Day 30: Hour 720

They say that lightening occurs when opposite, attractive charges build up between the chasm of heaven and earth. That it results when positive and negative powerfully surge toward each other. Remaining apart, maintaining separation – it’s simply too difficult. This deep, natural longing for reunion is solemnly echoed by the low and forceful groans of the billowing thunder clouds.

With a magnanimous flash, dust and sky become one.

And it lights up the darkness.

I sat in the consult room, inches away from this precious little boy. I could almost feel the heat that emanated from his fever-stricken, mangled body. His chest rose and fell rapidly. He was ten years old. And I have to tell you about him.

He had one arm. No legs.

From his wheelchair, he smiled. Sweat dripping from his temples.

It wasn’t that warm today.

Infectious abscesses ravaged his body. One fluctuant mass stared at us from his wrist, perturbed at the attention we were giving it. The other was perched on his shoulder. It had clearly invaded the joint. He had been battling these infections for years. And his missing limbs seemed to announce that they were winning.

Yet he smiled. He was a smart boy, I could tell. We handed him a sucker and it was clear we had made his day. Perhaps his week.

His fever, combined with increased respirations and a rapid pulse indicated he was septic. This means that the bacteria had likely made it into his blood. And was spreading.

He was still smiling, the sucker lost to sight in his mouth. But there was a deep-seated fatigue to his eyes. He was a tired little child.

My heart ached.

Suffering, pain, disease, heartbreak. I saw it in his face.

I see it in the mirror.

They are the dark, menacing clouds that rumble. That cry out. Reminding us of the deep canyon between earth and heaven. Between pain and healing.

Between that which is Whole and all that is broken.

We talked to his mother about making the 5 hour trip to Huambo, where he might be able to have the abscesses surgically lanced open. It was the same hospital where he received his amputations. With a look of anguished resignation, she informed us that she would not take him. She was tired too. How long can a mother watch her little boy fight a losing battle? When does a mother break?

Moisture flooded my eyes. Sometimes I feel that to care is to hurt. This curse called compassion seems to end far too often in tears.

But, I suppose to feel is to be fundamentally human. To love is to mirror our Maker. How I wish I could just see Him. With my own two eyes. I wish I could wrap myself in His embrace.

Since there was no way to get him to Huambo without his mother, we would have to treat him here. The first step was antibiotics. The treatment regimen would cover everything we could think to suspect, including milliary tuberculosis. We needed to weigh him to calculate the correct dosages. Because he couldn’t walk on his own, I stooped over and picked up what was left of his tiny frame. Like a newborn baby, I held him to my body and stepped on the scale.

The heat from his fever surged into my chest.

His rapid heartbeat was introduced to mine.

I realized then that this boy and I were not so different. His physical deformities only a visual narrative of my own inward condition. Like him, I was ravaged, broken, hurting. In desperate need of healing.

Thunder rolled across the skies. Yearning for that healing. Calling out for a reconnection between the Healer and the sick.

We calculated the dose of medicine he would need. Our plan was to lance the abscess on his wrist, clean it out, and allow it to drain. I asked Dr. Kubacki about the abscess on his shoulder and he wisely taught us that opening up a joint in the outpatient setting would be asking for complications.

He reminded us of the mandate of every physician: First do no harm.

In preparation, Kyle skillfully inserted an IV line to run much needed fluids into the child’s veins. The boy was whimpering now. Not crying. Just whimpering. After giving him some numbing medicine, Kyle lanced his abscess and wrapped a bandage around his wrist. Dr. Kubacki stood near, guiding him through the process. With one hand on the boys shoulder, and the other gently on his head, I watched.

And prayed. As the sky cried out in my heart.

My mind went again to One who says He can heal. When faced with suffering, pain, brokenness…there is just nowhere else I can go.

With eyes that bespoke the weight on His shoulders, Jesus turned His back on the splendor of heaven to willingly walk the dusty streets of humanity.

The deep thunder of distress reached his ears. The agonizing cries of our broken hearts, longing for wholeness. He could be silent no longer. He would come to be our Comforter. He would come to hold us. And as His gaze panned across our world, He hurt with us. He entered humanity and experienced what it meant to be called mortal.

He came to show us the way to life. Deep, satisfying life.

And as He did, the charges between soil and space began to accumulate; Electric chills fired through the spine of every man, woman, and child who recognized what was about to take place.

The chasm was preparing to be bridged.

He didn’t come to die. He came to drink. To drink in the separation, the darkness, the pain. Hell was poured into his chalice. Yet He did not back down. Instead, He drank deep. The moments when he hung on the cross were not the moments of a man dying. The Son of God breathed into his heaving lungs the agony that would have consumed and ravaged us. From the cross, Jesus moaned to His Father: “Why have you forsaken me?” Because in that moment, His Father looked away. In taking on the blackness of our evil, He existed in complete isolation from God. And every fiber in his weak and tattered body screamed in utter despair.

It was because of love. Sweet, mind-numbing love.

A flash of electricity brilliantly illuminated the horizon.

Heaven and earth met in a spectacular display of force. Hardly was this a safe scene to be near. Lightening can be powerfully destructive, after all. We had to back away, with our heads bowed low as Love did what only Love could do. And our only hope was to allow Him to suffer. To watch as He inhaled death, in all its fury. For us.

For me.

And He lit up the darkness.

How often have I wondered how such a beautiful story could be true. It seems too much to hope. Too breathtaking to be grounded in reality. That my Creator loves me and wants to walk with me is the stuff that fairy tales are made of.


But what if it is true?

What if we really are loved deeper than we dare believe?


Day 24: Hour 576


If I am being honest, I’m not sure I know what that word even means. Truly, it seems to defy our ability to obtain definition. Like a deep, scarlet-toned sunset exploding across the western horizon, ablaze in all its fury. Like a gorgeously harmonious piano melody played gently, softly, quietly. To try to define it seems to be an attempt to limit its expanse. Beauty has the ability to connect with longings for eternity that we rarely realize we have.

Our culture has so much to say about it. So does our Maker.

That we as humans are drawn to the beautiful is a gentle reminder to our tired eyes that our Father has not forgotten us.

I sat.

She entered.

My eyes could not pull away.

I had never seen an actual case of leprosy before. They say that the disease distorts the face so much so that it begins to take on a characteristic “lion-like” appearance. Without a doubt, she fit that description. This skin condition had afflicted her for three years.

But beneath the disfigurement, beneath the lesions that were slowly eating away at her flesh, a beautiful woman shone forth. A tender, loving mother.

She sat quietly, her child whimpering on her lap, demanding to be consoled.

The precious little one had a head that was swollen to twice its normal size. Hydrocephalus. The pressure inside her enlarged skull was pushing on the nerves that controlled her eyes which resulted in an unmistakable nystagmus. She was three. With a soft voice, her mother informed us that her child could neither walk nor hear.

But she loved to sing.


I looked down at my hand, the creases danced across my my skin. Rivungo is a village in the extreme southeast corner of the country. It is about as rural as you can get in Africa. My outstretched palm looked back up at me solemnly. The number of times a doctor visits this community each year can be expressed by this one hand of mine.

This one hand of mine. I have been given hands. And they were pleading with my brain to allow them to be transformed into extensions of God’s love.

Dr. Kubacki, Kyle, and I examined the child and within minutes concluded that this was a problem fixed only by surgery. If we could get this baby to the surgical hospital in Lubango, the doctors there may be able to correct the problem. Which could potentially mean a new life for this little girl. They would also have the medicines to treat the mother’s leprosy.

The only problem was that we were sitting in a hot, dusty town hundreds of empty miles from nowhere. To reach Lubango would take close to three days by car. And this family had no access to that kind of transportation.

But we had a plane. We talked with Gary, our pilot.

There were several empty seats on the aircraft that was heading back to Lubango. After a quick calculation to ensure we were not exceeding the weight limit, we arranged for them to join.

Her baby might survive. Within a matter of days, they would have access to life-altering treatment.

The mother was overjoyed, evidenced by the wide smile she offered us. She was missing several teeth.


I know that deep need exists everywhere. I know it does. Western nations need doctors. No doubt, that is true. Dr. Kubacki shared with us the struggles he faced when he embraced his desire to pursue medical missionary work. When he and his family made the decision to uproot, to plunge into a poor foreign country in order to serve, he was met with well-intentioned people who thought he was making a mistake.

Lovingly, with hearts of concern, they expressed to him that he should consider staying put, serving the needs of his own home country. Rash, radical decisions like this are not necessary, he was told. Interpreting Jesus’ beckon to “Follow me” need not be read so literally.

There is some truth to what they had to say. The western world needs doctors. Badly. And there are so many wonderful ways to serve. I am looking at me. Nobody else. Asking myself what am I going to do with these two hands, this beating heart I have been given. My dilemma is that I have been offered a 720 hour introduction to need of a different sort than I have ever experienced before. Face-to-face, I’ve now peered into its eyes. I have always known it existed. But I had never felt its existence breathing down my neck, chilling my bones.

That is my struggle. And I absolutely don’t know what to think.

I allowed my gaze to linger on this beautiful leprous mother and her sick daughter as my heart and my hands waged battle with my mind. Never were two foes as equally matched in strength.

A question surfaced, toying with my brain. From whence it came, I cannot say. It was not a safe question. For it challenged me in ways that I find disturbing, uncomfortable:

What if he had listened to them?

What if he had never come?

When we boarded the plane, I sat near the front. With a turn of my head, my eyes connected with this wonderful family, mother and daughter, sitting in the back. No doubt they were flying for the first time. Their starry-eyed expressions said it all. They were headed toward Lubango.

Toward hope.

Beauty. I still can’t define it.

But I think I saw it that day. In the loving eyes of a gentle leper. In those eyes, Jesus intersected this world of mine.

And it messed me up.

Day 20: Hour 480

I tossed and turned all night. I am not really sure why. Sleep is often an elusive companion. Last night he took a trip. Far away from me. I glanced at my bedraggled form in the mirror as the morning sun filtered through the glass door.

In jest, I whispered to my reflection that sleep would be back for a visit soon. Probably during today’s clinic time, unfortunately.

Today was my birthday. I had forgotten until late last night when Betsy reminded me. It’s amazing. I can remember as a young boy, the sharp excitement that would fill my core at the thought of my birthday. The countdown would usually begin several weeks away.

I really must be getting old.

There’s something about your birthday. You probably know what I’m talking about. The question “What am I doing with my life?” traveled up and down my neurons. It’s a healthy question to ask, no doubt. But for an introspective and philosophical guy like me, it can be a double-edged sword. Thankfully, I didn’t have much time to think. The clock was ticking towards when we needed to be at the clinic. I made my disheveled form appear a little less disheveled before sauntering toward the kitchen.

I sat down at the table for a quick cup of hot coffee with Betsy, Kyle, and Ben. Tiny sugar molecules escaped my spoon as I shoveled it into the steaming cup. Such wonderful company. So many good conversations.

I will miss this table.

Dr. Kubacki joined us in the room and announced it was time to leave. Again, we were reunited with our morning routine of driving to the clinic. We chatted briefly about the two beautiful babies who had been born yesterday. As we drove, my eyes caught the gray sky that was beginning to enshroud the sun.

The air grew thick and heavy, pregnant with the promise of rain.

But the dark clouds were not confined to the heavens.

Before I set foot in the clinic, I could hear their sobs. The three of us entered single file with somewhat confused looks on our faces. What was going on? With a glazed look, the nurse met us. He shared the unexpected news.

Last night, the two precious newborn babies died.

My throat went dry.


When we left last night, they both were doing well. An image of me and Kyle standing over the cooing baby yesterday crash collided into my reeling skull. Such beautiful little lives.

Dr. Kubacki entered the patient room first. The mother cradled the lifeless child close to her chest, tears bursting forth. The moans that traveled from her throat knew no language barrier. Her heart was swallowed in grief.

He gently put the stethoscope onto the tiny frame and paused momentarily.

With a nod of his head, he softly rubbed the mother’s shoulder.

No heartbeat.

There I stood, beside him. Questioning my ability to move.

According to the families, both children had been fine until the early hours of the morning. The one child “lost strength” and died suddenly. The other family reported that their child began to seize before passing just as quickly.

Dr. Kubacki motioned for us to follow him outside, like a coach would call his players in for a huddle. I needed something. Anything. Some sweet words of comfort to latch on to, to communicate to me that everything was going to be okay. I could tell he did too. The infant mortality rate here in these rural villages soar high above those in developed nations. The conditions, the lack of prenatal care, the rampant infectious diseases, they all conspire together to make a newborn’s chances of survival slim.

He reminded us that as a doctor, it is okay to grieve. He reminded us that we do not hold the keys to life and death. He reminded us that it’s okay to ask “why?”


With tears in our eyes and anguish in our hearts, we beg for answers.

Why create a precious life, only to stand by as the same life is snuffed out?

Dr. Kubacki retold us the story of how humanity looked into the loving eyes of Jesus and asked Him why. They wanted to know why a man was born blind. I needed to hear this. Jesus gave a short answer. But then He acted. There is nothing passive about Jesus. He is not far off. He is not a mere theoretical figure. He refuses to be confined to the abstract.

He moves toward suffering. Not away.

He lit up the blind man’s eyes.

“We too are called to act”, Dr. Kubacki continued. “Like Jesus. And as a physician, one of the best ways that I know how is to learn.” He was right. We need to learn why the babies died. What can we do next time to foresee complications? To alleviate suffering. We discussed several reasons why the infants may have died. Cerebral malaria jumped to the top of the list. It is a disease that doesn’t necessarily manifest itself in any obvious way until it is too late. It gives little warning.

As we finished talking, the crowd of Angolans that gathered around for the pre-clinic discussion grew quiet. These people see far more death than we do in the developed world. They are a hearty folk. They do not expect to live a life without pain. Though they grieve genuinely, they do not expect to live a life without loss.

We sat down as Dr. Kubacki addressed them. He shared with them that we have a God who knows about suffering. Who knows what it is like to lose a Son. When Jesus arrived on our earth, He suffered much.

But amidst that suffering, He had a few things to say about the life to come.


Yesterday, two precious little babies entered the world in rural Angola.

Today, two precious little babies died.

As I wrestle. As you wrestle. Call to mind and heart the recognition that beyond our need for answers, beyond our need to understand, beyond our need to control…

We need deep relationship. It is in knowing our Father that we can come to trust. It is in walking with Jesus that we can hope to be able to slip our hand gently into His. And feel His strength.

I have repeated these lines numerous times throughout my many posts. Forgive me if you tire of hearing it. It’s not necessarily for you.

It’s for me.

Day 16: Hour 384

I hate feeling out of control. In so many ways.

The butterflies in my stomach fluttered as the small aircraft that was carrying us picked up speed down the runway. Faster, faster, faster. My body was stapled to the seat and my heart was vigorously reminding me that it was still located within my chest cavity.

I was used to big planes…

But a small 10 seater? Different story.

We were flying southeast to the province of Cuando Cubango. Dr. Kubacki was scouting this province for potential medical work. We were headed to the provincial capitol, Monangue for a few meetings before flying out to explore the rural villages.

The Portuguese used to refer to this region as “The end of the world.” The thought laced my veins with an epic surge of adrenaline. Our plane neared the group of trees at the end of the runway and the front wheels lifted off. Butterflies. Adrenaline. I never did like Cedar Point. The feeling of impending death is not something that I joyfully embrace.

We began climbing higher in the gorgeous African sky, the turbulence jostling my frame against my carefully tightened seatbelt. Far below, the terrain, the rivers, the trees, the huts began to shrink.

Our pilot, Gary is skilled at what he does.

But I still hate feeling out of control. In so many ways.

When circumstances happen in my life that threaten my facade of control, I respond with the fear and desperation of an injured animal. When things that I feel are necessary for my very existence are abruptly removed from my life, I break down. Unable to move. No matter how much money I possess. No matter the comprehensive nature of my insurance plan. No matter the relational security that I think I enjoy.

I lose control.

Life happens, right? Investments go bad. Accidents occur. Relationships are broken.

How do I respond?

More turbulence. The butterflies seemed to be morphing into birds within the confines of my insides, clamoring for a way out. I was seated directly behind Gary. He leaned back in his seat, elbow resting comfortably on the armrest at his side.

Our pilot wasn’t concerned.

He was in control.

I watched as he and his “co-pilot”, Dr. Kubacki traded smiles through their headsets. They were laughing about something.

My mind eased. And the butterflies began to dissipate, content with the knowledge that I was going to be okay.

I don’t think I need to even finish the spiritual application. But for my own sake, because I need to see it written down, because I need to remind myself of it again, I will.

So far in my relatively young life, I have learned a few simple things. Detours are going to happen. They just are. And most of the time they hurt. Horribly. Painful changes parade into what we thought was going to be a “wonderful” life. Circumstances mock our ability to control. For as long as I can remember, my reaction has been to arrogantly cling tighter to the control panel. It’s the “American” way. With white knuckles and clenched jaw, I wrap my fingers around the steering wheel, daring even heaven itself to pry them off.

But strength wanes. Fingers tire. Fighting to remain “in control” becomes miserable.

And heaven wins.

In walking with Jesus, I am coming to learn that surrender is beautiful freedom.

Not painless. But beautiful.

I peered out the window as we began our smooth descent into Monangue. Slowly, the leaves on the trees began to regain their demarcations. The landing gear engaged the ground with a thud. Thanks to our experienced pilot, we landed safely.

And I was okay.

In single file, we exited the plane.

My feet graced the floors of the beautiful government airport. This palatial structure stood in stark contrast to the rest of the city. Everything sparkled. Only a few meters away, homes were built of clay and the floors were made of dirt.

My mind wrestled again.

We and our luggage were escorted through the city to a mission which would serve as our home for the night. Our hosts, a beautiful South African missionary couple were incredibly gracious to us. These wonderful people whom we had never met, welcomed us as if they had just discovered long-lost relatives. So much love on this trip. They shared their story with us. For years they have been faithfully serving the people of Angola, despite many obstacles and discouragement.

You can learn so much about a person from their eyes. They say it’s the “window of the soul.” I believe it. And when I looked into the eyes of our hosts, I came face-to-face with genuine, humble, sacrificial love. Everything I desire to be was here, right in front of me. Eyes like that don’t develop by default. No, I imagine they can only come from hours, days, years spent walking slowly with our Creator.

They cared for us well.

Our meeting was in the morning. In order to do his medical mission work in this rural province, Dr. Kubacki needed permission from the provincial vice-governer. It was a somewhat pivotal moment for the mission work here and we were unsure of how our proposal would be received. We slept quietly that night, wondering, hoping for a positive reception.

The following morning, the hot sun rose again — as it always seems to do. We ate our breakfast of cereal served with hot milk and tea. As I chewed, I could tell Dr. Kubacki was mentally preparing, steeling himself for whatever the vice-governor might say. When he donned a suitcoat on top of his jeans and polo, I knew he was taking this meeting seriously. He was the picture of confidence.

That’s when he said it.

He looked at Kyle and I and said: “Boys, go put on the best clothes that you packed.”

The blood drained from my face.

I hadn’t thought to pack nice clothes. My dusty jeans and this old plaid button down WERE the best that I had packed. I didn’t even bring shoes, only my trail running sandals. I didn’t see this one coming. Kyle and I looked at each other with wide eyes and I knew we were thinking the same thing: “We can make this work.”

So, with meticulous attention to detail and the confidence of a couple of Hollywood movie stars, Kyle tucked his t-shirt into his jeans while I tried to wipe the dirt stains off of my pants. There wasn’t time to shower so I splashed water onto my face and tried to fix my hair. But I would need more time than I had. The back of my head carried an uncanny resemblance to a disheveled peacock. And it refused to be tamed.


Our morning hair was certain to impress the vice-governor.

We arrived to the meeting. And it actually went quite well! All of the government officials were dressed to the hilt in their neatly pressed suits and ties. Gary was dressed in his impressive pilot uniform, wing button sparkling from his front pocket. And of course, our fearless leader Dr. Kubacki, in his sportcoat and polo shirt.

And then there was us…dirty blue jeans, dusty sandals, old t-shirts, and hair that would have made Albert Einstein feel at home.

Thankfully, the vice-governor gave us the permission we were looking for. And that is truly all that matters. It was encouraging, to be sure.

Today was an incredible day. There is so much more that I could write about. I am constantly coming face to face with ways in which I need to grow.

And I am meeting so many incredible people in the process.

Day 13: Hour 312

The relentless buzzing of my alarm beckoned me from my dreams. If I could have rolled out of bed, I would have…but I was on the top bunk…so I carefully navigated down the ladder to the steady surface of the floor. I took a moment to briefly orient myself.

My name is Nigel.

I am a medical student.

And I am in the backwoods of Africa. Worlds away from my previous life.

With that much needed introduction to reality, I splashed some water on my face, threw on some clothes and tossed a few snacks in my bag. Good to go.

I made my way to the kitchen and was greeted by the morning faces of Kyle and Dr. Kubacki. The three of us weren’t about to win any beauty pageants…but I couldn’t deny that these were amazing guys to get to share the month with.

Last night, Dr. Kubacki went over today’s schedule with us. We would rise early, drive to the Cavango clinic to check on a patient, then head out for a two-hour road trip to Vicungo, a village where Dr. Kubacki holds a monthly clinic.

We packed up the 4 cases of medical supplies for the mobile clinic and headed to the car. As I rolled down my window, the cool breeze that drifted into the vehicle was a beautiful gift. The sun was bidding us good morning.

It’s the simple things in life, right?

Bouncing our way over this rough terrain to the Cavango clinic, I had to chuckle as I tried to sip my water, failing miserably thanks to the numerous African potholes that obstructed our way. I smiled.

It’s the simple things.

It was 6:30 AM. Oddly enough, I didn’t feel overly exhausted. On the contrary, I felt fairly alive. Life is a beautiful thing. What a gift to be able to breathe, to see, to think, and to feel.

After the short drive, the truck came to a halt outside the Cavango clinic.

Our patient here was a seventeen-year old girl whom we admitted yesterday for hypertension and ankle swelling. She was a few weeks post-partum. Normally preeclampsia resolves with delivery…but it’s possible for it to last several weeks afterward in some cases. We had given her some blood pressure medicine and although it was too soon to see if it had made any difference, we checked in on her anyway.

She was so shy — whether it was because of our white complexions or not, I can’t say for sure. Several times I caught her quizzical glance and offered her a wide grin. Each time she jerked her eyes away. I kept smiling as I remembered something Dr. Kubacki had told us on our first day here:

“Don’t be surprised if you don’t see as many smiles here in Angola as you might expect. It’s not because they are unfriendly.”

It’s just that, well…life is hard here.

The idea that life is meant to be enjoyed is a foreign thought to the rural Angolan culture. Inside, I wrestled momentarily. I come from a world that preaches the necessity of “doing what makes you happy.” They just don’t see things that way here in Angola.

I snapped back from my thoughts.

We had finished our brief work at the Cavango clinic and slowly meandered back to the vehicle, preparing to head out to Vicungo.

As we made it back to the truck, I grasped the cool metal door handle and pulled it open. An Angolan woman ran up to us. She was one of our tuberculosis patients and was receiving the two-month long treatment here at the Cavango clinic. In words that I couldn’t hope to discern, she explained that she needed a ride to the next village for the day and asked if she could hitch a ride. Since it was on our way to Vicungo, we happily agreed.

The group of us piled in.

In a stoic manner, our Angolan friend sat in the middle back seat, flanked on each side by Kyle and me.

We drove away, leaving the clinic in the rearview mirror. Dr. Kubacki conversed with the nurse in the front seat who had also joined the trip while the three of us in the back sat in silence. I can only imagine what she was thinking…sitting between two white guys. Probably for the first time.

The potholes jostled us around like blueberries in a blender. With every left turn, she was thrown into my shoulder. Every right turn, Kyle’s. What different worlds we were from…with no way to communicate beyond the expressions on our faces. But here we sat, like the three amigos, bouncing around side by side in the backseat of a truck. In the backseat of Africa.

It’s the simple things in life that, when reflected upon, can paint wonderful pictures, teach precious lessons, convey timeless wisdom.

When we finally hit a smooth patch of road, I pulled out a small bag of almonds I had stowed neatly away for a snack. I breathed a brief, silent prayer of gratitude for a mother who cared to pack them for me. I twisted my head to see the girl beside me.

I nudged her shoulder. She looked. I opened her hand. Her skin was tough. I looked at my own hand. Smooth, soft. It’s doubtful that she was much younger than me, yet something down deep communicated that she had been forced to mature much quicker.

As carefully as I could manage, I dumped a few of the treats into her hand. She accepted with a nod. I watched as she quietly munched.

Satisfied that she was content with the portion I had given her, I threw a handful back into my own mouth and chewed slowly. I gazed out the open window as the engine bemoaned the agony of traversing this rough terrain. The breeze that wafted in felt amazing. I was lost in thought as the beautiful scenery flashed across my gaze.

Today, I was able to share a pack of almonds with a young woman suffering from tuberculosis.

It sounds so small. So insignificant. So forgettable, I know. But it was a moment where the reality of my life and the beauty of simple kindness came into pristine focus. Jesus said “It is more blessed to give than to receive.” He promises that when we speak kindness, express love, give freely of the little that we have…well…it’s the same as if we did it to Him.

My mind cannot grasp the love He has for us.

I experienced a tiny speck of that today.

With a pack of almonds.

When we begin to walk with Jesus intimately, I suppose that giving becomes the most natural thing in the world to our hearts. How can we hold on to our blessings when we serve a God who takes such pleasure in giving of Himself? The Kubacki family (and so many others back home in the US) are an amazing example of this to me.

I still feel that I have so much to learn…and a long way to go.

I wish I could chronicle every one of these “small” but profoundly moving encounters I am allowed to experience every day here. I probably experience similar moments back home in the States. Let me rephrase that: I am sure I experience similar moments back home in the States. But I think I am just too preoccupied with “doing” things. Too busy accomplishing tasks to notice. After all, why sit down and reflect when I can check one more thing off of my to-do list?

Why does it take transplanting myself to a poor foreign country to realize that real, true, relationship-driven life is experienced in between the many tasks on my list?

This journey in Angola has given me so much to chew on. I feel like a cow. Chewing, chewing, chewing.

My jaw is getting tired… 🙂

“Leave enough margin in your life to be a “Good Samaritan” when your day is “interrupted” by someone wounded.” – Dr. Kubacki

Dear reader, if you made it this far, I just want to thank you for taking the time to travel with me on this journey. I know you’re busy. Things to do. The fact that you spent a few of your valuable moments to jump inside my head with me…well, I am incredibly grateful. In turn, I hope that I was able to share some thoughts of value for you to consider.

May you live today knowing that you are loved by our Father in heaven. Because you are. Oh my friend, you truly are…

Day 11: Hour 264

Sweat droplets began forming along the creases in my forehead. For some reason, the heat seemed heavier this morning. In my mind, I pictured the snow that was likely blanketing my home back in Ohio. Conscious of the need to stay hydrated, I took a short gulp of water from the bottle I had tucked snugly into the side pocket of my backpack. The water came out quickly, some of it escaping onto the dusty concrete floor that supported the clinic.

The air was still and the sun was getting higher.

Kyle, Dr. Kubacki, and I sat in the exam room where we would see our patients. By now, we had developed somewhat of a routine. Breakfast, the drive to the clinic, gathering the patients around for our “discussion” time. All of this before heading to the exam room. It’s strange how even in a foreign environment we humans still grasp for routine. Today seemed no different than any other day.

I was wrong. Today would be different.

As soon as her exhausted form illuminated the corners of the exam room door, I knew she was sick. I instinctively put my water bottle away and pulled out my notebook, pen poised to write. Dr. Kubacki has a way of teaching that requires us to be ready at all times.

She could barely sit up straight on the bed. Her husband sat nearby, concern drenching his face as he began to dialogue with us. In Portuguese, he told us their story.

They had traveled 100 km on motorcycle to see us.

The road conditions likely made it feel twice that distance.

She was 39. She looked 60. Her thin frame appeared as if a small gust of wind would have the power to overtake her. Seven months ago, she began to experience abdominal pain. At the same time, she stopped having menstrual periods and started to experience fatigue along with trouble urinating.

It was getting warmer in the clinic. I reached up to wipe away the sweat from my eyes.

We gently laid her back on the exam table to take a look at her abdomen under ultrasound. It was Kyle’s turn. Together, we pulled out and prepared the machine. She looked so tired. When Kyle placed the probe over her right ribs, a dark cystic mass stared ominously back at us from the region of her kidney. We then moved to check her other kidney and found the same thing. By now, she had fallen asleep on the table, her shallow breaths exhaling noisily.

More sweat in my eyes.

Hydronephrosis refers to an engorgement of the kidney reservoirs and it usually occurs due to an obstruction somewhere along the urinary tract.

“But where is the obstruction?” I asked aloud.

As soon as the question left my lips, my heart sank. Dr. Kubacki stood behind in deep concentration and directed Kyle to move the probe to the bladder. He obeyed.

Where the bladder should have been, we didn’t see any bladder. Just a large solid cancerous tumour that consumed almost the entire ultrasound field. I was stunned. We sat. I listened as Dr. Kubacki calmly and compassionately gave them the news.

She was going to die.

And there was really nothing we could do to stop it. Due to her neurologic symptoms, he speculated that she possibly had brain metastasis on top of it. Surgery is always an option but at most it might increase her lifespan by 10-12 months. However, to even get the surgery, this couple would have to find a way to make the 10-hour drive to Lubango. Likely spending their life’s savings in the process.

I quietly set my notebook down on the table behind me.

Schistosoma haematobium is a blood-borne parasite that is contracted through contaminated water. If it makes it’s way to the bladder, it causes longstanding inflammation which can eventually produce bladder cancer. This takes place over the course of decades.

She most likely contracted it when she was a little girl. And the initial infection could have been treated with one medication.

Dr. Kubacki dialogued further with the couple, explaining that it would be best for them to go back to their village and spend the remaining months she had with each other and their family. She was trying to sit up now, her face communicating nothing but exhaustion. Her husband still wore the same expression of concern, now mingled with an unmistakable sadness and resignation.

I reached up to wipe the sweat that had mixed with tears from my eyes.

Before they left, Dr. Kubacki put his hand on her shoulder and offered to pray for them. We bowed our heads as he prayed. I couldn’t understand everything he was praying since it was in Portuguese.

There are so many things I don’t understand. Today I encountered impending death in the eyes of a young woman. And it bothered me deeply.

I was hit with a flashback to yesterday morning. Dr. Kubacki shared the story of Lazarus with the patients that had gathered around before we began clinic. Lazarus had been dead for days when Jesus arrived. Everybody was mourning his passing.

Death robs. It steals those precious people away from us. Those people that we need.

And when Jesus arrives, He doesn’t act the way we would expect God to act. Jesus knows what is coming. He knows that Lazarus will walk again. But instead of parading down in majestic confidence…

Jesus kneels down. And weeps.

The death and and suffering that we experience deeply bothers our Creator. I don’t believe Jesus was only mourning the loss of Lazarus. He was embracing the heavy sorrow that accompanies humanity. Our tears move His heart. And He enters the scene as one of us, to walk with us, to weep with us, to heal us. Whether in this life or the next.

As I rested my head in the crease of my elbow in this humid African clinic and listened to a doctor pray softly with a woman who has months to live, I faltered under the stiffening reality of life and death.

“To selflessly care for one suffering is equally as beautiful as to suffer well.” – Dr. Kubacki

I know this is really heavy…my goal is not to depress you! There are so many light and happy moments that I am experiencing here in Angola (and I am learning so many amazing things). Truly, the challenge for me is deciding what NOT to write about.

My bottom line? I want to share with you the deep moments. The ones that perhaps may resonate with you in fresh ways. The moments that might lend themselves to opening up our eyes to the millions of precious people who live around the world.

To get you to think and to feel.

Also, today I tried to write in more of a story format because I truly believe that we as humans resonate with story. It engages our minds and our hearts. It pulls us in and forces us to wrestle. And that is good for all of us.

Day 9: Hour 216

The stars here in Africa are awe-inspiring. For the first time in my existence, I laid eyes on the Southern Cross. Wow!

Being able to stay with Dr. Kubacki and his family has been amazing. His wife Betsy is wonderful and has taken such good care of us. His kids, Ben and Meredith, are a blast to hang out with. Kyle, Ben, and I recently got the chance to play soccer with some of the local Angolan guys. And it seemed like every kid in the village came out to watch us! So much fun. A few of the local guys played in their bare feet. But that’s where I drew the “cultural assimilation” line. I slapped on my Reeboks and threw on my Beckham jersey for some much needed inspiration.

Afterwards, Kyle and I were both a little sore…but in our minds it was well worth it. There were only 2 goals scored in the game. I assisted one and Kyle scored the other.

Way to represent, huh? 🙂

Clinic continues to be such a great experience. Working at making challenging diagnoses with an incredibly limited arsenal of tests has highlighted the importance of taking a thorough history and physical exam. Medicine is still an art that requires skills of deduction and observation. It’s what I love about it.

We had a pregnant woman come in who had a history of 11 pregnancies with 2 miscarriages and one child who had died in infancy. She was complaining of headaches and some lower extremity edema. Dr. Kubacki was surprised that she had so many children survive. In his experience in Angola, one-third of children born here don’t survive past their 5th birthday. This woman had “beaten the odds” somehow. When we measured her blood pressure, it was elevated. Our challenge was to determine if she had pre-ecclampsia, gestational hypertension, or if she was in labor. We worked our way through each possible scenario and treated her the best we could with the tools that we had.

The other challenging patient we saw was a 63 year old woman complaining of symmetrical weakness, fatigue, and persistent vomiting several hours after each meal. I performed an ultrasound to look at her liver, spleen, and kidneys. We found a few abnormalities but nothing we could really hang our hats on. The three of us put our heads together and came up with a list of differential diagnoses that fit the clinical scenario. It was challenging without access to the battery of tests that we would have had access to in the U.S.

On our drive to the clinic after lunch, Dr. Kubacki told us that he has gotten into the habit of telling his patients: “I am as much a counselor as I am a physician. So please tell me if there is any way I can help you.” He truly has a heart to serve these people. Something I hope to emulate. His attitude toward medicine and life have reminded me that I am here to serve. To participate in bringing hope and healing to those around me.

The realization of the life-giving freedom that comes with taking myself off of center stage has struck me in such a way that I know God has to be truly behind it.

Yesterday we attended church here in Cavango. Talk about an incredible experience! We sat near the front where all the children (and a fair number of adults) could steal easy glances at our white skin. If you’ve never been in an environment where you stood out starkly from the people you are surrounded by, I’d suggest giving it a shot sometime. The tension that it stirs up internally is absolutely beautiful in its ability to uncover insecurities inside of your heart that you didn’t even realize existed.

After the many songs and times of teaching, we left the four brick walls of the village church to stand outside and greet each other. People began to line up to shake our hands. There was one little boy who came through the line 5 times with a beaming smile on his face. As I stood there and saw each pair of eyes pass me in line, I wondered to myself: “If the lines on their faces could speak, what would they say?”

I love hearing people’s stories.

The local pastor here in Cavango has an incredibly moving story. His name is Jeremias. His face speaks a language that needs no interpreter. A face that has seen much pain, struggle, suffering. But that same face is dripping with love and a joy that is real. Joy that seems strangely detached from this life.

Jeremias grew up on the opposite side of the country. When he was 10 years old, the brutal civil war that ravaged Angola reached his village. So much of the fighting revolved around terror. Military groups would march into homes and dismember children in order to gain control through fear. When word reached Jeremias’ village that they were coming, he and his 21-member family fled. They found a dirt hole by a river. They huddled in together, filled with terror of being found.

It didn’t take much time for their nightmare to become reality.

The group of fighters riddled the hole with gunfire before savagely tossing in several grenades and walking away, satisfied that the entire family had been destroyed.

But they were wrong.

One little 10-year old boy survived.

Jeremias stayed in that hole for 3 days with the rotting bodies of his dead family, immobilized by fear and terror. On the third day, a woman passing by heard the cries of this precious child. She scooped him up and brought him to her home. For 2 years, she loved and cared for him as her own son. Because she was a Christian, she would instruct him “If anything happens to me, I want you to go find a church. They will take care of you because they are God’s people.”

This woman who became a mother to Jeremias was murdered when he was 12. Only two years after their miraculous meeting.

Again, he fled.

Eventually, he stumbled upon a village which happened to have a church building. He took shelter there for the night. In the morning, a few church members found him. Once again, he was offered a home.

When he turned 18, he decided that he wanted to become a pastor.

He relays why he made this decision: “I don’t understand why my family was murdered. But I believe that God has a purpose for suffering. I want to serve Him with my life.” Despite not being able to understand, he trusts.

The first person we met when we arrived here in the village of Cavango was the friendly face of Pastor Jeremias, smiling from ear to ear.

Yesterday during the service, he stood up and preached. It was a message about prayer. He boldly proclaimed the beautiful truth that God has a Father’s heart toward us and emphasized the importance of embracing that relationship. He continued to teach about how we can forgive those who hurt us because God offered the life of His Son to forgive us.

This man who last saw his earthly father in a bloody hole in the ground on the other side of the country…was introducing these villagers to their Heavenly Father. Tears welled up in my eyes.

These are the moments that I feel completely inadequate to describe with mere words on a page.