Stateside

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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.
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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.
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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!
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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.
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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. 
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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!
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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!
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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.
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And with a trip to Mount Vernon comes a good bit of time at real, bonafide playgrounds.
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This was the last photo taken of my growing belly before the babies came a week later.
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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.
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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.
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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.
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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.
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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.
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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.
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After Naomi’s CPAP mask was removed, we enjoyed seeing more of her face too.
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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.
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These were the finished Valentine cards for the littlest Valentines!
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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.
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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.
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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.
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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.
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This was my post-op room where I spent two night before being discharged in record time!
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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.
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Ben’s shirt says it all!
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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!
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My brother, and our kids’ beloved Uncle Peter, had never held ONE baby this small, let alone TWO!!
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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.)
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And the fun continued for these boys as we explored a nearby “real” train!
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Every once in awhile Tabea got really blessed in her sleep.
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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.
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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!
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There’s hardly a caption worthy of this photo.
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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.
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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.
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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.
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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.
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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!”
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Matthias, on the other hand, asked frequently to hold “twooo bobby”!
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We train them young to love cars. At least that’s what Matthias thinks!
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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.
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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.
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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!
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Whit’s Frozen Custard opened while we were home too. We didn’t enjoy it one single bit.
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Goldfish and cars are close-at-hand when Matthias is on baby duty.
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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.
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Behind the scenes of a “triplet” photo shoot!  Tabea (L), Lola, and Naomi (R)
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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.
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These girls were swaddled until they were 5 months old. And this was not an unusual place to find Ben.
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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.
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Simeon turned FOUR on May 30th and we celebrated with a Paw Patrol cake with all the family!
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And hardly a birthday would be complete without an ALL-FAMILY water balloon fight. Adam didn’t last long in that hammock.
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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.
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Another day. Another playground. Aunt Bethany and Baby Betsy joined in on the fun!
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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.
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Naomi (L) and Tabea (R) turned four-months-old just before we left the States for PNG.
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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.

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Monday mornings start at the Chapel with Morning Report
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The chapel is one of the original build and stands at the center of the hospital grounds.
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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

All in a Day’s Work…at Home

Last week we celebrated THREE months of living and serving in PNG!  There is a fairly commonly described “honeymoon phase” of the missionary life and we’re probably still in the thick of it. But as it winds down and we settle into the long-haul of our ministry here, I want to look back and remember what the “early days” looked like. And, since most of my perspective is from home these days, this particular “day in the life” post will detail our exciting lives (mostly) within these four walls. But don’t be too disappointed, as a post about a full day’s work at the hospital is on the horizon!

So, to honor this three month anniversary I’ve taken photos of an entire day of our lives. Actually, I lie. You’ll notice that the photos stop just after dinner time. And, well, the only explanation I can give is the honest truth. Ben and I were both exhausted and I forgot to take photos of bath and bedtime. And sure, I could’ve scrapped it all and started fresh the next day being sure to include every waking minute. But I didn’t want these moments to be wasted.  So, there you have it. But honestly, you didn’t miss much. Directly after dinner comes baths and within 30 minutes after baths comes the boys’ bedtime. Picture some rowdy bath-time play…followed by the donning of pajamas which often turns into a wrestling match…followed by some relieved parents as they turn out the lights and say good night to two sweet (and exhausting) children. And…you’re all caught up! And as things go around here, I’m finding my way to bed not long after the kids are settled in for the night. Afterall, our mornings do start early!

Morning
5:50 AM: Our days start early because of this guy AND the cicadas that squeal loudly at 6 AM everyday. (There have been volunteers that have come to Kudjip and wondered about the station-wide alarm system that goes off every morning at 6! Nope. Just the cicadas.)
Simeon and Matthias
6:30 AM: Its not long before Simeon asks, “Can I check on Matthias?” And Matthias is usually happy for the morning greeting!
Breakfast
7:15 AM: The sun shines brightly through the east-facing windows each morning. This particular morning we were enjoying some banana baked oatmeal, which just happens to be a favorite of Simeon and Matthias.
DSC_4445
7:50 AM: Ben unlocks his bike from the porch and rides the 1/4 mile up the hill to the hospital where surgery rounds will start at 8 AM. Simeon’s send-off goes something like this…”Bye Daddy! Have a good work!”
Morning play
8:00 AM: The boys are quick to start their play.
Breakfast dishes
8:05 AM: And I’m quick to start washing breakfast dishes! If this little chore doesn’t happen RIGHT after breakfast, surely they’ll pile up and make the lunch dishes even MORE of a chore. Go Virginia!
Jim is coming.
8:10 AM: We hear Jim, our young outside worker, walking down the hill and Simeon is quick to yell out the window, “Hi Jim! Hi Jim!”
Roast
8:30 AM: After getting Jim started on some outdoor work, including digging out a flower bed and spreading gravel on our driveway, I start thawing our dinner…which on this Thursday night will be a roast with potatoes and carrots.
Boys at play
8:45 AM: Most mornings, the boys are happy to play together, at least for a short while. This morning Simeon put on a riveting finger puppet show for Matthias.
laundry
9:00 AM: I try to get a start on the laundry for the day. Cloth diapers keep our laundry business hoppin’ but we’re very grateful for a washer and the dryer we shipped from the States (although we use our line to hang things out often as well).
Ibuprofen
9:30 AM: Shortly after Matthias goes down for his nap I get a phone call from my friend, Dr. Erin, who is looking for some ibuprofen suspension for Baby of Elizabeth (the premature son of my language tutor who is still in the hospital). There is no ibuprofen suspension left at the hospital pharmacy and this tiny baby has a heart murmur indicating a possible patent ductus arteriosus (a vessel that routes blood around the lungs before birth and USUALLY closes shortly after birth, but sometimes remains open, causing a murmur and other symptoms). A medicine like ibuprofen can help to close the blood vessel, although we had no guarantee it would help in this case, now several weeks after birth.
Dr. Erin
9:35 AM: Within minutes Dr. Erin was at our doorstep and ready to deliver the ibuprofen to the newborn nursery.
surgery
9:45 AM: And not to leave Ben out of this day, he and our volunteer surgeon, Dr. Mike Pyle, are busy sewing up a chop-chop (machete) injury.
bread
10:00 AM: Simeon has a severe peanut allergy and we can’t be certain that the bread made in the bakery in town is safe, so….I make bread…a lot. Fortunately, we have a bread machine and this makes my job MUCH easier. After 5 minutes of adding ingredients, in two hours we have fresh, warm bread. Some days I just use the bread maker to mix the dough, then I make hamburger buns or French bread, depending on the menu for the day.
Simeon and Jim
10:15 AM: Simeon gets his much-needed outdoor play alongside Jim who sometimes has to tolerate a three-year-old giving him (bossy) instructions in English which he can’t understand. “Jim, don’t make another path. Jim you can’t put those rocks there.” I have to remind Simeon frequently that Jim is doing exactly what I want him to be doing!
diapers
10:30 AM: I take an opportunity to hang the diapers on the line. Sometimes its nice to have a line under the cover of our porch for those mornings that it rains.
roast vegetables
11 AM: Matthias usually sleeps until just after 11, so I knew I had a few minutes to chop vegetables and brown the roast before he woke up. And before you get all impressed that I’m making a roast on a normal Thursday, its actually a really simple meal here that can go in the oven for hours and then its ready to pull out at dinner time. I don’t have a crockpot yet, so this is my equivalent to that.
Banana bread
11:45 AM: Did I mention we make a lot of bread. And with a hanging stalk of very ripe bananas on the front porch, our bread is often banana bread.
lunch
12:00 PM: Matthias woke from his nap just in time for lunch, which on this day was a bit of a blur. Thursday is a surgery day for Ben, so he usually just rides home between cases for a quick bite. On other days, he can relax for a few minutes and play with the boys before going back to the hospital. We had leftovers, which is often the case. But other favorite lunches include Wowbutter and honey sandwiches, macaroni and cheese and Maggi noodles (essentially ramen noodles).
cushions
12:30 PM: This is a DAILY occurrence in our living room. We build “puppy dog houses” and stacks of huge, blue pancakes. These cushions are thrown and wrestled on until someone is in tears most days. BUT, this game often buys me 30 minutes to get something else done, so I rarely complain.
kitchen
1 PM: Simeon has JUST gone down for a rest and now I’m left with THIS. But, I spy some fresh bread and a roast ready to go in the oven, so I’m one happy lady. If only Matthias could wash the pile of lunch dishes.
Matthias style
1:15 PM: I try to keep Matthias busy and entertained while I also try to accomplish a few things around the house. But on SOME days, he has a way of keeping himself busy. He is constantly bringing me shoes and hats that he wants to wear and today is no different. What can I say, he’s got style.
Daddy is home
3:15 PM: Simeon took a 2-hour nap and Matthias took a 30 minute nap, but THANK GOODNESS Daddy is home a little early from work today.
Folding laundry
3:30 PM: Our bedroom is the only place in the house that I can fold laundry without too many little hands “helping” me! But those little hands are never far away, as you can see!
Starting a walk
3:30 PM: I made Ben take a picture of us getting ready for a walk to Grandma’s house, but we had a screaming toddler and bright sun in our eyes, so this is what we got.
Grandma's house
3:35 PM: Sometimes we have to escape to Grandma and Grandpops’ house.
Masa and Matthias.
4:00 PM: Some friends were waiting on the back porch of Grandma’s house, so we joined them for a visit. This is Masa, a long-time friend of the Radcliffe family. Matthias knows no strangers and was very happy to swing with him for awhile.
Simeon playing blocks
4:10 PM: Simeon pulls out the blocks that his Daddy used to play with when he was a boy.
Joy
4:30 PM: And our other dear friend, Joy, came to visit too, so Matthias was sure to get some kisses and waves from her!
Simeon and Grandpops.
5:00 PM: Simeon ran to find Grandpops talking to a friend in front of their house. The white buildings in the distance are the hospital.
Dinner
5:45 PM: Back home for dinner of roast beef, potatoes and carrots, followed by the aforementioned post-dinner activities.

The Gift of Giving

I stood in the hallway as I watched his little hands sWilliamcavenge through his toy bins. I heard the clinking of toys. He was searching. Searching for the perfect car or truck to give to William on C ward. Although I found myself hoping he wouldn’t choose one of his favorites (afterall, did his almost-three-year-old little mind REALLY understand that this was a gift…as in…gone forever). But as soon as that thought entered my mind, I was quickly reminded that this was HIS idea. When I informed Simeon earlier in the morning that today we’d visit the surgery ward and some sick children that Daddy had helped to take care of, I asked him what he thought we could take to those kids to make them happy. I also told him specifically about William, a 6 year-old-boy, who three weeks ago was walking home from school when his feet and the bottom of both legs were run over by a Land Cruiser. Of course, Simeon has a fascination with all trucks, so that led to a lengthy conversation about the specifics of a Land Cruiser. I informed him that its the same type of truck that we have here on the Station and that he’s ridden in many times and he seemed satisfied with that. He asked curiously about William’s injuries and I explained that he had broken the bones in his lower left leg and foot and that he lost his skin on both feet as well.  (Simeon is quite used to medical talk, given that he’s the child of two physicians and the grandson of one too and he is ALWAYS curious and asking about scratches or marks on someone’s body and wondering if they need some cream to make it feel better.) So, as I shared matter-of-factly about William, he listened intently. I asked him if he’d like to take a gift to William. I tried to explain (in several different ways) that whatever he gave to William would be William’s toy forever. He’d take it home to his house when he left the hospital.  Simeon didn’t seem bothered by this at all and actually seemed eager to share something with “his friend.” He had two ideas—a lollipop (thanks to the recent box we got from Ohio) and a truck. It was at this point I realized we were about to have our first lesson in gift-giving. The lollipop was an easy one and he was frequently happy to share his food treats with friends and family. The truck, on the other hand, might get a little dicey. Simeon has a fiercely strong loveSimeon on ward (bordering on obsession) with any wheeled vehicle and when he suggested he’d like to give a car or a truck I worried that it might be harder than he thought. I just decided I’d let him lead the way and as he emerged from his bedroom with a (previously favorite) blue HotWheels truck I explained again that this was going to be a GIFT and William would get to keep it.  He smiled and nodded and I knew at that moment that he got it.  I was proud as proud could be and couldn’t wait to see the look on his face when he got to experience the true joy of giving that sweet little sacrificial gift.  I loaded the dum-dum’s, blue truck and the two boys into the stroller to make our 1/4 mile journey to the hospital.

Ben met us in the breezeway outside of C ward. I was behind him with thSimeon giving his care stroller when Simeon hollered back and excitedly waved me into the ward, “Come on Mama!”  William was in the far back corner of the ward. We made our way past the two rows of beds filled with sick, but smiling patients and their families. Simeon and Matthias were (of course) the
main event as we strolled through the center aisle. With very little prompting, Simeon gave his sweet little wave and said “apinun” (the afternoon greeting here). The Papua New Guinean people love to shakeWilliam with the blue truck hands and both boys obliged. We finally reached William’s bed where he was joined by his mother and younger sibling. He is one of five children. Simeon stood sweetly at the side of his bed and gladly shook his hand. William was quiet, but did seem interested in this little white boy who had come to visit him. His mother was delighted and grinned from ear to ear. I handed Simeon the prized blue truck and he knew JUST what to do with it. Without a moment’s hesitation he put that truck in William’s little hand and then glanced back at me and smiled.  He reminded me about the lollipops and I encouraged him to give one to William which he did with somewhat serious determination. After we sang a song with William we decided we had enouSimeon handing out lollisgh suckers for the rest of the children on the ward and Simeon very willingly handed one to each outstretched hand. Its easy to think that Simeon couldn’t possibly know the joy he shared with those children, but then I remember that Simeon himself can easily be overwhelmed with joy at the sight of a lollipop! He was doing EXACTLY what I’d hoped he could do. He was giving to them some of the things that he loved very most in life. And he reveled in every minute of it.

As we were getting rSimeon handing out a lollieady to leave the ward we decided to sing one last song with the patients. Its one of the pidgin songs that Simeon has been singing for months now—Jisas Laikim Olgeta. Its a simple song with a simple message of Jesus’ love for all of us. There’s nothing profound about it, but as we stood around the beds of these sick men, women and children, their smiles and joy were a testament to God’s love for us. We went to give gifts and spread cheer, but in the end we were given an even greater gift of fellowship with some very precious people.