Cambodia

Jesus, Colonoscopies, etc

The day I was supposed to show up at the clinic for an interview, I had a panic attack.

Yes, that’s right…I was interviewing at a clinic for a nursing position—that dear, difficult profession that has brought me so much grief and so much growth. The profession I swore I never wanted to return to, at least “not as long as I can help it,” as I often quipped when asked about nursing.

Yet here I am, a year and a half into my purely non-clinical life as a nurse, and I find myself interviewing at a clinic. It started with a blog post…about what I’d learned from quitting nursing (ironic, isn’t it?). I posted a graphic on Instagram, and somehow a stranger in town stumbled upon it and direct messaged me because in many ways, she could relate to my story.

We eventually became friends (this is the beauty of social media—when screens lead to person-to-person relationships), and she’s the one who told me about this PRN job at a gastrointestinal clinic that does outpatient endoscopies and colonoscopies. The more she described the job, the more attractive it sounded: 1:1 or 1:2 patient ratios, healthy patients, 8-5 hours… She had emailed the manager, she told me. I should too, she said.

To my surprise, I did.

During the past year and a half outside the nursing world, I’ve battled thoughts of insecurity. Am I crazy for not working as a nurse? Am I going to lose my clinical skills? This one was the real kicker: Am I selfish for not using my skills to help others?

Each time these thoughts crowded my head, I came back to the moment in Cambodia I decided to quit nursing—that single, simple moment of clarity that gave me peace and confidence in my decision. I considered various PRN positions (where I could work on an as-needed basis when extra staffing was required) every once in a while, but anxiety always rose up, and I always backed down.

This time, however, anxiety sat quietly by as I emailed, called about the job, and set up an interview—that is, until the day of the interview. The reality of going back to nursing came crashing down on me, and panic rose up in my chest. I remembered the stressful days and long hours, the hurtful comments from patients and their families, the constant strain of expectations from “the people upstairs” (which is what I called the people who controlled the budget and sat in offices on the top floor of the building).

To be quite honest, the anxiety was overwhelming. I canceled my interview. A couple weeks later, with my therapist’s mantra “Exposure reduces anxiety; avoidance increases it,” ringing in my head, I rescheduled the interview simply so I could face the anxiety of walking into a nursing setting and then probably not take the job.

After praying about it, I took the job—once again to my surprise. As I began training, I was nervous, and I found all my insecurities voicing their concerns in my head. I found that my inner critic was coming out in a way I hadn’t experienced since…I had worked in nursing at the hospital. Even though the clinic setting was extraordinarily calmer and more peaceful than the hospital, in the same quiet moments of changing out a linen bag, the old, familiar voice of my inner critic showed up.

“You’re not good at this. What are you doing here? You don’t belong here. You’ll never be enough. Just give up,” the voice grumbled.

As I processed my struggles with a dear friend from nursing school, she asked two questions about this inner critic that guided me to great insight and the beginnings of peace (and grief).

First, she asked, “Do you think the inner critic has to do with your experiences at the hospital?”

“Yes,” I replied immediately. “I’ve been so stressed because all these memories of hard things from the hospital have been coming back up.”

We discussed this for a while, noting how the mindset of me being “never enough” was intertwined with my work experience at the hospital.

Then she asked the second question. “I’m pretty sure the answer to this question will be yes too, but I’ll ask it anyway,” she said. “Do you think the inner critic has to do with your experiences in Cambodia, too?”

This time I hesitated, and then replied affirmatively again. It had been a long time since I dredged up those memories from the Cambodian hospital. Quite honestly, I didn’t want to bring them back up to the surface again; I didn’t want to grieve again.

So I tried to push it back down, but I couldn’t avoid it. Each time I went to the clinic, I felt major anxiety and stress that couldn’t be explained by just starting a new job. So once again, I opened back up my memory bank; the memories come flooding back, even now:

I remember how hard volunteering in that Cambodian hospital was.

I remember how hard watching the woman with the upper GI bleed was.

And this is when it hits me. The woman with the upper GI bleed.

What broke me most about this woman was that I knew the treatment but did not have the capabilities or equipment to help.

Years later, continents apart, I show up to work at a specialty clinic—a clinic that only does two things: EGDs and colonoscopies. Things that could have saved this woman’s life.

Out of all the places I could have ended up working, I wonder at the fact that I am at a GI clinic. A place where for which GI bleeds are routinely screened.

As I reflect on this, marvel at this, grieve over this (oh, the healthcare disparity!), I notice how I call this patient, “the woman in the Cambodian hospital” or “the woman with the upper GI bleed.”

The verbiage reminds me of another famous woman, one who was also acquainted with pain and suffering. One whose name I still don’t know, yet one who has taught me much about the kingdom of God. Among church-goers, she is known as “the woman at the well.

I wonder if that woman knew, if she had any idea, how others would learn of Jesus through her. I wonder if she imagined how people would read about her encounter with Jesus and be drawn to the Messiah as well.

I wonder if the woman in the Cambodian hospital had any inkling of how she would help me encounter Jesus in a new way. I wonder if she knew I would one day write about her and remember her, over and over and over, and every time return to the conclusion that Jesus is present, and Jesus is enough. I wonder if she knew her experience would live in my memory and impact every patient interaction I ever had again.

I remember her lying there. I remember her coughing up blood. I remember desperately wishing for EGD and cauterizing capabilities. I remember the desperation as I watched her suffer.

And I remember the presence of God. I remember that Jesus was with the woman in the Cambodian hospital, and I hope she’s in His presence now. I remember that He was enough then, and I remember that He is enough now.

In the hospital. In the GI clinic. In the country with EGDs and colonoscopies. In the place without any scopes at all. In the town with the woman at the well, rejected and shunned by society. In the town with the nurse at the GI clinic, plagued by an inner critic as she works. In the town with the woman in the Cambodian hospital, slowly losing blood from an upper GI bleed.

He is there, and He is enough. For my needs and for yours, He is enough.

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Flashes of Lightning and Flashes of Clarity

One summer a few years ago I was in Cambodia with a team. Darkness had fallen, and we finished scarfing down fried rice for dinner so we could load up in the van and head back to the hotel. We were staying near the Vietnam-Cambodia border, and as we drove down the bumpy, pot-hole-filled route, enormous trucks full of imported goods from Vietnam would rumble by, shaking the whole road as they passed. Rain began to patter on the windshield. Everything was pitch black, but I knew the road sloped down on either side and morphed into acres and acres of muddy rice fields. As I stared out the windshield, two tiny dots of light slowly enlarged as the headlights of a vehicle approached: another gigantic truck full of imported goods.

Windshield view during the day

Windshield view during the day

Side view of the road during the day

Side view of the road during the day

When we were about 100 meters from the oncoming truck, a flash of lightning suddenly illuminated the sky, the road, and everything around us.

In that split second, we could see everything. We could see the ditches alongside the road. We could see the miles of rice fields and the hills beyond them. We could see the long stretch of road ahead. And we could see the over-sized truck ahead of us. The truck was carrying an extra-wide load that stretched across nearly two-thirds of the road. We were heading straight for it.

One split second, and everything was dark again.

Stock photo from Pixabay.com

Stock photo from Pixabay.com

But one split second of clarity was all we needed. Our driver swerved to the side of the road as we passed the truck, thunder clapping in the distance and cement road vibrating under us. We all exhaled loudly.

We could have died. But God, in His mercy and in His sovereignty, placed a lightning bolt exactly where it needed to be, exactly when it needed to be there, and we were safe. This single moment of clarity had the power to change a van-full of young people's lives. When I think back on this experience, I marvel at the Lord's providence. I wonder at His power and His goodness. I realize again how a single moment of stark clarity can change a life. 

When I visited Cambodia in July and came back with the decision to quit nursing, I reached a pivot point. Though I didn't intend on resigning my nursing job when I left for Cambodia, my time there provided the right setting for the Lord to provide significant clarity.

Once again, a moment of clarity in Cambodia changed the my life. It wasn't a bolt of lightning, and it wasn't a literal swerving on a concrete road during a storm. It was, however, perhaps just as important a moment of clarity in my life. It eliminated guesswork, extra stress and anxiety about putting in my two weeks' notice. It was crystal clear I needed to reroute the direction of my life to avoid a major wreck.

As I'm following this new route, I'm learning each day that the change in direction isn't as much a switch from nursing to writing as it is a transition from prioritizing my reputation to building my life around the Lord. Each day, I learn a little more about trust.

Slowly, I'm learning to accept that I'm out of my comfort zone in this new line of work. I'm learning to let go of the pride that says, "I have to be the best in my field."

When it comes down to it, I could work in writing/editing for a couple years, and then this career could completely fizzle out. It could take a nosedive. It could explode. I have no idea what the outcome will be, and I'm learning to be okay with that.

Part of surrendering to the Lord and crafting my life around Him means trusting that what He has for me is better than the dreams of success I have for myself. I can't help but think this is the lesson He wants me to focus on over the lessons in marketing, gaining clients, and self-employment. Because no matter what career I land in, this truth remains: He is faithful, He is trustworthy, and He will take care of me. With flashes of lightning and flashes of clarity, He guides my path and protects my life. All I have to do is to keep my eyes open and say yes.

 

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How the Cardiovascular System Helped Me Find My Purpose

Music played from my laptop next to the couch. I pulled my blanket up to my chin and listened and prayed. A friend came to mind, and I thought about how she was a conduit, a vessel for the Gospel. My mind turned over the word "vessel" and since my friend is also a nurse, wandered to thoughts of blood vessels and the body's vasculature.

All at once, something clicked inside me, and I sat straight up. When I thought of my friend—and myself, and everyone—as blood vessels, something suddenly made sense to me. Bear with me while I give some backstory.

It's been a year since I have moved back to the United States. A year full of struggles, depression, hope, and growth only reentry could bring (it was so crazy I even wrote an ebook on it). One of the things I struggled with during the transition from life overseas to life in Waco, Texas, was finding purpose in my location and vocation Stateside.

While in Cambodia, I learned the missionary lifestyle is not so different from—or more important than—the lifestyle of a believer back home. However, this knowledge didn't prevent guilt from creeping up on me when I moved to the States. I felt guilty for abandoning those I loved in Cambodia, and I questioned whether I was weak for not staying there. The attention and applause the American church gave to missionaries no longer applied to me. Without a clear-cut outline defining my goals and my purpose, I felt lost, out of place, and particularly unimportant

Though the Lord has since provided incredible community, a sense of purpose and contribution, and relentless reminders of His love, in the back of my mind I have still believed that what I am doing here in the United States is less important—less vital—to the Kingdom than what I was doing in Cambodia. We often call missionaries the people on the "front lines," but where does that leave the rest of us?

When I thought of people as blood vessels, as conduits supplying life to other body parts, I realized it didn't matter what my location was. I could be a capillary in the pinky toe all the way in Cambodia, where the vasculature isn't as dense, or I could be part of the aorta at the hub of the heart. I could be a coronary artery, feeding the heart itself and keeping it strong so it could continue sending out blood to the body. I could be a femoral artery, a little farther from the heart but not in the boonies of the fingertips. Regardless of where I was, I was neither less important nor "more" vital than any other vessel. "More" and "less" do not exist as long as I pulse with the heartbeat of the One who gives life.

blood-pixabay.jpg

The goal of the cardiovascular system is to keep the body alive—all parts of the body. The aorta has no purpose if no arteries supply the brain; likewise, capillaries in the brain have nothing to give if the carotid is not functioning. My purpose is the same in both places, though it may look different. It may involve giving more of my financial resources (now that I have a paying job again!) and less time traveling to remote villages that have no blood supply yet. It may look like resting and soaking up the extra access to life-giving friends and community, hearing the Gospel preached in my own language every week, and feeling the pulse of His heartbeat, strong and regular as it reshapes my attitude and habits and life to be more like His.

When I was in Cambodia, I thirsted for community and soaked up every bit I received. I treasured phone calls and found Jesus to be my closest companion as I sought Him on my knees (in front of the oscillating fan, of course). I desperately hungered for the encouragement and prayers sent to me through friends and family and strangers, all the way from the heart of God to mine. I could not have survived without this. I am forever grateful for those who served as vessels at every step of the way: from the aorta to the arcuate artery, allowing hope to flow to me in the pinky toe of Kratie, Cambodia.

Here in the States, I am deeply grateful for community, for the people who draw near to the heart of God and who urge me to do the same. My soul feasts on the abundance of spiritual resources, and I am refreshed and restored. And I hope I too am a conduit. I hope I too am a vessel allowing hope to flow through me straight to the one who needs it, or to trickle from me to another to another to another, eventually reaching a girl on the other side of the world who is on her knees seeking the One who fills our deepest needs. I hope I get to play a part in her experiencing community and purpose and forgiveness. I hope she would know there is One who loves her, and this One who loves her most is there with her, on the floor in front of the fan, ready to refresh her soul.

 

To those who have been and to those who are conduits and vessels, thank you. What an honor to serve Jesus alongside you.

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12 Reflections on the Past 24 Months

I turn 24 today. Two years ago I was fresh out of nursing school and two days into my first nursing job. One year ago I was living in Cambodia celebrating with Khmer friends over a dinner of bun xeo. This year I'm laying in my Cambodian hammock at a park in Waco, sipping Dr Pepper and crunching on baked Lays chips (don't judge. I exercised...sometime this week...). So much has happened and I've learned so muchin the past two years! Here are 12 reflections on the past 24 months:

1. Therapy is not for the faint of heart. I used to think asking for help was weak, but now I know it's one of the wisest things we can do. It's also one of the hardest things. I mean, who wants to spend an hour with someone pushing you to exit your comfort zone (even if it is the healthier thing to do)?

2. Switching cultures can trigger my depression. It's no secret I've struggled with depression overseas, in the workplace, and just in general. I've learned a lot about coping mechanisms and mental health, and I've also learned about triggers. Switching cultures between the States and Cambodia is one of the most thrilling and life changing experiences, but it's also extremely stressful and can trigger unhealthy habits and thinking patterns in me, leading to depression. 

3. Nursing is hard. Every nurse I've met had said they didn't know what nursing was like until they were in the middle of it. I didn't really know what to expect, but it's certainly up there on the list of physically and emotionally demanding jobs. 

4. Boundaries are also hard (but necessary). "Part of being an adult," my friend Jena recently told me, "is knowing what you need and asking for it." I hate causing others inconvenience, but I'm learning doing what's best for me doesn't just benefit me - it benefits all those around me too. A prime example is quitting full time nursing because that’s what benefits me, my patients, and my coworkers most.

5. It’s okay not to be okay. Nursing, along with some rough experiences in a Cambodian hospital, brought out my belief I could be a superhuman (and super nurse). In the past couple years, I've had to face the reality of my humanity and begin to embrace it, leaving people pleasing and HCAHPS scores behind.

6. Khmer language. I've learned lots and lots of Khmer language. I've learned how to make new sounds that aren't in the English language, and I've been stretched to acquire vocabulary because I love the people of Cambodia, and I want to be able to communicate with them.

7. Life as an expat is hard, and so is life in the States. It's all hard because I will always be missing someone. Yet, it's worth it, and it's the people around me who help me make it through the hard parts.

8. I’m not meant to do any of this (life) alone. My friend Erin told me that a long time ago, and it took me a couple years to figure out it's actually true. Jesus wasn't messing around when he prioritized community, and even He allowed Simon of Cyrene to carry his cross part of the way to Golgatha. Life isn't just harder if I do it on my own; it's impossible. 

9. I’m beautiful. The past couple years I've come to peace with insecurities about my ethnicity, culture, and heritage I didn't even realize I had. This has made me more confident and allowed me to relate to others a little more from a place of love and a little less from a place of fear.

10. Rejection. I applied for a job last fall working with students in an after school program, and they never called me back. This program was one of the reasons I felt God has called me back to the US, so it was s pretty big disappointment (ok, also rage-inducer and self-esteem-crusher) not to get the job. However, in lieu of the job I started volunteering at the Cove with high school students, which had been incredibly rewarding and one of the best experiences I've ever had with students!

11. Loving and investing in people is always worth it. I wondered if it was worth loving others when I experienced the pain of leaving and the grief that came with moving back to the United States. I wondered if it was worth loving myself when I was in the pits of depression. In the end, though, it’s worth it. Because loving others (and myself) is only possible through Jesus, and practicing love brings me closer to Jesus. And knowing Jesus more? Knowing Jesus more is always worth it.

12. Fulfillment and meaning aren’t found in a job or a community or a relationship. As “millennials,” we’re often stereotyped as job-hopping to find meaning in the workplace. I wonder though if a cultural shift away from spirituality is the culprit behind what appears to be an enigma. I know it’s true for me—when depression and doubts cloud my view of Jesus, I look to other things (including switching jobs), trying to figure out what needs to change for me to find meaning in life. But when I know I have Jesus, nothing else matters; as long as He’s here, I have everything I need and more, regardless of job, geographical location, culture, or financial status. With Him, I have everything I need and more.

For more adventures from the past couple years, check out my ebook or other posts (and be on the look out for new ones soon!), email me, or get coffee with me in Waco!

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