Wednesday, September 14, 2016

A "widow's" offering

Mark 12:41- 44 - Is the story of the widow's offering, where all the rich people put in large amounts of money, but Jesus sees a poor widow put in two small copper coins and calls his disciples over.  He says, "I tell you the truth, this poor widow has put more into the treasury than all the others.  They gave out of their wealth, but she, out of her poverty, put in everything - all she has to live on."

Today, I witnessed a "widow's offering" and I was blown away.  Today was the last day of the Crusade that Immanuel Church (the local PNG station church) was having, ending a week of nighttime services with the theme of "Say NO! To Sin."  Today was the day of for the Thanksgiving offering.  The altar area was lined with sugarcane, papaya, bananas, chickens, cabbage, onions and more.  Outside of the offering from everyone's gardens, there was a time to give into the offering plate that was placed in the center of the tent. 

As the offertory song was playing missionaries, nurses, nursing tutors, teachers, security guards, cleaners, chaplains and their kids stood up, formed some semblance of a line and made their way to the box to put their offering inside.  Sitting just in front of me a bit was a young boy (maybe 10 yo) named Kua. 

For the past 3 months, Kua's home has been Nazarene Hospital.  He was hit by a car and brought to our hospital and has lived here ever since.  We initially weren't sure how well he would do, since he sustained fractures of both legs, and bad lacerations to his head and face, but 3 months later, he is improving and getting closer to going home.  His fractures have healed, he is walking with crutches and I every time I see him, he is smiling. 

As I was walking back from placing my offering, I saw Kua start to move his crutches and I thought to myself, certainly, he is just moving his crutches out of the way so other's don't step on them, he isn't going up, is he?  I walked by him and sat down in my chair 2 rows behind him, watching him the whole time.  As I sat there, I realized that he wasn't moving his crutches out of the way, he was moving his crutches to get up.  Slowly, but surely, he made his way from his seated position to standing with his crutches, his sister close behind him, and then he joined the line.  Tears started streaming down my face, as I watched this boy go up and give his offering to God. 

Compared to Kua, all those who had gone before, were the rich in PNG - those with jobs, those who got fortnightly payment from the Hospital or the locals schools.  They gave out of their wealth, but as I stood watching Kua, I knew he was giving out of his poverty.  I don't know how much he gave, or if he gave everything like the widow did, but anything he gave was a sacrifice. 

Kua's family isn't rich, they don't have a regular paying job, they have found ways to keep Kua fed while he has been in the hospital, they have found ways to make sure he has clothes - but he is poor, very poor.  Yet, despite the little he has, he gave.  He gave out of his poverty, and seemingly joyfully and very happily and willingly.  

Jim Radcliffe, who has served at Kudjip for over 31 yrs was sitting next to me during the service and as folks were worshipping the Lord and the line was starting to form for the offering, he leaned over and said, "Doesn't this make you glad you are a missionary."  I hadn't thought about it before, but the reason we had a tent Crusade, that we had 100s of people at the service, that people were giving to Missions was because almost 60 years ago the first Nazarene Missionaries came to Kudjip and as a result of that the word of God has spread.  There are 100s of churches in PNG, all of which started because years ago Sydney and Wanda Knox obeyed God and came to PNG as missionaries.  The seeds they planted have born fruit over and over again, and kids like Kua and others are hearing about God's love and giving what they have to help that continue, and I get to be a part of it.  I get to try to continue to help share and show God's word and love with those who come to the Kudjip Nazarene Hospital each day - what a privilege.

As Kua got up and gave his offering, and the tears were streaming down my face, I couldn't help but ask God if I was being obedient to all God was asking of me with my money, my time, myself, my life, my career, my heart to Him, etc.  What we give to God and what God asks of us looks different for each of us and that is okay, but like the widow and Kua, we have to be willing to give it all, and be obedient to what He is asking of us.  Are you? 

Friday, September 9, 2016

Mystery Solved

He had been running and playing, he was talking and acting normal, and then his body started to tighten up and he started to shake.  He slept for a while and then it happened again, and again and again.  When he was brought to the ER, he had been having seizures for most of the day and he looked really really sick.  Dr. Bill was called to assess him and knew this kid was in trouble.  The nurses got an IV going and he ordered some medicines, and then tried to figure out what had happened.  He attempted to get the history from those who brought him up, but all he knew was that he had been well and now he was close to death.  Bill's mind went to poisoning, he asked the family if the kids ate wild beans (which can cause cyanide poisoning), asked if he had taken any medicine, but got "No" to each question.

With no clear cause, Bill admitted him to the pediatric ward, praying the medicine he gave him would keep him from seizing again overnight, and that something might be clearer the next day.  I was rounding on the pediatric ward and so Bill filled me in on what had happened the night before.  As I looked at the ward, I saw this 2yo boy (Jordan) laying still as can be on the bed, IV fluid running into his arm. Mom reported he had only one more seizure overnight and had just slept.  I explained that I needed to try and figure out why he was seizing and needed to take some fluid from his back, she was okay with that.  As I did the lumbar puncture, he didn't move - not even a flinch.  He just was still as can be - this was a bad sign.  No movement from a kid when a needle is put into their body is never a good sign.  The fluid looked clear, but I wasn't very optimistic about his prognosis, thinking he had some sort of brain tumor or other horrible condition causing him to be this sick.

The next day, I came onto the ward and started seeing the kids on the opposite side of the ward first.  As I was rounding, I kept hearing a little boy talking, yelling at times, but I didn't think much of it.  Then I started to get closer to his bed, and heard the talking and yelling louder and as I looked up to see which kid was making all the noise, I realized it was Jordan.  I smiled, enjoying hearing him talking, thankful he was better.

When I got to his bed, he got quiet and wouldn't talk to me.  I asked his mom why he was yelling and she said he wanted the IV out and wanted to get off the bed.  WOW - yesterday he laid as still as could be when I poked a needle in his back and today he wants to run and play.  I asked if he had any seizures, nope, he woke up the afternoon before and started talking and eating and was back to normal.  I was speechless and thankful.

Grandma was there and she had a bottle in her hand and wanted to show it to me.  She said that Jordan had gone with her to the river and had carried her medicine with him.  When they got to the river, she was busy washing the kaukau and Jordan was playing with another child, and later on when she got closer to him she found her medicine on the ground and picked it back up and put it in the bottle and they came home.  He started having seizures the next day, but it wasn't until he woke up and started talking that he told her that he took her medicine.

The mystery was solved.  Jordan didn't have a horrible brain tumor or infection causing his seizures, he just took his grandma's medicine which caused the seizures and once it was out of his body, he was better.  Our pharmacy doesn't have childproof bottles, we have plastic bags and small glass bottles with rubber stoppers that we put medicines in.  Like all hospitals in PNG, we do the best we can with what we have, even if it isn't ideal.  We will continue to instruct patients to keep the medicines away from their kids in hopes that this doesn't happen again.

Saturday, September 3, 2016

A better way?

A 4 yo boy ran onto the pediatric ward and beelined for bed number 16.  As he got closer, he ran up to the head of the bed and his face brightened up when he saw his sister's face, and then he started talking a mile a minute.  Her face brightened up too, at the sight of her brother.  I smiled as I observed their love for one another.

The sight brought joy and sadness to my heart at the same time, as her prognosis isn't good.  Anita is 7yo and 2 days ago her legs became so weak that she couldn't walk and her arms became weak so that she can barely raise them.  As her brother is running around her bed, she is laying on her side and can't move out of that position without her mom or dad helping her. 

Anita just came to us the day before, and all blood work only confirmed my suspicion that Anita is suffering from GBS - Guillian Barre Syndrome.  GBS is a condition that causes paralysis that often progresses from the legs to the arms and if it gets to the muscles that help us breathe, it often causes death.  In our situation here, we have no medicine to alter the course of the disease and we have no ventilator to help someone breathe, if their muscles quit working.  Most of our success with GBS comes from the patients who don't need a ventilator, as ventilators in PNG are quite challenging. 
As her doctor, my job is to try and provide Anita with the best care we can.  As I looked at her and her brother, I knew I wanted to give her every shot she had at making it.  Her best shot at making it, was to be at a hospital that had the ability to breathe for her, if she couldn't.  It is quite difficult to make that transfer when someone already requires assisted breathing, so I contacted nearby hospitals to see if they take this girl now, in case she would need intubated later that day or night.  Getting a positive response from one of the hospitals, I went to the family to explain what their options were. 

The language of Tok Pisin is made up of about 1000 words.  With the limited number of words, there isn't a specific word for each word in the English language, so most concepts are communicated by describing the word or words you are wanting to say.   This often gets the concept across without specifics or details.  It works, but it has limitations. 

Knowing that this was going to be hard to communicate to the family, I asked our Pediatric Nursing Supervisor to help me communicate clearly to the family.  I would talk and at times the nurse would repeat what I said in Tok Ples (specific language of the village or area, often more specific).  They asked questions and we repeated things numerous times. 

As the dad asked if there was a medicine we could give her to help her and if they were going to have to pay anything, my eyes diverted to her bedside again.  The brother had just run onto the ward again, up to the head of her bed, his face bright with excitement as he whispered something to his sister.  I smiled as I saw this brotherly affection and then, looking back at mom and dad, I explained how there is no medicine for this illness that we could give her, but that her body just needed time to fight the infection and get stronger.  As we talked, it seemed, to me, like the family understood, that they agreed that taking her to the other hospital for possible intubation would be the best.  We prayed and then proceeded to get our ambulance ready to take her to the other hospital. 

Lunch came and went, I was back at the hospital and the Pediatric Supervisor told me that the family decided to take the patient home instead of going in the ambulance.  I was stunned.  I wondered what I did wrong or if there was something else I could have done to get the family to understand her condition, to understand what was going on her in body. 

I thought I had communicated clearly, had taken the necessary steps by having our Pedi Supervisor with me to explain her condition and what we needed to do, and yet they didn't get it.  I know my worldview is different than many PNGians, but until now it hasn't seemed to really matter.  I understand the physiology of disease, of infections, of microscopic organisms that we can only see in microscopes that wreck havoc on our bodies, but not all PNGians understand this.  In general, they understand what they can see and what they can't see or can't explain, is often attributed to witchcraft or sin in the family, among other things.  Taking the sick person home, so the family can pray about the situation and can have peace among themselves is a common way to deal with illnesses that don't seem to be going well. 

I am definitely all about praying for healing, and about being at peace with your brothers and sisters and asking for forgiveness when appropriate, but I also hold a pretty high regard for medicine.  I have been here for 9 years and I am still learning how to do this better, how to break down the cultural barriers and worldview, when appropriate, to help them understand disease, death and the factors that can help when someone is sick. 

Pray for me to know how to do this better, to have wisdom as I talk with patients so they will have a clear understanding of what is happening and how we are trying/wanting to help.  Pray for Anita and her brother, for their relationship to go on for years and years, for her to beat the odds of GBS and make it, even while at home.  Pray for her parents to seek their strength in God, even when it seems like their world maybe crumbling around them.    

Ps 46:1-3 "God is our refuge and strength, an ever-present help in trouble.  Therefore we will not fear though the earth give way and the mountains fall into the heart of the sea, though its waters roar and foam and the mountains quake with their surging."

Wednesday, August 24, 2016

Thank You

Many of you support Kudjip Nazarene Hospital through prayers and financial support.  Thank you for making it possible for us to continue to share and show God's love to the hurting and lost each day at Kudjip.  We couldn't do it without your support.


To learn more about how to support the Hospital - go here:

To learn more about how to support me and my ministry here - go here:

Sunday, August 21, 2016

Nash Family Visit

Megan and I on a boat in Madang

Playing Settlers of Catan
Kayaking in Madang

Handing out stuffed animals on Pediatric Ward
Luke and a traditional dressed guy

Luke hanging a sign

My sister and two oldest nephews came to visit me for 2 weeks beginning of August.  I had a great vacation with them while they were here and enjoyed showing them PNG and introducing them to those I live and work with.  We did some fun stuff like snorkeling in Madang and playing games, but we also packaged pills in the pharmacy, hung up signs around the hospital and gave animals to the kids in the hospital.  Before heading home, we spent a few days in Australia and enjoyed feeding kangaroos and seeing koalas and other Australian animals.
Graham and his alligator hat

Megan and I with a kangaroo
On a hike in PNG
With Miles and Graham
Luke and an emu
Luke snorkeling
Graham snorkeling
Luke feeding a kangaroo
Up in a tree house
Graham feeding a kangaroo

Megan, Luke, Graham and I with a Kangaroo
In front of the Nazarene Hospital Sign

Monday, August 1, 2016

The One

9 years ago, I left the world of US Family Practice and became a Missionary Physician.  As a Missionary Physician I care for patients and administer treatment in ways that I would have never have done if I was still in the US.  Diagnosing and treating cancer are some of those things that I do now, that I wouldn't be doing if I was still in the US.

One of the hard parts about caring for patients with cancer in PNG is that our options of treatment are limited.  We have about 6 basic drugs that we can give, but we have to balance the doses we give with our ability to support someone whose immune system is weakened.  Along with chemotherapy, we have surgery and at times radiation.  We hope and pray that the combination of the 3 will be enough for our patients, but way too often it isn't.  Outside of a surgical cure, we rarely get cures in patients with cancer.

Topias is treating to beat those odds.  Topias came in almost 2 years ago with an abdominal mass.  It was initially too large for surgery, so we gave him chemotherapy, suspecting he had lymphoma.  Thankfully, the chemo shrunk it down to a size that was small enough for surgery.  As surgery, the biopsy came back as a Wilm's tumor, a tumor of the kidney found in kids and one of the most responsive to chemotherapy.  We altered our chemotherapy a little bit and thankful Topias continues to do well.

He is usually happy when he comes inside to be seen, but still cries when Aunti Letti (what he calls me - where he got that name I don't know) and Dr. Bill do ultrasounds to look for any sign of the mass returning.  So far, we haven't been able to find any recurrence of the mass and are very thankful.  We hope Topias, the youngest of 5 boys in his family, grows up to go to school, get married and have kids of his own.  Until then, we will keep checking him for recurrence and thanking God for the one who has made it (at least for now), the one who has survived cancer despite our limitations, and keep praying for others to make it too.

Sunday, July 24, 2016

Neurosurgery Success

We don't do a lot of neurosurgery, but occasionally when the opportunities arise, we do what we can/have to.  Last year, a little boy was having fevers and headache and then he lost the function of one side of his body.  At that point, we found on ultrasound what looked like an abscess in his brain, and were able to successfully drain it.  When he left the hospital, he was a happy little kid, but we weren't sure how he would do (wondering if we really got it all, would it come back, would he recover, etc?)  Now it is 8 months later, and he is doing great.  Mom brought him back because he had a little fever and she was worried he might have a brain infection again.  I reassured her that he didn't and was happy for the followup in how well this little one did.  Praise God for his mercies to us, being new each morning.