These were the first words out of Keir's mouth as he stood up to address us that first day of orientation. 'Us' being a group of almost 20 docs fresh out of residency in various fields (orthopedics, neurosurgery, gen-surg, obstretics/gynecology, pediatrics, family medicine, internal med) and now preparing to enter medical missions with Samaritan's Purse. We are headed to various corners of the world (Honduras, Peru, Nepal, Papau New Guinea, Malawai, Togo, Niger, Nigeria, Cameroon, Kenya, and Ethiopia), but the majority of us to the PAACS hospitals scattered across the dark continent. Keir was dead serious in his statement, and he set the precedent for the next ten days of reflection and anticipation as our mentors prepared us for all that we may encounter in the field.
They did not sugar coat their advice and admonishments, things that they wished they had known before stepping out, some of them over 10-20 years ago. Our predecessors recounted how pervasive death will be and how that will affect the young physician. Doubts will flood in from every direction, as we will question our abilities and whether there was anything left to do. We will struggle with the schedule, as most of us will be the only docs in our specialty serving a never-ending stream of patients. Burn out will be much more of a demon ready to pounce upon us than any other time in our lives, definitely more real than when we had certain hour limit protections in training. And it will be up to us to strike a balance for our time. Because the reality is, that not being at the hospital will result in people dying, yet even more people will be hurting if we burn-out and pack our bags and return home.
In much of the world too, death is not the enemy. I think we have made death an 'evil' entity in western culture, but anywhere else (probably because of lower standards) death is just the way of things, a part of life, not to be railed against (and thus crushed by). Somehow though, this shift in cultural mindset will not assuage the hurt I will endure when I watch my first patient die. And that's not an if, it's only a matter of time. I have been in contact with the pediatrician who I will be working alongside this next year Ethan Helm, and he has had only 1 week since starting this past January where all the children in his ward had survived. The norm is the passing of at least 2-3/week.
So, I bring us back to what Keir initially proposed, 'if you want more of God, then, by all means, go because you are running to a world of hurt.' And that's exactly right, aren't we all called to be the salt and light. Matt 5:13-16. Thank God, He has overcome the world and it's darkness, John 1:5 John 16:33 and has given us His Helper to show his love to others John 7:38, and that's precisely why I'm going.
***A shameless shout out to an awesome brother of mine John Parker, you were right, Dan Baumann's "Intimacy with Jesus" talk regarding his transformative experience in Iranian imprisonment has changed my life. Thank you John for sharing, and in turn, I would like to pay it foward.***
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