An Early Morning Call

It was 2:00 o'clock in the morning, I was on-call, and our phone rang.   The voice on the other line calmly told me that I should make my way to the hospital.  I thought I heard something about "transito," which would indicate a motor vehicle accident (I barely catch a word of Spanish when it's spoken over the phone).  Whenever I get called, I just head to the hospital to find out what's going on.

Upon arriving at the ER, I found that we were dealing with a major trauma victim.  Several sites where broken and bleeding.  We're always taught to go through the ABC's--Airway, Breathing, and Circulation.  For the time being, he didn't seem to be having any trouble with the A or B, but his ability to circulate blood effectively was definitely compromised by his many injuries.   His heart rate had climbed into the 150s.  The long bone in each leg was visibly broken, and the toes on his right foot where extremely pale.  An injury to his head was bleeding fairly rapidly, and his level of consciousness was depressed.  We had lots of help that night from the residents and medical students who were working.  I quickly called in our surgeon, Dr. Graham.  It didn't take long before he was there, along with one of our anesthesiologists, Dr. Suarez, and an orthopedic surgeon from a neighboring community who has been helping us out while Dr. Wolff is in Haiti.  I didn't even know who had called everyone, but I was just thankful to have them all there!  Our medical students maintained traction (pulled) on his legs to reduce the broken legs back into their usual positions.  This maneuver thankfully made the color return to his right foot.  Apparently a major artery in his leg was being compressed by the fractured bone.

In the midst of our efforts to stabilize the patient, we brought him over to the x-ray department to get some films and we all had a few moments to reflect on what was going on.  During these moments, we decided that this gentlemen needed to be transferred to a place with a neurosurgeon and a CT scanner.  A glance at the patient's father, who had been staying by the patient's side during the entire process, also made me reflect on the fact that we were dealing with a precious soul--what if that were my son Caleb laying on the table?  More prayers were said in my head.

As he was prepared for transfer, his fractures reduced and his head laceration repaired, we placed an endotracheal tube using our GlideScope (thank you Verathon) to ensure that the "A" of the ABC's wouldn't be lost during the long drive.  The delivery from our blood bank arrived, and our patient began to receive red blood cells as fast as his IVs could deliver them.  We sent him on his way, and we were thankful to find out that he had safely arrived at his destination.  In a situation like this one, what a privilege it was to have such a great team of people working together, and an amazing God intervening in all of our lives.  My limitations will constantly be stretched during my work at our hospital here in Shell, but it's so comforting to know that I'm not on my own.

Work at the hospital

Now that we've been in Shell for almost a month, I'm starting to learn the work routine here.  There's quite a variety on a daily basis.  We always start the morning with a short devotional and prayer.  Then we have a sit down meeting with the Ecuadorian residents and medical students who are rotating with us.  Every six to eight weeks we have a new set of residents and students.  It's been a pleasure working with all of them, and we consider our relationships with them to be a huge part of our ministry here.  Many of the residents have a heart to do medical missionary work.  We hope to be able to help them mature in their faith as well as their medical abilities, and by so doing, to get to be a special part of the development of a group of Ecuadorian physicians who are serving the Lord and many sick people in Ecuador and surrounding countries.

After we talk about the hospital patients in our morning rounds, we walk over to the wards and examine the patients with the residents.  When that is finished, each physician heads to the outpatient area to begin seeing patients there.  Each family doctor spends about 1/2 a day every two weeks doing endoscopies instead of clinic.  On the days that we're on-call, we don't see clinic patients.  The on-call physician supervises the admissions and deliveries and answers any questions from the resident who is running the ER on that particular day.

I've had many great times praying with patients and discussing their relationship with Jesus in the hospital.  And, whether a missionary on the field or a faithful Christian back home, our responsibility to represent Jesus doesn't end at work.  During our bus trip to Quito last weekend, I had the opportunity to share Christ with two people on the bus.  Both had come from a Catholic background but did not profess to have a relationship with Jesus.  Like so many folks in any part of the world, many people here are going through the motions of some form of religion without really knowing what it means to know Jesus on a personal level.  We all fall into that category at times.  My deepest desire is to help the people here understand that they don't have to, and cannot, earn a right relationship with God by doing any number of works.  Peace with God can only come through the acceptance of Jesus' sacrifice on the cross.  Without a doubt, it is only God who can speak to people's hearts and help them to have a right relationship with Him.  Please be praying that He'll be speaking to many hearts, and that we'll be sensitive to His guiding during our conversations with those around us.

  

Getting Creative

On the mission field sometimes parents have to be a little more thoughtful to insure that the kids are having fun.  There certainly aren't any McDonald's Playlands or tumbling classes in which to enroll the kids.  However, with a little creativity, there is a lot of fun to be found.

Caleb really wanted to sleep in a tent like he did with his auntie this summer.  We were a little hesitant to allow him to sleep outside with all the creepy, crawlies here (plus, we didn't want to have to join him), so Dan rigged up a blanket tent right in Caleb's own bed.

The kids have done quite a bit of painting in the house, but we needed to get out in the sunlight.  We decided to make their bodies the canvas.  They had a great time decorating each other, and cleanup was simple since I could just throw them in the tub.

Speaking of being creative...our Nazarene church here in Shell has a real heart for reaching the community and tribes deeper in the jungle.  They have begun to reach out with a preschool that ministers to many indigenous children.  They also have a dream to create a center for higher education.  They have begun construction at the church site and plan to complete four stories for this purpose, but they need help to complete it.  If anyone is interested in coming to work with the church and the indigenous tribes they are ministering to, we'd be glad to help you get involved.

A Day in the Life...

We're well settled into our home in Shell and are establishing our routines.  There are new things we're getting used to every day (like the 'pet' tarantula we have outside our bedroom window that makes an appearance every night) and some things that are already seeming part of normal life (like walking to fours different stores to buy: bread, vegetables, meat, and diapers).  Caleb loves his new missionary friends....

 And the strange bugs we find outside....

And now that Jael is walking she loves to sneak out the screen doors if I don't lock them and pick all the beautiful jungle flowers we have growing in our yard.

I'm learning to live a more quiet life and though at times I wouldn't mind jumping in the car and heading to Target or Costco, God is teaching me to pray in the midst of my day and enjoy the many things that in the states I seemed to rushed to notice... how the birds sing right after a rainstorm...how funny it is when my children are cover in mud (and that it's not just a mess to clean up) ... what fun a swing can be.

Take time to enjoy Him and His creation today.

Tropical Medicine 101

By the beginning of this week we were pretty much moved in so it was time for me (Dan) to begin my duties in the hospital.  While going through medical training it's necessary to work in a huge variety of clinics and hospitals.  I think I've worked in at least ten different large centers over the past 7 years.  So, I know that it's always a bit of a challenge to get used to a new system and find out where everything is.  Pile that on top of learning to speak Spanish in every conversation and note, gaining a grasp of tropical medicine, and taking on a role as a teaching physician, and you've got yourself a nice little challenge.  Every medicine, disease, instrument, and body part has a name in Spanish, and many of those words are still unknown to me.  When in doubt, you can usually try to say the English word with a bit of a Spanish accent, consider adding an "o" to the end, and just say what comes to mind.  I find that that works at least half the time.

It's been a huge blessing being around such supportive people at the hospital to make sure that I'm not drowning in the newness.  There aren't too many jobs in the world where you can go to work and be surrounded by committed Christians on every side.  And of course, Kristina and the kids have been a huge help around our home, and I look forward to their hugs each day at lunch break and at the end of the day.  Kristina has a great heart for encouragement, and she's already been baking for patients and bringing them special treats.

One of the new things that I've had to get used to is the fact that almost everyone has one or many "friends" living in their digestive tract.  One of the docs here gave me the advice to just give anti-parasite drugs to anyone who hasn't been treated during the past 6 months.  Since almost every stool test I've ordered has come back positive for critters, I think it was good advice. 

I've already been involved in a couple of c-sections.  I'm finding that I really enjoy getting to do that procedure and help a baby come into the world.  Unfortunately, my first c-section patient has had a bear of a time recovering from surgery, as she seems to be suffering from just about every possible post-operative complication. I have to admit it's been humbling for me to have one of my first patients have so much trouble, because, as the new guy, I'd like to show that I know what I'm doing.  Alas, God is definitely in control, and it's been a good experience for me to keep my confidence where it should be--in the Lord who created all of us!  As Socrates once said, "True wisdom consists of knowing that you know nothing."  I'm thankful to God that He will guide me through important decisions with patients, and that I don't have to prove my worth by my knowledge of medicine.  I pray that He'll help me to remember that my worth is in Him.

Thank you all for your prayers, support, and interest in what's going on down here at the Equator.  Please be praying that I'll be open to the Holy Spirit's leading to know what to say to patients to bring them closer to a relationship with Jesus.  Also pray for Kristina, as she is seeking the Lord's will as to which ministries to be involved in.

Spanish Lesson for the Day:
desafio (with an accent on the "i")-  challenge