I went to medical school fourteen years ago thinking that I wanted to be a small-town family doctor. I’m a Christian, and while I had a clear sense that my vocation was medicine and that God had created me to be a physician, I definitely didn’t think that I was ever going to be, in any way, a medical missionary. Missions were something that people who were far more spiritually perfect than I engaged in, people who had visions or dreams and were—without a doubt—called specifically by God. In other words: not me. But during my fourth year of medical school, motivated by a love for travel, the encouragement of an Africa-loving friend, and an awful lot of elective time, I found myself at a missions hospital in rural western Kenya for two months. There I served as a volunteer at Tenwek Hospital, a Christian hospital that was founded in 1937 in Bomet, Kenya by the World Gospel Mission. In addition to being the primary hospital for the region, Tenwek also serves as a training site for medical staff around the country. The hospital’s mission is to “meet their patient’s spiritual needs and physical needs through compassionate healthcare, spiritual ministry, and training for service.”
Although my first time at Tenwek did lead to the inevitable destruction of a lot of my missionary misconceptions, during those two months I also realized that I found caring for patients in an explicitly Christian context incredibly fulfilling. Caring for the whole patient, not just their physical bodies, gave me a sense of vocational coherence that I hadn’t experienced before. I felt challenged by God to consider that, in spite of my brokenness and imperfections, I could still be of use to Him in such a setting. In the decade since that first trip, I’ve returned to Kenya several times. Each visit has stretched me in slightly different ways, sometimes spiritually and sometimes professionally. I’ve developed a habit of writing about some of these challenges over the years, and it helps me process events and serves as a reminder of important lessons.
Here is one such story from the spring of 2013:
I’m an intensivist, and that means that an all-too-regular part of my job involves having sad and difficult conversations with parents when their children aren’t doing well. Because training has changed a lot in recent years, I’ve been coached in how to approach these conversations since the first year of medical school. So in spite of the heaviness I still often feel in my chest, it’s a familiar scenario for me, and I understand how to navigate the discussion. But a large part of that familiarity, I am realizing, is connected to a familiarity with my own culture and how Americans respond to and process grief.
This past week in the nursery, we had a mother bring in her three-week-old daughter; by history, she’d had a “large head” since birth, but it had been getting worse, and the day before she’d stopped breastfeeding. The baby had the most impressive bulging fontanelle I’ve ever seen, and when we tapped it for CSF, it seemed likely that the baby had developed hydrocephalus after suffering a bleed either before birth or shortly thereafter. Our visiting neurosurgeon evaluated the baby and because of some test results and some findings on his exam, he thought it unlikely—even with a shunt to relieve the fluid build-up on the brain—that the baby had a good prognosis.
It fell to me to communicate this to the baby’s mother. Accompanied by one of the nurses who spoke Kipsigis, I led the mother to a small office down the hall from the nursery. I tried to start from the beginning, explaining what we thought had happened to baby Faith, and then tried to ask a little more about their family—were they a well-resourced family who would want to pay for a shunt in spite of the grim prognosis? But no, neither the mother nor her husband were employed. Faith was the fifth child in their family, and they owned only a small piece of land on which they farmed enough to feed their household. Her husband, in fact, was an amputee, and she had no one with her in the hospital as she cared for the baby. During the conversation, I watched the mother slowly turning further and further away from me in her chair, until finally her back was to me, and she asked in a broken voice through the interpreter what she should do next and if she could go home.
Looking at her, I realized that I didn’t have any idea how to comfort her; I didn’t know how to engage the grieving process in her culture. Quite honestly, it made me feel rather helpless, and I wasn’t getting any cues from my nurse-interpreter. In the end, I offered her the only thing I could: prayer. Which is probably the most powerful comfort, in that situation, we could hope to hold out to her anyway. But her grief and her tears were heartfelt for her little girl, and my heart ached for not knowing how to care for her.
Participating in another’s grief is perhaps one of the most difficult experiences we undertake as humans. Even under the best of circumstances, with close friends in our own culture, it’s common to hear “I just don’t know what to say to him,” or “I can’t imagine how she must feel.” It’s uncomfortable and risky, even painful at times. But Christians are asked to set aside the awkwardness and discomfort and “weep with those who weep” (Romans 12:15).
While it’s hard enough to care well for grieving parents in Boston (even with multidisciplinary human resources at my disposal) the chasm of cultural difference I experience at Tenwek can make that care even harder. Being at a Christian hospital, however, and the freedom to offer the light of the Gospel does mean that there is the possibility of a greater hope in spite of the grimmest prognoses. And while that hope doesn’t negate the difficulties of navigating present sadness, it does allow a fundamental certainty that God is good, and loving, and sovereign, and the truth of it bridges culture in a way that good intentions simply can’t. Grief needs Hope, and that’s the kind of healing I want to be able to offer in any context.
Image is of the view from Tenwek’s education wing. Courtesy of Carolyn Stickney.
Carolyn Stickney is an instructor of pediatrics at Harvard Medical School and an attending physician in the Division of Medicine Critical Care at Boston Children’s Hospital. She has been traveling to Tenwek Hospital as a volunteer with Samaritan’s Purse since 2006 and is looking forward to her next trip in April 2015. You can read more about her work at Tenwek Hospital on her blog.