The Parents are Coming!

So Mom and Dad will be back tomorrow night and our two house guests left today. Which means just the four of us kids left to frantically clean the house tomorrow. Good thing it's a holiday! I'm kidding, nobody's thrown any parties. We were all too tired out after having to do things for ourselves. Grocery shopping, making meals, taking people places, there are so many things we had to take care of.
For example I am terrible at waking-up early, especially on weekends, and after the first week when everyone missed church because of me I made arrangements to get them a ride the next two weeks. The Ellington family kindly agreed to stop by and bring anyone ready along with them to church, they had 4 open seats in their car. They, and many other families, have been stopping by and inviting the boys out over the weekends or inviting all of us out for dinner.
But even with all the help we've all noticed how much Mom and Dad do things we really miss around here. Chris probably misses having Dad make him breakfast every morning, John doesn't have school any more. Last night I just gave in and bought pizza for dinner. I drove with Chris to this bible study so he could go to the youth group and we ended up back home a little after 6 without any dinner plans. Chris was lobbying for going out somewhere and I decided it would be way easier. We're all definitely ready to have our parents back.
-Ruth

Time for a brief medical update. I have been out of the hospital for a week now. Forced to recover in a local bed and breakfast here in Pretoria. It is actually a nice place, but mostly I am resting and reading, not really site seeing. The State Department Medical Unit would not let me go back to Zambia with drains, tubes, and staples in place for fear I might develop an infection or other complication and get septic. They said, "Do you know how expensive it is to evacuate a septic patient?" The compassion was touching. I said, "Come on what are the odds of that..." Well, probably greater than the odds of developing a hole in one's colon, a pelvic abscess and fistula following a routine colonoscopy! It did strike me as somewhat ironic that an infectious disease doctor would be done in by septic shock. I did mention that I was well aware of the risks and as soon as I developed fever and evidence of a pelvic abscess in Lusaka a few weeks back (hematuria and pneumoturia for the medical people) I started oral ciprofolxacin and flagyl which I just happened to have on hand. I have always firmly believed that oral antibiotics are just as good as intravenous and I am sure this kept me stable during my transport here. They did not take this as reassuring but probably as a good reason to not let me go too soon - who knows what this guy might do if we send him back to Lusaka.

It is very tedious being away from everyone (except Amy who has been a true helpmate) with not much to do. I have managed to walk to the local CDC office and put in time on the computers there - teleworking. But one still feels pretty disconnected from work. I have always known that my self-image is tightly connected to what I do at work, but this has really highlighted that in my mind. How dare they survive without me! I also realize how much my self-image is tied to being a parent. Makes me wonder a bit about how I will do when I retire and the kids are all gone...maybe I will have to take up golf afterall! Not likely.

I have been much more tired than I expected. I also have a fair bit of pain with most movement thanks to the urinary catheter so I am looking forward to its removal on Monday. The actual incisions and holes are not so bad, although I am not sure I am ready for sit-ups just yet. I appreciated Sue Makin's comment that I am holier than most right now, probably the only time.

Enough for now. We appreciate your prayers. Jim

The Question and Call of God

Recovery takes time. It cannot be speeded up. We are waiting for Monday’s visit to the surgeon and the OK to return to Zambia. Each morning we share devotions. In the evenings we play cards and read books. I have just finished the inspiring Bonhoeffer, Pastor, Martyr, Prophet, Spy by Eric Metaxas. Bonhoeffer’s impressions of American religious life in 1930, seem prophetically relevant for today, 82 years later. “In the conflict between determination for truth with all of its consequences and the will for community, the latter prevails. This is characteristic of all American thought, particularly as I have observed it in theology and the church, they do not see the radical claim of truth on the shaping of their lives. Community is therefore founded less on truth than on the spirit of fairness.” According to Metaxas, as Bonhoeffer reflected on the American church scene he was fascinated that “tolerance trumped truth.” It was fascinating to read about the birth of the Confessing Church which came about in response to the “bastardized theology…coming from the German church” and which chose to repudiate “anti-Semitism and other heresies of the German Christians and their “official” church.” I am reminded of the struggle the PCUSA faces today as some are leaving the denomination and others are forming groups such as the ECO (Evangelical Covenant Order) as they try to work out how to respond to tolerance and fairness trumping the Word of God.

“Who stands fast? Only the man whose final standard is not his reason, his principles, his conscience, his freedom, or his virtue, but who is ready to sacrifice all this when he is called to obedient and responsible action in faith and in exclusive allegiance to God-the responsible man, who tries to make his whole life an answer to the question and call of God.”-Bonhoeffer

What is the Question and Call of God today? To Adam and Eve God asked “Where are you?” to Cain he questioned “Where is your brother?” to Peter Jesus queried “Who do you say that I am?” and later “Do you truly love me?” to Paul he inquired “Why do you persecute me?”  What question is God asking each of us? Is it one of these questions or something else? What if we made our lives an answer to the question and call of God?

Waiting

It is Sunday, five days since surgery. I still have a fair bit of abdominal pain around the various holes. No appetite but I am careful to eat a full balanced diet to help the healing process. We walked about 5 blocks to a large mall in Pretoria. It was so much like any mall in the US or Europe, hard to believe we are in Africa (at least not the Africa of my stereotypes).  We had declined to interview for a CDC spot in Pretoria and both Amy and I commented that we are glad – it really would have been like being back in the US. We went to a movie and out to lunch, stopped in a bookstore where I purchased a tome on colonialism in Africa, and then walked back to our bed and breakfast.

Amy found this place which is within walking distance to the CDC offices – but I think the real reason she picked it is because it is across from an amazing bird sanctuary! I may never get her to go back to the kids, at least not until she sees the 108 birds listed as being found in the sanctuary! I have to agree with her that it is healing to observe God’s wonderful creation.

Thank you for the continued prayers.

Jim

God is Good , All the Time......

 “I sought the Lord and, and he answered me; he delivered me from all my fears” Psalm 34:4

“For I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call upon me and come and pray to me, and I will listen to you. You will seek me and find me when you seek me with all your heart.” Isaiah 29:11-13.

I want to share with you how good God is and how the body of Christ works in such an amazing and interconnected way. When I received the SMS message from Jim  "hematuria, pneumaturia..." I was four hours away from Lusaka Airport in the town of Nyimba at the first CHE, Community Health Evangelism, training of trainers program for the CCAP, our PCUSA partner church here in Zambia.  The CCAP picked a very ecumenical group to be trained, representing at least 6 different churches and denominations from Nyimba and Pitauke. Half of those being trained were women and half were men. I was staying in a locally owned guesthouse with meals cooked over a fire out back and bathes in a bucket of water heated over the fire. As soon as I got his text I realised I need to leave right away or miss the flight to Johannesburg. Before I left the group training, I was surrounded by a chorus of prayers and support in multiple tongues, only two of which I understood. It took me four hours to drive to Nyimba in the Eastern Province, but only 3 hours and 15 minutes to return to the airport in Lusaka, slowing down only for the skid marks on the winding road.This morning we moved from the lovely Lizas Cottage, run by Gert and Alida, a retired Dutch Reformed pastor and his wife, as a ministry to families with loved ones receiving care in the Urological Hospital to The Crane's Nest. Those who know me will suspect that I had this secretly planned since it faces the Austin-Roberts bird sanctuary but as it turns out it is the closest accomodations I could find only three blocks from the CDC headquarters in Pretoria where Jim can work until the foley is removed and he can travel safely back to Zambia. We had a lovely lunch at the Blue Crane Restaurant on the pond in the middle of the sanctuary. While Jim ate soup and I had vegetable quiche, three blue cranes kept begging Jim for food through the fence posts on the veranda. It is very peaceful here. Jim is sleeping again after walking back the 500 meters to our B&B.  I just happened to have my new South African bird book, a gift from Dr. Boyer and binoculars in the village so I am all set. 

In the airport, waiting for the flight with Jim, Caryl Weinberg called me to join the weekly international Tumekutana steering committee conference call to discuss the summary document report from our October 2011 conference "Women as agents of peace, healing and reconciliation". I explained the situation and immediately women from partner churches in Ghana, Nigeria, Congo, Kenya, Rwanda, and the US began lifting up prayers. Within hours of arrival, we were visited by two pastors from a partner church in South Africa thanks to mission co-worker Janet Guyer who was on that phone call. The St. Columbas church secretary even began looking for housing for me.

When it was clear I would not be able to travel to Houston for the Medical Benevolence Foundation board meeting this weekend,  I emailed the MBF President-Elect Shelley and our new Executive Director Andy Mayo and then the board went into action too. Jerry Veldman contacted former MBF trustee Tom Logan who had been a patient in South Africa some years ago. We contacted his former doctor and were given the name of a first class GI surgeon, Dr. van  Niekerk, who we have since discovered used to work at Nkhoma Hospital where I served in February. Our experience has been a demonstration of how amazingly the universal (worldwide) Church can function to support, encourage, care for and build up the hurting body of Christ.

Notes from the bed and breakfast

Discharged from the hospital yesterday and had an uneventful night in the local bed and breakfast that has served as Amy’s home for the past 10 days. Typically the first day or so out of hospital is difficult, or so I have always told my patients, because there is no one to provide for your needs and one is more physically active. Most of the time the patient is exhausted and even seems to take a few steps backwards. Although I am tired I do feel that the pain and mobility is improving steadily. Sitting up can be uncomfortable – after all they did create four holes in my lower abdomen. I am not ready for doing sit-ups just yet.

While it fresh on my mind I should share an observation of health care in South Africa. They are one of the few ‘westernized’ countries that does not have a national health insurance (guess the other). Private practice is thriving. My second day in the hospital I was somewhat surprised to be waiting in the radiology waiting room, assuming it was for transport back to my room following a CT scan with bladder contrast. In fact we were waiting for the bill which they handed me as they gave me directions to walk back to my room! Later that morning the pathology lab came to my room and asked if there was someone there who could come downstairs and settle my bill from the morning blood draw. Amy and I got the impression that one needed to travel the day with credit card in hand, sort of a pay as you go system. It was both maddening and funny. In some ways it makes sense from a business model point of view, collect while you can rather than run the risk of not being paid. Fortunately for us it turns out we just turned the bills over to the US Embassy Health unit. Seems they will pay, give me the bills, I will send to my insurance who will pay me and I will reimburse the US government. I am only liable up to my annual deductable. The actual care seems to be every bit as good as one would receive in the US.

Other noteworthy experiences include: patients are to bring their own pajamas, no one uses hospital gowns – kind of nice, less dehumanizing, but unexpected if one doesn’t actually have pajamas! Amy ran to the local store and bought me some; every morning at 4:45 am the sisters (nurses, not Catholic nuns) start the day with a hymn sing and prayer – nice, but perhaps a little early; tea is served three times a day, with cucumber sandwiches in the evening; and apparently infectious disease consultants are quite rare in South Africa, though I must say they might benefit (I was unable to convince the surgeon that oral levofloxacin is just as good as IV…some things are universal).

Thank you again for the prayers and thoughts.

Jim

Letters from the Hospital

As most of our family and friends know I (Jim) was flown to Pretoria last Wednesday for emergency surgery – seems I developed a hole in my colon which led to an abscess and fistula to my bladder. It has been quite a ride this past week. Up until now I have never really been a patient and my only stay in a hospital was as a small child when I had my tonsils out. All I remember from that episode is lots of ice cream and a new toy truck. I am waiting for the same this time.

I have taken the opportunity to read the new Bonheoffer biography, it was quite good. It also served as a healthy perspective on real suffering, by so many millions of people.  I won’t minimize the pain I have had this past week, but I am fortunate and have so many resources to address my physical problems; which is not the case for most people in the world. I am glad we came to Africa to do our small part to correct the situation, and am looking forward to getting back to work. However, I am afraid it will be at least 6 weeks before the king’s men can put me back together again.

I have so many somewhat random thoughts to share and I know that most of us have very short attention spans, so I will share just a few. I have been amazed and touched by all the family and friends who have wished me well and offered prayers and thoughts, I think I will make an even greater effort to do the same for others in the future, it means so much. I have been delighted to see my children rise to the occasion of living ‘alone’ (can you ever be alone with four adolescents in one house) – they come from good stock, on their mother’s side of course. I have been uplifted by the “coincidences” that have supported us here – from Zambian friends who just happened to be in South Africa and could come visit, a surgeon who worked at the same mission hospital that Amy and I have worked (Nkhoma, Malawi), a local Presbyterian Church, St. Columba’s (same name as ours in Lusaka) who came to visit, and a retired pastor and his wife who run a bed and breakfast that Amy happened upon and has served as a place of respite for her. I am reminded of the comment by Albert Einstein, “There are two ways to view the world, one is as if everything is a miracle, and the other is as if nothing is.” I am seeing a lot of miracles.

So, thanks to all of you for your prayers, looking in on the kids, researching treatment options for me, and covering in my absence at work. I anticipate discharge tomorrow but will need to remain in Pretoria for at least another week or so. Sometime in May or June I will return for a reconnection of the pieces. Pray specifically that I adjust to life as a colostomate (didn’t know that was a word until now) and learn to convalesce well. –Jim

Strength and Refuge

"God is our refuge and strength, an ever present help in trouble. Therefore we will not fear though the earth give way and the mountains fall into the heart of the sea, though its waters roar and foam and the mountains quake with their surging.....the Lord Almighty is with us; the God of Jacob is our strength." Psalm 46

Jim is sleeping with only a little pain. He is on antibiotics and we are praying that the infection will be healed, that the passage from bowel to bladder will close as the infection resolves. God is able and we are prepared to face surgical correction in His strength if it does not. Thank you Lou for the insight that "Our God is with us recovering Himself." I AM is also praying as the Holy Spirit with us. Certainly I have always been comforted that He is deeply aware of our condition, our hurts and our suffering but I had not thought of healing in quite that way. At times of personal pain I have thought about Christ's obedient suffering and that strangely beautiful passage in Philippians 3:10 "I want to know Christ and the power of His resurrection and the fellowship of sharing in his sufferings, becoming like Him in his death, and so somehow to attain to the resurrection from the dead" It seems to me that surrendering with open hands "Thy will be done" is to become like Him my Savior. It is not fatalistic acquiescence but obedience to a loving Father for the joy set before me. We are being "Held." Natalie Grant fans will know what I mean. Thank you for watching and praying with us.

-Amy (via email to Ruth)

United by Prayer

Dad has to fly to South Africa for an emergency surgery right now. He's been sick for a few days and it turned out that his intestine has been ruptured. This could be a long hospital stint since there is clearly a high risk of infection. Mom, who is already in South Africa, will be meeting him at the airport in a few hours and the doctors want to preform surgery tonight.

This leaves John still in Paris, since his plane was canceled, for another day and the rest of us kids home alone with our two house guests. Please be praying for all of us. Dad's surgery, Mom who will be anxiously waiting for the outcome of her husband's surgery, John who will be flying home tomorrow, and those of us at home awaiting news of the other three. Although we'll be in three different countries, four when you count our grandparents and the rest of our family in the States, our prayer will unite us. Right now I'd like everyone to keep one goal in mind as they think of us: health and safety for our family.

-Ruth

Conflict can be fun

Last week I had a wonderful opportunity to work with15 student evangelists at Justo Mwale Theological University College. Selina Zulu graciously asked me to co-facilitate "Peacemaking and Conflict Resolution"a course for their certificate program. In preparation, I read The Peacemaking Pastor: A Biblical Guide to Resolving Church Conflict, Working With Conflict: Skills and Strategies for Action, and World Report 2012:Events of 2011 (Human Rights Watch World Report). I was able to share some of the crazy cross-cultural conflicts I have experienced such as repeatedly saying "Ah... no" when relatives in Czechoslovakia kept bringing food out only to discover a day later "Ah, no" in Czech means "YES." The class was wonderful with skits, dramas and practical exercises each day. One day, I taught principles of using "I" statements and active listening during conflict mediation. Then the students created skits and performed in Chichewa. In one skit I could only tell there was a conflict over "mbuzi"/ goats. Otherwise, I was clueless. I began questioning the two actors and the audience. "Sooooo, tell me what happened in that skit? Did he use active listening techniques? What did you notice about his body language? Did he use "I" statements? How did you feel when he was talking to you? Did you trust him?" Even though I did not understand exactly what was said I about the goats, (It turns out they had gotten loose and eaten the neighbor's garden) I was still able to conduct a dissection and analysis of the conflict. Great fun. On the last day many of the participants thanked me and gave speeches about what they had learned. I felt so honored and was reminded about how much I enjoy small group participatory learning.