Don't Welcome Me Back Home

Photo: Natasha Kanji 2011

A/N: Thoughts after attending the Institute of World Mission Welcome Home Family Re-entry Seminar 2015. I'd rather have a mission than welcome home accolades. 

Don’t Welcome Me Back Home

“My desire is to depart ... But to remain in the flesh is more necessary .... Convinced of this, I know that I will remain and continue with you all, for your progress and joy in the faith, so that in me you may have ample cause to glory in Christ Jesus, because of my coming to you again…”

Philippians 1:24-26

I don’t want your welcome back greetings.

Please don’t think me ungrateful. Obviously, I won’t tell you to stop since I know you mean well. Your motives are pure.

But the greeting is erroneous. I am not  back home. Not by my definition of ‘home’ anyway.  Home doesn’t represent a permanent place on earth for me. Yes, there are pockets of space where I am best adapted, places I feel safe and abide within a relatively congenial community. These locations are familiar to me. They are a domicile where I sleep and eat my meals and where I am most relaxed and at ease. But they are not home. Instead, my heart yearns for a deeper home.

As C.S. Lewis so eloquently penned in the following quote:

“If we find ourselves with a desire that nothing in this world can satisfy, the most probable explanation is that we were made for another world.”      ― C.S. Lewis

Living for any significant period in another country, another culture changes you. Whether you were an accountant, a nurse, or a pastor, you cannot leave without permanent scars. The simple act of surviving in a foreign environment spoils naïve ideas about a cohesive, simplistic worldview.  The world is a messy place to live where chaos thrives. Submerged under the colours of a strange and different culture, you emerge with multicoloured lenses. Unlike real glasses though, you can’t remove them. There is no returning to your virgin views.

Even as your heart aches for home, a permanent resting place, travelling around the world proves there is no place completely safe, completely perfect. Heaven is not yet; it is still a hope; your heart’s anticipated future. You may have citizenship in your passport country but real homage belongs to the Lord of heaven and earth. We are citizens of another world as Paul outlines in Philippians chapter 1, verse 20: “…But our citizenship is in heaven, and from it we await a Saviour, the Lord Jesus Christ…”

And so… I remind you, there’s no need to welcome me back home. No adulations, please. Don’t put me on a pestle and treat me like a hero. Don’t try to reacclimatise me to a life of mundane mediocrity with wrappings of cultural adaptation. Instead, remind me that there is a reason for reverse culture shock.  Acknowledge that there’s a basis for why I don’t feel at home. Tell me there is value in my brokenness. Comfort me with words that give meaning to the bleeding of my wounds.

Don’t tell me everything will be ok.

Don’t tell me to ‘give it time’.

Instead, remind me I’m part of a bigger picture. These tears that flow without warning from deep recesses of my soul are reminders that the process of homecoming isn’t finished. The grand universal cosmic conflict is still ongoing and I have a part to play in it.  The epic isn’t complete. The novel hasn’t come to the last page.

When I am overwhelmed by yet another teary-eyed patient in my office with problems beyond medical solutions, remind me that I’m still God’s hands to comfort the suffering.  

When the sun has set and I’m putting in prescription renewals and answering messages while completing a hectic days worth of charting, all the while tired and hungry because I’ve missed lunch and now supper, tell me that the sacrifice is worth it.

When I fear I cannot face another unsatisfied patient seeking easy fixes for unsolvable circumstances, remind me I’m an ambassador of love and not of miracles. And when he gets angry and storms out of the room because I suggest changes in diet and weight loss to ease his aching arthritic knees or bring his diabetes under control, remind me again that I can still love without expectation or reciprocity.

I don’t need a hero’s welcome home. I don’t want a hero’s welcome.

I want a hero’s mission.

Remind me I’m part of a higher calling. I’m still part of a mission. I still have a job to do on this earth to represent Christ’s love to those I come in contact with each day.

Remind me that my mission service is not over. I am not coming home. I survived five years in Cameroon as a naïve and inexperienced physician. Through threats, thefts, fire, and tragedies, I survived and came through changed for the better. When I am tempted to forget, remind me of those valuable lessons I learned through people management, administrative duties, intercultural communication, adaptation, and flexibility. I am stronger than before. I survived adversities and adulations in Cameroon. Surely I can endure the challenges of today.

When I sigh and complain that home is tedious and dull, don’t tell me to appreciate my blessed abode. . Instead, remind me that I’m not home. I remain God’s ambassador to the world, whether here or in Africa. He hasn’t called it quits on my mission yet. There is a purpose in the pain that imbues meaning in the suffering. I can accept the frustrations, disappointments, disillusionments, and fatigue when I remember that this isn’t the end. The mission continues.

“ All this is from God, who reconciled us to himself through Christ and gave us the ministry of reconciliation: that God was reconciling the world to himself in Christ, not counting people’s sins against them. And he has committed to us the message of reconciliation.  We are therefore Christ’s ambassadors, as though God were making his appeal through us.”

2 Corinthians 5: 18-20

Here is a doctor...

Watercolour and Ink Painting by Mrs P

Author's Note: A dear friend who has been a tremendous encouragement to me recently composed the following verse to brighten my day. She has generously agreed to allow me to share it with you all on this blog. May you be blessed as well!

Here is a doctor in need of some rest.
~0~
Here is a doctor who'll never get bored,
She dashes from meetings to clinic and ward.
~0~
Here is a doctor who gets up each day,
And takes on the challenges placed in her way,
And tries to keep death and diseases at bay.
~0~
Here is a doctor who's longing for bed;
By midnight such hopeful ambition has fled,
For here is the call she must answer instead
As patients, prescriptions and pain fill her head.
~0~
Here is a doctor, not fully awake
Who crawls from her bed for Hippocrates' sake
Just one more dark night when more lives are at stake
With split second vital decisions to make;
Unsure every time what will mend, what will break.
~0~
Here is a doctor with nothing to spare
Who knows that a straightforward night shift is rare;
And here are the souls who depend on  her care.
Despite shedding tears of exhaustion, she's there
She prays that there's always more toil she can bear,
Accepting that life can be hard and unfair.
~0~
Here is a doctor, recalling the night,
A stroll led by chance to a soul lifting sight
The African moon, and the stars clear and bright
A moment to reach out, and claim and hold tight
And picture when dark shadows threaten the light.
~0~
Here is a doctor, in spite of it all
Who listened and wondered and followed the call.
Her path isn't easy, she'll stumble and fall
Then pick herself up, shake the dust and stand tall.
~0~
Here is a doctor with much more to face
Her weapons are those which no gold could replace;
Good humour, the blessing of friends and God's grace
~o~
Here is a doctor whose soul is at peace
All storm clouds will vanish, all striving will cease.
~0~
Here is a doctor in need of some rest.
~0~

Written by the talented and ever encouraging by Mrs P. Thank you!

For He careth for you...

Author's note: Life has been busy at the hospital this year. Not everything has gone according to plan - in fact, very little has gone according to plan! Today God reminds me that He is still the One who is ultimately in control. It is His work and His mission. So, once again, I "...cast all my cares upon Him..."

Stumbling with trials, duties, life’s affairs

Dark, bitter fears choke heart and soul

Casting all your cares upon Him who cares.

Too many hats all alone that one wears

Too many nights slowly losing control

Stumbling under trials, duties, life’s affairs.

Unable to rest lest by mistake one errs

Unable to cure, can but weep to console

Casting all your cares upon Him who cares.

Looks for help and sees nothing but stares

Looks to the shallows, no friend on the shoal

Stumbling under trials, duties, world affairs.

Relief, come relief! Cries and more prayers

Relief, no relief. Haunting echoes, black hole

Casting all your cares upon Him who cares.

Faint whispers of hope, life’s musical chairs

The day will come when another takes the role

Stumbling under trials, duties, world affairs

Casting all your cares upon Him who cares.

            

"Therefore humble yourselves under the mighty hand of God, that He may exalt you in due time, casting all your care upon Him, for He cares for you."

 1 Peter 5:7

A New Way To Pray?

Prayers in the Exam Room: A New Way to Elicit Prayers with One’s Patients?

He was an elderly Cameroonian man that fit the description of “Pa” to the letter. He wore a loose suit sewn of brown polyester and sported a small round knitted cap of green, which he respectfully removed for the physical exam.  His short wiry hair was white and a bit thinned from his earlier days. His eyes were still bright and his expression sharp despite his advance years.

Smiling at me with teeth stained brown from years of chewing kola nuts and drinking local mimbo, he enthusiastically bobbed his head up and down while I asked questions. From his answers it was clear that he only understood parts of my English. I began by asking him his reason for coming to consult the doctor today. I find this a rather useful question when someone tells me that he or she has been having a particular problem for “long time” or in other English, “years”.  Why today? Why consult me today versus last week or last year? This is a valid question with surprisingly revealing answers at times!

Our communication wasn’t ideal but after much repeating and rephrasing of questions, I finally deduced that he was here to see me because, well, the pain in his right leg was a bit worse than usual and I was the next doctor in the queue to consult. Upon review of his medical book it was apparent I was one of many in a long string of doctors he’d been to over the years.

In Pa’s case, one would not have required an understanding of Pidgin to realize he was having pain in his right leg. With much fanfare and flair, he indicated his right hip area and patted it firmly to emphasize how the pain began in his right flank and went all the way down to his toes! Just so I couldn’t miss this fact, he demonstrated how the pain traveled by re-enacting up and down motions with his hand several times, each time with more flair and emphasis.

Ee de pain me! Doctor, he persisted. “Ee de pain me all the way to ma foot and my back! Ee no de waka fine!”

I nodded my head in understanding and observed his charade. “Does anything make the pain worse?” I asked him.

“Yes, doctor, ee de pain me!”

“Is it a sharp pain or more like a bruise inside?” I asked more out of routine than any expectation of a useful answer.

“Ee be in ma bone, doctor!” He pointed from hip to lower leg again. “Ma bone, ee pain me for ma bone! Oooeeee, ee pain me plenty!”

(I was rather getting the picture!)

After a few more pointless questions on my part, I gave up and had him climb up to the exam table in hopes of discovering a few more clues to his diagnosis. Our verbal interview had definitely reached its limit! He was quite fixated on the pain and I found I was not getting any helpful new information.

Pa limped painfully over to the table and removed his sandals and clamored awkwardly onto the table while I watched and waited.

“Ee de pain me here.” He repeated as he patted his right hip and groin having seated himself on the bed.

I nodded. “I de hear you, Pa.”  I thumped and prodded and attempted to figure out more precisely where his pain might be originating. He cooperated rather a little too enthusiastically. This turned out to be an advantage while I listened to his lungs. However, when I wanted to assess his knee reflexes -- then we had problems.

Even under the best of circumstances it is difficult to relax your limbs and allow someone else to manipulate them. Cognitively the brain is telling you that you must not actively move your arm but reflectively, your body rebels at such an absurd thought.

For my elderly Pa with less than ideal communication, getting him to relax his legs so I could check reflexes was nearly impossible!

“Just relax,” I soothed as I tried to get him to sit on the table and let his legs dangle. Instead, he straightened and stuck out his right leg for a closer inspection of his kneecap on my part!

“No, relax.” I repeated. “Soften your legs. Just let them be.”

He straightened one leg then the other. Clearly we were getting nowhere.

In this type of circumstance, I sometimes find the art of distraction helpful! If you’re concentrating on something else, you’re much less likely to interfere with my neurological reflex exam! “Pa, put your hands together and push, like this.” I held my arms at chest level and placed my hands in the prayer position keeping them tightly together. “Keep pushing your hands together.” I cajoled as he tried to obey my instructions.

“Perfect!” I praised him as he concentrated on pushing his hands together in prayer while I successfully tapped his knees and assessed his reflexes.

“Ok, finished,” I exclaimed. “You can get down now.” He hesitated a moment. “We’re done.” I affirmed and nodded. Then I turned my attention to writing up my medical findings in his book.

After a few moments, I shifted my weight to my other foot and turned slightly. A pair of bright, beady eyes staring intently at me startled me! His hands were still held reverently together in the same pose as previously. He positioned himself just behind my shoulder, much closer than my personal space bubble generally felt comfortable with.

“Umm, you can sit down now,” I politely informed my patient after my initial shock wore off. “Have a seat. Sit, while I finish writing everything.”

He seemed hesitant at first but at last he limped over to the chair indicated, hands still held in prayer pose. “It’s ok, Pa,” I insisted, “You can relax your hands now.”

Finally, he released his grasp and situated himself in the chair to wait for me. I finished writing up everything and turned to give him my full attention. This time, he was sitting normally. His face still eager and hopeful, he looked up at me.

“Ok. We’re going to do a few tests to check out your bones and nerves…” I continued my explanation knowing he probably understood less than three percent of it but he was very happy to have me talk! He nodded in rapt appreciation. Thankfully, communication between doctor and patient is not completely dependent on me. After humoring him for a few minutes, I escorted him to the reception desk where our register translated my recommendations and explanations. He nodded his head with the same enthusiasm although this time I knew he actually understood what he heard!

As I think about this elderly man and his enthusiastic praying hands, I wonder what he thought. Did he think I was asking him to pray? Did he think such a posture was good for his health or just another odd thing doctors make patients do? He was a Christian and as he was leaving the clinic he informed us he would ask for blessings on us all. Maybe my reflex prayer pose served more than it’s intended purpose? Maybe it helped him feel more comfortable in bringing up spiritual issues, or maybe he concluded we were simply a clinic that was serious about praying. I’m not sure. He did come back the next day! We prayed officially with him then!

~o~

“And when you pray, do not be like the hypocrites, for they love to pray standing in the synagogues and on the street corners to be seen by others. Truly I tell you, they have received their reward in full. But when you pray, go into your room, close the door and pray to your Father, who is unseen. Then your Father, who sees what is done in secret, will reward you. And when you pray, do not keep on babbling like pagans, for they think they will be heard because of their many words. Do not be like them, for your Father knows what you need before you ask him.” Matthew 6: 5-7

Strangers and Pilgrims

 Four Student Missionaries Practicing the Art of Bowl Balancing

A/N: The following poem was inspired from observations made during my yearly vacation in the U.S. from my work in Cameroon. It struck me how my husband and I can cross two cultures without even thinking. Because of our time overseas, we will never have the same perspectives and insights. We have joined the relatively fortunate few who can say they’ve lived internationally. The following verse in Hebrews reminded me that our real citizenship is in heaven.

“These all died in faith, not having received the promises but having seen them afar off, and were persuaded by them and embraced them, and confessed that they were strangers and pilgrims on the earth.”                                                                                                                          Hebrews 11:13

I.D.E.

It’s short for Interdivisional Employee

The title denotes work as a missionary

Commissioned to travel across the land and the sea

An ambassador of love in a new country

It’s a calling of excitement and adventure

With a small dash of difficulty to be sure

However extended you choose to venture

You will never emerge the same ol’ trencher

You used to belong within society

Cocooned within a wall of familiarity

Now life’s ejected you from its propriety

And you roam around with some anxiety

Your passport cover that’s within your berth

Has a color telling your place of birth

It’s a name that no longer gives much worth

To that peculiar patch of nascent earth

Typhoid malaria and midgets bold

Are just as normal as the common cold

Cockroaches and mosquitoes fourfold

Are no more foreign than the flies of old

Black white brown red or other hue untold

Dark wiry hair or tresses straight and gold

Blue eyes that calm or brown eyes that are bold

All are unique and lovely to behold

Adjustable hot water bathroom showers

Cultivated garden with neat rows of flowers

These novelties are pleasant and pass the hours

But none surpass a ‘net speed that empowers

Quiet skies with no flying jet from Boeing

In contrast noisy markets and roosters crowing

Your ears can recognize the sounds out flowing

You sleep even with taxi horns a blowing

You jam forward in funneling queue with a wink

Or stand in neatly cordoned lines without a kink

You can place your demand for fish chips and a drink

Or order ice cream from a menu on the brink

It’s nice to swallow water straight from the tap

But Berkey filters easily fill the gap

Water is quite wet anywhere on the map

Filtered or bottled you just untwist the cap

Traditional Braids and Dress

White man, nasara, mzungu, and names akin

Whatever others call you with a cheerful grin

All remind that whatever color of your skin

You’ll never be a native or blend and fit in

Always an enigma in the current population

Not once an ordinary citizen of the nation

Never a common local of current habitation

You float between different worlds like an aberration

Your culture is distinct and its own creation

Based on your experience with some frustration

Life’s not confined to one style or summation

A variety but God’s your one foundation

Even if you wanted to return to days of old

You would never fit within that former rigid mould

Branded alien foreign wild and uncontrolled

A single country can never keep you in its hold

Whether for the better or for the worse

You must now trek long and forever traverse

A broadened view of third cultural verse

Where strange and different is not a curse

You may settle or you may pick up and go

You may return and live in former chateau

Or make another place your lasting furlough

Or even stay within your current escrow

No longer a self-centered and brash young fox

You realize that now you think outside the box

On the fringe of social order wearing socks

New perspective on things that used to flummox

You’ve become a wandering pilgrim in waiting

A promised rest for body and soul awaiting

One day when Jesus appears heaven translating

Your spirit will be complete full never hating

Within heaven you are perfectly understood

Communication’s great and quarrels are withstood

All are together in unity and are good

Your lonely wandering heart is home as it should

At last you’re a pilgrim and a stranger no more

Upon the weary travelings you’ve closed the door

Your soul is content upon heaven’s dazzling shore

The label I.D.E. is gone forevermore

Closing Tradition at Church with Hand Holding - Can you find the white man?

“Now therefore, you are strangers and foreigners no more, but fellow citizens with the saints, and of the household of God.”                                                                                                            Ephesians 2:19

CLEMENTINE: A GROWING EXPERIENCE

Photo Compliments of the Talented Photographer Natasha Kanji

The hospital room held three beds. She was lying in the far bed next to the wall with a novel, reading and waiting. The downstairs of our 18-bed hospital is now open. We have three moderate size rooms each holding three beds and bedside cupboards. A fourth room is reserved as a private. A fifth hides behind the nurses consulting room as a semi-private ward holding two beds.

Although our patient was situated in the public ward, she had it completely to herself because the hospital portion of Buea Adventist Health Centre is only partially completed. We are waiting for hospital equipment to finish an operating and delivery room and bring the standards up to a full hospital before we advertise. So for now, only a handful of patients stumble in for hospital for admissions.

Today, Clementine seems content despite a rather sad prequel to her admission. One month ago she came to consult the doctor. “Is this your first antenatal visit?” I asked her then.

“Yes, doctor,” she said.

“Are you having any particular problems?” I queried as I continued my initial history.

“I am worried because I haven’t felt the baby move yet,” she replied. I think I am supposed to feel the baby kick by now. I haven’t seen my period for five months.”

Clementine strikes me as an intelligent, thoughtful Cameroonian. She is 22 years old. She has a boyfriend and is a student in the university. In the waiting room, she reads through the assortment of donated books and magazines. On her first visit, she is dressed in a neat skirt and blouse. Although women do not have maternity clothes here, they manage to dress quite smartly no matter how many months along their tell-tale bellies proclaim.

During the exam I am unable to find any fetal heartbeat with my handheld Doppler machine. We do an ultrasound later that same day. On the exam, I find a fully formed fetus but no heartbeat. The fetus looks like he was about 4 ½ months old when something happened. I cannot tell exactly what has gone wrong on the ultrasound. I hate breaking bad news, but Clementine seems to understand. Her boyfriend comes later and together we discuss why the fetus might have died. I don’t have any definite answers. I hope I can convey empathy and kindness to the couple. It is obviously disturbing. Unfortunately, less than a year ago, Clementine had another pregnancy that ended with intrauterine fetal demise. How can this happen twice? None of us have any good answers.

In the end, we have to face the reality too. “What now?” Clementine finally poses the question.

“Well, you can’t allow a dead baby forever in your womb. It will have to come out. It will be similar to last time.”

“Not again!” she moans. “Why?”

We finally get through talking and she leaves with her boyfriend promising to come back for admission and forced labor to abort the already dead fetus.  She doesn’t come back for a long time though. I wonder what happened. Did she go to another hospital for induction? Did complications occur? Is she all right?

Now unexpectedly she returns over a month later.  “I went back to stay with my family,” she replies when I question her why so long. “I did another ultrasound too. They told me the same thing.”

Clementine is finally admitted to our little health centre hospital. We don’t have a delivery suite, but, for this induction I don’t feel there is a high risk of surgical intervention so I allow her to have her induction here. The fetus was not too big – only 4 ½ months. Clementine begs to deliver here anyway. She likes our staff and feels comfortable here.

I ask Clementine who she has here to help her in the hospital – bring her food, wash clothes or sheets and the like. “No one really, doctor,” she answers. “There is just a little girl; ten years old who is around to help”.

I am amazed at this young lady’s courage. I am also proud of our staff at the hospital here. Although she does not say such in words, I know she has chosen to deliver here over other health center’s that might be closer to family support because she likes the staff and feels safer here.

We give her misoprostel, a drug that is designed to start contractions. I check on her frequently. Each time I ask, “How are you?” she has a cheerful reply.

“I’m fine.”

“Any contractions or pains?”

“Not yet.”

We wait through the night. In the morning, she gives an affirmative to my question about abdominal pains. “Last night I had some cramping pains. They have cooled now.” She says.

Her cervix is dilated (open) and I can feel the amniotic sac with the fetus inside bulging in the vaginal vault. We wait for a while to see if her body has any more contractions. Nothing happens all morning. We finally start an IV drip with oxytocin. Oxytocin causes the uterus to contract.

In less than an hour, Moriah, our nurse on duty for the day comes to my office where I am consulting. She informs me that Clementine has some more pain and now there is a bloody mess in the bed.

Although I am in the middle of an ultrasound on a lady in the clinic, I decide this sounds more serious. I wipe off the gel from the pregnant patient’s stomach on which I’m doing the ultrasound, tell her to relax and wait, and head over to the hospital.

On examination, brown ooze which was once amniotic fluids, forms a puddle on the bed. A small amount of pink tissue protrudes from the vagina. On closer inspection, it appears to be a small foot.

We take the patient back to our make shift delivery room. After some waiting at which time I almost walk out of the hospital, Clementine feels the urge to push. She delivers fetus and placenta intact in one push. The fetus has obviously been long dead. It is wrinkled and macerated. The good news is that everything is out now. The uterus contracts down like it should. There is limited bleeding afterwards.

Clementine delivers with our support and we help her clean up too. I am confident her physical situation is fine  but I worry about her mental and emotional recovery. She is here all alone. She lost two fetuses in the last year and a half. It is difficult emotionally for anyone. She does not have any visitors except a 10 year old girl. Thankfully, she has done much of her grieving already at the parent’s house in the village before she came.

“How are you?” I ask that evening.

“I’m fine, doctor,” she says quietly but emphatically. She smiles to reinforce her words.

The next morning, Clementine is ready to go. I am glad things have gone smoothly as far as her medical problems were concerned. I say a prayer for her and her future dreams of being a mother.

She has a simple, trusting smile. She packs her bag with her few articles she brought with her – one change of clothes, a cloth, a bed sheet, toilet paper, and of course, her novel. The little girl helps her.

For me, the case has a bittersweet ending. I am glad she is well and no complications occurred during her induction. I am sad that she had to lose a second pregnancy so soon from the first. I am glad that although we are an incomplete hospital, we could provide the care required for this induction of a second trimester fetal demise. I wish we could provide the same care for deliveries of full term and live babies too!!! “One day,” I tell myself. “One day we’ll have the capability to delivery live babies too – God willing”.

“If you then, who are evil, know how to give good gifts to your children, how much more will your Father who is in heaven give good things to those who ask him!” Matthew 7:11

Lord, I ask you for equipment and personnel to handle both operative and normal baby deliveries.

Getting ready

I keep wanting to post reflections on IWM (Institute of World Missions) 2009 and just can't seem to find the time to specifically - well - reflect!! So what is happening with us?

Our home is on the market; we are selling off furniture; we have packed up and moved stuff we want to keep (and come home to); we continue to organize in preparation for the shipper to pick up what is going to Cameroon; and Trixy is working, I am studying.

Current plans have us "pre-embarkation" for the month of November. We plan to visit both sets of parents/families as well as attend the Global Missions Health Conference in Louisville KY. If you plan to be there give us a shout.

Some time the week of November 29 we are planning to depart for Cameroon. Naturally this can change. We are still awaiting word on our visas and work permits.