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6-27-2014 (Friday)

6:15 am.  Daylight is beginning.  About an hour ago I was awakened by the sound of the diesel generator starting.  It sits in a small building next to the house and supplies emergency electricity to the clinic when the power goes out.  Being a diesel is noisy enough but I don’t think it has much of a muffler as well.  So one has to quickly accommodate to the new noise level.  At least it drowns out the traffic noise, dogs barking and the other sounds of San Lorenzo.  This is the first time we have had a power outage this week.  In the past the power would go out intermittently, sometimes more than once per day.  However, in recent years the electrical grid for this corner of the world has improved and we could have a fairly steady source of electricity.  We have no electricity at the house but we do have water.  The water may be gravity fed by the roof top storage tank or possibly the pump is connected to the power grid for the clinic which the generator is currently supporting.  At any rate, I could at least wash the face and clean off some of the grunge.

Lord, life is stressful here.  We depend so much on a variety of conveniences every day and when things like our electricity are not available the stress level goes up.  Yet, I have to back off and remember that I have a relationship with You and that will never end.  Nothing is impossible with You and even when we have some inconvenience that may disrupt our work, You are not caught by surprise and You can handle it.  I rest in that confidence, Lord.  Sometimes these inconveniences are there to teach us to lean more on You.  Sometimes they make us more thankful for the life we have.  Thank You, Lord, for the opportunity to come close to You, to walk with You, to have a close, intimate relationship with You, to dwell in Your love, and to serve You as we walk along life’s path together.  Thank You, Father, for what You teach me in what I read, what I experience, and the challenges that push me closer to You.  

Father, I pray for this day.  I pray for the patients who are recovering from surgery.  Thank You for allowing us to be here to employ the skills You have given us to bring Your help and Your healing to these people.  Thank You for their faith in us as evidenced by their open willingness to come to us and place their health and lives in our hands.  I pray for their healing and restoration of their health.  Thank You, Lord, for the opportunity You have given us to serve You in this way.  I pray, Father, for the patients who will be coming today for surgery.  I pray for their safety.  I pray for wisdom and the skill necessary to manage their problems.  

Father, I pray especially for Jane.  You have given her the vision to serve You here in San Lorenzo.  She is highly skilled and an excellent surgeon.  You have called her here to be Your representative to bring Your good news and healing to the people here.  Thank You for allowing Jane and I to cross paths and become colleagues and close friends.  I must truly say that coming here and working with Jane in serving You is a highlight of my career and my life.  Thank You, Father, for bringing this ministry to fruition.  Lord, You are awesome.  Thank You for the joy and hope and peace that comes from knowing You and walking with You every step every day along life’s path.  Thank You, Father.  Amen.

The power issue this morning could easily be a thorn that bothers me and distracts me from understanding why I am really here.  Satan would love to have anything that would take my focus off of Christ.  He is always alert to my relationship with Jesus and looks for any opportunity to attack me to take me away from this relationship, to take me out.  The battle constantly is intense for the control of my heart, and your heart.  We may not realize it but there is a spiritual battle raging continually for control of our hearts.  We are instructed to wear the full armor of God (Ephesians 6) and part of that armor is to carry the shield of faith “so that we can extinguish all the flaming arrows from the evil one.”  Those arrows come at us continually and the shield is so important to deflect those arrows.  If we put down that shield, we are vulnerable and before you know it you are pulled away from Christ.  All it takes is a look sometimes and suddenly you find yourself distracted and even wondering how that all happened.  The loss of the convenience of electricity could easily make me grumble and frustrated and then my thankfulness and joy from walking with Christ disappears.  I must always wear the full armor of God so I can stand in the battle and when it is over I am still standing.  That is so important.

Matthew 14:22-33 22Immediately Jesus made the disciples get into the boat and go on ahead of him to the other side, while he dismissed the crowd.  23After he had dismissed them, he went up on a mountainside by himself to pray.  Later that night, he was there alone, 24and the boat was already a considerable distance from land, buffeted by the waves because the wind was against it.

25Shortly before dawn Jesus went out the them, walking on the lake.  26When the disciples saw him walking on the lake, they were terrified.  “It’s a ghost,” they said, and cried out in fear.

27But Jesus immediately said to them, “Take courage!  It is I.  Don’t be afraid.”

28“Lord, if it’s you,” Peter replied, “tell me to come to you on the water.

29“Come,” he said.

Then Peter got down out of the boat, walked on the water and came toward Jesus.  30But when he saw the wind, he was afraid and, beginning to sink, cried out, “Lord, save me!”

31Immediately Jesus reached out his hand and caught him.  “You of little faith,” he said, “why did you doubt?”

32And when they climbed into the boat, the wind died down.  33Then those who were in the boat worshiped him, saying, “Truly you are the Son of God.” (NIV)

This is a familiar story and we sometimes struggle with really accepting that Jesus actually did walk on the water.  All sorts of efforts have been made to explain this miracle such as Jesus was walking on rocks just beneath the surface, or this was just a fairy tale, or other efforts to justify unbelief in a miracle.  But, working here in San Lorenzo and even in my clinical practice I was privileged to witness and even participate in what I would call miracles.  Events occurred that barred any rational explanation.  Healings occurred that were unexplainable in what I could understand from the scientific or medical perspective.  These events certainly strengthened my faith in God.

What is interesting in this story is what happened to Peter.  He was so devoted to Jesus and when He saw Him walking on the water’s surface, he wanted to go to Him.  He seems to be testing his own faith by climbing out of the boat and stepping forward without hesitation.  Notice he was the only one who got out of the boat.  Yet, when Peter took his eyes off Jesus and looked around, he saw something else that Jesus.  He saw the wind.  Even though the passage doesn’t say this, he obviously saw the waves.  And he saw himself standing on the water doing what he knew was impossible.  And once he took his eyes off Jesus, he started to sink.

The spiritual battle that rages for our hearts brings in arrows of doubt into each situation.  To derail my faith all that is needed is the introduction of doubt.  When the question, “Are you sure?” comes in, then my faith starts to crumble.  Instead of looking to Jesus I start looking at the wind and the waves and then I begin to sink.  Here in San Lorenzo and even in the operating room at home I am plagued by the doubt questions that keep trying to penetrate my shield of faith.  If I keep the shield in place my faith remains strong and I can then enjoy the walking on water type of miracle that plays out before me.

In the footnotes on this passage of Scripture in his study Bible, Dr. David Jeremiah makes this comment, “The difference between faith and fear is focus.”  That is so true.  Once you take your focus off of Jesus, then fear sets in and you start to sink.  I would even take the liberty to add the word frustration instead of fear to say the same thing.  The frustration of a power outage can take my focus off of Jesus just as easily and then I start sinking.  If I am to be Jesus in someone’s life today, I must remember to keep my focus on Him and Him only.  This is the only way I can truly represent Jesus to the world around me.

Father, Lord Jesus, thank You for this portion of Scripture that speaks so loudly to me.  Thank You for the reminder to keep my focus on You for that is the only way I can ever walk on water.  Lord, You have allowed me to witness and even participate in miracles, Your works.  It is such a pleasure and privilege to be Your hands and do Your work through serving others.  Lord, I pray for opportunities to be Jesus today.

Father, I pray for our patients today.  Please nestle them in Your arms and give them peace and assurance.  Please protect them, Lord.  Also, please wrap Your hands around our Hands and fill our minds with the knowledge and wisdom we need to do the work You have called us to do.  Thank You Father.

Father, I pray for Howard and Jordan today as they work together to put up wall tile.  Thank You for bringing them here with me.  Thank You for the opportunities You are giving them to serve You through the work they are doing.  Thank You for the teaching that Howard is doing for Jordan.  Lord, please protect them and bless them.  Amen.

Our surgery schedule has five cases and Jane added a little boy who is our first surgery.  In fact she is doing the surgery by herself as this little boy has some sebaceous cysts on his eyelids near the corners of the eye.  The boy was crying and refusing to come into the OR but eventually he came in and Dahlia gave him an anesthetic so Jane could remove the small cysts.

The second surgery was on E.A., Damarys’ sister.  I remember her from October 2008 when she cooked for us.  She has a mass or possibly infection in the right breast.  Jane is doing the surgery with Damarys assisting.  I am in the room but not scrubbed, just observing.  The mass appears to be papillomatous and as Jane dissected it out it seemed to get bigger and bigger.  She removed a mass about 3 cm in diameter.

Our next patient is R.T., age 36, with an umbilical hernia.  This hernia was fairly straight forward with a sac that had loops of bowel directly beneath the opening.  Jane dissected out the sac and then closed the hernia defect with non-absorbable suture.  This should prevent a recurrence of the hernia.

The next surgery was also an umbilical hernia repair.  This man, E.V., had a small hernia opening with fatty tissue trapped in the sac.  Jane freed up the tissue and returned it to the abdominal cavity and then closed the hernia.  The actual hernia opening was no bigger than a button hole.

Our fifth surgery is on G.G.  She has had some bleeding from the urethra and has some polypoid tissue protruding from the urethral meatus.  Our plan is to excise this tissue.  Looking at the tissue under magnification there were several tiny polyps protruding from the edge of the urethra.  Jane excised these and prepared them for pathology examination.  There was also one individual polyp on the labia minora that appeared different.  She excised this and sent it separately for pathology.  I will be interested to learn what the pathology diagnosis is.

Our last patient is W.P.  He is 78 and has a right inguinal hernia.  He had an indirect hernia and was quite thin making exposure very easy.  Jane closed the hernia sac and placed mesh.  The surgery went very well.

Father, thank You for a great week of surgery.  We helped so many people and this all goes to Your glory.  Thank You for giving Jane and me the skills needed to do these surgeries.  Thank You for protecting the patients and allowing us to administer Your healing to them.  Thank You, Lord for two patients coming to know You for the first time.  Lord, their spiritual healing is a great tribute to Your love and grace.  Lord, thank You for this ministry.  I praise Your name, Father.  Amen.

A thrill for me this week was to meet Beatriz, a lady I met in 2004 on my first trip here.  She came in bleeding heavily from a large cancer of the cervix.  This cancer filled a good part of the vagina and was coming from the cervix but not attached to the vagina.  It was very friable and would fall apart and bleed very heavily.  She had gone to Ibarra to get some blood transfusions because of the bleeding.  When she came to see us I was unsure if we could even help her.  I remember telling Jane that we could possibly do a hysterectomy basically to stop the bleeding but this in no way would cure her of her cancer.  The hysterectomy would at least keep her from bleeding to death.  We took her to surgery and took out the uterus and the attached cancer to the cervix.  Along with this before, during and after surgery I remember praying intensely for her.  Jane and I prayed together for her and over her. She recovered and was able to move on in life without the dangerous bleeding.  I did not hear anything about her after that and I suspected she would have had development of cancer in the pelvis that would ultimately take her life.  However, in 2009 Beatriz walked in to the clinic to visit a patient we had operated on.  I was thrilled to see her and I had Jane take a picture of us.  I asked Beatriz if I could examine her and she consented.  To my surprise there was absolutely no trace of cancer in the pelvis.  I was astounded and then I realized that God answered our prayers and cured her of this terrible disease.  She was 5 years out from this cancer and clinically could be labeled cured.  Jane said Beatriz was still living close to the clinic and now she is 10 years out from our surgery.  I did see her briefly the other night just in passing.  She was there to visit one of our post-op patients.  She and Carmen are friends and Carmen called her to come over to the clinic so I could see her again so I could talk with her some and find out how she is doing.  However, Carmen learned that she was out of town today and would not be back before we leave.  Jane has seen her a few times and said she is doing great and still has no evidence of any cancer.  That is absolutely a miracle!

Jane and I took one of the solar-powered digital players that has the entire Bible in Spanish on it to Carmen’s mother.  She is illiterate and earlier this week put her faith in Jesus Christ as her Savior and Lord.  We did surgery on her early in the week and she has been staying at the clinic so Carmen can care for her.  We took the player to her and she was delighted to have her own personal Bible.  This technology is a wonderful help to people like her who would not be able to read God’s Word otherwise.

Carmen's mother receiving her own copy of the Word of God.

Carmen’s mother receiving her own copy of the Word of God.

As we were getting around to go get dinner a knock on the door revealed Angelita with her son and granddaughter coming to visit.  In 2010 I delivered this little girl when I was here and this was the first delivery at the clinic.  Two years ago when I was here the son and his wife brought their little daughter to me so I could she her.  Again, I got the opportunity to see this little bundle of life that is now 4 years old.  She is a cute, shy little girl and it is a thrill for me to see a child whom I helped into this world.

Angelita, her son and granddaughter.

Angelita, her son and granddaughter.

Tonight we went out to eat and then will be packing to leave in the morning.  We plan to visit the local food market to see all the food vendors who come in to sell their products.  Then we will travel to Quito.



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