Sunday, July 26, 2015

The leper's feet...

The women in the leprosy ward have broken me ten times over in these past six weeks. 
They love being admitted here. 
In fact, they come back with only minor wounds, trying to get admitted just to get back in on the fellowship and family of the other women.  
They are stunning, sweet, and gentle souls that have intrigued, challenged, and captivated me. They are beautiful- absolutely beautiful, my favorite smiles of the week.

Can the health-nerd in me give you a little bit of an education on leprosy?
Though I could talk about this for days, I promise to keep it short and sweet. 

Leprosy is a disease in which bacteria invade the body and affect the skin and peripheral nerves. There's a lot of medical talk that would explain it's disease process, but, essentially what you need to know is that it causes a slow and gradual loss of sensation in the hands, arms, feet, and legs. 
Patients literally lose their sensation of pain. 
That might sound ideal on the surface, 
but let me assure you that it is not. 

Pain is the body's natural warning sign. 
It lets the brain know, "Hey! Something's not right here. Protect yourself!"
Without it, you wouldn't know things like how much pressure to exert on a door handle when you want to open a door. 
You wouldn't be able to feel if you were being burned, or bit by a rat in your sleep, which is a real problem here. 
You wouldn't be able to  feel the grass under your feet, or another human holding your hand. 
And, in my opinion, worst of all: you'd have no idea how to walk properly. You wouldn't know how much pressure to put on your heel, or your toes, or anywhere for that matter. 

It's this problem- the walking one- that has filled the leprosy ward with patients. 
Without pain and sensation, their hands and feet develop wounds, which turn into ulcers, which turn into bigger ulcers, which turn into, well, you get the point. 

If they were to seek treatment for the wound at its beginning, then it would be an easy fix. 
But, the problem is twofold. They either don't see it until it gets out of control, or, more likely, they see it, but it doesn't hurt; it's not that bad yet.
So they keep walking. Keep doing what they're doing.
And the ulcer gets worse.

The ulcers deepen, get infected, and expand.  
Toes get worn off, or have to be surgically removed. 
(Side note : I actually cut someone's toe off during a surgery the other day. I'm still so unsure how to feel about that...)
Bones get exposed; muscles get displaced. 
Toes start pointing in different directions, and tibias start coming through heels. 

But, these ulcers don't form over night.
They take days, weeks, months, and-the worst ones-years to form.
They are created by a repetition of the same thing over a long period of time. 

One patient came in with an ulcer that had been forming for five years.
Five stinking years. 
As I stared at her ulcer I racked my brain, thinking, "Why didn't you get help!? This could have been prevented!"

Once the ulcers have gotten to a certain point, the patient can be admitted to the leprosy ward. 
It's here that they’re put on "bed rest" and their ulcers are cared for, debrided, cleaned out, bandaged, and protected; it's here that they receive the merciful care and support that they need, so that they can return to their daily life. 

In these last few weeks, I have come to a startling realization: 
I am the leper.

Walking around with selfishness,
judgement, self-righteousness, 
dignified pride, and vanity in my heart,
I'm numb to the ulcers and wounds that sin is creating.

I've heard the Lord point it out before, 
seen it’s symptoms in the past,
but it was easy to disguise, 
easy to self-medicate, 
to pretend they weren't there & forget, 
to keep walking, 
keep doing what I was doing.

And the ulcers get worse, 
the disease starts settling in deeper and deeper, 
creeping into new parts of my body, 
new parts of my life. 
Until finally, one day, it can't be hidden anymore. 
It rears it's ugly head and bites, 
& I begin to realize that I should have fixed that long ago,
should have seen the Physician five years back.

So here I am, 
back at the throne of his overflowing mercy, 
finding grace abundant, 
and forgiveness unending.  

Isn't that how it goes? 
On our feet one minute, 
on our knees the next. 

The good news, though, is this:
Mercy triumphs over judgment, every time. 
He doesn't scold or mock, 
doesn't rub our face in the messes that we've made. 
He doesn't cast us out or hold us at an arm's length, like people do to the lepers. 
He doesn't shame; He doesn't hold it over our head. 
He's not waiting for us to have our ten steps to recovery ready for presentation. 

He draws near and says, "Beloved, you are forgiven. Come, get off your feet. Let's bandage up those wounds. Let's get you new shoes, so we can alter the way you walk. Let me clean out the ulcers, and make you fresh and new." He's capable of erasing and redeeming all wounds, all scars, all deformities. 

But, here's the best news: 
There's now a sulfone drug that can arrest leprosy at the first sign of its presence. 
Ulcers don't even have to form in the first place. Feet don't have to become deformed, and sensation doesn't have to be lost anymore.

While He's capable of erasing all wounds and correcting all things, there's a better option yet. The wounds and deformities don't even have to be there in the first place, not if we get help at the first sign of their onset. 
His love and presence are the sulfone drug to our sin, and he died so that we could have free access to that medicine.

May I encourage you to get close to Him, 
to continually be evaluating your heart for signs of sin's onset,
to constantly be searching yourself for fear, doubt, vanity, pride, greed, etc..,  
to not ignore the warnings, 
to not ignore his voice, 
to not be afraid to run unashamed to the throne of mercy now, rather than waiting until it gets worse? 

Because who really wants to be the woman with a hole in her foot, two toes gone, and a limp in her walk? Who really wants to be the woman with biting words, a bitter heart, and contempt on her lips? 

Every morning his mercy is new, which means every morning there are new things in us that need his mercy. 
Thank you, Lord, for coming close to us, even when we're covered in sin and should be cast to the outskirts of your village. Thank you, Lord, for your furious love and relentless pursuit of our hearts. You've always got our best in mind.  

And now a song from my very favorite songbird: 

Monday, July 6, 2015

Becoming the patient: 3 nights in an Indian isolation ward.

In the last four days I have been pumped with
3 or 4 different antibiotics,
some antispasmodics,
a few different antiemetics,
the generic acetaminophen and ibuprofen,
a holy ton of normal saline,
and so much more…
That’s a lot of drugs for a self proclaimed “drug free zone”, but, let me tell you, this week I am praising Jesus for modern medicine.

It all started with a stomach ache.
Just a little one, ya know?
We were on a bus- fourteen hours from Narsapur, heading to a big hospital for a sweet and sick little boy (we’ll call him M.)- so maybe it was just some motion sickness.
We had gotten up before 4 AM, so maybe it was just from being tired.

And then, it got a little worse.
And, ya know, things started moving.
Nothing I couldn’t handle.

And then I got a little headache.
And then the headache got a little worse.
Manageable. No biggie.

And, then I started to run a little fever and get a little nauseous.
Okay, better just take some time to rest this afternoon.
So, like a good, tough, American, medical professional, I popped some aspirin and went to bed.
I’ll be better in the morning, I thought. 


At about 11:00 PM, Annie woke up to hear me groaning in my sleep. She woke me up and I could see the worry in her eyes. She felt my head and quickly started wetting tissues with cold water and laying them on my body.

After about 45 minutes of failed attempts to break what we're estimating was a 104+ degree fever, she took my pulse & insisted we go to the casualty unit (ER).
I fought.
No, I’ll just sleep it off. I’ll be fine.

She didn’t listen.

Her friend, a doctor at the hospital, drove across the city to pick us up.
It’s hard to explain the days that followed, because they have been such a blur, but I consider myself a royal guest to the side of healthcare that most healthcare professionals don’t get to see. Granted it was in a foreign hospital in a third world country, but I got to be on the other end of the needle, the cuff, the palpating, and questioning, and, let me tell you friends, it has changed me for the better.

I will always remember the waiting in a cage-like area, on a hard chair, half passed out, high fever, and stomach pains from hell, while they got me admitted.

I will always remember being wheeled on a stretcher through masses of people.

Never will I forget the fear in people’s eyes as they looked at me & I began to realize that I must be worse than I thought.

I will not forget feeling so miserably out of control of my own body.

When I go to start an IV back in the states, you can be sure I will remember the three attempts it took to get one on me, and the burning fire of the infected line that developed after a day.  I will not forget the feeling of becoming a human pincushion, stuck over twenty times.

When my patient needs an arterial blood gas draw, you better believe I’ll remember that that one-that one- is the worst of them all.

When a patient comes in and crashes, I’ll remember what it felt like to be completely dependent on others when I got up to go to the bathroom, causing my BP (and body) to crash.

I’ll remember the embarrassment of throwing up on the floor and myself because no one could understand my frantic waves for a bag.

I’ll remember to close the curtains before I give someone a shot in the butt, and I surely won’t sit and rub the site afterwards with all my strength, because that just stinking hurts.

I’ll remember the bedpans- the dirty, metal, bedpans.

I’ll remember the humility of not being able to lift my head for a drink and having to have someone bring the bottle to my mouth.

For the next patient I see in isolation, I’ll remember the people wearing masks and gowns, and acting as though I was untouchable.

I’ll never forget the fan that tried mercilessly to make up for the lack of AC, and the constant three days of soaked-with-sweat sheets and gowns.

I will not forget the night nurse who was there to do her job, and the day nurse who took an interest in who I was.

I will remember that, in India, the hospitals- and pretty much everywhere else- are BYOTP: bring your own toilet paper. I had forgotten mine. (Thank God, Annie had a pack of tissues! It's the little things, people.) 

When a patient needs a test and doesn’t understand why, I won’t forget the nurse who came to get me for a chest X-Ray- though I had no known problems with my chest- being unable to explain why I needed it.  I won’t forget being too tired to argue.

When my patient is in a gown, I won’t forget what it feels like to be wheeled to radiology in a half-see-though, white, stained gown, past hundreds of people.

I won’t forget the staring. To the people that stood within two feet & just stared, the woman who stood in my doorway and stared, the crowds that stared- I won’t forget any of you.

When I wheel a patient somewhere, I will remember what it felt like to sit in that gown, looking and feeling like straight up hell, while I waited in a metal wheelchair, in a crowded hallway, for an x-ray I didn’t really need, for twenty minutes or more.

And when my patient is waiting desperately for discharge, I will remember what it felt like to be told, "No. You have to stay for some more time." 

This is the smile that I genuinely thought would convince people I was ready to be discharged. I can see now why it didn't work. 

But, let me tell you what else I won’t forget:

I won’t forget Angelee who dropped what she was doing and drove across town in the middle of the night to pick me up.

I will not forget the constant cycle of Annie’s friends who came and stayed by my side when Annie had to go be with M. I will not forget them sleeping in chairs, or bringing me crackers, or talking about life just to get my mind off things.

I will not forget the kindness of the attendant who, through his mask, kept telling me I’d be okay, and wanted to know all about my life as he wheeled me to isolation. That one, he was an angel, I’m sure.

I won’t forget the pictures of Jesus and postings of scripture on the walls, leading all the way to my room.

I will always remember the perfect peace of being close to Jesus through the whole thing, and the atmosphere shift that happened when I started playing worship on my phone. 

I won’t forget the luxury of being able to hear my mom- a familiar voice- after the first day settled down, even if it was only for five minutes.

When my patient is NPO and begging for food, I won’t forget the glory of that one, beautiful, single breadstick-my first food in three days.

I will remember how funny the whole situation became by the third day, and how Annie and I were laughing so hard that two nurses came running because they thought something was wrong. 

And most of all, I will remember every. single. touch. I’ll remember the rubbing my back & holding my hair back while I dry heaved…and heaved…and heaved, and the touching of my arm and assuring me everything would be fine, and the holding my hand during the second, third, and fourth IV attempts. I won’t forget the hands that held me steady when my BP kept bottoming out, or the nurse that patted me on the shoulder and laughed when I proudly announced that I hadn’t gone to the bathroom all night & was now ready for discharge.  I won’t even forget the hands on my feet when someone was checking for edema.

I will remember it all, both the good and the bad, because both have made me a better nurse, a better friend, and a better lover of Jesus.

Even in the midst of chaos and sickness, Jesus is good,
fear has no place,
and His peace is overwhelming in a heart that’s close to His.

P.S. I’ve been discharged and am doing much better! Resting, mending, and hyping my body up with some probiotics at a nearby house until we take the train back to Narsapur tomorrow.

Doing good, friends! I'm doing good! :) 

P.S.S. There’s also a story about a drunken rickshaw driver that picked us up after the hospital stay, but I’ve put my family through enough torture these last few days, so we’ll keep that as a story for another day. J

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