Tuesday, August 24, 2010

The importance of listening

I prefer being the doctor, not the patient. After all I spent 8 years of my life learning to be a doctor, have practiced 2 years as a doctor and so it makes sense that's the role I know best. Having had 4 surgeries the past year though, I've learned a bit about being a patient.

This last surgery reminded me of the importance of listening to the patient's story. Taking the patient's history is one of the first skills acquired in medical school: you learn to ask open ended questions, focused questions, system specific questions, and learn to direct your questions based on what the patient is telling you. The patient's story should begin your differential diagnosis and in many times will make the diagnosis. Physical exam and testing should confirm what you already believe to be true. Granted there are times when things are unclear and we tend to blaim the patient as a "poor historian," but perhaps we're just not asking the right questions.

I left Crescent Lake certain of my diagnosis because of my history; I had not had a pregnancy test, ultrasound or exam. However, when seen by the doctor I felt I was convincing him that this was even a plausible diagnosis and should be considered on the differential. Maybe I was a "poor historian" from the pain I was in--but even that pain level points to a ruptured ectopic. As he started to talk about anovulatory cycles, thyroid dsyfunction and stress I finally fessed up that I was an Ob/Gyn and certain of my diagnosis. (Also, if some one shows-up in your office wearing yoga pants and a polar fleece when its 90 outside and hasn't showered for 3-4 days you better think something is seriously wrong!) While I still accepted his care plan and the right diagnosis was made I mostly wanted to know that I had been heard. That the testing was done because he believed me rather than to try to prove me wrong.

I'm finding that true with grieving as well. Sometimes the story just needs to be heard. So thank you to those that have offerred and willingly listened; it helps.

Friday, August 20, 2010

"Show your knees Sunday..."

I'm not saying it's easy Sunday after Sunday to preach and speak truth, but sometimes listening to a pastor try to be funny I start to cringe in my seat. Take last Sunday when we visited a church in Bend and the pastor, at length, talked about why everyone was supposed to be wearing sandals this Sunday (something about trying to wear the shoes Jesus wore). I had on 3 inch black heals with blue trim and thought at least the open toes were probably similar to Jesus' shoes. So the pastor continued on to explain that people were asking him about dress code as he also had on shorts to match his sandals so he declared next Sunday "show your knees Sunday."

Well, having lived the past 2 years in a society were showing my knees is equivalent to showing my breasts in the West I spent the rest of the service thinking about dress codes, the Bible and whether or not God would find "show your knees Sunday" humorous. Needless to say I don't remember the sermon.

Tuesday, August 17, 2010


If vacation had been as planned we'd be back in Kenya today. Thankfully we had travel insurance and were able to re-book our flights. However because of the class of tickets we had and because it's high-season the first available flight was September 9th. Our future plans remain uncertain, but we are using this additional month in the States to look at our options. 

Amelia and Meredith have been able to participate in vacation bible school this week. Both have enjoyed meeting other kids, crafts, and attending with their second-cousins from Bend. 

Sunday, August 15, 2010


Some of you might know that Malin is an Eagle Scout. I don't know much about scouting but I'm pretty sure the motto is still, "Always be prepared." Well, Malin and his Dad decided to go on a long bike ride yesterday starting at the top of Mt. Bachelor going to Sun River and then splitting up; Malin going back up to get the car and his dad going on to Bend. 

While Malin brought 2 bottles of water in 90 degree weather, heading straight up hill after 55 miles he found himself quite dehydrated. And with 6 miles left to go literally unable to go on. So he did the only sensible thing and hitch hiked. That's right he put his thumb out and the first truck that passed him stopped, put his bike in the back and drove him to the car. I still have yet to try hitch hiking although I have picked people up before.

Friday, August 13, 2010

Stuff Christians Like

Jonathan Acuff author of the book "Stuff Christians Like" also maintains a popular blog at (http://stuffchristianslike.net/).  An example of a few of his posts are: the youth minister who tries to talk like the kids, hand-raising worship-- 10 styles, wishing your testimony was more exciting, playing the G card, judging someone's faith based on their Bible underlining, always sitting in the same seat at church, and vuvuzelas at church.

      July 10th Jonathan asked the blogosphere for a creative guest post.  There were 7 things he was looking for this post to do:

1. The topic has to be unique to Christians.

“Hating to wait in line” is a bad topic to write about on SCL because that is not unique to Christians. Bipeds hate to wait in line. “Singing hymns while waiting in line” would fit however.

2. It has to be true.

Honesty is the cornerstone of humor. Blow it up, exaggerate it, expand it, but try to start with something that is true. Write about something that happened to you or something that is real in Christian culture.

3. It has to be fresh.

Use the google search bar above to see if we’ve already covered your idea. (And it has to be original and not already published on any other site.)

4. It has to have a twist.

Although it’s technically true that Casting Crowns are stuff Christians like, I will never write about that band. And not because I’m trying to get in good with NeedtoBreathe. There’s just no twist. Satire needs a twist. Everyone knows lots of people like Casting Crowns, the challenge is to find a different angle to write about.

5. It has to be satire, not mockery.

Don’t wound someone with your guest post. Don’t be a Christian jerk. Don’t take a shortcut to an easy laugh at someone else’s expense. Mockery is a great way to get laughs now but it removes the ability to speak love later.

6. It has to be hilarious.

Don’t send a Serious Wednesday post. Keep it satire.

7. It has to be shortish.

Aim for 500 words. 

Spotting a missionary. (& Caption this photo)

Our blog was selected. The comments range from "say hello to Georgia the Giraffe" to "Dad why do we have to sit so close to that scary animal." Click on the Caption text above to see the guest post.


Besides quilting and running, reading has also helped with the grief. A book can offer an escape to an alternative reality or in some cases something that's completely unrealistic, or a book can offer suggestions which I can choose to agree with or completely ignore and not have to explain why like I would in conversation, or a book tells a story that I relate too and provides words to the deep hurt I feel but find hard to articulate. So I offer-up my reading list for the past few months and a few brief comments on each book and welcome any suggestions on books you've read and really enjoyed. 

Here if You Need Me by Kate Braestrup
 -Her humor and grief made this one of my favorites

Bel Canto by Ann Patchett
- unique plot and contains a lot about opera and love

The Reader by Schlink
- Can the worst crimes ever be forgiven or forgotten?

The Gospel According to Job by Mike Mason
- most helpful thing was the intro which said if you're grieving you should only read the parts of the book that speak to you and skim over the rest

When I don't Desire God by John Piper
- His book Desiring God was much better and the grand conclusion was to help others as a way to overcome the self-centeredness of grief

The Alchemist and The Zahir by Paulo Coelho
- his style of writing is like nothing else I've read and really detailed

Infidel by Ayaan Hirsi Ali
-since 25 percent of my patients are Somalian I found her story very interesting

Praying our Goodbyes by Joyce Rupp
- I'd just skip most of the book and go to the prayer section in the back

Just Do Something by Kevin DeYoung
- quick read, but probably better for someone less driven

Handle with Care and House Rules by Jodi Piccoult
- I loved her opening paragraph to Handle with Care about all that can break in life. House Rules was too predictable.

Call the Midwife by Jennifer Worth
- This is probably one of the few historical accounts I enjoyed reading.

The Checklist Manifesto by Atul Gawande
- We actually have his checklist at Kijabe, but it's only on the wall and not in use--that would probably make him crazy to hear.

When Helping Hurts by Corbett
-This book applies most to vacationaries (mission trips with vacation packages combined)

Outliers by Malcolm Gladwell 
-most people with "gifts" have actually worked 10,000 hours to be elite... loved all the statistics

When Crocodile Eats the Sun by Peter Godwin
- Beautiful Memoir set in Africa

Blood Sisters and To my daughter in France by Barbara Keating
-Loved these stories and their settings

Secret Daughter by Somaya
- Starts with the tragedy of pregnancy loss in a female doctor and I almost couldn't read it, but identified with how the character's view of medicine and hospitals changed being a patient.

Evolving in Monkey Town by Rachel Evans
-Her writing is like talking to a friend about her faith and also pretty funny.

All the books of Marian Keyes, Sophia Kinsella, Janet Evanovich and Jennifer Worth. Really all I can say about these authors is that they are entertaining, but I hide their books on my shelves behind the ones with more literary value or return them to the shelf of my dear friend Jacqui (who has helped me explore British literature).

P.S. There are a few books I'll never admit to reading. 

Thursday, August 12, 2010

A few pictures from Crescent Lake

Crescent Lake was filled with the usual activities: face painting, T-shirt painting, squirrel feeding, a bike parade, a talent show, water sports, and family meals. While I missed most of this, Malin and the kids had a fabulous time as the pictures show. Amelia performed her Dutch girl dance for the talent show and sang all the books of the Bible. Meredith was ready to swim at 7am every morning even though it was only 50-60 degrees outside. The girls were so excited to reconnect with their cousins. And while it took a little time for Meredith to keep the names straight she's now asking daily when they can play together again.

Friday, August 6, 2010


Thank you for the e-mails, face-book messages, blog comments, calls and flowers this past week! Each brought a smile to my face as a reflected on some of the amazing people in my life. 

My parents were able to come to Bend for 3 days so Malin could return to the girls and the rest of his family at Crescent Lake. Mom and Dad will leave today and Malin and the girls will return. I'm eager to see them. Until I'm medically cleared we will stay in Bend, Oregon. 

It seems I've been the patient too often this past year. And I really don't enjoy resting, never have liked to nap and don't generally sit still. Television really is not that entertaining; I mostly find myself annoyed: that people get rewarded for having filthy houses (like in Clean Sweep), can talk about how hard  it is to find the perfect home for 1 million (don't we all feel sorry for them), I certainly don't want to see 19 kids and counting, the news has had nothing on the constitutional election in Kenya, and my usual default--cooking shows, just makes me nauseated. But I will admit I'd still be happy to appear on What Not to Wear (who wouldn't want personal shoppers and 5000 dollars for new clothes).

So I'll keep reading, take some slow walks, and try to use the time to reflect on the past year. Or maybe I should try just to rest?

Wednesday, August 4, 2010


I am publicly declaring I have had enough. Enough pregnancy losses, enough disappoint, enough grief, enough sadness and enough wondering why.

Our vacation with Malin's family at Crescent Lake, Oregon was interrupted Monday when I started having severe pain and bleeding. Even though I had a normal sonohystogram 1 week prior my medical knowledge made me worry of ectopic pregnancy (although I really didn't think I could be pregnant). We waited a few hours and then drove the 1.5 hours back to Bend. In the end I had an emergency laparoscopy that evening for a ruptured ectopic pregnancy. How I had hoped my diagnosis was wrong! While I received good care and am now recovering at Malin's parents home, it's been overwhelming. The doctor found no obvious reason for the ectopic and called it a "spontaneous, random ectopic." Do random things happen or does it all come from the hand of God?

Further difficult news came today when I learned I did not receive a fellowship position. While I still have plenty of options for the future it's still hard to have this option closed. 

So the answer to the question, "What's next?" remains open. How do you navigate life in the midst of tremendous grief?  How do you derive God's will or plan through pain?  How do you decipher a divineness when the losses seem senseless? 

For now, perhaps all I can say and believe with confidence is that God still loves me, still loves our family, and still has plans for us.