Matters of the Heart

Being a general surgeon in Papua New Guinea means that some days I do orthopedic surgery, others urologic or gynecologic, and on others, trauma, plastic or burn surgery.  Variety truly is the spice of a surgeon’s life here. One of the more rewarding “surgeons” that I get to be is a pediatric surgeon.

Each week I have the privilege of getting to take care of children who are sick, hurting, and in need of surgical care. This past month seems to have been filled with more sick kids than usual. I wanted to share the stories of two of those children with you. Getting to take care of these small patients has been an incredible privilege.

Simpson is two-and-a-half-year-old boy who is almost the exact age of our second son, Matthias. Simpson came to the hospital short of breath and very sick. His chest x-ray showed an enlarged heart, several times bigger than normal. dsc_0152Based on the history of tuberculosis in his family, he was started on a course of treatment. However, after a couple of days of this his condition worsened. Dr. Erin, one of our family doctors, realized that something other than tuberculosis must be the cause. In the middle of the night he was having difficulty breathing and his blood pressure began dropping. After scanning his heart with the ultrasound, Dr. Erin drained a significant amount of pus from his pericardium (the lining that surrounds the heart). This temporarily relieved the pressure on his heart and allowed his vital signs to improve. The next morning I took him to surgery and did a procedure called a pericardial window to drain and washout the infection surrounding his heart. When we arrived in the OR we found that Simpson had no intravenous access because of the severe swelling from his infection. In the night, Erin had put in a special IV line directly into the marrow of one of his leg bones. Unfortunately, this was no longer working and we struggled to find alternate access. Simpson’s infection was so severe that it had caused a condition called Disseminated Intravascular Coagulopathy (DIC), which was making the veins all over his body fill up with clots. I tried unsuccessfully to put a large IV  in one of the veins in his neck, legs or upper arms.

Simpson and his family member got to meet Tabea and Naomi.

Dr. Paul Hitchen, a visiting orthopedic surgeon from Australia, was finally able to place another IV in Simpson’s bone and this allowed us to complete the procedure.
Simpson is still in the hospital and has had several setbacks along the way, but we praise God that he will soon be going home.  He’s alive today because of the Lord and thanks to the great team of doctors, nurses and volunteers we have here at Kudjip.


Remna is a ten-year-old girl who has been Simpson’s bed neighbor on the surgery ward for the past couple of weeks. Remna was initially admitted to the pediatric ward with fevers and several painful and swollen joints from septic arthritis. Unfortunately, like many of our patients, she had come to the hospital very late and her disease was extensive. Despite being started on multiple antibiotics, her infection spread and she began to have difficulty breathing and, just like Simpson, her blood pressure started to drop.

This is Remna on the morning after surgery.

On chest x-ray, her heart, like Simpson’s, was enlarged. The ultrasound showed that her heart was struggling to beat because of all the pressure from the fluid. As we were getting ready to start the procedure to drain the fluid around her heart, her heart suddenly stopped beating and we had to begin CPR in order to save her life. I quickly placed a large needle under the edge of her breast bone and withdrew some of the fluid around her heart to relieve the pressure. Fortunately, it was thin, watery fluid and not pus. During CPR I was able to place a drain into the space around the heart that allowed the fluid to come out. The drain removed almost a liter of fluid from around her heart. During the next twenty minutes (which felt more like twenty hours) we continued CPR.


In total, Remna was defibrillated four times, but eventually she resumed a normal heart beat and regained a blood pressure. Clearly the hand of the Lord was upon Remna in those moments. The type of drain that we used to remove the fluid from her heart is not something that could be purchased here in Papua New Guinea. However, on the most recent shipment of supplies from Nazarene Hospital Foundation, we received a number of donated pericardial drain kits. This is not coincidence, but rather divine provision!

Dr. Rebecca (a PNG rural registrar) is reviewing Remna’s case with volunteer orthopedic surgeon, Dr. Paul Hitchen.

When the procedure was complete, we eventually drained the infection from her joints and then prayed that she would wake up. When we checked on her later that evening she was awake, talking, and telling her mother that she was hungry!  Through her recovery she has shown no signs of any brain injury or damage. Remna still needs a lot of prayer and ongoing care. She now has a deep infection in several of her major bones (called osteomyelitis) that will require months of care, and possibly more operations in the future.


These two children represent the reward and privilege that I feel it is to care for some of the sick children who arrive at Kudjip Nazarene Hospital. They are a testament to how the Lord provides what we need exactly when we need it. Sometimes he sends the right person to do a procedure or sometimes its a medicine or specialized piece of equipment. These kids also represent the many other stories of children that I haven’t shared. Perhaps some of those stories aren’t as hopeful and unfortunately, in some cases, the families of those children continue to feel the loss of their little ones that we couldn’t save. But in the midst of it all, we know that God provides the hope, grace and comfort that each of our patients needs.

Whatever you did for one of the least of these brothers and sisters of mine, you did for me.”           – Jesus


I’m grateful for a mentor who models this truth–that while we treat patients and try to do our best, we must rely on Jesus to truly make the difference.

There and Back Again

Since we’ve only been back in PNG for three months now, now seemed like a good time to share all about our journey home to Kudjip after the birth of the girls and a few things that have happened since. Several weeks before leaving Ohio, we found out that my brother Peter would “get to” travel with us and stay at Kudjip for a few weeks. And in hindsight, we could NOT have done it without him. Or I suppose we would’ve risen to the occasion and figured things out, but it would’ve been ugly. Here we are. All new and fresh and seemingly ready for the hours of work ahead of us. 
Uncle Peter quickly became a sleeping buddy.
And a carry-on packer extraordinaire.
And a toddler wardrobe assistant.
Back then we still swaddled the girls and it took a good bit of work (and standing and bouncing) to get them to sleep. Aside from a miraculous work of God, I’m not sure how we survived that trip.
If we ever thought traveling with two young boys was a challenge, we got a WHOLE new taste of “traveling with young children” on this five-flight, 54-hour journey from Ohio to Papua New Guinea. When we took our first trip to PNG with (only) Simeon, I remember reading a lot of blogs about how to make life on an airplane (and in airports) much easier with small children. I was naive back then. But now I could write the blog. Fruit loops, iPads and earplugs. That about covers it. Well, not exactly. Most of you know me far too well to think I’d let the rest fall to chance. I was prepared as prepared could be and even so, we had some absolute meltdowns. But during this fine moment in the Los Angeles airport, we felt like we had conquered the world with our jammies and camping pad.
And THEN, we moved to the other end of the terminal to wait for our 14-hour flight to Brisbane. And by now, its 2AM for those sweet little bodies and they’ve hit the wall. That is, until an ear-piercingly loud door alarm at our gate started blaring through the entire room. Our (somewhat) peacefully sleeping children were startled awake and restless for the 15 minute ordeal. And then they settled again…and we waited.
Dr. Mike Noce is a volunteer who was on his way to Kudjip as well and we met up with him in LA. Remember what I said about Uncle Peter and how we couldn’t have done it without him? Well, the same applies to this man (who is a father of six and grandpa to many). Literally, we had JUST met him an hour before this photo and all of a sudden he’s carrying our children, our bags and anything else we could throw on his shoulders. Shortly before we thought our flight was to board, Ben looked over at our gate and saw a young family and someone in a wheelchair being wheeled through the door. Of course, we wanted to be among the first on the plane so we could snag all the overhead space and get sufficiently settled. After seeing those early boarders we realized we’d better load up and make our way to the gate. We carefully pick up sleeping children (two of which are babies already strapped to our chests) and balance our 10 carry-ons on any remaining limbs. We were a sight. We lumbered up to the gate and told the kind attendant that we were ready to board early with the other young family. And she sweetly replied, “Oh, its not time for boarding yet, but we’ll make an announcement when that time comes.” And I’m thinking, “Really? How is that possible? Could you graciously have mercy on our sorry souls and please let us on that plane?” So, we did the only thing we could. We dragged ourselves back to our seats, now with a deliriously awake 4-year-old who all-of-a-sudden starts crying (loudly) about his legs hurting and how I (since I’m holding all 42 pound of him at this point) should simultaneously hold both of his socked-feet while massaging his left calf in the process. Did I mention he was delirious? Like, night-terror delirious. He was absolutely inconsolable and hardly knew where he was. There wasn’t a comforting word or deed that I could do to calm him. His volume and requests only escalated. All 250 pairs of eyes were on us at this point. I asked the Lord for divine help in that moment. And several minutes later I was finally able to awaken Simeon enough for him to be distractible. And finally, after about 20 minutes, he fell asleep on my lap. Just in time for the door alarm to sound again.
When we FINALLY arrived in Port Moresby with only a one-hour flight to finish our long journey, we were all exhausted. With tremendous help from a couple of immigration employees we transferred all 15 of our checked bags to the domestic terminal and quickly got our boarding passes because our layover was short and we knew we’d cut it close. We finally found ourselves in the humid 85 degree domestic terminal which was packed with passengers awaiting the last flights of the day as it was now 3 PM. We waited, paced, dripped sweat, tried our hardest to keep two deliriously exhausted boys as comfortable as possible and then we waited some more. After over an hour of delay with no word about our flight and after hearing the PA announcement of three other cancelled flights we began to worry. Sure enough, when we had reached our peak frustration and exhaustion level, we heard the dreaded words. Our flight was cancelled. To put it mildly, Simeon was a basket case when he found out. Really he was just expressing exactly what the rest of us were feeling in his own four-year-old fashion. The boy SO desperately wanted to be home and now we had to sleep in a hotel and do this all over again tomorrow. “No! I am NOT going to sleep in a hotel. No, No, No!” Over and over. There was no consoling him and frankly we all felt the same! But I donned a smile and faked a good attitude to try to encourage him that it wouldn’t be so bad and we’d all be together. We received our hotel and meal vouchers and lugged all of that baggage to the door where we’d wait for our shuttle. There was a small (lightly) air conditioned room next to the exit where we settled for a bit. Simeon was still a mess, crying and so upset. There were a handful of other passengers waiting there and this sweet lady noticed Simeon, got up from her seat and walked toward him. She stretched out her arms to him and said, “Come.” He (oh so surprisingly) lifted his tired arms to her and she hoisted all 43 pounds of him to her chest where he seemed to just absolutely relax in a way he couldn’t up to that point. He stayed there for some time before finally falling asleep in my lap. Every bit of it was beautiful.



This is the only photo that I took once we found out that our flight out of Port Moresby had been cancelled. We got all of us and our luggage safely to the hotel. [This just HAPPENED to be the same day as some big riots and a couple of shootings at the University.] But, we neither heard nor saw anything concerning. We were safely tucked away in the Holiday Inn for the night. The boys were asleep on the beds instantly (only to be awakened a couple of hours later for a bath to wash off the layers of sweat and airport floor filth). But they slept the rest of the night until our 5 AM wake up call. This is us outside of the hotel waiting for the second 15-passenger van that would be our ride to the airport. We were all rested, clean and ready to be HOME! 
And in the midst of all of the chaos, I was reminded that this is Peter’s very first time to visit Papua New Guinea. I realized how excited I was for him to see this place that we love. We had a REALLY happy welcoming committee! 
And, you must remember that this is the very first time for Grandma Kathy and Grandpops Jim to meet their grandgirls in person. Wasn’t it nice of us to have a baby for each of them?!
The seating arrangements for our 1-hour drive to Kudjip were prearranged…perhaps as far back as the day these girls were born.
This is entry gate to the hospital and mission station. That building on the right is the hospital.  We were greeted by beautiful decorations and a lot of happy faces!
Generally Grandma and Grandpops live about a quarter of a mile from our house, but since their home was being remodeled when we returned, they were actually living right next door. Grandpops found this especially convenient for some early morning baby snuggles. 
I knew that when we returned to Kudjip there would be MANY helping hands. We’ve been loved in so very many ways since coming back. But I think my favorite thing is when one of our Kudjip family members takes the time to invest in our children. Emma Goossens is one of the younger examples of this! This precious young lady came to our home MANY afternoons during her summer to play with the kids and help me around the house.  
As much as possible we attempt to get out of the house. Its a challenge sometimes, but very worth it. And if there are sports involved for Ben and the boys, its even better!
This was our first Sunday morning walk to church. Or at least half of us are walking. 
With Uncle Peter often comes a good art lesson or two. 
A few weeks after our return these lovely ladies organized a baby shower in honor of Tabea and Naomi. 
If any of you ladies ever organize a baby shower, do THIS! It changed my life in our first couple of months adjusting to life with four children here (let alone, twins!).  
Baby shower attire. 
Before we knew it, Peter’s three weeks were all spent and he was headed back to the States. I love it that he knows this place now. And that he’ll definitely come back!
At the end of June, a work and witness team from Xenia Nazarene came to Kudjip. It was so fun to have Uncle Mike and Aunt Becky Hancock here along with the rest of the team. Their project during their 10 days was to work on Jim and Kathy Radcliffe’s home remodel. It was a complete gut job, so this group had their work cut out for them!
Tabea will smile at most anything. But one of her favorites is definitely Naomi.
Some of our dear missionary friends moved back to the States while we were away and they gave us their amazing popcorn machine. Thank you, Mike and Diane! To this day it has provided lots of entertainment. 
Did I mention that Emma does dishes?!  She does and its amazing. 
I tried to picture life back at Kudjip with the boys AND their new sisters. And everytime I imagined life here (at least in my dreams) it always included our Papua New Guinean friends. We had always had some help around the house, but I knew I’d need a LOT more help and probably on a daily basis. Joy has been one of the answers to my prayers about this. She loves and cares for all of us so well.  
This is the Xenia team and lots of their national friends who helped with the house. 
While Mom, Dad and Aunt Lydia were gone to take part in Priscilla and Wyatt’s wedding in Ohio, lots of folks here stepped up and filled in. We’ve had so many people in and out of our home now that anytime someone comes to our door, Matthias greets them, takes their hand and says, “Come in. Sit down.” And almost daily Simeon asks who our company will be! Aunt Judy and Uncle Andy Bennett brought us dinner once a week and Judy was a surrogate Grandma for a few weeks. 
Ben’s sister Priscilla married Wyatt Mills on July 8th!  My sister-in-law, Bethany, texted me this photo that day and it made me so happy and sad all at the same time. We knew we needed to be here for the surgical ministry at the hospital to continue, but it was so difficult to miss a family wedding.
But thank goodness for technology, because it allowed us (and some missionary friends) to watch the wedding LIVE!
Like I said, we get out as much as we can. And this double stroller is pretty much the only way it can happen. 
Here’s a diaper changing technique I’d never tried before.  
We were REALLY glad when the container with some of our “twin” things arrived, including a second crib and these high chairs.
Here’s the outside of Jim and Kathy’s house with a new coat of pain and some beautiful kwila doors. The inside is just as great.
I have this photo to document the one (and only) time we’ve all ventured out since our return. We took a “quick” trip to town for some shopping and lunch at one of the few restaurants we have here. 
Matthias had an outbreak of bug bites for a few days before we decided to undress the bunkbeds and wash and spray the mattresses. In the meantime, their room looked like this. 
Joy was singing a song about blue eyes and brown eyes.  
Frequently, Matthias wants to be a part of the sister photo shoots. 
Matthias has adjusted well to the bottom bunk. He was still sleeping in a crib until we came home this time. I suppose his cars and trucks would be quite the deterrent to rolling out of bed!
We’re enjoying life now that we’re settled and into a good routine. These four sweet children keep us so busy and so entertained. 
Lately we’ve had a couple of opportunities that have reminded us why we’re here. Sharing Christ with those who enter the walls of our hospital is one of the greatest privileges of our lives. We’re thankful for the example of Dr. Jim and for the many years that he has given to serve the Lord here. 
And what’s the end of a blog post without the latest and greatest photo of the girls??  Future posts are almost guaranteed to be shorter, but now you’re all caught up. And, if you want to stay in touch on a daily basis, feel free to find me (Katherine Stevens Radcliffe) on Facebook or (katherineradcliffe) on Instagram. 




Flashback to August 8, 2015 when we sneaked into the hospital here at Kudjip to do an ultrasound (since I’d known I was pregnant for about 3 weeks at that point). To our GREAT surprise we discovered TWO tiny babies growing in there, each with a perfect heartbeat and measuring 7-weeks size. After weeks of thinking and praying and receiving good counsel from our fellow physicians here, we decided to return to Ohio for the delivery of the babies. We wanted to stay through Christmas and enjoy that time with the entire immediate Radcliffe family who travelled great distances to be together at Kudjip. So, at 28 weeks along, we packed up our family for the five months we’d spend Stateside.
On January 6th we began our long journey back to the States where we would wait for the birth of the twins. Here we sat in the departure lounge of the airport in Mount Hagen, PNG. AND, we got to enjoy the first two legs of our journey with Uncle Josiah and his girlfriend, Sarah, who were returning to the States after spending Christmas with the entire Radcliffe crew in PNG.
Several days before departing PNG I started to experience some painful contractions which required me to take it REALLY easy and not do any heavy-lifting. We decided at the last minute that we’d need lots more help on the flights home and we recruited Aunt Cilla to join us. She was an absolute gift to us and kept us from missing at least one flight!
It took 5 planes and an overnight stop in Brisbane, Australia to get us home to Ohio, so you can imagine how excited this 28-weeks-pregnant-with-twins mama was when several of our flights had room to stretch out a bit.
After a fairly restful and uneventful overnight in Brisbane, we managed the short flight to Sydney before boarding our Airbus A380 (the world’s largest passenger airliner) for the 15 hour flight to Dallas. It never takes long for our boys to get acquainted with the technology on board. Oh, and you can’t tell from this photo, but there is actually NO SEAT in front of me. That’s right. I paid about a hundred bucks to upgrade to the one and only seat like this on the plane (its the spot for the emergency hatch to the crew cabin below). And it might just  be the best money I’ve ever spent on airline travel. 
After arriving in Dallas with only a matter of minutes to run to our connecting flight to Columbus, Ohio, we arrived breathless at the gate only to discover the flight had just departed. So our 6pm flight was changed to a 9pm flight and after some McDonald’s, sponge baths and clean jammies, we were the first to board the small, almost-empty plane. And the very kind and conscientous pilot must have noticed our kids were on their last leg (ha!) and offered for them to sit in the cockpit. Excitement abounded!
We didn’t arrive to snow-covered ground, but shortly after our arrival the boys experienced some of the white stuff for the first time in awhile. And since we lived with Grandma and Grandpa Stevens for our 5 months in Ohio, we enjoyed all the perks of their home and yard, including the fire pit!
Another beloved activity for the boys was to accompany us to ANY store in order to peruse the toy department. And (almost) always, they knew they would only get to LOOK, but they were totally okay with that. On a good day we’d spend 30-40 minutes literally looking at the two aisles of wheeled vehicles.
And with a trip to Mount Vernon comes a good bit of time at real, bonafide playgrounds.
This was the last photo taken of my growing belly before the babies came a week later.
Sunday, February 7th was Super Bowl Sunday. It was that day and the few days prior that I began to experience left side pain that felt very familiar. I had a history of kidney stones when I was pregnant with Simeon, so I was quite certain what was causing my pain. But I also knew that I was only 33 weeks along and we wanted the babies to stay put as long as possible. We were in Mount Vernon, but it didn’t take us long to determine we’d need to make the one-hour drive to Riverside Methodist Hospital in Columbus where Ben did his surgery training and where we planned to deliver the babies. I was evaluated in triage of the OB department and since I was contracting a fair bit by the time we arrived, they decided to admit me for observation. It turned out that I had multiple kidney stones in both kidneys and passing a stone was indeed the reason for my premature labor. We realized pretty quickly the next afternoon on February 8th that we wouldn’t be able to stop my labor. As is typical with twin deliveries, when we knew delivery was inevitable, I was moved to the OR in case there was a need for an emergent c-section (although both babies were head down and I was planning to attempt a natural delivery). After only a few pushes, at 9:55 pm, we found out that the first baby was a GIRL! After months of anticipation of their genders, we were thrilled to finally meet Tabea Betsy Radcliffe. She weighed 4 pounds, 10 ounces and required no major interventions after birth. We were praising the Lord as Ben texted and called a few family members quickly to give them the news. But then…on to Baby B! The resident quickly put the ultrasound on my abdomen to find that Baby B had flipped to a breech position. This led to about 10 minutes of attempts by my (very seasoned) physician to turn baby in order for me to attempt a vaginal delivery. Once it was determined that this baby was not turning, the OB/GYN was planning for a breech vaginal delivery until he realized that the baby’s umbilical cord was blocking the birth canal and a delivery at this point would be life-threatening to the baby.
So, we quickly determined to prepare for a c-section. I was transferred to the OR table, drapes and lights were positioned, and while everything was being prepared, I got to get a good look at Tabea for the first time. And then at 10:15 pm, we found out that Baby B was a GIRL too! I don’t think we ever dreamed that both were girls, but we were overjoyed when we found out.
Naomi Katherine Radcliffe weighed 4 pounds, 7 ounces and was perfect as could be! She needed some CPAP to help keep her airways open a bit after delivery, but by the next day she was weaned from the CPAP and continued to do so well. I remember asking Ben shortly after they were born whether or not the girls were identical. And he replied that they definitely did NOT look alike! We were prepared for the fact that since the girls were 7 weeks premature they’d go directly to the NICU after they were born.
After my c-section and short recovery, I was wheeled to the NICU where I got to visit the girls briefly before getting settled into the postpartum room.
Since it was flu season in Ohio, there were strict limits on visitor to the NICU. We could list only four visitors for the entirety of the girls’ stay in the NICU and no children were ever allowed to visit during flu season. So, the boys came to see Mama, but didn’t meet their sisters in person for another 4 weeks.
On Day 2 of life, Tabea had a rare few moments without any cords or tubes connected to her before her nasogastric tube and IV were replaced.
After Naomi’s CPAP mask was removed, we enjoyed seeing more of her face too.
Simeon and Matthias drove the hour with Daddy to the hospital on Valentine’s Day for lunch, a visit, and to make cards for their sisters.
These were the finished Valentine cards for the littlest Valentines!
We were only missing the two big brothers here!  This was one of the last photos in the main NICU before we were moved to C Room where we spent the remaining weeks. C Room is generally for babies that are just learning to eat and grow.
Years ago the nurses in the NICU would c0-sleep twins. Modern day medicine has changed this, but there were a few nurses who encouraged us to put them together for a bit each day and it was so fun. The girls are 20 days old here and clearly they remembered each other from the womb. They were quick to snuggle up and no part of this photo was staged.
There is something incredibly special about twins. I think I was aware of it before we knew we would have our own, but living each day with them for these six months has been a special (and most challenging) gift.
I woke up this morning and drove to the NICU as I did each day before. I had a routine by now, since I’d done this for 24 days in a row. I arrived in time for the 8 am “care” each day. The nurse and I would tag-team taking vitals, changing diapers, adjusting bed positions, baths on Wednesdays and then feeding. I was allowed to nurse the girls during 4 of the 8 cares each day. So, I spent the entire day with them in order to give them the best shot at successfully breastfeeding. By suppertime I was exhausted and made my way to one of the two homes provided for us to stay during our time in Columbus. I attempted to eat 3,000 calories a day and drink 120 ounces of water in order to maintain my milk production. It was absolutely a full-time job, but as it turned out, probably the only way that I was able to do this was because the girls were in the NICU for 4 weeks and the boys were being cared for by Ben and my parents in Mount Vernon. Anyway, on this particular day, I was anticipating that Tabea (pictured here) would be discharged as the previous day’s doctor had informed us. But as we’d experienced twice before, there was a new (more conservative) doc on this day and she decided she wanted to see Tabea have more consistent weight gain before discharging her. I was so incredibly frustrated and disappointed. I had been so patient and diligent each day, but I had reached my limit. I called Ben right away and explained it all through tears. I felt alone. He encouraged me to drive to Mount Vernon that evening after the last care and spend the night with the rest of the family. He gave such wise counsel. I went to our “home away from home” shortly after the phone call and got an overnight bag ready for my trip later that day. But as the lunch hour progressed, I found that I was having some increasing abdominal pain. It was not the typical pain that I will sometimes experience related to my Crohn’s Disease, but I was uncomfortable enough that I decided to just drive on to Mount Vernon then (knowing the nurses had plenty of frozen breast milk for the girls). The discomfort progressed to pain as I pulled into my parents’ driveway. I was greeted by two very happy boys, but I immediately had to try to get comfortable on the couch. After pumping some milk and writhing around due to the ever-increasing pain, I called Ben in to help assess me. I was starting to feel as though this pain was similar to the pain I experienced with the bowel obstruction I’d had in 2010 when I was diagnosed with Crohn’s Disease. We quickly decided that I’d need to return to Riverside (where my surgeon practices) and go to the emergency room. After a very sad goodbye to two boys I’d only seen three times in the last month, I proceeded to experience the absolute worst one-hour car ride I’ve ever experienced in my life. Increasing pain came in waves every 20-30 seconds. We finally reached the ER and since Ben had called ahead to some of his previous colleagues, I was literally in an ER bed with an IV and pain medication in a matter of minutes. And then I was on to the CT scan that indeed revealed a bowel obstruction that would require emergent surgery. My surgeon happened to be on call that night and I believe in record time I was in pre-op, on the OR table, and then in PACU before I hardly could take it all in. Of course, we were worried all along about the worst possible scenario being a Crohn’s flare. All that I remember from my post-operative time in the PACU was Dr. Toscano coming to the bedside once I was barely awake and informing me that he did everything laparoscopically because the closed-loop could simply be “untwisted” to relieve the obstruction AND he scanned the entire bowel to discover there was NO evidence of active Crohn’s Disease. Never had more reassuring words been spoken! A loop of bowel had been twisted around one solitary piece of scar tissue from my previous surgery and once the babies were delivered, the anatomy shifted enough for this to occur. We were praising the Lord that He knew just where we needed to be during this time, with access to a CT scan, my surgeon, good medications and a laparoscopic procedure. AND, can you imagine if Tabea had been discharged that morning as planned and we’d taken her home?!  The girls were still safely tucked away in the NICU and the boys with my parents.
This was my post-op room where I spent two night before being discharged in record time!
It was an incredible gift to be in the same hospital where the girls were. The day after surgery Ben wheeled me to the NICU where I received the BEST medicine.
Ben’s shirt says it all!
Four days later, and after 28 total days in the NICU, we FINALLY got to go home and introduce these sweet bundles to their family!
My brother, and our kids’ beloved Uncle Peter, had never held ONE baby this small, let alone TWO!!
And so the visiting commenced! Ben’s sister, Bekah, and her family were in town because of their daughter Sylvia’s open-heart surgery at the children’s hospital in Columbus. So we had the privilege of introducing them to the girls. We have some pictures like this of them with their identical twin girls, Dora and Sylvia, 6 years earlier! (They reminded us that they forget a LOT about those early days.)
And the fun continued for these boys as we explored a nearby “real” train!
Every once in awhile Tabea got really blessed in her sleep.
We had the privilege of getting some family photos on the girls’ due date, March 26th. Ben’s cousin’s new wife, Larisa Radcliffe, is a gifted photographer and helped to capture the look and feel of these girls at 7 weeks of age.
Every bit of this journey has been a team…or perhaps a VILLAGE effort. But if I, for one second, thought that I could have done this without Ben by my side I’d be lying to us all. We would easily classify the first 8 weeks home with these girls as the most difficult of our married lives. But with great tribulation comes the greatest blessing. I know for certain that we’ll forget the hardships, the never-ending diapers and spit-up, the constant holding and bouncing and consoling, and the utter exhaustion. But as we often remind each other, good things are still coming!
There’s hardly a caption worthy of this photo.
And Grandma Betsy has THE greatest playroom. Its so great that when we FaceTime from PNG these days, the boys ask to see the play room and all the toys.
Without fail, when one of the girls was just inconsolable, my dad would say, “Let me try.” He’d prop her against his chest like this, holding the pacifier with his left hand and he would often bounce straight up and down very gently while singing a medley of songs, which always included, but was not limited to…Oh Happy Day, Precious Name and Battle Hymn of the Republic. And without fail, in 5, 10 or 30 minutes, she’d finally calm. He was always available and always persistent.
We never planned to be back Stateside after 11 months in PNG, but one of the blessings of those five months was getting to spend time with my brother Adam and his three children. Cousins are a special thing.
I’ll never forget when Simeon was about 5 months old and I was preparing to finish up the last months of my family medicine residency. I asked around at church if there was anyone that might be willing to watch him. I was given the name Sue Noll. And here we are 4 years later and she is one of our VERY favorites. She and her husband gave us their home to use during part of our NICU time and then she drove from Columbus to Mount Vernon twice after we were home to help hold babies, play with boys, and bring us delicious food.
To this day, Simeon has held the girls only maybe a handful of times. He’s a firstborn with high expectations of himself and he admits that it makes him nervous. But, boy oh boy is he sweet with his sisters. It took him a good two months at home before he really was confident identifying them properly (despite the fact that they look VERY different), but he’d find a toy and sit next to them, often saying in the highest pitch possible, “They’re so cute!”
Matthias, on the other hand, asked frequently to hold “twooo bobby”!
We train them young to love cars. At least that’s what Matthias thinks!
We wore the girls a good bit in the first weeks. This was mostly because it was absolutely necessary if we wanted to do things like say, make supper or go on a walk.
We celebrated a lot of birthdays in Ohio this year. Matthias turned TWO. And when you have an almost four-year-old brother you’re bound to have some help opening gifts.
The girls were given a BEAUTIFUL shower by dear friends Karen Doenges, Ami Workman, Steph Diehlmann and Sonja Smith. Great Grandma Beam got a kick out of trying to hold two babies at once!
Whit’s Frozen Custard opened while we were home too. We didn’t enjoy it one single bit.
Goldfish and cars are close-at-hand when Matthias is on baby duty.
My older sister and I shared the joys of pregnancy at the same time. We were due just 3 weeks apart and here after delivering Lola Rae just two weeks earlier, she and her husband drove 7 hours to be with us before we returned to PNG.
Behind the scenes of a “triplet” photo shoot!  Tabea (L), Lola, and Naomi (R)
We had a coordinated visit with the EIGHT Stevens cousins. It only took about 65 shots and 22 Tic-Tacs to make this photo happen.
These girls were swaddled until they were 5 months old. And this was not an unusual place to find Ben.
We squeezed in a trip to Xenia with all four kids so we could visit with Great Grandma Beam and the rest of the family there. And her new kittens, of course.
Simeon turned FOUR on May 30th and we celebrated with a Paw Patrol cake with all the family!
And hardly a birthday would be complete without an ALL-FAMILY water balloon fight. Adam didn’t last long in that hammock.
When Grandma Betsy left for 10 days to be with Sarah, David and their new baby Lola in Virginia, we hardly knew what to do with ourselves! She was the constant cuddler, consoler and comic relief. Tabea seems to agree, I’d say.
Another day. Another playground. Aunt Bethany and Baby Betsy joined in on the fun!
We loved being in the same town with Great Grandma and Great Grandpa Radcliffe. And Great Grandma took every chance she could to hold these girls. We made some sweet memories.
Naomi (L) and Tabea (R) turned four-months-old just before we left the States for PNG.
It takes a good bit of work to take a family photo these days, but I say its worth every fuss and holler. Stay tuned for a photo tour of our return to PNG and all that’s happened since!

A Day in Pictures

I’ve been meaning to get this post up for over a month now but haven’t been able to get around to it.  What follows is a collection of photos from one Monday at the hospital.  This was a busy day that included forty-nine patients in the clinic, three minor procedures and two major surgeries.  Thanks to our amazing staff and my doctor colleagues I still made it home in time to play with my boys.

Monday mornings start at the Chapel with Morning Report
The chapel is one of the original build and stands at the center of the hospital grounds.
Chaplain Moses leads the staff in a devotional thought to start the week.

After morning report I head for the pediatric and medical wards to see consults and then to the surgery ward to round.  As I’m starting rounds we find out there is a cesarean section that needs to be done before I start seeing clinic patients.

The operating theatre staff (yes, the British colonial influence lives on) had the patient ready and mother and baby were soon headed back to labour and delivery safe and sound.  I couldn’t do what I do without such committed, caring and compassionate co-workers.

With the case done we all head for the surgery clinic to get started, a little late but all the patients are still there waiting.  Walking through the ER on the way I find Dr. Bill and Dr. Erin  stopping the bleeding from a patients arm who had been assaulted with a machete.  Looks like I have another case for a little later.

The rest of the morning and early afternoon are spent bouncing between the clinic and the minor procedure room.  Later in the afternoon we head to the Operating Theatre to finish patching up the man from the ER.  During the case the skies open up with a downpour, it’s finally raining in PNG again!!.  The afternoon rains also serve another purpose, they cool of the OR.

I take one last look at the ER door through the trees as I make the turn for home, hoping I don’t get called tonight. On the walk home I enjoy the views and the smell of a rainy PNG highlands afternoon. I’m almost home when I hear, “Daddy!” and see Simeon sprinting up the road towards me. It’s now a very good day. I’m grateful that we are here.

A Dry and Thirsty Land

Papua New Guinea is a land covered in mountains and rainforests.  Typically the monsoon rains roll out across the Pacific from southeast Asia and keep PNG soaked.  Our year here is marked by two seasons “rainy” and “dry.” IMG_1890 Dry season usually meaning it only rains 2-3 times per week instead of twice a day.  This year is quite different.  The monsoon season that usually will run through June ended early with very little rain in June-September. This included a five week stretch without a drop.  This abnormal weather is being caused by one of the most significant El Niño weather patterns in recent history.  While other parts of the world are flooding PNG is on pace to have one of the driest years in its’ history. Similar droughts having occurred in 1964 and 1997. In a place where almost everyone relies on their gardens for most of their staple food this is starting to become a real hardship with many families going hungry. The staple food here is kaukau, very similar to yam or sweat potato, which is harvested four times per year. DSC_5803One growing cycle has been completely lost and another is in jeopardy. Imagine how this affects a place that has no familiarity with drought and where most homes are still without electricity. This country’s ability to cope with drought and famine is not present.  We need rain and need it badly.  I can not recall every experiencing first hand how important water is. We’ve begun seeing increasing numbers of infectious diseases related to the worsening water supply.  As small streams are drying up and people are utilizing the bigger rivers nearby much more heavily the contamination in these water sources is mounting. The Kane, our river, is now so low that even with the new reservoir the hospital’s hydro is not able to produce enough electricity to keep the station and hospital powered.  We have resorted to running on generators for long stints when the water level is too low.  The hospital’s backup generator is in the process of being replaced as the current one is well beyond its’ lifespan.  Usually the generator kicks on in a few seconds when the power goes down but today the auto switch was not working. The lights were out for several minutes in the operating theatre. Today, I was thankful for battery powered headlamps and a battery backup for the anesthesia machine.  I was also reminded of one of my favorite quotes from a seasoned missionary surgeon, “Anyone can operate with the lights on.”

When you turn on your faucet and water comes out, flip on a light switch and the lights come on or enjoy the luxury of flushing a toilet,  remember to pray for rain in PNG.DSC_5800

A Matter of Prayer

In my short career as a physician I have offered to pray with countless patients.  I remember feeling a bit apprehensive about this in my early years of medical training.  Would he be offended?  Might she say ‘no’?  What if a nurse (or worse yet, my preceptor) walked in while I was praying with a patient?  But very quickly, those moments of solitude and connection with patients and their families became my own refuge.  I would look forward to opportunities to provide this gift of prayer to those who desired comfort and peace in some of the most lonesome days of their lives.  And since that very first day that I, a timid medical student, sat at the bedside of a terminal patient and prayed a quiet prayer, not one patient or family member has ever declined my offer.  I believe there’s a message there!  Particularly in the medical world, prayer opens doors and creates a space that is safe, accepting, whole and impartial.  Prayer allows for the most unique opportunity to commune with the One who makes all things new, whether in body or spirit.  Now that I’ve transitioned into this life of medical service in a mission hospital  you’d be correct to assume that the opportunities to pray with patients are countless and precious.  My challenge at the start was to learn how to pray in a new language and meaningfully express what I could easily articulate in my own language.  I still find myself paying close attention during prayers in church or when I’m working with one of our hospital chaplains as they comfort a patient.  There are certainly times when my Tok Pisin words are not enough, but thankfully, God hears prayers in all languages, including those of the heart.  In the last two weeks it seems that I’ve encountered some of my more sweet moments of connection with patients and I hope that these glimpses into my clinic exam room will serve as a reminder to pray for our work in the hospital as we minister to both the physical and spiritual needs of our patients.

IMG_1780Maria came to my clinic room with her son one morning.  As she entered the room, I hoped that she might share that she was here for an antenatal visit.  Unfortunately, this was not the case.  She was not pregnant.  For several months now she had slowly been accumulating fluid in her abdominal cavity and she also complained of right-sided pain.  She had been seen in several other medical facilities and at the last hospital where she was evaluated, she was told she likely had abdominal tuberculosis.  As I heard her story and examined her full-term-sized abdomen, the diagnosis of abdominal tuberculosis rose to the top of my differential diagnosis.  However, as I got her comfortable on the ultrasound table and moved the probe over her right-upper quadrant, the abnormal appearance of her liver suggested that her diagnosis was unlikely Tb and more likely chronic liver disease.  I had hoped it was tuberculosis, because we have treatments for this very prevalent disease.  Chronic liver disease in this middle-aged woman will come with many doctor visits and likely hospitalizations as well.  She’ll be on diuretic medications for the rest of her life and eventually this disease will likely claim her life.  I prayed with Maria that morning after sharing this news with her.  I prayed a prayer that I pray with most every patient.  “Papa God, stap klostu Maria. (Father, be near Maria.)”  In my own heartache and desperation, I’ve found that closeness and communion with my God is the only thing that brings peace beyond measure.

Nenspe is a sweet old papa who was led into my exam room by his two adult children.  He used IMG_1954his bamboo walking stick to lower himself onto the chair.  Nenspe’s daughter shared his story. For two months he’s been having increasing difficulty swallowing.  At first it was hard to swallow rice and kaukau, but now water won’t seem to stay down either.  He vomits after most meals and says food seems to get stuck in his chest.  He has been losing weight and can hardly climb small hills, let alone the mountains that he could easily manage before.  The rest of his story, my exam, and his chest x-ray confirmed what seemed most likely from the start.  Nenspe most certainly has esophageal cancer.  His children were realistic about his diagnosis and his daughter even said that Nenspe himself felt certain he had cancer.  I referred him to a nearby hospital for a barium swallow study to help confirm the diagnosis and I prescribed some mild pain medication.  The family is IMG_1955Lutheran and Nenspe has given his life to the Lord.  His son, who was present, is a pastor and felt so privileged that I would offer to pray with them.  They all prayed aloud with me and I believe the Lord heard our prayers and will answer our request for peace that passes understanding.  I asked if I could take a photo of Nenspe to share with my family and friends who will also be praying for him.  I’m grateful for the lack of privacy laws in PNG that in any developed nation would prevent me from sharing these stories and photos.  This family was thrilled to know that others would pray as well.  After I took their picture, Nenspe’s son insisted that I get in the photo as well so that he could take one with his phone and share it with their village.  Nenspe knows that this cancer will claim his life one day, but he testified that God claimed him first, so he’ll rest easy in that promise.  What a beautiful story of the surrendered life!

Matlyn was especially quiet as she made her way into my room with her grown daughter and brother. As I asked about her symptoms and what brought her to Kudjip that day, her daughter asked if she could tell the story for her mom.  About seven months ago, Matlyn felt a small lump IMG_1951in her tongue.  She ignored it at first because it was small and not all that bothersome.  But over the last few months her tongue has become more sore, firm and now she can hardly talk or swallow.  As I listened, I wondered to myself what I would find when I donned my gloves and asked her to open her mouth.  The few times that Matlyn spoke were mumbled and she had difficulty controlling her saliva.  My exam revealed what I feared…advanced tongue cancer.  The entire right side of her tongue was a solid mass which had grown into the soft tissues below, tightly tethering it.  She could not move her tongue more than a centimeter at the very tip. Unfortunately, Matlyn was not from our province and any biopsy or treatment (which was unlikely) would have to be done at the next provincial hospital. Her prognosis is dismal, but once again, I was allowed to enter into a beautiful time of prayer with this family.  As I began to pray, the daughter asked if she could share one more thing.  Matlyn is a mother of eight children, but only five are now living. Matlyn’s oldest daughter proceeded to share that Matlyn’s 17-month-old daughter passed away last week after complications from tuberculosis.  I could hardly contain my sadness as I allowed this piece of news to sink in.  In those moments, I prayed for God’s infinite grace to settle over this family and for His spirit to comfort the deepest reaches of their souls.  And what a blessing to know that those words are not empty, nor do they fall on deaf ears.  In this place, where death and tragedy are daily occurrences, I often remind patients (and myself) that God does not promise to bring complete and miraculous physical healing (although He is able), but he DOES promise to abide with us and weather the storm with our hand tightly grasped in His.  The storm may rage around us and threaten to swallow us, but our God remains a firm foundation, the hearer of our prayers.

When My Best Isn’t Good Enough

IMG_1233As a surgeon I often get to care for patients who find themselves in desperate need. One time it may be from advanced cancer, another from severe infection, and yet another due to a car accident or an act of tribal or domestic violence. These individuals come to Kudjip looking for healing as well as something or someone to ease their suffering. One of the most challenging lessons that I am learning is that not every patient can be helped. Sometimes my best as a surgeon just isn’t good enough. Too often what we have to offer in this resource-limited place just doesn’t cut it. I knew that this would be the case long before I moved back to PNG to serve. I don’t think I was naive about the reality of being a surgeon in Papua New Guinea. In the past five months I have witnessed more death on my watch than in my five years of surgical training.  I’d like to think that each of these deaths has been from advanced disease or lack of resources.  But I know there have been instances when my inexperience as a young surgeon has led me to operate when perhaps I should have waited or maybe not even gone to surgery at all. Thankfully I have an experienced, invested, and supportive senior partner who on many occasions has gotten me out of a jam or kept me from getting into one in the first place. To have my father as a partner is an incredible resource and thrill for me. He has helped me to see which patients we can help and how best to do it. And at times, he’s shown when it is best to do nothing. I am coming to realize the truth of the surgical adage that states, “The best surgeons are the ones who know when not to operate.” Its becoming clear that this wisdom comes from experience…experience that sometimes teaches unpleasant lessons.

IMG_1287As a physician I feel that I’m called to go to battle with death and disease. But as a follower of Jesus I am compelled to believe that we were not brought into existence for death and disease. The Creator’s intent was never suffering, but rather life…and life to the fullest.  Two poems have been on my mind as I have been wrestling with these concepts of life and death in this setting where they are so very tangible. These poems have crossed my mind frequently at the end of the day or in the middle of the night after a particularly difficult case or when I’ve done all I can for a patient on the ward. I’ll share portions of each that have been especially present on my mind in these days. The first is Dylan Thomas’s, “Do not go gentle into that good night.”

And you, my father, there on the sad height.                                                                                     Curse, bless, me now with your fierce tears, I pray.                                                                                 Do not go gentle into that good night.                                                                                                 Rage, rage against the dying of the light.

The second that has become so meaningful to me is Annie Flint’s, “He giveth more grace.” The second stanza has become my testimony in recent days.

When we have exhausted our store of endurance,                                                                           When our strength has failed ere the day is half done,                                                                   When we reach the end of our hoarded resources                                                                               Our Father’s full giving is only begun.                                                                                                     His love has no limits                                                                                                                                   His grace has no measure,                                                                                                                             His power, no boundary know unto men;                                                                                               For out of His infinite riches in Jesus                                                                                                         He giveth, and giveth, and giveth again.

IMG_1493I want my patients to rage against the dying of the light. My promise to them is that I will do the same. The only way I make this commitment is through my firm belief in a God who cares infinitely more for my patients than I ever can.

But He said to me, ‘My grace is sufficient for you, for My power is made perfect in weakness.’”  2 Corinthians 12:9a