Big Daddy in Memoriam

Last Sunday my grandfather passed away.  His name was “Big Daddy.” He was so named, not because of his ample girth (though he had the usual southern-fried extra around the middle, from eating my grandmother’s cooking for 63 years).  No, his name was Big Daddy because that was his personality.  His personality was huge, and left just such an impression everywhere he went.

One of his greatest loves in life was to make people laugh.  Any kind of person and any kind of laugh would do; from the smiles of the church lady at Cartwright Baptist, to the stately chuckles of the officials and politicos during his time as County Commissioner;  and the guffaws and belly laughs of the truckers at Wagner Freight and farmers of the Sequatchie Valley Co-op.  And there was no area of humor that he did not master: practical jokes were probably his favorite (including, maybe especially, the one where he ended up in jail), but the outrageous were probably his second favorite (ask his grandchildren about his toilet bowl guitar).  There were no topics that were off-limits: politics, race, family, religion all played into his jokes, and I will never forget the twinkle in his eyes just before he got to the punch line.

And another thing that everyone who knew Big Daddy appreciated about him was his generosity.  He gave so much, in so many ways.  He never met a stranger, and gave away his extraordinary personality to everyone he met.  One of my strongest memories of spending time with him was rising early in the morning on Saturday at the farm, driving in his old beat up Datsun pickup, which smelled like chewing tobacco and his dog (who accompanied him everywhere). We’d drive to Hardees, where they knew to expect him, and he would buy a bag of biscuits and drive through the valley, visiting neighbors, especially the homebound or poor, sitting with them and sharing breakfast.  I have no idea how much of his wealth he has given to charitable causes.  He never spoke of it to me.  But I am certain it is an astounding amount, because that’s the kind of person he was.

We always spent holidays at the farm.  And ever so occasionally, he would sit us (his grandchildren) down after a holiday meal for one of his fireside chats.  He rarely gave us advice, but when he did, it was best to listen closely.  His favorite topics were hard work, integrity, and family values.  He came to hear me speak several times, a message to our church, a valedictory speech, and a mission presentation, and he would give me pointers; most notably to always speak up and stand tall, and I always remember this in that second after I walk to a podium and before I open my mouth.

He is, and always will be, with me.  In the moments after his death, as I try to gather every memory and store it away for safekeeping, these are the first things that I recall.  They are by no means the only things, and everyone who has known him has a story.  That is legacy in its own right, and to be remembered in stories is to be remembered forever.  Thank you Big Daddy.

Josiah's Broken Arm

It was the first warm week of April in the East Tennessee mountains; the first opportunity to let the kids roam free outside with their friends.  There is a small pack of them on our street.  Usually 4-5 kids, aged 5-11, with the occasional older kid and the occasional Annie bringing up the rear at 2.  This group has spent a lot of time together over the past couple of years, and we’ve spent a lot of time in the yard with them.  And in this crowd there is a bully.  We’ve known about this group dynamic, and have been more or less involved in parenting this as it happens.

But on this particular Monday evening, we are inside getting ready to host a dinner, and the kids are in the tree house in the backyard.  We hear the thud and the scream, and rush outside to see Josiah lying on the ground in front of the tree.  From the tree house we hear a chorus of, “she pushed him,” and register the words; but our focus is on our son on the ground, with the broken arm.

Over to the ER (where he knows which flavor of Popsicle he likes best), an X-ray and a cast, and we’re back home that night.  The arm doesn’t hurt so much anymore, but Josiah is very upset.  “She pushed me!” he says over and over.  What would you do with this?

Eventually, he goes to sleep and we go downstairs.  We’re sitting on the couch in the living room, and my blood is boiling.  This is my son, my only son, the one I love; and he has been hurt, maliciously not accidentally.  Hot tears are running down my face. 

And it is just a week after Easter.  The Spirit through Katie reminded me of this story.  There was a Father whose Son was hurt, maliciously not accidentally by the people who were supposed to be His friends.  The Father must have felt this pain, and more in a way I cannot imagine.  And the Son looked down from the cross and said, “Father forgive them, they don’t know what they’re doing.”

So we tell this story to ourselves, and to our son, and we become part of that story.  Josiah has a grasp on grace and forgiveness, and we are reminded.  And we go back out in the yard; we speak to the bully and her parents, telling them about what happened, that it mattered and that it was wrong, and that they’re forgiven.  It’s not a perfect story, and still awkward on our hill.  “But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me.”

Daktari wife: on getting ready

I wrote this entry in my trusty ol' paper and leather journal while sitting at the DMV.  It felt closer to "nature" that way I suppose.  This is the Daktari's wife entry into the Blogosfear.
 

Blogging is looking at me like a big rumbling yella school bus looks at a 5 year old.  Who knows that one day it will be coming for him too.
Do I want to get on the bus and party with a make-believe identity, indulgent in self-expression and independence? Or do I fear getting on completely unnoticed and totally insecure in bearing me wee little soul to the big wide world, like a kindergartner in with 4th graders? Yes!

The truth is, I fear not measuring up to the blogger mommies who write such pithy and literary accounts of life.   I fear not measuring up to insta-gramming enough documentation of my beautiful life.  Moving to East Africa in 4 months with our pre-schoolers, living at a hospital amidst infectious tropical diseases, sharing our family in community with strangers, crossing the cultural divide of east/ west, all these things thrill me!  But writing about it for the www makes me quake!
Not that other people's children don't make demands on their time or that other people aren't struggling to process their life as it is lived too.  But I still have trouble getting dirty dishes out of the sink every night.  Let alone contemplative journal writing.  Online.

But the fact is, we are moving to Kenya in 4 months and like getting ready for the first day of school, I've got a lot of preparation to do before we get on the bus and go (or 747, actually). First, we've got to get freed up from much of our belongings.  (anybody want baby toys?) Moreover, I need to figure out how homeschooling or MK schooling works for my real kindergartner this fall.  No actual big yella bus is going to take him into academia out there in Bomet. There's some "supply" shopping to be done: long skirts, rain boots, learning apps for the kid's devices.  One more things is, I need to start blogging to build a bridge between our family and the ones we have to leave behind.  I desire to build understanding of what Africa is like, what our kids are like, what God is doing in our lives.

Mostly though, getting ready to go for me means trying to listen for the rumbling sound of troops marching in the top of the balsam trees- for the God of Angel Armies who goes before me.  Listen for the rhythm of the Good News that pounds down everyday saying "You'll never measure up to my requirements."  You aren't good enough.  (what?!) And THAT is why Jesus came for you.  THAT is where Jesus brings life, drives out fear, gives His Very Self to bring little ole you and me through battles of life.  It's Good News because it's not up to me.  It's Good News because it's about Jesus taking care of all my fears.  Because His love is stronger than the power of death- what have I to fear?  Fear is about death.  I will not fear being unnoticed, unliked, unfollowed, unpinned.  Listen, Katie.  Listen for the sound of the Gospel.  For without that engine rumble, it is all in vain. 

Malaria for Grandview Kids

This is a talk I gave to the 4-12 year-olds at Grandview Christian Church, who are doing an awesome project: collecting money to buy insecticide-treated bed nets.

Miss Anna told me about this awesome project that you were doing to collect money to buy bed nets for poor children in Africa, and I was so excited that I asked her for the opportunity to talk about one of my worst enemies…

-Which do you think is the most dangerous animal in Africa? 

-The answer is…the mosquito.  He looks scary here, but this little guy is almost microscopic; you’ve heard him, buzzing in your ears on a summer night, leaving those tiny welps on your exposed arms or legs.  The mosquito, fairly harmless and annoying to us, but in much of the world it holds this even tinier, truly microscopic killer: malaria.  The malaria parasite invades your own red blood cells, just like it’s doing here, and keeps them from doing their job of carrying oxygen and nutrients to your body’s cells. 

-Malaria kills about one million people per year, which averages out to about 2 people per minute.  Most of the people who die from malaria are kids under 5 years old, and it is the leading infectious cause of death.  In Kenya, where we’re moving, almost 1 in 10 children die before their 5^th birthday, in Sierra Leone, it’s 1 in 5.  Josiah turned 5 years old today, and we celebrated. 

-So what can we do about this?

-That brings us to this campaign:  this girl Esther is a Maasai girl living in the Rift Valley, an area in Kenya where there is a lot of malaria.  She lives in a hut next to a slow-moving river.  They need the water to survive, but having stagnant water standing in the rainy season is a perfect breeding ground for mosquitoes, and subsequently for epidemic malaria.  Having this bed net that she’s peeking out from under gives her a much higher chance of surviving to adulthood, and to living without malaria.

-Another extremely high-risk group is pregnant women.  This woman: Mma Makutsi is protecting from that same village, and she is protecting herself, her current children, and her future children from malaria.  Pregnant women get sicker, and even get more mosquito bites than other adults.  And protecting them protects the baby, and gives the baby its best chance to be healthy.

 

-So, why should the church do something about malaria?  Here are two maps of the world.  On the top map in red are the places in the world where there is malaria.  The green places in the world have no malaria transmission.  On the blue map at the bottom, the darker blue places are the places in the world where there are the most Christians.  You can see that there is a lot of overlap between these red areas and dark blue areas.  These are our brothers and sisters in Christ who suffer from this deadly disease.  They need our help.  Also, if you look at Asia, and where the red area of malaria covers, it’s the area of the world where there is almost no Christians.  This is the unreached mission field of the church.  And because God has been so good to us, we can be good to others. 

-And when we are being good to others in need, it’s as though we are being good to Jesus himself.  Here’s how he tells the story:

More of the Equation: need (n)

Here are some pictures that demonstrate the need for trained healthcare workers.

  This article was published in December 2011 in the New England Journal of Medicine highlighting the disparities in the distribution of healthcare workers worldwide.  These areas of purple shading are the places of the most critical shortages of healthcare workers, including Kenya.  

 In the figure, there is a graph plotting percentage of global health workforce, and disease burden.  The size of the dot represents the percentage of healthcare expenditures.  Sub-Saharan Africa bears 24% of the world’s disease burden but has only 3% of the global health workforce.

I = nP^er   .......    Impact = need (Patient Care) ^ (education x research)

An Equation for "Why move to Africa?"

I wanted to give you an introduction to our medical mission vision.  A mentor once advised me to formulate an equation to measure my values, and thus give me a litmus test for decision making for our future.  This is it, the impact of our work is equal to need times patient care to the exponents of education and research.

 

 The first variable is that impact is proportional to need.  And this is a snapshot of the world in terms of mortality.  It compares mortality rates among adults by cause and region.  Your eyes are drawn to this bottom row, where the overall mortality for Africa more than doubles the rate of high-income countries, and the cause-specific mortality encompassed in these grey bars: HIV/AIDS and other infectious/parasitic diseases causes more death than all of the combined mortality in the high-income countries.  This is why I am an infectious disease doctor moving to Africa.

And here in the blog, I get to dive a little deeper into global health statistics.  And I think that these statistics have an important message.  I promise only one new acronym from the alphabet soup of the World Health Organization statistics set: Disability Adjusted Life Years.   It is the accepted way of quantifying years of life lost due to early mortality and years of healthy life lost due to disability, and gives a more holistic view than total mortality rates.  Because though more people in the world may die from ischemic heart disease, more disability and early death are actually due to lower respiratory infection, diarrheal disease and surprisingly to me: depression.

And these people, suffering and dying from these preventable and treatable diseases cannot be reduced to numbers on a bar graph.  I can see their faces, with their hollow sunken eyes, overcome and hopeless by the wasting disease of HIV/AIDS.  I can hear their labored breathing as they struggle to get enough air through their lungs, thick with tuberculosis and bacterial pneumonia.  And I can see the children, their unnaturally swollen potbellies from malnutrition.  These are real people, who Christ lived and died for.

Full Circle: Starting Point

This is a picture of us from 10 years ago.  It makes me smile.  There we are, 20 years old, our first adventure in Kenya together.  It’s set in a village called Maji Moto, a little outpost of civilization, rising out of the dust of Massailand around a geothermal vent (maji moto = hot water).  You can see a lot about these two characters by this picture.  They are young and browned by the African sun.  They like to stand close together, despite the heat and the dust.  They wear the beadwork handicrafts given to them by their friends, and rest in the shade of an mbati (tin) roof in the equatorial sun.  He wears around his neck a stethoscope, just taking a lunch break from a busy clinic.  It’s a symbol, of his dreams to be a healer, of the revelation in the human body; he is just beginning to hear the voice of God through it.  And it rests atop a thrift-store polyester button-up, uniform of the bohemian to match the afro that blends into the shade of the building.  I like this guy.  And there she is; the golden one that he’s pursued across the world.  The Peachtree Road Race t-shirt reminds her of the races she’s run and calls her to the ones before her.  Sunglasses and twin braids.  And you can see it in their eyes and in their posture: the passion and the idealism.  This is where it truly began for us; the opening act of this chapter of the story of Yahweh, in which our parts are set in Africa.