Tuesday, November 6, 2018

Miracle Child

Please don’t think that as a surgeon in a mission hospital, my days are always filled with amazing life saving stories. Sadly, it is quite frequent that I watch patients pass away because of late presentations of readily treatable illnesses or because of the inability to provide first world intensive care. I am often haunted by the faces of children who pass away after attempted life saving measures. But, while this may seem quite depressing, there are stories lift my spirit. One of these stories involves a 4 year old named Oliver. Oliver is the miracle child of the surgery service. He has lived on the surgery ward for over 2 months. Mostly in bed.

I first met Oliver when he was booked for my OR for a skin graft for extensive burns. Extensive burns makes his condition sound trivial. He had fallen into a fire and sustained full thickness burns over his entire abdomen/chest, arms and upper legs. Care for this boy was going to take an incredible amount of work. 

Burns are deadly for a number of reasons. They require daily dressing changes in an attempt to avoid getting infected and they are the highest calorie consuming injury, often requiring more than double the normal caloric intake. This is even higher than for trauma injuries.

He needed calories and was immediately started on our hospital’s high protein porridge called Busoma. I recently ate some crêpes made with Busoma. It's actually quite good! This high protein porridge made from local ingredients, is made by our hospital to nourish our undernourished patients. If you are going to ask a body to heal, you have to give it the building blocks to fight infection and heal.

The first surgery was painstakingly long as I harvested skin from his tiny body to cover the wounds on his tiny fingers and arms. What breaks my heart is trying to explain to a child that we must cause him pain to heal him. For every wound needing covering, I had to create one roughly the same size in order to harvest the skin. Then, we cover and wait for the grafts to take hoping and praying infection doesn't kill the carefully placed skin.

Oliver went through 3 major operations as we harvested skin from one part of his body and delicately sewed it to his wounds while undergoing daily (thats more than 70 to date) dressing changes to treat his existing wounds that were awaiting grafts or had been donor sites. Our nurses and medical students are the real heros for these challenging dressing changes.

Miraculously, Olivier survived all this. His entire body including back and extremities are either donor or recipient graft sites.

Today was extra special because I wanted to see if he could walk. He knew the drill. I hold a lollipop just out of reach and he must move to get it. But today was more challenging because I squatted 3 feet from his bed with my hand held out to help him walk to get it. 

Tears welled in my eyes along with a cheering group of onlookers as Oliver bum-scootched across his bed and took the first steps I have witnessed to get that coveted lollipop. And not only that, I got a confident high-five and a fist pump with his grafted fingers, not to mention a huge smile of accomplishment.

He may be the most extensive burn patient to have survived to date. He is truly a miracle, and the work of countless hours by nurses, medical students and doctors.

"Thanks Oliver for being such an incredible encouragement." 




Sunday, October 14, 2018

As for Me and My House...

Sipping my coffee in our new little office as a touch of colour signals the start of a new day, I am soaking in a moment of solitude (well, along with a thousand birds and a few crows in the distance). On the heels of Canadian thanksgiving, my mind has wandered to the many ways for which I am incredibly thankful.

Not the least is the recent move my family has made into our home for the next couple of years. As we pull out the dishes and unpack treasures safely tucked into bins over a year and a half ago, it’s an absolute delight. We have been dreaming of making our home here for many years now, and moving in is the last step of this process.

In spite of it's limited 850 sq.ft of living space, we have managed to find a place for (almost!) everything. We had the luxury of choosing very specific furniture to use the space well, including floor-to-ceiling shelving units and a triple bunk bed (with room for storage bins underneath, of course). I was feeling rather good about how all the children would fit snugly into one room, until I was chatting with one of the painters about it, and he replied with "they each get their own bed?"

I am daily reminded of the abundance we have come from. 


The cute front porch!
Actually, this is the identical adjoined duplex
because our porch is still a little chaotic.
As we set up this house, it's the first time in a decade of marriage we have a new set of dishes and pots and pans. It’s our first time owning a new couch, and having an actual bed frame under our mattress. These tangible gifts remind us of those who have generously provided to help us live and serve here, and as we sink into our couch at the end of the day, these “things” really do help us rest and prepare to continue the next day.


At the same time, my overwhelming gratitude is intermingled with the juxtaposition of having so very much in a country where the majority live so minimally. Although the contrast of what we have compared to those around us can make me uneasy, it also challenges me to be grateful while finding ways to give. It's an important reminder to daily appreciate what we are blessed with, and seek ways to live with our hands open to give freely.


Welcome! This is the view as we walk in the door..
The Burundian-made furniture and imported seating
make this main living space a cozy and
comfortable place to rest and host.


Oh man, you know what though? I still find myself falling into the old trap of comparison and discontentment. How can I be so grateful for what we have, feeling like we have more then we need, and the next moment be noticing or thinking of what we don't have? Even while living next to those for whom poverty and hardship are a daily part of life. How quick my attitude can change!

I wish I had some awesome solution to share on how to "fix" these tendencies. What I do know to be true is that gratefulness and generosity seem to be a good place to start in battling this selfish nature. And, in spite of the fact it is uncomfortable, I hope that tension remains (read: not the same as guilt!) and can motivate me to think and live differently.

And so it’s with thanksgiving and a healthy dose of tension that we place the coffee cups into cupboards and serving plates onto shelves, and ask God to show us how to best use them for His glory. 





By Julie

Saturday, September 1, 2018

Spiderman Says

Spiderman says "With great power comes great responsibility." 

I tell my medical students that with great privilege comes great responsibility. And it is truly is a privilege to do what I get to do. It's the reason I work long and hard hours.
Bed Overflow

When I signed up for a surgical residency, I didn’t do it for the money. I certainly wasn’t looking for a life of ease. To be honest, I was slightly naive at the time of all that it would demand. But I knew that surgery was an invaluable tool that could be used to impact the the world around me.

Covering the ward this week, I start my day seeing all our inpatients. This last month the surgery department was the busiest it has been in the history of Kibuye with more surgeries, more consults and more hospitalized patients than ever before. Yet we had below-average numbers of deaths. This week alone we had over 50 hospitalized surgical patients at one point. 

BEFORE
AFTER
As most of our patients speak Kirundi and my medical students speak French and Kirundi, all bedside care is performed in at least 2 languages. Unfortunately for me, the medical students prefer my french to my english. 

At several minutes per patient, if we add some bedside teaching, rounding on every patient can take around 4 hours. Then begins the daily tasks of checking X-rays, wound care, fracture reductions, casting, discharges, and new consults that arrive in emergency and clinic throughout the day.

My students have quickly learned that surgery life is not easy. It requires long hours of patient-care while studying outside those hours. 

This week included rounding on one of the medical students who was sick - in his dorm bed. His student colleagues put on their most serious faces and presented him as they would any other surgery patient. We even offered him a surgical bed so he could complete his work while being sick, although for some unknown reason he politely declined. Surgery life is hard but we find ways to laugh during the day. 


My kids often pray for my patients and I am so grateful for this. For several weeks a young boy, who fell 5m onto his head while playing, has been hospitalized. He presented after 1 week to our hospital, paralyzed on one side and unable to speak since the accident. I wasn't too hopeful for him when I took him to the OR to discover multiple skull fragments floating around the back of his head in a sea of infection, although I couldn't find an obvious reason for why the speaking part of his brain was not working. These are the times when from behind my surgical mask I truly cry out to God. Not only because of the injured child on the table before me, but also because a paralyzed child in Burundi has a very challenging life ahead of him.

Over the next days we continued caring for him and did our best to protect his fragile head. This week on rounds his father, who has been at his bedside each day feeding, carrying and moving his son, nearly leapt for joy as he showed me how his son could move both his arm and leg at will. When I offered the boy a sucker (which I regularly I stock in my white coat pockets) he was almost able to speak the word "urakoze", meaning "thank you!" And while he is not completely out of the woods yet, I believe that God is the great engineer and healer of the human brain and I am grateful for his amazing work.

What gets me out of bed early in the morning and keeps me up late at night is the impact of surgery, hope and compassion which can not only bring about healing but can also give dignity to those who are suffering. Demonstrating the compassion of Jesus in this setting though quality surgical care is truly a privilege. It's what we at Kibuye Hope Hospital want to model to our patients and medical students. It's why we are here!








Saturday, August 18, 2018

The Life-Change Scale



Transition, adaptation, adjustment...how does one even begin to articulate the massive life change that has happened over the last month and a half since being here?

That said, you can imagine the hundreds of things, big and small, that are new. And I'm not just talking about weird spiders or rainbow-colored locusts

Let me begin by saying that so far, we have been adjusting well to this new life. It's beginning to feel like home, even as we wait for our longer-term home to be ready for us. We have been blessed with plenty of electricity, which is not taken for granted, and even when the propane was hard to come by, we found creative ways to keep cooking (see our team blog post for more on that!).



Without listing every detail that's so completely different, let me attempt to shed some light and offer some perspective.

Have you ever heard of the "Stress Scale" (also seen as "Life Change Index")? It's a system used by health care professionals to measure someone's stress and the potential health risks associated by putting a value to the "weight" of different life-changes that have recently or are currently happening.

For fun, I plugged in our numbers (I did this one) and we "scored" well into the "high-risk" category for becoming sick in the near future as a result (proactive prayer request?). I'm not overly concerned about becoming ill, but I did look a little more into it.

As it turns out, there is some interesting research that missionaries (especially first-term missionaries) are in a whole other category when they take these tests. They typically hit well beyond the highest levels in the first two years on the field, and consistently live in the "high-risk" category for years beyond that*.

It kind of makes sense when you consider all the "normal" things that are so different. I could make a pretty long list here, and we will have some fun sharing stories in months to come. For starters, driving around here is not for the faint of heart. There are certainly new and unusual "bugs" - both illnesses and creepy crawlies! Add to that constant language barriers, unfamiliar cultural differences....even the simple things like cooking with new ingredients, or figuring out what to do when resources are unavailable! This doesn't even begin to touch on the things Jesh faces every day in the hospital...

Overlooking our little community of Kibuye
For now, it makes me realize that our life, sometimes even the very basics, can be a wild ride. It helps me see the need to hold onto God, and truth found in His word, all the more in the months and years to come. And it serves as a reminder to intentionally find ways for our family to rest (is that even possible with a nearly-two-year-old running around?!?).

In the end, I don't believe that these stressors mean poor health will follow, but I think we'd be crazy not to acknowledge that it all has an impact on our lives. In all this change and transition, I pray we will make healthy habits and wise decisions that allow us to build in routines that keep us grounded.




By Julie

*References:
- Dodds, Lois A. (2015). Resiliency - The Secret to Longevity and Effectiveness in Ministry. Liverpool, PA: Heartstream Resources. www.heartstreamresources.org
- Dodds, Lois A. and Dodds, Larry (2000). Love and Survival: Personality, Stress Symptoms and Stressors in Cross-Cultural Life Liverpool, PA: Heartstream Resources. www.heartstreamresources.org



Monday, July 9, 2018

It Only Took 12 Years...

So 11 years of schooling and surgical training, 1 year of French language study and today I got to start my first day of work. I have been dreaming, training, praying for this day. It was right into the deep end for me with a ward of 30 surgical inpatients, clinic appointments, working 3 languages and seeing diseases that I have only read about and some I have not even read about. This is the work that I have dreamt of doing for most of my surgical education.


There is much to learn and plenty of room to demonstrate compassion. Like to the 3 year old I saw today with burns over a leg and both her feet, or the elderly lady with metastatic breast cancer and a necrotic breast. The 6 year old hit by a motorcycle with a fractured arm. I was saddened to learn today of a newborn who passed away from an illness with an over 90% survival in North America but a 0% survival here in Burundi. These are the realities of my new world. These are the battles my colleagues and I will be fighting.


It was also a day of smiles from old friends who remembered me during my visit as a surgical resident 3 years ago. It was was a day of excitement seeing all the new changes at the hospital. It was a day of hope as I look forward to the coming years serving here. What a privilege to serve in this capacity. Thank you to those who stand with my family and I in this work.

Monday, May 21, 2018

Dear Super Yacht Owner

My family and I are currently studying french at a language school in France. We noticed your incredible super yacht in a harbour in France a few weeks ago while we were on a road trip with my visiting family. Your yacht was incredible to say the least. Multiple decks, 2 helicopter pads. I couldn’t help but think of the indoor pools, jacuzzis, probably multiple kitchens and I sure hope there is a theatre room or two or three. I did notice a few vehicles on one of the many decks. That must be nice that you can bring them with you.

Welcome aboard our "yacht"
It holds 7 passengers including driver
I was amazed by your yacht and aside from gawking at it, I decided to look it up on wikipedia. You should know it is really easy to find. It is the fourth largest super yacht in the world and the largest by volume. And $600 million dollars to build!  Since you can take 40 guests, I bet everyone wants to be your friend. Do you need all 80 crew members on every trip you go on?


I wanted to apologize for the english only speaking lady who tried to come aboard. That was my mom. She thought if she asked, you might let her on but I told her it was unlikely. It seems that your security people do an effective job of screening unwanted visitors.



I am writing to tell you that your super yacht really amazed me; in fact, part of me imagined what my life might be like to have one. But know that I wouldn’t trade my life for your boat. Not in the slightest. In fact, my family and I just booked our flights to Burundi for July 2018. We have been working towards this opportunity longer than it took to build your boat and we couldn't be more excited. 


I will get to use every bit of experience and training I have accumulated over the course of my life. I will be working with an incredible team of medical and non-medical staff. We get the privilege to serve in ways few people do, and to be the hands and feet of Jesus to the best of our abilities.

Not only that, we have a family, church and group of friends excited to be a part of the mission we will be joining.

I hope you enjoy your yacht, my regards to your guests. And if you think your yacht is exciting, you should see what is happening in Kibuye! 

Sincerely, 

Jesh


Alors il dit à ses disciples: "La moisson est grande, mais il y a peu d'ouvriers. 
Priez donc le maître de la moisson d'envoyer des ouvriers dans sa moisson."

Matt 9: 37-38

Tuesday, April 17, 2018

Time to Be Still - and Eat Croissants!


Arriving in France nearly 8 months ago, we were all excited and enthusiastic to have so much time dedicated to learning french. 

Well, French, and which pastry we like the best:)





It's been an incredible place to get to explore while we learn. I mean seriously, it's the French Alps! And as we have unwound in this beautiful setting, I have found myself contemplating how we got here, and what we've come away from.

For years, our family lived under a constant pressure.

Originating by the pursuit of medicine, worsened by financial constraints, and enhanced by our desire to have a family amidst it all, we have learned to live in this pressure cooker. By God's grace, we even had seasons of thriving despite it all.

But the reality is that years of living in that sort of state of survival left a mark.

I've dubbed it "Residency Residue".

It's strange to realize that we have become so used to functioning within the parameters of just getting through, that we don't even know how to function in a more "normal" life.

(Granted, nothing about our current situation is completely normal. I mean, what is normal anyways?).

But in this beautiful and unusual and awkward year of transition, our family has actually has had this rare thing happen to us. We have had time.

Time to drink coffee together in the morning.

Time to ride our bikes to school...and sometimes even just to ride our bikes for fun (I know, right?).

Time to eat meals together - EVERY meal.

Time to explore.

Time to play a french word game or read bedtime stories together.

In fact, there has been so much time together that, as Jesh mentioned we have a new saying in our family of being A Together Family.

It's a stark contrast from so many years of feeling like we are just surviving, just trying to get through.

Get through all the paperwork and interviews to make it into med school. Then, get through first year of med school, and simultaneously the first year as new parents.

Get through a move up north to Yellowknife, a second child, then move back to BC while Jesh finished med school. Add in applications and national travel for interviews to get into residency, and packing for another move across the country.

Then it's get through residency. Start fresh, further away from family. Get through having one car while Jesh was starting at 5:30am (thankfully that changed), a new city, new church and finding our place in it all.

Get through adapting for this new season, trying to be intentional as a parent and wife while running the home. Get through that, and then keep going.

The second year, the 3 months he spent working out of town, the long nights of call. Then do it again the next. And the next.

And then we found ourselves at the start of the last year. There was a light at the end of the tunnel, and things were coming together for our life beyond this pursuit of general surgery. We just needed to get through one more year.

It was the most difficult and exciting and busiest year to get through yet. Every time we got through another item on our long list, another took it's place.

It was full of hard goodbyes and beautiful plans as we begun to see our future, and our dream of serving internationally, begin to take place.

By God' grace, and I could tell you story after story of how He provided the people and the provisions along the way, we got through. We made it here, and suddenly...we had time.

The irony is realizing that it kind of feels like it was easier to handle our rigid and pressurized life of "getting through" to this new life that is so new and unfamiliar.

I knew how to function better within the old constraints then in this newer season. I had a way of doing things that I felt worked, and now I have had to learn and change. To let Jesh share the load, and share the parenting, and have his own ideas of how things could go.

Maybe some day I will be able to articulate more about this "residency residue".

For now, time is allowing us to grow, to heal, to learn new rhythms and make new habits as a family. It's time to break old ways, old survival tactics and habits that had been necessary to get through.

Time to be still. To know. To remember what kept us going, and Who it's all for in the first place.



By Julie



Wednesday, February 28, 2018

How I to speak good french?

Have you ever tried to speak to someone who speaks little to no english? Would you agree to meet with that person each week while they painstakingly try to get their words out? 

Would you enjoy having coffee each week for 2 hours with someone who speaks like a 4 year old? 

I honestly don’t know if I would have that patience for that… In fact, to be brutally honest, I don’t think I could do that at all.

One of the suggestions by our language school was to find a french speaking language partner with who we could practice french conversation. My first thought about this, was who on earth would agree to do this?

Some of the many books aiding French studies
Given that I didn’t think I could ever be such a person, I didn’t think I would find such a person. I needed some divine intervention and so I prayed… And shortly after, while taking my kids to school, I was approached by a friendly gentleman on the street who greeted me in French and gave me a pamphlet for an upcoming event. Of course my instinct was to be suspicious of anyone giving me a pamphlet but his motivation was truly sincere. I did the token nod and smile so as to not butcher his language in front of him. I saw him not infrequently after that while I waited for my kids at their school and after several friendly interactions I wondered if he might consider meeting with me. 

I felt like I needed some sort of confirmation though since asking him to be a language partner was no small request. One day, while I tried to comment on the weather to him, he corrected me on the gender of the word “snow.” At that moment, I knew he was a good candidate. 

My next mission was to get up my nerve to ask him in French (as he literally spoke no English). I spent several weeks trying to figure out in my head how to even ask this of this pleasant stranger.

Thankfully whatever I said, must have conveyed the right idea because we have met each week for usually 2 hours to speak french ever since.

The first few meetings with a language partner usually go something like this: 
  • He asks me, so how is your family? And me, not understanding reply “Yes, the weather makes well” 
  • So he tries something else and asks if I want to join him go to an event with him tomorrow and I reply, “I ate my dog tomorrow.” 

And this is why I am so grateful for my language partner and his patience!

Thankfully now 4 months later, we can talk about weather, family, events, politics and world issues. I have had the privilege of meeting his family and he has met mine. He is an example of patience to me and his friendship and continued investment in me is so appreciated!

His friendship reminds me of the importance of mentoring whether it be in language, medicine, relationships or life. Perhaps all of us could use a mentor of some sort and for some of us, we could use a little more motivation to be one! 

By JESH

Monday, January 29, 2018

"A Together" family

We have a saying in our family. It usually comes out when I try to push my way into our tiny bathroom to brush my teeth at the same time Julie is trying to do her make-up. It's often when we are late for something or when all of us are tripping over each other trying to help make dinner in the kitchen.

"Why do you have to do that HERE and NOW?" is usually what prompts the statement.

Well, its because we are "a together" family! We wish it meant we have it all together but it usually means we are doing things all together. On one hand it diffuses the obvious annoyance of having your entire family or spouse in your space when you just want some space. But on the other hand, I am super grateful and proud of our family. And yes for better or worse...we are a together family.



Recently one of our children was saddened by the challenge of having to complete work (in French) at school while being timed and said that it sometimes made them feel like crying because they just couldn't do it. They weren't upset at the school or even their teacher but simply that their best wasn't good enough.

I responded that I felt the same when my best isn't good enough since if I mess up at work, people could get really sick or even die. In hindsight I think I hit the fly with a sledge hammer but with good intentions. Unfortunately, they couldn't relate to the life of surgeon very well so instead, I grabbed my french journal. I write a journal in french each day which is subsequently corrected. 

If you can read french, you may find the journal entries and mistakes amusing.

I showed them the the endless red ink of all my corrections on my last 55 journal entries. They flipped the pages of my notebook astonished that their dad could have made so many mistakes. I had them fooled for so long. I was quite astonished too as I usually don't look at every mistake I have ever made all at once! Thankfully, for two kids in a new country, new language, new school, trying to make new friends and satisfy their new teachers, it was what they needed to see to be encouraged. 

We regularly pray for courage in the small daily challenges facing our kids in this sometimes hard adventure. This week for the first time one of our kids volunteered to read aloud in their French class while the other feels confident enough to speak french to their new national friends. These are the answers to many dinner and devotion-time prayers. And no, we definitely don't have it all together but despite our mistakes, we are all in this as "a together" family..... JESH


Thursday, January 4, 2018

Happy... cough... New Year!

Bonne Année! And yes we all began 2018 sick...

Jesh and his siblings 25 years ago.
As Christmas approached and french classes finished for the holidays, we decided to make a trip to Scotland. My (Jesh's) family had spent a year when I was a child and  I had long been awaiting an opportunity to return. 

During my time there as a child, I had many memories of living in a small shepherd cottage, attending a one room schoolhouse, working on a sheep farm and making many Scottish friends. I would say it is the highlight of many childhood memories – I have nothing but positive memories of that time. Living in that rural peaceful place has shaped who I am today.



So we packed our car and began the over 1600km trek - driving. Yes you read correctly. Driving was definitely not Julie’s first choice of transportation but we did find a Starbucks along the way. She figured the savings from driving should equate to the occasional Starbucks drink.


We stumbled on Vimy Ridge and reflected on our proud Canadian heritage in World War I.

Did you know that there are 28 Costcos in the UK? A Thiessen road trip would not be complete without a Costco hotdog and fountain drink and thankfully we were able to continue this tradition.

My family's longtime Scottish friends who run Greenhope Bed & Breakfast were very hospitable despite us being quite ill with colds and coughs during our entire stay. 

We were welcomed with a blanket of snow and being Canadian, this brought great joy to our kids.

What a treat to stay at Greenhope cottage, the same cottage (now renovated and expanded) that my family lived in 25 years ago.
View from Greenhope 25 years later.

As I reflected on my many childhood memories, I was struck by the fact that my parents took many risks including selling their successful business, shipping a few possessions overseas and moving to a new country and culture. I do recall living humbly but this didn't negatively impact my memories of this time.

As my children witness abundance and poverty in many countries and cultures in 2018, my prayer for them is that would be that they would be continually shaped for God’s purpose and that their memories of these times would purposefully contribute to who they will be and what they will do.    JESH




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