"Stand up and fight, ye yellow-bellied scoundrel!"

Are there any other House fanatics out there? It’s okay. Raise your hands high. Be proud.

As insufferably condescending and irritating as Hugh Laurie’s character can sometimes be, I’m a bit endeared to him nonetheless.  I love how imperfect he is. I’m also kind of drawn to broken people, and he is certainly that.  Most of all, I appreciate the questions posed by his actions and attitude.

In one episode, Foreman (a Dr. who works under House) hands in his resignation because he sees in House the same vices that dwell within himself. He fears that if he isn’t careful, he’ll turn into House.  His parting remarks to House were something to the effect of, “You’ll save more people than I will. But I’ll settle for killing less.”

It’s a dilemma that every medical professional comes up against eventually. Do you take a risk, knowing that your patient might die as a direct result of your actions?  What if it’s really a long shot? What if it’s their only shot? Or what if it’s a 50/50 gamble, and they might be just as well off if you do nothing—but you have no idea which course of action will save them, and there’s a pretty decent chance that neither will?

My least favorite medical procedure that I have ever performed is an NG tube insertion.  On one hand, it’s pretty easy—stick a tube in someone’s nostril and push. Getting it down the hole isn’t the hard part. Getting it down the right hole into the right organ is a bit trickier.

The day I arrived in Kazembe, I met a very sick little boy named Nicholas. He wasn’t eating, and that on top of whatever illness he had was causing him to fade fast.  Amy and I tossed around the idea of trying a feeding tube, but I was way out of my element.  I had never done the procedure on a real person before. I know the theory like the back of my hand, but the actuality is nothing short of terrifying.  Depending on the statistics you trust, as many as 50% of NG tubes inserted on neonates are placed incorrectly initially.  If the tube is in too far, the milk bypasses the stomach and little to no nutrients are absorbed. If it’s still in the esophagus, aspiration pneumonia will be your next battle.  If it’s in the lungs and you push milk through the tube…

The only sure-fire way to verify placement (that I’m aware of, at any rate…) is an X-ray.  Wanna guess how plentiful those are in the African bush?

Little Nicholas didn’t make it.  I suspect he may have had a heart condition—there was an audible third heart sound.  Of course, it’s impossible to know if the condition caused the heart failure or the other way around.

Let me pause for a moment to clarify something. I’m not blaming myself entirely for the deaths of these kids. That being said, it would be foolish not to acknowledge the direct role that my (and everyone else’s) actions played in the way circumstances panned out.  Some of the most impactful lessons my professors have taught me have been in the form of stories about their own mistakes.  No, I can’t change what happened to Nicholas and Jessie, but perhaps I can take from my time with them lessons that will save the next one.

When Jessie could not find the strength to eat, it became very evident very quickly that an NG tube was pretty much her only chance.  I’ve written about the whole well-meaning-but-inept-midwife-putting-the-NG-tube-down episode before, and since she pulled it out two hours later I ended up having to put it back down myself.  A couple days before she died, she stopped eating again.  I tried eight times with two different tubes before I finally felt it might possibly be in the right place, and she immediately developed breathing difficulties again.  I’m not sure how many times I had to insert and reinsert that stupid tube during the short six weeks of her life, but it must have been close to a dozen if you count each attempt. That is incredibly hard on a very small and weak body.  Unfortunately, so is starvation. It was our only choice.

In Jessie’s case, circumstances made the decision for me. It’s not always that easy.  Sometimes, you have to choose whether to be House or Foreman.

There are very few instances where I will side with House, but I think that for the most part this is one of them.  Abdication of responsibility does not confer innocence.  Better to be guilty of trying than “innocent” of messing up.  In medicine, that’s a pretty tough pill to swallow.  When nurses and doctors mess up, people die.

Many folks, upon seeing Jessie for the first time, totally wrote her off. She was too little, too sick, and too far gone.  They couldn’t see anything in her worth fighting for. I did.

Maybe, just maybe, deciding it’s worth the fight is half the battle.

My Little Iwes

Alright, fair warning: It's 1:30 in the morning. There's a really decent chance that this is going to be a fractured, rambling, nonsensical post. I don't believe in proofreading after midnight. Bear with me. I'll try to make it come together in the end.

I've become that person.  You know, that one girl...  The one who freaks out when someone wastes food.  The one with a story about Africa for every situation. The one who harbors unreasonable irritation against Western culture as if she isn't part of it. Yikes.

A few weeks have passed, but I still feel like I'm floating around in Limbo. It's sort of as if I'm watching myself from the outside.  Not to prolong the Narnian metaphor beyond it's lifespan, but I wonder if this isn't how Peter, Susan, Edmond, and Lucy felt upon returning "home." Did they see Narnia everywhere? Did they dream about it? Did they close their eyes and cling desperately to memories in a wild attempt to convince themselves that it had really happened? And how, pray tell, did they go back to their normal lives as normal school children?

I wonder if Narnia changed them. I wonder if it changed them and shaped them so much that they no longer fit back into the puzzle they originally came from.  In many ways, that is where I find myself-- trapped between two worlds. Not quite Narnian, but a stranger in my own land.

Weird.

Anyway...

Peter, Susan, and Lucy each received a gift to use in their times of greatest need.  Aslan sent me one too.

Once upon a time, the dusty and quiet streets of Kazembe began to stir with life. Dust turned the sky a dull orange. People appeared from everywhere, as though they were simply rising up out of the ground. A massive celebration was brewing.

I can tell you more about the Mutomboko celebration later. Pretty much all you need to know at this point is that there were thousands and thousands of Zambians crammed shoulder to shoulder in the streets for pretty much three days straight. Because I'm hopelessly in love with all things African, Zeger and I were in the Boma for basically all of that time. It was absolutely amazing, a little terrifying, and a whole lot of fun.

The word "Iwe" (ee-way) means something akin to "hey you" in Bemba.  I would often hear it used to get someone's attention amongst people in the village.  The nannies often address the kids that way.  It has also become a name for the street children. They are Iwes. Hey You's.

I heard many people use it in that context as a rather derogatory term. "I had to chase the Iwes off my porch again this morning."  I hate that any child is thought of that way.  For me, there are few sweeter words.  Many of the non-Zambians I came in contact with said that I'm still in my Zambian honeymoon phase-- I'm totally in love with everything even remotely related to Zambia. Maybe they're right. May God grant that it never ends.  

Some of my sweetest memories are of my little Iwes.  Especially during Mutomboko.

The first morning we went down, we were all crowded around the entrance to the Mwata's palace for the bringing of the beer (don't ask...).  Several dozen village kids were gathered around us (as per usual).  I could not have been happier.  I could go on for hours about the little moments I shared with them, but for your sanity's sake I'll just tell you about Monica and Cynthia.

They were both beautiful little girls. It's so difficult to guess their age-- they were probably older than I suspected. I would venture a guess at somewhere between 8 and 10 for each of them. Both of them were literally dressed in rags. Cynthia's shirt was falling off, and some of the other better-dressed kids were laughing at her. She kept clutching it up over her shoulder, the shame evident on her face. She was one of many that I took into my lap as I carefully tied the tattered pieces of their clothing back together. I sang softly in her ear and ran my fingers through her brittle hair. Monica stood protectively over her.  I wondered if the two of them were sisters, or merely friends fighting for survival together.  They stayed with us the whole morning. I tried to talk with them, but their English was very limited. Most of the time, we just stood there holding hands. I was okay with that.

Later that day, Zeger and I were headed back to the orphanage to grab some food.  I felt little fingers grab my shirt. As I turned around, Monica pressed something into my hand. It was a small, pink and silver metal bangle. I asked if it was hers. She shook her head and pointed to Cynthia.  I reached out my hand, and Cynthia placed her little hand in mine. I thanked her, a little at loss for what to say. She only said one word. "Remember."

I gave her a black hair elastic from my wrist in exchange, and we parted ways.  I remember being totally shellshocked. There's a pretty decent chance that this little Iwe had just given me the only piece of jewelry she owned. Maybe not. But maybe so.  This terribly dirty little girl who smelled like urine and barely spoke a word of English somehow found the right word to say and made a gesture that spoke louder than words ever could.

That bangle hangs from a beaded cord around my neck. A charm shaped like Africa and painted with the colors of the Zambian flag is nestled in the middle. In my times of greatest need, when I can't imagine going one more single second without holding one of my kids, when the sights and smells slip like vapor through the windows of my memory, I reach up and grab that bracelet. As the harsh metal edges press into my skin, I close my eyes and am carried back to a place where, for me at least, the world makes a little more sense.

My Prayer

Two weeks ago, I stepped onto an airplane in Lusaka, Zambia. My knees shook. My hands were sweaty, and my heart was racing. The idea of reentering my own culture had nearly crippled me with terror. I shot a desperate prayer heavenward and begged sweet Jesus in heaven to preserve my sanity.

As per usual, He came through.

The first week or so was pretty rough. Thankfully, I have better friends than I deserve. They have listened to my constant rants. They have patiently sat through tears of homesickness and separation. They have diligently pulled me away from cute little babies in Walmart (apparently I have a staring problem…), and they have endured hearing the same stories, the same regrets, the same nostalgic musings over and over and over again. They have brought my scattered wild thoughts into focus, and they have reminded me to be where I am until I get where I’m going.

At the end of the day, I find my prayers centering on two groups of people—the friends I left behind  and the friends who were waiting for me here. In many ways, my friends and I here at Belmont are all on the same journey. We’re all trying to figure out what on earth we’re here for, what God has called us to (both individually and collectively), what that looks like in daily life, and how to make the changes in our own hearts and actions that need to be made (did I mention that my friends are pretty much awesome?).

With that quest in mind, I offer this prayer for those dearest to me, whatever continent they may find themselves on...

May your eyes be opened to a world you have never seen before. May you be willing to love those who don’t deserve it and those who won’t love you back, even if it hurts and disappoints you. Especially if it hurts and disappoints you. May you banish laziness and complacency from your lives. May you recognize your vices and temptations and flee from them. May you work with all the passion and fervor that one heart can contain while still remembering Paul’s warning: “If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing.” May you encounter the Living God in everything that you do, even if you’re not looking for Him. May religion be stripped away to be replaced by Relationship. May you never look at a hurting person—man, woman, or child-- and feel nothing. May you banish the “I can’t” statements from your life. Don’t say you can’t go, or you can’t fix it, or you can’t endure it. May the cultural expectations that fuel those “I can’t” statements become steadily less important as you draw closer to the cross of Christ. May you ask difficult questions. May you demand difficult answers. May you be willing to ask for help when you need it, and may you offer help wherever it’s needed. May you not be discouraged if you continually lose the battle. Sometimes that’s life. But that’s okay, because it’s not about the battle. In the end, the Victory has already been won. 

May we be better for knowing each other.  Thanks for putting up with me. ;)

Chasing Aslan

A week and one day have passed since my arrival back in the States. It seems like months. It's as though I'm watching myself from the outside. The world around me feels mechanical and foreign, like something out of a bad futuristic movie with no plot line and flat characters.

I think constantly of Kazembe.  Every sunset breaks my heart a little bit more as the last light of the evening glares harshly off of metal buildings instead of enveloping earthy huts surrounded by half-dressed children. The only thing I've unpacked in my dorm room is a small stack of pictures. Flipping through them is small comfort.

I'm stuck in cultural limbo.  My heart longs for Africa.  I don't understand life here. It's madness.  This obsession with convenience and luxury and possessions is like an acid slowly eating away at whatever sanity I still have left, yet I find myself slowly slipping back into it-- coffee from Bongo, complaining about minor delays, wasting food...  I liked who I was while I was in Africa a whole lot better than I like who I am while I'm here.  I truly believe that God has been molding me my entire life to serve in Africa. Suddenly I find myself on the wrong continent, and I realize that I just don't fit here. I'm homesick for Zambia.

Perhaps the hardest part is trying to explain it all, trying to communicate to the people here what I saw, did and experienced.  Words cannot suffice. Pictures fall woefully short. How do I describe the weight of a fragile little life in my hands?  The beauty of a child's generosity? The brutal cruelty of poverty? The terrible price of prosperity? How could I possibly explain what those kids mean to me? They are the beautiful answer to over a decade of desperate prayers and wild dreams. I've been asking God to bring me to them since before any of them were born.  Leaving them was like cutting myself in half.

I want to shake the world around me and scream at it to wake up. Wake up and realize the terrible price of our apathy.  Redeem the time.  Realize what you have.  See beyond your own front porch.  And then move beyond your own front porch. It will probably hurt. It will definitely be worth it. You have no idea what you're missing.

I've shared a bit about my journey to Christ before, but a big part of coming to understand who He is as a child for me was the Narnian Chronicles.  Well, I found Narnia. It's not on the other side of the wardrobe.  It's two planes, a taxi, and a really smelly bus away.  It's not a perfect world-- the White Witch has her hold, and she's recruited a posse of witch doctors to help her out.  The Narnians have retreated so far into themselves that they don't even know who they are; they do not recognize their own worth.  But Aslan is on the move.  I could hear his whisper as we explored the bush every morning... "Farther up and farther in."  I saw his reflection in the eyes of dirty village kids and tired kitchen ladies.  I felt His comforting warmth as He gently took Jessie from my arms.  I saw Him moving in the lives of people who don't know Him and didn't even realize He was there.  I didn't know if I was ready for what Africa would demand of me. "Good," said Aslan. "If you had felt yourself sufficient, it would have been a proof that you were not."  For the first time in my life, I woke up every morning feeling like I was in the right place at the right time.  That itchy restless flighty feeling that I always have was simply gone. I was home.

Regina Spektor's song The Call plays at the end of the movie Prince Caspian.

"Now we're back to the beginning,
It's just a feeling and no one knows yet.
But just because they can't feel it too,
doesn't mean that you have to forget.
Let your memories grow stronger and stronger,
'Til they are before your eyes.
You'll come back when they call you--
No need to say goodbye."

That verse has become my anthem, playing over and over in my head.  More than anything, I need someone to understand where I'm at right now. But just because they can't feel it too doesn't mean that I have to forget.  There is sadness in separation, but there is joyful hope in the promise of reunion.

The day I left Kazembe, Johnny looked me in the eye and said he didn't think I would come back. "No one ever does." Hold on, kiddo. Ten months and counting.

The Adventures of Travels

Four and a half days have passed since my plane touched down in Indy. The journey was long and bittersweet. Zeger was flying out the day before me, so we went down to Lusaka together.  We visited a few markets around town. I learned to bargain (although not well), and I bought enough to share a bit with friends and decorate my room with African mementos. We had a really good time and spent the evening reminiscing about the summer and the little ones we had left behind. Amy joined us the next day. We hit one more market, then Zeger grabbed a taxi for the airport. Amy took me for a pedicure that afternoon (my first ever-- my feet are unreasonably ticklish).  I'm pretty sure that's the first time my feet had been soft and clean since I arrived in Africa. Then we drank coffee, watched the new Harry Potter movie, and ate Indian food.  I was already missing those kids more than words could possibly express, but at the same time I really enjoyed the chance to spend some time with Amy aside from the distractions that the orphanage inevitably brings.

I cried like a crazy person during the second half of the movie.  I'm not really even sure why. Amy kept glancing at me nervously out of the corner of her eye.  Partially, I just really desperately needed the good guys to win one, even if it was only on a movie. I knew they would in the end, but the journey hurt an awful lot.

The next morning, Amy picked up a team from the airport. I had a chance to get to know them a little before I had to leave that afternoon. The thought of leaving Africa was in and of itself enough to make me feel nauseous, but knowing that those people got to go to Kazembe and love on the kids who had hijacked my heart left me downright jealous.

After Amy and the new volunteers left for the bus station, I had a chance to sit and talk with Lydia, the woman whose house we were staying at. She is wonderfully sweet, and I really treasured the opportunity to get to know her heart.

I spent most of the plane ride memorizing everything I could out of the Bemba grammar papers that a Peace Corp friend gave me. The woman sitting next to me happened to grow up in Luapula, so she helped me with some pronunciations. It made the trip a bit more bearable.

When I finally arrived in Indianapolis, I found that my bags had been seized by customs in DC. Perfect. After several hours, we were told they had been released. We waited five hours for the next flight to get there. It was delayed. Twice. Then once it finally arrived, they couldn't unload the luggage because of lightening. Finally I got my bags. Nothing was missing.

I fell asleep almost instantly in the car on the way home. Forty-eight hours after landing in the States, I pulled out of my driveway and headed to Nashville. Ten minutes out of Evansville, the rear driver's side tire blew on my car. An hour later, AAA got there. Yet another hour and a half later, Walmart finished switching the tire. Finally, I got back on the road. I barely made it to Nashville in time for my 5pm move-in time.

The next morning, I started RA training. I have to say, despite all the craziness and the brutally long days on top of relentless jetlag, I'm loving every minute of it. It looks like God knew what He was doing after all.

Well, that's the dry and emotionless version of my week. I could share a million little stories about the people I met and the adventures I had, but for now, I must sleep. My African blanket is beckoning me from my bed.

Goodnight, all. Laala.