The Last Day

My last day at Mukinge was bitter sweet.

On the one hand, I was excited to go home to my husband.

On the other hand, I was sorry to leave behind the work here, and the amazing doctors and nurses and students.

Me and sister Linda, one of the OR nurses

Me and Sister Mwansa (spelling?) the OR charge nurse

Me and sister Rebecca, one of the OR nurses

Me and Jolene, who keeps the OR spotless

Me and Sister Masowi (spelling?), another OR nurse

Mr. Fumpa, the Executive Director of Mukinge, who also happens to be an eye surgeon

Monday, my last full day in the OR, was probably the day where I actually felt like I was supposed to be here. The Lord gave me such enthusiasm and joy for the work. We set multiple fractures, did a skin graft on a hand, performed a C-section, and repaired a perforated peptic ulcer. And also rounded on about 30-50 patients on the wards.

Me and Dr. Missy after an emergency C-section
That is our own sweat on our scrubs-it was a hot day

An amazing Zambian lunch,which was interrupted by said C-section

I love the OR. I am never happier or closer to God than when I am in the OR. It’s a strange feeling, having your hands in someone’s abdomen. It’s strange holding a knife to skin, knowing you’re going to cause damage but the damage caused internally is far greater.

For the first time since coming to Mukinge, I felt peace being here. I felt God smiling down at me, saying, “Now you get why I brought you here.”

I probably still do not fully understand why He brought me to Mukinge. I’m sure in many years down the road He will make it clear.

However, for now, I am content to say He brought me here to humble me.

My last day at Mukinge brought its fair share of craziness. Emergency C-sections while I was left to round on the wards. Long, long hours of rounding as we had some complicated patients. Then yet another C-section while I was lecturing to nursing students.

Then the good-byes. I had to say good-bye to the OR staff. To the charge nurses of the surgical wards. To all the nursing students on male surgical ward that I had grown so fond of. Their desire to learn was infectious. It rejuvenated my desire to learn.

Me and some of the nursing students form male surgical ward

I walked around the area surrounding Mukinge today after I said my good-byes. It was hard to hold back the tears. I had just finished reading the book “To Africa with Love.” It’s about one of the surgeons, Jim Foulkes, who served here for so many years. To think that I was probably walking the same grounds as so many amazing, godly men and women who came before me was almost overwhelming.

I pray that one day, Lawrence and I will be serving the Lord somewhere like those brave doctors, nurses, teachers. Wherever the Lord calls us, I pray we do it all for His glory. For His name. For His Kingdom.

May God bless Mukinge. May God bless Zambia.

Me and Dr. Missy 

Me and Dr. Molly Lin, who came to Mukinge the week before I left

Peace out Mukinge

A typical day at Mukinge-no such thing exists

A typical day at Mukinge begins with chapel at 0730. Then the docs and clinical officers (they're the equivalent of a nurse practitioner or physician's assistant) have handoff and turnover, discussing interesting cases from the day before or cases that came in overnight. Then, if you're on the surgery team, head to the OR.

Depending on our case load for the day, we would either round before starting the cases or one of the surgeons would round while the other started cases. I guess I should introduce the surgeons I worked with: Dr. David Friend and Dr. Cath Wallis. I totally forgot to take a picture of me and Cath while I was there. My brain was quite scattered the majority of the time. Jet lag.

Patients on our male surgical ward

Some days I would go on rounds, some days (busy days) I would just start cases with either Cath or David.

Dr. Friend operating

 Disclaimer: I will be talking about some of the cases I saw while at Mukinge. If you have a weak stomach, don't read further.

General surgery at Mukinge was very different than general surgery in the states. To begin with, the only imaging we had was ultrasound and Xray. No CT, no MRI. I never realized how much surgeons in the states rely on CT until I didn't have it.

I remember one of my first cases there. We were doing clinic (Tuesdays and Thursdays), and Dr. Missy Sandberg (one of the family docs there) popped her head in (which I soon learned usually meant she was bringing us something either really bad or really fun or both). She throws up an abdominal Xray on the box. Massive amounts of free air under the diaphragm-aka somewhere along this man's GI tract there was a hole. Dr. Friend told me at Mukinge that typically meant a perforated peptic ulcer in the first part of the small intestine.

So we did a big midline incision, found the whole and patched it up. And as Dr. Cath always says, "The solution to pollution is dilution!" So yeah we had to suck bits of food out of his abdomen and wash him out with warm sterile saline.

I had so much fun operating at Mukinge. In the States, generally I would be second or third assistant. Or just standing there scrubbed in watching the operation. At Mukinge, if I was scrubbed in, I was first assistant. Which was amazing experience! I learned so much and I feel like my assisting skills increased dramatically. I've been told to be a good surgeon you first have to be a good assistant. I hope I'm on my way to being a good assistant.

I also learned that general surgeons in under-developed places in the world literally are general surgeons. In the states usually a general surgeon pretty much just operates in the abdomen.

Not at Mukinge. The number of fractures we set, burns we grafted, gynecologic and urologic procedures we did far surpassed the number of abdominal operations. Dr. Friend really likes orthopedic procedures. I learned a great deal from him. I also learned I need to work on my upper body strength. This girl doesn't hold traction very well.

A bladder stone we removed-one of my favorite procedures from my time at Mukinge

smoothing out pieces of skin to graft onto a massive burn

Probably one of my favorite moments operating with Dr. Friend was when we were doing a SIGN nail. The patient had been hit by a car while crossing the street and had broken both his legs at different places. We were able to fix one but had to wait for the orthopedic team to fix the other. So we put this big rod in his tibia (your lower leg bone). It was a difficult procedure and took longer than we expected. At the end, Dr. Friend allowed me to sew up a few of the incisions we had made. When I asked him what stitch he would like me to use, he said, "How ever the Spirit leads you." Michelle, our anesthesia nurse, and I had quite a chuckle over that one. 

Me sewing up our SIGN nail incision

Needless to say, I gained alot of experience at Mukinge. I am so thankful to God for taking me there. As Lawrence and I prepare for a life of global medicine and surgery, I am grateful to be able to look back on this experience to know what I need to be trained in before we launch. Things like burns, orthopedic procedures, urologic procedures, C-sections. I need to learn all these things or at least have some exposure to them. 

I miss operating at Mukinge. I miss operating with David and Cath and the OR team. I'm thankful to be home with my husband, but a part of my heart will always be at Mukinge. 

David, Me, Michelle

Zambia: Week 1

I’m going to be frank.

My first week in Zambia was not at all what I had anticipated.

I think I came with some sort of expectation that I would be like a hero or something. Like I would swoop in and provide all this help. That somehow Zambia needed me.

How the Lord humbled me. Zambia did not need me. I needed Zambia.

To start with, I had horrible jet lag. And almost every day, I was nauseous and had to take Zofran. One morning, I actually had to rush out of morning chapel to go dry heave and nearly passed out. Of course, the good doctors sent me home and told me to rest.

I cried myself to sleep every night for the first week, missing my husband. Wondering why on earth God brought me to this seemingly God-forsaken place? I couldn’t eat, I couldn’t sleep. Worst of all, I could not talk to my husband or family because there was no internet at my house. There were bugs and spiders everywhere.

I felt so alone. So weak. I wanted to come home. I was doubting my call to medical missions. If I couldn’t handle a few days with bad internet, bugs, and without my husband, how on earth was I going to make it as a long-term missionary?

But God.

I know we throw around the verse that says He will not give us more than we are able to bear. Honestly, I think this time, He gave me way more than I could bear. On my own. I finally, in desperation, wept aloud to Him and told Him I couldn’t bear it. I could not do this on my own. I was completely and utterly dependent on Him.

A verse I clung to during this time was 1 Peter 5:10 “And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.”

Peter probably wasn’t talking about the little sufferings of no internet, no husband, and bugs in this verse. But for some reason, it spoke to me. I think I needed this time of suffering to remind me that I am weak. Without God, I am utterly helpless.

And thank God for the wonderful doctors and nurses and team members here at Mukinge. They welcomed me with open arms, comforted me as I cried, fed me, loved me. We celebrated the little victories, wept over the losses, and praised God for sustaining us.

God didn’t bring me to Zambia because Zambia needed me. I’ve probably been more of a burden to the people here than a help. But I believe He brought me here to humble me, to bring me to my knees. To remind me of how it is only through His strength that I can do any of this.

May God forgive my pride.

My ride to Mukinge

flying over Zambia

Kasempa

My bed-with the massive mosquito net

OR 1

Where we scrub

my walk to my house

My house

My alopecia story: chapter 15,671

I haven't posted about my journey with alopecia in quite some time. Alot has happened in the past few years and seeing as I've posted pictures of my hair down to my waist and then not even an inch long, I figured I might want to update everyone.

When I came back from China, I had lost quite a bit of hair. Probably around 25-30%. It was getting difficult to hide the bald patches. I ended up trying multiple hair solutions, from extensions to actual patches of hair glued to my scalp. Soon, that wasn't enough. The disease had a mind of its own.

I'm sure the stress of medical school did not help the situation, but contrary to popular belief, stress is not the primary cause of alopecia. However, stress can definitely exacerbate a myriad of diseases.

My fear of losing all my hair had taken a deep hold in my heart. It made going out terrifying. What if someone saw? What would my patients think?

I ended up going to counseling because I could not deal with the fear, the anxiety, and the stress. And it was about the time that the alopecia began to worsen further, that Lawrence came into my life. Funny how the Lord does things like that.

Through Lawrence and my incredible counselor, the Lord began taking away my fear and anxiety. It's not easy, being a woman. Our cultures lies to us and tells us our only value is in our appearance. And despite my best efforts, I at times believed that lie.

I still remember when I had to tell Lawrence about the alopecia. It was maybe a month into our relationship, and he looked at me one evening and said, "Why don't you have little sideburns?"

I had not wanted to tell him. I was afraid he would run. I had been told by men before that they would never consider a relationship with a woman who had no hair. I figured as soon as I told him, he would take off.

I told him. And I took of my hair pieces and my headband and showed him.

His reaction was the exact opposite of what I expected. He told me he didn't care and that I was beautiful. Of course I cried. I never thought the Lord would make any man tender and caring enough to think I was beautiful with no hair. I had believed that lie, that no man could ever love me.

So, in June of 2016, I made the leap that I should have made many years ago. I shaved my head.

Lawrence sat and held my hand while they did it. I'm not going to lie, it was one of the hardest moments of my life. My mom even drove out to Memphis to be there when they did it. The emotional support I received from friends. classmates, and family was astounding. When they shaved my head, I realized how widespread by disease was.

I loved having my wig. The freedom was amazing. It was like this burden had been lifted. I look back at all the times my disease was bad and I wish I had shaved my head years ago.

Also, just an aside, having a shaved head in the OR is THE BEST. I don't get hot because of all that hair under the caps. My head can breathe!

You can also get the best head rubs with a shaved head. Just sayin'

So let me show you the progression of my disease over the past 18 months.

The day I shaved my head: June 2016

A couple months later: October 2016

in January of 2017, I noticed alot of white hair coming back into the bald spots. I call them my "little fuzzies." And then those bald patches started growing smaller. And smaller.

January 2017

Enter the wedding. I knew I needed a new wig for the wedding. So I had one custom made that was ridiculously long. Just so I had options for the wedding day.

3 hours worth of work

On our honeymoon, I started letting my hair grow out. I knew I wasn't going to take my wig to Zambia. Too much maintenance and I was afraid of sweating too much into it. Lawrence convinced me to not shave my head at all until I returned. Just to see what happened.

And hence the product you see now. For the first time in more years than I can remember, I have almost a full head of hair. My stupid eyebrows haven't seemed to come back yet. And I'm allergic to tattoo ink, so can't even get them permanently tattooed on. Oh yes, I also found out I had a bazillion allergies to various chemicals. Fun stuff.

My hair right before I left for Zambia

My hair after not shaving it for over 2 months

So there you have it. I have no idea what happened that my hair decided to grow back. Lawrence jokes that it was his calming presence in my life that appeased the alopecia.

But yes, this is the most hair I've had on my head since I was 4 or 5 years old. It's a strange disease. We'll see how long my hair sticks around this time. For now, I'm grateful to God for letting it grow back. And I'm thankful to Him for bringing such a wonderful man into my life who loves me for more than the way I look. Of course he totally digs the short hair now.