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Day 9 – August 24, 2017

I think back on my training as a physician.  It is one thing to sit in a classroom and read a textbook to learn about the delivery of proper care for specific illnesses.  It is another to learn when you are with the patient, a real patient, and now you are on stage, so to speak, and must make the right decision on the first encounter all the time.  You have to learn all about the disease process and also all about how this particular problem may present a little differently in one situation compared to another.  It becomes scary because you quickly realize your own insufficiency.  This is where it was always a comfort to have my mentor who was a seasoned physician who had been around the block several times.  This mentor had the wisdom of experience and could guide me through the process.  I always enjoyed having the mentor close by and enjoyed the freedom the mentor gave me to make my own decisions.  The mentor was there to help me and also prevent a misjudgment on my part because of my inexperience.  

Eventually you graduate.  You reach the point where the mentor feels you have sufficient training and can now work independently.  You still lack experience but you have attained a wealth of knowledge that should allow you to function without fear.  The graduation is a milestone in the career.  It is exciting to reach this point.  But it still is fearful because suddenly the presence of the mentor is gone and you find yourself realizing how alone you are.  

I see the same process of training from God.  He gives us an example of this in the story of Elijah and Elisha.  Elijah is the seasoned prophet who walks confidently in the presence of God and effectively represents God to his world.  He has a servant, a trainee, Elisha, who follow him and learns from him.  Eventually, Elijah announces that the time has come for him to depart to be with God.  Elijah then takes his mantle that he wore all the time and placed it on Elisha’s shoulders.  This mantle was that graduation certificate, that outward symbol verifying that Elisha had now arrived and was to resume the ministry that Elijah would leave for him.  

As we walk with Christ we undergo constant training from Him as we interact with Him along the way.  I look at it as conversation where I speak and I listen.  This conversation is aptly described as prayer.  Jesus and I talk a lot about what we are encountering and He teaches me to respond to those situations as He would.  Like Elisha, Jesus trains me to assume roles of higher service and responsibility.  Some of that higher service is the call to come to Ecuador and work with Jane in helping the people here.  Also I feel the nudge to go to Matthew 25 clinic to help the people there.  When I was still in active practice the work I did transformed into a ministry.  I didn’t view it as work any more but as opportunities to reach out to my patients in Jesus’ name.  Walking with Christ is an adventure filled activity that is filled with incredible peace and joy and that sense of fulfillment that doesn’t come from any other source.

Thank You, Lord Jesus, for inviting me to walk with You and to learn from You.  You are training me to be a disciple and are empowering me to go and make more disciples and to keep training others.  Thank You for filling me with Yourself and honoring me with Your presence and Your blessing.  Thank You, Lord.

I met Jane for rounds at 6 am. There were only two patients to be seen as the rest of them had gone home the night before. These two were recovering well and will likely go home today.

Devotions before breakfast. We read Scripture and the daily entry in Our Daily Bread.

After breakfast and devotions, we started our day in surgery. We had six surgeries scheduled for the day, all of these patients were dealing with some form of pelvic relaxation with bladder and bowel function problems because of the prolapse causing these structures to change position. For the bladder to function normally the position in the pelvis is important. If it drops out of its normal position, the muscular mechanism needed to hold urine in and have normal urination doesn’t work as well. The aim of surgery is to restore the normal anatomy and position. Sometimes that is relatively easy and other times when there is pronounced relaxation and stretching of ligaments has occurred, the surgery can be quite complex and difficult. My intent is to help restore function and in the process not cause any further change or harm that can’t be corrected later. Sometimes the surgery doesn’t work as well as anticipated and other times the bladder doesn’t work well and new problems develop. It is very difficult to determine just how much should be done so that function is restored and no new problems occur. What looks like normal positioning may not always result in normal function. So many variables factor into this and that creates a lot of complexity.

One patient today had long standing prolapse with pronounced change in position to the point the bladder and part of the bowel were contained in an everted vagina hanging outside the body. To repair this takes a lot of time and prayer to be able to put the anatomy back together as God designed it. Her surgery was our longest today and most involved. There were five other surgeries all related to prolapse to some degree. We were able to finish our day by 7 pm.

One of our patients accepted Jesus as her Lord and Savior while she was recovering from her surgery. This is one of the main reasons Jane has her mission work here. Her primary objective is to share the love of Jesus with those who walk through the door. The second objective is to provide top quality health care. It is always a joy to see someone learn to know and trust Jesus.

Lord, this has been a tiring day but also a good day as You worked with us to help these people. Father, You prepared the heart of the one patient to come to a saving faith in Jesus. You placed Maria Luisa in that room at that time and used her willingness to share openly about Jesus and this patient become a child of Yours! Thank You, Father, for blessing us even more by allowing us to play some role in this patient’s life so that she could learn to know Jesus. Lord, thank You for bringing us here and empowering us to serve the people here in Your name. I worship You tonight, Father. Amen.

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