Sustained and restored after cholecystitis

Psalm 41 says "Blessed is the one who has regard for the weak; the Lord delivers him in times of trouble." Indeed, "The Lord has protected me and preserved my life. The Lord has sustained me on my sickbed and restored me from my bed of illness. I said, O Lord have mercy on me; heal me..... "

It began abruptly just after 9pm on a Wednesday evening. Shortly thereafter I was unable to remain in bed due to the severity of pain. I paced and tried various positions; on my hands and knees, leaning over the table, sitting upright, to no avail. As doctors we are trained to ask, "Is there any position that makes it better or worse. Is there anything you do (eating, going to the bathroom etc) that brings it on or makes it better or worse." The answer to all of those questions was "no." The pain remained constant and severe, a band reaching from the middle just below the sternum to the far right side of my upper abdomen boring through into the back. After three hours I woke Jim up to examine me, not because he could do anything except perhaps be impressed.  I had Murphy's sign: as the patient takes a deep breath the liver is palpated and when the gallbladder is irritated there is an immediate cessation of breathing due to pain. I had been teaching this maneuver to 4th year medical students at the medical school just a few weeks earlier.  Jim agreed that it was most probably my gallbladder.  As I huffed and puffed, I prayed God would help me bear the pain and give relief. An hour later after vomiting several times the pain resolved within minutes (most likely after the stone passed into the intestines) and I was able to sleep. In the morning I proceeded to the get an ultrasound (+gallstones) and blood tests (my liver tests were 100 times the normal level). The clinical picture looked like a stone had been blocking the common bile duct. By the afternoon I developed a fever and started antibiotics. At that point I felt really exhausted and crummy. Friday morning Jim and I set out on a flight to South Africa. The ANTS taxi service took us directly to hospital where I was admitted and had repeat testing. Surgery was performed Saturday.  Less than 24 hours later I was discharged and we headed to the same B&B, The Crane's Nest, where Jim had recovered after colostomy two years previously.

Jim left Monday night to return to Zambia where Chris had fallen by the wayside with gastroenteritis. Then on Friday with my suitcase and backpack in hand ready to go directly to the airport I arrived at the surgeon's office only to be told the repeat blood tests were not all improving and some were worse. Jim felt the elevated tests were easily explained; the surgery, intraoperative dye study and the physiology of one test (alkaline phosphatase); delayed manufacture and release had all led to the increase. The surgeon insisted I remain. I returned to the Villas next to the US Embassy for easy access to the Internet and medical unit. Over the weekend I watched some of the winter Olympics (we don't have TV in Zambia so this was a treat).  Amazing what the human body can do.

On Monday the labs had all improved and it was agreed I would repeat them in Zambia in a month to be sure they were normal. I had the opportunity to share scripture with my surgeon who was troubled by a decision he needed to make. One of his patient's had end stage cancer and bowel obstruction. There was no further treatment or hope of prolonging her life. He was unsure as to whether to recommend a line be placed into a large central vein to give nutrition because this can sometimes result in discomfort and even infection and death. I asked him what the patient wanted and he said, "That's a good question." He didn't know. Doctors in South Africa do not always talk with their patients in the same way we do in the US. I went on to suggest that most people at the end of their life just want a little more time to be with family. We can always give hope and assure them we will be there for them. I told him that Psalm 139 has always been a comfort to me when it says, "Everyone of our days is already written in His book before there is even one." I cannot shorten or lengthen anyone's life. I am not God. I am grateful He is in control. Many times I can do very little for my patients except to be present at the end and that is enough." I sensed a deep loneliness in this man. He mentioned in a pained way that he did not have the same intimate relationship with many of his patients that an internist or a general practitioner might. People often did not even remember his name. As I left I thanked him and called him by name.

I thank God for all of you; my friends and family around the world who supported me in prayer, praying for my healing and for all the emails which were a daily encouragement and blessing!

Today I delivered food to the children in the prison. Last Friday I discovered a malnourished 9 month old with brittle reddish tinged hair, no family to bring food and a 3 year old from Congo, again no one to bring food. I was again reminded of Psalm 41 “Blessed is the one who has regard for the weak…”as well as the passage in my daily reading in Luke 14, ”When you give a luncheon, or a dinner …or a banquet invite the poor.” I don’t think God wants us to just read the words and study them. I think He’s serious about us doing them. So, today I delivered peanut butter, mango, potatoes, rice, Cheerios, avocado, biscuits and bananas.

This is my Life

The week I decide to blog about a typical week, ends up being the week I end up being medavaced to South Africa. If you asked Molly Crane who stayed with us a month last summer she would laugh and agree that yes that would be a typical week. Just when you thought you knew what you would be doing everything changes  (both car batteries die in one day and you aren't going anywhere). It reminds me of Jesus words about not worrying about tomorrow ,in fact don't even plan tomorrow but instead just be faithful with what God puts in front of you today. (Matthew 6:34, James 4:24)

Monday I drive to Mercy Ministries to drop off the $500 that Molly and her mother raised. I had called Dorothy, the Zambian woman in charge of the school for orphaned and vulnerable children and agreed with Edna her daughter on the date and time. When I arrive no one is there to accept the money. Edna has been admitted to the University Teaching Hospital, has had a c-section and delivered a healthy baby boy. Dorothy has taken a group of children to the ophthalmologist for eye exams. I depart taking the envelope with me.  I will text and make plans for a drop off next week.

Tuesday I lecture to 4th year medical students on Five Common Diseases in Children in Zambia; acute respiratory infection (pneumonia), malaria, diarrhea, HIV/AIDS, and malnutrition. I try an interactive style picking out a name on the list of over 100 students and calling on students to answer questions. Although not intended to be a humorous presentation one slide gets a laugh. It's a picture of a severely malnourished child. What I failed to notice before is the filthy ragged grey shirt worn by the mother with "Survivor" printed on it.

Most Tuesday mornings I attend an International Women's Bible study with a wonderfully prayerful group of ladies from all over the world; Zambia, Zimbabwe, South Africa, Ireland, Holland, New Zealand, Australia, Guatemala, Philippians, US, Ethiopia and England. A recent Beth Moore study on Daniel was a great encouragement to me as I under went three mammograms, an ultrasound and a breast aspiration during our month home in the US. I kept recalling the fiery furnaces of life where there are 3 possible endings. God either delivers us from the fire (we don't have to endure it, the spot on the CXR disappears, our faith is built up), or he delivers us through the fire (we have to have the radiation and chemo but we are cured and our faith is refined) or he delivers us by the fire and takes us into the arms of Jesus (the trial or suffering ends in death with no miraculous healing and our faith is perfected) As Jim and I often joke "What's the worst thing that could happen? and then what? and then what? "and eventually we end up in the arms of Jesus and remember that that is actually the best place to be.

Wednesday morning I paint with a multi-generational, multicultural art group at a local cafe. The owner of an art supply shop offers lessons and artists come for fellowship, encouragement and inspiration. In the  afternoon I experiment with a sack of guavas from a friend with a guava tree in her yard; the guava sorbet is refreshing, the guava and apple curry is inedible and the guava jelly well to be honest no one has actually tried it yet.

Thursday I head to the prison. I drop off the hot water kettle (thanks to Luke/Atticus Getz for his donation). The women are surprised. I assure them I have the commander's permission. I emphasize due to the filthy conditions and the recent outbreak of Shigella that all drinking water should be boiled. I say this as I stand by a pile of sacks reaching to the ceiling filled with dried foul smelling kapenta fish. I try not to stare at the flies creeping into the holes in the sacks. I pretend they are not there as if the situation is not that bad. I sit down and take out my bag and begin to listen to the stories in French, Swahili, Bemba, Nyanja and English. There are rashes, bug bites, headaches, back aches, watery eyes, stomach pain, heavy periods, vomiting, coughs, weight loss, racing hearts, anxiety, too much thinking, fear and depression. I pray with everyone. Many weep. I assure them there is a God who sees. The God who made them and formed them in their mother's womb has not forgotten them. If they were the only person in the world God would have still sent his Son Jesus to die for them. They are precious in His sight. They are not forgotten. Some women are refugees, some have been trafficked, some are drug addicts, thieves, even murderers. A few of the women guards stop by for medical advise and prayer. I am following His great commission in Mark 16:18 to place my hands on sick people so that they will get well." I am trying to do what Jesus did "preaching good news to the poor, proclaiming freedom for the prisoner, releasing the oppressed" Luke 4:18 and I am trying to be a sheep watching for the Son of Man,  the King who reminds us that when we serve others we are serving Him. "I was sick and you looked after me, I was in prison and you came to visit me." Matthew 25:31-46.

Friday I am back at the medical school pretending to be a patient waiting to receive "Bad News" from one of the 4th year medical students. My child has died. I am devastated. I weep tears.  I have a positive HIV test. They are nervous. I am in denial, I am angry and going to kill my husband, I refuse to get my result, I cry, I rage... you get the picture. Then we sit and discuss the interaction. Did they make sure they had the right patient, did they look me in the face, were they empathetic, did they make rash promises for a long life or a cure....or that surely God would give me another child.

Saturday I walk Terra with Jim at 6am. Nose to the ground she discovers an owl pellet and looking up we can see an owl roosting in a palm tree. Good dog! Back at home she jumps in the pool and lies down on the step submerging herself and gulping water. She shakes water all over us, leaps on the lounge chair and then onto the metal table. She towers above us standing upright.  Bad dog! "Down" I tell her. She lays down on the table and curls into a ball. I realize we need a new word, "Off."

Sunday we worship. The sermon focuses on the beatitudes; blessed are those who spiritually mourn over their lost and sinful condition, for they will be comforted by God's forgiveness and grace. I plant flower seeds in old plastic yogurt containers and harvest onions and avocados. Jim sleeps in the afternoon. Chris plays frisbee with friends and then attends the Baptist Fellowship where the topic of discussion is euthanasia. We talk about the lie of unmanageable pain over dinner.

Keeping Busy in Zambia

Amy's Class

Jim and I had the pleasure of teaching at Justo Mwale Theological College University from April to June. I had 12 students in the first year Pastoral Counseling course (one woman).  Jim taught a counseling course on AIDS to 4th year students. We both enjoyed discussing various Biblical passages regarding gender equality. Not surprisingly the Christianity brought to Africa by colonialist was a male dominant leadership model. Thinking about human beings made in the image of God and the feminine characteristics of God was challenging for many. I arranged for a tea just for female seminary students to meet and share their challenges and experiences and to encourage one another.

President and Mrs. Bush with Zambian
First Lady Dr. Christine Kaseba

At the end of June President and Mrs. Bush made another trip to Zambia to encourage cervical cancer prevention and treatment. During the week they were in Livingston Jim organized many local volunteers to paint a health center and I watercolor painted in the hotel room. President Bush has taken up painting (oil) as well and is doing a series on world leaders he has met. I thought I could do the same and have a series of one (him).

In July Jim attended the African First Lady's Conference in Tanzania, to encourage other countries to bring women's health issues, specifically cervical cancer, forward in their countries. You may recall Jim was tasked with reducing maternal mortality by 50% in one year, a task many said was impossible. Results from the project are coming in and through the combined efforts of CDC, USAID, and many others it looks like we may actually hit our target. Now to expand country wide!

Terra

In July Terra, an almost 8 week old female German Shepherd joined our household. This was just days before Molly Crane's month long visit. Our socks, pants and skirts have small holes as do our legs from Terra teething.

I left in early August for a month in the US ostensibly to visit my parents and three of the kids. My dad has had several surgeries and hospitalizations and it looked like a good time to visit. It turned out I needed foot surgery and then a molar extraction for a large abscess I had failed to notice until Bob LoCascio took routine wing bite films. I wasn't even planning on getting my teeth cleaned until January but then there was a cancellation and I took it. As the oral surgeon said, "Someone is looking out for you." "Yes, you are right. God is" I responded.  

In August, Ruth began courses at Oakton including acting, creative writing, and a design art course. She seems to be thriving and has recently dyed her hair blonde for a role (check her out on facebook).

In September, Miriam adopted a lovely black cat, Magic, from Heartland shelter.  

Miriam continues to thrive living independently and participating in the PACE program. She put her guardian angel to the test recently, when she was struck by a car while crossing a busy road. Typical of Miriam, she flew and tumbled, broke her glasses, but told the police and paramedics, "I am fine, no need to go to the hospital..."  She is resilient!

Perhaps we won't drive this way...

John visited us for two weeks in September, following his summer as a camp counselor at Phantom Ranch and before he headed back to Seattle Pacific University. We took an adventuresome drive to the Lower Zambezi National Park. Typically one drives around the escarpment to remain on paved roads for as long as possible. Instead Jim suggested a short cut out Leopard's Hill Road 'through the bush' - only about 90 miles, but really off the beaten path. Jim spoke to others who had made the trip, and they said, "No worries, as long as you don't encounter another vehicle while in the mountains, and bring food, water, extra fuel, a satellite phone, and a winch ..." We did pretty well, using every bit of the 4-wheel capability of our Land Cruiser, until we encountered a truck coming at us in the mountain pass. Fortunately we got to climb the wall of the mountain while he got to inch along the edge - we exchanged looks of terror as we passed, and a big thumbs up when it became clear we would both live!

John and Chris fishing

The Park was awesome - amazing encounters with elephants, including a juvenile bull charging Jim as he scrambled to get into the tent - if only the elephant knew how flimsy that canvas was he might have kept coming. I helpfully pointed out to Jim that there was a large elephant charging at him as he struggled with the tent zipper. We tried our luck fishing for tiger fish on the Zambezi, always with an eye on the nearby crocodiles. No bites from either.

Thank you all for praying for the food situation in the prison. Just a few weeks ago, while I was in the US, the women and children incarcerated with them, were again allowed to have food brought in by their families. Prior to this they had only some dried fish and nshima provided by the prison.

Tumekutana 2014 Planning Committee

After returning to Zambia, I flew to Ghana to meet up with Caryl Weinberg and Rev Erica Rader and the Tumekutana team to begin working on the 2014 conference "Freedom in Christ: From Slavery to Empowerment." You can be in prayer as plans move forward.

Back in Lusaka Chris is busy with the school musical (Shakespeare's Pericles, Prince of Tyre, set to Fleetwood Mac!) and the IB program (large amounts of homework every day).  Chris worked this summer at the Embassy - in IT. Jim regularly meets people who comment on how great a worker Chris was and how they want him back next summer.

Tenacious

I  put five of my paintings into an exhibit and sold three (2 to Jim - he couldn't stand to see them go) to benefit wildlife conservation in Zambia.

Behemoth

We have home leave this December-January and so are looking forward to time with family and friends. We will try to look at a few colleges with Chris during the time, but mostly we hope to rest and enjoy running water, electricity, internet, and paved roads...

Eulogy for Rascal

Rascal in Zambia 2012

Rascal, nee Milkyway, died in Lusaka Zambia on May 11th 2013 at the age of about 15 years. He is remembered for his faithful companionship and incredibly soft fur and beauty. He was born into a litter of three kittens in Oak Park, Illinois. His parents both were free range cats with a love of wanderlust. His owners spread the story that he and his littermates would be taken to the forest reserve in River Forest and dropped off to fend for themsleves.

The McAuley children brought this woeful tale home and their parents succumbed to their pleas. Within a very short time it was clear that Milkyway had been misnamed. In his first few weeks he crossed a freshly oil painted floor and tracked grey paint through the house and all over Amy's blue sweater. Even turpentine could not remove all traces of paint.When he discovered the sticky mouse traps under the kitchen sink and came out covered in them a quick call to the vet revealed that mineral oil could be used to remove them. Cleaning off the mineral oil was more difficult as Milkway was so slick and greasy that soaping him up and keeping him under a stream of water was almost impossible. About this time Amy decided he should be rebaptized Trouble however not wanting to brand him for life he was instead named Rascal. Rascal quickly bonded to Christopher who carried his kitten wrapped around his neck. We wish we had a picture of the night Chris came to dinner just wearing Rascal but we failed to get this photo. Rascal was young and often terrorized Christopher trapping him on the stairs and clawing him up and down his legs so Rascal was sent for declawing and neutering at an early age. This did not deter his playful nature.


Rascal and Chris 2002

He grew up with Mundy our lab-mix, thinking Mundy was his mother. Mundy took on the role of mother with grace. Although Rascal lurked on the stairs and pounced on Mundy from the banisters, Mundy would willingly play. Often she saw Rascal coming and would look sideways with a wag of the tail. Even when she had Rascal's head in her jaws, she was gentle and never growled. If Rascal began to get a bit fierce she would send him across the floor with a shove of a paw. Unlike Mundy, Rascal never led anyone into a Wisconsin cornfield, got picked up by the police on Christmas Day or ended up at the pound after being a little too friendly on the corner of Church and Wesley. Rascal's worst adventure was being dried in a dryer and left there for several days. This occurred at a busy time, when the washer and dryer where located in the basement. Amy noticed the clothes were still damp and turned the dryer on for a quick 15min more. She thought the clunking sound she heard was probably some tennis shoes.....three days later the family was in mourning, notices and photos had been put up around the neighborhood but there was no sign of Rascal. When he was finally discovered it was not a pretty sight!

Rascal's best qualities were his doglike desire to be close to family; sleeping every night on someone's bed usually Christopher's, sitting on the keyboard as you attempted to type, climbing into a lap during a quiet time, curling up next to you when you came home exhausted from school, running across the yard when called and meowing when meowed to (really only Chris and John were able to get him to do this), sitting next to Amy while she stretched her neck in the cervical collar or under her feet as she painted.

Rascal and Chris 2013

When the family moved to Zambia we thought it would be difficult for him to remain in the US. In his final two years of life he was allowed outside and enjoyed the breeze, the birds, lizards, grass and gardens. Sometimes he just sat and smelled the flowers.

Having grown up with a dog he was curious and excited but a bit fearful of Gambol the German Shepherd we had last year for a few months. Gambol treed him several times which amazed all of us since the tree he routinely climbed (without claws) was almost a 90 degree climb.

Rascal is survived by his beloved family and two refugee cats Gus and Mama who could not return to the US with their previous family. We will all miss him.

Wedding Anniversary Celebration

May 4th Jim, Ruth, Chris and I headed out for dinner at a local restaurant. You may not have realized that an orchid is the gift for the 28th wedding anniversary. Ruth managed to find a lovely white, rose and purple orchid! I'm now the proud owner of a Zambian recipe book and can make caterpillar soup, mouse fritters, roast termite, moringa porridge and nshima with relish.

Thanking God for another year!
 

Swimming with the Sharks

Getting the shark's attention

The family went to Cape Town for Chris' spring break in early April. It was so beautiful, and of course Chris and Jim just had to go swimming with the Great White Sharks!. For those of you who are You Tube followers (we are not - no band width) there was a video of a shark getting into the protective cage just a few days before we went - yes, same cage, same place (http://live.wsj.com/video/raw-video-great-white-gets-into-shark-cage/)! But truthfully, there were many more wonderful things in Cape Town than sharks - beautiful coast line, stunning sunsets, an amazing botanical garden, great birds, and good food. Definitely a place I would recommend for a visit. Visiting Robben Island was a moving experience, as one can imagine. We suspect we were one of the few tourists to Cape Town who went to see sewage treatment ponds - naturally it is birding hot-spot - flamingos, pelicans, grebes...


Jim in cage counting shark teeth,
trying to remember the warning:
"Never touch the sharks"

The family has been busy with both Jim and Amy having trips back to the US in the last month or so. It was great to see family and friends. Miriam and John both seem to be doing well.
 
Amy applied for a mission co-worker position with PC-USA based in Malawi in community health. We were hoping that PC-USA would be creative in thinking about the possibility of her working from Zambia. We were not too optimistic given our previous experince with PC-USA and informal feedback. We tried to point out that it would have been so cost-effective - as she is already here, speaks the local language, has housing and health insurance, is trained in public health, etc. We knew from previous inquiries that PCUSA is not inclined to hire  physicians, but of course we know that physicians can actually do public health, teaching, and prevention (example - CDC)!

African penguins

I (Jim) recently attended a meeting to discuss the way forward for one of my main activities - reducing maternal mortality (http://savingmothersgivinglife.org/). One person representing a donor-partner commented that we needed to aim more for a Fiat rather than a Mercedes, as our intervention appears to cost about $100 per pregnant woman. If it weren't so sad I would have laughed - women in clinics sleeping on the floor, being delivered by an environmental health technician because no trained midwife is present...while in the US a delivery typically costs $10,000-20,000. Listening to the language from donors (including the church) I have decided that "partnership" and "leveraging" and "sustainability" are ways to say, "Sorry, no money." Two highlights though - the US government is steadfast in its support, and the Zambia team decided we would forge ahead anyway - a country led, grass roots conspiracy to save pregnant women's lives!

Amy and me start teaching for ten weeks next week at Justo Mwale Theological Seminary. Amy teaches Pastoral Counseling and I teach HIV and the Church's Response. It will be a busy time - so prayers for our family, as well as the students we teach, are greatly appreciated. It look slike we will not be traveling back to the US as a family until Christmas time. We will keep you posted.




News Flash

Last week, Amy travelled with Nancy Collins, PCUSA regional liaison and Rev Rob Weingartner, director of the Outreach Foundation to visit several ministries where US Presbyterians are engaged with Zambian Christians. We drove south from Lusaka to Siavonga on Lake Kariba to Namumu Orphanage Centre where supporters funded the construction of two dormitories, kitchen, dining hall, staff houses, a clinic and chapel  As happens the world over when "moth and rust" break in (or an attic full of bats) as the case may be, there are repairs to be made.

Mwandi First Ambulance

Namumu Dorm with squeeky bats in the ceiling

The following day we moved on to Mwandi Mission 10 hours west along the Zambezi river, about 150 kilometers northwest of Livingston.


Nancy drove most of the way. During our visit we met with the chief, walked through the village, saw the United Church of Zambia Orphan and Vulnerable Children(OVC) program as well as the Mwandi Hospital which I had heard about from Medical Benevolence Trustees (MBF) who'd volunteered there. The OVC program is expansive with a supportive income generating agricultural program of fishponds raising tilapia, beef cattle, pigs and egg-laying chickens.

Pastors leading Devotion and Songs

Income generating fish ponds

We were told that HIV rates are one in four, alcoholism and sexual abuse are major problems and people still drink river water.

The hospital has fallen into some disrepair with a very low census, but there are plans for renovation.

We met a local pastor excited about evangelism and training, a lovely couple from Australia who work with the OVC program and a trustee from the OF who was doing training with villagers in microenterprise, savings and loan as well as a group of medical students and residents on a short term mission trip. The day Nancy and I left, Salvadore de la Torres (and his wife Irma), the PCUSA missionary doctor who was there for 10 years beginning in the 90's arrived for a visit. Salvadore and I met yesterday to talk about what could be done to support the church and community. Pray that God gives wisdom and that the hearts of the community, chief, American hospital board members, missionaries and staff working at Mwandi Mission would be open to His leading and transformation.

Family news: Jim's in the States for two weeks so if you see him, give him a hug.

 

Tuesday night we celebrated Chris' induction into the National Honor Society



Gus Lounging



One of our new cats, Gus has given us fleas. His mother, Mama briefly eats and departs for the day. Rascal is tolerating it all.  

Amy is painting again