let us run...

"let us run with perseverance the race marked out for us..."

Hebrews 12:1

When I traveled to West Africa in 2009, I was confronted with an overwhelming sadness of how so many of God's children are suffering in this world. We are so comfortable with our environment here in this country. We know that when we wake up every morning, we can walk into our kitchen, turn on the faucet and drink water from a clean water supply. Our infrastructure gives us that confidence daily. We flip on a light switch and immediately our rooms are illuminated and we can go about our lives, even when the outside world is dark. We walk to our driveway and get in our car, and drive to the grocery store where we can buy virtually any kind of food from anywhere in the world - no matter if you are in the mood for Italian pasta, Greek salads, Indian curry, or good ole Eastern North Carolina BBQ. It is all there waiting for you every day. Perhaps one of our greatest inconveniences may be when snow has been forecast (a big event in eastern NC) and the bread supply drops to critically low levels on the store shelves - for up to 5 days in some cases!

But in West Africa, there are regions where there is no clean water supply, no electricity, not even grocery stores for food. The "lucky" people may have a well....a mere $2000 US can pay for a well installation which can serve entire communities...but these are scarce in many regions. Children have no clothes. Babies have no diapers....think about that. Their waste is captured either on the tapestry they are swaddled in, or their mother's lap, then just wiped away without any semblance of cleanliness. 

 

Our waiting room ...

While there, we ran a clinic over a week. We treated about 1000 patients that week. All ages represented, their problems ranged from malaria to parasites, to asthma...the pollution in this country is particularly horrible as all vehicles are operated with leaded fuel, often smuggled in illegally from other countries, making respiratory illnesses very prevalent. Our clinic, that one week, was probably the only medical care in that area in a 6-12 month period. They could only wait for the next mission team to come and hopefully continue their care. Without mission groups providing care, their only other option was to travel to the country's only main hospital, many miles away. 

 

I met a young patient - she could not have been more than 30 years old - with a large breast tumor, clearly a cancer - causing her great pain and clearly taking her life. She came to us hoping we could help her. Obviously, I thought, she needs surgery, and chemotherapy, and with treatment she may be able to live a long time. Even if we couldn't cure her cancer, I knew the medicine existed to ease her suffering and prolong her life. She and her family were desperate. But I was in West Africa, not North Carolina, and so my options were very different - very limited. If only I could get her to a hospital. But she was on a moped and had traveled close to an hour just to get to me, and she had no resources to go any further. And so what could be done? Truthfully, she probably had less than a month to live if she had no treatment, and realistically, there was no way to get treatment to her in these conditions. 

 

So I knew then that my role for her was not to cure her cancer, but rather to pray for her, with her and her family, and to tell her what was happening to her body. She seemed to have peace - finally - when she understood what was going on in her breast - and what that meant to her health. Her family was so grateful to finally have answers. They thanked me (!) for what I did - which I did not comprehend until much later. Knowing God is with you, and that you are not alone, is often the greater medicine. This alone seemed to ease her pain that day. 

with the children at clinic

If the ill were fortunate enough to make it to the local hospital, they would be seen and treated - only if they had money to pay before any care was rendered. For example, a blood transfusion costs $400 US. I met a young mother who had taken her 2 year old son to the hospital in the weeks before we arrived. He had malaria and a simple blood transfusion would save his life. She finally found a ride for her and her only son to get to the emergency department, only to be turned away for not having the money. Her son then died in her arms - while sitting in the ER waiting room. 

treating malaria

 

 

 

 

 

 

 

 

This of course does not happen in our country! As many problems as our health care system has, we live in the comfort of knowing we have emergency care available to us. I have struggled so much with the question of ?why are we so blessed here, when in so many other parts of the world people are suffering? Why does God let this happen? 

Before I left for this trip, someone told my husband to be prepared for such questions. His way of coping with the disparity was to know that God put us here, and God put those people there. I still cannot understand why, but I did come to know one thing for certain. God may have put me here in this country, but He did not put me here to just sit here and do nothing. I was sent to West Africa, and I will go back. And I am also called to work here. God's children are suffering everywhere and He makes is presence know to us all. He sends us out to do His work and we are obligated to listen to His instruction. He equips us with the knowledge and the endurance to run His race. Hebrews 12:1 instructs us "let us run with perseverance the race marked out for us..."

 

Some days are difficult, some are rewarding. But there is no greater reward than the peace of knowing I have done on that day what the Lord has called me to do. 

 

 

His presence is enough..

His presence is enough...
"The LORD is my rock, my fortress and my deliverer; my God is my rock, in whom I take refuge. He is my shield and the horn of my salvation, my stronghold" Psalm 18:2

This week I am blessed with respite from the craziness of my busy practice, and I have spent time with my family at the beach. We have slept late, watched television, lazed around, napped, played with the dogs, and we have eaten every time our stomachs even start to feel empty. It has been what I can only imagine a part of heaven must be like!

So many days, especially lately, I have felt completely overwhelmed at work. I have delivered a lot of sad news, which is particularly heartbreaking right before Christmas. I never understand why so many people get so critically ill just before the holidays. I know illness does not follow a calendar, but it seems I always have a jump in numbers of cancer relapses, infections, and just general "turns for the worse" right around the holiday season. I have speculated that perhaps it is the stress of the holidays that weakens the body to a threshold beyond what the body can handle. Or perhaps, there are other influences of which I am unaware. Suffice it to say, I am always apprehensive about being on call over Christmas. I know there will be completely unforeseen emergencies, and I am always on edge just waiting for the next call.

The amazing thing I have learned throughout the years, however, is that such devastating news never seems to affect my patient the way I would predict. I mean to say, I have delivered news that I would literally crumble under if I were given the same news...like having to tell someone they have only about a month or two to live. I cannot imagine hearing those words should I ever be told.

I had a patient once who was my age, and had a son the same age as my son. I immediately identified with her and her circumstances. She was a single mother and at the time so was I. She had a devastating cancer that ultimately took her life. And every time I saw her, my heart sank, and tears were always on the brink of bursting through. I tried so hard to remain strong for her (who can feel good about their doctor if their doctor cannot hold it together?) but it was so hard some days!

Regardless of any bad news I ever told her, she seemed to always be okay. Some might call it denial? But she never seemed out of touch with what she was going through. She made arrangements for her very young son that he would always be taken care of. She traveled with him all the way until the days before her death. And her son was amazing too. His strength was nothing short of miraculous.

How could she remain so calm and collected - and sane - through such a trial? There are so many possible scientific explanations - denial, medications, depression - but I know the only way she had the strength and courage to face what she faced was because God had given her the strength to do so. He surrounded her by angels and told her that her son would be okay and so would she. Her healing did not come in the form of physical healing in her earthly body, but when God took her home, she did not suffer any more. She was healed of the cancer. 

I am in the midst of reading an amazing account of a near death experience entitled To Heaven and back: A doctor's extraordinary Account of Her Death, Heaven, Angels and Life Again (Mary C. Neal, MD). Dr. Neal is an orthopedic surgeon who died in a kayak accident and went to heaven, then returned and recounts her entire experience, and how it changed her life. She suffered such physical injury and pain, and yet even her death she describes only as a blessing. Her perspective on suffering is so much like the perspective from my conversations with patients. So many times what I would say would be my worst nightmare (being told I have 2 months to live, for example), my patients tell me they have been blessed by such news.  Somehow the tragedy is transformed into bringing us closer to our Lord - our Healer, our Strength, our Father. We feel His presence with an unknown sense, and His presence is enough that we know everything is going to be okay. Both for ourselves and for our loved ones. Hebrews 13:5 assures us "never will I leave you, never will I forsake you." Deuteronomy 31:6 tells us "Be strong and courageous. Do not be afraid or terrified...for the Lord your God goes with you; he will never leave you nor forsake you." 

I have seen first hand the peace and comfort of the Lord in times of what should be insurmountable grief. His love is unconditional and always present. Even in the direst of circumstances we cannot even comprehend. We look to Him, we are guided to Him and we have comfort and healing from Him and only Him. 

"The Lord himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged." Deut 31:9

beginning here and now

I have spent many hours thinking, "I need to write this stuff down..."

My life as a medical oncologist is stressful and meaningful, and so complex. Cancer is vicious in so many ways and I struggle many days to head in to work, knowing the sadness that could be waiting at every turn. I have seen grief that would be too much even for Hollywood to capture. I have felt the heartbreak of true suffering, fear, loneliness, despair - all of it.

But in the midst of every storm, I feel the presence of God giving me the strength and the knowledge of what I must do, in every circumstance. I see the presence of God in my patient's lives, and in the journeys they make through this fearful dreaded disease. I feel compelled to share those daily experiences with people, and I am regretful that it has taken me this long to do it...I have been in private practice now for 9 years, and I can clearly see -  every single day -  how God has orchestrated my career to glorify only Him. Whether I somehow end up in the emergency department at 10:00 on Christmas eve, or I am back in the office for another "routine" day, I know that I am where God has placed me for that moment. I am always mystified and amazed at how differently His plans are for me on a day to day basis, as opposed to what plans I think I have for myself.

We are best when we surrender our plans and pray without ceasing that we will always be in the place where He places us. Whether we are needed in a hospital or in a grocery store...He has great works for us. We are continually blessed with His presence.

I hope this writing will touch your heart the way my heart has been touched with the experiences I have had as a medical oncologist. My stories must be respectful to my patients, and I will have to write in a way that no identity of a single patient will be disclosed. But I feel led to share here. So prayerfully I will try to do so, and I hope you will pray for me too....

1 Thessalonians 5:17 "Pray without ceasing..."