week 1/4

7/11 There’s a Lifting

Foreword: We started this blog to document the medical missionary life.  It was hard to get the medical experiences in writing during the crucible days of 2013-2015.  We returned to the States July 1, 2015 and have come back to do one month rotations here in Kenya for the past 3 years.  The blog will now try to resume its original identity for a while in attempt pull out of the mommy-blogosphere. 

Back home in Chattanooga, TN, New City Fellowship was worshipping the last Sunday in June with the song “There’s A Lifting” and it has been reverberating in our heads ever since.  The song is about lifting up our eyes to realize where our help comes from.  Our help comes from the Lord, the Maker of Heaven and Earth.  As we lift our eyes, he lifts our hearts.  Here are some case reports of the lifting:

 Patient 1 is a 31-year-old man who was admitted to Tenwek for an upper gi bleed caused by an ulcer in his duodenum.  There is an increased incidence of peptic ulcer disease in the developing world because of the prevalence of a bacteria called Helicobacter pylori.  The bacteria spirals down into the lining of the stomach, and allows the stomach acid to erode down into blood vessels below the surface.  This causes the bleeding.  Yesterday he had an endoscopy procedure to cauterize the bleeding vessels.  Today, he done fell out on the way to the bathroom just because there was not enough blood volume in his body to perfuse his brain when he stood up from the squatting position. This man, thankfully fell on the floor near, not in the bathrooms  (The bathrooms are not a pleasant place for falling out as you could imagine). Thankfully for the medical team, the excitement of shouting family members called our attention to him. The team ran to him, and found he was awake and talking so we raised his legs up to drain the remaining blood volume up to his head before he was lifted up and put into a wheel chair, then promptly placed in bed with his legs elevated and a nice pint of hearty blood transfused from the family  (that’s how we get blood  here at Tenwek- family donors on the spot- no lie).  Imagine- the family members were documenting the event on their mobile phones the whole time.  Maybe we will be on their social media posts.

Patient 2  is an 81-year-old man who suffered an intertrochanteric femur fracture from a fall.*  He had also some shortness of breath and a cough, and was “sick-looking” thus an internal medicine consultation was requested for evaluation prior to orthopedic surgery. He improved after a day of antibiotics and supplemental oxygen, was breathing more comfortably and had no other cardiorespiratory conditions to prevent him undergoing an operation to fix his fracture. After reviewing the American Heart Association guidelines for perioperative clearance, we gave our clearance to proceed with surgery.  Approximately 10 minutes after we cleared him for surgery, he sat bolt upright in his bed and fell over dead.   Resuscitation was attempted with what was available on hand i.e. our hands., but unfortunately unsuccessful  (90% of patients remain dead after losing a pulse in the developing world hospitals).  We have no idea why he suddenly died and there is no way to find out for sure.  As we broke the news to his adult grandson who was there to care for him, he stood bolt upright also and yelled aloud and  fell out on the ground.  Gladly, at least the young man recovered.

Life is not a guarantee. Doing medicine here can knock me over at times too.   It’s intense, and an intense challenge to my assumptions: that I can figure out and fix the medical problems that our patients are suffering.  I lift up my eyes to the green hills of Africa- where does our help come from? 

Every Wednesday at Tenwek we have staff devotions at 8 a.m..  Today, our hospital statistician, Geoffrey Mushyoka,, gave the message to us.  He said, “You people are wonderfully trained and gifted by God to serve your patients.  But by yourself you can do nothing.  Jesus is the only healer. Our job is to serve the best that we can but without Jesus, we can do nothing.”  .  He is the Lifter of our heads and our hearts. He is the Lifter of the living and the dead.  We must realize where Our Help comes from.

Lecture 1- today I gave a lunch time lecture on antibiotic stewardship in the hospital classroom. We had 2 faculty members attending and about 20 medical students, interns, and residents.  We came here for the purpose of preparing God’s people for works of service, so that the body of Christ may be built up.  These are the long term investments we are aiming at: teaching the teachers, equipping the national providers to steward medical resources wisely.  The projector was broken and thankfully too, because power point is a smoke screen all too often.  So I “hand crafted” the lecture on a white board with markers.  The risk of drug resistant bacteria in the developing world is far more potentially hazardous because the only available antibiotics are on a very short list here.  We must carefully steward the gifts that God has given us through modern medicine. Antibiotics are a gift, but they too must be submitted to the LORD for appropriate usage.  Here’s a picture of how that wonderful design works scientifically:

Thanks for lifting us up in prayer,
Daktari "Davies"