Tuesday, November 15, 2016

A boy named Gideon

Gideon is a 17 year old boy whose parents brought him to Tenwek in a coma.  I did a double take at his head CT when the resident came to tell me about him...it showed the largest brain tumor I think I've ever seen! 
The tumor looked to be outside the brain, so while Gideon was unresponsive, I thought if we could remove it and take the pressure off his brain, perhaps he'd have a chance at some improvement.  We took him to the OR urgently that night and, as I feared, the tumor had developed an extensive vascular supply so that even as we made the incision and peeled down his scalp his skull was bleeding in countless places.  The hospital's only electric craniotomy drill had broken just a few days prior so we had the tedious task of removing his skull using a hand twist drill and manual saw.  I had planned to open the covering of the brain over the center of the tumor and begin removing pieces of it, but quickly realized the tumor was way too bloody for that tactic.  So instead I opened along the margins of the tumor in hopes of perhaps coming around it.  The neurosurgeons reading this know what happened next though.  The tumor was putting so much pressure on the brain, the minute the brain was exposed it began herniating toward us, begging to get away from the tumor.  I knew between the brain trying to squeeze out of the head and the tumor bleeding, we needed to move fast.  I've never done what I did next, and my mentors at Mayo would cringe had they been watching.  The plane between the tumor and the brain was actually pretty favorable so I literally ran my hand between the brain and the tumor all around its margins until I was able to remove the thing in one chunk.
Even later that night in the ICU Gideon began to open his eyes and over the course of the next week he made a remarkably full recovery.  Thankfully, and somewhat surprisingly, his tumor was a benign tumor called a meningioma, so I'm hopeful he's cured.

Gideon really endeared himself to me and the day he came back to clinic a month after surgery was a special day.  I believe God spared Gideon's life and I shared with him the following scripture from the book of Jeremiah.
"For I know the plans I have for you," declares the Lord,
"plans to prosper you and not harm you, plans to give you a hope and a future."

I believe that's true for Gideon and I believe it's true for my family here in Kenya.  
It’s hard to believe I'm finishing my seventh week of work here at Tenwek.  Certainly it has had its challenges and many days we still feel unsettled, but there has been something entirely fulfilling about serving the people here and being where we’re confident God has led us.

Work at the hospital has been plenty busy.  Just yesterday I gave a lecture to the residents, performed three operations while bouncing back and forth to clinic to see 31 patients, and had a ruptured aneurysm come to casualty (what we call the ER here), which I added to the already two cases scheduled for today. I have good help though.  The surgical residents here are great and interacting with them has been one of the most enjoyable aspects of my work.

Operating is almost always an adventure.  More days than not I feel out of my element.  Either I’m doing cases I’ve rarely (or never) done, or even in those cases I would otherwise be comfortable, I often don’t have some piece of equipment and am left needing to improvise.  I’ve found myself in the middle of many cases feeling way in over my head, being keenly aware of my own limitations as a surgeon, and asking God to intervene.  That is a humbling situation to be in and it’s teaching me a reliance on Him I’ve not previously allowed.

Thank you so much to the many of you who have supported us in various ways.  Please know your support makes a real difference for us and is so encouraging as we continue to settle in to our new home here in Kenya.


Saturday, November 5, 2016

Feet on the ground

I have been waiting for mental clarity to write but I better not wait any longer! It's hard to believe that 7 weeks have passed since we moved to Kenya!

Packed and ready to move - 2 parents, 5 kids and our life inside 24 pieces of luggage
These are words that I wrote shortly after we arrived at Tenwek Hospital:

Our feet are on the ground in Kenya! We left Little Rock, Arkansas on Tuesday, September 13th.  After 24 hours of travel, a 2 day stay in Nairobi and a 4 hour drive, we walked into our new home at Tenwek.

The journey went... ummmm.... smoothly?  God graciously delivered us from one point to the next.  However, I think of Jim Gaffigan's line when people ask him what it's like to have 4+ kids. "Imagine you're drowning... and someone hands you a baby."  This is also descriptive of traveling internationally with five kids.  Constant survival mode - Is everyone accounted for? Is a carseat optional for this toddler?  Are we supposed to be awake or asleep now? Can 7 people survive on five granola bars and a bag of jolly ranchers before the next stop?

I am so thankful for each person that prayed for us through our travel days and the challenging days of preparation before.  Many texts, calls and emails of love and prayer were sent our way from friends in the US and new friends in Kenya.  And at just the right times when I thought I couldn't do it!

I do not have enough words of gratitude for our families.  They were troopers and rallied together to get us off the ground in Little Rock.  Here are some traveling photos.
Pops helping us pack the trailor on the morning of our flight
Nora keeping an eye on the luggage
At the Little Rock Airport and so happy to be done with the packing part!
Checking it all in at the airport
Hard good-byes to grandparents
Will's mom and Harper Claire
Liam, Uncle Ellis and Hayden
Happy to be on the plane
Getting into the entertainment bags packed by family and friends

Thank you to the Cruce family for these airplane toys!
Landed in Nairobi
I have a cousin, Sarah Nicholson, that lives in Malindi, Kenya.  I have not communicated well with her since she moved to Kenya 5 years ago, and I did not communicate well with her as we prepared to move ourselves to the same country!  But when we walked out of the airport in Nairobi, her husband Chris was standing there waiting for us!! We couldn't believe it!!  To step off of a plane at night in a new country with 24 pieces of luggage after 24 hours of travel, and to see a familiar face - it was like seeing an angel sent from God.  This sounds dramatic, but it's true!  We hadn't even told Chris or Sarah our travel details, but he had found out for himself and hopped on a flight from Malindi to Nairobi to meet us.  He helped us get our luggage out of the airport and to the Samaritan's Purse vehicle that was waiting for us.  And then while our family drove with our SP driver to the guesthouse where we were staying for the night, Chris hopped a taxi, picked up pizza from Domino's and met us back at the guesthouse.  THEN he said, if your kids have trouble sleeping tonight, just come get me and I'll help you out so you can get some sleep.  This guy!!  This kind of unexpected help and kindness when we were worn out and vulnerable was an amazing gift.  And Sarah flew in the next day to spend some time with us in Nairobi before we drove on to Tenwek on Friday.  We are so so grateful for their support and encouragement.
Chris and Will outside of the Nairobi airport
Eating a nice lunch in Nairobi hosted by Samaritan's Purse staff.  A Brazilian steak house!
Liam watching a pig being butchered outside of the restaurant
Doing a big grocery run at the Nakumat (sort of like Wal-Mart but not) in Nairobi with Hayden and Beth White
One of the long-term missionaries from Tenwek, Beth White, met us in Nairobi to help orient us.  She ran around with us to tour the Samaritan's Purse headquarters, arrange for new cell phone service, and do a giant grocery run to stock up on basics before leaving the city.  She and her family have lived in Kenya for 19 years and she is a wealth of wisdom.  She and her husband Russ have been assigned to us as mentors and we are so glad to have their support and guidance.  Beth has a quiet confidence and steady trust in God.  I have found her to be a good listener and trustworthy.  She has already become a friend!
Sarah helping with the big grocery run
Jet lag
Saying goodbye to Chris and Sarah and looking forward to more time together
View of the Rift Valley as we drove from Nairobi to Tenwek
Will and the kids with Tony, our driver from Samaritan's Purse.  Tony drove us carefully through the chaotic traffic and bumpy, pitted roads and delivered us safely to Tenwek.
Our new home
We were greeted at our new home by Dan and Heather Galat.  This is the house Dan and Heather lived in and grew their family in for 7 years.  This summer they unexpectedly needed to move to Kijabe, Kenya for the foreseeable future and so we will be living in their home in their absence.  They lived many memories here and put lots of love and work into this home.  It really is a beautiful house.  They were there to pass it on from their family to ours.  It was an emotional hand-off and we are so grateful for the time they spent orienting us to the house and the start of life in Kenya.

Nora walking with Sheila, our new house helper
Now our feet are on the ground at Tenwek Hospital!  As I stumble through these first days and weeks, I am a mixed bag of emotions...

So grateful to finally be here but missing the family we left behind.

So excited to be in our new home right next to the hospital but not feeling at home yet in these new walls.

Struck by the beauty of the country around me but feeling awkward in my own skin as I walk from one place to another.

Surrounded by a kind and welcoming team of missionaries but feeling largely unknown.

The kids have all had highs and lows but are overall positive and happy to be here.  They are making fast friends with the other missionary kids and easing their way into the world of homeschooling - that's another post for another day.
Harper and Charley playing with flower pods in the yard
A little homeschooling action
I find myself grasping for familiarity...

smelling all of my clothes and towels that still smell like detergent from home

taking an extra minute to hold and snuggle Nora before bed

looking at my mother's handwriting from a note in the front of my journal

Today after a meal of rice, beans and chapati (a Kenyan flat bread), Charley said, "Mom, can you make macaroni and popcorn and pizza?" I think she is looking for familiarity too.

This is ringing in my ears now... a song I used to sing as a kid.  I haven't sung this song in so many years and now it is always in my mind and a song I've begun singing at bedtime to the kids.  It's from a chapter in the book of Lamentations.

The steadfast love of the Lord never ceases
His mercies never come to an end
They are new every morning
Great is your faithfulness
The Lord is my portion says my soul
Therefore I will hope in Him

God, may I be grounded in you as the smell of my detergent from home fades.