A Different Kind of Culture Shock

Sitting in the closet of a local cathedral I opened my computer and connected to our makeshift Internet, and waited for my first patient of the day. I felt at home in these surrounds; dirt floors and dust that made clean floors impossible, concrete buildings with tin roofs, and meals that always had rice as a base. This was my fourth medical brigade and though the culture and people were all too familiar this one was totally different. For starters, this was my first brigade as Doctora Janie instead of estudente de medicina. Being one of the providers brought much more responsibility and fatigue, but also great reward. The most striking difference this trip, however, was the stark contrast between my world view and that of the other 54 people on this brigade. I was very much an outsider. 

I did get to see some interesting cases this trip. And seeing them on my own was very empowering but also terrifying. I saw chikungunya, epidermolysis bullosa, club feet, pyelonephritis, and an undiagnosed congenital heart defect. The medical aspect of this trip was wonderful. And thankfully there is a great clinic in Santo Domingo that will be following up with these patients. Collectively as a team we saw over 1,000 patients. A successful trip by most accounts. But why am I here again? I do not fit in. By their account, we have done a great thing worth celebrating. But really, what have we done? I know life is eternal and if I am not impacting eternity, what help am I really giving? I have struggled most of the trip with this, wondering if I should ever do another trip like it ever again. When Christ is not the center, what's the point? Why am I here again? Especially when my little sister required a C-section to deliver her twins at 35 weeks and I wasn't there. I wasn't there when she hemorrhaged and needed a transfusion. I wasn't there when my nephew went to the NICU and my family had a million questions I could've helped with. Yes, I made some new friends and strengthened others, but was that worth not being there for my family? Why is it that the only type of culture shock I experienced was with that of my own culture and how disgusting it is.

Well, I don't know why, and I don't have to. 

One of the things I've noticed about myself is that God seems to come into much clearer view when I'm out of the States and away from all the distractions. It seems so much easier to sit at His feet. I finally had the time this week to read a book that has been sitting on my night stand for weeks, it goes through some of the attributes of God and how unlike us He is. This has been a wonderful reminder of who my God is. If nothing else, God has shown me more of himself, and more of my sin this trip, and I can honestly say that is enough. He is enough. He was there with my sister and nephews the entire time and He was and is more than enough.

This past year has made me a much better physician but it brought much depression and anxiety with it. To the point that I didn't recognize myself anymore. I couldn't process anything so it all got stuffed on top of each other until I just about blew up a couple of weeks ago. I didn't have someone to talk through things with and I honestly had a hard time talking to God. The motto God gave me when He called me into medicine was: "He is worth it. He is enough." I kept telling myself that, but I wasn't feeling it. I have been able to process difficult things alone with Him before, so why do I need a physical body to talk to now? I know the root of depression and anxiety is sin. Period. It's unbelief plain and simple; not really believing I'm secure in Him, not trusting Him to take care of the big things and the small details. When I finally had a vacation, I was praying the Lord would show up and blow my mind with Himself in such a way that made my walls fall like Jericho. But He didn't. I had a relaxing wonderful vacation but I still couldn’t completely clear my head of all the mess. But one morning as I sat on a bus in Santo Domingo Ecuador leaving the places where we served over a thousand people last week, and my head finally felt clear, free and I can honestly say I have peace again. I was exhausted from little sleep all week, but I wouldn't trade that place right now for anything. No distractions, serving people in a way that pushed me to my limits physically, mentally, and spiritually, God emptied me of myself. 

What mercy! What grace! That our Lord would pull me out of my surroundings and distractions to truly set my focus on Him again. How simple it seems that the answer to all of life’s questions is God Himself. And yet, how difficult that can be. I cannot will myself to know Him more, I cannot study and work harder to know Him more. I could read the Bible 10 times through and spend every waking hour meditating on its meaning, but apart from the grace of our Lord opening my eyes to is beauty and power it would have no impact on my life. How sweet and kind our Lord is that He reveals Himself to us and in so doing gives us all we need for life and godliness (2Peter 1:3-4). God lifted my spirit last week in a way no person or experience could, and I am so grateful. Dear reader, as you find yourself cast down, depressed, anxious, or just caught up in the everyday without joy, I urge you to run to Christ and beg Him to allow you to know Him more. 

The Abundant Life

What happens when the day to day becomes mundane and you find yourself just surviving? I know we all experience it from time to time. Discontentment with life, not knowing why we are doing what we are doing or more importantly not knowing what we are missing.

Tomorrow I start the last month of my intern year of residency. That first year that is notorious for the grueling hours and hard work. That time where you have your degree and are officially a doctor, but people still smirk when you call yourself one because you really don’t know anything and everyone loves to remind you of that. You thought medical school was hard? Well, welcome to residency. Yeah, you don’t have to spend 80 hours a week on your bottom studying, but now you’ll spend 80 hours a week learning on your feet. Okay, I am being dramatic. I did not work 80 hours a week at work every week. But, on inpatient months I did average 72. I’ll be honest, I expected residency to nearly kill me and it wasn’t nearly as bad as I had imagined. The Lord has been good to me in the daily grind and kept me going. Most people don’t make it a few months without trying to figure out how to opt out and quit gracefully, but we are all in too much debt to quit now. I can honestly say that I never once wanted to quit, and that is only by the grace of God.

With that being said, this has 100% definitely been the hardest year of my life (again a little dramatic I know). And, it’s not so much because of the work. I enjoy what I do, and the people I work with. I don’t even mind working 72 hours a week (for the most part). It’s the way residency completely over runs my life that I don’t like. When you don’t get Sundays off all month, it’s hard to get involved in church and meet people outside of work. When you typically only get 4 days off a month and work 11-13 hours shifts daily it’s hard to keep up with friends and family. When you sleep, eat, live and breathe medicine, yes you learn a ton about medicine, but it’s really hard to just live. Life goes on around you almost as if you’re a spectator to its production. Even studying 80 hours a week in medical school I still felt like I was part of life. I didn’t miss out too much on things with family and I can honestly say I still had fun outside of school. But, this year I don’t know where I’ve been.

The most concerning part of this is its impact on my walk with God. I’ve always felt God so much closer in my darkest times, and I really thought this was my darkest time of all. But, where has He been? I still went to church as I could, and I still got up early to pray and read His word before work, but it was all empty. Why have I not felt Him near when I know He lead me here? What am I missing? He led me to a great church here and even a great Godly man, but why has it been so hard to stay involved and why didn’t that relationship work? Can’t He see I’m trying here? I kept thinking maybe I’m just at that point where I really do need a better half to get me back to where I was. Or maybe it is just residency and it’s not going to get any better until it’s over. I started just surviving. Forget everyone and everything else and just get through this. No, I wouldn’t come out and say that but that’s how I felt. Always looking to the next thing.

But, a strange thing happened. As I grew colder and colder and father and father from God I was miserable. Still going through the motions, desperate to break though somehow, but I was just so tired. Lord, I don’t get it. Where are you? Aren’t you enough, even for all of this? Even when I’m trying to walk this road alone, aren’t you enough? What am I doing wrong? For the past month or so, I have been seriously trying to get back to where I left the road less traveled. No more just going through the motions, but really taking time to remember who I’m talking to when I pray and really trying to sit and listen when I read. I snapped out of it when someone challenged me on the doctrine of the perseverance of the saints. I know I believe that once a child of God always one, that no principalities nor powers nor any other created thing could separate me from God’s love. But it made me question myself, what if I could lose my salvation? What about Billy Graham’s mentor who walked away from the faith after years of evangelism? Am I walking worthy of the calling? I was awoken again to the seriousness of the matter. Lord am I really yours? I couldn’t brush it off no matter how tired, or how far God felt.

So, where do you start? Well, in the beginning was God. Thankfully, last year I was introduced to one of the most raw, ‘this is how it is’ Bible Studies about knowing God. It breaks down who God is and why that matters. It also points out (if you let it) major areas of sin that block our ability to see Him. I pulled this study out and started going through it slowly. Lord, please, open MY eyes, search me and know me, grant me the most precious of gifts- to know you. I’ll say that my desire to know God has brought with it a revelation of how sinful I am, and far from this God of light I really am. The past few days especially, I felt more and more the weight of sin. I am so incredibly selfish with my time and sleep, so incredibly prideful thinking I don’t need God, and I really don’t believe God is who He says He is or will do what He says, because I don’t live like it. I came to the point where I honestly cried out to God, am I even yours? You are the Father of Light and in you is no darkness at all. This morning, I found myself in 1^st John, that blessed book that John wrote so that we may know. As I read through the tests John places before us, I prayed. Lord show me my heart that only you know. Show me if I am yours. Oh, the joy that rushes over when that still small voices whispers your name! What joy and peace to know you are beloved! Nothing compares.

I had been wondering the past few days, how do I love my coworkers and patients when I am so selfish and just want to be done so I can go sleep? How can I have the right motives to go above and beyond for them when I get frustrated so easily? How am I supposed to be different, when I feel like this inside? But, today, praise be to God, He answered my prayers. In His grace he restored my joy and lifted my head. Today, going to work after refocusing on the Gospel and who God says I am gave me joy to work and love harder and longer. Today was a rough day at work, and I am more tired than usual, but it didn’t matter. With the Gospel as my foundation once again today felt right. That’s how God is enough, always enough no matter what.

“I came that they may have life, and that they may have it more abundantly.”

Let’s be clear though. None of this was because of my great effort to return to God. On my own I would not want Him (they loved the darkness rather than the light, there is none who seeks after God). This was the gracious work of a loving God wooing me patiently back to Himself. He did not have to show me my sin, or remind me I am forgiven. And most importantly, He did not have to forgive me. Oh praise the Lord, Oh my soul!

So, here’s to the abundant life. If you are reading this and your life doesn’t feel abundant, cry out to the God of salvation whose grace is greater than all our sin.

The depth of Christmas

This has been a very different year for me to say the least. Residency has come with a mix of joy, satisfaction, and yet heart break and frustration. This Christmas day for the first time, probably of several to come, I will be working.  I must be honest and say it has been very difficult for me to get in the Christmas spirit all month long. I had good intentions and put my tree up at the beginning of the month. For the first time I actually listened to Christmas music all month long instead of waiting until like 2 weeks before. I was really enjoying it all, until the Gatlinburg fires. I don’t really understand why exactly, but they hit me pretty hard, and every time I listened to Christmas music that’s all I could think about. Because few things go with the Christmas season like Gatlinburg TN. Since then all I could see was what I was missing out on. How lonely it can be to be working the holidays while in a different state than your family, without a family of your own. . . and so forth and so on. I kept telling myself, this isn’t about me. Christmas isn’t about the lights, or the fun extra things we could do while on a break from school or work. It’s not about even family and getting to see loved ones you haven’t seen in a while (granted I will get to see them, just a few days after Christmas). It’s really all about Christ, the gift God gave us, gave me. Why wasn’t this enough to give me just as much or even more joy than a kid on Christmas morning.

Last week I kept trying to make myself be joyful, and it just wasn’t happening. Then I started praying. Lord, I don’t really feel it, but I chose to worship in this moment, I chose to think on you, and I ask, I plead that you would fill my thoughts with you, that I may be able to worship you this season, and be overflowing with joy solely because of you and what you did for me.

Well it didn’t happen immediately, but I kept praying. And the Lord answered my prayers. Tonight, though I am tired and have to work in the morning, though I’m not home for Christmas, and though I didn’t get to worship with my home church tonight. I still worshiped! This season, this baby, it means everything. God gave up His only son, Jesus set aside His glory as God to come and He veiled Himself in human form so that He could live a perfect life, and die in MY place. He came to pay my ransom that I could never pay! He is my hope, my rock, my life. And even though Christmas looks way different for me this year than it ever has, it is just as sweet and joyous!

So for those who don’t get to celebrate with family or friends, who have to work, or for those who feel much more sadness and emptiness this season than joy, for the family that lost loved ones even this week; “The people who walked in darkness, have seen a great Light; those who live in a dark land, the Light will shine on them” Isaiah 9:2. This Light has come. And, He not only came, but He defeated death, and if you will repent and believe, that is your victory too! This is Christmas. This baby, He is life, and life more abundantly!

So, instead of opening gifts in the morning, I pray God will so work in my heart that I can give Him all I have. That He would allow me the grace to bring all that I have and lay it at His feet. I am overwhelmed this Christmas Eve night with the grace and love and longsuffering of my God. That He would be patient with me in my struggles, and that He would ultimately allow me the indescribable gift of knowing Him! There is no greater thing! “For to me, to live is Christ!”