The Lord's Prayer

The Pope visited the east coast this week. His last stop was Philadelphia, a place that owns a piece of my heart. During his visit, I ran across this piece I had written long ago. I remember feeling so confused about religion while my team and I were tumbling through the emotions of caring for this beautiful soul. I was mad at God, yet he stood by me and did not let me falter. I doubted him, yet he brought comfort to those who needed it most. I label myself as "spiritual, sometimes religious" and was happy to learn that the Pope recognizes my faith. "Nature can be church ..." he said and I am proud to worship at the alter of the ocean. But during the time when I was involved with this story, I worshiped in the hospital chapel, and my hotel room, and the moments of solitude in the busy days. When I hear the Lord's Prayer now, I remember that last day ... and I believe. Let us pray. 

Our Father

The nervous energy is palpable the minute I walk into the room. My task is simple. I just have to clean up a wound and be on my way. From here, the antibiotics and the ICU would take care of the rest. Not a problem, I’ve been here before. It is a quick procedure. “I am just going to clean up the knee. Scrub up the wound. It won’t take long. Not much for me to do but make it prettier.” Dad wanted details, wanted as much information as possible. Wanted me to talk to some other doctor friends. I obliged and told them we had nothing more surgically to offer and the ICU was treating the infection. Patience, I asked for, just give it some time.

Who art in heaven

Dad is a pilot. I understand the personality. He is not in control here. Too many alarms he does not understand, too many variables outside of anyone’s control. I watch as this progresses and see him, frightened and grasping for answers that don’t exist in our world. The physics and the precise science of his world collide with the multifactorial variables of ours. Here, science can only rule so much, we can’t control every encounter with turbulence.

Hallowed be thy name

The hardest part of my day is stopping by the room. I have explained to dad that I am only one part of the team and that what I have to offer at this point is limited. I pray that the antibiotics work. I pray that the infection is conquered, but I know that something more is at work here.

Thy kingdom come

We put him on bypass. His lungs failed. Riddled with infection they could take no more. A strong, youthful heart, persistently pounding and we used it to power our machine. Give him some time. Let the lungs heal. Circulate the antibiotics and kill the infection. We watch him swell to disfigurement. We watch him withdraw to the point of no pain, no tears, no reactions. All the while, pictures of his healthy self stare down at us from the decorated ICU room walls. How did he come to this?

Thy will be done

2am. No choices. His abdominal pressures are too high and his kidneys have stopped working. Though he is anticoagulated, bleeding is no longer a concern, death is. We have no choice. Expecting the worst, my team rolls in for a bedside laparotomy in the ICU. We find destruction beyond our expectations but we will fight on, we won’t give up.

On earth as it is in heaven

Angels help us bring him to the OR. I have never seen such teamwork. Everyone is fully invested. Everyone is there to give all they have for one life, his life. Everyone is witness to the love in that room. Angels guide us as we bring him back to the ICU. We have done our best and cleaned up the damage. But we cannot do enough. 

Give us this day our daily bread

A reprieve. Nothing looks good but we can take a breath, have a sleep, collect ourselves.

And forgive us our trespasses

I can't help but cry. 12 years old. His room is plastered with pictures of a healthy boy. Vibrant, alive, thriving. I think of my nieces, my nephews, my friends' children and I cry. How is there a god who can do this? How is there a god who can put a family through this torture? I cannot accept it.

As we forgive those who trespass against us

Dad is mad. At me. At God. At everyone. I will let him yell. I will let him cry. I will answer every question, with a full heart and an honest soul. I will cry in front of him. I will tell him the hard stuff. I will explain the painful truth of body system after body system failing. I will tell him his son isn’t suffering because I still believe in a merciful god. I will tell him his son can hear him because I believe in a loving god. I will tell him that I will fight as long as he wants me to fight. But I will admit, I am losing.

Lead us not into temptation

Now, as dad has relented, mom is certain of a miracle. It will happen she says. I will be the vehicle, she believes. And I wish it were so, but I know too much. I will go back. I will fight one more time.

But deliver us from evil

I lose myself in the task. Break it down into its parts and just keep working. Open, clean it out, stop the bleeding, remove the dead tissue, dress the wound with the temporary closure … and then steal yourself to tell the family there is no miracle today.

For thine is the kingdom

Everyone meets in a blank conference room. Frustrated questions that hit like accusations  are thrown around. I cut to the chase and simply state the obvious “we have done everything we can do. I cannot make this better” as I admit defeat, the most courageous person in the room claims a victory. “My son is not going to make it here with you, but he will make it, in a better place, with god.”

The power and the glory

How can I stop the tears? I can’t. I cannot begin to understand this courage. I cannot begin to understand this pain. I cannot begin to imagine the emptiness in this father's heart.

Forever and ever

As I watch the family gather around his bedside, his dad says the Lord’s prayer.

Amen.

How to "Act" like a Doctor

Last year I had this cool gig as a medical consultant for a short-lived TV show. It was fun. I got to read the scripts, throw my two-cents in as to how to make things slightly more accurate, though often tragically less dramatic; and watch how it all turned out on the little screen. I liked the main character who was a doctor working outside the lines with a troubled personal life, messy in every possible way - but he was my kind of guy ... handsome, swaggering, trouble disguising deep-seated insecurities and a beautiful boyishly tender heart. 

One day i got an urgent call from the set ... "We need a line. Just a line. The doctor needs to explain to his friend, an actor auditioning for a part, how to 'play a doctor realistically'."

Oh the challenge of 'the play within the play'! I asked for five minutes and I went a bit overboard. I sent them a monologue, not 'a line'. Needless to say, they did not use it all but I got to hear the charming actor recite a few of my words on national TV and it made me smile. I still like the monologue, annoying rhymes and all. Read it with the handsome 'doctor on the fringe' in mind.

How to "act" like a doctor:

“…it’s all about confidence mixed with empathy, swagger with some sympathy. It’s a gentle hand on the shoulder when you tell them they need a biopsy; eye contact when you let them know it’s carcinoma. Make them know you’ve got this even though you’ve never seen a CT scan that bad before. Explain cardiogenic shock in terms a kindergartener can understand, and then explain it again. Listen. Really listen to their confusion and pain. Tell them what they want to hear wrapped into what they need to hear. You, the doctor are fearless in the face of their greatest fear. You are what stands between them and the reality of their mortality. Believe that. And that, well that, is how you ‘sell yourself’ as a doctor. (beat) That and great Italian shoes.”

ps. The actor, Tom Ellis, now plays Lucifer on the Fox show of the same name ... from renegade surgeon to Lucifer ... hmmmm

A Return to Blogging ...

I am gearing up for another trip to Haiti. Last year I organized a group of 10 willing volunteers to go to Jacmel and spend a week doing pediatric general surgery. Over the next few months we are raising money and finishing the plans for our return in November. I will be posting blog posts about our Journey to Jacmel 2014 over the next few weeks. 

But for now, I wanted to introduce you to another project, and a bit of a collision of my worlds. I took a trip to China last year with an established volunteer surgical group (Children of China Pediatrics Foundation: CCPF). Many serendipitous forces conspired to make it possible, and fantastically rewarding. My father was the first "Welcome House" child in Pearl S. Buck's humanitarian project to help children of mixed race. China was Pearl S. Buck's home and heart. The CCPF was traveling to the area of China where Pearl spent her childhood and early married life. As my worlds collided, I was able to participate in a worthwhile mission and learn some valuable lessons about an important part of my family's history. I wrote this blog post for Pearl S. Buck International and encourage you to check out the link http://www.psbi.org if you are further interested in the organization. I am working on returning to China again with CCPF http://chinapediatrics.org and encourage you to check out their website too. And now .... A return to blogging. 

Surrounded by girls at the Chongshi Girls School, Zhenjiang, China

“If you want to understand today, you have to search yesterday.” – Pearl S. Buck

It was a last minute trip – a chance email followed by a phone call and I was on my way to Nanjing, China. As a replacement for a surgical colleague who could not make the trip, I was going to Nanjing to work with the Children of China Pediatrics Foundation and to perform surgeries on orphans.

While I hurriedly prepared for the trip, my quick search of information on Nanjing turned up a mention of the Pearl S. Buck House at Nanjing University. As the first Welcome House child, my father, David Yoder, shares in the rich legacy of Pearl S. Buck’s humanitarian work. With help from Janet Mintzer and Pearl S. Buck International, I was able to arrange a visit to the house and the nearby Pearl S. Buck sites in Zhenjiang. Ultimately, these opportunities allowed me to better understand China of “yesterday” and helped me to make sense of China as I was experiencing it “today.”

I have had the privilege of travelling rather extensively and have spent time doing service work in places as diverse as Mongolia, Vietnam, Haiti, Bolivia and Tanzania. Despite my thick passport my initial experiences in China were intimidating. The airports were massive, the cities crowded.  Shiny modernity is pushed up against ancient sites of unfathomable age. With no talent for languages, eastern characters and sounds were lost to my understanding. Cultural sites of human dedication and persistence – the Great Wall, the Terracota Warriors – were perplexing in their massive scale and crude beauty. Of the places I have been, none seemed so different from the place I call home. China “today” is hard for me to understand.

As a fitting start, I toured Pearl’s house in Nanjing on the day of my arrival. Tucked in the University grounds, there are photographs and books displayed throughout the two story structure. It has beautiful windows which open out to the campus and let in the purposeful energy of the bustling students. There is a quiet in this place, a respite from the frenetic noise and clutter of the city and perhaps a recollection of a more simple “yesterday.”

The work of the Children of China Pediatrics Foundation took me inside two hospitals and an orphanage in Nanjing. I worked with other volunteer doctors and nurses and gave lectures to Chinese providers. We had banquets and parties and saw the great historical sites of Nanjing. Interwoven through these experiences was my growing understanding of Pearl Buck’s love of this country and especially these people.

Towards the end of the trip, I left my group in Nanjing and took a half-day trip to Zhenjiang. The modern efficiency of the bullet train beautifully contrasted with the historic home of Pearl S. Buck and the accompanying museum. Carefully curated the museum paints a vivid picture of Pearl Buck’s life in China and beyond.  I surprised the tour guide when I pointed out my dad (David Yoder) in one of the pictures of children from Welcome House. She was excited about the connection I had to Pearl S. Buck and more excited to hear my dad would be joining the PSBI cultural tour in September or 2015.

After a great visit at the house and museum, the highlight of my trip was the visit to the Chongshi Girls High School. Pearl S. Buck was a student at this school and later taught English on the campus. I it was here that I best understood Pearl’s passion and love for China and her people. My tour guides were two enthusiastic, curious, smart girls. Their beautiful English was punctuated with earnest teenage silliness. They showed me the cafeteria and the classrooms, the cool hang-out loft with beanbag chairs and pool tables. They were proud of the school museum and the areas for learning and practicing calligraphy, traditional dance, meditation and make-up application. I could have stayed there all day, soaking in their chatter about their studies and their plans for the future. Both girls were participating in upcoming trips to the United States – one with PSBI and one with a sister-city student exchange program - and they were both nervous yet excited about these far away adventures. This was the China of “today” that I could relate to and understand. This was the China that I am sure Pearl S. Buck loved – this hope, energy, enthusiasm, dedication and commitment – this “today” owns the beauty and passion of a more simple, but just as determined, “yesterday.”

China is still intimidating to me. Unlike our culture in so many ways, its rich ancient, history, it’s complex “yesterday” guides its modernizing “today.” Touching the parts of China’s past that captivated Pearl S. Buck helped to personalize my involvement in work in this country. Her love for the Chinese people, children and culture, so masterfully expressed in her writing, live on in Pearl S. Buck’s legacy in China and beyond. I am proud to have a connection to her story and hopeful that my work in China can, in some small way, honor her legacy.

Faces from Jacmel

Alexis ... I operated on him a few years back

Baby and Momma

Kevin's patient ... That Face!

Patient ... Playa ...

Watching Curious George

Selfies :-)

These kids saw me in town and started yelling "Blanc, Blanc!"
and laughing ... and i think I'm a brown girl ... apparently, not in Haiti :-)

What I Know about Love

My Angel - Post Op

If you know me, even a little, you know that I love children. When your faith is faltering and you seek a glimpse of integrity and grace in this oft jaded life, you will doubtless find what you seek in the actions of a child. Don’t look to narcissistic, vacant, unimaginative adults who think their baseless wisdom will lead them to understand love … look at the children. Really study them. Their grace is effortless; their intentions, honest; their hearts, well their hearts are truly miraculous.

Ruthferlie was visiting clinic to see the orthopedic doctors for her bowlegs. Nothing need be done but wait that problem out and let her grow. She had an umbilical hernia too so Kevin asked me to see her. When I walked into the room her huge eyes locked on me and would not leave. She was sitting in a chair next to her mom and as I started to ask questions through a translator, Ruthferlie got off the chair and came to me. I was standing, continuing to talk to her mom, and she just wrapped her arms around my left leg and hugged – really hugged me. I put my hand on her head as I continued to nonchalantly talk to her mom but inside, my heart was overwhelmed as her little body clung so tightly.

Children know. Children see what is in your heart. They see the good, and the bad, the victory and the struggle. They see the pain and the beauty, the hope and the despair. Not only do they see it, but the special ones, they try to fix it. After I examined her, I left Ruthferlie with her mom and retrieved the paper work I needed to complete. When I walked back into the room, Ruthferlie walked into my arms and I filled out the forms with her tiny body propped on my left hip, as she squeezed me with all her might. It was 90 degrees that day and every bony inch of her was radiating that heat – she was literally warming me with her love.

That child will never know the gift she gave me that day. All I did was fix her belly button, but she snuck into my heart and fixed some of the broken with pure, unadulterated,* love. If you want to understand love, the really, really, good kind, let a child teach you.

*pun completely intentional

(disclaimer: There are plenty of adults I know who love with the vulnerable purity and grace of children. My point is more that children know this love effortlessly. In my experience, adults often struggle through circumstance and ego, while floundering at the process of getting back to honest, fearless, unconditional love ... The title of this blog is a joke ... I really know nothing about love - but I keep trying to learn from the ones who do it best.) 

For Diane

Truth: we tire of news that is not headline grabbing. Our attention moves quickly away from that which lacks urgency, and that which lacks of tidy finality. My dear friend Diane England asked me to report on what is happening now in Haiti – now that we hear so much less in the news – now that the acute, dramatic emergency seems to have passed. How are things progressing? How are people surviving? What is it like now?

I have visited Haiti four times and only after the acute emergency of the earthquake had passed. The sentiments expressed in this post are solely my observations – and surely more reliable, less subjective references can offer a more accurate accounting of the progress. (Check these out for numbers and hard facts: http://www.clintonfoundation.org/our-work/clinton-foundation-haiti, http://www.cdc.gov/globalhealth/countries/haiti/) This is a statistics free look at what I have seen change over the three years that I have been coming to Haiti.

Pazapa 2 years ago

Pazapa Now

Mural Project 2 years ago

Mural Project at Waterfront Now

Mosaic Sidewalk along the Waterfront

1. Construction

Each time I return to Haiti I witness the results of more construction. On arrival this trip I was welcomed with joyous, Haitian music echoing boldly in a new airport terminal replete with a modern immigration area and updated baggage claim. Every step of my trip saw new building construction. In Jacmel, I walked on a new mosaic path along the shore and observed the expansion of the mosaic wall project I had seen two years ago. I worked in the CCH (Community Coalition for Haiti http://cchaiti.org) clinic building in two modern, bright, operating rooms. We visited Pazapa (a tremendous center for children with special needs in Jacmel) www.pazapa.org and saw the progress on their permanent home. Where once temporary shelters stood, construction is nearing completion on classrooms, offices, and a cafeteria. Back in Port-Au-Prince I stayed in a hotel (www.nh-hotels.com/NHHaitiElRancho) in Petionville that was as nice as some resorts I have stayed in in the US. I ate at a restaurant (Papaya) that would be right at home nestled in the Hollywood Hills of Los Angeles. I saw fewer tents, though they are still there in ridiculous numbers. I saw less trash, though there is still plenty of rubble and litter. But in my mind, there is no doubt, that while building hotels, and restaurants, and schools for the disabled, Haiti is progressing and revitalizing.

2. Physical Exercise

Humor me; this is one of my “things” about being in countries less fortunate than ours. Think about it: if people, in numbers, have the time and energy to “work out” for recreation, something in your society is moving away from the fight or flight energy expenditures that are necessary in an acute trauma or disaster. If you can step away from using your energy for staying alive and keeping those you love alive, and actually spend some time “getting in shape” … well that just tells me you finally have some extra energy to burn and things are less dire and less stressful in your life. Again, my observations and opinions are NOT scientific but this was the FIRST time I saw Haitians exercising in Haiti! As we were walking the shoreline in Jacmel, I observed a man swimming in the ocean and then running out of the water to do push-ups in the sand. He would then jump back in the water and swim out past the breakers and repeat. I’ve never seen that in Haiti before – never. Driving through Port-au-Prince, we saw an outdoor cluster of metal gym equipment (identical to equipment I have seen – and played on - in Mongolia). All of the equipment was being used and a large group of people were waiting their turn. It was rush hour at the gym – and it made me smile. This was a people moving away from their posttraumatic stress and coming back to a more rich life.

Workers at Project Stitch

Founders Dr. Joann Cherry and Scott Gillenwater
 award participants at Project Stitch graduation

3. Sustainable Industry

And finally, my last measure of progress and hope has to be the success of projects promoting homegrown, local, sustainable industry. Project Stitch (www.projectstitch.org) founded by a Dr. Joann Cherry and my friend Scott Gillenwater, teaches participants how to use sewing machines and tailor. Culling its participants from patients who have suffered spinal cord and amputation injuries, the project provides an underserved population with a vocational skill, an opportunity for employment, financial independence, and the consequent feelings of self-worth. The participants create ties, bags, school uniforms, curtains, tailored shirts … and they sell them to support themselves and their families. Scott shared the progress of this program with me – it has grown, and it will continue to grow providing opportunities for its participants to reintegrate and thrive in Haiti's evolving future. Industry like this, if supported by locals and visitors alike, will carry Haiti into a self-sustainable future. 

So for Diane, my report is positive. I have a more substantial faith in Haiti’s recovery. Every time I return, I see more slow and steady progress. As I frame my goals for future visits, I look towards opportunities to teach local health care providers: doctors, nurses, and medical assistants, in order to foster self-sustainability.  Please check out some of the organizations I have highlighted in this post and feel free to contact me if you are interested in helping in anyway.