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10/10/08 (Friday)

Exhibiting compassion for the harassed and helpless.

6:00 AM.  I awoke about 4:30 having slept in one position the whole night.  That was a good sleep!  What awakened me was the image of Maria with the massive lymphedema and the compelling urge to pray for her.  This urge was strong and I have learned that these are usually God tapping me on the shoulder telling me to pray and/or to go.  Maria’s condition is just overwhelming to me.  Last evening Jane showed me pictures of Maria with the elephantiasis.  She said this is a congenital problem and that this lady tested parasite negative.  Jane’s sister, Susan, is a physical therapist and did some extra work in managing lymphedema.  Susan came to Ecuador in June to see this lady and work with her.  She trained her on how to put on the dressings and do the massage.  Maria has made some remarkable improvement with this therapy and has taken off over 100 pounds of fluid.  Jane wants to see if Maria can get a visa to travel to Florida to spend some time with Susan to receive some intensive therapy on this lymphedema.  I feel so sorry for Maria.  She is living with a deplorable condition and yet has a smile that just radiates hope.  We all need to take some lessons from this lady on how to truly view life and its blessings.  I feel so sorry for her; yet, the first response is not pity, as what would be the usual and expected response, but of compassion.  Maybe the pity drives the compassion; I don’t know for sure.  At any rate, I see a need and I want to help but don’t know how but to pray.


As I have been reading in the Gospel of Matthew studying Jesus, one facet of His person and ministry was and is compassion.  Chapter 9:36: When he saw the crowds, he had compassion on them, because they were harassed and helpless.  Other places in Scripture He demonstrates compassion first and foremost.  He confronted the religious leaders of the day because of their pompous pride and the lack of compassion.  His compassion for people, the harassed and helpless, drove Him to reach out and heal. 


Christ possessed incredible power of healing.  Look at some of the miracles He performed.  Yet, we don’t see Him with His magic wand waving and touching with sudden healing, sudden transformation resulting.  Over and over Jesus used the words, “Your faith healed you.”  In Matthew 9 a woman plagued with bleeding even the gynecologists couldn’t treat came to Jesus saying to herself, “If I only touch his cloak, I will be healed.”  When she did Jesus turned to her and said, “Take heart, daughter, your faith healed you.”  Others whose healing was described in the Scripture also learned from Christ that their faith was the trigger for the administration of healing power from Christ. 


Christ had immense power and He demonstrated this through stilling the raging sea, walking on water, raising the dead and healing in miraculous ways.  Yet, this power was always used and demonstrated in the context of faith.  This faith was the faith of the recipient.  To receive Christ and all He is, one must have faith.  One must put trust, confidence and hope in Him and nothing else.  One must allow Christ to enter the heart and orient the perspective on living each day through the lens of Christ.  The religious leaders described in Matthew didn’t understand and didn’t accept Christ because they had no faith in Him.  Their pride, power and prestige got in the way and drove them to destroy Him.  I have to ask myself if I at times act like these leaders when I put more confidence in myself or in something I want to have happen than in Christ.  My faith must be rooted in Christ, first and foremost.  Then, with that perspective, I can approach each day in the proper context.  This gives me the wisdom and insight I need to deal with the issues that cross my path.


I look at Jane and her team here.  What drives them to come to San Lorenzo and pour their heart and soul into this effort?  I believe the answer is rooted in compassion driven by faith.  One characteristic of Jane that stands above the rest is compassion.  That compassion is the lure that pulls people in from all around.  They come because they know Jane will love them, listen to them, respect them, treat them with compassion and even initiate healing for them.  They have faith in her and through her can strengthen their faith in God and His Son, Jesus Christ. 


Yesterday, while eating lunch in Lita the lady who operated the little eatery brought her daughter to Jane to look at an umbilical hernia on her abdomen.  She knew who Jane was and she came to her demonstrating faith that Jane could help.  I asked Jane afterward if the fact that she conducted a medical evaluation in the middle of lunch counted as a business expense since it was a corporate activity.  Here we were, an hour plus from San Lorenzo and the people knew Jane and respected her.


When Jane showed me her pictures of Maria and the lymphedema she told me about her sister, Susan, who possessed the knowledge and skills to treat that problem.  Jane happened to mention Maria in an email to her family and Susan immediately responded with the intent to come to San Lorenzo and do what needed to be done to help this lady.  She packed three bags of suitcases full of supplies and came for three weeks to work specifically with Maria.  Susan’s profession is physical therapy and she specializes in managing lymphedema.  When Maria came in to see Susan, she weighed over 350 pounds, most of that weight in her legs.  With Susan working with Maria 4 to 6 hours a day doing massage and wrapping the legs with pressure wrappings, Maria shed over 100 pounds of weight in just 8 days.  When Maria came in she could hardly walk and needed a cane to help her.  Her legs were massive, literally massive.  Jane has one picture of Susan trying to reach around the thigh to wrap the leg with the pressure wrap and it was all Susan could do to hand the wrapping from one hand to the other.  After the first 8 days, Maria could walk unassisted.  Maria now has learned how to do the massage herself and to install the pressure wraps correctly.  She continues to see the lymphedema in her legs decrease.  The before and after pictures are just incredible!  Susan came out of compassion and faith and brought the healing touch of Christ to Maria. 


I admire Jane and Susan’s parents, Don and Dixie Weaver, for providing a home that centered on this faith.  They instilled into their children the example of following Christ and their children now carry that torch to distant horizons.  What a legacy!  I see Steve, Jane’s brother, serving Christ in Fort Wayne and supporting Jane by being the administrative help for Jane’s mission board.  I see Susan being ready to come and serve to help people, especially Maria.  And I see Jane and have the distinct privilege of coming and helping her in this ministry.  It is not work; it is a ministry.  This is an opportunity to serve.  Serving others in Jesus’ name brings glory and honor to Him.  That should be our life purpose.


Father, I pray for Maria.  Please tend to her and help her.  Thank You for the progress so far.  Thank You for loving her the way You do.  I pray for healing for her, physically, emotionally and spiritually.  Thank You that Maria believes in You.  Please encourage her.  Thank You for Jane and her team here.  I pray for Maria Luisa and her dispute with her ex-husband.  Please penetrate his dark heart with the light of Your love, Lord.  Father, I pray for today.  I pray for the patients we will see and for the wisdom we will need to make correct decisions.  I pray for our stamina, Lord.  I pray that above all we continually display our faith in You and that we show Your love to others.  Thank You, Lord.  Amen.


10:00 AM.  We are in clinic and have been seeing patients for the past couple hours.  Only one so far did not need surgery.  This new building and the exam room is much more comfortable.  There is plenty of room and we have good ventilation.  I haven’t had much to sweat about yet!  Rain started to fall early this morning and it is still raining steadily.  That is probably why it is cooler in the exam room.


11:00 AM.  One patient came in with a history of having a hysterectomy 17 years ago, when she was age 20, and has not had any bleeding since.  On a recent exam Jane found a cervix and then obtained an ultrasound that showed a large ovarian cyst.  Jane had her return to see me for further consultation.  Prior to coming in the patient obtained a second ultrasound that showed a large, complex cyst in the pelvis and a uterus.  The uterus looked intact and complete.  We cannot understand what really happened when this lady had a hysterectomy.  Possibly, what was done was removal of both ovaries.  If that is the case, then this complex cyst leaves us wondering what could be its origin.  Her husband came along and announced in front of her that she was “slow.”  Apparently, she has epilepsy that remains untreated.  She has periodic seizures and her husband just lets her shake through it.  The husband did all the talking while the lady sat there cowering somewhat and looking down.  This poor lady lives such a suppressed life.  Imagine being introduced as being “slow.”  Jane said this is how she was introduced before when she came to the clinic.  I really feel sorry for her.  On our exam she had a large pelvic mass along with a uterus.  We need to do surgery to identify and remove the cystic mass and then sort out what had been done on the previous “hysterectomy.”  We called the anesthesiologist for next week to discuss this lady and the seizure disorder.  She initially recommended obtaining a neurology consult but that would mean a trip to Ibarra, two hours away at least, and getting an appointment on Monday.  Then after further discussion, the anesthesiologist said she would give this lady a general anesthetic so that would control any seizure activity while in the operating room and then we will keep her in our recovery room all day to watch her more closely and respond with help if a seizure occurs.  What a challenge! 


1:45 PM.  We just finished lunch.  Esther fixed a wonderful hot meal.  If she keeps this up I will experience some of the best Ecuadorian food ever!  Our morning went well and we have 10 people to see this afternoon.  The surgery schedule is filling up.  It should be a good week.


3:00 PM.  Our surgery schedule continues to build.  This trip I am seeing more vaginal surgery cases.  I am very glad I was able to bring the candy cane stirrups as they will allow much better positioning for these surgeries.  We saw a lady with a large lipoma of the left labia.  Five years ago Jane excised three very large lipomas from this area.  Now this lady presents with another one developing.  A lipoma is a tumor composed of fat cells.  This is benign and is just normal fat tissue that seems to congeal together into a mass.  The labia contain a fair amount of fat tissue so this would be a place where a lipoma could start.  I have not seen a lipoma of the labia specifically in my career.  I have seen them in the abdominal wall, on the back, on the hips and other places.  With the better stirrups we should be able to get exposure to remove this lipoma more easily.  This could be a challenging dissection with all the blood supply in the area. 


5:15 PM.  Our day is done with 22 patients being seen.  Our last patient was an infertility problem I had seen last year.  At that time I recommended the husband obtain a sperm count since this lady was normal on exam and had been pregnant several times.  Now with a new husband she is unable to conceive and he believes she is the problem.  He did submit to a sperm count and it came back as zero.  Jane referred him to a urologist in Quito.  However, the husband then went and had another count which came back as normal.  This convinced him that she was the problem and therefore she should go through surgery to fix her problem, whatever that may be.  Jane and I both independently wondered to ourselves if the husband had a friend donate a sperm specimen in his name so the count would come back okay and he could then blame his wife for the lack of children.  She came in wanting to go through tests and surgery in hopes of conceiving and we tried to convince her that doing all that would not help.  The pressure to conceive is so intense.  In this culture the men do not accept the idea that fertility involves both partners.  The women go through a lot of unnecessary tests and even surgery when the cause of the infertility is not even their problem.


We have next week’s schedule mostly full with a few slots remaining at the end of the week.  Tomorrow, we have three colposcopies and one endometrial biopsy to do.  We will do these in the OR where we have more equipment, especially to give local anesthesia if needed and to control bleeding.  I think we will also see a few more people in the clinic. 


This day in the clinic was much easier because the room was comfortable with good ventilation.  Also, with the rain and cloudy sky the heat of the day was less.  Jane said this is the dry season and to have so much rain is very unusual.  At least the cistern is full and our water supply will be sufficient.


Father, thank You for this good day.  What a fulfilling experience to be able to help another person through a problem, to be that cup of cold water that refreshes the soul.  Thank You, Father, for providing Jane and me with the wisdom we needed to discern the problem and the management.  Thank You for giving us strength as well.  Father, I pray for those we saw today.  Hold them in Your arms and instill in them Your healing power.  Thank You also for the rain.  You bless over and over and even keep the cistern full so Jane does not have to purchase water next week.  Thank You, Lord!  Amen. 


7:30 PM.  Esther scored another home run with dinner.  We had a delicious soup served over rice.  We laughed about the possibility of taking her back with me to Fort Wayne and how Phyl would appreciate that.  I have to admit, Phyl is a tremendous cook and she can work some real magic in the kitchen.  I would really miss that special part of her.  Therefore, I will just have to keep Esther for my Ecuadorian cook when I travel here.  The rest of the evening I will spend trying to get online and loading this journal into the blog.


1. Tom Beckner - October 15, 2008

Interesting connection re: your comments about about people coming to Jane because they see her compassion. Her compassion elicits their faith/trust in her to heal them; she is empowered and her activities blessed by God; the process of healing takes place through a convergence of faith, caring compassion, and the exercise of trained giftedness.

What a joy you all must be feeling! Blessings.

2. Phil - October 24, 2008

Marv and Jane, Your account is so inspiring and gives me pause regarding my own commitment to serving others. The day at Matthew 25 went well although only 4 patients showed and another 4 failed to do so. I saw a lady that you had seen in the past and ordered a repeat U/S which showed a persistent 2 x 3 cm ovarian cyst that had mixed components. Her story includes persistent pelvic pain, dysmenorrhea a and dyspareunia. I discussed the need for a gyn consultation to consider laparoscopy with possible hysterectomy. Arrangements are being made. God bless your efforts and I pray that He will continue to guide you both. Phil

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