medical missions

Beyond the Smiles (Part II)

(For Part I, click here.) 

I remember him laying there. The bare white mattress in the Emergency Ward. The blanket stained with sweat and dirt wrapped around his waist. His ribs protruding from his thin, malnourished frame.

I remember him turning onto his side, obviously in pain. I remember his mother standing at the bedside, anxiety and fear written clearly across her face.

A group of American healthcare workers, part of a medical mission team I was working with, flocked around him and hooked up an ancient ECG machine to confirm a diagnosis of pericarditis—a diagnosis for which nothing more could be done in this rural Cambodian hospital. 

As they gathered around the bed adjusting ECG leads and talking among themselves, I stood in the back. Listening, observing, and praying.

I took in a deep breath, and I let it out. This young man was dying. There was nothing we could do about it. With all our knowledge, with all our experience, with all our compassion and good intentions, there was nothing we could do to prevent this man’s suffering and death. 

There was a time when seeing a patient like this young man broke me. It led me on a journey of desperate brokenness and incredible healing. It led me to face truths concerning what I believed about God and myself. Ultimately, it led me to rest in knowing I don’t have to be enough.

This time, as I stood near the patient's bed, everything was different. Outwardly, I was surrounded by Americans, and I was grateful to be with so many whose education and experience exceeded mine. Things had shifted inwardly, too; I found I had courage to reach out to this patient in a way I was too timid to do before but was incredibly important.

When I close my eyes, I am back in the hot, humid, Cambodian Emergency Ward. I breathe in deep, and I choose to rest in this truth: I don’t have to be enough, for Christ is enough. When I stop worrying about how much I can’t do because I am not enough, I hear Jesus’ quiet invitation to sit in His presence, even in the midst of such deep suffering. And I accept. 

I sit in His presence and bring this young man to Him, praying he would know the peace of Jesus’ presence, too. I sit in His presence and bring myself and my broken heart to Him, finding space to grieve and freedom to be sad because when I’m with Jesus, the lie that “I have to be the strong one” crumbles. Jesus is the strong one. I never have to act like I have it all together—because I don’t. Jesus knows this. He's okay with this.

The Americans clear out, and it’s just my dad and me left. With the help of our friend and translator, Dad explains why the American team is there, to teach and work with the local doctors. The patient’s mother looks up tearfully and asks if her son will live.

All our knowledge, all our diagnostic powers, all our education and good intentions—it means nothing in this moment. We have nothing to offer this woman and her son. Nothing except Jesus. So we ask if we can pray, and I reach out my hand to touch this patient’s dirt-smeared blanket and lift him up to Jesus.

And I know in all our heartbreak, in all their heartbreak, Jesus is enough, and He is with us. 

His presence is so strong. It always is, if we'll just acknowledge it. If we'll just accept His invitation and stop our striving to be everything, fix everything, and know everything. Perhaps this is the most important thing I’ve learned about poverty in the past few years. Poverty and suffering highlight our sense of helplessness, and so often our response is to push this uncomfortable feeling down and ignore it or to grit our teeth and take it upon ourselves to eliminate disparities. Yet I’ve found no freedom there. 

No, freedom is found in Jesus' presence, in trust. It's found in trusting God is enough, trusting He cares and is big enough for all the hurts in the world and my grief over poverty and suffering and death, and trusting God is, indeed, good.

He is good. Even when everything around us seems to be wrong and impossible and heart-wrenching and clouded with evil. He is, indeed, good, and He is enough.

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For Nurses in Developing Countries

You know you're a nurse living in a developing country when...

1. Every time you see a body of water you think about Schistosomiasis or some other water-borne parasite.

2. You're sitting on the commode with diarrhea and as you think about your lack of water intake and proper diet during the day, you literally say out loud to yourself, "I'm losing so many electrolytes right now..."


3. You dutifully use hand sanitizer every time soap and water isn't available, but secretly you're thinking of all the diseases only soap and water can kill.

4. You notice how dilated everyone's veins are in the hot, humid climate you're in and wish you could teleport your renal patients here for the fifteen minutes prior to starting an IV on them.

5. You're constantly telling people to change their diet to include more iron because you have a strong suspicion they're anemic after quick visual assessments, such as noting pallor in their nail beds.

6. You text your friends unashamedly about your abnormal bowel function overseas.

7. You adjust your diet according to your current bowel ailments. (More tamarind allowed today I'm constipated. More rice and less fiber when I have diarrhea.)

8. You're constantly reminding people to wear their motorbike helmets because safety always comes first, no matter the heat or discomfort. (You've seen one too many head traumas from motorbike accidents.)

9. It bothers you to the nth degree when you see people smoking on hospital grounds (considering all wards have open windows and doors and smoke can go everywhere).

10 Your heart breaks a little every time you see malnourishment. Which is pretty much every day.

11. You struggle because you have an overwhelming instinct to fix everything and make everyone feel better, but you're simply unable to. You find hope in helping one person at a time entrusting them to a Higher Power.

12. You are assessing community health needs continually, as you learn more and more about the culture, health care, and superstitions/beliefs affecting health practices.

13. Your friend in your passport country still sends you a picture of her infected eye to ask if it's pinkeye. (You reply yes, it looks like it is.)

14. Your days of running around a hospital floor getting cups of ice water so your patient will take their pills - all the while wearing a jacket because the a/c is turned up so high - seem like a distant dream.

15. Though your tolerance for super-entitled patients drops a few notches, you still respond to all with compassion and empathy because you realize in developed or developing countries, people's needs are the same: physical needs for food, water, medications, and hygiene, but also emotional and mental and spiritual needs. They just manifest in a different way. No matter if they're upset in a private American hospital room or in tears in a hot, crowded Cambodian ward, they are scared, stressed, and in need of healing and a Healer. So we respond with compassion to all. Because that's what we do. Because we are nurses.


To nurses in developing countries:

May your learning experiences, encounters with the sick, and poops be solid but not too hard.

May your heart, food, and water be purified and well prepared.

May the days you have the runs be blessed with plentiful access to flush toilets, toilet paper, and empathy for  patients with E. coli.

May your searches for soap and water, Lysol, deeper meaning in life, and a paradigm for suffering be fruitful and rewarding.

Most of all, may your compassion, immune system, and faith only be strengthened by your time overseas.

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Beyond the Smiles

I remember her lying there. The bare metal bed frame. Her hair pulled back behind her head. The blood on the floor. The coughing and then the bright red vomiting as her thin frame twisted and shook. And the pool of blood grew.

This woman had no family. In this Cambodian hospital, family members are the ones who bathe, clean, clothe, reposition, provide food for and feed patients. They are the ones who faithfully stand at the bedside and move plastic fans back and forth, back and forth, creating air movement in an un-air-conditioned building and preventing the ever-present flies from landing on the sick. 

This woman had no family. 

Her eyes were closed, her body weak. There was nothing with which to clean up the crimson puddle. “Wait,” they told me. “The cleaning lady will come later with the mop and bucket.”

I remember the moral dilemma when a doctor told me they had no more blood to transfuse for this woman. The need for blood, the safety concerns if I dared donate, the fact that even with several transfusions this woman may not live because we could not correct the bleed at this facility… These are the moments that pushed me to the end of my rope again and again until eventually, when I came back to the States, I felt I had completely lost the rope a long, long time ago.

Yet, as Bethany Williams writes in The Color of Grace, “when our level of desperation becomes greater than our pride, true healing can begin.”1

It has been in the pride-swallowing desperation following those experiences that I have discovered true healing. 

True healing, I found, requires courage—and learning what courage is. Courage isn’t going without water heaters and microwaves; it isn’t forcing my eyes open to watch drivers navigate the wildly crowded streets of Phnom Penh. It isn’t becoming comfortable riding on a motorbike or even eating fried crickets and silk worms.

Courage is living the story that is happening beyond the smiles, beyond the Facebook posts and beyond the Instagram snapshots. Courage is struggling—hard—and being vulnerable with others about those struggles. Courage is walking into a counselor’s office; courage is asking for help. 

Courage is learning to acknowledge grief and wrestle with suffering, being willing to embrace my humanity, and humbling myself enough to recognize I'm in over my head. In that moment in the Cambodian hospital, standing at the bedside of a dying woman, I felt helpless and defeated. What had eaten away at me for years was shoved in my face: I was not enough. This time courage meant wading through years of lies to find the truth that although I am not and never will be enough, I don’t have to be.

True healing, I found, happens in the presence of Jesus. 

I can never do enough, say enough, sacrifice enough, love enough; I can never be enough for Cambodia, for those around me, or for myself. Yet when I relive that moment in the Cambodian hospital remembering that Jesus was present, too, I find that He is enough.

As healing happens within, grace creeps into the relationships with those around us. We don’t have to be enough, for God is enough. When we believe this truth for ourselves, we can extend grace to ourselves for our imperfections and failures. When we believe this truth for others, that they don’t have to be enough either (for God is more than enough for all of us), we can extend grace to them. True healing embraces Truth, brings forgiveness, and overflows with grace.

Healing is a process, and it requires humility and perseverance and sincerity. It is not easy. But the freedom on the other side is well worth the work. For me, it has brought freedom from the pressure to please, perform, and perfect. I am free to feel and to fail and to forgive, to be the imperfect me He created me to be.

If healing happens in the presence of Jesus, what glorious news that Jesus is Immanuel, that Jesus is here with us! And He is enough. His sacrifice is enough for our sins. His love is enough for our souls’ deepest needs. His compassion is enough for our grief. His strength is enough to catch us when we fall. His presence is enough to heal. He is enough.

Deepest gratitude to my wonderful counselor, Lynette, who continually ushers me into Jesus’ presence and who walks with me in this healing process. I am truly thankful, from the bottom of my heart…

1) Williams, B. (2015). The color of grace: How one woman's brokenness brought healing and hope to child survivors of war (p. 29).

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