I glance at my watch. Eleven o’clock. I rub my eyes, aware that my hands are far from clean. Dried sweat and grimy hand sanitizer cling shamelessly to my knuckles and nails. But I couldn’t care less.
Twenty feet in front of me over two hundred people wait patiently, both anxious and eager to be seen by a nurse. Some arrived last night, determined to make the appointment on time so they slept on the hospital compound. Others come today for their screening appointments with Mercy Ships. Either way, today is the first day that these potential patients will meet a crew member. Expectations are high.
Last September twelve referral day crew (local translators hired by Mercy Ships) traveled north from Cotonou to register people who live in the bush, far from blood pressure cuffs and scalpels. The day crew sent us (screening nurses) patient information via phone and instructed the people to come today.
Early this morning we reminded our patients that these appointments are not for surgery but only for screening. The surgeons are not here today, and they need to see the patients themselves before a final decision is made. Still, people come expecting surgery today because hope is unyielding.
Our hopes are also high; however, some of the patients we preregistered are not good candidates for surgery. My team approved appointments based on demographics, minimal medical information, and photos. As my dad would say, “For every one thing you miss for not knowing, you miss ten for not looking.” He’s right. A face-to-face visit with a patient reveals far more information than what is transmitted over a phone (singles, remember that for dating. It applies there, too).
Infrequent glances at the crowd inform me that we have a long day ahead of us. I watch the jagged line shift as patients inch their way towards me. December does not equal cold weather in Dassa, Benin. It’s quite warm despite the overcast morning. We are nestled within the hospital compound. When I say “nestled” I actually mean crammed along a covered path attached to the hospital building.
Mel, Rachel, and I set up our screening stations in close proximity to Ria, the surgeon screening coordinator. As the patients queue to the nurses, crew members measure their temperatures and take their weights. Rachel, Mel and I assess potential patients. If they are good surgical candidates we forward them to Ria, who schedules an appointment for the patients to come to the ship for diagnostics or a surgeon screening.
Eleven o’clock. I shift in my chair and focus again on the patient in front of me. Samuel, my translator, tells me that she takes no medications from the pharmacy or market. No herbs or leaves or roots. “Okay,” I respond, “You can wait at the end of the building to see Ria, a nurse who will give you an appointment for consultation at the ship.” I smile at the patient. Her smile consumes her face; her eyes disappear.
I motion the next patient to come. I can’t help but notice the messy clothing sagging from his limbs. The fabric seems to be too heavy for his frail body. He approaches me calmly.
Samuel, my translator, tells me the patient has come for a hernia. There isn’t time for formalities so we get right down to business.
“Okay, can you ask him to show me in a private room?”
The patient agrees. The three of us step inside a dimly lit room. Many curious eyes from the waiting line follow us. Privately, I assess his hernia and scribble a few notes:
+ reducible, + painful, + scrotal involvement
No previous surgeries
We return to our seats. Something seems off. The patient is wearing a winter hat over his head. That’s pretty full on, I think to myself. We’re in West Africa. Winter hats are not necessary. The man catches me staring at him. He points to the back of his head and quickly removes his hat.
My eyes widen. At the nape of his neck lies a softball-sized tumor, weeping and open-sored. I exhale, my breath saturated with disappointment. This mass is slowly murdering him. I can’t form words. Instead, I continue my exam.
His eyelids are more pale than my yovo (“white person”) skin. He reports ongoing nausea and fatigue since the tumor started growing less than a year ago. He is unable to work as much as he used to because he feels ill. I skim the screening sheet. He is only twenty-nine.
I know what to do, but my heart stutters. I need a team member’s agreement, so I ask Mel to come. She confirms my assessment. “There’s a high probability of malignancy,” she says sadly.
I look at Samuel. He is doing an amazing job.
“Samuel,” I say slowly, “I want to tell you this first before you translate. This patient cannot have surgery on his hernia. If he has surgery he may not recover because he is so sick. Can you please explain to him, however you think is appropriate, that yes the hernia is there, I can see that. But it is not causing him to be sick. The real problem is the tumor behind his neck, and Mercy Ships cannot help with this kind of tumor. He needs to go to the local hospital to see what kind of treatment they offer. I am so sorry that we cannot help him.”
Samuel nods. He pauses, contemplating, then begins to speak in the man’s local language. I feel frustrated that I cannot communicate directly with my patients. I would love to know what they actually think about the situation. But, simultaneously, I love working with translators like Samuel. I trust him to deliver the news in a culturally appropriate manner. He is sensitive and respectful to the patients.
The man listens quietly, expressionless. After, I invite him to ask questions. He inquires once more about the hernia surgery.
I swallow. “It is not possible for Mercy Ships,” I answer. The man looks at the ground. Then, rather suddenly, he thanks us, gets up from his chair and walks to the exit of the compound.
I motion the next patient over, and we begin again.
The day is taxing for the team. We turn away many patients who are too sick to have surgery, but who also have little hope for treatment. Children with ascites, aggressive spinal tumors, and rare genetic disorders that surgery will not improve. Adults with hypertension, diabetes, anemia, and oozing wounds. These problems are only a small representation of the conditions we see.
At some point during the day each of us takes a moment. “I need a minute” is a common phrase we use. My teammates are strong but also very human. We feel the patients’ emotions and reactions. Processing and debriefing with each other is a crucial aspect of screening.
Come to think of it, I think that’s what this year is for me: constant processing. Every day I witness the plights of the poor. I talk with those who have been abandoned, neglected, and forsaken. I discuss ethical problems and am forced to make decisions that usually don’t feel good. Over time, that weighs on a person.
Nate, my supervisor, has worked in screening for several years. He once told me that this job has changed his perspective on life. “For better or worse, I don’t know,” he said. “But I know that I don’t ever want to recover.”
I don’t want to recover either. Right now I wouldn’t trade this job, one teeming with raw human suffering, for anything. I will always remember these delicate stories. They hold me accountable to live responsibly, walk humbly, and pray constantly.
“We have been waiting here since Monday. We came from Nigeria.”
Our eyes meet. I glance at the four-year-old twins next to him, both struggling to balance on extremely bowed legs. I try to hide my expression from their father, fearing my transparency will only make the situation worse.
“Please. You can help us?” His words feel like fire.
I apologize again. The response doesn’t feel natural at all, but thick and poisonous. My explanation regarding a full orthopedic program cannot dissipate his tangible sadness. Or his continued questions.
“But they have pain. Can you fix it?”
My mind knows the answer is still “no” but my heart cannot support it. I need back up.
“Nate?” I beckon my supervisor. “These twins…they’ve been waiting outside the gate for five days. I know we can’t…but I need your confirmation.”
Nate’s gaze falls on the young girls. “Technically, we can’t,” he says softly.
I turn back to three pairs of desperate eyes. Feigning confidence, I repeat that the program is full.
The father is staring at me. Finally, with a quick nod he motions his family off the cement slab and toward the exit gate. I watch the man shuffle through shifty sand, trying to support his twin daughters. My heart breaks. I feel like a liar.
Our orthopedic program isn’t full.
As a screening team we had decided to allocate the sixty one orthopedic surgery slots. We divided the slots among three weeks, which is how long the screening center is open. The alternative was to take all sixty one patients as they come. First come, first serve. If we had chosen this option our slots would have filled in about three days’ time.
Some team members thought it would be fair to offer surgical opportunities to patients who will journey to Cotonou over the next two weeks. We agreed that we would attempt this approach. This meant that we would take only ten more orthopedic patients this week. We had already found those ten.
I had thought we made a sound decision. After all, I had turned countless patients away this week. This is difficult; however, “no” is more straightforward and undemanding when the patient doesn’t meet surgical critera. I feel okay when I can shunt the control elsewhere because the disappointment is not my fault. You’re too young to have the surgery. Mercy Ships only offers this to women who are past child-bearing age. Or I’m sorry, but Mercy Ships does not do this kind of surgery. Or unfortunately, surgery could make the problem worse. These conversations are certainly sad, but they’re doable.
This “no” felt completely different. Gone were the external factors. I had no organizational chart to fall back on, no exclusion critera to support my verdict. These Nigerian twins met the requirements for surgery, but there is an overwhelming demand so we had to pick and choose. Our selection system seemed ungrounded and unstable. I don’t even want to make life-changing decisions for myself. How can I make them for other people?
When the decision is mine (or ours, as a team) the responsibility feels sovereign. The power is dreadful and condemning.
I feel like I am playing God.
Speaking of God, I am not sure what Jesus would do in this situation. He faced desperate eyes and crippling ailments. I am willing to bet that he felt overwhelmed. Even though his divine nature had no healing limitations or surgical quotas, I am convinced that as a man he felt aching disappointment and deep discouragement in every breath he took.
I watch the twins approach the exit gate. I want to scream, Come back next week! We have more slots! But what if they are too late? What if they can’t make it through the gate? What if they are the ninth and tenth orthopedic patients in line, and are denied again because we accept the first seven?
I turn back to the weaving line of people, some of them soon-to-be patients. The queue seems more like a maze of fraught individuals eager to come out at the right end. I signal the next man to approach me.
Now I understand what Jesus would do. He would keep meeting with those who are suffering. He would come back to this cement slab every day. He would remain open and continue to offer his heart to the wounded, broken, and downtrodden.
Just because you can’t help everyone does not mean that you don’t try to help anyone.
Disclaimer: This is a personal and private page about my experience aboard. This is not an official Mercy Ships page. The reviews and statements presented here may not reflect the beliefs of the organization.
“Why don’t you go out with him?” My mom asked me over breakfast.
I replied without hesitation. “He’s way too vanilla.”
“What exactly does that mean?” She looked confused.
I straightened, confident. “It means he’s too boring, settled, and plain. You know, like vanilla.”
My mom tried to suppress a chuckle. “So it has absolutely nothing to do with his ice cream flavor preferences? It’s a judgment about who he is?”
I nodded my head as she gave me a look. You know, one of those looks that screams, I’m-your-mom-so-I-love-you-but-sometimes-you-drive-me-crazy. “You’re ridiculous,” she said, and turned back to her breakfast.
Our brief conversation alluded to a deep flaw that I have: I tend to view matters black or white or, in this case, chocolate or vanilla. Analogies aside, I’m learning something new. Each of us has a Choose Your Own Adventure book of life, which contains vanilla fragments on different pages, in various settings and disguises. What is vanilla for me might be a flashy flavor for someone else or vice versa. Life is not black or white. There is beauty in the mundane and disappointment in the seemingly perfect. It’s all mixed up and in, and I cannot categorize everything.
Unfortunately, my categorizing has affected my friendships. A few weeks ago I attended church with my friend, Bekah. She’s my shopping cohort, neighborhood walking partner, bantering buddy, and happy hour comrade. It also helps (or *doesn’t* help) that we both enjoy binge-watching “Jane the Virgin”–you just don’t let friendships like that fade. As we exited the church service together, I posed a question:
“Can we talk about something?” I asked, already knowing the answer.
“Of course,” Bekah replied.
I kicked an unruly pebble, wishing that I could punt it across the parking lot. “I feel like you’re frustrated with me. True or false?”
“What? I thought you were frustrated with me!”
We stopped, looked at each other momentarily, and then laughed. A few minutes later we had unraveled misunderstandings, poor communication, and harmful assumptions. She confessed that she thought that I was disappointed in her “because she’s getting married” and “buying a house in Grand Rapids.” Essentially, she assumed that I thought she’s settling, boring, life over, i.e. too vanilla.
Aghast, I had to convince her that this isn’t true. I am giddy for her wedding and proud of her commitment to her awesome fiancé. “You’re starting a new adventure that no one has embarked on before,” I pointed out. “No one has married Matt–at least, not that we know of.” I winked, and the conversation ended. But my thoughts didn’t.
I felt uneasy that one of my best friends believed I am disappointed in her. Just because I am choosing differently from her (I am returning to Mercy Ships) doesn’t mean that her journey is less valuable.
The thing is, we feel strengthened and supported when people choose the same as us (this is how peer pressure works, yea?). So how do we go about our own business confidently and boldly without feeling insecure when no one strives for the same?
I wish for a simple, easy answer but at least for me, it’s not. When I embark on a unique path I suddenly think that no one can relate to me or no one is bold enough to try. This mentality manifested itself recently.
Memorial Day is one of my favorite holidays of the year. My extended family spends the weekend at my family’s cottage, which entails 25-30 humans living in a small house for four days, sharing meals and jokes, playing volleyball game after card game after board game. This year, though, I dedicated nearly eight solitary hours to a 1,000 piece puzzle. EIGHT. HOURS. Am I an introvert now? I wondered. God, help me. I played one or two games but mostly I kept to my puzzle and Sudoku book.
While it’s true living on the Africa Mercy has influenced my personality, it is more true that I felt (and still feel) dissociated from people in my hometown. I can’t relate to how the emergency department is functioning because I haven’t been there in eight months. I can’t understand the significance of which paint color to choose for the living room or which school to send my children to because (surprise!) I don’t have children to educate or a living room to decorate. I don’t even have a dog to care for. My heart is stretched and divided across the world; between blood and non-blood families; among African, mariner, Catholic and Protestant communities. My heart and brain are worldwide, so I feel exhausted if I try to share my thoughts and feelings.
But it’s important to keep trying. When I feel I can’t relate to others, I withdraw from social interaction. Instead of investing energy into conversations, I seek isolation. But guess what isolation does: it makes you feel isolated, which is not helpful. I am about to leave for ten months. Isn’t this the time to laugh, build experiences and memories with my loved ones?
I’m sorry if you tried to spend time with me and I withdrew. I hope I didn’t make you feel uninteresting or unimportant. I’m sorry if I made you feel like your life choices are less significant. They’re not. Raising a child appears overwhelming. Marrying your significant other is courageous. Buying a house is bold. Applying to a new job is ambitious. Enrolling in graduate school is admirable. And just being yourself is enough.
You are enough. I am enough. Vanilla ice cream is delicious, especially with sprinkles.
I’m seated inside the Toamasina port drinking a lukewarm beer that cost less than $1, staring at striped fish in transparent waters beneath my feet. The quiet moment invites contemplation; thoughts swarm my mind, tugging about, and I continue to stare.
My gaze focuses on my sandals–Chacos, to be exact. They’re great, aren’t they? If you’re from the United States, you’re probably nodding your head. If you’re from Michigan, it’s likely that the word “Chacos” itself causes you to salivate.
Most Chaco owners invested in the sandals because they are particularly nifty for walking, traveling, hiking, and water activities. They are sturdy and dry easily. I don’t typically wear mine to work or to run errands (clarification: they’re so comfortable that I want to wear them everywhere. Sometimes I do wear them to the grocery store). But more often than not, if I don my Chacos I’m probably headed for something slightly out of the ordinary. These sandals are, inevitably, tied to fond memories. And weird tanlines.
Right now I am especially grateful for footwear that has accompanied me around the globe, across and through nine countries and many more to come. I am astounded that slabs of brilliantly-shaped rubber could last for many years and graze a variety of terrains.
If I didn’t clean my Chacos they would smell like bus floors, rotten soil, stale sweat, and animal shit. The cleansing and refitting of these sandals, my favorite job, is 100% necessary in order to keep using them.
But you know what? I swear that as soon as I clean them, they dirty again.
Alas, my fondness for the footwear urges me to scrub again and again. I’m happy to do it because they are worth investing in. If I take care of them they can endure many years (that’s what my parents always taught me about owning quality items. I didn’t actually start listening to this advice until I turned 24).
I take another sip of beer, glance at my feet, and pause.
I’m basically a dirty Chaco sandal.
I think God treats me like a Chaco sandal.
That seems a bit odd, but the analogy holds truth. God leads me on journeys I would never tread if I were alone. When he (or she?) cleanses me, a lazy scratch at the surface doesn’t suffice. A deep clean, often with some sort of uncomfortable, wiry brush, is necessary to release and rid the grime.
Because I am human, I also will “dirty” again, but the best thing about love is that it never ceases. God’s love for me is unending and given generously. He will never give up on me even though I mess up repeatedly. In fact, I will probably screw up before I finish writing this. I’ll probably drink way too much beer (just kidding, it’s too warm for that. I also don’t think God would be upset with me–he probably has far more to worry about than my beer consumption in Madagascar). Regardless, it won’t be long before I do something stupid or hurt someone.
The whole point of Jesus’ teachings, I think, is to never give up and always persevere. God didn’t give up on me and if I claim to follow Christ, I also cannot give up on God’s promises. He promises in the Bible to fight for me, redeem me, give me hope and a life that never ends.
So don’t give up! Even if a person or situation feels dirty, hopeless, or useless. Refuse to give up on your marriage, your children, each other, or yourself.
If you do, come to Madagascar, sit by the Indian waters and drink a lukewarm beer. I promise that you will gain the strength to continue. I might even feel inspired to buy you your own Chacos*, if that’s what it would take to prove my point.
*let’s discuss this offer after I start earning an income again
Yesterday marked my first Christmas away from home, in a warm climate, and aboard a ship. Rough life, huh? In all sincerity, I wasn’t particularly excited to celebrate this year. Since I arrived on the Africa Mercy five weeks ago I have battled a severe case of “scrambled egg brain.” This self-diagnosis reflects the ever-changing emotions and tired, mushy state of mind I now possess. Anyway, Christmas:
At 0640 an abrupt alarm unkindly reminded me I had to work. After a mostly sleepless night, I rolled out of bed with a scowl on my heart.
I arrived on the ward and took report from the night shift nurse. As I planned out my shift I grew more and more annoyed. Every task and assessment felt unnecessary and too involved. I convinced myself that the job requirements today were too taxing because it was Christmas. I sat down anyway and created my schedule.
My co-workers and I soon discovered a slight problem. Three of the nursing staff wanted to eat brunch at 1130 but only two could attend. We had signed up for time slots with our friends. I planned to meet three close friends and eat our Christmas meal together.
Guess who drew the short straw.
In addition to the morning excitement, I’d get to eat my holiday meal alone. It was only 0737 and I was already fighting back tears. Every muscle in my body wanted to fight the injustice. I felt sorry for my poor self.
I’m away from home. I’m tired. I have to work on Christmas. I can’t eat brunch with my friends. I have to measure urine and clean vaginas and take care of a diabetic and convince a child to exercise and…
Thankfully, these depressing thoughts prompted me to take a break early. I walked to the cafe to collect a coffee and croissant. My already sad heart almost broke when I saw the length of the line. I didn’t have to check my watch to calculate I would not have enough time to even place an order.
I asked an acquaintance if I could jump ahead. Almost immediately I was at the front. My friend, Krystal (also the holiday barista), asked me what I wanted.
“Uh, something peppermint?” I muttered.
The man in line ahead of me turned to face me. I had met him before. The spunky Aussie was the principal of the school. He spoke.
“Oh, dont worry, yours is already being made then! There, set your mug down.”
“What?” Confusion contorted my face into a funny expression.
“My wife and I had another drink made to give away. It’s peppermint and coffee. You take it! It’s for you. On us. Merry Christmas!”
I smiled, thanked him, took the coffee and sat down at a nearby table. I knew the coffee was cheap, if not free today. Why was I so touched by his kindness?
I returned to work feeling slightly more grateful. I smiled at my patients. I provided better care. I began to see all the blessings that followed in the day.
This Christmas I am thankful for different things. I appreciate the British stranger who served as a delightful brunch companion. I am thankful for the fellow Midwesterner who stopped by the ward on her Christmas to bring me delicious coffee. For the first time in a month I tasted coffee so smooth that I could drink it black. I will never forget the sweet, motherly pharmacist who spoiled me with a back massage after I told her I missed my touchy family. I am thankful for the drizzly evening weather and a close friend who sang beneath the moon with me.
It’s amazing, you know, just how much simple kindness can change your perspective. Open your eyes. Reset your mind. The feeling that comes from knowing someone is taking care of you can gently force you to start thinking of someone other than yourself.
I think God’s love works in me quite the same way. After I have spent time praying and praising in whatever form (singing, writing, taking a quiet walk) my heart transforms, shifting my gaze. The Lord’s peace, grace, and mercy cleanse my mind. They remind me of my responsibility to look after others.
What would have happened without that peppermint coffee? Sure, things could have turned around. But it would have taken longer. My endangered spirit would have stayed tucked beneath self pity, lying to people, “I’m good. I’m okay.” All for the sake of preserving a stupid sorry-for-myself attitude.
I hope this resonates with you somehow. If not, learn from my mess. Do something kind for a stranger. Pause. Share a little love. You never know what could follow.
I left Grand Rapids in a whirlwind and didn’t get a chance to tell loved ones my thoughts. Or perhaps I just hadn’t yet articulated my goodbyes. Either way, during my 13 hour flight across the Atlantic I finally had time to process–shortly after the middle-aged Ethiopian passenger convinced me (quite easily) to ask the flight attendant for wine, and sometime before I fell into REM sleep.
I’m extending a ginormous THANK YOU to everyone who went out of their way to see me and/or bid farewell. I couldn’t see all of you but I so appreciate the thought behind your efforts. For those who I did have the opportunity to see, I carry those heartfelt and intermittently tearful conversations with me.
The final, face-to-face (because I’m certainly not dead) conversations were decorated with various words, but almost all contained the same one: “Have so much fun on your adventure!” I felt a little guilty when I heard this over and over again. I felt like a real life quitter who decided to pursue my generation’s chronic disease known as wanderlust. But, really, I think I felt guilty because you are absolutely right: my seven month journey through Africa is, undoubtedly, an adventure.
But why are these seven months, specifically, an adventure? Because I’m in Africa? I think it has to be more than that. For the Malagasy people “going to Africa” might not be an adventure, and I know plenty of folks who live adventurously without stepping across a foreign border.
These months are an adventure because I chose risk. I quit my job and willingly entered the unknown. I am surrounded by new faces, smells, sights, and sounds. I got electrocuted by a shower faucet. I have to reconnect to wifi at least a dozen times just to have a short conversation with a friend. I didn’t pack enough underwear (Kelsey, I should’ve listened to you). All of these mishaps are what construct said adventure.
You, also, have the capability to live adventurously. Maybe you’ve hesitated to spend money on that seemingly irresponsible vacation. Go now. Maybe you’ve thought about accepting the new job offer but you’re afraid you will like it less than what you have now. Dare to hope a little! Perhaps you’ve always wanted to talk with the teary-eyed woman you see at mass every week. Why not ask her how she’s feeling? Why not treat the homeless man to pizza instead of walking away with a full pocket and a guilty heart? Why not visit the local restaurant even if it’s not as cheap as Applebees after 9 pm? Why not ask that girl out? For crying out loud, WEAR the purple lipstick you bought months ago and stop worrying what people will think.
Adventure is all around you. You just need to choose it.
On a related note, I want to share that my days leading up to my depature were exhausting and challenging. I experienced every emotion and feeling possible during the last two weeks: pain, loss, heartache, fear, anger, joy, surprise, love, disgust, fatigue, excitement. I left like a hurricane and secretly expected that all the kinks would even out once my chacos greeted new soil. That hasn’t exactly been the case.
I’m struggling to be fully present here because I am still so connected to home. But I think it’s okay to have this struggle, and I don’t think it’ll go away anytime soon because these connections (people, really) are incredibly meaningful to me.
I miss my roommates. I miss Bekah’s word puns, Brittney’s palpable energy, Sarah’s laugh, and Christina’s passion for Chuck. I miss hospital banter with Ashley and Andrea and encountering those ridiculous RAZ moms. I miss my brothers’ hugs, my parents’ advice, and my sister’s sense of humor. I miss my pastor’s quirky sermons and the rowdy priest from mass at St. Andrews. I miss long happy hours and late night conversations and spontaneous salsa dancing lessons and Paddy’s irish accent when he reads out loud.
AND IT’S ONLY BEEN FOUR DAYS. Good things are to come, but not without sacrifice.
That’s what I ask you to remember. You can wish me well on my adventure but ONLY if you promise to see your own potential for adventure, right where you are. Sacrifice some comfort for the unknown. Start small and see where you end up. And, of course, tell me all about it!
Cheers to YOU! I love you all.
P.S. I realize that I used the word “adventure” a million times in this post, and I actually thought about using my friend, the thesaurus, to mix it up. But I thought it’d be better to use it as many times as I heard it before I left!