I lied.

I actually love it. The medicine is acute, fascinating and finally teaching me all the physiology that never quite added up for me in my textbooks.

Second Lie:

I do care about what happens job wise in 13 months. And as I brave as I sound. I have only begun to come to terms with how hard it will be to leave a place like where i work.  I would leave the best all around children hospital in the world, anywhere is going to be a change.  Moving to Africa will be bit like academic suicide or at least feel like it. Above all its kind of scary even though its a dream.

there I told the truth

It was not my pastor. It was a kind man about my parents’ age who is also a bad evangelical who runs an intentional community.  I am not quite where he is, in that I am pretty sure he simply sees Jesus as a moral teacher. But I so greatly appreciated his story, his life and his willingness to listen to my story.

He told me that he had built his career as a missionary and now has very little to show for it because now he has evolved into a liberal that is no longer accepted in evangelical circles.  His biggest advice was to not end up that way. It will be different from me as a physician but still very good advice.

Literally 15 mins after that I sat in a strange yellow room on a sofa saying I wanted prayer for the choices I had to make.  Two things were abundantly clear to me in that moment.  This guy who is my pastor really doesn’t know me so well and well as a result its awkward. And then I also realized that while he and I on paper have similar theology, our application of that theology is completely different.  I handed them my reference form and ran to PT.

So I stand in the middle of these two extremes.  And for now that is ok.  The reality is for now I am a liberal evangelical and I am ok with that.

JANE, another colleague says, “I think BOB got that schedule because he had JESUS on his side.”

I laugh and said, well I go to the same church and it didn’t work for me.

JANE and JOAN stare for a moment.

JANE says, “I didn’t know you were an evangelical”  But she said it in such a way that it was like I didn’t know you smoked or I didn’t know you throw rocks at puppies on the weekends…..

“UM, well yeah….maybe a bit more laid back.” I flounder wanting desperately to explain I didn’t love BUSH, Im a pacifist, I haven’t bombed any abortion clinics, I watch trashy TV sometimes, I read Harry Potter and yes in my less thoughtful moments I use off color words I learned from my naval heritage.

JANE smiles, “Yeah, well I love Bob, I was just joking around.”

Then one of us got paged.

….two weeks latter….

Two weeks later I am out with GABI who I have been friends with for a while but whom I find myself having a series of deep and more personal conversations with.  GABI tells me she is something akin to gnostic. She impressed I know what that means and we start talking world religions. I am holding my own.  Then she comes right out and says it:

“So you love Jesus? You’re a Christian?”

I explain that in all my studies what impressed me the most was the incarnation that God would come down and live as we do to provide a vehicle to get us out of a spiritual life the equivalent of a TO DO LIST which we could never complete  and that its all about the relationship with GOD that we can have through knowing and believing in Christ.

This question was easy.

It was the series of next questions that I found myself sweating a bit.

“So how do you feel about missionaries?” (which is a big question if you look at historically and currently) (or as I like to say do you mean in the JOSEPH CONRAD’s HEART OF DARKNESS sense?)

I start with HEART OF DARKNESS and colonialism and move on down to my own experiences. I end with saying what I believe in the context of a relationship is quite different than the HEART OF DARKNESS sense.  She nods and talks about how Church NGOs do a lot of good.

“So do you think, Christianity is the only path to heaven? DO you believe in a literal hell?”

(these are loaded questions: If the answer is YES and YES you are condemning 5 billion humans on earth today to hell).

I believe in Christ (note that I separate Christ and the gospel from Christianity which is a human construct) is the truth and the path. However, I don’t really know how it all works out.  Only God truly knows people’s hearts and knowledge.   As for Hell, Milton and Dante seem to know a lot more about it than I do because other than a parable or two in the Gospels and some heavily loaded metaphor in Revelation, Hell is not described in detail in scripture.  I know it will be separate from GOD which sounds terrible but in the spiritual sense not so much the physical sense.

At this point, GABI who is also a physician interrupts me and says “When I think of Hell, I think of homeless schizophrenics at war with their selves and living cast off from any sense of human contact.”

I nod, who knows, maybe HELL is like that.  I continue…

As for who goes to whatever it is, well again GOD only knows.   The party line Billy Graham crusade answer is that its a punch ticket kind of thing, you go through the right prayer, life style change or whatnot and you get the right ticket punch. Over the millennium Christians have  made up all kinds of ideas of  loopholes. Babies for example apparently are innocent so if they die, its OK they get to go without a ticket, developmentally disabled people too (a babe in Arms kind of ticket).  These babe in arms kind of tickets are made up, they are not in scripture, we don’t know what happens.  Now, do I honestly believe that God sends babies to Hell?  My understanding of God is somewhat different than that, so NO I don’t believe that. But I don’t how it works.  So do I believe that folks in some dark jungle who never heard about Dante or JESUS go to hell?  My church peers would say that’s on us to some degree for not going as missionaries.  Do I think God will send them to hell?  Again I do not know.  I don’t know what that looks like.  I also don’t know exactly what will happen to all the people pre-Jesus. I don’t know.  SO do I believe people, go to hell, YES but I don’t know who or where or what exactly it is.

As for Heaven, some believe the Kingdom of God will come to earth over time as we build it, some believe we will go to it.  I think the former is ambitious and maybe a bit impossible but I think the Gospels are pretty clear about trying anyway. While I am interested in hell, I am far more interested in what we do now to mirror heaven and spread its seeds in the mud and mire of the hellish elements of now.

I explain as well that while I believe in things absolutely, I live with mystery in my faith, of unanswered questions and gratitude to a GOD who is big enough to be mysterious to my human mind. I live with unanswered questions, with faith and I am OK with that.

My friend seems impressed.   We drank our tea and then we go home.  I think she expected me to start reading Romans out loud and pray the sinner’s prayer and give her a tract.  Because I am evangelical, right?

As I go home that night, I think what would my friends from church say if they listened to this conversation? What would BOB say? What would they say if they heard me admit that I don’t have all the answers?  Would they have done the same?  Some would have, but I think most would have stayed within safety of the party line where we have the answers.  I think they would think that I lost my religion.

Am I failed evangelical?  Have  I gone native in all my intellectual quests of reading the Koran, the Mormons, the Buddhists, the Baptists, the Skeptics and the Gnostics, dissecting the layers of culture, history, human creativity from the raw text, from what we call religion?  Do I believe in nothing because I “tolerate” and analyze everything?

NO.

I do believe in something, actually its quite akin to what I believed when I told my parents I wanted to be baptized when I was five before I knew about all of the other stuff we tacked on to the truth.  I believe in the love of a GOD who would love me even though I hit my sisters Emily and Tori every day and some times wish I could go back to being three when I was an only child.  A GOD who created the trees, the deer behind our house that left footprints in the snow, my cat, the moon, the stars Daddy taught me the names of, a GOD who created an elaborate plan to love me  me despite the my wrongs. The plan included sending someone he loved like I loved my parents and my paternal grandparents (and mostly Emily and Tori), a piece of himself who suffered through annoying little siblings and stuff and in the end died pretty awfully  and somehow in something that seemed at the time a lot like magic came back alive to get the rest of us before he went ON so we could all still be friends with God.

GABI says her husband and I have little girl and boy souls, we still believe the same as we did when we were children.

I would say that’s actually quite biblical and I am OK with that.

What has changed somewhere between church camp and now  is that the religious brainwashing has melted gradually over the Serengeti grasses, my ferocious appetite for books and reading, the wails of orphaned, neglected Romanian babies, long nights of organic chemistry followed by ethics and human rights essays in college and blood dripping off my gloves, sweat and tears running down my face as I beat on a child’s chest trying to save their life, I lost my religion.

And found JESUS.

Baking something yummy.

North Carolina Wine

Old Friends.

New Friends.

Summer Nights.

Clean clothes.

Good Books

Clean hair.

Pedicures

Grace

Children and their wisdom.

A Good Night’s Sleep

“To whom much is given, much is required.”

90% of the world’s children live in the developing world and a huge chunk of them have limited access to care. In the world of endless ventilators and children who are trached and have permanent feeding tubes where I live it is easy to forget that most children are lucky if they can get IV fluids.

We have so much.  And much, much is required.

As I stare in the face SHINY HIP number two a procedure that costs 50,000 Kenyan Shillings and probably at least 30,000 to 40,000 US dollars.  I am so grateful. So grateful. That I don’t have to go beg my relatives to come up with the money or choose between eating and my medicine.  I am so grateful for my magical insurance card that several precious friends here in the States do not have. Not to mention for the divine provision that the best surgeon in the US is at my finger tips in network, four hours from my parents’ home.

I have been given so much.  And much, much is required.

I am disappointed about canceling my trip to Zambia in Jan, a casualty of the scheduling changes that took place to make way for the shiny hip. But I am so grateful. So grateful that I have been given a way out of the constant pain and the progressive disability so that I can be healthy enough to move to Africa full time a year and half post-op.

So much given and I am ready to do what is required.

As I stood in the chronic trach/vent unit surrounded by ventilators, monitors, suction tubes, catheters and back up ventilators and tubes and catheters….I could still taste the Kenyan Chai that I had a breakfast and I found myself carried away to  place of red dirt, mothers that breastfeed without shame and my one precious ventilator.  Suddenly I am filled with a deep longing to just be there in the Kenyan sunshine where my job makes sense. I find myself feeling guilty not for what I don’t have in Africa but what I don’t have in America which is some sense of guiding purpose. We are surrounded by options but we seem in some ways to lack the ability to discern any option other than just keep swimming.  Countless kids with medical laundry lists of problems, half of whom were there a year ago when I cared for them last. I can’t see the forest through the trees.  Am I really helping them or am I prolonging their pain?

But then the internal slippery slope sensor in my disabled souls says I cannot stop swimming….because these children belong to my tribe. But I feel like there are  prisoners. We have a created a system where we save them but we cannot sustain them, they can’t go home and well…as we say in Africa they can’t go HOME. (meaning the next life).

So I struggle to help my interns not drown and keep myself treading water. I find myself stopping and talking firemen with one child and light sabers with another and I hope for them and I pray for them. Both have been there for literally years of their lives. And while I travel the world, they stay. They stay.

And I drink chai.

Because sometimes being on Africa time if only for a moment keeps me from internally combusting from how much I ache for the lives in my care both my new interns and for the children who steal my heart as they perform acrobatics on the thin line between life in this world and what lies beyond.

And one day I will sit down with God and drink chai and ask him what was the right answer to the painful questions that haunt me…

I am so tired I can hardly move much less make a life altering decision for someone else’s baby.   I am so tired that despite my fleece, knee high socks and scrubs I am shivering. My body aches, my right hip feels like its going to burst and the muscles around the shiny hip are stained.  I am tired to the point that I am short tempered, angry and I can’t remember why I am doing this no matter how hard I try all I can feel is anger. Anger at the child. At the parent. At the nurse. I try so hard not but all i feel is anger. Its not the baby’s fault. Its not the baby’s fault I say to myself.  As I drag myself to the room of another sick child, I can’t remember the child’s name and awkwardly refer to them as “the sweet baby” or “pretty little girl” or “buddy”.  I am covering 60 kids and I am on hour 23 of call and I just can’t bring myself to care beyond just making it another two hours to sign out when my comrades will get there…..and beyond to 7 hours from now when I can go home and sleep in my warm bed….

I look down at the baby, someone’s child and all I can think is how did I get here and why am I going through this torture.  Where is the compassion I had in medical school? Where is the excitement I had in college? Where is the dream?

I am making preparations for Kenya. I am counting down the hours till I can pack up my little CRV and drive across the mountains home for a night, north for a precious and much needed steroid shot and then boarding a plane to take me EAST…..

and then SOUTH. to warmth.

escape.

to more sick children….but somehow in Kenya its different.  Maybe it waking up to the Great Rift Valley with the mist burning off the smoldering African plains, maybe its the craziness, the chaos that is a hospital in rural East Africa, maybe its the grateful smiles of every parent, maybe its quiet morning prayers. Maybe its that life exists on Africa time.  Maybe its that I can’t call for 20 consults.  Maybe its that the internet works ON A GOOD DAY only. Maybe its because for a little while I can be Amy again not Amy the super intern at a top program or Amy who wants a competitive fellowship or chief spot.  I can just be Amy who knows some medicine, who knows what its like to suffer and who works to find some way to bring those things together in a productive way that brings healing. Maybe I can just be.

Its the 4 AM of my 12 month internship and I am tired, cold, sore and angry.

so I do the only thing I know how to do….fly, fly, fly away to somewhere life is harsher yet simpler.   Somewhere that i knew and learned compassion and that I pray will be gracious enough to teach and humble me again.

I heard a sermon this weekend, the first sermon I had heard in a month, on biblical manhood. It was actually decent. He discussed how men have lost a sense of purpose, have a prolonged adolescence and a lost a sense of value for women and children. And frankly any pediatrician with half a brain has to affirm all of this.  But then at  the bitter end, it all went wrong.  The elder started talking about providing and dependents on his taxes and then he went there.  He said, “If given the choice nearly all women would stay at home and care for their children.”   I nearly stood up and marched out in a huff of self-righteousness as a young women physician not only for my own choices but because he had dove into the pool of fundamentalist, SBC BS clothed in biblical language.  What he intended was not nearly as important as what the congregation heard.

First I refer back to this from 2009 in which I previously spoke to the subject.   and then I echo my last paragraph…

Could you imagine a woman would shrewdly crush the head of a foreign general (either figuratively or literally, diplomatically)? Or could you imagine a woman so strong and wise that a general refuses to go to battle without her? Could you imagine if there was a woman like Esther who would go before the governments of nations where genocides, other hate crimes or gross human rights violations are happening and convince them to stop? Could you imagine if women would support their elderly, widowed family members like Ruth rather than sending them to nursing homes or griping about them? Could you imagine if women of the world fought back against violence toward women and children like Tamar? Could you imagine if the women of the world embraced the children born unplanned or unwanted? Could you imagine if women in nations where there is no freedom of religion quietly yet openly worshiped and ministered like the women at the tomb? Could you imagine if women stepped up as leaders yes pastors, ministers, teachers in places where there is no faith or where faith has died?

How different would our churches be?

How different would our families be?

How different would our world be?

…if every woman got up from the mud of our world that exploits women and their bodies and brushed off the dirt of centuries of fear and ignorance hidden in church tradition but lacking biblical substance and embraced her calling…whatever that calling may be from motherhood (yes even the stay at home kind…love ya MOM!) to ministry to beyond.

how desperate our world is for biblical womanhood….how desperate…

This is what I want.   I am tired of apologizing for my extra X chromosome or my kooky religion. I want to find a place where they can coexist as they were intended to in harmony.

Then the conversation turns to me.  So Amy?

WHAT I SHOULD SAY if I WAS BEING AN 100% honest: um.. in five  years…..I want to work and teach  in Africa.  I save money for plane tickets.  I  am not sure if I will ever own a home. I dream about having a clinic that has an x-ray machine and a wheelchair ramp.   Oh and I dream about having two shiny hips  so I can put my socks on in the AM without extreme pain.  My desires for the next 10 years:  I want to get married but even if I dont I want to adopt babies, currently I am praying about interracial adoption because African American babies particularly boys hardly ever get adopted. And I want to write books about disability and doctoring and Africa.

Response: Oh.   silence.

Right so Bob, where did you say you were looking to buy a house?

What I say instead: Oh you know get married, have some kids, get a academic pediatric position somewhere, write some books.

Response:  DO you want to buy a house?

silence.

Me: Um probably not.

Right, so Bob…?

Recently I have really been trying to make friends here outside of work. I love my work friends but it would be nice to have friends at church or elsewhere. Its been about like the above snipet every time.  Apparently my interests at 26 are supposed to be marriage, career, house and a retirement plan.   I may live in the city. I may go to a inner city church plant but I feel like I live in the suburbs. I am surrounded by people who in five years will live in the suburbs and have 2.5 kids, a SUV and picket fence.

How is it that I can make friends in  the slums of Romania or with beggars and homeless young mothers in Africa but I struggle to  make friends with my peers in the US OF A? How is it I have so little in common?

The smell of urine,  sunbeams through a barred window, the feeling of chapped hands, the smell of stale bread and boiled cabbage….  These are the things that take me back to being 19 yo, young, idealist who walked down the OTHER hallway at child protective services in Bucharest…

July 13, 2004 (from my journal)

Eerie silence echoed through the long, narrow, gray room. It was frozen in time; the light from the singled barred window on the far side seemed listless, much like the occupants of the cribs. I tiptoed over to the first crib:  there was a heap of brown curls wet with tears, sweat and urine scrunched in the far corner. At the sound of my footsteps, she jerked her head up from her hushed sobbing and looked at toward my quiet steps, scars of untreated infantile galucoma clouded her sky blue eyes. How could a eight year-old know such grief, such fear? I reached down to pick her up:  she was weightless it seemed. I let her down gently to the floor. She stood slowly, her tear streaked face seemed to come alive.  She held my hand with a death grip:  don’t let go, don’t let me go.  She walked with careful steps fearful of the monsters she could no longer see.  At the dark end of the room, another crib had been pushed away from the others.  .I heard the sound of metal striking metal against the rail of the crib. Then I saw a hand and unnaturally slender wrist is covered with red welts and oozing blisters. I peer into the crib and discover the etiology of his suffering. A single piece of cloth encircles his other wrist and the bar of his crib. I gasped, on the sign above the stated this child was 14 but he was the size of a toddler. His head was grotesquely mishapen with untreated hydrocephalus. No wonder she was so afraid, no wonder she grieved. This was not a hospital for disabled children, it was a prison.

I am haunted by these children…orphans…some abandoned because of poor resources, some because they are members of my tribe and their families left them and the stigma of raising a cursed child behind,  some born on the streets, some badly abused and taken for their own safety. But all left in a pitiless system that devalues their potential and slowly teaches them and even molds them (both physically and emotionally)  that they are not worth it.

And don’t this is about Romania or even Eastern Europe.   I could tell stories about the slums of Nairobi where children die of dehydration, HIV and TB and no one cares.  I could tell you about young beautiful African teenagers selling themselves to survive.

And don’t think this is about the developing world either. There are 888,000  children in foster care in the US.   And I shudder to tell you the stories I see every day on the pysch Ward, in the ED of abuse, neglect or kids who have never known a stable environment in their 10 years…who can tell you the top drug lords of their housing project are but can’t find the state they live in on a map….

But yesterday I saw the other side…. White people from the suburbs who I half expect to invite me to a Wednesday night church supper or run into when I shop at the uppity grocery store in uptown who have adopted from China, from Ethiopia, from the Ukraine and yes from the US of A.  People from the culture I grew up in who went to the cultures I live and work in now and brought back a child. I saw one little girl who had just come from China a week ago…she has a clef palate.  In two weeks she had advanced 2-3 months developmentally. In just 2 weeks…. I had tears in my eyes taking her history.     Because I have seen 100s of these children , room after room of babies who get fed and changed twice a day who never learn to sit up or crawl or walk much less talk or interact not because they are not capable but becuase no one holds them.

And I was overjoyed for this little girl…for this chosen one…..  But what about the others…..a 147 million others. What about them?  I found myself wanting to scream this loudly at these parents.  “WHAT ABOUT THE OTHER BABIES???”   I didn’t of course because I knew that I was being absurd.  Its just that while I love the idea of adoption and I think its a beautiful reflection of what Christ does for us…. and I admit I even plan to adopt myself  one day… its a drop in the bucket.

147 million is a lot of drops…

I want to answer the question why babies get abandoned.  I want to be about de-stigmatizing disability/birth defects in the developing world, preventing HIV in Africa, decreasing maternal mortality in the 10/40 window,  changing the way cultures think about little girls, building sustainable economies in nations so that families can keep their babies….

we are called to care for orphans and widows….but what does that mean in our modern world? what does that mean as spoiled, pretentious, well-meaning Americans… ???   I don’t know the answer but the longer I reread the gospel and the more I travel the world, the more I realize that the redeeming, trans formative answers are the ones that make me in my home culture and yes in my home religion the most uncomfortable.

My prayer is that I am ready and willing to look beyond my own fears and my own bias and believe that its possible. TO believe that there are answers and be ready to radically follow my God in search of them.

….147 million