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A New Kind of Healer

Linda's Orchid

The other day I ran into a co-worker who had just returned from a trip to India. He and his wife go every year to study Ayurveda, the traditional medicine of India. Ayurveda tries to recreate harmony in the body through a healthy balance of nutrition, movement and rest.

Robert asked me where I had been the past few months and we discussed my time in Uganda. We talked about how, in spite of the extreme poverty and suffering, the inhabitants of both India and Uganda are known to be happy and generous people who realize the importance of addressing spiritual healing.

We both work in mainstream healthcare, yet Robert is using his income to open an Ayurvedic medical clinic with his wife. He is so excited about the new kind of “healer” he is becoming because, as both of us have seen, the body does not heal if the underlying problem is not addressed.

Robert’s time spent in India and my time in Uganda taught us one very important lesson: Our training does not make us healers. What we know is less important than what we have lived, and our knowledge is worthless without the compassion and understanding that comes from having walked a similar path.

We become healers through our willingness to be used by God, to hold a sacred space for others that takes the emphasis away from the tasks of our work, and focuses instead on the testimony of our wounds.

Wounded healers can offer not only empathy, but hope.

Rachel Remen, M.D reminds of this:

“It is the wisdom gained from our wounds and from our own experiences of suffering that makes us able to heal. Expertise cures, but wounded people can best be healed by other wounded people. Only other wounded people can understand what is needed, for the healing of suffering is compassion, not expertise.”

A reminder that our relationships with others hold unimaginable possibilities – the blessing of touch, the grace of forgiveness, and the kindness of being accepted just as we are.

1 Peter 2:24  ” …by His wounds you are healed…” (NLT)

Last Minute Love Letter

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I have a letter to my family that I keep in a gray, fireproof box.

The state calls it an Advanced Directive. I call it a Love Letter.

I have watched enough dying to know how I want to live….and how I want to die.

I have known patients whose love was brave enough to face the hard questions so their family didn’t have to; and I have been with family members who agonized over whether they had made the right decision in those last, desperate moments of panic.

My grandmother didn’t need an Advanced Directive. She was 92 years old and living in a nursing home. She told my mom she was tired and wanted to take a nap. Thirty minutes later she passed peacefully in her sleep.

My mother was always healthy and always practical. She had filled out an Advanced Directive decades before she ever needed one. She wanted us to know her wishes so she told us where she kept the original and gave copies to her doctor and to each of her children. She was healthy until she was 82 years old and had her first stroke. When her second stroke came less than a year later, the neurologist told me she would not recover this time, that her brain would continue to bleed and her bodily functions  shut down. He gave us the option of putting in a feeding tube to prolong her life.

My mother was awake and alert when I told her what the doctor had said. Unable to speak or move, she was still able to understand, and even though we had talked often about her wishes, now was when it really mattered. Even though I knew what her answer would be, I asked her if she wanted the doctor to put in a feeding tube. She mouthed the word “No” and shaking her head said, “Take me home.”

My mother fell into a deep sleep and peacefully died at home 4 days later, just as she had requested. She was surrounded by her family in a room filled with prayer, music and candlelight.

My sister died 2 years ago today, and she is the reason I am writing this.

How my sister died is the reason we all need to have an Advanced Directive.

You see, my sister had been on life support for two weeks before I even knew she was in the hospital. She did not have an Advanced Directive, even though she had been very, very ill for over 3 years, bedridden with chronic, degenerative disease from which she would not recover. She spent the last years of her life in and out of nursing homes, the last having a locked psychiatric unit – because that’s just how sick she was.

In previous years, I had brought up the subject of putting her last wishes in writing when she could still understand what an Advanced Directive meant. But she never wanted to talk about it.

A few weeks before she died, she came down with pneumonia and landed in a hospital emergency room.

Pneumonia has been described as one of the more peaceful and least painful ways for the body to die. Dr. Ira Byock, Director of Palliative Care at Dartmouth Hitchcock Medical Center says,

“The human body is hardwired with a variety of ways to shut itself down naturally, and pneumonia is one of its least painful exit strategies. It’s also one of the most treatable, so doctors rush in to intervene, and each regimen–antibiotics, ventilators, surgery – forces the body of a critically ill patient to find a more painful way to die.”

As is typical with pneumonia, my sister’s oxygen levels were dropping. She was having trouble breathing so the doctors cut a hole in her neck to insert a tube into her airway and hooked her up to a ventilator that would breathe for her. They did this (her nurse told me later) even as she screamed at them to stop. She was not out of her mind, she was just tired of fighting her illness and did not want any more medical intervention.

But there were no documents supporting her decision. And sadly, practicing medicine has become more about protecting ourselves from lawsuits than asking if we are doing what is ethically right for this patient at this point in her disease. So, numerous other lines and monitors and tubes followed, to breathe for her, feed her, keep her hydrated, give her medications, monitor her heart, and record her brain activity. She was technically alive, but only with the help of the machines she was attached to.

An Advanced Directive could have prevented this– not her death – but how she died.

She still would have died, just not the way she did.

The way she died wasn’t just awful for her, it was awful for me and it was horrific for her husband.

It was excruciatingly painful for those of us who had to make the decision to take her off life-support – to make decisions that could have and should have been discussed and decided before they were ever needed and even if they were never needed.

You may not know this, but it’s a lot easier to put someone on life support than to take  them off. Not just emotionally or ethically – but legally.

People don’t like to think about it or talk about it, but the reality is, every one of us is dying. At some point we are called home. We may fall asleep peacefully, or we may have a chronic disease that gives us some time to plan, or much more likely, we won’t have any time to plan.

Either way, if there are people who love us and who would be shattered by having to make those hard choices for us, then the most loving thing is to decide for ourselves. Today. Ahead of time. In advance. Hoping that we never need to use it…

Because to put our love in writing is to save others from having to live with doubt or guilt that maybe, just maybe, it wasn’t the right choice. And it’s those unanswered questions that keep us awake at night.

You don’t need a lawyer or a notary to write an Advanced Directive.
It’s not hard to find and it’s not hard to fill out.

But it becomes very hard for the people you leave behind if you don’t fill one out.
So, if you can’t do this for yourself, do this for them.
They will want to know they honored your wishes.
They will want to know they made the right decision.
Don’t let them down.

 

 

 

Just Google “Advanced Directive” or “Living Will” or pick up a hard copy at your local hospital or doctor’s office.

800 Pages

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Two days ago a heavy box requiring my signature was delivered to my door. The box contained eight-hundred pages of medical records from the last year of my sister’s life. Just one year of her life.

How many pages compose a life? I like to read books that are thick and heavy. I feel cheated by slim ones with too-few chapters. So is a life any less lived or worthy if it is short on experience but heavy on character? Are lives truly ever wasted or can we find meaning in a life that ends too soon? Surely this heavy box, stamped and certified will have the answer.

I want these eight-hundred pages to tell me how it started, the wall-staring, the flesh-tearing descent. How quickly grief remembers the first of it, the subtle details: She would not come to the phone. She refused to get out of bed. She stopped taking her child to school. When I think of how the very nature of love is to fear loss, I must ask how it must have felt to see the ones she loved go on living without her – in spite of her.

Did she not see the outstretched hands that tried to pull her back?

It must be possible for the crushing weight of despair to make marking time as little more than counting shadows, a pain so deep it leaves gaping wounds to physically witness grief. And I hold my breath, afraid to ask or even wonder, if she ever tried to get up again, too late realizing she no longer had the strength or a reason to.

These pages are efficiently filled – with time stamps and signatures – but there are no answers here. These pages testify to all that was done right, but they cannot tell me the moment when it all went wrong. The pages chronicle how a life ended, but not why it chose to.

How, I ask, can God look at all of this – even this – and say that this is good?

I believe if I could see with God’s eyes, I would see that this is good. God is good. Always. All the time. And I will continue to say this, even when it doesn’t always feel true. Truth is not a feeling. Perhaps I cannot see through this in this moment, but it really doesn’t matter: Faith is believing God even when I cannot see Him.

In the end, we can trust an empty unknown rather than fill it with fears never realized, answers that do not soothe or comfort, resting our faith on a dependable Father whose children have never known want.

We can be held even as wanderers, not knowing where God leads, yet trusting He knows the way. For to receive God’s love does not require effort, but abandoning all but His embrace.

Where then, does love go when we die?

Love is not blind, however impractical. Love may see defeat and failure yet still stand and wait and hope, believing that a miracle can still happen. Love may bargain or negotiate with God, hoping He will agree to what we promise to surrender in return for a life restored. But even on knees of desperation we must eventually look up, like flowers turning their faces toward the sun, allowing Light to warm us with the understanding that to leave a badly broken body and not look back – this is the healing, this is the miracle we prayed for. And we are already healed.

My sister left so quickly once she knew she could. When earthly love relinquished its’ grasp and met the heart of Heaven’s embrace. For if we believe that God exists, then we must also know His love waits for us, longs for us to return to Him. Death is not defeat, for we do not give up. We go home.

Every life is valuable, and I have hope that the pages missing from my sister’s life, will doubly fill and transform mine. God is faithful, not because of who we are or anything we may have done, but because of who He is.

We may forget ourselves, but God will never forget us. He is still our loving Father even when we forget that we are His child.

When we do unravel or lose our way, God is there. When time is marked by unchanged walls, when we are broken or confused, when we are lost even to ourselves, God will find us there. He can reach us no matter how deeply we have fallen or how dark it is.

And as He holds us, even in darkness, we will know Him.

 

For I am convinced that neither death nor life,
Neither angels nor demons, neither the present nor the future,
Nor any powers, neither height nor depth, nor anything else in all creation,
Will be able to separate us from the love of God that is in Christ Jesus our Lord.
(Romans 8: 38-39)

 

 

Transformation

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I woke up feeling irritable and tired, a deep ache in my bones that did not resolve with heat or coffee. Even my bible felt too heavy.

There is a despair that sometimes visits me and it’s hard to tell if it’s depression or simply fatigue. But it has value. It makes me vulnerable and real and honest and helps me talk out loud to God without feeling silly. “How did I end up here again? I thought it would be different now. Why do You expect so much of me and how can I do anything when I feel this bad all the time?”

Silence.

I thought about what what I might be doing wrong. (I always assume I’m doing something wrong.) I wondered why God wouldn’t let me just stop – not just working – but living. Sometimes it’s just too hard to keep trying to do the right thing.

But then I realized I was looking at it all wrong, that is, thinking that anything I could ever do on my own strength would be worthwhile.

Agnes Gonxha Bojaxhiu called herself “a pencil in God’s hand.” She knew what it meant to allow God to use you, to change you. Her belief led to her transformation into one of the most potent examples of Christ-like love on earth. Most of us know her as Mother Theresa.

Transformation is defined as “changing in composition or structure, outward form or appearance”. It also means to change in character or condition. The Business dictionary defines transformation, in an organizational context, as a “process of profound and radical change that orients an organization in a new direction and takes it to an entirely different level of effectiveness”.  Boring, but I like it.

Perhaps by changing the words I can make it more personal: A process of intense and revolutionary change that turns us around and sets us on a completely new path with a “fully equipped” and entirely different level of worth, significance and effectiveness. So much better than the basic model.

Jesus was certainly our best example of how love can transform people. He looked beyond what was lacking and loved people into wholeness. And He sees our ultimate potential and promise underneath the wounded, imperfect armor we wear.

He was the ultimate Resolutionary.

No, I didn’t misspell it, I simply found a word that suited me. “Resolutionary”

Revolution vs. Resolution: where Revolution is defined as an uprising, upheaval, transformation, change and Resolution is defined as determination, perseverance, purpose, promise.

Jesus, the Resolutionary, is the One who up-ends our lives with a  transformation of purpose, a riot of possibility, and our full potential to rise up with determination and promise. He sees that there is the tiniest space, a sliver of a void that is the ending of who we are and who we can become – if we allow Him to heal us.

Spiritual transformation is always personal. My Shepherd says to me:

“Do you really want to be healed and whole? Then stretch out your hand, reach out for me as I am reaching out for you. I love the imperfect mess you are, and because I love you I give you the grace to choose.”

The gift of freewill is just that – a gift. He wants us to choose him. Didn’t I want my husband to choose me? Love me freely without being talked into it? Didn’t I want to be his pearl, his chosen bride? And so Jesus wants me to choose Him. He doesn’t want me to settle for him, think he’s the best I can probably do for myself. He wants me to say Forever. For always. For keeps.

So yes, I do choose you Jesus – as my Savior, my Beloved, my Bridegroom. And I  choose your best for me whatever that may be. I trust you to love me enough to change and transform me into Your vision and dream for me, rather than my limited vision of myself.  To you I am a pearl, a “pearl of great price” that you gave all You had for.

If You think I was worth dying for, then I can believe You are worth living for.

Healing in Uganda Part 2

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Today I’m on the ward with the children who have been discharged from the ICU. During rounds I watch Dr. John, one of the neurosurgeons, discuss each child with the medical officers. He greets each mother and says “Are you happy today mama?”  He explains in very simple terms what is happening and what they can expect. He tells one mother she can take her baby home now, but she will need to come back in a week for further treatment. The mother cries and tells him she cannot afford the 8,000 Shillings (about $5) to ride the bus to go home and then back. Sometimes this happens and CURE will let them stay over. Sometimes the women have no home to return to.

A baby was brought in last night with sepsis. His mother was putting cow dung on his umbilical cord because she thought it would dry and fall off more quickly. The antibiotics that were started here could do nothing for the massive infection and the baby died. Four more die by the end of my first week.

On Thursday I observed a craniotomy on a 2 month old. I asked the surgeon if the baby was dropped? How did he get this head injury? In the US we would probably assume child abuse for this sort of head injury. He told me the child’s house fell on him. Many of these people live in mud and straw huts, and when the rains come the roof caves in  and the houses fall apart. So sad.

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The OR had a full schedule of surgeries yesterday so the PICU is full.  Today there is no water. I am told the tanks have run dry. The surgeries scheduled for today will have to be pushed back until tomorrow. The mothers have traveled so far to be here and then they must wait. We are never sure if the water or power will be off, or what child will develop a fever and be too sick for surgery.

I meet a woman from Sudan. Her daughter is 17 and has a brain tumor. Once a healthy teenager, she is now deaf and blind. Her words are unintelligible. The family did not know to take her to a doctor when she lost focus in one eye, but when she went blind and her behavior changed, they had to. Even then they could not come right away because they did not have the money to travel. Today the surgeons will try to remove the tumor, but are not sure if it will restore her sight.

Another young mother tells me her back is hurting. I know it must be painful because she never talks about herself, only her daughter “Mercy.” I can’t help but wonder if her back hurts from her cramped bed, from lifting her 4 year old daughter heavy with hydrocephalus or because she is so worried about Mercy’s surgery tomorrow. The mothers come with their babies and rarely does anyone accompany them. Such a heavy emotional load for a young mother to bear alone.

In the next bed is a 1 month old baby who looks chubby and has a healthy cry. He has myelomeningocele, a condition where the neural tube in the spine fails to close. He is having surgery tomorrow also. I see his Mom struggle to keep him dry, but there are no diapers, cloth or disposable. The mothers use thin rags from torn up sheets that they wash when they are soiled and then use again. Not the best for preventing infection when your spine has a hole in it. Children with this condition are incontinent of urine and stool and have a constant stream of both. The mothers simply keep wiping it away. It’s almost impossible to keep their incision clean.

I spend the afternoon cutting my brand new, lightweight flannel robe from Land’s End into large squares. The material is absolutely perfect for soft diapers – even if it is magenta. I can’t help but giggle as I think how silly it was to bring a flannel robe to such a hot and humid country. Now it makes perfect sense.

Healing in Uganda

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It is 5am and I know this because I hear the Adhan, the morning call to prayer coming from the mosque a block away. Here in Mbale, it doesn’t matter that my phone has died and I have no alarm clock. The Adhan or local rooster will wake me every morning. I am in Uganda, at CURE Children’s hospital in Uganda. Today I will meet the two neurosurgeons who perform life-changing surgery every day. The doctors round at 7:30am, then meet in the chapel at 8:00 for morning prayers. There are bibles on every other chair, tattered and worn, some missing covers. They have been well loved.

I meet the nurses and other staff. They are so kind and humble. One says, ”She is here to teach us how to do better.” The truth is, I have much to learn from them. I meet Miriam, the hospital’s Spiritual Director. I ask her what she does on an average day. She tells me, “I sit with every mother and child and just listen. The mama she has so much sorrow to share. I pray with them, with every one of them“. Miriam expresses her dismay when I tell her we have hospital chaplains, but they only come at the patient or family’s request. “Who attends to the spiritual healing?” She asks, “How can the patient heal if the spiritual is not addressed?” I agree with her and I ask her what is most needed, what is the most important thing for me to do while I’m here?  “Hold their babies, love them” she says, “No one in their village will touch them because they think they are bewitched. They need your heart and your hands much more than your head. Your presence is enough.”

The neurosurgeons are John and Peter. They have me stand behind them as they operate, explaining each anatomical structure and procedure. They do the most intricate part of the surgery in the dark. There is a light over the incision point, but they are looking straight ahead at a monitor, their hands like a typist whose fingers tap the keyboard while her eyes stare at the page. I believe they could do this in their sleep.

These doctors have every reason not to be humble, but they are. They are kind to patients and staff. There is compassion in their eyes. I am moved at how they give God all the credit for a patient’s healing. I hear Dr. John singing “How Great Thou Art” in an off-key but sincere falsetto as he works. Dr. Peter has gospel music playing full-blast in the OR and he and the staff sing while they work.

But what makes me cry is when the lights are dimmed, and before any incision is made, the entire surgical team bows their heads in prayer: A heartfelt, out-loud, specifically for this child prayer. They ask God for his help. And this is what they do before every surgery – ask God for His mercy, to heal this child. They acknowledge God as the only true source of healing, remembering that their skillful hands are simply God’s instrument. And in that moment of quiet with the lights dim, the surgical suite becomes a sanctuary, a holy place. There is a calm, a peace and an undeniable healing presence.

Each of these tiny patients has a name, a family, a story. And although state of the art neurosurgery is being done here, even more evident is the spiritual transformation taking place. These children can return home, go to school and live a productive life. No longer will they be looked upon by their community as cursed. Instead, they are a miracle.

Grace

The walking wounded. I see them every day, emotionally spent, tired of trying, and ready to give up. Physically, stress has taken its toll on their bodies and they are overwhelmed by  the demands of others. Because of their kind and giving nature, they are the ones that others rely on and constantly turn to.  And it never ends until one day it’s just too much – they  break.

This is how good people go bad. They walk out on their relationships, their  jobs, they make poor choices….sometimes they close their hearts….all because they thought that God expected all this “doing” of them.

A crucial part of our healing is to recognize that God does not expect this of us. He asks only that we put  Him first in our lives and love each another. It’s really just that simple. When we love and honor God with our lives, then the “doing” comes from an overflow, not an empty, broken  vessel.

God wants only the best for his children. He does not want us to exhaust ourselves to the point of mental and physical breakdown in order to gain his approval. We make it difficult. We forget the price for our imperfection  has already been paid. We need only accept this gift and rest in His grace.

Jan Johnson reminds us of this:

” Life is a journey of coming to know God, not achieving or gaining others approval. Letting go is both too simple and too difficult. It looks like weakness instead of strength, like losing instead of winning,..yet it is in responding to God’s call to surrender that forces me to value my brokeness as well as my strength.”

As children of God, we can be assured that we are cherished and loved. We don’t have to earn God’s love, nor do we need to punish ourselves by rushing and working and worrying ourselves to the point of collapse to prove that we are enough. God has already said that we are.

Here is a statement that changed my life. Repeat this out loud until you believe it: Who I am in Christ is more important than anything I could ever do for him.