetThe Cave Singers
Throw Me the Statue
Death Cab for Cutie (Sasquatch)
The Cure
Mates of State
The Classic Crime (plugged)
Jimmy Eat World
Justice

The Best Day of My Life

Michael Franti & Spearhead
The Classic Crime (unplugged)
Death Cab for Cutie (Bremerton)
Steve Earle
Ghostland Observatory
Anberlin
Hell's Belles

I'd recommend checking out anything at the Sweet level or below. It's been a good year. (these are all the BANDS I've seen, not individual shows)

A True Beauty

2008-04-15T19:20:00.000-07:00

This week's episode is brought to you by Solstice Cafe, a favorite venue for long study sessions, some good brew of the stimulant or depressant varieties, or just a quick stop in to catch up with the current trends in edge music. To start off an evening of studying, grab yourself a cup of coffee and a peaches and cream scone, or to wind down after a long day, tap into their rotating selections from Elysian Brewing. You're can't go wrong at Solstice! Now, back to our (ir)regularly scheduled broadcast...

Confident that nothing else could go awry, our heroes spent a pleasant half hour en route to the quaint little town of Surrey.

Rossulous Maximus: "Gosh Davius Awesomnis, it feels great to have all those foul knaves behind us. Surely our luck is about to change for the better!"
Davius Awesomnis: "I concur my esteemed compatriot. Tis a grand day for fine fortune."
Rossulous Maximus: "Ahhh... how pleasant a half hour this has been... but Davius, does not your... umm... toyota pickup... normally make that ticking sound?"
Davius Awesomnis: "By Jupiter, it surely does not! Quick! Crawl under this rapidly moving transit and give a differential diagnosis of its ailment!"

Braving the extremely-nearby, rapidly-moving countryside Rossulous lowered himself into the undercarriage much like the renowned warrior, James Bond. With extreme horror, his eyes came to rest upon a bomb firmly affixed to the frame with a bright, flashing 30:00, 29:59, 29:58 light staring him coldly in the face. After futile attempts at deactivating it, he returned to the cab in a smooth, 70 mph tuck-flip through the window.

By consensus, he and Davius agreed that the only reasonable option was a race against the clock to their awaiting destination. Failure was not an option. A tense 25 minutes passed.

Devoid of the resources needed to zero in on their destination, they circled the area where they knew the beauty to reside, but the clock was ticking. With only minutes left, they elected to abandon their trusty steed to the streets of Surrey and take off on foot. As they sprinted down the byways, through the trees, over bridges and through groomed yards, they could feel the ticking of the clock as a weight upon their souls, a pacemaker on their emotions and a fine example of sinus bradycardia.

Bursting through a hedge, guided by pure instinct (and conveniently-placed street numbers), all thought and emotion vaporized, replaced by a radiant glow encompassing them in its brilliant light and goodness.

KJ the Keeper: "You have arrived, with only seconds to spare."
Rossulous Maximus: "Seconds to spare?? You knew of the bomb?"
KJ the Keeper: "Yes. It was necessary to insure your prompt arrival. Fear not, for I have deactivated it."
Rossulous Maximus: "You are most... uh... kind. Now, you must know my purpose in being here, yet you look not dressed for combat?"
KJ the Keeper: "Combat we shall not engage, but ritual rather. Join with me in the most ancient dance of The Sale and The Title."

What happened next must not be spoken, for it is a sacred ritual passed down through the ages...

-- Break of character --

Okay, I thought I was going to finish this thing and talk about the registered importer meeting me for vehicle inspection and the border crossing that took 4 hours because the computers broke down and the triumphant return to Seattle, but this has dragged on long enough (despite it being really fun to write), so without further ado, I present to you the fruit of our adventures, a rare feast for your eyes, a most noble vehicle: the diesel, the 4 speed, the 1988 Toyota Land Cruiser!!!!!

And there was peace throughout the land.

Battling the Giant

2008-04-07T21:20:00.000-07:00

We left our heroes with their sights on the horizon, speeding off into the great unknown, enemies in hot pursuit. However, thanks to the speediness of their trusty steed and the skillful driving of Dashing Dave, they arrived at their destination without a challenge. Little did they know that the monster awaiting them sufficed to set even the boldest adventurer aquiver.

As they pulled into the small town of Chilliwack, everything seemed peaceful and quiet on the surface. Coming to a halt at a neighborhood curbside, they could scarce believe their eyes as they spied the object of their affections seated pleasantly across the street. Emerging from their transport, they started toward their coveted prize with eagerness, only to be met by a rumbling, "WHO GOES THERE??"

Chivalross: "Tis I, Chivalross, here to sweep fair maiden off her feet and return her to the pedestal that she belongs upon."
Jeff the Giant: "Jeff see... well... you come at good time. She many beautifuls and run like deer. You speak her. You give Jeff monies."
Chivalross: "This seems easy... a little tooooo easy. I was expecting a fight. What do you have up your sleeve?"
Jeff the Giant: "One arm. Each side. What you mean?"
Chivalross: "Never you mind. But know this, giant, I'll be keeping my eyes on you."

The excitement built as Chivalross approached the maiden. Yet as she turned around, he was overcome by horror!! This was not the ravishing beauty praised by the muses in song, but a hideous, rusty, old witch!! Her flesh was tainted, scoured and giving way to bone and hollow recesses the sight of which chilled our hero to the bone. Unlikely as it may seem, our hero and Dashing Dave had let their guards down at the shock of the sight before them just long enough for Jeff the Giant to sneak up behind them. They were whisked off their feet, hanging from their collars in the hands of the giant before they even had a chance to bust out some reflex break-dance fighting moves. "Now we all go nice walk. You like girl. You give money Jeff."

Admittedly, the witch had a soothing voice and kept pleasant enough company, but the enchantment she had cast over the giant was a constant reminder of her true treachery. Given no other alternatives, Chivalross made conversation, enough to learn that the witch had spent much of her time in the corrosive Saltlands of Vancouver. But even as he pretended conversation, he was plotting their escape and thinking to himself, "It's a good thing we keep changing our names, or these bad guys might track us down!!"

Without loosening the strength of his grip one newton, Jeff the Giant demanded his bounty of 9,000 pieces of eight... err... dollars. And that's when Chivalross sprung into action. Blinding Jeff with an outrageously small offering of cash, he stunned the giant, rendering him speechless and causing him to swoon in delirium. As the witch sat patiently in the driveway, waiting for her minion to carry out her dirty work, Dashing Dave and Chivalross dashed across the road, into their waiting autocarriage... really great pirate landship... Batmobile... toyota pickup... And picking up speed, they blazed away from Chilliwack, never looking back.

(...except for the stop they made at this really good pub. Chivalross would recommend the buffalo chicken wrap with delicious steak fries. Canadians sure know how to do fries.)

And so they set off again, with their eyes to the road and discouragement at their backs with only the promise of a brighter this-afternoon to beckon them on...

To be continued...

Fleeing from the Mounties!

2008-04-06T13:13:00.000-07:00

This weekend saw your hero (in case you forgot, that's me... at least on this blog) face-to-face with the Royal Canadian Mounted Police. As they brutally interrogated him, he responded coolly, without hesitation and with great confidence in his voice.

Evil Max the Border Guard: "Why are you coming to Canada?"
Ross the Avenger: "To liberate a damsel in distress!"
Evil Max the Border Guard: "How much currency are you transporting?"
Ross the Avenger: "Enough to free said damsel, 85 hundred U.S.! Now, HAVE AT YE!!!"

Your protagonist then proceeded to slay the villain with a swift ninja-kick to the trachea, delivering him into the next life with a painless farewell and a stunned expression on his face.
As the dust settled, the hero hearkened back (heroes hearken frequently) to earlier in the day, when he held up a bank...

Savage Scott the Bank Teller of Bellingham: "You need this much cash... why??"
Masked Man: "My reasons are my own, but know that you will be serving a most noble purpose!"
Savage Scott the Bank Teller of Bellingham: "Uh... we usually don't just hand out cash. Do you have an account here?"
Masked Man: "I have not the time for your pithy responses. Your lack of chivalry overwhelms me. You leave me no choice."

As you have distilled by now, the Masked Man in question was indeed our would-be rescuer forced into the realm of crookery by the sheer magnitude of his quest and the exorbitant costs of medical education. Minutes after the above exchange, the smoke began to dissipate, leaving only a few scattered bills softly drifting to the ground still and a smattering of bank clerks hog-tied and gagged with various currencies, deposit slips and advertisements for loans that would make the whole family happy.

As our famed avenger un-hearkened, he thought to himself, "I have no time for daydreaming. My fate awaits me miles ahead."

The storyteller would be remiss to neglect an important character in this tale. You may be wondering... how could one man dispense with multiple bank tellers in the brief span of a giant smoke bomb? Indeed, he was not alone, and as our hero sequentially incapacitated each unsuspecting worker, Daring Dave the Diligent was busy entangling them in his devious webs and stuffing paper in their mouths. And if not for the brilliant distractions of Daring Dave, Evil Max may well have seen coming the ninja kick from Ross the Avenger in time to avert his trachea.

As Daring Dave and Ross the Avenger sped down the highway, leaving a wake of destruction and children holding flowers behind them, they gazed ahead with grim expressions, knowing the Mounties would be hot on their tail.

To be continued...

What We Crave

2008-04-02T20:11:00.001-07:00

Last winter I had a transcendent experience in the Wrangell-St. Elias mountains that reminded me of a freedom I had thought lost upon moving to Texas. I can't explain the nature of that freedom or how it felt different from any other unburdening my soul had experienced previously. Two snapshots ebb and flow into each other with the same energy and emotion:

My last night in Alaska. As a farewell to our childhood home and in a sense, to childhood itself, 3 friends and I set off north along the coast at the end of the North Road in late summer. Firecrackers, hot dogs, marshmallows, and some pure sodium metal (which is REALLY cool in water) in our packs. We road our bikes until civilization was long gone and commenced with our evening entertainment. As the sun set and the stars came out, we folded out our sleeping bags on the beach and watched the meteors rain down in a salute to a childhood well-lived.

My return to Alaska. "...the great white silence, not a snow-gemmed twig aquiver/ eternal truths that shame our soothing lies..." A line from Robert Service that bubbled up as I trudged along the frozen river at 20 below. I knew a warm fire awaited me, but in the moment, the air sparkled, the trees shone and the mountains rose up to meet the sky all around me. A time spent away had only heightened my longing for the pure tranquility of absolute focus on and unity with beauty.

This week I made a declaration, to myself at least, that I officially do not like Seattle. And yet as I sit outside Chocolati with the face of a robustly blooming cherry tree beckoning me to appreciate the landscape: the lake, the evening colors, the industrious exercisers, I am reminded of the same sense of freedom. And I realize that my surroundings do not dictate my joy, nor my tranquility, nor my sense of place in the universe. It is rather my acceptance of life and the willingness to fully engage all that it persistently and patiently offers.

It is in these moments that I find peace, purpose and the gentle, loving touch of my Creator.

Going out in a blaze of glory

2008-03-31T20:49:00.000-07:00

My last post was written in response to an assignment on death and dying. We were supposed to reflect and write about our role as a physician in the face of death. I realized that my perspective on death was shaped dramatically by my experience with Grandma. In some ways, I'm still processing her passing. Unlike others who I have known and are no longer here, it feels like I could still go visit her. It doesn't feel like she's really gone.

Yet writing that still chokes me up and brings tears to my eyes in the midst of a crowded coffee shop.

I had another moment of self-realization today in our clinical medicine class. Our professors invited a lady with metastatic breast cancer to be a patient in front of the entire class. A psychiatrist interviewed her, demonstrating for us a proper psychiatric evaluation. She seemed perfectly healthy, but death loomed in her eminent future. It made me think of my own mortality and how I would respond to terminal illness.

My dad used to say if he ever knew he was on his way out, he'd just fly his airplane into the side of a mountain out in the wilderness. I tried to talk him out of it... no reason to waste a perfectly good airplane. He said I had a good point.

He did too, though. I don't want to languish. Faced with terminal illness, I would not want my last years/months/weeks spent in a hospital scraping for life. There are stories of terminal patients smuggling Bibles into closed countries, risking execution to bring good news to the oppressed. That's how I'd want to go out. I don't necessarily want to smuggle Bibles, but something along those lines would be sweet. Our ambitions for greatness aren't always out of pure motives, but somehow, there is a certain romance about giving your all, even if your all will soon be taken anyway.

I suppose it has something to do with this:

"Greater love has no one than this, that one lay down his life for his friends." - John 15:13

Grandma

2008-03-28T10:22:00.000-07:00

I got the call late one night as thoughts of video games, quantum mechanics and the intricacies of the college-aged feminine mind were dancing through my head. A contented existence devoid of major preoccupations suddenly exploded into a myriad of questions, unknowns and uncertainties. My cousin and her boyfriend picked me up and we were off on an after-midnight outing, destination known, but dreaded.

We didn't know what to expect when we got there, but we needed to be there. I dozed restlessly as the miles passed, waking to cold bursts of air when the truck door would open long enough for Heath to jump out. After a few sprints up and down the highway shoulder, he would jump back in car with a little more adrenaline and drive the next stretch until sleep began to overtake him again.

My Grandad was in surprisingly optimistic spirits considering that his wife was lying in a comatose state just yards away. You could tell our arrival there was a relief however. He seemed tired, yet vigilant, a worn-out wolf guarding over his wounded mate. Grandma looked like death and I had to take another breath before fully stepping into the room. A lively, spunky, pie-making, laundry-doing lady with a heart of gold was transformed into this gray wraith sparsely covered by sheets that served only to accentuate her weakened state.

"Brain stem stroke" "wait and See" "We Don't Know" "We'll Know More..."

Words that meant nothing to me flashed in my head and bounced off the walls shattering in brilliant displays of frustration. And then we gathered around the bed. As we joined together as family to lift up our loved one before our Lord, a sense of peace and healing settled over the sterility of the room that smelled of Purgatory.

And through the calm and unspoken uncertainty, a toe moved.

The next few years were absolute gifts. Grandma never really recovered, but we ate Mexican food together. Grandad cooked for the woman who had prepared his meals for over 50 years, nursing her, helping her fight on, loving her.

She passed one night, moving into the next life with ease and grace. My aunt, who had been a stronghold for Grandma and Grandad in their battle, awoke to a voice at her ear, "I'm free Judy-babe." She got the call an hour later.

The funeral was a celebration. All those who attended remembered not the mourning, but the laughter and the tears, sadness mixed with joy. We do not weep for her. We weep for us, because we miss her and will not see her until we too rise to new life.

Death is not a bleak occasion for me. It is the graceful transition from pain to the final testing grounds where we all will answer for the choices we've made. I anticipate the day when I can look back on my life and look forward to death as a step into freedom.

3rd Year Schedule

2008-03-27T16:46:00.000-07:00

And the moment we've all been waiting for...

Pocatello, ID: Pediatrics, July 7th - Aug 15th
Free time!! Aug 16th - Sep 28th
Seattle: Internal Med, Sep 29th - Nov 7th
Anchorage: Internal Med, Nov 10th - Dec 19th
Christmas!! Dec 20th - Jan 4th
Anchorage: Psychiatry, Jan 5th - Feb 13th
Fairbanks: Surgery, Feb 16th - Mar 27th
Anchorage: Ob/gyn, Mar 30th - May 8th
Wrangall: Family Medicine, May 11th - June 19th

That's all for now!

What the Easter Bunny isn't telling you

2008-03-19T19:46:00.000-07:00

My favorite Puerta Rican recently made me aware of a problem with Easter. While I fully support egg-hunting, bunnies, bright colors, fake grass, jelly beans and Jesus rising from the dead to bring life to the world, there is one aspect of this joyful holiday I can no longer endorse with a clear conscience.

I'm warning you right now, if you are female or under the age of 13 and want to fully enjoy the holiday, go read about the latest invention that should be in every Easter basket.

Just so that you're fully informed, this will definitely put on smudge on your festivities.

Last chance.

Ok.

For real.

...

It's the chocolate. (you still have a chance to stop reading!!) I can no longer endorse most chocolate for Easter or any other application for that matter. If there was an official website where you could endorse things officially, I would heretofore withdraw my endorsement of chocolate in most forms.

Here's the scoop. Most cocoa or cacao or whatever you want to call it is grown in Ivory Coast, roughly 40% comes from there. Now while there are many family farms that pass from generation to generation, there are also farms that employ forced labor, offering lucrative jobs to children and then completely enslaving the workers once they arrive on site. They often recruit from other countries in order to completely subjugate their workers and leave them no recourse to protest their conditions. Mali has been especially hard-hit by slave traders. There are countless stories online detail the practice of cocoa slave traders. One boy way promised a bicycle to come work, then inhumanely abused as a worker. Needless to say, no bicycle ever appeared.

What can we do about it? Not a whole lot right now, but the idea of buying a Snickers doesn't seem quite as sweet now thinking that I would be enjoying on the backs of abused children. It actually bothers me a lot that I could still eat chocolate and probably not flinch. I've become dulled to oppressing others by my purchasing and indulging habits. Is it ridiculous to cut out chocolate completely? Probably. But that's the kind of life I have committed myself to when I signed on with Christ. Ridiculous. oh well.

Who's guilty??? Almost all cocoa not specified as "Fair Trade" is bought by purchasers at cocoa markets where cocoa from all over the world mixes. In these markets, there is no differentiation between chocolate produced by just practices and that produced by oppression. This almost guarantees that slave cocoa makes it into the mix of most major brands. Specifically, Nestle, Hershey's, Mars and yes, even Cadbury all purchase "blood cocoa."

There is a spark of hope for chocolate lovers: Fair Trade chocolate. I wouldn't suggest that every single person stop eating all chocolate, but I would request that you would support an alternative to slavery. Start mixing some Fair Trade chocolate into your purchases.

Every purchase you make supports either fair practices or unjust practices.

P.S. I concede that not all children can realistically jump and dance all day in fields of green with butterflies and bubbles, and realize that working is actually a pretty good choice for children in poor countries given the current social conditions. Read up on what's going on in the slave trade and realize that we are supporting unnecessary slavery and abuse with our $13 billion of chocolate purchases every year.

Whoa.

2008-03-18T15:26:00.001-07:00

I just read my cousin's latest blog. And it's rad. You've got to check it out. Seriously.

http://shellywillbanks.blogspot.com/

The Clean-up Hitter

2008-03-16T19:43:00.000-07:00

Love. It's about love.

There's a series of videos called NOOMA with a guy named Rob Bell talking about all kinds of weird stuff. In one, he poses the following questions:

We'll tell somebody we love them and in the same breath, we'll talk about how much we love a new car, or a certain pair of pants. I mean, I love my wife, and I also love... tacos?

Do you think the word love loses its meaning when we use it for so many things?

Does it affect our understanding of what real love is?

I was talking about the ideas in the blog below (judging and stuff) with a friend and the subject of love weaseled its way into the conversation. You know, the usual stuff like, "What is love? How is it perceived? How do we describe it?" It then hit me like a speeding semi-truck: We (as a society) get so worked up about "judging" because we have redefined love as something conditional.

Western Love When I talk about loving almost anything, I'm talking about how it makes me feel. I love skiing because of the sweet sensation I get in a (mostly) controlled fall. I love fajitas because they set off a brilliant array of delectable explosions in my mouth. I love mountains because of the soaring feeling I get standing on top of one and the sheer awe that surrounds me when I see them rise up to meet the sky.

If all those things lost their sweetness, my love for them would vanish. And so it is that we have defined our love for each other. Words have power and the associations we form with them have power as well. When I say "I love you" to a friend or relative, I could essentially replace that sentiment with "You bring me joy/happiness/entertainment." Still complimentary, but less so. There is no word that means I love you unconditionally because of who you are, not because of the choices you make or what you do for me. Some would argue that our choices define us, but that assumes that we have no deeper identity which lends us greater worth.

Do You Love Me? If loving some one is simply an effect of how they make us feel, then it is easy to see why it could be so upsetting to lose some one's approval. If some one stops pleasing me, I stop loving them. Me not liking your shoes because they're not hipster enough isn't a huge deal. Me not "loving" you anymore because your look clashes could cause some significant emotional pain.

Back to the Basics Back when love was invented, it wasn't based on a "give-and-take" system. It was more of a "give" system. A reputable source claims that the greatest display of love is to give up your life for another. Hardly a pleasurable activity. That kind of love doesn't say "You please me," but rather, "Your worth to me is immeasurable, infinite." It is that kind of love that is unconditional, seeking the betterment of the other and not the pleasing of self.

There is no word in our language to express unconditional love which is rooted in loving some one because of their innate value. In fact, many times we don't assign value based on the right stuff. Everyone reflects the image of God. We all have a chunk of perfection that we can uniquely illuminate to the world. We are all sons and daughters of the King. THAT'S worth loving. And if we start loving people because of the worth of their deepest identity, I have a feeling they wouldn't feel quite so rejected when we tell them their shoes are ugly. They might even smile. 'Cause they know they have our love, regardless.

No one is into all kinds of music

2008-03-06T17:01:00.000-08:00

But everyone says they are. Is it an unwillingness to admit our own personal preferences that drives this phenomenon? Perhaps just social laziness? When I ask some one what kind of music they like, and they say, "I'm into all kinds of stuff," I immediately judge them as being noncommittal. I don't want to, it just happens.

There's a lot of talk these days about judging and not judging people. It's the social equivalent of painting yourself with honey and going bear-slapping to bust out a particularly judgmental phrase. And no, I'm not going to give examples. And here it comes, the elephant in the room...

Everyone judges. But that doesn't mean they hate you.

Having opinions and expressing yourself in various ways is intrinsically a form of judgment. By making one choice over another, you're evaluating that option as more valuable, thus naturally demonstrating your preferences. I'm about to order a mocha, NOT a latte, because a mocha is a better choice for me right now. When Ted just ordered his iced mocha, I judged that choice. I actually thought, "Wow, that looks really good, I wish I was more like Ted right now."

Now if he'd made what I would consider a bad choice, like ordering a cappuccino, I would have thought, "Dang, that looks like drinking bitter foam." And been quite content with my own choices.

Neither one of those hypotheticals would diminish the friendship or respect that I have for him, and this is the point I'm trying to make. It's okay to disagree with, or even disapprove of the choices other people make. It's okay to express that. It's honesty. I think what people are really adamantly opposed to are the judgments that say, "Because you made this choice, you're a terrible person." Yeah, not cool.

So here's my goal, to keep our preferences apart from our acceptance of people, but on the same token, not insult each other by pretending we don't actually have any preferences.

I almost didn't post this because it's kind of abrasive, but it's a topic that seems important to me, so feel free to call me out if I'm in left field on this one.

Meeting amongst friends

2008-03-04T15:56:00.001-08:00

He described the first sensation as a warm buzz that he immediately wanted to experience again. He did experience that buzz, many times over and many times stronger over the years to come, but that one experiment, that 11-year-old curiosity, that open bottle of wine was the spark that ignited a blaze of alcoholism culminating in a 25-year-old high school graduate dragging himself, drunk as a skunk, into his first AA meeting.

My first AA meeting was a class requirement. I went to observe what it's like to admit you're totally out of control and cannot change yourself. Actually, it's a lot like me. Actually, it's a lot like you.

It's smiling faces,
It's raucous laughter,
It's taking a big bite of chocolate cupcake and almost snorting frosting up your nose at a buddy's joke.
Sitting tiredly waiting for the one to finish,
Secretly wondering if, when your time comes, you'll spill the beans
The whole can of beans
Not just the top that looks nice and tasty,
The dark bottom where the squished beans reside,
Where it's cold and agglutinated.

But smiling face after smiling face
Urges you on,
You sip some ground-filled coffee and remember all the times you spilled the beans
And the relief and the joy
And the freedom
It's curtains for your fears
As the words pour out
Acceptance, pure acceptance

They don't even break stride when you tell them you did coke
Are they paying attention?
Sure, they've just heard it all
They walk on the razor edges
Another round
With cream and sugar to boot

This is real
Real, shaky, life
With all its uncertainties exposed, no one is a stranger
Drifting in, drifting out
Week after week
Month after month
Decade after decade
It's like finding an old restaurant with a crabby waitress. The food's not great. The coffee always tastes burnt. And don't get started on the smell. The table wobbles, but you keep coming back. Even though the table wobbles, you keep coming back.

It must be something in the coffee. Or maybe the cup. But probably the hand the pours it for you. It's 'cause that hand's attached to some one who understands you. 'Cause, really, they're a lot like you. A lot like me.

Sometimes I do stupid stuff

2008-02-29T10:11:00.000-08:00

As a brilliantly ironic contrast to the post directly below, I was riding my bike yesterday to go pick up my truck, when I suddenly felt my back tire lose traction and begin to skid this way and that. I was already pulling off to the side, but had little control and subsequently hit a curb and went flying off. No injuries were incurred.

I was going so fast because I was racing against the clock to get to the transmission shop before they closed. The transmission shop is about 5 miles from my house, and I had no intention of walking all the way home empty-handed, so I started running... to the wrong address. Breathless, I called the shop and asked for directions. A mere 10 blocks to the north they were, so I started running again. Fortunately, the guy on the other end of the line said he would wait for me to get there. Clary's Transmission: I salute you.

To add to the further irony, it took a $2 part to fix my transmission, but the total bill for diagnostics, shop time and replacing the fluids was well in the 3 digit range. It's moments like these that make the moments below that much sweeter.

Sometimes I do cool stuff

2008-02-28T10:18:00.000-08:00

For the full walkthrough of the trip, please see Dave Brown's account of the Kaleetan Peak summit. In brief, it was an awesome trip, although the snow was less-than-desirable at times. The picture is from the descent from Kaleetan Peak (close to the Alpental ski resort) as we passed through Malakwa Pass. I was really freakin' sore the next day, but moments like this make it all worthwhile:

My To-Do List of Blogdom

2008-02-25T16:49:00.000-08:00

My blog (who I will henceforth refer to as "Harvey") has underlying goals to which it aspires and meets to varying degrees depending on the author's energy level and creativity:

P - Provoke thought
I - Inspire
B - Be funny
I - Illuminate my world to the masses

Harvey does a better job of this when there are interesting things going on in my life. Unfortunately, many of the interesting things are not suitable for publication because they may evoke unintended reactions in those who observe Harvey. To achieve PIBI today, Harvey will wax upon the subject of "What Ross Did Today."

Still being tired, from getting up at hours suitable only for roosters and yuppies, and sore, from putting 2,500 feet of elevation on my legs, I slept in. My truck has been having reversing difficulties. The mechanic informed me that the problem could be two things which differ mostly by a decimal place or two in the bill. Upon PIBI analysis: Not challenging, inspiring, maybe slightly funny, but mostly illuminatory.

Most of my day, I spent at The Blue Dog Kitchen, attempting to study, but I ended up planning Spring Break and buying 3 books:

Rod Machado's Private Pilot Handbook: The Ultimate Private Pilot Book
Gleim's 2008 Private Pilot Written Exam Guide
The Hipster Handbook

I'm getting excited about Spring Break, but will not allow Harvey to speak of such plans until they are official. Hopefully, part of it will entail studying for ground school and then starting my flight training this summer. P-, I-, B-, I+

This blog is failing to do little more than tell you about my day and plans.

And actually, I'm going to be late meeting Ted at the rock gym if I try to add anything inspirational or provocative. I am henceforth abandoning the PIBI system and will now stop referring to my blog as "Harvey."

What a random entry.

Priorities

2008-02-19T15:16:00.000-08:00

We had an interesting discussion in class today revolving around the idea of a system of financial compensation for excellence in providing health care. We had a lengthy discourse on the "fight for justice" paradigm, this idea that if I've EARNED something, I'd better get what I've earned. Everyone was squabbling about how to insure that no one who didn't deserve their reward got it.

In one of my more abrasive moments, I challenged our class to aspire to more than merely working for the payday, but to be motivated by altruism and sacrificial giving. We must renew our minds now so that when confronted with a choice, we naturally react by nature of our virtue. I got a mixed response, varying between those demanding that a lucrative salary was a great reason to be a physician and those who were visibly stirred to think that there is something more to life than "getting their just desserts."

It really made me reflect on authenticity and honesty with one's self. It's a question I've asked myself before and will ask many times again: If I really believe what I say I believe, what practical choices will I make?

If I say I care most about loving my patients, I won't care about how well I'm compensated so long as I earn enough to continue to love my patients.

If I say I care most about getting what I deserve, I will do everything I can to protect and promote myself and do nothing that hinders me getting mine.

Just expressing the first of those dichotomous viewpoints brings over me a rush of peace and Godly wisdom, the principle of freely giving because I have freely received. The second reeks of futility, greed and frustration, characterized by a life lived surrounded by others, but alone.

It took some encouragement from one of my dear friends to get the ball rolling in class today, further confirming the importance of community in my life. I wasn't sure it would go over too well, and with some, it didn't. However, as class ended, several of my classmates approached me with gratitude for expressing what needed a voice.

We are surrounded by a great number of allies, no matter what our position, who will encourage and support us if only we will rise to the occasion.

Reminiscing

2008-02-14T00:51:00.001-08:00

I've spent the last 30 minutes or so reading over some of my old posts. I could almost taste the curry in Siem Riep, feel the bites of the bed bugs in Phnom Penh and see the smiles of my friends as we lounged at Amok. A long night of laying on a wooden mat contrasts sharply with the luxurious bed that I will sleep in tonight. Dreams of 50 cent noodle plates and glasses of Angkor beer give way to $10 burgers and $4 pints.

A 90 dollar CT for a dying child and a 180 dollar coat for an outdoor enthusiast.

A day of mending deformed faces and a day of listening to the mechanisms of the intrinsic clotting pathway.

A 3 hour bus ride to a fishing village to work in a clinic and a morning listening to a patient tell her story.

An endless day by the bedside of my best friend and an endless night absorbing pages upon pages.

Life measured by constant surprises and unknown horizons and life predictable, yet imposing.

Undecipherable foreign jabber and complex guarded conversation.

The green, the stone, the sea and the green, the clouds, the buildings.

Dust blown in my face by the countless sea of motos and wind blown in my face as I navigate the city.

Poverty at every turn and the homeless with their empty stares.

Clambering orphans with incessant chatter and the people of cell phones, oblivious to the world.

A seat on a bus, bound for the horizon and a seat on a bus, bound for downtown.

A borrowed computer, barely responsive and borrowed internet, efficient and impatient.

Captures of a life lived. Parades of the past and possibilities for the future.

Sentiments of sacrifice. Joy at the return to haphazard paradise.

A Trip to the ER

2008-02-07T22:47:00.000-08:00

I realized today that I've told this story multiple times in person, but have neglected to inform the world at large of my exploits, so here goes.

It all started in our PBL group (that is, Problem Based Learning) when we got a case centering around a "curbside" consult which is medicalese for professional courtesy, or more simply put, free health care because you happen to be in the club. The issue was raised: is this case centered in reality, or is it merely pop fiction that docs can get free care from other docs. I took that issue home as a "learning objective."

My learning objective took me to Smallville Hospital ER [names have been changed to protect the victims]. I cased the joint. Up front was an administrative assistant, who are usually pretty sharp and able to keep the riffraff from getting to the docs. I almost knocked on the back entrance so a janitor I had spied would let me in, but figured she might sound the alarm. Then it came to me: the security guard. A venerable spot in the defenses.

"Excuse me sir, I'm a second year medical student and I need to speak with an ER doc. Is there any way you could let me in?"

After a little finagling, I was past the first obstacle.

A complication! The security guard didn't just let me into the ER to wander about aimlessly, but escorted me to the physicians' desk. As I stood there awkwardly, he explained that I had a question for one of the ER docs. I willed him to go away, but he was impervious to my mind control. So I suspiciously leaned down with my back to the guard, only to be met with a startling,
"Is this a personal health question?"

from the ER doc of choice. Yikes! I wasn't the first with this idea. Not one to be perturbed, I pressed on.

"Kind of. I've actually been fasting for several days and I'm worried about my ketone levels causing kidney damage. Is there any way I could get a urine dipstick."

Here's the shocking part. Without a pause:

"Can you do it yourself?"

Not a "Get out of here kid." No hint of "Your behavior is completely out of line." And definitely no nod toward security to dispose of me properly.

My response: "Sure!" And the doc: "Let's get you a dipstick."

Now my assignment was to find out if a medical professional could actually get lab tests done without being an official patient, so my work was done. I sheepishly explained that I didn't actually need the test and mumbled something about it being an assignment for a class before I took my nervous, sweaty self off the premises. I don't think the doc was too impressed with my covert op skills, but neither seemed too put off at my imposition on his time (for which I expressed my gratitude).

Is this a sad commentary on our medical system? Nah, I think it's pretty cool that we haven't become so bureaucratic as to totally abandon professional courtesy. Medicine seems like a pretty tight-knit group at times.

I'm so in.

A Tribute to Tributes

2008-01-27T12:57:00.001-08:00

In honor of my 99th post, before I spring into the triple-digit blogging world, I feel compelled to reflect.

This all started one morning when I poured myself a bowl of Captain Crunch with Crunchberries cereal (it was on sale, I'm not usually a sugar cereal fiend... really) and a lone blue Crunchberry went skittering away from my bowl upon application of milk. I reached to retrieve it only to find it well-fortified under the microwave. I bent down to see a collection of various items, mostly bread-tabbie-like things and set to pondering the location of various by-gone possessions to which this post is dedicated.

[Interruption]

This post had genius written all over it, I had a great mental list of things gone by. Then life happened. Mostly I couldn't find a picture of my old Ford Ranger which was going to be the first thing on my list. Oh how I miss her... Unfortunately, at this point in my life, I've realized I have little time for putting together creative little projects, and so what you get instead is a brief apology for not writing a creative post and scattered thoughts. Enjoy.

But gosh I love tributes and I think it's great to remember the good that once was while being thankful for the good that still is.

On a larger scale, I think that pattern speaks a lot to my current situation... Life was so good in Girdwood and Anchorage, but that doesn't negate the good that I'm finding in Seattle. I declare this post, my 99th, a tribute to good ...everything... gone by: possessions, friends, seasons of life, sports, cities, relationships, dwellings, adventures... the list goes on.

In that spirit, I am now free to write about whatever pops into my head. Who knows, maybe post 100 will be totally mundane.

Mistakes

2008-01-18T16:33:00.000-08:00

That feeling where your stomach drops out from under you, indicating that melting into the ground and out of existence would be preferable to exerting the strength to remain standing... yeah, I get that. Vivid images flash through my mind... snapshots of my past forever mentally preserved by the sheer impact of their arrivals. Time is a great analgesic, but despite the transition from sharp to dull, the pain remains.

Envisioning the next shot of sorrow directly dependent on my choices could paralyze me. Indeed, the aftermath of a single incident is near crippling. However, accumulating the combined weight of my future failures in the present borders on insanity. To achieve peace in the face of such opposition, I become mindful of the words of my Master.

Your heavenly Father already knows all your needs, and he will give you all you need from day to day if you live for him and make the Kingdom of God your primary concern. So don't worry about tomorrow, for tomorrow will bring its own worries. Today's trouble is enough for today.

I don't understand how to manage my impending mistakes, but the one who made me understands life much more deeply than I do. When I accept the reality that He offers, I lose the motivations of guilt and fear and can confidently move forward in love and thankfulness. This is not a ploy to shirk responsibility, but to embrace my own limitations as a necessary state of my dependence on the unlimited one. In Him I find mercy for my mistakes and stern admonition to be His hands and feet to those in a broken world.

I share in the sorrow of those I hurt. And I will hurt many in my life. As my character grows more and more like that of God, and my medical knowledge increases in depth and breadth, and my judgment and wisdom gain firm holds on my heart, I will learn to do less damage and do more good. But in this life, I will always be limited.

By the grace of God, I have the blessing to recognize my own weakness and fallibility. By the love of God, I am forgiven because He he taken the burden of guilt upon Himself.

Now all that I have to do is really believe that.

Closing Thoughts on Physicianhood (part 3)

2008-01-10T10:45:00.000-08:00

Seeing as this series of reflections is due tomorrow, I thought I'd better wrap it up.

I know who I am at my core and want to paint a picture of how that could possibly play out in my role as a physician 10 years from now.

The wind blusters at my back as I reach out to unlock the door, spawning snow swirls and depositing a few more crystals into the drift at my feet that has built up overnight. Before wrenching the door open, I look over my shoulder to admire the fresh ski tracks the full moon is illuminating on the mountain face rising behind me. Another good weekend.

My office is cozy at this hour of the day, more resembling a private study than a place of business, but if an outsider were to peer in, they might think the coziness had won over, exiling me again to the lands of sleep. This is not the case. My thoughts fill with anticipation of the day to come and prayerful presentation of my concerns to my Lord. In a few minutes, I will be dashing about talking, testing, evaluating and diagnosing. But for a few minutes, I am still and quiet before my God, seeking His strength and wisdom for the day to come.

I know the answer to my first case before I even walk in the door. Ellen was one of the first people to welcome me here and despite her warm tone, already had concerns about her heart that she wanted addressed on my first day of business. Her heart is perfectly healthy, but she's convinced that no one can make it 91 years without heart trouble. I'll of course do a thorough exam and refill her hypertension meds in hopes of encountering nothing more than a little pleasant banter with a feisty old lady.

As lunch time rolls around, I look forward to seeing my wife and kids as I step back out into the cool Alaskan midday. Clearly a highlight of my day. My wife and oldest always have stories to share about their days at school and the little guy is just starting to form full sentences. The other teachers now know that I'm a regular in the lounge and always try to update me on the latest gossip, which leaves me feeling a little awkward, but accepted.

We talk about our plans for the evening and how we'd all like to get outside and do something, just not sure what. In the back of my mind, I'm making allowances for tomorrow when I'll, weather-permitting, take my Cub out to the closest village. It's been a while since I've checked on them and the PA should be able to handle anything urgent that comes through the doors at the office. I tune back in just in time to hear a lingering question about "Are we really all going to Africa this year?" from my daughter. I smile and say "Lord willing," which gets me a frustrated look. She doesn't quite grasp that our lives are not our own and wishes her parents were a little less kooky sometimes. I really think she is starting to grasp the freedom and joy that come from walking with God though. In small ways.

As I walk back toward the clinic, I lift my eyes up to the mountains and begin to sing a song of praise. Joy overflows, and I thank God for the life I have been given.

Grace

2008-01-07T17:43:00.000-08:00

I cannot even begin to explain how refreshing Christmas Break was for me. I've expressed frustration with words like "awesome," "amazing," and "incredible" before and this is no exception. In light of their insufficiency, I will resort to expressions such as life-giving. restorative. nostalgic. heart-warming. spiritually filling. enlightening. and emotionally fusing. In short, being surrounded by people who know me deeply and understand and share the things most important to me reminded me of who I am.

I can't describe each facet of this restoration, but a different need of mine was met in Anchorage, in Girdwood and in Kenai. If you'd like the details, I guess you'll just have to ask. I'd be more than happy to share but I anticipate an inverse relationships between the length of a blog and the number of people who finish reading it.

The heart of what I want to say and what I experienced.

You cannot choose your actions independently of outside influence. We make choices daily that demonstrate what is in our heart. Sometimes we love what we do, sometimes we don't. How is it that we do things we dislike? It's counterintuitive. It is the core of who we are, our heart, that dictates the choices we make, despite our thick rationalization and heavy brooding.

How then do we have any amount of say into what happens to us? How can a man choose his course in life? Or even in one day?

By grace alone.

Most of what I'm saying was revealed to my dear brother Adam after intense study and prayer and seeking after wisdom from God. Through revelation, he challenged my understanding of grace and what it meant before we Hallmarked* it. I did a quick search just now and found a website with an awesome description: In most of the passages, however, in which the word "charis" [grace] is used in the New Testament, it signifies the unmerited operation of God in the heart of man, affected through the agency of the Holy Spirit.

Simply, grace is the direct influence of God upon our hearts.

We may not be able to control our decisions as much as we would like to, but we have a great deal of control over what we allow to influence our hearts. Our hearts may remain wild and untamed, subject to whim and circumstance, but they will be shaped into the image of that which influences them.

For those who don't yet know God, this still leaves an important principle dictating that we pour into our hearts that which we wish to become. What source is worthy of emulating? Who can we look to in perfect admiration?

To truly shine, we only need ask for grace to become more like the Holy One. He is faithful and eagerly awaiting those who desire to know Him.

An unlikely source to leave a lingering thought, but fitting nonetheless, Bloc Party's "The Prayer:"

Lord give me grace and dancing feet...

*the act of Hallmarking is where you take something beautiful and mysterious and reduce it to warm platitudes often expressed on cheesy cards that cost six dollars.

Seeing beyond

2007-12-22T12:12:00.000-08:00

#1 question asked to me since returning to Alaska: "How do you like living in Seattle??"

The frequency of that question has allowed me to explore the many (accurate) responses I can provide to that question:

"It's great! There's always something going on!"
"I'm not much of a city guy, but as far as cities go, Seattle is pretty cool."
"I miss Alaska and I'm excited to get back up here."
"It's been tough living in a huge, pagan city."

Ooh, that last one sounded a little judgmental. But let's remember, this blog is about ME, not about everyone else. And I'M using those terms to describe a culture moving away from Christian majority influence. So before getting all huffy with me for calling Seattle "pagan" (and I know that's a generalization), consider that not all "Christians" necessarily like being pegged as a "Christian." I digress.

That discussion is NOT what this is about, but sets the stage for it.

If a car starts running out of oil, it basically freezes up with no warning signs except for a possible decline on some obscure gauge on the dash. I like to think that the Holy Spirit is kind of like that for me. And living in Seattle, I started running dry.

Since coming back up here, I have been surrounded by men and women of faith moving forward in their lives with Christ, walking in faith and power. Geez, I'd reduced the Gospel to simple logic and principle and forgotten all the good stuff!! God has reminded me that He is not just a thought, but that in seeking Him we learn who He is and we are filled! I may not be able to argue my way out of a paper bag, but I have experienced God, and He has chosen the weak things of this world to shame the strong. I count myself among the weak, as one unable to sustain myself.

It feels so good.

After realizing all this, I have a new response in my repertoire: Gratefulness.

I am thankful first of all for my friends down there. I have learned so much from them and shared some great times! I'm looking forward to continuing to get to know people and to meeting new people and all that fun stuff.

I am super excited to learn all the great stuff coming up in school and no matter what anyone else says, I DON'T hate school, I'm NOT sick of learning and some of the lectures are actually GOOD.

I'm really grateful for my church down there, for learning and growing and being filled. I look forward to getting more involved with them and hopefully having something to offer.

I'm ready to start skiing. So far, it's been mostly talk, but now that the snow has arrived, it's time to get down to business and lay down some tracks. Let's rip it up.

I love having awesome people to climb with too.

This was a good thing to write. I'm getting pumped up to be back in Seattle. Right now though, it's time to go hang out with the fam.

7 Things You Will Never Hear Me Say

2007-12-12T14:01:00.000-08:00

Figured this blog needed to lighten up a little bit, get outside and have a little fun, so in response to Annie's challenge, without further ado...

1. "So when I was running this marathon..." I really admire people who can subject themselves to that kind of torture. Really. But the idea of running for the sake of running basically gives me mental cramps. It hurts to even think about it. I'd be happy to pass out water to my friends at marathons, but I'll content myself with running after soccer balls and propelling myself down mountains at high rates of speed.

2. "I could never date her, she's way too feisty." There's this dirty rumor going around that all guys who follow Jesus want nice Christian girls who are sweet, pleasant and follow the rules. Society has trained me to think that way too, but when I'm really honest with myself, I was a fireball, a girl who is playful, passionate, fully alive and free.

3. "That song had too many rockin' guitar solos." It's practically the sweetest thing in the world when some guy just rallies his guitar in the middle of a song. You can tell when a guy knows his guitar, because he makes her sing and it's so dang sweet. Conversely, I hate crappy solos when the lead guy can barely put 4 notes together.

4. "No, I'd never go to ______. That place is too poor/dirty/scary." Seriously. I have this great longing to go to the poor and dirty and scary parts of the world and love people. It is so much easier to show love to people when no one else does, because they are so dang receptive to it. I'm still trying to live that desire out more practically. Stay tuned, work in progress.

5. "Gross." I hate it when you're about to sink your teeth into some delicious bit of tastiness and then some goober at the table informs you that what you're about to immensely enjoy is actually disgusting and loathsome. Jerk. Go eat a tub full of butter and watch me not say a single word. If I ever say "Gross," I'm totally joking.

6. "Let's get online and watch movies previews!!!" There was a time when I enjoyed watching movie previews. Actually, that's a complete lie. They are the worst thing ever invented. Good idea: "Let's suck people in so they want to go watch the movie." Bad idea: "Let's tell the whole story and put all the funny parts in a preview to make people wish they could have their money back when they actually fall for our devious plot." People who talk about what happens in a movie you really want to see should have their tongues removed.

7. "Nope, can't go, gotta watch the big game." Given the option between playing sports and watching sports, it's a no-brainer. I really wish that I liked watching sports. It would give me something to talk about with people who do. I'm not entirely opposed to it even, I just can't bring myself to sit down and watch "the game" unless I'm actively hanging out with some one I care about. Then, it's okay.

Oppression through $$$

2007-12-08T11:44:00.000-08:00

One of the perks of medical school is being constantly surrounded by brilliant people who have had very different life experiences than I. When we get together, we have such different things to bring to the table, and fiery, but friendly, discussions can ensue. A few of us really get into social issues and trying to predict the best ways to take care of the poor, the outcasts and the disabled. I'd just like to credit my wonderful friends for spurring and shaping the following thoughts.

Voting is a small way we can provide direction for our country, care for the underserved and have a hand in many social issues concurrently. However, there is a better way.

Every purchase I make is a vote. Whether I'm voting for one particular restaurant over another, or one particular clothing company, or one particular record label, I cast my vote with my 3"x2" chunk of plastic daily. Even which chunk of plastic I choose casts a vote.

I implicitly imply with each vote the business practices I approve of. Recently, Gap took action to stop child labor practices in several of its overseas factories, but that leaves you wondering... how could a commercial giant like this be employing sweatshops in 2007 to begin with?? I like Gap clothing, but by some of the purchases I have made, my money has been used to propagate the oppression of children in foreign countries.

As an alternative, I could have voted for Patagonia. They have been acclaimed for their efforts to protect the environment through responsible business practices, yet they still turn out quality products. Oh, and they are frequently acclaimed for working to ensure fair employment, not just for their own workers, but for other companies as well.

My point here isn't to knock Gap or prop up Patagonia, but to point out that who you buy from matters. If customers demanded that their products be made by fairly-paid and fairly-treated workers, no business that oppressed its workers could survive.

Here are a few resources to help inform your vote:

Do The Right Thing - A conglomerate blog on some of the top companies
Business & Human Rights - Great site for checking up on your favorite companies
Human Rights USA - activist company with regular news releases... check out what they say about Yahoo!

If I run into any others, I'll try to post them here.

I'll leave you with this:

"Do not oppress foreigners in any way. Remember, you yourselves were once foreigners in the land of Egypt." - Exodus 22:21

"Those who oppress the poor insult their Maker, but those who help the poor honor him." - Proverbs 14:31

"At that time I will put you on trial. I will be a ready witness against all sorcerers and adulterers and liars. I will speak against those who cheat employees of their wages, who oppress widows and orphans, or who deprive the foreigners living among you of justice, for these people do not fear me," says the LORD Almighty." - Malachi 3:5

"Tell them to use their money to do good. They should be rich in good works and should give generously to those in need, always being ready to share with others whatever God has given them." - I Timothy 6:17

A True Wannabe

2007-12-05T11:33:00.000-08:00

We used to sing a little song in church growing up that was probably called "When I grow up..." It went something like this:

When I grow up, I want to be... (vigorous clapping)
I want to beeee a [insert profession here, i.e. doctor]
And if I am, I'm going to be... (more vigorous clapping)
A [doctor] whoooo's a Christian!!

Repeat as necessary to include all the dreams of the little kids in the group. Pretty sure we had cowboys, football players, firemen... you know, the usual suspects. Now despite "The Organization's" attempts to indoctrinate (pun, oops!) me, I've realized something recently.

My goal in life is not to become a good Christian whatever.

That is selling Christ so incredibly short and putting way too many blinders on the diversity and beauty of life. I was reading this morning about Mary and Martha's responses to Jesus being at their house. Martha was being the "good Christian woman" preparing food, cleaning the kitchen, setting the table, making sure all the kids were dressed appropriately, you know, because they had company. She got all hacked off at Mary who was in there lazing around listening to God speak.

Now this isn't to denigrate any of the aforementioned activities. I've been raised to have a large amount of respect for anyone who can cook, clean, organize, raise and coordinate, and even aspire to most of those things myself. The point here is the timing and the attitude toward God.

Fascination with people and Truth and full attentiveness to the ways in which God is moving in the world are all qualities that I desire much more than living by the norms. Sure, I want to have people over and cook for them, but when there is a precious moment to be shared, I also want to be the first one out of the kitchen.

This is where I tie it all together.

Some day, I'm hopefully going to be a doctor. Some day a patient is going to come in on the verge of tears wanting desperately just to talk and having no where else to turn. Efficiency, economy and propriety dictate that I take care of his/her medical concern and leave the emotional stuff to some one more qualified. This unnamed principle I've been pondering dictates that I drop everything else, reschedule my other patients and take the time to sit down and just allow some one to pour out there heart, giving them my full attention. I think that unnamed principle is called love.

When I grow up, I want to be, oh I want to be a doctor who is a passionate lover of people.

Physicianhood...ish. Part 2...ish

2007-11-13T00:25:00.000-08:00

Every time I propose a brilliant theory for how life works, it gets tragically shot down... usually by me and before anyone else gets a chance. By the wonder of technology, I can now project a hint of what goes on internally to my friends or whoever searches for "Ross Baldwin" on Google. Try it. Top ten baby. Those other Ross Baldwins are going down.

I ran into a mental middle linebacker at the end of my last post. After establishing the core of who I am and my driving forces, I had a hard time coming up with anything intelligent to add. And because I can squeeze meaning out of anything, I figured out what that means. Here's my next attempt at explaining what should be better left to sociologists.

I detest and suck at (ATTENTION: Please leave a comment with a better word that can be used actively here, I'm failing to think of one and feel that it would be a valuable addition to my regular vocabulary) forecasting, and currently, I equate not forecasting with trusting God. I have a difficult time imagining what struggles I will face as a physician in the future. It's hard for me to worry about things, not because there aren't valid concerns, but because I sincerely have a hard time conceiving of unfavorable circumstances. Huh.

I don't know how to go about changing that, and I'm not entirely convinced that I should, except when it inconveniences others. Here's what I can, and daily attempt to, do:

I can shape who I am right now by the ideals insisted upon by my core values. That's what I do instinctively and it is where God meets me. If I say I want to be a physician who loves kindness, I need to love kindness. Here's a thought: I should treat my practice patients the way I want to eventually treat my actual patients. I should take off a weekend and go climbing every once in a while, but more often, I should give until there's nothing left, then give some more. I should do things not for the pleasure they bring me, but for the glory they bring God. I should wake up each day with the knowledge that love starts over at midnight, and it's a brand new day to show God and the people around me how much I love them. And always pressing on, to run in such a way that I will attain the prize, and never looking back.

And if something is going on that's not quite right, I should change it.

I heard an OUTSTANDING word this week (and actually, every week since I started going to Bethany and I'm not saying that lightly). Over the past month, the guy has systematically described what has happened to me over the last year up to where I am now and then rendered a God-centered view of how it has shaped me into a more faithful, humble and loving human. This week, I heard that no trend can replace Christ. Not the power of the Spirit, not social justice, not rocking worship music. It all comes back to Christ and if it doesn't, it starts feeling really hollow really fast. I identified with his bad examples in way too many ways. On the plus side, I heard how God continually peels back layers of defense and callousness to make us more valuable tools in His hands, and if we respond in faith to this painful process, we grow immensely...

"If you keep yourself pure, you will be a tool God can use for His purpose."

cool

A Reflection on "Physicianhood" - Part 1

2007-11-06T16:47:00.000-08:00

So this is actually an assignment that we are completing in the South Campus Center as a small group. We just sat through a couple hours of lecture on "Physicianhood," which is basically all the gushy, emotional stuff attached to taking care of yourself and achieving "balance" as a physician. There were a lot of ideals put forward from the agnostic science-driven perspective about everyone's needs for love and approval and all that, and now I'm reflecting on what that means to me personally. Okay, end intro, here goes.

Christ is central to my life. Not central in the sense that I'm a Jesus superfan that goes to all His games and buys all his T-shirts and always bets on Him in the World Championships or whatever. Rather, He is central in the sense that my life is contingent upon His and that there is a flow that begins in Him that sustains and emboldens me. All of my philosophy, my "core values," and motivations derive directly from my understanding and knowledge of Him. This is not a convenient extract of a philosophy that I base on personal needs, but rather a realty that defines and reshapes my identity as I come to experience it more deeply.

So what do I do with all that? I'm more asking myself that than posing a brilliant rhetorical question. It means that my ideals as a physician, the standards to which I aspire, are not rooted in the values held by the medical community at large, nor even in my own personal beliefs and desires, but rather my ideals flourish where the Word has been revealed to the world. This is all very high-sounding talk simply to say that what God through Christ wants is what I want, even when I don't (temporarily) want it.

Some questions from the reflections paper we got:

What are your core personal values?

Rather than thinking about what pleases and motivates me most, I can respond with simplicity:

Love.

More specifically:

Seeking justice in the world I find myself in
Delighting myself in kindness
Recognizing my true strength and my true weakness in light of the glory of God.

I have not yet attained realization of those core values in my daily life, but to them I aspire and I persist.

After establishing such a base, my picture of physicianhood paints itself.

Physicianhood means committing everything I am and have to God and to the principles set forward by Him and learning how to share the light that I have with those around me, being Christ to a broken world.

Outro

I plan to finish up this writing assignment over the next few weeks to months, and I'll plan to post it up here as it takes shape.

Asking and Receiving

2007-10-19T12:50:00.000-07:00

I haven't figured out that fine line that differentiates asking and receiving from asking and being rude. I've erred on both sides, but more frequently on the latter I would say. Nonetheless, I know that if I DON'T ask, I WON'T receive, so I persist.

A great example arose this weekend when I decided that a sunny weekend in western Washington was a terrible thing to waste studying, so I took off on Saturday for destinations previously unknown. I found myself hiking alongside a mountain stream punctuated by two impressive and one not-so-impressive waterfalls crashing through a forest of large evergreens. It was a peaceful and enchanting place.

The asking came when I realized that the picture of a tent with a circle-slash over it might apply to me. I inquired at the park manager office and found to my delight that I would be able to camp in certain areas of the park if I wasn't too obnoxious. What could have been merely a beautiful day hike turned to a wonderful solitary experience and some long-overdue time spent with my Creator.

This came on the coattails of procuring three tickets outside the door to a sold-out Jimmy Eat World concert earlier in the week. I had prayed that morning for friends to hang out with and ended up helping out a few friends who also were trying to get tickets. I was thankful to God for working through all things.

The following Sunday rocked me. I found a church. The music made me feel at home (Jars of Clay's "Hymn") and the message was all about God's tough love. He lets us experience the consequences of our actions, even when our actions lead us away from Him. Graciously, He is always there to receive us and help us when we decide to return.

A Random Assortment of Unrelated... stuff

2007-10-06T21:12:00.000-07:00

I just got my ticket today for Thanksgiving... in Texas. It's kind of weird that I can go home to Alaska but I'm heading south. I guess that just means there are a bunch of people I love down there. I'm really looking forward to seeing all of them, both family and friends.

It's been weird settling into a city. I find it incredibly easy here to be surrounded by people, but not really know anyone. Acquaintances have always been difficult for me... not quite a stranger, yet not quite a friend. I've always been one for either meaningful relationship, or temporary interaction. On that note, I'm incredibly thankful for moving down here with 9 good friends from last year. Alaska WWAMI rules!!

Today made me realize it's about time to grow up. There were several factors that kind of converged at one time, giving me the epiphany that life requires discipline and determination. It also requires sensitivity to others' needs, and no matter how much I wish everyone would just be open and honest, that's not life. Sometimes, you have to play by societal rules and not take people at their word. You have to play the game of "guess what I'm REALLY thinking." Okay. I give. I'll play.

I realized that so much of the Word talks about us being righteous. Not that we don't have all the freedom in the world, but that application of that freedom looks a lot like legalism. We don't do things because they are rules, but because of how they impact our character and identity. In order to experience true freedom, we cannot separate our actions from our ideals. Everything must work together. Here's where the rubber meets the road.

We have all been given the capacity to do a lot with our lives, the time I have on Earth. I have the freedom to waste that time or to invest that time. I want to use my time wisely, to do well in school, to invest in other people, to serve and to enjoy the world God has given us.

I will never abandon some of my child-like behavior, but I am resolved to abandon childish behavior. I am resolved to give more than I take and to love more than I am loved. That's a tall order, but it's time to grow up.

2 down...

2007-10-04T18:12:00.000-07:00

Dermatology and endocrinology.

Fast and furious for a few weeks and those classes are nothing but fond memories. I've finished both of those finals now (passed) and am now sorting out pharmacology, cardiovascular, urinary system and clinical medicine. It's hard to believe that classroom instruction in those areas is done. Sure I'll attend lectures and learn hands-on, but the good majority of my learning in those fields is done.

I feel like some one should come tell me that I haven't learned enough and I'll have to take the classes again. But I passed. And somewhat convincingly.

I'm a little excited about that, and it's nice to move on to new subjects.

That's pretty much it. It's just weird to be finishing classes already.

The final chapter on Daniel (in the Ecuador saga anyway)

2007-10-02T12:01:00.000-07:00

Monday, October 1, 2007

Dear All,

As most of you will remember, at 4:30am on Monday, July 2, 2007, I got a phone call that rocked our world. I assumed it was from Africa where Eddie was doing mission work in Chimala, Tanzania with his brother Bill and Bill's wife, Cyndi. Instead I was stunned to hear it was Ross Baldwin in South America where he and our son Daniel were doing mission work in Ecuador. Ross was calling to tell me that Daniel was going to be ok, he had been shot in the stomach a couple of hours ago and was in surgery at that time. After a brief conversation (what is there to say at a time like that?) I prayed with Ross, especially asking for Daniel's complete recovery.

Well, we are more than grateful to our God above to say that our prayers (and yours) have been answered in a mighty way. Daniel headed out with the majority of his earthly belonging in his black Hyundai (that he is going to work on buying back from us -- its a long story) from Arlington after eating spicy Mexican food with Eddie and I at Taco Cabana at 1:30pm today. He headed to his new place to live in Abilene,Texas, almost exactly 3 months from that life changing day in July. After 3 surgeries and many adventures, we believe only 3 months is an incredible recovery.

Why now? We are so thankful to say that Daniel had his last medical visit on Thursday. The hole in his back has healed. His shingles healed up weeks ago. He is completely released from all doctors. Praise God for that. In fact, the medical supply people had UPS pick up his Wound VAC ( a.k.a. man purse) today. And he bragged a couple of days ago that the only medication he is taking is multiple vitamins (name brand, not generic, Dr. Hendrickson).

This has been an incredible saga. And we have been incredibly blessed. In some ways much of it seems like a blur now. But in other ways it is very, very real. To say it has been challenging is an understatement. But with all the struggles have come so many lessons learned and lives blessed. And of course, all that is important on an earthly level is that Daniel's prognosis is complete recovery with absolutely no aftereffects. Although he has much of his strength back compared to where he was in July, he still has to take some things easy. No heavy lifting, of course. He walks with a little bit of a hunch due to his abdominal muscles being weak. But he is still taller than most of us at 6'3" --hunch or no hunch. He is working on getting back into shape with long walks (do you walk 3 miles several times a week?). The doctors say it will be a year before he has all his strength back but he is released to do whatever he feels like. Some things still hurt, like jogging and sneezing. But he is coping well. Since he can't jog his Dad got one of his bikes adjusted for Daniel to take to Abilene. And Daniel informed us the other day that if you blow your nose when you feel like you might sneeze, the latter can sometimes be avoided.

What's in Abilene? A job soon, hopefully. He has applied for several hoping to use his business degree if that works out. Also there is a great support group of friends. Plus, his brother Jonathan, who lives in Lubbock is working on getting a computer job there so they can share a small, 2 bedroom rent house. Interestingly, both boys felt led to move to Abilene without knowing the other was going to move there. When Jonathan found out Daniel was moving there, that cinched the deal. Jonathan had already applied for jobs there. (Remember our family doesn't believe in coincidences.) So Daniel has made it to Abilene slightly sooner than Jonathan. As parents, we are very pleased with this development. Both are godly young men looking forward to serving the Lord in whatever ways He desires. They are like-minded in ways but very different in other ways so there will be lots of "iron sharpening iron" moments. Jonathan, who is younger by 17 months, just stresses he has put in his time and he won't share a room with his brother! Fourteen years was enough for him. So, it seems this is the answer to why Daniel didn't get to move to Seattle at the first of September as we had prayed. God had other plans as Daniel has noted in his blog.

Besides praising God, we can't say thank you enough to each of you for your love, concern, encouraging words, and many acts of kindness, such as bringing us dinner on many occasions. Also, thank you so much to those of you who contributed to Daniel's medical expenses. And of course, we are deeply thankful for all the prayers. We have been lifted up so many times. During the dark moments, God used so many of you to keep us going -- and looking up. This may sound goofy, but I am so thankful to live in the modern age where we have email to communicate to and be communicated with. Both were vital throughout the last three months. And the cards have been an intricate part of Daniel's healing as well as our encouragement. It was fun to watch Daniel look for the mail each day, anticipating if he would get any cards, as he often did. Thank you all.

Eddie and I are thankful for the care we received from so many with whom we work. When the going gets tough it is amazing how people come through and you can see how they deeply care about you. Church family has been awesome -- those from Pleasant Ridge and North Davis, from churches in Alaska and from churches many other places. We have felt your prayers. We are truly blessed. And of course there is earthly family. I can't express all the things you have done, from staying in the hospital overnight, to regular phone calls and cards and much more. Thank you for being there for us. Of course Sara Ann, who moved to Crowley, Texas, two weeks ago, gave up her summer for her brother. Thank you Baby.

So the saga that started in Ecuador 3 months ago on a potentially very low note ends on a high note today. I have continually prayed we will never be the same. In many ways things are back to normal. In only the last couple of weeks we have engaged in some things in life that we had not since before July 2nd (who cares to go to a bunch of social activities or the mall for that matter when these things happen?). Yet in other ways life seems changed forever. Some things that seemed important or irritating just don't seem to matter as much now. We are thankful Daniel has had this experience and look forward to how God will use it in his life in the years to come. In fact, Daniel told me before he ever left for Ecuador that he sensed that God was going to allow him to be in danger during his life. After Ecuador happened though, he said he never expected it to include getting shot! So we won't be surprised if more danger lies ahead. And we don't worry about that (Matthew 6:34). We just live our lives today and look for God to be God.

So today, prayers of thanksgiving. Prayers of awe to God for his abundance and love. And prayers confessing our weakness and moment by moment need for a loving Savior and friend. In crisis moments it is easier to rely on God. I pray that for you today you will rely on God if you are in a big crisis, a small crisis or no crisis at all. Its an awesome life to live (II Cor 1:8-11). God, forgive each of us when we forget that.

Again, thank you for your interest and concern. We are deeply humbled by your love! May God richly bless you and yours.

We are grateful to say that at the Stinson household, the saga has ended.

Love,
Eddie, Marilyn, Sara Ann, Daniel and Jonathan

Nothing like warm cookies

2007-09-27T00:29:00.000-07:00

Life has definitely been getting better the last couple weeks. Tonight, I celebrated absolutely nothing at all by making chocolate chip cookies. For some reason, I've been pining to make cookies lately. So I did. And they were good. And there was evening and morning, the 4th week of second year.

I also slept til 11:30 today. Because I could. It was wonderful. I rode my bike to school with Ted. I learned all about EKG's and catecholamines today in class! I listened to a lady talk about experiencing a heart attack at age 25 because of a genetic disorder, and while that doesn't sound particularly wonderful, she knew the Lord and spoke with love and truth and gentleness to a group notoriously skeptical and won their hearts. She admonished us that without wisdom and grace, our knowledge is nothing. I wanted to hug her. Then I ate some delicious Thai food on the Av. I went climbing at the UW rock gym with Ted and Josh and Melissa. And I made cookies. Did I mention they were delicious?

Why is life so good you might ask? Well, I guess because I've finally started pursuing God again. I've been pretty disagreeable with Him because of how He chose to do some things in my life last year, and I've finally come to the conclusion that being bitter only hurts me more. Life in the Spirit... there's just nothing like it. It's good to be moving that direction again.

So enjoy your day and give thanks to God for the ways He is blessing you in every moment.
And make chocolate chip cookies. Then, send them to me!

May I be so Bold... Yahoo!!

2007-09-19T14:39:00.000-07:00

I am currently riding the bus having just left my HOUSE, which I am living in as people are known to do who are NO LONGER HOMELESS. Just thought I’d emphasize that. Praise God who provides and allows us to experience testing so that our endurance will grow. Although to be honest, I’ve had just about enough testing for one summer.

Here are the specifics on the house, cause everyone wants to know I’m sure. 2BR+ 1BA W/D D/W util inc big BY great neighborhood.

For those of you who are not fluent in Craigslist, that means 2 bedroom with an extra little room downstairs, washer, dryer and dishwaster, utilities included and a big backyard! All that for a mere $1400/month. Yikes. This is more rent than I have ever paid in my life times 1.5. But I’m grateful to have a place to call home. It even comes with old lady furniture (including beds). I made sure to replace as many decorations with weapons and outdoor gear as quickly as possible so as to not confuse any guests about my status as an old lady.

Not that I dislike old ladies. I’m actually rather fond of them and have even been related to a few in my day who were fine examples of human excellence.

One irony. I unpacked my stuff last night, including a watch that was still on Alaska time, so I am late for the med school a capella practice today. Bummer. I got a great night’s sleep though. In my own bed. In my own house.

Homelessness

2007-09-15T18:59:00.000-07:00

I'm sitting in a coffee shop on Canal Street (which I highly recommend by the way) not out of choice, but out of desperation. Despite the fact that it is now 7pm, I have done nothing resembling productivity today. And I didn't plan anything because I had full intentions of studying diligently. The desperation part comes in when you start asking questions like: where else could I go to study? Nada. Homelessness is a nomadic disease devoid of direction and security.

All that after only 3 weeks. I hear some people live without a home for more than 3 weeks sometimes.

Of course, they're not scraping through medical school.

Then again, they don't have gracious friends who take them in.

I won't pretend that I have it nearly as bad as guys like "Guitar Man" who I enjoyed breakfast with today, but he seemed pretty content with life as he ate his sausage and cheese bagel sandwich.

The canal looks peaceful from here, a calming presense in this currently scattered mood.

The couple in the corner cuddles and steals kisses... obviously infatuated with each other and oblivious to the world quickly streaming by on all sides.

Who knew blogging could be so random and yet somehow therapeutic. This one was definitely more for me than for you.

With high hopes of healed homelessness hereafter,

Ross

Continued blogging affairs

2007-09-05T11:23:00.000-07:00

After a conversation over wine with some dear friends/fellow travelers on this journey of medicine, I've decided to make an attempt at continued blogging. Thanks for the encouragement guys.

I'm still in search of a house, but hopeful. More and more places keep popping up that are closer to what I'm looking for. Kind of like women in my life. Huh.

In an attempt to more fully focus on God and prayer, I've given up food for a little while. I'm not sure how long this will last, but I'm predicting that I will have my first meal shortly after acquiring a new residence. Let's hope that comes sooner rather than later.

(saying this isn't to show how cool and spiritual I am, but more to encourage people to fast. I think it's underdone in our culture, and given the preoccupation many of us have with food [myself included], it strikes me as a good idea to remind ourselves who really controls our bodies. plus, lots of cool Bible people did it. like Jesus.)

Another random bit that excites: whilst wandering around Ravenna looking for a fax machine, I came across a retirement home. Brilliant!! Both close to my future residence (I hope) and the UW! One thing I really want to do here is get some good, old-fashioned dominoes going with good, old-fashioned people. It's really quite spectacular if you've never tried it. One of the activities I looked forward to attending back in my darker days of soul searching.

That's it for now... if anyone is still bothering to check this site, I hope you find my ponderings rewarding! I really enjoy writing them.

Ok. I'm really done.

For now.

Septemberly News on Daniel

2007-09-04T19:41:00.000-07:00

Dear All,

What a magnificent week God gave us last week! Daniel had the usual 3 appointments for wound care but he also saw his Infectious Disease (ID) Doctor and his trauma Surgeon. Both were very pleased with his progress. Both moved his care to the next level - which I'll explain in a minute. Many things for which we praise God.

Dr. P (you couldn't pronounce his first and last name even if I spelled it out) is originally from India. When he was first asked to be the ID Doctor to treat Daniel's raging infections, he came in with a very professional, business attitude. You could tell he knew his stuff but he was quiet and we couldn't engage him. For example, we told him that Eddie, Sara Ann, Aunt Sara and I had been to India. Well, usually that starts a big conversation. People want to know what part of the country you visited and they tell you where they are from. And the conversation goes on from there. Well, Dr. P barely acknowledged we had said anything. He wasn't rude, just quiet. The Internist had told us he is quiet when he is worried. Well, on Tuesday morning of last week, he came in smiling, friendly and open to conversation. What a difference. Why the difference? He had a CT scan done the Friday before and it showed Daniel's infection was completely gone! As we conversed with him he stressed the seriousness of Daniel's condition when he arrived in the States but now was very positive and took Daniel off of IV drugs completely. No more spending 3-4 hours per day watching an IV drip for Daniel. So we no longer have a son who is an IV drug user! (ha!) Life is much more normal for Daniel. Thank you Lord. He just has to take oral antibiotics for 4 weeks as a precaution.

Then on Friday we went to see the surgeon. He is always friendly. He was happy with Daniel's progress. To stress how much healing Daniel had done and what the prognosis is he said that no matter what Daniel does the hole in his back is going to close. He can do any activity that he feels up to (and that a Wound VAC will allow). His sister has told him she wants a room painted!! Anyway, the trauma Surgeon discharged Daniel and said he didn't need to see him anymore. Praise be to God. So obviously Mom and Dad are grateful and doing better.

So, what about leaving the first week of September as Daniel had hoped? The hole is still there but not worrisome in the way it was. It is closing and there is skin growing around it. You can tell a big difference every time the nurses change the dressing (which is the only time you can see it). We are much encouraged by being able to see the dramatic healing God is doing. But it is still open. Also a further development. As of yesterday, Daniel was diagnosed with shingles. It is on his neck and scalp. A doctor told us that happens sometimes after someone has taken steroids. Daniel had steroids to counteract a rash from antibiotics a couple of weeks ago. So, obviously, God has plans for Daniel to stay around at least a little longer. Ok by us.

So, Daniel is on 5 different medications right now and has the Wound VAC (man purse) with him all the time. He began driving again on Saturday (he even drove me to the wound care visit on Monday, as it should be!). He said it took a minute for him to get the hang of driving - like staying in his own lane - but then it was normal after that. He has more energy in general. He is playing his guitar more. He is just doing more. For example, he drove to the park on Monday and walked for about 3 miles while it was still kind of cool. The only thing was the old ladies (like 40s and 50s he said- I gave him a hard time for that) were passing him. Sara Ann and I tell him we can still "take him" (down) at this point. But we know our days are numbered. And thankfully so. His strength is returning although the surgeon said it will be a year before he is completely back to normal strength.

Please continue to pray for his healing. The shingles are not very painful at this point but we understand they can be. So pray for freedom from pain. And while you are praying, praise God for your love and interest and support you have given the Stinsons in our time need. We certainly praise God for YOU!! The ordeal is almost over but the blessings from the outcome have not all been revealed yet. We look forward to that. God's blessings are new every morning. Without struggle, there is no growth.

Obviously Daniel will always have a testimony to give of God's love and care and how He spared his life. Pray that he will be used mightily by the Lord in His kingdom in the days, weeks and years ahead. How gracious our Lord is! When Daniel was only midway through his hospital stay in Ecuador and he was very foggy, I told him that 10 years from now if the conversation got slow or boring, he could just say something about the time he got shot in the stomach in Ecuador and that would get things going. My son who is usually sharp and with it looked at me and asked, "Why would I wait 10 years to talk about it?" Today he is clear headed and looking forward to God's continued working in his life -- if it is in Arlington Texas for a few more days or weeks or in Seattle or somewhere else after that. By this, we are much encouraged.

May God richly bless you today. May you see His hand on you. May you continually hear and respond to the Holy Spirit's prompting. And through that glorify the Lord and be blessed as well as be a blessing to others. May God lift you up today, no matter what your struggle.

Love,
Eddie, Marilyn, Daniel, Sara Ann and Jonathan

The Latest

2007-08-29T00:05:00.001-07:00

Dear All,

Overall, Daniel continues to progress well. The hole in his back continues to heal. It is less deep and skin has grown some on the edges of it. He usually has energy to get out some each day, even if it is going to another doctor appointment. He is still taking IV antibiotics 3 times a day which he administers himself. He did have an allergic reaction to one this last week so he had to change one and take a round of steroids. He has an appointment with the Infectious Diseases Doctor on Tuesday morning. Please pray for wisdom for this doctor on his continued treatment of Daniel's infection from the gunshot wound that created seepage from his intestines, causing infection.

Saturday Daniel saw his internist for the first time since he was discharged from the hospital. She was happy with his progress but stressed he needs to be entirely healed before he leaves for Seattle. His back wound has to be completely taken care of. For the first time, to stress how seriously the situation needs to be taken, she stated that some doctors weren't sure Daniel would survive when he first arrived in the US. (That caused me to sit in the corner with tears quietly coming down my cheeks. It was very sad and sobering yet made me grateful to God, too.) The wounds on his front from the gunshot, surgeries and various tubes are all healing nicely. It's the wound on his back that is open that is the concern. So even though all medical people involved are pleased with his progress, it is still a serious condition. There is no reason to assume there will be major problems but it would be foolish to be casual about it.

This weekend Daniel was especially blessed in two ways. He had 6 friends from ACU (most of them roommates of his for a year or more when he lived in a house with a bunch of guys) come to town to spend about 24 hours with him. Daniel and his "man friends" (as he calls them) did guy things like going to a guy movie, eating manly bar-b-que, and playing guy video games. Thank you Stephen, Curtis, Marcus, Mark, Phil and Bret for coming. I pray God will bless your generosity. Also, thank you wives for those of you who are married. Then also Jonathan was able to get a few days off work and arrived tonight from Lubbock and won't have to go home until Tuesday. So a mother has all three of her chicks here. Yea!

We have been very loved and encouraged by people. Daniel has received many cards and really good food. People have said many encouraging things to us. The love has been wonderful.

On the other hand, I have really prayed about sharing this next series of thoughts. Before you read the next paragraphs, know that we feel deeply loved and can't express how much we appreciate all the love and concern shown to us. Just today I had several people tell me they are still praying for Daniel and us. The prayers have been incredible. By that we are greatly encouraged and blessed. God has been gracious beyond our belief. Yet, I still want to share some thoughts that might be helpful to others and have humbled me when it comes to sharing my concerns for others in difficult situations. So here goes.

Sometimes its hard to know what to say to people. God has shown me in a small degree what people go through who deal with chronic illness. When people ask how Daniel is doing, I say he is "going the right direction". Of course with that I mean in my heart that his wound is healing, closing more all the time, he has more life in him and is seeming more himself. But I also think in my heart that my son almost died, has had three major surgeries, he has a hole in his back that is packed 3 times a week with special healing materials, and has to take antibiotics 3 times a day through a PIC line that is semi-permanently inserted in his arm where they also draw out blood regularly. One day a loving brother in Christ asked me how Daniel was doing. I barely got through saying "he's going the right direction" when the brother enthusiastically said "Great!" and abruptly walked off. Although I didn't respond outwardly, inwardly I thought, "There is nothing great about this! My son almost died!" Oh, I know God is great. And I know that is what this kind gentleman meant. But what we have been going through is not "Great!" Don't get me wrong. I did appreciate being asked about Daniel by this man. I deeply appreciate all the encouragement and love that has been shown. But relying on the Lord doesn't mean it doesn't hurt and that it is not difficult. It is emotionally a whippin' at times.

Again, don't get me wrong. I see God working every day. I have been especially aware the last few days that God orchestrated Sara Ann being home this summer after being away except for college breaks for the last 8 years. There are no accidents. We have really needed Sara Ann this summer. I don't know what we would have done without her in the hospital and since we have been home. She has been a great comfort to her brother. And she cooks great too!

In addition, I have continually prayed that we would never be the same again. I see God bringing that true in many wonderful ways. Spiritually I feel God's presence in ways that would be difficult to explain in an email. I understand more fully Paul's words in II Corinthians 4:6-9. " For God, who said, "Let light shine out of darkness,"made his light shine in our hearts to give us the light of the knowledge of the glory of God in the face of Christ. But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us. We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed."

Long-term illness or chronic illness or what ever you want to call it is not for wimps! (Do I hear some loud "Amen"s in the background??) For example, just this week Daniel has had a fever two different nights. This has not happened since he left the hospital on August 1. Should we be concerned or not? The doctor says it is ok. Daniel thinks it is just because he has gotten too tired at times from being up too much. You know it is hard to keep a 24-year-old down too much!

I am reminded of the old "can't go around it, can't go over it, gotta go through it" when it comes to what is happening. I am grateful for where we are and all is going the right direction. We have our son and we know others don't. I would be very ungrateful to not be aware of that every day and count each day as precious. The prognosis is "complete recovery expected". I know many who have cancer who don't know if their loved one will be here another season, much less many more years. But when I was on the phone with my mother today and she told me that my sweet Aunt Jill had prayed "God, please don't take another one" (family members know what that means) I had to shed a few tears.

So, please keep praying. Please know that God is working mightily and we are blessed. But please also be aware that anyone who has a loved one or is themselves going through a serious illness needs your continued love and support and concern. Do ask how they are doing but realize their answer may not say even half of what they are saying in their heart. Send them cards, share a word of encouragement, in general show your love.

We are still praying in faith for God's healing by September 1 (God does still do miracles) but also accept whatever his plan is for Daniel. As said before, "the Lord giveth, the Lord taketh away, blessed be the name of the Lord." We are enjoying sweet times with each other. It would certainly be fine to have him here more but would be great if he leaves too.

Overall, things truly are "going the right direction." Again, thank you for your love and concern. Pray for the healing of Daniel's wound. Pray for the infection to be completely gone. Pray for our emotional, physical, and spiritual strength. And pray that God will be glorified.

May God bless you and your family whatever your circumstances today. May He richly bless you in the days ahead. May you feel His presence. May others comfort you and care for you in exactly the ways you need it today.

Keep the prayers going. To God be the glory.

Love,
Eddie, Marilyn, Daniel, Sara Ann, and Jonathan

P.S. If you would like to see pictures of Daniel's stay in the hospital in Ecuador and here, you can look at his blog at http://toorestlessfortexas.blogspot.com/. I do warn you that the last picture is of his wound. So you may want to skip that one.

Healing Right Up

2007-08-12T12:59:00.000-07:00

Dear All,

Daniel has been home from the hospital for over a week. Hard to believe. His health is getting better every day. We are thankful. For example, the hole in his back has shrunk. It is now 6 by 1.9 cm on the outside with a depth of 3.2 cm. Only two days before the depth had been 4.5 cm.

So what all is happening now? He has IV antibiotics 3 times a day. He still has his Wound VAC (we call it his "man purse") which he is able to plug in at night then go on battery all day. So he is mobile and has had several outings. He can't drive for 6 weeks after surgery (basically till Sept 1) so he is always chauffeured. He has 4-5 doctor/nurse appointments per week that Sara Ann and I divide up taking him to.

We have been blessed by meals (nothing nurtures like food!), phone calls, emails, cards and people contributing to his medical expenses. Daniel specifically said to tell everyone he is thankful for the prayers, cards, food and support. He said he has really been humbled by how people have come in to help him and his family. Every day he checks the mail, looking for cards. And he has certainly enjoyed eating after not being able to for weeks and weeks.

He has also had several visits by his peers. He has been greatly encouraged by that. Just today 3 young women that he went on a Spring Break Campaign with his sophomore year of college came to visit and laid hands on him and prayed over him before they left. He had not seen or talked to any of these young women in years. Praise God for servant hearts.

I have personally been amazed at how God is working in so many lives of so many we are getting to touch base with. God is working powerfully through people who are single, young married, middle aged or retired. Regardless of their walk in life, God has great plans and is using each life in His own unique way. Daniel and I have been talking about how God puts people at different places in life and then utilizes their unique abilities and circumstances in His kingdom. It is great to see the creativity of God and how He works mightily to have a relationship with His people. It reminds me of Romans 12 and I Corinthians 12 and how God has chosen each part of the body for the work He has for that person. Each may look different and have different functions, like the eye and ear, but each is designed to function as God has made them. May God work in your life mightily today whatever your station. May you feel His presence and the peace that passes understanding that comes only through Jesus Christ and the Holy Spirit. May you be aware of being an ambassador for Jesus if you are working in an office, getting ready to go back to teach this fall, wading through lots of laundry and dirty diapers, or being limited in life by your aging body. May you remember that your generous, caring Heavenly Father loves you if you are struggling with your marriage, your health, your children, your finances, your lack of relationships or your mental or spiritual health.

What is Daniel's main prayer request? Daniel is fervently praying and ask others to pray that he will be healed by September 1st and be able to move to Seattle. What will that take? The Infectious Disease Doctor releasing him from taking the intravenous antibiotics. The wound on his back must be closed and no more need for wound care for that wound or the other various holes from surgery, gun shot, etc. And the Trauma Surgeon releasing him.

If you want to drop Daniel a card with a message, his address is 2801 S. Shady Lane, Arlington, Texas, 76001.

Again, we praise God for your interest, love and prayers. May the peace of Christ be with you.

Love,
Eddie, Marilyn, Daniel, Sara Ann and Jonathan

How Do You Explain?

2007-08-08T01:47:00.000-07:00

Fairbanks has been great. Alaska has been great. I love so many people here. Theoretically, I love so many people everywhere, but practically, this is where it's at.

Here's a rundown on what's happened with me since coming back to Alaska.

Loved seeing my parents. They are such a strength for me. I know that no matter what is going on in my life, their love is unchanging and stronger than I can conceive of. I hope to someday love as deeply as they do.
Loved seeing my brothers and sisters in Kenai. I especially loved some of the conversations I got to have and excitement I got to share over what God is doing in Kenai. He is moving! Again, the love my brothers and sisters in Kenai have for me is humbling. I don't understand it, but it is a source of strength for me.
Loved seeing my friends, brothers and sisters in Girdwood... and Mandy, Darren & Ely. Coming to Girdwood feels almost like coming come for me. I really love that place! It was great to see Roberto from Ecuador and talk about my trip to his country, and see my friends from The Pond, and hear about Adam's epic spiritual adventure to Haiti and stay with my wonderful family there.
Loved camping with my friends in Hope. A great time of relaxation, conversation and reflection. Am SO grateful to have friends who love me enough to come visit me and go camping with me in Fairbanks! I don't deserve you.
Loved seeing my sister in Anchorage and getting some in-your-face kind of challenges that caused me to reconsider my view of the Kingdom of Heaven on Earth. We truly are caught between the times.
Loved spending time with my brothers and sisters in Anchorage. Had some great conversation and renewal. And some great pizza for that matter =).
I'm realizing that more and more places are starting to feel like home and that it is more a reflection of how I have come to know God in those places than anything else.
I'm happy to be in Fairbanks learning about primary care!
For the first time, I saw a child be born last night... twice. Incredible.
For the first time, I scrubbed in on an emergency surgery (a D&C for you medical folks).
I've been to a recovery camp for substance abusers and seen the face of Christ in the very warm people there.
I've realized my own weakness and inability to stand on my own. If I look strong to you, it's a show and I'm sorry. My only strength comes from what the Lord gives me.
I've made plans to live with Daniel in Seattle, counting on God to heal Him because of His marvelous glory and excellence.
I am so incredibly happy to have Abe in town with me. I need Christian brothers around me at all times or I fall apart.

So much more I could say. May God receive glory for everything I've written tonight and may He continue to become greater as I continue to become less.

Home at Last!

2007-08-02T21:00:00.000-07:00

Dear All,

We are thrilled to report that Daniel was released from the hospital today, Wednesday, August 1, exactly one month after he was shot in the stomach in Ecuador. He goes home with a Wound V.A.C. that he must be attached to 22 or 24 hours per day, a PICC (sp?) in his arm to get IV antibiotics twice a day, many medicines and lots of "cool scars" / wounds. He also goes home weighing 30 lbs less. Yes, when we weighed him on Tuesday, he had lost 30 lbs in 30 days. WARNING: this diet is not FDA approved!

The next few months are going to be eye opening for Daniel. He has been in such a fog for so long now. Daniel knows God has much more service for him to do. He feels the calling. He wants to hear and see God's direction each and every moment of the day as well as show others Jesus. Pray that he will hear God's sweet and gentle voice. He knows beyond a shadow of a doubt that this injury is part of how God is going to use him. One time I said something about "when the accident happened". He quickly but calmly corrected me and said, "Mom, it wasn't an accident." He not only meant that from the shooter purposely shooting into his tent but also from a spiritual point of view. Romans 8:28-29 anyone?

As I was reading the Bible to Daniel a couple of days ago, he asked me where the verses are that say God will never leave us or forsake us. I turned to Hebrews 13 and we read them. He said that people's prayers can be so weak. That is why we don't see God doing powerful things in the United States. People don't boldly ask God for specifics. Why would we just ask God to be with us when He has already clearly said He will be? Ask for more! Be bold. Be brave. Let God work powerfully. Then praise Him! We are asking boldly for a complete healing and many blessings to continue.

We have learned so much. We've learned a lot about how God provides what we need just when we need it. I read Acts last week and felt close to the apostles, seeing the many ways God provided for us in Ecuador and when we got back to the US. I pray that each day, just as God provided for Paul and the apostles on Paul's oceanic cruise to prison, that you and I will see God providing for the smallest things, each and every step of the day throughout our lives. And not only in the crisis times! But in the daily humdrum, too. He is there. Count on it. Watch for it. Believe it. Share it with others.

We are beginning to know a little bit about the weariness that can settle in when you have a loved one with a long term illness. (Forgive us if we have not loved you enough when you needed someone to continue to care about you during your time of ordeal.) But getting Daniel home today will help greatly with that. He has a long way to go with lots of recovery and doctors appointments and medicines, etc. Thankfully, Sara Ann is still around to help as are other loved ones.

Where do we go from here as a family? All 3 of our children want others to know the love Jesus has for them. Sara Ann was a vocational missionary in China for 2 years and feels led to move to LA in about a year for more vocational ministry (any one interested in forming a team?). Jonathan graduated from Harding in the Spring and is on a church planting team headed for Chicago in about a year. Eddie and I are amazed at the faith of this younger generation -- not just our children. God is on the verge of doing incredible things with so many of them. So where do we go? We look for God's blessings to be new every morning and seeing how we can join Him in His work. We will let you know about that every once in a while as Daniel continues his recovery.

Please don't forget us in prayer. If you would like to send Daniel a card now and over the coming weeks, I know that would be a great encouragement to him (Daniel Stinson, 2801 S. Shady Lane, Arlington, TX 76001). In some ways he should heal fast since he is 24 years old but also it will be months so that will seem slow in ways. But we do believe he will heal.

Thank you again for your love and prayers. Thank God for the wonderful doctors and staff who He has used thus far and will continue to use. May God bless you richly today. His blessings ARE new every morning.

Love,

Eddie, Marilyn, Daniel, Sara Ann and Jonathan

I'm still here

2007-07-31T23:21:00.001-07:00

I'm in Fairbanks. I'm pretty sure I'm going to keep blogging, but have had limited Internet access until now and have been under the gun to get lots of things done.

I had an awesome time with my family, friends and brothers & sisters in Christ in Kenai, Girdwood and Anchorage. I love all of you guys. You have touched my life in the last week.

I am incredibly blessed to have such amazing people in my life.

Boredom is a Good Thing

2007-07-30T21:19:00.000-07:00

Dear All,

Well, we are very excited to say we are nearing the end of Daniel's hospital stay. It may be a few days but we are getting signs that he will get to go home soon. He had 3 solid meals today. Paraphrasing, he said he knew it was cafeteria food so wasn't great but tasted really good to him. He had small portions of eggs and bacon for breakfast, chicken and mashed potatoes for lunch and chicken and rice and apple pie for dinner. Can you imagine eating solid food after basically living off of IVs since July 2nd?

Yesterday he asked us to bring his guitar to the hospital. He's played a little each day. Today, before Jonathan headed out of town, he stopped by and played a quick board game with Daniel and me. Daniel's attention span gets better each day. In fact, today he seemed a little bored. He has been too sick to be bored before today. We praise the Lord for simplicities of life. So taken for granted normally but not today.

So, we praise the Lord for continued recovery of our precious son, Daniel. He still has a drainage tube that will have to be removed, he's connected to wound care and IVs and his pneumonia is still being worked on. But, the doctors have said he should be fully functioning in all ways after some time of recovery. What more could we ask? Thank you Lord.

We pray that none of us will ever be the same again. Forgive us Lord when we forget your many blessings and continued care that is always there regardless of our circumstances. You have provided so many blessings. Simply amazing.

Thank you for caring. We can not thank you enough for all your love and prayers. We have learned so much from you.

To God be all the glory. May He increase your faith and richly bless you.

Love,
Eddie, Marilyn, Daniel, Sara Ann, and Jonathan (and Aunt Sara)

...And We're Back

2007-07-28T10:01:00.001-07:00

Dear All,

Daniel had a much better day Friday. He showed some energy that hasn't been there since he was shot in the stomach in Ecuador. It warmed our hearts to see him respond to his friends who called him from Alaska in the afternoon. He smiled as he listened. He chuckled some. It was very encouraging. Still tired and with pneumonia but going the right direction. Thank you Lord.

Other good notes. Daniel is on full liquids today instead of clear liquids. He only took a few spoonfuls of the soup and about two bites of pudding at lunch and dinner but that is a start to getting his system working. Something that is necessary for him to be released from the hospital. And he kept it all down -- which didn't happen yesterday with clear liquids. Only two IVs now. Got 20 staples out of incision from his surgery so now he has steri strips. Etc. Etc. So good signs.

Aunt Sara made it through the night with Daniel just fine -- especially considering she is my older sister! Sara Ann is on tonight. So the young blood is back. Jonathan is in a wedding this weekend and then has to return to Lubbock. But Aunt Sara is a school teacher so she has nothing to do with her life in the summer time (just kidding -- it is a labor of love!) Daniel said she did "great" so she is in the rotation. But hopefully Daniel won't be in the hospital too much longer. God's timing is perfect since Aunt Sara couldn't get here till now and Jonathan has to leave now.

We are thinking Daniel will be released this week sometime. But we patiently wait upon the Lord and know He has a plan. Do we patiently wait every minute? Oh course not. We each live in this earthly tent. But overall we do. And are very grateful just to have our son alive. And to see him walk. And to see a smile. This is his 14th day in the hospital -- in the US. The month of July 2007 is a blur (he was wounded about 2am July 2). But we are grateful there is a July 2007 to have him with us.

Daniel says visitors are fine now. He even says it with a little energy (that warms a parent's heart). Of course we know many of you are visiting us in your hearts and with your prayers. And with cards. And with your love and concern in general. Through that the Lord sustains us and we are very grateful to each of you. The Lord has certainly blessed us with the love of many. So keep those prayers going. That is obviously the thing we need the most.

Thank you for loving us -- even if you barely know us. May God richly bless you today. May He hold you close in His heart and may YOU feel it. We pray for each of you and the difficulties you are going through --- at this very moment. May the Lord bless you and keep you.

Love,

Eddie, Marilyn, Daniel, Sara Ann, Jonathan - and Aunt Sara

Continued Progress

2007-07-26T16:16:00.000-07:00

Dear All,

Today was a better day for Daniel! Daniel's treatment for anemia seems to be helping - IVs of iron. His pneumonia is being worked on - breathing treatments, new antibiotics, etc. He walked several more laps today than yesterday when he was so tired and drowsy. He was able to interact with my sister, Aunt Sara, when she got to the hospital (yea for reinforcements!). He sat in the chair for awhile. Several little things. Little things mean a lot.

Also exciting, Ross Baldwin called today when he was on a layover in Houston headed home to Alaska from Ecuador. It was so good to hear his voice. God has really sustained him. We pray rich blessings on him as he does an internship in Fairbanks for a month then on to Seattle to continue with Med School. The verse I read a couple of days ago that reminds me of Ross is: John 15:13

"Greater love has no one than this, that he lay down his life for his friends."

So needless to say, Eddie and I are doing better. We felt your prayers throughout the day. The sweet words of encouragement we have received help us so much. We, like everyone else, need the love of our brothers and sisters. So thank you for lifting us up in so many ways. God is sending blessings from different directions. He wants us to not forget how creative He is. Or how much He has the bases covered. Incredible. We don't walk this walk alone -- but with you and God with us.

As I mentioned, Aunt Sara is here. In some ways we are different as sisters and in some ways very much alike. She is very tender-hearted. So when given the option of looking at the wound care specialist change the sponge/ wound care stuff on Daniel's back, she opted to stay on the other side of the bed and shed some tears as she saw his physical pain. (Been there, done that.) She is going to take duty tomorrow night. She will fit right in with the other attending night monitors (Sara Ann and Jonathan) who can also read big honker books (that means 700-1000 page books) like A History of the American People, Harry Potter and Einstein. Eddie and I can only read little wimpy 200-300 page books like A New Kind of Christian, Irresistible Revolution, and a.k.a. Lost: Discovering Ways to Connect with he People Jesus Misses Most . Its not fair they can read them all.

So tonight its a little easier to focus on God's plan and his glory. After a long couple of days. Have you ever noticed how some days are just longer than others? Especially those days you don't want to repeat!

We love you and appreciate you. All praise to God. The creator of all.

Sweet dreams.

Love,

Eddie, Marilyn, Daniel, Sara Ann, and Jonathan

El Ultimo

2007-07-24T20:30:00.000-07:00

My final foreign entry... ¡Que triste!

As if to affirm me as His child walking in His will, I got a sweet little going away present. Walking away from the airport in Guayaquil after confirming my flight time, I walked up next to a guy with a Bible in his hand walking along the sidewalk. Here's a translation of our conversation:

Me: "Good evening"
Him: "Good evening, you are a Christian?"
Me (a little surprised): "Yes..."
Him: "Mormon?"
Me: "No."
Him: "Evangelical?"
Me: "More or less."
Him: (goes off into this story about how he had just arrived and needed to go somewhere and didn't have money for a taxi for some reason I didn't understand.)
Me: *hands him cab fare* "Were you praying about this just now?"
Him: (affirmative, excited Spanish noises accompanied by many thank you's and praise God's)
Me: all smiles

Just to catch you up, I left the Hacienda de Esperanza after a 7:30 breakfast. A bunch of the kids, Becki, some random guy and I piled into the Hacienda's van and headed down to the main road, otherwise a 15 minute walk. After some quick hugs and Ecuadorian-style fake kisses, I jumped on the bus that pulled up JUST in time. Except for a couple quick food breaks, and a bus switch in Quito, I traveled all day and am now waiting for my flight in Guayaquil.

It leaves at 1am, I have 6 hours in Houston and then a direct flight home to Anchorage getting in at 4:30pm. I have an ERA reservation for 7:30 to come back to Kenai!

I think my last post had some pretty good end-of-trip reflections in it, and I'm pretty tired right now. I might have to keep writing about the rest of my summer just so I don't end on a lame note.

Oh yeah, just thought of another cool thing. I sat next to a Christian lady on the bus too. This place is swarming with them. She had a really cute little girl that was a fireball the whole trip, but not in an annoying way. It was really cool because I had no clue what the other girl I was sitting next to was saying, but could understand the Christian lady really well. It made me wonder if there was something more going on there.

And another thing, I put Justin (the administrator at the Hacienda) in touch with Eduardo. The Hacienda is looking for house parents and Eduardo is looking for work... I figured, what the heck. I hope it works out, he would be an AWESOME dad for a bunch of little kids, and his wife would be great with them too.

Okay, that's feeling a little less lame. I just had my last meal of chicken, rice and lentils, my staple here and am going to head back to the airport to stir up some more trouble. Thanks for being readers, faithful or spontaneous! And thanks to God for giving me fingers with good endurance... actually, we can go ahead and thank Him for everything.

Leave Daniel Alone... please

2007-07-24T20:22:00.000-07:00

Dear All,

Daniel has had a couple of tough days. He is anemic now. So he doesn't feel like much. Plus the pneumonia. Plus the fever continues to be pesky and they are trying to narrow that down some more. So another CT scan tonight. More breathing treatments. Etc. Etc. So at this time, Daniel prefers to have no visitors for a couple of days. He just needs to be allowed to rest and let the doctors and nurses do their thing. He didn't even take a phone call from a very loved close friend tonight. So you know the body is weary.

Is this disheartening. Of course it is. He's our baby. Are we distraught? No. Our Savior lives and our God has a plan. Do we covet your prayers? Without question. So on your knees, standing looking up to heaven or sitting quietly with your head bowed. How ever you connect with the Father. Let it rip. But be sure and thank Him for His bountiful blessings and His continued care. Be sure to praise Him for the glorious loving Father He is.

A few days after Daniel was shot, the song that God placed on my heart is based on the book of Job. It says "Blessed be the name of the Lord . . . He gives and takes away . . . Blessed be the name of the Lord". That is a very comforting truth. I also think of Hebrews at this time. God says never will I leave you, never will I forsake you. Thank you Lord for that truth. With that, we are comforted. Dr. Hendrickson continues to indicate these are medical things Daniel just has to go through. So we continue to trust in her and the other doctors God has put in Daniel's life. This is just a phase that has to be gone through.

On a lighter note, Daniel is not a tv watcher. I mean none at all. So we are all getting a lot of reading done. Besides the Bible I think we have each read about 3 books. I don't know why this is taking the time it is (possibly another week or so in the hospital - maybe more then a long recovery at home) but I do believe God has a plan and part of it if for each of the 4 of us to be still at times.

Have a fantastic evening and a wonderful tomorrow. May God be praised and glorified in your life.

Love,
Eddie, Marilyn, Daniel, Sara Ann and Daniel

Pneumonia, but Happy

2007-07-24T08:37:00.000-07:00

Latest word from the Stinsons:

Dear All,

Overall there is much to be thankful for with Daniel. For example, he walked bunches on Sunday, so much so that the doctor was going to order therapy and changed her mind. Of course he has had to have his entourage to walk since he needs the support of Eddie or Jonathan to walk as well as Sara Ann or me to push his IV pole along. When nurse Bud (that's his real name) saw him walking, he said, "Daniel, you look taller when you're out of bed". (Daniel is 6'3'.) "Good one, Bud!"

Daniel's color is better and his responses to things are more alert. But he has continued to have that pesky fever, especially at night. So today they ordered a chest x-ray and sure enough, as they suspected, he has pneumonia. Dr. Hendrickson says that is not unusual with someone who has had 3 surgeries. The fact that he traveled from a foreign country as he did could have led to pneumonia all by itself. The good news is she consulted with the other doctors and they continue to be pleased with things (thank you Lord) and say that his belly is fine and the antibiotics he is on are doing what they should be doing. So there you go. More good news. No, that is really great news. More surgeries are unlikely.

He got a Wound V.A.C. today. The wound care nurse said that this machine, which he will basically be attached to 24/7 for 2-4 weeks, could make the open wound on his back heal twice as fast. You haven't lived until you have seen an open 3" by 1" wound on your son's back. But it is pink, good skin and the doctors are much encouraged. Why not just sew it up? Due to the infection. So we are thankful for wise doctors and special care products and people.

So please continue to praise the Lord for good progress. Even finding out he has pneumonia is good news since it gives direction --and rules out big problems! Please pray for Daniel's comfort as it is hard for him to breath and be restful. Please pray his lungs will clear and he'll continue to be motivated to walk and he will heal. Please continue to pray God's blessing on the rest of our family as this is a long haul. God told us there would be marathons, didn't he? But to just continue to run the race. So we run.

My sweet sister, Sara, (we call her Aunt Sara so all are not confused) will be here tomorrow. We are overjoyed by that. For as she says, when she gets here, she will be Aunt Sara (the family knows how glorious that is!!!).

Thank you for the cards, emails, and visits. By all this we are much encouraged. And thank you so much for all the prayers. We are so blessed to be lifted up. God has a call on Daniel's life, and you are part of it. Thank you!

To God be the power and glory for ever and ever. Amen.

Love,

Eddie, Marilyn, Daniel, Sara Ann, and Jonathan

Hacienda de Esperanza and Otovalo

2007-07-23T11:46:00.000-07:00

The kids are darling. I don't know what it is about orphans, but it seems like they just soak up love and attention. Diana, Maria, Katy, Gladys, Jorge and John are absolutely adorable and range from 5 to 10 years old. There are two older kids that have been at a local Christian camp this week, Christian and Leoli. The little girls run up to you for hugs and crawl in your lap when you have a lap available. They are all smiles and their words to God before meals have been very humbling and inspiring.

(Hacienda de Esperanza is translated as ¨home of hope¨ roughly)

It was hard to leave this morning, but I wanted to make it up to Otavalo (where I am sitting right now) so that I could leave a significant amount of money behind me when I go back home. I was successful. Otavalo is known for its handmade crafts sold by the local indigios (natives). And if you're wondering, no, I didn't get you anything. =)

Lately, people have been asking me what I learned in Ecuador, or why I think God sent me here. Oh boy, here it comes!

I have absolutely no idea.

And I'm okay with that.

I honestly don't care too much about the why's. I'm not too concerned with putting things in nice tidy boxes so I can pull one out labeled ¨Ecuador¨ and display it to the curious passerby. The mystery of God is beckoning me to realize that I am changed deeply by encountering Him, in ways that words only serve to cheapen. I follow Him regardless of whether I am blessed or beaten down, whether he opens up the floodlights to the path ahead, or whether I stumble in the dark with only His hand to guide me.

My righteousness is looking less like me being a good person and more like me realizing my depravity and need for constant reconciliation with God. And yet, at the same time, my flesh is dying to the joys of this world and desiring more permanent satisfaction. And I don't mean to sound ascetic because I clearly love good food and hurling my body up and down various courses, but I'm realizing that those things are merely shadows of something much greater.

The fruits of this trip to Ecuador and both tangible and intangible. I've talked mostly about the intangible because it's a lot more mysterious and intriguing, but let me just conclude for now by praising God for the countless impacts He has had on lives because of the experiences of a couple clueless guys stumbling around a foreign country or two. I am humbled by the fact that you have taken the time to follow our stories and shown such incredibly love and faithfulness, both in your words and prayers.

I'm feeling a little nostalgic because I'm leaving tomorrow, so if that sounded like a farewell address, it's just me warming up to leave. Peace!

Beauty

2007-07-22T16:05:00.000-07:00

I had a good night in Tena, visiting with expats, eating good food and all that. I met some girls from California that I talked to for a while and had a great time with. Michelle gave me some ad hoc salsa lessons and said I was catching on! I got to share a little of Christ with them, but wasn't quite as resolute as I could have been. Next time. There's always next time to be more like Christ.

I read II Peter today and realized that the promises he is talking about are things like Jesus said about repenting from your sins and receiving forgiveness. It's putting our faith in those promises that motivates us to grow through moral excellence, knowledge, self-control, patient endurance and all that. After all, when we realize that it is Christ alone and the forgiveness of God that purifies us, we are motivated out of thanks to respond by honoring God.

That said, yesterday was incredibly purifying. I rafted in Tena with an Irish guide who has lived in Tena since he was 14. His family runs the Riverpeople rafting company and rafting with them, in Tena, is the absolute best rafting in the country. Go with the Riverpeople! We went cliff jumping and waterfall sliding before hitting the river for the day. There was a diverse group with 4-5 in two rafts. Mostly British girls and a couple from Canada. I teamed up with the Canadiens and the guide Tim for an amazing day of all kinds of terrain from thick jungle to grassly lowlands surrounded by green mountains shimmering beneath the intense Ecuadorian sun.

Lunch was along the river with the local village kids coming up to stare, play and get our leftovers. The rapids were exhilerating, but managable (nothing too life-threatening, Mom) and there were several places to jump out of the raft and swim. The most memorable event on the trip was the raft ahead of us hitting a wave, going straight up, and then curling over to fully inverted, like a back flip, and seeing everyone in the boat falling out. And then realizing that we were intentionally heading for the same spot =). Good times. Our raft did more of a tornado, backwards surfing type thing there.

I could write a lot more about the rafting trip, but I digress. After returning to Tena, I met up with Becki again to head toward Quito. We took a taxi north to a place called Paraiso de Orchida, which is an animal refuge. I made friends with a monkey named Lucho and did some walking through the actual jungle there. I needed a machete.

We ended up waiting by the side of the road for a bus to Quito with some of the local town people. They were really nice and helped us figure out which bus to take. So we ended up outside of Baeza at a highway junction trying to pick up the next bus, and decided not to keep traveling because Quito at night is dangerous, so we found a cheap hotel where we could each get our own room and crashed (after eating across the highway of course).

I'll write more about the Hacienda de Esperanza later, but today we basically took the bus to Quito, met up with Cecilia (Jon's wife) and drove north to the Hacienda. It's a home for several orphans and is a part of a larger missionary effort called Operation Ecuador. Lots of cool connections all over the place up here... staff from Seattle, Washington and Pensacola, Florida (where my preacher at home is from!) Time to stop typing though. Night!

No Pain, No Gain, but Pray Anyway

2007-07-22T16:03:00.000-07:00

We are thankful for a good day for Daniel. Yesterday was good in that he had the surgery the day before so God gave him the start of healing and the doctors said the surgery was successful. But, he had a lot of pain. I mean a lot. Thank you for your prayers for his pain. Today, it was much better.

Today, Daniel was able to sit up for 4 hours. He also got the catheter out. The tube came out of his nose yesterday. He is still tethered by several tubes of various kinds but going the right direction. The wound care for his back is painful (there's a hole in his back that is about 3 inches long) but Dr. Hendrickson says there is healthy tissue and that is good. When the wound care nurse showed him the picture she took to show the doctors (aren't we in the modern age to just whip out our little camera and take a quick digital?!), Daniel said it looked like "lips". The wound is about that shape. I just keep thinking when things come up about all his wounds (the gun shot, the stitches down the middle in the front, the hole in his back, etc) that saying -- "Chicks dig guys with cool scars!" Well, there should be a lot of "diggin'" going on with Daniel.

Daniel was asking about visits from friends today. Tomorrow and in the days ahead, he should be very ready for visits. I hope his peers especially can visit him in the hospital or even when he gets home. This would be a great encouragement to him. But I can't promise you'll get to see the cool scars!

So, all of our spirits are good. I was especially blessed today when I got to spend several hours with him alone in the afternoon and he felt well enough to talk and for me to read the Word to him. I, II, and III John have an awful lot to say about loving others. And that is something that Daniel relates to -- and lives I might add. He and I agreed as we read that one of our favorite verses is "perfect love cast out fear". I pray each of you have the freedom to love and not fear. Even if God sends you to Ecuador.

All praise to the Father above. Glory to His Holy name. May all that is done in the days ahead to heal Daniel be a blessing to us and an honor to God. Pray for his healing. But also pray for his witness and blessing to others today and in the days ahead.

Thank each of you for your concern and love and prayers. We feel them. We are truly blessed.

Love,
Eddie, Marilyn, Daniel, Sara Ann and Jonathan

Welcome to the Jungle

2007-07-20T17:34:00.000-07:00

Lots of terrain covered today. I started out in the midst of a verdant, green valley with mountainsides covered with the markings of agriculture: green houses growing tomatoes, fields staged to produce all kinds of things from bananas to melons to weird fruits and vegetables that don´t have English names. My drive today from Baños to Tena took me through winding mountains roads sprinkled with cascading waterfalls. At times the road came precariously close to the edge that separated the bus from hundreds of feet ending in a meandering river. We drove through a rainstorm that threatened to change my plans only to arrive in Tena to a beautiful sunny afternoon.

All that to say, yep, my camera got stolen/lost (either is likely), so I'm resorting to the ¨thousand words¨ approach. Oh, and by ¨my camera¨ I mean my dad's. Sorry Pop. (stack that one on with the rest of the below confessions!)

Tena really is beautiful though. It's in the jungle with a couple rivers flowing through it. There's an island with a zoo of sorts on it that I visited after arriving. The squirrel monkeys ruthlessly pursue any type of fruit you may offer them. I felt like a pirate walking around with a squirrel monkey perched on my shoulder. YAARRR!!

[FYI: at this point I lost my blog due to crappy internet. Pity me.]

Post-zoo I spent some sweet time in the Word on the banks of the Tena River. A comment I received today on here suggested that I spend some purifying time by running water. Sound advice!! There's nothing quite like experiencing God in the midst of His Creation.

A cool randomness (look for this phrase in a blog title coming soon): I sat down by a kid with a runny nose on the bus and gave him some Kleenex. He looked like he was in pain or something, but insisted he wasn't sick. We ended up talking a bit and it turns out that he wants to be a doctor when he grows up! He has a sister in med school in Ambato and furthermore, his family follows Christ and attends an evangelical church! He was so darn cute I had to buy him an ice cream. I love the body of Christ (oh yeah, the other internet café I went to in Baños was Christian-run... I think it's a conspiracy).

Wow I had a great meal tonight... steak and fries for $1.50. Do I really have to come home??

I thought about a lot of cool stuff today too, but it was in the lost blog, so I'll just leave you with this, which is quite timely considering the recent events:

Dear brothers and sisters, when troubles come your way, consider it an opportunity for great joy. For you know that when your faith is tested, your endurance has a chance to grow. So let it grow!! For when your endurance is fully developed, you will be perfect and complete, needing nothing.

Now imagine that on a sunny rock with a rippling river emerging from the jungle greenery upsteam and calmly flowing by, drowning out the noise of the surrounding city, and you might feel the confident hope that I caught a glimpse of today.

Surgery Results a.k.a. Being Showered in Prayer Helps

2007-07-20T08:24:00.000-07:00

Dear All,

Praise the Lord! Praise the Lord! Praise the Lord! Daniel is out of surgery and it went well. He did in fact have his right colon removed. But more importantly, Dr. Eliason removed a lot of infection that needed to be taken care of for him to be healed. He said that before he thought that was what needed to be done but now he knows that was exactly what needed to be done. So, thank you for your prayers for Dr. Eliason having wisdom.

We were blessed to have many of you with us in heart and prayer this afternoon and several in person. We did have to behave ourselves in the surgery waiting room since we had an elder from Pleasant Ridge, an elder from N. Davis and an elder from New York Ave present. We thank God for each of you that were present in person or in spirit. What a blessed encouragement to Eddie and me!

I would like to say that Daniel is resting comfortably but in fact with a tube up his nose and pain from surgery, he is going to have a tough couple of days. But that is ok. Its the cost of healing. I don't say that to be flippant. I don't like to see my baby suffer. I say that because I know that is how Daniel feels about it. I don't expect Jonathan to get much of Irresistible Revolution by Shane Claiborn (Daniel's favorite book right now) read tonight between giving Daniel chips of ice and other things. Please pray for Daniel to be pain free quickly.

We are so grateful that there is a clear plan. For example, Daniel has a hole in his back still for drainage that they will purposefully keep open for awhile. Our friend Connie was talking about wound care this afternoon and then Dr. Hendrickson told us she was going to order the exact wound care products that nurse Connie talked about. Coincidence? I think not.

How long will Daniel be in the hospital? About a week, give or take. Jonathan can stay in town until next weekend so that should work out well with him and Sara Ann trading off night shift.

Thank you for your continued love and support. To God be all glory and praise. We place You in the highest place. Sweet dreams to each of you.

Love,
Eddie, Marilyn, Daniel, Sara Ann and Jonathan

Renewal & Confession

2007-07-19T18:14:00.000-07:00

Wow, I have about a million things to write about, but such poor recollection. =)

One really cool thing happened last night when I went to pay for using the Internet. I noticed that lady up front reading the Bible and asked her what she was reading. The conversation progressed and I found that she and her husband are yet another example of Christians who genuinely love God and don´t let denominational boundaries interfere. I don´t know how to explain it, but I had a really great kinship with them. I had noticed that there was Christian music there earlier and asked about it, only to have a copy of the CD handed to me. So now my drive to Washington can be complimented by praises to God... in Spanish.

I woke up early and met Becki to get her shipped off to the right city. Then I went back to sleep until my body decided it was done. Ahh glorious day!! When I could sleep no more, I mosied on for breakfast and some sweet time in the word. I´m going to miss the coffee & milk, the bread and the fresh fruit for breakfast when I leave.

I spent some quality time on the Internet this morning, writing overdue emails and taking care of business for school. It turns out that if I didn´t accept my financial aid today, I would have some problems to deal with later. Yay!

Most of today I spent hiking in the mountains/pueblos outside of Baños. I met some great people including a lady with 8 kids and a sweet mountainside farm. I helped her with some sticks for firewood and she gave me a lemon off of her tree. Delish.

I had time to do a lot of thinking and praying and generally hanging out with God. It made me realize how weak and dependent I am. I think I can fool myself into thinking I´ve got things figured out, but coming face to face with the Holy One reminds me of how UN-holy I am. So in the spirit of dismissing any myths of my status as a super-Christian:

I am prideful and think I can do it on my own, even after severe humiliation and humbling, I am not broken enough.
I fight a constant battle with lust. Sometimes I let God win, and sometimes I rebel. This is especially difficult when I haven´t been walking closely with the Lord. When I am close to Him, most of my problems generally dissipate.
I am judgmental and entertain thoughts of other people not living up to what they could. I am sorry and wish for this to be gone from my life for good. It hurts people and separates me from God.
I care too much about impressing people and not enough about impressing God. This applies to doing cool things and to being spiritual.
I am not disciplined and use the excuse that I have freedom in Christ. That is a terrible excuse.

Please don´t excuse these dark places in my life. I want them exposed to the light so that I can be healed, not dismissed because others fight the same battles. I need forgiveness from those I have wronged and I realized today that forgiveness comes with a price. Forgiveness comes with the shedding of blood, metaphorical and literal.

Forgive me.

Now all Glory to God who is able to do immeasurably more than we could ever hope or imagine. May His name be lifted up because of His faithfulness to show mercy and love to those who deserve neither.