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9-9-2010 (Thursday)

After a good night’s sleep I awoke with a throbbing headache that I am sure is related to the altitude.  Now that I have consumed more water and had breakfast I feel better although the headache is not completely gone. 

Father, thank You for the restful sleep and the new day.  Thank You for giving us the fruits of Your creative wisdom for our enjoyment.  I look at the different flowers, the mountains, the multiple hummingbirds and even the clouds in the bright blue sky and appreciate Your touch in creating these.  Your creative touch is everywhere and so often I don’t take the time to even look nor appreciate it.  Forgive me for that, Lord.  I pray, Lord, for safe travel for Jane, Damarys and me today.  I pray especially for the coming days of seeing patients in the clinic and also performing needed surgery.  Lord, please give Jane and me the wisdom to determine the right care for these people.  We are privileged to be Your hands, Your eyes, Your mouth as we become Your instruments in delivering Your love to these people.  And in the process Lord, open their hearts to the message of the Gospel so spiritual healing can take place as well as physical healing.  Lord, You give us an awesome opportunity and an awesome responsibility.  Hold us close to You and keep Your hand on our shoulders as we serve You and walk with You.  I pray this in the name of Jesus, our Savior and Redeemer.  Amen.

Jane is coming to pick me up after 9:30 this morning.  Usually we leave earlier, more like 6 because of the long trip.  However, here in Quito Jane must comply with the new traffic management rules.  Because of the crush of vehicles during rush hour here, a new system to help make rush hour more manageable was instituted.  This involves rationing of the road, so to speak.  If the last number of your license plate ends in 1 or 2 then you are not to be on the road during 7 to 9:30 in the morning and 3 to 6 in the evening.  If you are driving “illegally” you will not only be fined $80 but the police will impound your car for 24 hours.  So the cost of breaking the law is steep and that keeps the roads clear.  The rotation goes through the week with numbers 3 and 4 not driving on Tuesday, 5 and 6 on Wednesday, 7 and 8 on Thursday, etc.  That means every Thursday Jane cannot be on the roads during the rush hour traffic time.  Damarys said this system has helped a lot in reducing the number of cars on the roads each day.  I guess it is the type of fix that gives quick results since there is no good way to widen the roads or improve the highways without lots of expense and more traffic congestion in the process.  The system does create scheduling problems for people’s work schedules and the transportation of children to and from school.  If you knew that on a specific day of the week your travel time would be different, then you could arrange your schedule around that more consistently and it would encourage car pooling for schools and work.  Here in Quito there are a lot of school buses and I suspect a fair number of the school kid ride these to school instead of going in the family car.

Here at the HCJB Guesthouse I am able to access broadband Internet via a wireless connection.  I can be online in my room and that allowed Phyl and I to enjoy a video call this morning.  I was able to connect with her and we spent about 15 minutes talking back and forth.  That was a great start for the day.  Our technology today allows connections like this even though we are thousands of miles apart from one another.  Through Skype Phyl and I were able to virtually join hands and share our love for one another.

Jane came to pick me up about 10 AM.  We loaded the car with my luggage and set off for San Lorenzo.  The trip was long with slower traffic and lots of police along the route.  There were sufficient big trucks along the way that really slowed down the traffic as they went very slow up and down the mountain roads.  You had few opportunities to pass them because of the oncoming traffic and the multiple curves.  We were in no big hurry and enjoyed the bright sun and mountain scenery.  Today the sky was very clear giving us clear views of 4 inactive volcanoes covered with snow.  We stopped to catch a couple photos of these beautiful mountains.  One rarely sees the snow –covered peaks because they are usually enshrouded with clouds.  Today, however, we were given a beautiful view of four different ones. 

We stopped in Ibarra for lunch and to pick up a couple items at the grocery store.  Then we made our way on to San Lorenzo.  Part way there we ran into some light rain for a short distance but otherwise the sun was out and sky clear.  For the last 30 to 40 kilometers we had to deal with a road resurfacing work in progress.  Once the new blacktop is fully installed, the road will be quite smooth and nice. 

Jane had talked with me yesterday about the possibility of delivering a baby while I am here.  Angelita’s daughter is due and desperately wants to deliver at the clinic.  A previous delivery resulted in a death of the baby and she is terrified to go to the local hospital for another delivery.  We don’t know all the details of that pregnancy and delivery but to the patient she feels she did not receive appropriate care and thus lost her baby at delivery.  Jane has cautioned her that she is not into obstetrics yet at the clinic but the mother begs for us to care for her.  This is her third baby and her last labor went very quick.  Jane received a call from Angelita while we were on our way to Ibarra.  The daughter, Sandra, thinks she may have lost some water and is having some contractions.  She asked if I could check her when we arrive.  We talked about it and then called back to tell Angelita to bring Sandra to the clinic and have her wait there. 

Once we arrived at the clinic I checked Sandra.  She is not in labor but has what appears to be a healthy, about 7 pound baby making preparations to enter into the world.  The heart rate was good and her cervix is dilated some.  I suspect she will become the first delivery at the clinic sometime this next week.  She is not in labor at the present but she is ready to go once it starts.  Checking her brought back many memories of my obstetrical practice. 

We also saw one other patient who is scheduled for a hysterectomy on Monday.  She was anemic and came in with another blood count after Jane has had her on iron.  The count today was much better, in the normal range, and this will significantly reduce her risk at the time of surgery.  Tomorrow we will see several patients in the clinic to evaluate them for surgery.  We have one patient Angelita added to the schedule who has a nasty pap smear result and may have cervical cancer.  We will see her to determine any surgical possibilities as well.  I suspect it won’t take long to fill up the surgical schedule for next week. 

I am mostly unpacked and moved into my room.  Jane is unpacking her stuff and then we will make some supper.  I am not very hungry at this point.  It is hot and humid and I feel all sweaty.  This certainly is a change compared to the dry and cold air in Quito.  At least I am at sea level and the headache is gone.  The sights and sounds of San Lorenzo is going strong.  Trucks and buses rumble by on the road punctuating the music and other noise that is drifting over the wall from somewhere.  Mixed in all this are conversations of people across the street.  I haven’t heard any roosters or dogs…yet.  Jane has a fenced in area in the back of the clinic grounds where she keeps some goats.  I’ll have to ask her why she is going into farming. 

Jane has moved up in technology.  In previous years my Internet connection was with a dial-up modem long distance to Quito.  The connection was mostly unreliable as you would frequently not be able to connect and then when you did connect you would then lose the connection.  She now works through the cell phone tower nearby with a cellular card that plugs into the USB port and gives me broadband Internet.  You pay by the week for service.  She set me up with the unit tonight and I should now have unlimited Internet for the time I am here.  We’ll see how this works.  It certainly has the potential of being better than the dial-up process.

It is time to turn in for the night.  We have a busy clinic day tomorrow.  Jane feels we will have our surgery schedule full by the end of clinic tomorrow.  We do not have patients scheduled for Saturday.  Possibly the only action will be a delivery if Sandra starts doing something with labor.  If she is going to deliver, that would be a better time instead of having things happen in the middle of our surgery day.  We would need to use the OR for the delivery and that could make things interesting if we are in the middle of a surgery when she is ready.  This could prove to be an interesting time here!

Lord, thank You for the safe trip to San Lorenzo.  Thank You for the spectacular displays of the snow-capped mountains that one rarely sees because of persistent clouds.  Not only did we see one, we saw four that thrust up into the sky north and south of Quito.  Lord, I pray for Sandra and her baby.  Please protect her and give us wisdom and the skill we need to care for her.  Lord, I pray for a good rest tonight so I can be alert and ready to help Jane as we see several patients tomorrow.  I pray for Your wisdom to fill us so we can appropriately care for these people.  Thank You again for this opportunity to serve You here.  Amen.



1. Tom Beckner - September 9, 2010

I join you in prayer for the blesings you can offer to your patients tomorrow.

Tom Beckner

2. Kent Brower - September 10, 2010

My prayers are with you. The Lord promises wisdom, and he is the giver of all! God Bless.

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