Monday, March 6, 2017

Panga attack

As one of the few hospitals still fully functioning in western Kenya, we are seeing more and more patients like John here at Tenwek.  As you may know, there has been a nationwide doctor's strike here in Kenya since December 5th of last year.  That means that for the last 13 weeks all government hospitals in the country have effectively been shut down with no doctors to care for their patients.  
John came in to casualty with his brain quite literally hanging out of his head. He'd been yet another victim of a panga (machete) attack.  In addition to the chop through the back of his head, he'd been hit higher above his ear and deep in his forehead, as well as having his finger nearly taken off.  We took him to the operating room where I amputated the exposed and contaminated brain, then patched the covering of the brain using tissue from his thigh.  Next to me were two general surgery residents washing out and closing his other scalp wounds while an orthopedic resident repaired his finger.
The strike has drastically changed the already busy workload here at Tenwek and the way I have to practice neurosurgery.  I'm seeing far more patients than I could ever treat...victims of assault or accidental trauma, those with brain tumors, or with spine infections, or babies with hydrocephalus. Patients that need an operation to save some aspect of their neurologic function, or even more, their life.  And that's to say nothing of the many with degenerative spine conditions causing them "only" pain, affecting their quality of life and often compromising their ability to work and provide for their family.  The latter have been destined to a long waiting list.  For the others I have had to resort to offering surgery only to those who I judge to be able to benefit most from my efforts.  And the ones I triage out I can't just send somewhere else.  There isn't a somewhere else for the vast majority of our patients who can't afford the prices of the few private practices still open in the country.  And that means I have to look a mother in the eyes and tell her I can't operate on her 7 year old son with a brain tumor because I'm estimating that his prognosis will be worse than the 14 year old girl in the bed next to him who came in with an intracranial hemorrhage from a vascular malformation, which if I remove will likely allow her to live an otherwise normal life.  Or telling every adult I suspect has a malignant brain tumor that I can't help them, like the 34 year old father of two I saw this week who may have his life extended by a few years with an operation.  
Two of my patients sharing a bed, a more common occurrence now during the strike.
The young man on the right is my most recent panga attack victim from last week.
When I reflect on the needs of so many hurting people and am at times tempted to give up, I'm reminded of Jesus, who made it his mission to serve others, even the "least of these", in the hope that they would come to know of God's love for them.  When Jesus was asked what the greatest commandment was, he answered and said "Love the Lord your God...and love your neighbor as yourself."  He told his followers that "By this all men will know that you are My disciples, if you love one another."  The New Testament writer Paul went so far as to say, "The only thing that counts is faith expressing itself through love."

It's a privilege to serve alongside my Kenyan brothers and sisters here at Tenwek, where we are trying to live out these words by loving our neighbors as we would ourselves.  Often it means providing care to patients with little or no resources to offer the hospital in return.  Or working longer, busier hours and taking on additional responsibilites as the hospital capacity overflows.  It means keeping our doors open and continuing to serve when so many around us have chosen not to.
Our 5 little monkeys lined up on the Maasai Mara during a recent safari.  How cool is that?!
Our family is doing well.  For the last two months I've been taking Swahili classes in the mornings, then trying to cram a full days work into the afternoons.  Perhaps not the wisest timing on my part, but I'm really enjoying it and think it's important to learn the language so I can best connect to the people here.  If you haven't heard, we're expecting our sixth baby in May...our fifth girl.  Heaven help us.  

Thanks for your continued support.  Please know it means so much to us.


Sunday, January 22, 2017


I have a college degree in communications but I am a poor communicator.  Day to day life overtakes me and there is always an excuse not to write, call, text, or reply.  This is true regardless of which side of the world I am living.  New experiences have piled in my mind to tell you - our first Christmas season in Kenya,  a special visit to a village church, our first Kenyan birthday party, and more.

But today all I can write about is Mimi.

Will's grandmother, Charlotte Copeland, passed away on Thursday morning.  The news that Mimi had died came suddenly and unexpectedly.  We love her so much.  The distance between Kenya and Arkansas is always far but feels even greater as we try to grieve from miles away.

One of the last things she asked of me this summer before we moved was for a hand-written letter with news about the kids.  I never sent one.

These are my thoughts that I wish I had communicated to her had I known...

I remember being at your house one day and you were admiring my mothering saying "Hon, how do you do it all?" And I laughed and said, "Oh Mimi, but you've done it all too!" And you said, "You know, you just do what you have to do, don't you?"

Those words "you just do what you have to do" have come to my mind often.  

You just do what you have to do...

When I am weary, when I am lonely, when I am overwhelmed.

You just do what you have to do.

And I think about how that rings true in your life.  You have set a high standard of what it means to do what you have to do - of making the right choice day after day, of living faithfully and loving well.  

I love this about you.  You passed this on to your son, Billy, and he passed it on to Will.  These men carry these traits of you.  Now I get to reap the great benefits of your legacy.  

Your legacy of living faithfully and loving well.  

Our fourth baby, Charlotte, carries your name because we hope that she can follow in this same example that you have set.  You are a true reflection of Christ and that is the greatest hope we can have for her.

Thank you so much for that.

Charlotte and Charlotte
On Thursday night, our family sat down and talked about the many things we remember and love about her...

Liam looked forward to motorcycle rides to her house with Pops (Billy).
Hayden remembers having a special morning with Mimi, making macaroni and cheese and cookies, just the two of them.
Harper loved popsicles at her house and remembers Mimi teaching her how to clap to turn the lamp off and on in her hallway.
Charley loved playing tea party with Mimi and going upstairs to see her purses.
We all remember celebrating Mimi's 87th birthday and Nora's 1st birthday together this summer.
We all loved the cards and gifts she never forgot to send on birthdays, holidays and anniversaries. 
We all remember how she loved Pawpaw.
We all loved how thrilled she always was to see us and be with us.  
Birthday celebration this summer
My grandmother has dementia and was moved to a nursing home not long ago.  Mimi began visiting her there.  I loved her so much for that.  And this summer I told her thank you for taking the time to go see her even when my grandma doesn't know who she is.  And Mimi said, "Oh, it just brightens my day to see her!"  It brightens HER day to visit my aging grandma in the nursing home.  Mimi was a rare and bright light in this world. 

We honor your memory across the ocean, Mimi.  We praise God for you and the glory you brought Him.  May we serve others here in Kenya as you did in your life.