Ninapenda Chai

Today was my first REAL day of being a second year. Last month I was in the ED, a wonderful place where I thrive in many ways. Now I am on Pulm which of every service in the hospital is the service I most despised as an intern. I despised because I never knew what was going on, now I am expected to teach brand new, first month on the wards interns what the heck is going on.  The problems are partly the nature of how ill these kids are but also due to the complex nature of chronic care in America, a sincere lack of understanding that JUST BECAUSE WE CAN DOES NOT MEAN WE SHOULD and the various social backlash of all that and the fact no one else in the hospital wants to manage these kids.

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…

Where is my compassion?

Its 4 AM.

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.

Here we go again…

I want to understand biblical womanhood…. not feminism or fundamentalism. I want a worldview that is not a reflection or deflection of our culture but rather of joyous redemption. Why does this have to be such a struggle?

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.

Please don’t send me to suburbia I don’t have what it takes

We are sitting around the table. We are all the same age. Nearly all of us have doctorate degrees or something similar. We are talking about our goals for the 1-10  years.  Everyone is buying houses and working for top positions in their field. Some of the older ones are having babies.

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?

147 Million………..

yesterday I went to adoption clinic…and I think it gave me PTSD in reverse.

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