Worst Losses…
We've clearly not been doing the greatest job on frequent updates, however we do have new pictures, some exciting developments and stories to share in this update! We have enjoyed a few months at home after finishing our tour of the 13 original colonies (you can find some pictures from our trip at the bottom of this post). We had an enjoyable time traveling from Dallas to Maine and enjoyed seeing dear friends and family members and some amazing historical sites. We enjoyed some amazing ethnic food at several hole in the wall places in New York, Boston and Washington D.C. and had fun hanging out with Kris, Melissa's sister, who joined us for about half our trip.
We spent Thanksgiving with my family where we had almost 70 people come to my parent's home for the annual flag football game, Thanksgiving meal and post-meal Cowboy game watching - accompanied by plenty of cheering courtesy of my aunts! The kiddos took their annual break during the time we were traveling up the East Coast but have since resumed their homeschooling. Karuna continues to amaze us with the vigor with which she devours books - often requiring multiple trips to the library each week to keep up with reading material for her! Luke has started working on learning to read which has been exciting for him since he desperately wants to read now that Karuna is always reading. Vivek of course tries to destroy the house as Melissa works with the older two in their schooling. We have also enjoyed this past month because Melissa's sister, Kris, moved down to stay with us at the end of November as she is searching for a new nursing job in Dallas - the kids have definitely enjoyed having their aunt here and enjoyed her two dogs and cat.
After much prayer and discussion we decided in the last few months to commit to serving at Duncan Hospital in Bihar, India with the plan to return to India in the latter half of 2013 after my board certification process is done along with student loans being paid off. We are excited to have committed to Duncan Hospital because it gives us a greater sense of direction as we prepare for our return to India. We felt that strategically Duncan is located in a part of India where we can be part of a team to help train young physicians while at the same time use the hospital as a platform for sharing the great news of Christ by providing compassionate and loving care to the poor in northern Bihar and southern Nepal.
Travel – Eureka Springs & Birmingham
We wanted to post some pictures from our recent travels. We celebrated my mom and dad's 30th wedding anniversary with a family trip up to Eureka Springs, Arkansas in August. We had a wonderful time celebrating with mom and dad along with all my siblings. We enjoyed horseback riding, canoeing and watching the Passion Play together (Luke was quite surprised when Jesus flew into the air!).
We are on another one of our crazy road trips around the country - this time up the East Coast. We just reached New York City yesterday after having visited Birmingham, AL, Atlanta, GA, Athens, GA, Durham, NC and Philadelphia, PA. We are continuing onward to hit Boston, Maine, Washington D.C., Nashville and finally home (total of almost 5000 miles). Below is a map of our trip across the U.S. We'll post pictures of our trip as I finish getting them all edited. Click below to see slideshows of our trips or click the individual pictures below.
Travel Plan for Trip Up East Coast - 4500 miles in 3 weeks
Life as an Attending & Humorous Stories from the ER
It's been nearly two months since I started my new job working at Hunt Regional and Presbyterian Kaufman. It has been a great couple of months so far with wonderful staff, sick patients and much more time off to spend with family. Melissa and the kids have kept on homeschooling through most of the summer so that we can take some time off in late September/early October to take a three week road trip from Dallas to Maine to explore the East Coast in the fall. I've enjoyed being able to have a lot more time with the kids since I'm working only about 14 shifts a month although I'm not sure if Melissa knows what to do with me when I'm pacing around the house looking for another project to keep me busy!
We had shared with some of you the difficulty Vivek had been having with his speech especially after he turned two. He had barely 10 words he could speak around that time and so we had started to meet with a speech therapist to help him with his language acquisition. Thankfully God had worked amazingly in his life and the switch seems to have flipped - in the past two months he has amassed a several hundred word vocabulary and started to put sentences together. In fact in early August he graduated out of speech therapy and I think he has been a much happier kid since he can communicate with us. Thank you to all those of you who had been praying for him! Luke is so excited about finishing his Pre-K workbooks and starting his kindergarden school work which includes teaching him how to read - something he has been desperately wanting to do since Karuna learned to read. Karuna has continued to do well in school and seems to show quite an aptitude for math and reading. Often times we'll find her reading chapter books in her room if she wakes up before everyone else to pass the time. We also know for sure we've produced nerds as her one request when we had our last daddy-daughter date was, "Daddy, can we do some of the X problems? (referring to some basic algebra I was teaching her)." So we pulled out a napkin and worked on 2x +2 = 10, (solve for x) while we ate dessert and in the end her love bank was full - she is a funny kid!
I've loved my new job so far! Perhaps the best part of my job when compared to residency is that I now have a scribe who follows me around whenever I work. For those of you who have never had a scribe, it is usually a student who is finishing undergrad and is interested in medicine who works with us to help us with our documentation.
Transitions
As evidenced by my lack of posts for several weeks, we’ve been in the midst of two busy months with the end of my emergency medicine residency and starting a new job working in the ER at Hunt Regional and Presbyterian-Kaufman. We do have some final pictures from our last days in Herbertpur and our time in Delhi posted along with this post – just scroll to the bottom to view the slideshow with music or click the pictures to see them individually.
My last month of residency was a bittersweet experience. I have loved my experience at Parkland and the wonderful staff who work in the ER. But I guess after 10 years of school and in training it was finally time to have the cord cut and be out on my own. Transitioning back to work and life in America has been with its challenges. Although we serve a very sick population of patients at Parkland who use the emergency room to get much needed healthcare in comparison to the dire medical need of the places we worked in India, the contrast was striking. We dealt with death on a far more constant basis in India as compared to the US. Here the expectation of most patients is that they come to the ER and they will get better – in India it is often that patients come to the hospital with the expectation that they could well die.
My last month of residency was a month of night shifts, which in some ways made the switch between India to America easier because I essentially stayed on the same schedule. In many ways caring for so many sick patients in India made me feel so much more comfortable taking care of patients at Parkland because I always thought – it could be a lot worse than this! I did find it somewhat amusing that my last night at Parkland was also one of the busiest nights we had had in a while – very similar to my last night on trauma call as a 2nd year resident when I had 5 gun shot victims show up in the ER within one hour. I worked a POD 3 shift my last night (this is the section that works primarily with the trauma team) and we got a call from Biotel (our prehospital EMS system) informing us that that a bunch of motorcycles were racing at around 120 mph and there was a big crash and that three of the people who were critically ill were coming to us. The first one to arrive was the worst, a young man in his 20s, ejected off the motorbike and then landed head first with no helmet.
Pictures from Mussoorie & Herbertpur
The dog days of June...the heat and lack of rain in Texas since we returned back to Texas have been intense. The kids seem to have recovered from jet lag fairly well although our whole family seems to still be suffering from GI problems. I think similar to what happened the last time we were in Assam, we might have all picked up Giardia again and so it might be about time for us all to get a course of tinidazole in our system.
Work has been going well - working a month of nights after coming back from India has been easier due to not having to worry about jet lag. However, there has been a lot of paperwork that needs to get done to finish my residency and so I've spent several days these past few weeks working all night and then spending most of the day getting things done for the residency which has led to several 3-4 hour sleep days. On top of that, I had all 4 of my wisdom teeth removed yesterday which was actually a much more pleasant experience than I thought it would be. I was quite amazed by the effect of nitrous oxide, midazolam, fentanyl and propofol in my system! I don't remember much of the surgery and for most of the day yesterday was in a narcotics-induced stupor. Today has been a little more painful but quite bearable and if it was not for the side effect of dizziness from the narcotics I would feel like I was back to 100%. Here's to praying for no dry sockets in the next few days and being able to go back to work on Monday night!
I also had my orientation with the organization I'll be working with for the next few years - Emergency Medicine Consultants. I was so impressed with them during my orientation and feel they really have both the physicians and patients's needs at heart much more than the survival of the company. They have put together a wonderful group of support staff that I think will make my life as an ER doctor as manageable as possible so that I can focus on the most important part of my job which is caring for patients well. EMC helps to coordinate my scheduling, keeps track of my credentialing at different hospitals and contracts with another company to get all my billing done. I'm excited to be part of this group (about 120 physicians all together serving at 12 hospitals in the area). They have several contracts which they have held for over 35 years! They seem very family centered and we were excited to see so many staff members who have stayed with this group for several decades which I think speaks to the quality support they provide. I'll find out soon for myself as I work my first shift on July 5th. Right now I'm planning on working primarily at Hunt Regional Medical Center in Greenville and Texas Health Presbyterian Hospital Kaufman with about two shifts a month as an attending at Parkland Hospital. We chose these two hospitals because they are rural enough that I'm often on my own without much in the way of subspecialty support and thus we thought it would help prepare us well for long term work in India when we'll be in a similar situation.
Finally, we wanted to share some final sets of pictures from India. The following are pictures from our visit to Mussoorie to see Landour Hospital where we met Joe and Sima Weaver and from our last weeks at Herbertpur Hospital. I wanted to try a different way to show a slideshow and so have created a video with music on animoto which I've posted below. Let us know if you like the slideshows better this way as opposed to previous versions. Also at the bottom of the post are individual pictures you can click on in case you just want to look at a few pictures. Have a wonderful week!
Adjusting to Life in America
So it has been four days since we returned back to America and life is moving fast. I was back at work doing my first overnight shift at Parkland within 24 hours of returning - greeted by a a list of 12 patients to see when I walked into work at 10 PM! We are also gearing up graduation on June 25th followed by Karuna's birthday party. The kids were so excited to see grandparents along with uncles and aunts when they returned and they have enjoyed being able to get back to their rooms, toys and pets. I think Melissa and I are still kind of stuck in between. Our hearts in many ways are still in India but we feel that these next two years are important in getting us ready to go back permanently.
Tomorrow I do a talk to the residency about our experiences abroad. I hope it will capture some of the immense medical and spiritual needs that are present in India and how medical providers can be part of helping to meet that need. We have been so grateful for all your prayers and support of us these past two months and have been so thankful to know that we had a big family of friends to return home to. We are glad about all the opportunities to serve in India and the many lessons God taught us over the trip. We ask for your prayers with regard to making a final decision about which hospital to join. We'll try to put up periodic updates on the blog over the next few months but wanted to share some more pictures from our first two weeks at Herbertpur and our visit to Nandyal in Andra Pradesh.
I was also excited to see the following excerpt in the "Parkland Now" newsletter from a few weeks ago that my dad forwarded to me. I'm so glad to know that the one time I've been mentioned in this newsletter to Parkland employees, it was about what is most important to me - being able to meet the spiritual needs of patients as I care for their physical needs.
Final Two Weeks at Herbertpur
The following is a delayed entry from a day ago...we could not find a way to update the blog prior to us arriving in America this afternoon. We have safely arrived back in Dallas this afternoon with all our luggage and children! Will write more about the trip once we get over jet lag.
So it is our final morning in India. We arrived in Delhi two days ago from Herbertpur Christian Hospital and have been exploring the city a bit before we head back to the US this afternoon. The day feels bittersweet – we are excited about being back in the US to see our families and getting back to home but also sad to leave India and the tremendous needs it has – both spiritually and physically. Thankfully this is not a final goodbye but instead it is the beginning of a process whereby we will, God willing, be back in India in late 2013 to work here long-term. In this post you will hear about some of the patients at Herbertpur and our time in Mussorie. There are also some pictures from Hyderabad and a village church we attended in Bihar at the bottom of the post (I’m still several weeks behind with regard to getting picture edited so hopefully by early next week you will be able to see the pictures from Herbertpur). Here are the highlights:
Praises:
- Safe journey from Dehradun to Delhi.
- Thankful for relatively being healthy – most of the serious diarrhea is gone and we seem to be improving.
- A very good clinical experience at Herbertpur with lots of sick patients and procedures
- An amazing opportunity to teach several great residents and share with them about our life and call to missions
- A wonderful weekend to rest in Mussorie and get to know Joe and Sima Weaver
Prayer Requests:
- Prayer with regard to making a decision about where to join staff in two years
- Wisdom with regard to where to do intensive Hindi study when we return to India
- Pray for us adjusting to life back in America after being away for several months
- Endurance to finish a month of nights and lots of paperwork when we return with regard to Christo’s residency before he graduates at the end of June
Our last two weeks at Herbertpur were better than the first two weeks in terms of our health and all of us seem to have recovered from whatever bug was causing us to feel so bad. I’ll start off with a story I shared with the residents prior to us leaving. The last few weeks have been difficult for the kids especially because they have been missing our families, pets and just the normalcy of their life back in Dallas. For two weeks in a row we have had several nights where both Karuna and Luke have gone to bed bawling their eyes out for 20 minutes with nothing being able to comfort them because they missed family so much. We tried multiple things to calm them but nothing seemed to work – by the end I had tears in my eyes as I heard them cry. Then a few days ago I was working in casualty when I heard the sound of women wailing.
Hyderabad & First Week at Herbertpur Christian Hospital
We are about half way through our time at Herbertpur Christian Hospital. Hopefully we can give you a little perspective about our time here so far and about our week in Hyderabad in this blog post. For those of you who like the bulleted version here we go: (Some final pictures of Duncan Hospital are at the bottom of the post)
Praises:
- Lots of opportunities to teach residents and interns at Herbertpur.
- Wider exposure to trauma care in India since there are a lot more motor vehicle accidents that present to Herbertpur when compared to Duncan hospital.
- The kids seem to be adjusting well to the routine at Herbertpur.
- A fun drive with Dr. Daniel and his family to the mountains outside Herbertpur for a few hours to get a better sense of where we were and for us to see the Yamuna river.
Prayer Requests:
- Pray for endurance. It has been difficult being away from home and a normal routine for over 6 weeks. I think we have all become fairly weary of living out of a suitcase.
- Pray for more laborers for Herbertpur. They are short staffed especially with regard to OB-GYN and surgical care – Dr. Daniel is taking his first vacation with his family in four years later this summer.
- Pray for discernment regarding a decision about where we should join staff long term – there are multiple pluses and minuses to each hospital and we need to approach this decision very prayerfully.
- Healing from sickness – Melissa, Luke, Vivek and I have all gotten a horrible case of dysentery and are not feeling well. I took off a day from work for the first time in the last 7 years of medical school and residency because I felt so poorly.
We’ll begin with our time in Hyderabad and then move on to some highlights from our time so far in Herbertpur. We had a much-needed week of rest in Hyderabad and got to spend time with Elvin, my cousin, who works for the US consulate in Hyderabad. We were excited to be able to eat more than dal, rice and chapati for a couple of days while we were there and the kids thoroughly enjoyed being able to eat at McDonald’s again! We were quite amazed by Hyderabad and how developed the city is. Its roads are amazingly well designed and you can find almost everything we find in the West in the city. We made a trip our first weekend to Inorbit mall – the first mall we had gone to in India. We are not the typical mall people and rarely during our time in Dallas have we gone to malls but it was nice to be able to do our shopping in one location rather than visiting 10 different stores in various parts of the city.
Early that week, we met with Dr. Varghese Philip (VP), the managing director for 4B Healthcare, an organization that seeks to make failing mission hospitals viable again by infusing capital and management expertise.
The Villages of Bihar
We are now at Herbertpur Christian Hospital in the state of Uttarakhand. We arrived here on Sunday night and will be here for a month before returning to Delhi and then on to Dallas. We had a wonderful week of rest in Hyderabad with my cousin Elvin and the kids got to heal up from all their mosquito bites. We enjoyed visiting several sites in Hyderabad along with some great food. We spent two days visiting a 4B hospital in Nandyal and then spent another day with 4B Serve to see how different ministries are partnering together to care for communities all across India. We’ll write more about our time in Hyderabad and the exciting things happening through 4B but wanted to share some final thoughts about our time in Bihar courtesy of Melissa (a guest post requested by many). But first some highlights (some amazing pictures we were able to capture about life in the villages are at the bottom of the post):
Praises:
- Safe travel from Hyderabad to Herbertpur with no lost luggage.
- A wonderful week to rest in Hyderabad before starting the second part of our trip.
- 4B Serve – a wonderful partnership between multiple ministries all across India that helps facilitate greater cooperation between organizations.
- Getting to meet and spend time with Dr. Varghese Philip – a man with a great heart and vision for meeting India’s healthcare needs.
- Elvin (my cousin) and the work that God is doing through him at the US consulate in Hyderabad to impact India and the US Foreign Service for Christ.
- A good start to life at Herbertpur with meeting new friends.
- Vivek is finally speaking – we were quite concerned about his speech (we had met a couple of times with a speech therapist before we left for India) but God has worked marvelously during the past month and he has probably tripled his vocabulary in the last month.
Prayer Requests:
- Quick integration into the team at Herbertpur.
- Provision of much needed staff for this mission hospital.
- Continued prayer for discerning God’s leading and direction regarding where to serve in India.
- Opportunities to challenge the junior doctors here to consider serving long-term in missions.
- Pray for Vivek’s sleep – he has been quite disturbed now by thoughts of lizards (or li-li’s as he calls them).
- Karuna and Luke’s understanding of life in India and the need for people to serve in hard places to that they can have access to good healthcare and opportunities to hear the Gospel.
Finally what many of you have been waiting for…a post from Melissa. Here are some thoughts that she penned together about some of the village work being done in Bihar.
One of our final days at Duncan Hospital was spent with the Chetna project which is the arm of Duncan that works in the surrounding villages. Altogether they serve in 152 villages in the East Champaran district and we got to visit seven of them as we caught a glimpse of how they are serving and transforming the area.
Changing Minds, Cultures & Lives
So we have finished the first part of our journey and are done with our time at Duncan Hospital. We arrived in Hyderabad, located in the state of Andhra Pradesh on Thursday night. We spent two days traveling by road from Raxaul to Patna with stopovers in Motihari and Muzzaffarpur to visit several Indian ministries that work among the people of Bihar to get their perspective on what God is doing in Bihar before flying to Hyderabad to commence on the second part of our journey.
We will be in Hyderabad for a week as we visit a second hospital in Nandyal (about 4 hours from where we are staying now) to see the work of an organization called 4B Healthcare which seeks to make mission hospitals viable again by infusing capital and management expertise. We will spend a few days visiting that hospital before traveling on to Herbertpur Chrisitan Hospital in the state of Uttarakhand where we will spend our final three weeks before returning to the US in June. I hope to cover some of the specific areas where there needs to be change in Bihar and about some of the work Duncan Hospital is doing to promote that change. Melissa will soon write some about the community development work that has been started in the East Champaran district of Bihar in the next post but first for those of you who want to get to the highlights (pictures are at the bottom of this post):
Praises:
- Safe travel through some very difficult roads from Raxaul to Patna.
- Great conversations with Indian missionaries serving in Bihar as we saw how powerfully God is working in Bihar to changes lives and communities.
- Safe arrival in Hyderabad with no missing luggage even after we barely caught the flight out of Mumbai since our flight was delayed in Patna.
- Wonderful time of fellowship with many families at Duncan to hear how they felt called to missions and to the work at Duncan Hospital.
- A wonderful farewell party where we got to spend time with the junior doctors and other friends we had made during our time at Duncan.
- An amazing time of worship with local villagers on Easter at one of the village churches near Raxaul.
- A great day of visiting about 7 villages with the CHETNA project to see the many ways Duncan Hospital is helping to reach the poor and marginalized in Bihar.
- Provision of an amazing place to stay and great company in Hyderbad as we stay with Christo's cousin, Elvin.
Prayer Requests:
- God would bless our time in Nandyal as we see a different model for medical missions and to see if this model might be a possibility for how we might be involved in medical missions in India.
- God would continue to increase the number of people that hear about Christ in Bihar and that He would transform the lives of individuals and their communities.
- God would use this week of rest in Hyderabad to rejuvinate us before traveling on to the third mission hospital at Herbertpur.
- Provision of much needed staff from different backgrounds to consider working at Duncan Hospital to make it a place of great training and teaching for medical professionals in North India.
Our second week at Duncan was largely spent working at the hospital during the days and during this week I took pediatric call every other night (splitting the responsibility with Dr. Blessy, the pediatrician at Duncan) so that she could have a break. We also had the opportunity to meet in the evenings with many of the senior staff at Duncan so that we could hear their stories and how they felt led to serve at Duncan. Those conversations were a great opportunity to hear about the myriad ways in which God has worked to put together an effective team at Duncan. The kids especially enjoyed getting to play with the many kids on campus and have stuck with this even after getting plenty of mosquito bites in the evenings.
The lack of good medical care in this region of north Bihar was especially impressed upon me during this past week. Although there are many so called doctors and pharmacists in the area, the medical advice and treatment given to a large majority of patients is suspect at best.
