"I Know One Thing..."

Dr. Paul had been diagnosed with a brain tumor that was causing him to loss vision.  As a native of the Ivory Coast and now one of only two general surgeons serving at a hospital in Guinea, he knew the challenges of accessing neurosurgical care in Sub-Saharan Africa. Through a mutual connection at Mayo Clinic Rochester, Dr. Paul was able to come all the way to Tenwek for a successful surgery.  That's a LOOONG way; think Seattle to Miami and then another 1500 miles into the Atlantic.  And this all happened without my even being in Kenya!  Since our family returned for our year stateside last July, there have been not only one but two full-time neurosurgeons to carry on the work at Tenwek.  My how things have changed since we first arrived at the hospital in 2016.

Dr. Paul and his wife with our neurosurgery social worker Dominic

January marks the beginning of a new academic year for our neurosurgery residents.  Below are Drs. Fraser Henderson Jr. and Hugh Sims-Williams (my co-consultants at Tenwek) presenting certificates to Drs. Josephat Mburu (top), Ivy Barasa (middle), and Daniel Ndaro (bottom).  Dr. Emmanuel Wafula, our most senior resident, is currently away on an external rotation.  These trainees are one of our greatest joys in being at Tenwek.  They are smart.  They are committed.  They are funny.  And they love Jesus.

Upon preparing to leave Tenwek and return home to Guinea, Dr. Paul wrote a note expressing his appreciation for the care he received.  In it he said, "Thank you for your prayers.  Thank you for your humility.  Thank you for your expertise.  I know one thing: God is at Tenwek Hospital."  Indeed, He is.  Much more than receiving needed neurosurgical care, our desire is that patients would encounter Jesus at Tenwek and come to know the lasting hope of eternal life that He offers to anyone who believes in Him.

Sledding with friends Tom and Kady Weigel

We just finished a trip back to Rochester, MN.  It was a busy three days, but a great time of reconnecting with  so many friends.  We spoke about Tenwek at an event with colleagues from Mayo Clinic and also shared at two church services.  We managed to enjoy some sledding too.  Nora, our 7-year-old, somewhere along the drive between Little Rock and Rochester, said to Alisa during one of our (innumerous) bathroom breaks, "Mom, is that white stuff on the ground snow?"  She's never seen that in Kenya! We will be returning to Tenwek this coming summer.  We don't have tickets purchased yet, but will keep you updated as to our plans.  As always, we cherish your prayers and words of encouragement.  Thank you for your continued love and support.

We're Still Here!

Remember us?  Our blog has sat silent for some time, but we are still here!  Lots of life has happened in Kenya over the past months - much to celebrate and much hardship.  Our family is learning the truth that in Christ we can be "sorrowful, yet always rejoicing"; both happy and sad at the same time.  That's good news because sorrow and struggle is all around us, whether in our inner-circle or something we hear about that's burdening someone else in the world.  We would sink if joy couldn't exist in our lives at the same time as sorrow.  Joy and sorrow can co-exist!  

On that note, here are some of the things that give us joy right now...

Tenwek's PAACS neurosurgery residency is growing.  We now have two consultants and three residents with a third consultant and fourth resident joining later this year.  Our first trainee is on track to graduate in January of 2024.

I Saw Another Neurosurgeon!

For the first time in almost nine months I had a companion!  For twenty minutes at least.  Dr. Bethwel Raore was born and raised in Kenya but did his neurosurgical training in the US and now practices in the Atlanta area.  He had returned to Kenya a couple of weeks ago to visit family and unknown to me had decided to drive four hours to Tenwek just to say hi briefly and drop off a much-needed electric surgical drill (I was down to my last functioning one).   Like for many of you, it's been a bit of a lonely year.  Because of COVID, there have been no neurosurgeons come to Tenwek since early March.  I've missed the camaraderie of those visits.  The work here has some high highs and low lows.  Often I wish there was a fellow neurosurgeon here who understood those victories and defeats  - who could celebrate the good outcomes, and listen and give advice after the bad ones.  Still, most evenings I walk home with a deep sense of fulfilment from the day's work, and Alisa and I remain with a strong conviction that this is where God has led our family.

Bethwel's surprise visit was such an encouragement

It's been as busy as ever at the hospital.  Early during the pandemic one of the main hospitals in Nairobi - where one of the larger neurosurgical practices in the country is - became a designated COVID hospital, and so many of their patients came to Tenwek instead.  More recently, because of continued frustration over lack of appropriate protective equipment and overall poor morale from being overworked, many doctors and nurses in surrounding hospitals have gone on strike, again leaving Tenwek to shoulder an extra heavy patient load.  And it's not just the people of Kenya we are serving.  Last week we removed a brain tumor in a lady who had travelled all the way from Gabon, a country on the complete opposite side of Africa.

Mouembe before leaving to return to Gabon

I wrote in my holiday email last year that 2020 marked a new chapter for neurosurgery at Tenwek.  Dr. Emmanuel Wafula has spent this year as a neurosurgery resident-in-waiting and in January 2021 will become the first official neurosurgical resident at Tenwek.  Tenwek will be not only the first neurosurgical training site in all of Africa for the Pan-African Academy of Christian Surgeons (PAACS, through which all surgical training at Tenwek happens), but also the only neurosurgical training program in Kenya currently outside of the capital of Nairobi. What I didn't know last year was that Dr. Fraser Henderson Jr.'s visit to Tenwek in February would lead he and his wife Betsy to commit to joining Alisa and I here full-time in January 2022.  That God would lead another neurosurgeon to Tenwek has been our hope for several years now.  It's hard to overstate our excitement at this news!

Emmanuel is going to be a great neurosurgeon.  He loves the Lord deeply.  The opportunity to work one-on-one daily with him is one of my greatest joys here.  Here he is operating on another patient with a brain tumor.

Fraser (left) operating with Emmanuel and I this past February

Fraser and Betsy, along with their daughter Phoebe, will be joining us in January 2022

Tenwek has been approved for a total of three residents and in January Emmanuel will be joined by Dr. Ivy Barasa as our second.  The surgical training programs at Tenwek rely 100% on the financial support of partners like you.  The cost of putting a resident through their 6 years of training is $25,000 per year.  In addition, there is a critical shortage of resident housing at Tenwek and fundraising continues for the building of more housing units.  Each of the three units needed for our neurosurgery residents will cost approximately $40,000. If you're interested in joining the work at Tenwek by supporting Emmanuel and Ivy, along with future neurosurgical trainees, Alisa and I would be very grateful.  To do so you can give a tax-deductible donation to Friends of Tenwek by clicking here and designating your gift for the "Neurosurgery Residency Scholarship Fund".

The Copeland crew at our Thanksgiving celebration last weekend.   We are grateful for the support of so many of you that allow us to continue serving here at Tenwek.  Blessings to you and yours during this Advent season.

Lest you think I'm the only one doing cool stuff around here...This is a picture of Alisa with the ladies of Side By Side-Tenwek when they received their copies of the Bible study book Seamless.  Side By Side is an outreach ministry of the Christian Medical and Dental Association designed to encourage women in their faith and medical marriages.  Alisa started Tenwek's chapter back in 2017 with one resident's wife and it has grown to now include most of the wives.  What a blessing it is to be united with Alisa in our purpose here - to train and disciple residents and their spouses to serve those in need and tell of God's goodness shown in Jesus Christ.

A Living Hope

You know the statistics.  You know what it's doing to the world.  Perhaps you know most keenly because you know what it's doing to you.  It's threatening so many of the foundations of your life - your job, your retirement account, your social network - and reminding each of us that the day will come when we won't ever work again, when we won't have a penny to our name, when our social calendars will forever be empty.  COVID-19 reminds us of death.  C.S. Lewis's words on war seem as pertinent in a pandemic:      What does war [or the coronavirus] do to death?  It certainly does not make        it more frequent; 100 percent of us die, and the percentage cannot be                increased.  It can put several deaths earlier, but I hardly suppose that that is      what we fear...Yet war does do something to death.  It forces us to                      remember it...War makes death real to us...("Learning in Wartime") Each of us who has known life has known the fear of death.  And yet in Jesus Christ the fear of death is turned on its head.  Consider the words of the biblical writer Paul:      For to me to live is Christ, and to die is gain.  If I am to live on in the flesh,          that means fruitful labor for me.  Yet which I shall choose I cannot tell.  I am        hard pressed between the two.  My desire is to depart and be with Christ,          for that is far better. (Philippians 1:21-23) Times like this test whether we can say the same.  It can be easy to say "to live is Christ, and to die is gain" when life costs us little and death seems far off.  It is another thing to say the same when disease is spreading and we, or someone we love, might die.  Is death really good news for those who love Jesus?  Is life after death really better, by far, than even the best this life on earth has to offer? With Jesus, death becomes a servant - a door into His all-satisfying presence forever.  Death is gain, not because the experience of death is any less likely, or any less painful, but because of what death gives us - because of Who death gives us. I've found myself lately cherishing anew the words of the apostle Peter:      Praise be to the God and Father of our Lord Jesus Christ!  In his great                mercy he has given us new birth into a living hope through the resurrection        of Jesus Christ from the dead, and into an inheritance that can never perish,      spoil or fade, kept in heaven for you...In this you greatly rejoice, though now      for a little while you may have had to suffer grief in all kinds of trials.      (1 Peter 1:3-4,6) In this time of uncertainty, when you're tempted to fear or despair, may you find rest in the assuredness of our living hope, Jesus Christ.  Or perhaps during this Easter week you would come to know that hope for the first time.   A friend sent me this song this week and I love the truth in its lyrics Many of you have reached out recently to see how we're doing and how the coronavirus is affecting Kenya.  Thank you.  It means more than you know to hear from you and know you're thinking of us. We're doing well.  The country's first case was diagnosed on March 12th and as of this morning there are 125 additional confirmed.  Tenwek Hospital has yet to receive a patient with COVID-19 but we have been busy making preparations in anticipation that, if it spreads like it has in so many countries, it may soon threaten to overwhelm our systems. Elective surgeries have been cancelled though most of what I do is urgent/emergent so my days feel mostly normal.  Alisa's Side By Side women's group has stopped meeting for the time.  And since homeschooling doesn't stop to social distance, the kids are enjoying being on Spring Break! Thanks again to all of you who support us in so many ways.  We couldn't continue in the work here without you.

Standing on our tallest step stool

Fresh passports of these sweet kids in this week! One step closer.

Yesterday I was standing on a step stool on the front porch with my 3 year old, Nora, on my shoulders.

Probably not the safest pregnant-lady move.

But an obscure little bird's nest is tucked behind our porch light next to the front door.  The momma bird secretly built it in the past days and we didn't notice until she was perched inside protecting her eggs. We wanted to see how many she had laid but even standing on our tallest step stool we couldn't get high enough to see inside.

I put Nora on my shoulders, stood on the stool and Nora joyfully said, "Oh my goodness!"

I asked," How many eggs do you see?"

"Two!" she replied.

Liam, my skeptical middle-schooler, wasn't taking her word for it.  He borrowed my phone, stood on the stool and raised his arms high to get a shot of the eggs down inside.  Here's what he saw:

From Nora's perspective there were two eggs, which pretty much to her means more than one.  Her perspective of numbers will one day change to a clearer understanding that 2 is actually the number between 1 and 3 but it is not the same as 5.

Even now, at 36 years old, my perspective continues to change.  I remember when Liam, my first baby, was born.  I felt like I was stuck in a newborn twilight zone and I would never again sleep three hours straight, cook a meal or make love again.  The early months seemed endless.

Then my second, third, and fourth babies were born and I realized that those early days are a blip, over so quickly and propelling you onward to toddlerhood, preschool and 1st grade before you are ready for it.

And the sleeping, cooking, and love-making pick back up pretty quickly too.

Not surprisingly, after living in Kenya for two years and returning to the United States for a year, my perspective on the US  has changed.  When our family returned 9 months ago, the one thing we were struck with was the excess of resources in the Unites States.  Before we left, we didn't give a second thought to clean water, smooth roads, or 732 cereal options.  I couldn't see those things until I lived without them.  I didn't know that I had a skewed perspective.

I didn't know what I didn't know.

But this is unsettling to me.

What else is there that I don't know that I don't know?

My temptation all year has been to climb up on my tallest step stool and look down at all the Americans who don't know what I know. Or at least what I think I know.

To look down at their excess.  To look down at their bigger remodeled homes.  To look down at their Pottery Barn porch furniture that is never used.

And when I'm up on that tall stool, rather than feeling lifted up and better, it's more of a sinking, desperate feeling.  Drowning even.  Up to my eye balls in judgement and bitterness.

Are there other things in life that draw us up on a step stool, up to our eye balls in judgement, to look down on everyone with a different perspective?

A cancer diagnosis? A miscarriage? A child with special needs? An aging parent? Suddenly, we know things we didn't know before and we see stupid people all around us that just don't know - stupid people saying and doing stupid things.

But what is that inside me? Irritation? Frustration? Anger? Ugliness? Insecurity? Sin?

"Save me, O God, for the waters have come up to my neck.  

I sink in the miry depths, where there is no foothold.

I have come in to the deep waters,

the floods engulf me.
You know my folly, O God.
My guilt is not hidden from you."
Psalm 69

Can I be angry at Nora for seeing 2 eggs when there are really 5? Irritated that she doesn't know?

I CAN be angry.  But that is senseless! Waste!

What else is there that I don't know that I don't know?

I cannot know.

So I'm coming down from my tall step stool and laying myself flat on the ground.  Flat on the ground. Humbled. Flawed. B-team missionary Jesus-following mom person.  Or whatever my title is.  At least I can't see the neighbor's porch furniture from there...

Alisa

"For God is greater than our hearts and he knows everything." 

1 John 3:20

Flights Purchased!

Check out this short video for an update on our return to Kenya

As we prepare to transition again, these words of Moses spoken to Joshua give us confidence. "The Lord is the one who goes ahead of you; He will be with you. He will not fail you or forsake you.  Do not fear or be dismayed." Deuteronomy 31:8

Why?

"Why?"  That's the most common question we've been asked during our time back stateside these last few months.   Why take this circus show on the road? Not “What have you been doing?” but "Why did you do it? Why did you just spend two years after residency in Kenya?  And why are you going back?" “Who am I that I should go?” That’s actually the first question Alisa asked herself when God began directing our family to move to Kenya. She was willing, she just questioned whether she was the right person to go.  I, on the other hand, tried to ignore God at first. I was busy with what had become most important to me - my career and trying to position myself to be one of the best. Sure I said my relationship with God, and my marriage, and my kids were my top priorities, but deep down I knew - and Alisa knew - that wasn't the case. During my fifth year of residency I was applying for sub-specialty training and beginning to inquire about jobs, not once thinking about living overseas.  I had some elective time and decided to take a trip through the Mayo International Health Program to this placed called Tenwek Hospital to see what doing neurosurgery looked like in a developing country.  The trip literally changed my life.  I found myself face-to-face with people in poverty and sickness like I'd never known before.  Face-to-face with people whom I'd read about Jesus caring so much for, but people who were so far from my mind.

The look of despair on faces like this mother's was hard to ignore. When I returned home, I was unsettled.  I was trying to reconcile the world I had just visited with the world I was living in.  Shortly thereafter Alisa and I learned of an opportunity to serve for two years at Tenwek through the Post-Residency Program with Samaritan's Purse.  About that same time I began to receive job offers.  All my hard work was paying off and the very thing I had wanted was now in hand.  But somehow it didn't seem to shine so bright anymore.  I couldn't shake the immense need for neurosurgical care that I'd encountered at Tenwek.  I remember thinking "If I turn down such and such a job they will easily fill my place with the next person in line.  But if I don't go to Kenya, who will?"  This dilemma actually irritated me.  I was perplexed with God.  "You brought me to an institution where I've received some of the best training in the world, and now you want me to go serve in obscurity?!  Don't you know how hard I've worked to get to this point?  Don't you know how much money I could make?  Why are you asking this of me?!" I believe God was asking Alisa and I to put what we were clinging so tightly to all on the line.  Not because He was testing our allegiance, or because He's insecure and needed the reassurance.  But because He is good and wanted to free us of the things that He knows can never satisfy.  And because He knows that in our choosing Him over ourselves, His worth is put on display for others to contemplate. Please don't hear me say that to be satisfied or to honor God you have to drop all your 'stuff' and move to Africa.  I don't believe that.  But I do believe that our 'stuff' has the potential to harden us to the needs of others and to deceive us into thinking that it will bring us happiness. Alisa and I are finding instead our greatest joy in treasuring God and serving others.  The reason why we're doing what we're doing is because we are learning what the writer Paul says in Philippians 3:8 to be true - “I count all things as loss compared to the surpassing value of knowing Christ Jesus." I love this circus show We have now officially transitioned to World Gospel Mission, the founding organization of Tenwek, to serve there indefinitely. I don't get paid to work at Tenwek.  We are able to do what we're doing only because of the generous financial support of people like you who want to be a part of serving the people of Kenya with us. Before we are allowed to return to Tenwek we must have 100% of our family's monthly expenses, as well as a portion of the anticipated neurosurgical needs, committed to by a team of monthly financial supporters.  If you would like to join that team go to wgm.org/copeland, type in the amount of support, and then on the next page it gives you the option to make your contribution recurring. Thank you to all of you who have supported our family and the work at Tenwek financially and in many other ways.  It is so very encouraging to us.