12 stones

i woke up early to get ready for my first day back at work, made the coffee and the boys breakfast, and got on the computer to check in with the other side of the world-going to sleep as i'm waking up. there was a post from my friend as she was going off to bed -about the irony of what she is facing today- the likely complete cure of cancer with her bilateral mastectomy, but the acute reality of cancer in a new and for the first time, visible way. and she admitted to feeling scared and not too funny- although i still laughed as i read her post and was blown away by her ability to scarf down an piece of apple pie the night before surgery- i'm the queen of the nervous stomach.

mike and i sat down for our time in the morning before the crazy begins, to read the bible and pray together.  i was ready in a feisty sort of way.  i wanted to jump right into the praying part because i had some things to say- but i thought maybe i should listen to God before i started speaking. the first reading was a psalm about God opening the red sea for the israelites despite their rebellion.   the next was in joshua- the story of the israelites crossing the jordan river- how God parted the waters for them again, and told them to take 12 stones from the middle of the river and set them up as a reminder that the hand of the Lord is powerful.  the last reading was from mark, the story of Jesus healing the boy with convulsions.  the father asks, 'if you can do anything for us, please do it.' and Jesus replies, 'IF? everything is possible for him who believes' and the father says, 'i believe, help me overcome my unbelief'.

today these reading were for us.  it's not a coincidence.  it was a moment of esctacy- the divine entering the regular.  God showing up on a tuesday morning.  i heard:
-i care and provide, even if you're ignoring me
-i make big things happen- the impossible, becomes possible
-have faith, and i'm safe enough that you can even ask me to help you believe

so i prayed.
"okay God.  you ask us to remember.  to carry the 12 stones.  you fill the old and new testament with examples of your power.  i know your power.  you parted a giant body of water, twice, to protect your people. you healed people right in front of an audience, you have provided friends for my girl in africa.  i know you can do anything - so i'm asking you to completely heal my three friends with cancer.  i know you don't always do it, but we are asking with full belief that you are able. " (but i was more specific and i begged more and my voice cracked and i might have even sounded a little bit mad by accident).

then i got in the shower and bawled my eyes out.  i mean the full on ugly cry.  and i washed and i cried and i prayed some more, because i remember being the child of a woman with breast cancer and feeling the tension of needing to care for her and desperately wanting her to care for me, and fearing that what if the unthinkable happened and she someday disappeared. so i prayed for her kids and her husband and her parents and her surgeons and for her safety and her peace and freedom from anxiety. and i thought about the last scene in the movie 'it's a wonderful life', how i always cry through it. tragedy happens and everyone shows up, and george sees how loved he is, how valued. i thought about all of our george bailey moments, how people respond to the nudgings, how we become the hands of God for each other, we become the answers to some of the prayers.  we help bring the peace and the strength. i dried off, and dried my tears.

then as i packed my bag to head out the door, i heard bryn and jude on the porch.  bryn was holding a fake candle from the american girl set, and sitting still with his eyes closed so i leaned in to hear with out being seen.
"dear God, i thank you for this day, i pray that you will protect us  from angry monkeys and black mambas. amen."
it was so sweet to see that childs faith. to see and hear that he knows God shows up. because yesterday we had some crazy monkeys in our yard and a baby black mamba (fo' reals).

and i kept thinking about those 12 stones taken from the middle of the jordan river- 12, one for each tribe.  stones carried on shoulders across a dried river bed where the water had been peeled away.  stones set up as a memorial on the other side.  and then the river flooded over.  stones that were carried with them as they camped- set up as a reminder of God's strength- because he knows we forget. we get busy.  things are going well. we aren't standing in front of waters that need parting. 

i love that the stones were Gods idea.  his way of saying, 'trust me, you'll forget'.  his first commission of an art installation.  His love of the symbol- not just any stones, the stones from the middle of the jordan- not just any number, twelve- the fact that they were heavy and carried far and set up where the people were.

i wonder what are my stones? the things that remind me of when the rivers were parted for me.  symbols of the power and the grace.  how quickly i can forget. 

what is in a year?

it's that in between time.  that week between Christmas and New Years.  the middle of the week that finishes one year and starts another.  i'm stuck between reflection and planning.  review and agenda, looking back and looking ahead.

what is in a year?

this was a big year on the outside.
i live here now.  these are the images of my days.

my boys with some other boys

drive home in the rain

the babies home

drying clothes on the lawn

side of the road fruit market

tea fields on route to jinja

so different than the year before.  wonderfully different.  wonderful in different ways.

but what about on the inside?
has there been any transformation? 
is my clackity clack the same?  where are my feet taking me?  what do i dream about?  am i loving better? caring more? being generous, and present, and still?  do i laugh more? am i dancing with my kids and singing in the car and spreading joy? am i letting things go that should be forgotten?  am i clinging to those things that i know are treasures?

what is in a year?  or a week? or a day?
what is in a moment?
good night.

remembering

trust. and faith. trust follows- or is it first?

i've been thinking about the importance of rituals and disciplines and holidays.  how they are more than patterns. more than frames to hang our days on- they are triggers to stop.  they are flags to remember.   they are pause- if we allow them to be.  they are opportunities to not forget things that we do forget. the things that often matter the most- but get stuck on the back burner of life.  so we need to dust them off- the important things.

holidays and traditions are also important sociologically- they are a group experience- they are collective memory- they are ways of teaching the next generation what was learned - passing on the story- histories of lessons- uniting us- calling us back to our people before- when the same dna was there and the same blood types and the same need for love and the same feeling of pain and the same desire to be known and valued.  they teach us where we came from- where we've been and might not want to go back to- they remind us that there is nothing new under the sun, or the moon- that we're not alone.

martin luther king jr day.  veterans day.  tomorrow is presidents day.  and there are religious holidays- all religions have them and we are told to keep them.  i'm most familiar with the christian and jewish holidays.  i love the purity of the jewish holidays.  they haven't been squashed by reindeers and easter bunnies.   i've been fortunate to celebrate passover many times with my jewish friends.  i love the many parts and symbols- that each have a lesson and a memory. and that it's about remembering God and his protection and provision- that they were not a forgotten people- that the celebration is to be a reminder that they still aren't forgotten.

Passover took on new meaning to me when i was in the eighth grade and my best friend, the one i'd celebrated passover with, became sick unto death.  and it was the week of passover.    i remember the D.C. hotel room - where i was sitting- overhearing my father on the phone getting the news that my friend was perhaps dying in the ICU. we were driving back to boston from our family vacation visiting grandparents in north carolina. it was the worst thing that had ever happened to me.  i remember looking out the window for the next 8 hours in the car- but all i saw was the rain- the drops on my window- how they start at the top and then fall -making a track that joins other drops- sliding together until they land at the bottom of the window and become part of the river leading  back to the air again. that was it- the blurry countryside and the crystal clear rain and my tears and my prayers. i would send one on each rain drop that i watched fall, and i begged.  i begged God to please allow death to pass over her.   i had faith that He could- but i wasn't sure that He would- because even at 13 i knew that bad things are allowed to happen- that we don't always understand it- that we are small- that life is fragile- that things aren't fair- but it didn't make me question God's existence.  so i cried and i begged and i hoped and i believed and i waited and i cried some more.

by the end of the week- we knew she was going to live.  she'd had her own passover.  we all had.  but we still didn't know what survival would look like.  would there be brain damage- would she talk and walk?  so i cried and begged and hoped and prayed some more.  it took a long time for her to come back to us as we knew her- as we now know her- but she did.  she walks and talks and spends her days helping other people as their doctor and their mother and their wife and their friend.  as my friend.

so passover is a really important season to remember.  it's a 'double'.  it's religious and personal.  we all have our own practices, or our own dates of remembrance.  i'm thinking back to the times that i forget.  those of deep wonder- of crying out and being answered. of when the answer wasn't always what i wanted - but even still, i wasn't abandoned. judes birthday is in a few weeks (see post 'happy birthday jude' for details).  how quickly i forget those months when we wondered if he'd walk and talk- when we lived in a season of waiting and hoping- when we lived with a daily sense of our fragility- and yet the gift it gave us of perspective and the importance of real things- family, friendship, faith and smiling.  i live with jude- i see him all the time- but i still forget.  bryn was born with a hole in his lung that kept him in the ICU for a week- i cried and begged and prayed- and thank God, he's fine, but i still forget.  i see zoe all day and see how far she's come- and again- i forget.

maybe i need to turn remembering into a practice. a daily ritual. 5 minutes to reflect on where i've been- to be thankful and not be stuck in the minor details.  uncover the important parts and live in them. because i am small and life is fragile- but God is not.

understanding backward

amazing.  cold and snow covered atlanta.  feels like i'm back in boston.  the kids were out of school all week- it was crazy-but fun.  yesterday i worked, and again, it was a welcome break.  when i got in early yesterday morning i found out two of my patients had died the day before.  i took comfort in knowing they died peacefully and pain free because they were up on our palliative care unit- with some amazing nurses who are so good at the caring part of their job. but there is always a little sting- even when expected- seasons of life.

last night i finished my book, 'the dirty life' by kristen kimball.  it was the book mike gave me for christmas- about farming, food and love. about a girl from NYC who meets a very different boy- on his farm- and how she leaves her life to join him.  she falls in love with him.  she falls in love with farming. with the dirt of it, the work of it.  and it seems for her- he and the earth and the produce of the earth are all one- they can't be separated. i'd complained about the book because i was hearing too much about farm logistics and not enough about love.  but the last couple of chapters pulled it all together for me. i began to understand that for her- they are all related.  she found her self- her identity- her place of peace- somewhere she never expected- somewhere she would never have purposely looked.  she stumbled into it and then she took a risk.
in the manure and the cold farm house and the 4 am waking and the calloused hands- she found purpose and meaning.  it wasn't pretty- but it was beautiful.  it was dirty- but glorious.  it was hard- but sustaining.  it took time, and work- but it gave back in abundance. she describes the constancy of it- the fight against nature trying to reclaim it's wildness.  the importance of vigilance- and the consequences of inattention. she began to value these things.  she saw both the reliability and unpredictability of nature. and to understand the importance of the heat in summer, the frosts and freezing winter, and the rains in between.  each needed, each with merit- even in their extremes.

it reminded me of many parts of my life.  of finding myself where i never dreamed i'd be.  of finding beauty in the difficult.  of process and work and the pain of it- and the glimpses of joy.  that joy often comes covered in dirty- like birthing.  it reminded me of the value of ritual- of the importance of routine- that those things (which we often complain about) ground us firmly- and we'd miss them desperately if they were gone. and of seasons.  the hard ones alternate with the gentle ones-and in the toughness, when our eyes are most wide open- we can see more.

she writes the book about her first year of farming, her first year with her fiancee, 6 years later. this is important. she has the advantage of perspective. of time settling things. of memory sculpting reality, shaving the sharp edges, smoothing the wrinkles. cultivating the lessons and mining the gems from the quarry of that first year.  time heals, but time also gives. that is why i love looking backwards, because that's when the understanding comes.  "you live it forward, but understand it backward." (cutting for stone). and reflection  helps me be more present-or more alive in the present. because my eyes are open and i see more.  there is a saying in medicine, "you see what you look for, and you look for what you know."  time and reflection-remembering- understanding- helps me to know- with out all the raw emotion that swells in the present. so i can look, so i can see.

finding the joy

quiet and icy and cold. today bryn turns 4.  my beautiful little boy.  my beautiful little un-timed but desperately wanted surprise- an answer to prayer as they all were.  i've been thinking about lots of things.  about people being born and people dying.   i've been thinking about being overwhelmed and how i respond to that. about how i treat people when i'm stressed.  and about how when you become a 'missionary' it's like having that fish symbol on your car- or walking around wearing a WWJD tee-shirt.  you'd better not cut someone off while driving, or not give the guy on the street a dollar.  there is something about its external nature, that holds you to be more accountable- that helps you be mindful of the way one should behave.  yesterday was a day of lessons learned. lessons that i really needed.

mr. A died yesterday.  i got a message at 6 am from his wonderful daughter.  we'd talked the day before- so i knew it would be soon.  he had started hemorrhaging at home - blood everywhere- from both ends and so she called 911.  he's on home hospice- but it's hard to not call for emergency help when you're dealing with that.  he was pretty much unresponsive- but not on any machines- per his wishes- and in the ICU.  she called to let me know. she called to ask what to do. what if his heart stops she said?  what if there is something we can do to stop the bleeding? "i know he can still hear me- because when i talk his heart rate goes up" she said.  i was so thankful she called.  i explained that at this point he was trying to go- his body was shutting down.  we were chasing failing organs- trying to fill a bucket with an unrepairable hole.  i reminded her of what we both knew- that he wanted us to let him go when his time came- that he didn't want his life prolonged on medicines and machines when he was dying.  i reminded her of the unbelievable care she'd given her dad- of what an example she had been to me and our clinic of love and commitment to family.  i told her her dad can still hear her, and sense her, and that she should go be with him- tell him everything she wants him to hear now- because he is dying- because we need to let him.  he died 14 hours later.

i've been thinking about the importance of honesty and ownership as physicians.  when i say ownership- i really mean leadership.  we do this with the medications we give- and the tests we order- we feel a sense of responsibility to make sure our patients take them, do them, and follow up with us- we are prescriptive with our prescriptions.  we write "orders" in the chart.  but when it comes to people dying- we often begin to cower.  we begin to realize our ultimate powerlessness.  and so we start offering things we know won't work- or won't work for long.  we do things, because we're  doing something. but this is not how we practice medicine with people who aren't dying.  we would never suggest an intervention- or a treatment or a medicine that we know would really not help.  but at the end of life- we begin to grapple at straws- we operate out of our own insecurities.  what if i'm wrong- what if he does pull through- what if he gets another 2 days?  we avoid.  we shuffle.  and in doing this we abandon.  and we push the responsibility onto the family.  i needed to tell her- even on the phone from a hour away- even though i hadn't seen him in 3 weeks, that he is dying.  that we need to let him go.  she needed that permission, she needed it from his doctor.

then the day began with the kids.  a snow day.  everyone home, everyone with energy, and mike and i with a giant todo list.  and after some squabbles and people picking at each other- mike and i went to have our time of regrouping- our time of prayer.  we realized we were stressed and not responding well.  we were feeling overwhelmed and not joyful.  our move to uganda- is actually really hard work.  we're getting ready to sell the house (2 weeks to go), we need to raise our own funds for the next three years, we need to prepare for what we'll be doing over there, we need to help our kids prepare, and we need to do all the same stuff we were doing before- like our jobs, and our laundry, and teach zoe and raise the boys- oh, and have some fun and see our friends once in a while.

and this is where the importance of ritual comes in- the importance of patterns and routines that give stability- when everything else is out of whack.  so following the celtic book of prayer has become our morning routine.  it grounds us- reminds us- puts us back together.  and yesterday, we really needed it- to be realigned.  and we realized that our todo list was rapidly eating our joy.  that the seriousness of it all was stealing our sense of humor.  that we had become the focus of what we're doing- not the missional work- not the call to serve. that we were operating out of fear and not faith, and that if felt bad, and that it was wrong.  we remembered why we love uganda and the ugandan people.  they have joy and laughter and smiles- in way more challenging situations than we're facing.  we remembered that we are only asked to take what we have and give it- not worry about coming up with more. we remembered Gods promise of provision. we remembered how blessed we are, and we smiled, got the kids together and went out and played in the snow with friends.

then came the part about being a missionary.  it was 4:40 in the afternoon, getting colder and about to get dark.  a man called me who i've never met, but who i'd spoken with the day before to ask if he could paint our kitchen (before we sell the house).  he called because he needed money- so he could get his medicine and a pay for a place to sleep.  he was hoping i could give him money today and he'd paint for me later this week. he was several miles away- the roads were all ice- many closed because of the snow stormed we'd had.  i thought about how easy it would be to say no. i've never even met him- and i never have any cash at home - how is he even going to get over here to get the money?
then i imagined him coming over to paint the next week- after someone else had helped him- or maybe after he'd ridden public transit all night to say warm.  i imagined telling him that i'm about to move to uganda as a missionary. and then i heard the words of Jesus- that i've read so many times.

feed my sheep.
i was hungry and you gave me food.
i was cold and you gave me shelter.
i was naked and you clothed me.

and i thought about how blessed we are- how warm we are- how we'd gone to the market and had food. i thought about injustice and homelessness as a reality, not a research topic.  i thought about the value of one human life.  i thought about WWJD (what would Jesus do).  and that answer was easy- it became a matter of how much should i do, not what should i do.

and i remembered the $100 dollar bill that was still in the purse i'd used in ethiopia- the $100 dollar bill that a man had given to me on the airplane- when i told him i was becoming a missionary in uganda.  that gift had had a huge impact on me.  a big gift from a man i'd never met- a man i'd never see again.  a man who'd felt a need to give- and responded.  that $100 dollar bill was a symbol- a promise of God's provision.

now, here before me was a man i'd never met- a man with a huge need- a man who needed to feel God's provision- and i was the one being asked to provide that.  so i responded.  i warmed some chicken and got some fruit and drinks together and packed him a dinner.  i got the $100 dollar bill  and asked mike to drive out and get him, to give him the food, the money, and take him to get his medicine and take him to a hotel- or a friends house. and mike did.  the man got what he needed and slept at a friends house.

when mike came home we sat down to dinner and talked about our day.  about what we'd learned about joy and peace and poverty and injustice and following Jesus.  we talked about provision. about how this man had actually given us a gift.  he'd helped us to step back and remember our mission, to look up, to get the focus off ourselves- to live as we should, as we are called to live, to live that now.  and in this day of lessons, we found our joy.