An Interesting Way to Give

SunTrust Banks are running an offer where you can open up a free checking account and let SunTrust give your favorite charity $100 or you can receive $50 yourself. Any registered non-profit organization is eligible for the donation.

This opportunity also raises the interesting question of:
Does one give more to others and receive nothing for one's self, or does one take for one's self and give nothing (or less) to others?

More to Come

Predisan, February-April 2008, child malnutrition, a chance to meet and love more of God's people...

I'm excited...

Who Would Have Ever Thought....

...that I'd be returning to Honduras anytime soon? Or in less than 6 months (Lord willing that all the hoops are jumped and hurdles are crossed)?

I'm kind of excited...

I really do try to visit other places...

More to come....

A Change of Plans

This had been an exciting week, working on plans for next semester's electives, preparing to start grad school next week, and enjoying the company of a wonderful couple from church who had graciously opened their home to a "cripple" (as my friends affectionately call me now) to avoid climbing 18 stairs every time she wanted to leave her apartment.

Yet, today I find my emotions of excitement muddled and fragmented with the somber realization that instead of starting a new chapter of my life next week, I will spend most of it in mid-TN closing an old one and sharing with my family the conglomeration of emotions and feelings that loss expects. I know God is faithful and loving and will see us through time as He has so many before.

An Interesting Verse

I believe that there's a verse to go with every situation in life.

I think I found mine for this situation in life after studying Hebrews 12 tonight at church:

"And make straight paths for your feet, so that what is lame may not be dislocated, but rather be healed." Hebrews 12:13 (emphasis mine)

So is this telling me that I should give up traversing all those crooked rocky hiking trails? I sure hope not. :o) Hmmm....

Praise

So I was originally going to title this post "Ponderings and the Pentateuch" but I've been reflecting on too many praise-worthy things lately so I just thought I'd share a few:

1. A new cast...which meant my old one was too loose because most of the swelling has disappeared (as long as its elevated). Recovery is going well. I didn't realize how much I needed this "mandatory down time," and how wonderful it's been to sleep in past 9am without feeling guilty about the precious hours of studying missed. I can't remember the last time I've slept in for so many days and so many hours and I definitely have no feelings of guilt for doing so.

2.Catching up on reading. Between being on crutches or a Roll-About (which is an ingenious invention that attracts as many stares and comments as taking a puppy or a baby to a park) and my hometown trying to vie with the Sahara desert for the title of "driest and hottest place to live," I haven't had the opportunity to do much more than read and watch movies. You've probably already noticed my recent reviews and reads.

3.Farmer's Market. Hands down there's nothing better than a freshly picked heirloom tomato sliced and eaten or some summer squash sauteed with onion, peppers, herbs, and placed on a piece of locally-made sourdough bread topped with melted Montery Jack cheese. Dee-lish. And if you attend a market in East Tennessee, you may just be pleasantly surprised by the sound of some local bluegrass music (no the musicians are not for sale).

4.U-Pick. If you're ever in Flag Pond, Tennessee around this time of year, stop by the Heavenly Holler Farm and pick some blackberries. The taste? Just heavenly of course.

5.Abel. He and his parents finally were able to return to East Tennessee!!!www.caringbridge.org/visit/abeltyson

6.It's almost Missions Seminar Time! September 14-16th. Mark your calendars.

7.A wonderful new temporary residence. Forget staying in my upstairs apartment, I have a room/house with a view, a pool, and an excellent environment to catch up on my reading and thinking about how I should probably start studying for my upcoming classes. Yay for those who practice hospitality :o)


"Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things." Philippians 4:8

Motion

Motion: the thing which allows us to leave the previous and move on to the next moment of life. It is the characteristic which separates life from death. Without movement our lungs cannot breathe, our blood cannot traverse the circuitous route of vessels to deliver oxygen to the body, and our nerves cannot deliver those thoughts which define our individual self.

As humans we crave motion. We look forward to our afternoon run, feeling our legs move under us as they connect and reconnect with the ground below. We spend hours repeating the same movements of fingers and hands until we have mastered a piece of music or conquered our opponents in some form of raquet sport. We save our money and our time so that we can move ourselves from one hemisphere of the globe to the next, defining such gross movement as "travel." We envy those with vehicles that can produce faster, quicker, more accurate motion than our own.

Our lives are often defined in terms of motion "a journey," "being stuck in a rut," or "about to take the next tep."

Our jobs are often defined in terms of motion "a rat race," a "climbing of the corporate ladder," or "feeling trapped at the bottom."

Even our thoughts "race," our words "stick," and our feelings "float on Cloud Nine" or topple us "head over heels." Where does all this motion take us?

We're told that 10,000 steps a day is encouraged to maintain good health, but what if those 10,000 steps furthur define the same rutted routine that we've been doing for years of our lives? And what if our thoughts continue to traverse the same boring path inside our mind, never taking the "road not taken"? Is that healthy motion? Is there such a thing as healthy and unhealthy motion or is just the lack of motion that may be unhealthy? But then again, sometimes it seems sufficient to "be still."

So not per usual, I leave you with no quote. Just a post about motion.

Just Read: All God's Children Need Traveling Shoes by Maya Angelou
Currently Reading: Numbers, Status Syndrome by Michael Marmot
Going to Read: The Problem of Pain by CS Lewis

More HodgePodge

So it's POD 15 though I feel like it should be POD 35. I'm learning alot (such as it's not a good idea to go outside in 100+ degree weather with a cast on...it's not a good idea to go outside in 100+ weather period), healing alot (or so I hope), and catching up on all the hours of sleep I lost the first 3 years of medical school and all the hours of sleep my friends lost the first 3 years, and all the hours we'll lose intern year, etc..

I have no great epiphanies or pearls of wisdom to offer you. I do have new respect for those patients in the VA wound care clinic who patiently let the neophyte surgery student (me) remove their stitches and staples sans much experience.

I have a new respect for caregivers. I'll readily admit that patience and dependence are not two of my natural gifts; rather, I seem to posess an abundance of the opposite qualities. You could say they are my Achilles heal, or peroneal tendon in my case. It's been a struggle the past few weeks letting people do for me and help me, accepting help, even non-perfect help, slow help, not-quite-what-I-was-expecting help. I'm learning...slowly.

So three more weeks in a cast, two more in a boot, and finally (hopefully) I'll be able to use two feet again. I'm almost there.

Just read: Exodus
Currently reading: The Status Syndrome (recommended) by somebody Marmot, Real Food by Nina Planck
Plan to read: All my public health books (in a few weeks, or at least look past the front cover)

(ok so all of the above are recommended)

Ones and Twos

Several moments of boredom have prompted me to create a hodgepodge list of one and two item suggestion that you may find helpful, amusing, or simply a means of passing a few moments of your own boredom:

One + One = One Great Dessert
Half of our fabulous female Quillen quartet accepted the invitation to have lunch today with one of the other members. The result led to the decadent dessert of homemade brownies coupled with Breyer's All Natural Vanilla Ice Cream. Wonderfully delicious and absolutely no calories (because calories don't count on birthdays, sickdays, girls' nights, etc..)!

One Website to Check Out:
www.freecycle.org Based on the principle that "one man's junk is another man's treasure, this site allows people of the same geographic area to post and accept unwanted items that would otherwise go into the trash. So whether it's a dozen toilet paper rolls, a bicycle, or an old printer, check out this site to find donors or recipients and leave trash for the trashcan.

Two Great Vegetables, One Great Recipe
I know you are all wondering what to do with all the fresh summer squash and zucchini you purchased at the market. Here's a great recipe to take care of some of your squash surplus:

1 Tbsp olive oil
2 cloves garlic, minced
1 c. Vidalia onion, finely chopped
2 cups zucchini sliced thinly and unpeeled
2 cups yellow squash sliced thinly and unpeeled
1/2 cup milk
1/2 cup freshly-shredded mozzarella cheese
3 Tbsp grated Parmesan cheese
1/4 teaspoon black pepper
Salt to taste
3 cups cooked brown rice
3 Tbsp flax meal (optional)

Heat oven to 400 degrees and grease 8x8 pan. Heat oil in a large non-stick skillet over medium heat and add garlic and onions. Cook until tender (3-5 min). Add squash and zucchini and cook another 5-10 minutes until tender. Remove from heat and stir in additional ingredients except flax meal. Place mixture in 8x8 pan, making sure it is packed into dish. Sprinkle with flax meal. Cover and bake 25 minutes.

(Adapted from Lean, Lucious, and Meatless Cookbook)


One Way to Dispose of Extra Flowers
Whether its a business event, wedding, or other event, a great way to dispose of all those extra freshly-cut flowers is to take them to a local nursing home. It'll brighten the patients' day and save those beautiful flowers from an untimely demise in the dumpster.

Two Random Facts
If a surgeon in Egypt lost a patient while performing an operation, his hands were cut off. (I guess there weren't many surgery residents back then!)

Gloucestershire airport in England, reportedly used to blast Tina Turner songs on runways to scare away birds. (I'm glad to know Tina Turner is helping keeping our airplanes safe)


So there's my list of randomness. Feel free to add your own list of ones and twos!

Post Op Day 6

5 library books, 3 PBS movies, 4 Blockbuster rentals, the entire Harry Potter DVD set, several naps, 1 bouquet of roses, and a gerber daisy later, I'm only at POD #6. Sigh...

I don't see how shut-ins do it. Knowing that I only have a few more days of official house confinement and a few more weeks of crutch confinement makes staying inside bearable. After all, I do need to catch up on my knowledge of certain important subjects...like planting an organic garden (in my non-existant lawn), the Holy Spirit, and Harry Potter. But to do this day after day, with decreased mobility, and no prognosis for things ever changing....no wonder rates of depression and suicide are higher in the elderly. And the sitters...fot those families who don't have the means to hire others to help take care of their loved ones...imagine the physical, mental, and emotional strain of having to always be present to care for someone. You'd think someone would start a volunteer service like a "Sitters' Day Off" similar to the "Moms' Day Out" programs already in existance. Or maybe someone should make "shut-in" packages to take to local shut-ins filled with games, novels, projects, etc....better yet, why not visit those people?

And what about people without the insurance to pay for crutches, walkers, boots, etc...? Do they just lay around and suffer? What happens to all the barely-used crutches, walkers, boots, etc. once people recover?

Just some more musings...

Currently reading: NMBE Step 2 Score
Just read: God, Medicine, and Miracles Dan Fountain, MD
Currently listening: Lucinda Williams
Currently watching: the dead leaves that need to be trimmed on my herb plants

Throwaway

I don't understand the allure of becoming addicted to "happy perscription pain meds." So far, they haven't made me very happy nor have they alleviated much pain; however, they have provided for some interesting eyes-closed entertainment ie dreams. I think my favorite thus far has been my uncle giving me a tour of the plumbing on his latest architectural project: a life-size reconstruction of Noah's Ark while a few of my relatives and a former African missionary chatted about how my long-since-been-sold horse has grown a thick coat of hair. I had no idea Noah's Ark had "indoor" plumbing...

Of course being off of my feet for the past few days has given me ample opportunity to think about others who have been off their feet. I don't understand the faith of many of the people Jesus healed, who somehow managed to recognize that their spiritual health was more important than whatever physical ailment caused them so much physical and emotional pain.

And then there's the rich man and Lazarus, the Lazarus who laid at his gate each day covered in sores, too weak to even fend off the dogs who licked his sores. Yet everyday the rich man ignored Lazarus, to the rich man he was invisible, a throwaway member of society. We were discussing this parable last Sunday and I've been thinking about it the past week. Who are the throwaways in my life? Obviously, our society considers the homeless and drug addicts throw aways.

What about immigrant/migrant workers? What about the mentally ill? What about the disabled? What about the sullen teenager behind the register at the local grocery store? What about the veteran wandering the campus at Mountain Home? What about the pregnant 18 year old about to give birth to her second child? Or the drunk twenty-something down in the trauma bay cussing every doctor who comes within two feet of him? What about the single mom or elderly widow at church? Are these people who mean nothing to me or to the rest of society? Should they? And what about those who seem to like being seen as a throwaway or worthless? How should I view those people? I still have a lot of thinking to do...back to the couch...

Just Read: Not All of Us Are Saints: A Doctor's Journey with the Poor, David Hilfiker, MD

Don't Bet on It

If you ever decide to go to the races (horse races), find out which horses the doctors and meteorologists are betting on, and don't bet on them. Despite the conglomeration of plastic, metal, and electronics known as technology at the disposal of each, they often are inept at predicting the weather, a patient's outcome, or the future in general. Place your dollars on another horse.

In addition to learning that doctors and meteorologists are poor predictors of the future, I've also realized that there's a lot of things I don't understand about the future, or the brevity of life, or life in general. I don't understand why a lady would be one moment dying with almost no chance of surviving surgery, and a few hours later be quietly sedated on the vent in ICU. I don't understand why another lady a few weeks before might have been in the same OR undergoing a simple, elective procedure and die of major complications a few days later. I don't understand why a man placed on hospice care with a 3-5 week maximum prognosis to live, 10 weeks later is sitting in bed more concerned about whether or not the mole on his face is cancerous than the fact that he "should" have died 5 weeks ago. I don't understand why a guy can subsist for years on a diet of burgers, ice cream, and cigarettes and suffer with n more medical problems than a few extra pounds and some shortness of breath while a marathon runner with no health problems suddenly dies while out on a morning jog.

I suppose there's a lot in life that doesn't make sense, there must be something bigger than me since despite my knowledge and the available technology I can't even tell what the next day will bring for a patient, prayer changes things, and that all this being realized I shouldn't worry about what might happen and just enjoy whatever does happen today. So I suppose I should live each day as if tomorrow may not come (does this mean I can eat ice cream and brownies everyday and not feel guilty?) and enjoy whatever life brings me at the current moment.

Enjoy today, and don't bet on my horses...

"So teach us to number our days, that we may gain a heart of wisdom." Psalms 90:12

Doffing the Coat and Donning the Cast

So today is my last day as a third year medical student...so technically I have an exam Tuesday and another one Friday, but today is my last day on the wards/clinic/etc. It's been an absolutely incredible year as I've helped pull life into the world and stood as a silent observer as life seeped out of this world. I've seen humanity at it's most joyful moments and it's most sorrowful moments. I've laughed, cried, pondered, vented, feared, lost sleep, and done more than I ever thought I could or would...and in the end it's been a wonderful experience. Call me and we'll grab a cup of tea to discuss it more...a year sampling most of what medicine has to offer leaves one with a novel full of stories (HIPAA compliant of course.)

But now it's time to hang up the coat that has gained me entrance into those sacred moments of humanity, study for that next requisite and way-over-priced exam, Step 2, and move on to the next role in my life: being a patient. They say doctors make poor patients. For someone who prides herself in her on-the-go mentality and who goes stir crazy when her weekly/monthly quota of physical activity and time spent outdoors isn't met, I fear that the next few months are going to be in some ways more of a challenge than the past 3 years. But then again, maybe not. Maybe this is an elusive period of time where I can catch up on my seemingly-shallow relationship with my Creator and really spend quality time in study and prayer. Maybe this is a "blessing in disguise", to use an over-used cliche. I still think spending 6 weeks on crutches + is going to be a challenging time. So with that said, I leave you until after exams and after surgery and request a few additions to your already lengthy prayer list:

1.That surgery goes well and that my tendon isn't torn or ruptured (which would mean an even longer recovery period)
2. That God grants me the strength and peace to accept adjusting to my temporary "lameness"
3.That I not become too discouraged but also use this time to not only physically heal but spiritually heal as well.
4.That I take advantage of this "free time" to really seek out God

38 days of "freedom" left and counting....

Hanging Up the Shingle

I've decided to add another career to my list of things to be should I fail out of medical school: wedding planner. This addition to the growing career list of street musician, professional beach bum, restaurant reviewer, travel guide writer, horseback riding instructor, etc.. (you can see that I've put much time and thought into this list) comes after the realization that I've already attended many weddings, and with the growing list of people getting married, I'm already going to have to take a second job anyways to pay for all the wedding gifts. Why not take advantage of such an opportunity and such experience?

Michele's Wedding Planning Service

Planning All Your Wedding Needs

With this in mind, I present to you a few of my "favorite" wedding ideas: *

1. The Hillbilly Wedding

This wedding option is perfect for those couples living in the East TN/Appalachia area or for those couples who wished they lived in such an area. This package includes the rental of one of Tennesse's fine historic barns, a wagon, two horses or mules, one square dance caller and accompanying musicians, and numerous square hay bales. The guests of the bride and groom will be comfortably seated on neatly arranged hay bales while the bride and groom say their "sure do's" . Attire is casual, and overalls and bare feet are allowed. After the vows are taken and the recessional is complete, the bales and guests will be asked to stand outside the barn for a few moments while the hay bales are cleared and the square dance caller and his fiddlers set up for the reception which will be a la "potluck." The bride and groom will be escorted from the barn via horse-drawn wagon. Honeymoon will follow in beautiful downtown Pigeon Forge complete with complimentary pancake breakfast and putt-putt admission.

2.Destination Wedding

Having problems coming up with the finances to pay for all the guests that you expect to attend your grand event but don't want to have a private wedding and hurt the feelings of all your would-be-guests? Choose a destination wedding. Invite all of your guests, and then choose a location so remote or distant that none of your guests will be able to attend (I recommend Tuba City, Arizona or Tasharte, Guatemala.) You and your future spouse can still get married, the guests still get invited, and you save money so you can spend it on something like the honeymoon...or that first house payment...or your student loans.

3.Luncheon Wedding

This is a perfect option for that busy professional-professional wedding. We all know that professionals live such extremely busy lives that the only time they stop and listen is during lunch, which often is catered by business reps. Why not squeeze in your wedding during this time? The food is already provided, the time is already allotted for something (I'm sure that day's business agenda can be readily changed to include your wedding), everyone is already in more-than-casual attire, and the company has already announced the event. All you have to plan for is the cake, unless the business reps have already catered that for you, too. After your luncheon wedding, subsequent lunch meetings can include pictures of the wedding/honeymoon (to be spent at the next business conference in a desirable destination), and/or a wedding shower as the agenda. A perfect option for those busy professionals or workaholics.

4. The Graduation Wedding

This option is great for all of those graduating college students who went to school to obtain their M.R.S. instead of a B.S. Since most of such students are planning their wedding for some day in the month following graduation, why not just combine the two dates? This saves the guests from filling in two dates on their calendar, it saves the bride and groom from sending out two invitations, and it saves the bride and groom from having to rent a separate facility. After commencement exercises are completed, an announcement will be made to those in attendance to remain seated while a brief wedding ceremony follows. At this time the college orchestra, glee club, etc.. will switch from "Pomp and Circumstance" to the wedding music of the bride and groom's choice. The bride and groom may wear appropriate wedding attire under their gowns to facilitate an easy transition from ending college to beginning marraige. Likewise, the bridal party may do the same. Attention will be given to the invitations to ensure that bride and groom will receive wedding as well as graduation gifts. Afterwards, a graduation party/reception will follow at the location of the bride and groom's choice and if they so desire, the bride and groom may combine their graduation trip with their honeymoon.

These and many other wonderful and creative opportunities exist for you and your spouse to be...

...so maybe I should stay with being a wedding attender instead of a wedding planner and focus on being a good doctor...

*The author of this post assumes no responsibility for the aforementioned advice or any damages caused by such advice nor does the author claim to be a professional wedding planner. Pricing and packages subject to change.

The Futility of Oversimplification

I hadn't planned on writing this post until after I returned from my brief weekend "study break," but Mer's post echoed some of the sentiments that have been rolling around in my head this past week as I've played mental marbles to keep myself occupied and focused during my days on the psych ward.

I find it fascinating that our society prides itself in oversimplified statements that are aimed to magically eliminate the problems of human nature. Does anyone remember the commercial back in the 80's about "Just say no...be an original" sang by a "Huey Lewis and the News" type character (ok so I had an older brother who was into that kind of music) ? Catchy phrase, lots of money invested in interesting commericials targeted at innocent-minded 4 year olds who would have rather watched five more minutes of cartoons as opposed to such commericals, but I have yet to meet a drug addict that has told me the reason for their drug problem is because "they just couldn't say no and be an original" or that if only they had seen or heard more of such propaganda they might not be in such a state of misery today.

Yet we like such short oversimplified phrases. They're catchy. They're comfortable. They bear no responsibility for the one that states them. It's easy to say "Don't drink" or "You should stop smoking. Smoking's bad for you." or "Just stop eating and you'll lose weight" or "Stealing's wrong." While all these statements bear validity, none of them address the real issues that drive these compulsions.

"Don't drink" doesn't address the chronic alcoholic's need to acknowledge and confront his emotions concerning past events which then leads him to feel lonely which then drives him to alleviate his loneliness through drinking. "You should stop smoking..." doesn't address the fact that smoking is part of the smoker's family culture, that they've grown up knowing nothing else and that part of their family's income depends on the annual crops of Burley tobacco. For them, smoking is a part of their life, a part of their heritage. "Just stop eating and you'll lose weight," doesn't address the fact that a person has found comfort in the consumption of food as a means of coping with stress in her life instead of having the courage and support to cope with it in more healthy ways. "Stealing's wrong" doesn't help the prescription drug addict who is desperate for their next fix of Xanax or Oxycontin because they haven't found a successful means to manage their pain following an accident or the family and relationship stress that ensued.

So we must discard such catchy simplified phrases and be willing to scratch beneath the surface of the outward manifestations of the inwardly suffocating pain that is born by many of those around us, to assume responsibility and make an investment in the form of time and emotions in those that "shouldn't" but "can't." It might just be worth it....

More than Crazy

Psychiatry--often dubbed the "easy rotation" of the 6 required third year rotations, the specialty most often joked about, and the one that conjures up images of long couches and "shrinks." Yet, during the past week, I haven't really found any of these terms or ideas particularly applicable. What I have encountered is alot of broken people, broken lives, broken relationships.

I have been astonished at the role sin plays in the causation and perpetuation of mental anguish. (I'm not oversimplifying mental disorders as a mere result of sin; many are due to organic causes). I am surprised at how scary and cruel the world can be without love, that people exist and live their lives with such blatant disregard for the rights, responsibilites, and limits of others. It is apalling that such people would cause such mental havoc in the lives of children by refusing to acknowledge and own their own sins and how the harboring of negative emotions and the refusal to deal with sorrow, suffering, and grief can display itself in such fearful and psychotic manifestations. At the same time, I realize that many of those people were probably once broken children as well.

Sometimes I wonder if we don't need a mental and spiritual "check-up" each year as much as we need a physical "check-up." And why is it that we're so willing to pray for and support the physical illnesses of others but seemingly reluctant to address the spiritual illnesses? Why does it seem like that the expression of grief and sorrow is sometimes perceived as less Biblical and that "just dealing with it" is a better option? My Savior grieved. Was he less of a person for doing so?

So after spending a week with "crazy" kids, I find my heart somewhat broken for them, I find my mind perplexed and wondering where I fit into this picture of broken people and a broken world, and I find my emotions grateful for a God who gladly mends the cracks in my own broken vessel and the vessels of others. I leave you with a few mental health "tips"... It should be an interesting rotation...

"A heart at peace gives life to the body, but envy rots the bones." -Proverbs 14:30

"Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests before God. And the peace of God, which transcends all understanding, will guard your hearts and minds in Christ Jesus." Philippians 4:6-7

"Godly sorrow brings repentence that leads to salvation and leaves no regret, but worldy sorrow brings death. See what this godly sorrow has produced in you: what earnestness, what eagerness to clear yourselves...what longing, what concern..." II Corinthians 7:10-11

"Therefore confess your sins to each other and pray for each other that you may be healed..." James 5:16

"A fool gives full vent to his anger, but a wise man keeps himself under control." -Proverbs 29:11

Some Good News

Yes, I realize I'm on a roll with the blog updates...

It's probably because I've been spending too much time on the road thinking and not enough time in the books studying. Anyways, I couldn't help but share this good but somewhat uncertain news and ask for your prayers for this family. Adam is a Quillen student in the class below me. I'll let his journal tell you the rest...

www.caringbridge.org/visit/abeltyson

"Praise be to the Lord, to God our Savior, who daily bears our burdens. Our God is a God who saves; from the Sovereign Lord comes escape from death." -Psalm 68:19-20

Reason #72....

....that Quillen is a wonderful place to become a doctor: domestic medical missions

When I was little, I grew up in what I thought was a small town, Smyrna, TN. However, as I grew, it grew until it was swallowed by the large metropolis of Nashville and became just another place to grab a white mocha raspberry latte from Starbucks and see another soon-to-be-forgotten film. Then I moved to Johnson City and took trips to a place called Rogersville. I thought it was a small town, but no town can be classified as small if a Super Walmart exists within its premises. This week I finally went to a small town, several of them, in rural southwest Virginia.

When I came to medical school, I was certain that real poverty only existed in "third-world countries" After all, with the US being such a "blessed nation," how could the poverty in our own country be equivalent to that in other countries? This week I was reminded that real poverty is alive and well in our own country. You may have to find it in the cracks and crevices between mountains where the river and road run and on a small piece of land in between someone has tried to etch out a living by means of a small coal-heated dwelling or elsewhere but it exists. Maybe the people have more than a few dollars a day but trying to support a family of 5 on less than $800 a month by legitimately working hard several hours a week is a seemingly impossible task. Not to mention that the nearest store and/or medical service is several miles away over curvy two-lane mountain roads and with gas being $3 a gallon...you can do the math...

This week as we worked to try to provide health care to those that have none, I met several beautiful, generous people. I'm never ceased to be amazed that no matter where I travel, it seems that those that have the least are willing to share the most. The generosity of local church members kept us amply fed everyday (I firmly believe that 3 days of church potluck consumption is very bad for the waistline but very good for the appetite :o) ). The children we visited in some of the local schools kept us amply supplied with curiosity-driven questions as we showed them organs and explained the function of each. Very bright children, but most may never have the opportunity to go to college due to lack of funds and opportunity.

So I guess with all this being said, it's made me think more than I'm comfortable doing so. When I came to medical school I was firm in my belief that "I'm going to be a longterm medical missionary somewhere in Latin America." Missions is what brought me to medicine. Yet the past week and months have opened my eyes to many seemingly equivalent needs here in my own country. I guess the crux of the matter is what's the best way to "go unto all the world?" People in other countries are suffering and need to hear about Jesus yet people in the United States are suffering and need to hear about Jesus, too. Any thoughts?

“Follow effective action with quiet reflection. From the quiet reflection will come even more effective action.” –Peter Drucker

More Late Night Thoughts

It seems like the only blogging I do is on those nights when I can't sleep. I blame this one on a distraught friend, the declaration of "it's a chocolate cake night," and the heartburn and consumption of caffeine that ensued. That being said, maybe this post is just preparation for tomorrow's (or should I say today's) marathon of research paper writing for my public health class.
I don't have any wonderful epiphanies to post. No profound meditations. Actually, the most insightful words I've read as of late come from writers like Peter, Paul, and Jesus (Mary didn't write a book as far as I know)...I find it interesting that so many people are intent on ridding the US of those "religious fanactics" known as Christians, but where would our country be without them? I'm not referring to the historical birth and development of our nation but to the numerous social services provided by faith-based organizations. If we eliminated Christians from our society, would our government be able to sustain the efforts of feeding and clothing the hungry, widowed, and poor that currently exist? Just an interesting thought....but here's some even more interesting thoughts as of late (not mine)....

Luke 8:48 "Then he said to her, "Daughter, your faith has healed you. Go in peace."
A woman who had spent all she had on professionals like me, an outcast with the audacity to reach out to someone like Jesus, and a compassion received that would call her "daughter."

James 4:9 "Grieve, mourn, and wail. Change your laughter to mourning and your joy to gloom."
Kind of a strange verse to be associated with drawing near to God.

Isaiah 58


1 Thes. 5:16-18. "Rejoice always. Pray without ceasing. In everything, give thanks. For this is God's will for you in Christ Jesus."
This is God's will for us, but why is it sometimes such a struggle to do these 3 seemingly simple things?

So those are the thoughts/verses of the week. It's been an interesting 3 months playing small town doc and with a few more months, I think I could have a collection of stories to rival that of Walt Larimore's Bryson City Tales. Anyways...it's one more month to go before I renounce my temporary citizenship of Rogersville for a one-residence status back in Johnson City...

On a Mission

When I signed up for the Rural Primary Care Track (RPCT) at Quillen, I just wanted more clinical experience than my peers the first two years and some extra "away" elective time my fourth year, not expecting my 4 month RPCT rotation to be anything more or less than the rest of the third year. I got more than I bargained for; I got a mission trip minus the cost of plane ticket, minus Guatemalan stomach guest (though I did pick up a nasty cold but what else could I expect from working in a peds clinic during the month of January?), and complete with an opportunity to practice my Spanish and a chance to meet some wonderful Christians.

Though thousands of miles away from Guatemala, I'm continually surprised at the similarities I see between those of rural Guatemala and those of rural Appalachia. It seems like even though we live in a land of the free and are "richly blessed" there are still those of our own country who are imprisoned by sins of addiction, trapped by lack of resources, and struggling to make a living. These past few weeks have brought me face to face with some of the rawest, roughest forms of humanity and some of the newest, purest forms of life about to be cast into that rough and raw world.
With all this being said, I think I've done more thinking, questioning, praying, and praising than I've done in a long time. I think these months are going to be about finding God in all circumstances. Finding God in an encounter with a patient with a small complaint, but large wounds of domestic violence on their body and fearful for their life b/c of their spouse's anger. Finding God in the 30 something year old patient whose 4 pack/day addiction to tobacco is literally taking years from his life. Finding God in the fellowship of those of a small, coutnry church. Finding God in the tiny life of the first baby I helped deliver, and whose Guatemalan mother seems indifferent to her existence, already having multiple mouths to feed.

Though I'm only a few hundred miles from the place I call "home" instead of a few thousand, there are definitely more spiritual and material needs than what I ever expected to find in my own state. Now, I'm just praying to see how God can use me in these situations and in this seemingly endless world of need, praying that I won't just focus my eyes abroad but take each day to open my eyes to my "neighbors" and their needs.

"Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us." Eph. 3:20