Born Free

Sometimes it's no wonder that missionaries end up a little awkward after enduring so many awkward moments in this life uncommon.  But I really do love how my own quirks jive so (seemingly) well in Kenyan culture.  For instance, I will never be accused of being type A but that's okay here.  Because if I make plans, things fall apart.  If I just roll with it as it happens, my creativity breathes and things tend to happen that we never expected but are grateful for by the end of the day.  I deeply love that aspect of our life in Kenya. 

Last week we were honored guests (read: token white people) at a passing out party. What the heck is a passing out party you ask? It is when a boy goes through initiation rites and passes out of childhood and into young manhood and then he comes back home for a celebration.   There was a party tent and a sound system and we were asked to make several speeches.  Fortunately for us, our kids love to hear themselves on a microphone and they even sang 2 solos as part of the circus act (Please consider paying for their therapy when we reintegrate into mainstream society).  If you know the Man-Cub, you may have guessed that he sang his favorite song "Go Tell it on the Mountain".  But the Little Miss, she sings her own music. 

Today Little Miss has left "free" and graduated to four.  She can actually pronounce "three" now that it comes to a close all too soon.  But she will always be free.  Her spirit is singing her own song- passionate- imaginative- and free as the wind blows.  She loves the original Elsa- the lioness that was "Born Free".  

Four years ago Little Miss was born as the darkest night in some 600 years ended and turned into light.  It was a full moon that was totally eclipsed on the winter solstice.  And she tore into this world like a rocket ablaze with love and joy and strong feelings whichever way they go. Never did a baby scream as loud as that child on the beautiful marvelous night she was born.  I remember how strangely empty inside I felt after her entry into the world.  Though I held her in my arms it was already an act of separation.  She came as a gift that I couldn't keep to myself.  

A wise person once said that we know God best in our missing Him.  

Beautiful, surprising, passionate zeal for life.  She has helped us to know God better from day one.

 

Advent

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I usually do my best thinking on scraps of worthless paper.  This faded folded piece of red construction paper was tucked in my purse one day a while back when I was taking a lady to the hospital.  Jotting down my observations back then, this is what I pull out today:

A 2^nd hand McDonalds uniform shirt delights and even entices me in the emergency room (called “casualty” here).  A Maasai woman in spectacular bling bling of beads and shiny silver on age old stretched out ear lobes, shaven head, black wrinkled skin like tar-pits swallowing an old dinosaur.  Who will save us from this body of death?

Crowded, quiet, curious, stares at the white lady.  Yes, even I have a body of death too.  We are bound by corruption inherited through our cells and genes and traditions and systemic oppressions. 

Daktari has been blazing bright in his work.  He is alone now.  And the suffering of his patients day after day after day has taken a toll.  He calls them the 20-20-20 club.  The 20 yr old woman with a CD-4 count of 20 (advanced AIDS) and she is typically 20 weeks pregnant: they come in frequently and do poorly.

Who will save us from this soul crushing fatalism that is life in Africa?

Mama said there’d be days like this.

And even Jesus said in this world we’d have trouble.  But here’s one thing that’s True too:  He will never leave us.  So we don’t give up on Him.

Now you know how to pray for us I hope.   I promise to be more merry and bright in the next post.  Watch for it.  Wait for it.  Don’t give up on me either.

November

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I love America. 

I love drinking tap water.

I love living in a Norman Rockwell. Or a Grandma Moses.

I love seasons in America.  Pumpkin season hits us with irony.  For one, we don’t do Halloween and two, just a few weeks ago in Kenya a nameless family member in Daktari’s house requested that we “take a break” from eating pumpkins for a while.  We eat them as vegetables in Kenya.  Not lattes.  We also eat a lot of cabbage.

At least there is no cabbage flavor craze in America too. 

I love Americans. I know how to navigate expected cultural norms and behaviors.  I can read people here  (Not that it takes a rocket scientist to read what many Americans are thinking).   Living cross culturally allows one to engage extra neurons at all times just trying to understand what’s going on.  It’s nice to relax that muscle a little and just sit back to enjoy the show-

Leaves blowing and long shadows, the slanted light at noon and where daylight is unnaturally shortened in one fell swoop of mass confusion called “fall back”.  Even the crickets seem to disoriented as to what time to chirp. Our life on the equator doesn’t get this same kind of seasonal drama and beauty.  We do get beauty, and drama, and seasons of wet or dry, but not this concoction of October in East Tennessee.   Fall used to make me kind of depressive and feeling like something good was going away too fast, but this time it just looks golden.

We have been in the US so that daktari could take an infectious diseases board exam. 

As he studied for it, I made an important non-medical discovery:

My discontent will not be bound by continents.  As a traveler who has lived overseas, there will be dings and dents in my shell wherever I go. In our home culture I carry traits from my host culture, and in my host culture we carry our home culture more than we can even realize.   That might explain why they say that missionaries are most content when they are on the airplane.

Recently we were walking in a pasture at our family’s farm when Little Miss told me “I don’t want to go in there cause there’s cow p**p there”.  Ah ha.  She too will always have an element of discontent.  Perhaps St. Paul learned the secret to being content whatever the circumstances, but I my friends, I have mastered the mad skill of discontent no matter how golden the circumstances.   Walking in fields of gold, Canaan land, our Nahala.  Then bam! Cow poop.  There’s a lot of optimists in the Daktari farm family and they’d say “ah, smells like money”.  There’s a lot of realist in me and I say “Well, it does happen”.

In Kenya I long for things at "home" in America and in America, things aren't all that perfect either, come to find out.

The struggle is to see Beauty that is right in front of us but hidden from view.   

In Kenya, when we go on safari, I always pray for open eyes to see the wonder and beauty of creation, alert to the intricacies.  Sometimes we find the most beautiful bird in all the world perched on bare branches against the sky- the Lilac Breasted Roller.  Sometimes we find a pride of lions camouflaged in the tall grass right beneath our feet.  You don’t see these things by default because only grace will allow it.  And if I pray for eyes to see what beauty God has for me each day, I end up surprised at the amazing interactions with people that I get to have.  In Kenya, a day without relating to people is like a day un-lived.  There is amazing beauty in relationships.

But Beauty is not my natural bent either.  I have to request the grace to find it.  The contrary nature of my heart is not contrite usually.  I am trained to think “yeah, but” as a pre-fix on my responses. Ever since that Fall in the Garden, I've got snake venom in my eye.  I tend to see the bad over the good.  And I have the dastardly pride to feel superior for my critical viewpoint.  Yes, I’m a flop in many departments of my soul. 

But here’s the Good News:  God loves me.  And my heart is being wooed by this persistent Love that is not shocked by my failings nor jaded by my weak recoveries.  I believe that God is neither naïve nor jaded and still chooses to love me.  That is grace.  That is why we are returning back to Africa this week, neither (too) naïve nor jaded (quite yet), and profoundly trusting in God’s love for us to be enough. 

And out of that grace, contentment is born in all circumstances. 

We fly out Nov.14.

Daktari Kids on One Year

saying goodbye last year

Good goodbyes help us make good hellos.

One year ago yesterday we flew away from the homeland.  Everything was awesome.  Until Man-Cub realized this was good bye.  A cousin and grandparents stood there in the new E concourse at the world's best airport watching as we approached the x ray and metal detector  and his heart broke out like a cup of pocket change.  Then we were all in tears.  They waved until we were out of sight. 

And a big metal bird carried us away to the land of our sojourn. 

Man-Cub and Little Miss "Free years old" have been thriving though.  There have been lots of changes and developments in their tender little hearts over the past year.  And (just) one broken arm and two lost teeth.

As they flip and jump off of "Mt. Ever-blanket" on the couch, I conduct a little interview on this past year in Kenya. 
Man-Cub, how long have you been in Kenya?  a year.
How old are you now?  6.  That's sita in Kiswahili.
What is your school like?  I am in first grade.  4 kids in my class.  "Aunt" Erin is our teacher.  She's my best buddy Cooper's mom.
Where is your school?  In somebody's basement, that is the Chupp's house.
How do you get to school?  Walk.  About 30 meters or so.

What do you like about Kenya?
Man-Cub:There is a lot of space to run.  There are some of the same things here like tractors, trucks, and milkshakes and bananas.  But the bananas are sweeter.

Little Miss what do you like in Kenya? Horses!  Horseback riding! And I saw a camel once in Nairobi.  There was nobody on it.  We were in the car but I wanted to ride it.
What else? Books.  Peter-Pan.  Tinkerbell. 
Okay.  What fun things do you do here? Play with Ellie.

What does your dad do?  Go to work.  Eat lunch.  And heal the people.
 Who heals people, Little Miss?  Jesus.
What does Jesus want us to do?  Be kind.

Man-Cub, what is your favorite thing to do here?  Play.
How often do you go outside? Everyday for five hours at least.  We go in the car about once a week.
What do your mom and dad do? Computer work.  And talk to people.
Oh, I see.
What did you do yesterday morning?  We went to a robber boy's house.  He's 7.  His nickname was Osama.  His real name though is Emmanuel.  We talked to him and gave him forgiveness and a Bible.  We told him to call himself Emmanuel.
Anything else? We told him God loves him.  And God is with us.
Were you glad you did that?  Yea.  Cause that's our job to do that cause we are missionaries.

What is something difficult for you here? Something that is difficult is I have to make new friends and leave the others in America.
Is there anything you don't like about Kenya? That there's not many toys to buy cause they break too easily.
Oh, do you think you might run out of toys? nnnn...(laughing) no!
Tell me, where are you going in October? WE ARE GOING TO AMERICA for 2 weeks!
That sounds great. Is your dad taking his Infectious Diseases board exam? Yes.       


So thanks everyone, for praying us through this first year.  We do depend so much on the God Who Hears our prayers.  Please continue to lift us up for protection, mercy, and that the Gospel will be known.  Here is a prayer called "Eli's Song" that was written by Rich Mullins. You can pray it for these kids.  Especially for Emmanuel across the river.

O Eli
There's a sanctity in your innocence

A certain beauty and no uncertain strength
That brings me to the faith
I don't know if I
If I am climbing to or falling in

But it comes like grace from your tiny hands
When I hold you in mine
And I pray that the eyes
Of your heart

Shine bright
With the hope to which you're called
And may you know with all the saints
The height, the depth, the width, and the length

Of the love of God
O Eli
There's a joy in your sweet abandon
Like the cowgirl ballerina

Leaves that ride
The wild and holy bucking wind that the sky
Sent through you to blow away these walls I've built
That leave me free to be a child

And I pray that the eyes
Of your heart
Shine bright
With the hope to which you're called

And may you know with all the saints
The height, the depth, the width, and the length
Of the love of God
O Eli

There's a joy in your sweet abandon
Like the cowgirl ballerina
Leaves that ride
The wild and holy bucking wind that the sky .

  

The missionary kids first day of school. Cinderella is in preschool.

 

 

Daktari wa damu

Welcome back to Daktari Cases.  These cases are NOT Ebola Virus Disease, and there are not (yet) any cases in Kenya.  We rejoice with Kent Brantley and Nancy Writebol in their recovery, and continue to remember those who are suffering in West Africa, and the brave men and women who are serving them.

No, today’s cases are examples of some mystery cases that I’ve seen of late that have ended up being outside my areas of expertise.  Life here stretches beyond your predetermined boundaries in many respects, and here are a couple of stories to illustrate.

John is a 52-year-old man from the other side of Nairobi with a 3-year history of a rash.  This itchy outbreak began on his hands and progressed to involve the entirety of his upper body, trunk, and lower extremities.  He had been seen at many health facilities, given many empiric treatments, and even had some response to topical steroids.  He had also variously been diagnosed with fungal infections of the skin and even leprosy, or a WTDNOS (weird tropical disease not otherwise specified), and that’s how he ended up coming to my attention at Tenwek.

 

After a glance and a gasp, I put on my gloves and had a feel.  A wise dermatologist once told me this, “If you know what it is, you don’t have to touch it.  If you don’t know what it is, for heaven’s sake, don’t touch it.”  Well, I once again ignored this good advice, and through this exam discovered that he had lymphadenopathy (swollen lymph nodes, lumps and bumps all over his body).

So, thinking there must be more here than meets the eye, and assuming it’s an indolent and potentially treatable disease, I rang over to my friends the surgeons to send off a skin biopsy.  “Tissue is the issue,” they say.  Anyhow, it turned out to be a Cutaneous T-cell Lymphoma, otherwise known as mycosis fungoides.  It turns out, since 1806 we have been mislabeling this slow-growing lymphoma as an infectious disease.  And if you’re going to get a lymphoma, this is one of the kinder gentler, and even treatable in Kenya ones.  And the treatment (here): nitrogen mustard.  If that sounds to you like a gas that killed people in trenches in World War 2, I think you’re right.

Our next patient is named Mary.  She is a 56-year-old Massai lady referred to me by my friends in an outlying clinic.  An aside, I get to go out to these clinics usually about one day per month, and it’s awesome: there’s no electricity, no running water, it’s just your wits and your stethoscope, and a handful of medicines.

Back to the story, this lady has a 1 month history of headache, with a pain in her left side “that is growing.”   So, I ask “what do you mean, ‘it is growing.’” At which she replies, “feel this.”  Protruding from the left upper quadrant of her abdomen is a subcutaneous American football.  But I’m not fooled, there’s not a real football in there, this is a massive spleen.  Ah, massive splenomegaly, the hallmark of many tropical infectious diseases.  This is a slide from a really smart guy from Mayo Clinic who taught us in Greece at the CMDA conference.

So, I ordered a complete blood count, and this is what we found.  So, I’m astonished by all of these results.  But most startling is her hematocrit.  We live in a land of chronic anemia, and it’s not surprising to see a patient walk into the hospital with some general malaise and a hematocrit of 7%.  This lady has a hematocrit of 70%.  She has the red blood cells of at least 3 Massai ladies.  This is abnormal.  The disease is called polycythemia vera.  It’s a myeloproliferative disorder (confusion in the bone marrow that makes too many red blood cells, and can be a precursor to leukemia).  And the treatment?  Very high-tech and modern: blood-letting, also known as serial phlebotomy.  It reduces the risk of stroke, the blood gets so thick it stops up the blood vessels in the brain.  So, once per week we are removing a unit of blood and keeping an eye on her blood counts.

These stories are ironic on many levels.  And that’s why this entry is called Daktari wa damu: the doctor of blood.

out of orbit

Do you remember motorcycle carnival rides where all the motorcycles ride around and around making lots of noise and lots of little children feel so happy and tough at the same time?

Bomet, our town, looks about like that except the ride spun out of orbit and all the colorful pleather and chrome scattered everywhere.

Motorbike taxis are a main source of income for young men these days.  They are also the main source of orthopedic patients at the hospital.  Driving a car on the highway amongst them can feel like a bird flying in a swarm of bees.

Sometimes the wind here is so strong that I feel like the whole planet is being flung out of orbit on one of those carnival rides.  Or maybe it’s just on the far reaches of a seasonal eclipse around the sun.

You know, we are just right below the equator so when seasons change we are the reverse of you “northerners”  (Did you ever think you’d be called that? Don’t worry I would never call Georgians and Tennesseans and Alabamians by that northerner term usually affixed to a prefix).

Yes, things are often the reverse of “normal” here.  And we are in the southern half of the world now where People are people through people.  That is, Africa is to relationships as North America is to individualism.  Mother T. used to say “loneliness is the leprosy of the West”.  Poverty of relationships is indeed true poverty. 

So I am indeed blessed and thankful in this upside down place.  While nothing good comes in the news out of Africa these days let me tell you, people here are people because of relationships with people.  I can stay holed up in isolation of the different house we’ve just moved into and try to locate where the heck is the scotch tape in this place- or I can walk 50 yards (45 meters), to the shops and shake hands with 10 people who all ask how I’m doing, how is my home, how are my kids, and where am I going. 

I am thankful for the wildness of an African rain that commands such respect all humanity stops together in our tracks until she passes by.  I am thankful for the beauty of obtrusively orange honeysuckle vines climbing over an otherwise gray stone building. It’s like Tennessee orange wisteria, ya’ll.  And I’m thankful for the stark rainbow of colors that African women wear like a kaleidoscope of beautiful black, brown, and boldness.  I like to see their reactions when I try to wear some of that funkytown.  We could say it’s good for building relationships perhaps.

So wild and out of control, that’s kinda what you hear about Africa isn’t it?  The idol of control is not worshipped here anyways.  Maybe that’s why I like it so much.  Maybe I find comfort in the ambiguity of plans as long as everyone is happy.

Can I ask you a favor?  Will you speak kindly and sincerely to someone in the store or on your street today?  Can you alleviate the loneliness of your neighbor by just showing up in your humanness too?  It might be off your normal orbit, but that could be truly a beautiful and wild ride.

To our readers, please pray for our friend Kent Brantley, a physician living and working in Liberia amidst the Ebola virus outbreak.  He has contracted this deadly virus.  He is a husband and father.

These are stories of tragedies.

Joseph was a young man of 28, a husband and father as well.  He suffered a motorcycle accident and a fractured femur (long bone in your thigh), an everyday story here.  His leg got infected, and when we first saw him, he was hanging on to life by a thin thread.

"There is a stat consult from ortho" I heard walking through the ICU on a Thursday morning.  And then he lost his pulse.  We coded him intermittently for about four hours, buffering in boluses the overwhelming death that was coming.  This young man was a fighter, and despite the failure of almost all his organs, he pulled through the day.

Like clockwork, the organs that failed him returned: he awoke (brain) started breathing on his own (lungs) maintaining his blood pressure (heart) making urine (kidneys) and blood cells (bone marrow).  It was a marvel of the created human body, like a re-do Garden of Eden.  We took this picture to illustrate this moment.

Because we knew he would never walk, the femur was gone, we found this wheelchair, complete with the hand crank, and the tires to handle the African village life.  We put it together in anticipation.

But this isn't the Garden and I warned you that these are stories of tragedies.  After four weeks in the ICU, Joseph was unable to get enough nutrition to rebuild his strength.  Over the course of about a week he wasted away, the will was gone, or was it his strength?  He died on my weekend off.






This is a man named Richard, and his children (all 7 of them).  The setting for this story is about 2 hours' drive off the paved road, a road I got to take because of the work that Katie does with a women's group called Tabitha Ministry.  The backstory is one that I'm all-too-familiar-with from Tenwek.  His wife suffered complications in pregnancy and died giving birth to these twins 2 years ago.  He is a widower, and with his community and with his mother-in-law he cares for these children.




We got invited to a ceremony to dedicate a house given to him by some donors from the US.  Mud and sticks and tin roof and all.  That's me (the white guy) in a somewhat-ridiculous African shirt that the Tabitha ladies gave to me.

The weight of tragedy that we see in everyday life at the hospital is the greatest challenge of living here.  Often I wonder, "what's going to happen to these people?" and without an answer I move on to the next patient in line.  Here's a community, a church, that has joined together to support this man in his tragedy.  We have a great deal to learn about community, about suffering, and endurance, and about hoping in the resurrection.  And these are our teachers.




And so, when we don't know what to do, or what to say, we speak the Good News, that God rescues sinners from death.  We treat the sick with compassion and thus fight an insurrection against the powers of this world: sickness and suffering,  and we plant a little bit of that news in this African soil.