Today

Today. 

That's all.

I'm not even sure how to actually describe it but here it goes...

Sometimes life throws days at you that you don't expect....And sometimes the lessons you learn from crisis are beautiful. 

This morning i had just dropped the boys at school and was headed to work...thinking to myself that I needed more coffee and was not super excited about the day. All the usual grumpy thoughts are flowing "Micah's traveling", "I'm always running late", "I wish I had been able to sleep better last night." 

And then I came to an accident. My training instinct kicked in as grumpy thoughts gave way to adrenaline. Long story short, I worked for 30 minutes to revive a worker who had been hit trying to cross the highway. 

I failed. 

I was shaken, sweaty, dirty, covered in tiny glass shards and feeling helpless and exhausted.

While I've been in these situations before as a physician, there's something different and surreal about doing it outside of the hospital, kneeling on gravel to do chest compressions and praying the ambulance arrives. Groups of people are staring and whispering all while I am robotically doing the only thing I can without success. It's horrible. 

As the day has moved on, those moments continue to replay in my head over and over. While sadness (and fatigue) persist, I've realized something else. 

The man who died today was a foreign worker in Malaysia. For those who may not understand what that means, it means long, hard work for very little pay all of which gets sent home to their families. It means sleeping in a makeshift kampung, metal containers set up as villages. It means immigration hassles and no legal rights. Don't think of it like foreign workers in the US-that would be luxury for many of these people. 

In the part of Malaysia where we live, money is being poured into new construction all around. We see these foreign workers very regularly but it's very much two different worlds that don't mix.  Our typically experience to see these workers daily piling onto buses or very often running in this exact spot (and many others) across the highway. I've probably grumbled at them myself for making me slow down as I drive by. Today could be any day, every day in Malaysia.

But when it happened, something changed, and it wasn't just me. 

A friend, with no medical background, immediately followed and was by my side. Another ran down the road to direct oncoming traffic out of our way. Others took over cpr when my fatigue caught up. Another started calling ambulances (it's not such a simple process as 911) and working to find an AED. Others took my teaching at work and made sure I had time to recover. Others drove my car back to school and made sure we were cleaned up and okay. Another waited at the roadside for a forensics team to arrive. Many others have offered support, prayers, and condolences throughout the day. 

What I saw today is that people cared. In the end, it doesn't matter. We are all the same. It didn't matter that we came from different worlds. It didn't matter that we didn't know who he was. It didn't matter how it happened or who was at fault. It didn't matter that we might be putting ourselves in harms way. We saw someone in need and we tried to help.  

It would have been easy to keep driving. In all honesty, I thought about it. But when I looked at his friends who were scared and had no idea what to do, I knew I had to stop. He is someone's family-maybe husband, maybe father. He is working to provide a better life for someone he loves. 

Just like I would. We are all the same. We may have been placed in different circumstances and places in the world, but at the core, we are all the same.

Much of what is happening in the world right now is very difficult for me to accept.I've been struggling. I am pained by the discrimination, the indifference to people in need, and especially the justification that can follow. It seems to be everywhere. 

But today was different. 

Today I saw tragedy but I also saw hope. I saw good people. 

Sometimes the loud voices of the world focus so much on the bad, it's easy to lose sight of the good. We see all the hate and anger and fear, but underneath all of that the quiet voices of love and goodness are constant. It's there. 

So today. 

Today, I grieve for the family and friends of the deceased.

But today I am also thankful for the opportunity to see hope. 

Hope can and will grow. 

Hope is exactly what I needed today. 

Never

I've always been a planner.

As a teenager I used to meticulously write down goals and deadlines for myself. My first year in college I planned all four years of my courses in the first week. In medical school I kept a constant countdown to milestones like exams and breaks. If something happened differently from my plan I would breakdown. It was devastating. 

Here's the part where I would like to say I've changed...but that need for control in knowing what comes next is still very much alive.  

My life has turned out nothing like I could have ever even imagined. My plans were very typical-have a family, be a doctor, live my happy live behind a white picket fence. 

Today, I am sitting on a unspoiled beach on a tiny island in Malaysia, that doesn't even show up on a map. Our arrival was full of hugs and gifts from friends and sweet "welcome home!" messages. Micah and the big boys are off scuba diving and Owen is playing at the bar with his best friend-a twenty something year old Indonesian guy. We drove to the port yesterday, passing monkeys and motorbikes on the way after leaving our rented, modern, (leaking!) house and spending the day teaching epidemiology to medical students. 

Never. If you would have made this life a multiple choice answer, I would have missed the question every time. Never did I think I would end up here. Never did I think my boys would have the travel experiences and "norms" that a part of our day. Never did I think I would meet the people that have taught me so much about the world. Never.

It's amazing. It's better than anything I could have imagined. 

And so, while the planner in me is still there, what has changed is my reaction. I've learned to roll with the punches and look forward to life's surprises. When things don't go according to plan, I have learned to take a deep breath and steer another way. 

It's not always great. It's sometimes lonely and hard. But it's always worth it. Letting go has allowed me so very much. 

The boys love to talk about their futures. Barrett in particular is a lot like me in making plans and goals. My advice for them has evolved through this journey. I tell them not to figure it all out now. Don't get set on anything. See it all. Do it all. Find your passion. Because that's where you'll find God's plan. 

What it's easy to forget is that it's never really our plan to make. We can try to control it, but it's not ours to control. It's ours to live and make the most of. Happiness, for me, is in listening to God. He speaks to me through my emotions, through my opportunities, through the people I love. When I stop fighting and dwelling and relax into following God's path, life is good. 

So what's next for me? Well, today I plan to go paddle boarding and finish a good book while the boys play football on the beach and jump off the jeti. I'm happy with that plan for now. What comes next will be. 

Many are the plans in the mind of a man, but it is the purpose of the Lord that will stand. Proverbs 19:21

13 things I want you to know at age 13. (Otherwise known as how I make sense of life)

It’s been a crazy week in our home – lots going on at work, deadlines in my master’s program, end of the year busyness for the boys, and world events as they’ve occurred have left me physically and emotionally exhausted. On top of it all, my first baby became a teenager and tomorrow heads off for a week on his school trip to trek, white water raft, and volunteer at an elephant sanctuary in Thailand. Today, feeling a bit overwhelmed and emotional, I’ve been taking some time in the middle of it all to try to process. Time is flying by and especially in weeks like these I sometimes feel like I’m just trying to keep my head above water and don’t take time to enjoy the moment, my kids, my life.

Parenting is hard. There’s no way around that. Parenting a teen will probably get even harder.  Barrett and I swing from extremes of laughing together to wanting to strangle each other…sometimes all within a few minute period. I don’t have it all figured out by any means, but I try my best to instil in him the things that matter. Today as I’ve been thinking, it dawned on me that these worries and struggles are the same things I want to teach him.

So I’ve complied them into a list for him of things I hope he will think about, focus on, add to, question. I can’t wait to see where God leads him in this life.

Barrett: 13 things I want you to know at age 13. (Otherwise known as how I make sense of life)

1. Think for yourself. There will always be persuasive friends and people with loud opinions.  Listen to them, but then educate yourself and make your own decisions. There’s no right way for everybody. Find your path and do what you know is right.

2. God’s plans are not the same as your plans. I think you know this one already. We are really good at making plans only to have them redirected. Be flexible, expect the unexpected, and listen to God. His timing is always best.

3. Trust is earned, but kindness and respect are not. Sometimes in today’s world, those things get confused. We don’t trust someone so they become an adversary. We don’t have to agree with someone or even know them to be respectful and kind. Every person deserves that.

4. Fall down, and get back up. We all fail. We all make mistakes. God’s mercy is new every day. You will be stronger for the obstacles you meet along the way, you just have to be willing to try again.

5. Don’t give up what you want most for what you want now. This is a hard one. Sometimes whether it’s how we spend money or time or friendships, we want something in front of us so much that we forget our real goals. Hang in there. Make sure your decisions are the same ones you’ll make tomorrow.

6. You always have to flush the toilet. Every time. Maybe this shouldn’t be a rule for teenage years, but for some reason it continues to be necessary to say on almost a daily basis.

7.  Laugh at yourself sometimes. You create your own happiness – it’s a choice. Don’t get caught up in seriousness all the time. Have some fun.

8.  Lead with the truth. Even when it’s not good news.

9. You can only be brave when you have something to be brave about. It’s easy to get comfortable but that comfort leads to complacency and closed mindedness. You have to try new things, go new places, meet new people, think new things. It’s scary, but it’s worth it. Just go.

10. Be a gentleman. Hold the door. Be polite. Say please and thank you.  

11. Clean clothes after a shower are a requirement. Clothes that pass the “smell” test don’t count. If you have to smell it or cover it with cologne, it’s time to wash it. While we’re at it, remember the shower itself is also a requirement.

12. There are good people in the world. And they aren’t good based labels like religion or nationality or skin color. Judge people for who they are not their labels. We are all the same and we’ve experienced the love and kindness of so many different people around the world. Spread that same love wherever you go.

13. I love you. Always. No matter what. Bad days, bad grades, mistakes and all. It will never matter. I love you. I am so proud of your huge heart and whoever you will become. Whether it's Norway or Texas or Nicaragua or Paris, we are always your home.

Come to think of it, this list kind of works no matter the age. I continue to be a work in progress and you will as well. Continue to make the effort…despite the chaos, despite the negativity, despite the sadness, despite the changes, despite the anxiety. I am so grateful for the child you are, the man you are becoming, and the person you are making me. Happy birthday.

Namaste

Namaste: My soul honors your soul. I honor the love, light, beauty, truth, and kindness within you because it is also within me. In sharing these things there is no distance and no difference between us. We are the same. We are one.

This is how you say hello and goodbye in Nepali language. With every person you meet, you are saying "I see you as God's child, just like me." I love this so much. I found this to be such a good representation of our Nepal adventure.

The people of Nepal have seen more than their share of hardship. Less than one year ago, the earthquake that hit central Nepal killed more than 8000 people, totally devastating some entire villages. Every person we met had an earthquake story to tell. One told us he was out trekking and had to run to find shelter in a cave. Over the next week as he tried to get back to the city he was without any food. Another told us of the primary school that collapsed. He spent more than a month sending food and water into a crevice to try to feed the children that remained trapped below the rubble. Even now, the damage is obvious. Buildings lay in crumbles, houses have lost walls, some roads are impassable.

Besides the natural disaster they've weathered, even more hardships exist. An electricity shortage in the country leaves most buildings with power for only about 8 hours a day. We became used to sudden power outages and even luxury hotels offered hot water for showers for only specific periods (usually 2 hours/day). An expat from Pakistan we met told us how much more difficult it had been in the winter when no heat was available.

Water itself is an issue. In one town, water flows only once every four days. We visited on a water day and saw women filling huge water jugs to last them for cooking, bathing, and washing.

 A recent petrol crisis has also left a major fuel shortage. Lines for gas were 50+ motorbikes long. Only a ration of fuel is given and when the station runs out for the day, many leave without to try again tomorrow.

Roads are indescribable. There is literally one road east to west in the country which winds through the mountains along a river. The roads are barely one lane wide with huge trucks trying to pass each other into oncoming traffic. Mix in livestock wandering into the road, people riding onto the top luggage racks of buses, gatherers walking carrying huge loads of firewood, and construction that directs you off-road onto dirt and needless to say, we saw multiple wrecks. I am beyond grateful for our driver who safely got us to our destinations.

In the jungle, there are even more concerns that are almost incomprehensible to me. Many small villages exist near the national park where wild animals remain a real problem. 20 tiger attacks occur every year. Just let that sink in. Every year, more than 1 person a month is attacked by a wild tiger. I am speechless. That number is actually a big improvement from the past. We learned that tigers often mistake people gathering wood and vegetables in the jungle for deer or other prey. Crop and livestock fields have towers in the middle where a farmer sleeps at night with a fire underneath to scare away predators.

Despite all these difficulties, the people of Nepal were BY FAR the nicest and most welcoming people I've ever met. They are friendly, loving to share their culture and stories and asking about ours. As male children are quite revered in the culture, I felt like a celebrity at times with people blessing us, hugging Owen especially, and asking to take pictures. I'm pretty sure we are all over Nepali Facebook this week!

The beauty of the country is breathtaking -- how can you not love Everest and the Himalayas-- but it was the people that I absolutely loved. We have such different experiences and perspectives, but we are the same. The more we travel, the more I understand that we are all God's children. The elephant guide, the drum player, the woman carrying water, we are all worthy and deserving of respect. I love that my boys live that. Barrett's life-plan of the week is to live in Nepal leading expeditions. Their horizons are so wide, I can't wait to see where they end up and how they serve God.

 I have a tendency to get caught up in my little world. My problems seem big. I convince myself that my efforts or money or circumstances have earned me something. My selfishness and sense of entitlement shine instead of God's light. How can I be true to my beliefs, to what God has required of me if I don't afford the same mercy and love to others as God has given me?

I have a confession, I am not an adventurous girl. I prefer comfort, safety, a beautiful beach and a fruity drink. But I have three incredibly important boys in my life that want and need more. I want them to become men who see who people are, not what they do or where they
are from. I want them to trust God and turn from fear. I want them to know that we are all the same. Namaste.

"a new command I give you: love one another. As I have loved you, so you must love one another. By this everyone will know that you are my disciples, if you love one another." John 13:34-35

PS I can't highly recommend a visit to Nepal enough. It is safe, friendly, and beautiful. Despite some of the difficulties, Nepal is warmly open for tourists. Putting money into rebuilding their tourist industry is a helping hand to rebuild the country. If you are interested, I am happy to share our hotel and guide recommendations with you.

One year

One year.

One year ago today we were living out of 3 suitcases in a hotel eating breakfasts at the buffet and doing laundry in the sink. The boys were navigating their way through the first day at school full of complicated schedules, multiple uniforms, and new expectations. Micah was beginning his job with new responsibilities and staff. And I was holding my breath as I learned to drive on the other side and prayed that we would find our place.

Sometimes it feels like we've still just arrived. I find myself still telling people "we are the new family." But then I look back at where we started and I can see how far we've come.

A year ago I would never have imagined having a job that I enjoyed and challenged me so much. A year ago I would never have imagined that the boys would take off to friends houses on their bikes as soon as they got home from school. A year ago I would never have imagined our new favorites--an Indian meal, a quiet secluded island, a comfortable and loving church in a strip center above a restaurant.

This reflection is so needed for me right now.

Guys. Let me let you in on a little secret.

This year has been HARD. Like, crazy hard. Everything feels so difficult and I am truly exhausted. We've had some great moments and experiences but we've also hit some bumps in the road. Housing problems, illnesses, frustrations, homesickness-sometimes it's felt more than overwhelming. We've had to change the way we live. We've held on tight to each other and drowned whoever was struggling in love as we dragged them along. It's been an adventure, to say the least.

There have been days that feel never ending. I can't possibly make it through. Yet, here we are.  The moments we've experienced, good and bad, have led us to today. Today one year later.

God is amazing. He has provided every challenge, smile, frustration, hug, tear, and peace. Even when I think I've figured it out, He throws something unexpected at me. I am not the person I was one year ago. What God has given me has changed me, made me grow. I am becoming...

I don't know how to finish that sentence. I honestly have no idea what I am becoming. I have no idea what this next year brings. But God does. He leads me, and I follow.  He accepts me as I am, in my bad days and good days. He gives new grace every day and I desperately accept.

So bring it on, 2016. I don't know what struggles and joys lie ahead but I trust in Him and remain faithful. I am grateful.

“But blessed is the one who trusts in the Lord, whose confidence is in him. They will be like a tree planted by the water that sends out its roots by the stream. It does not fear when heat comes; its leaves are always green. It has no worries in a year of drought and never fails to bear fruit.” Jeremiah 17:7-8.

Called to love

Warning....I am not typically one to chime in on political discussions. But I feel like this issue has much deeper roots and honestly, I need to process my emotions here.

I have to admit I've really been struggling this week with recent events. The horrific attacks on Paris that have influenced a firestorm of media attention about refugees and religion and safety have shaken me. I am having a hard time making sense of all of the feelings and opinions out there. This is where I'm coming from...

It's scary. I get it. I do. When we moved to Malaysia I thought about it all the time. I'm a Christian in a Muslim country. I'm a minority. I stick out like a sore thumb. I worried about whether I was wearing a cross necklace or shorts. I worried about being in crowded public places especially with my kids. I worried about stopping at hawker centers (outdoor food courts) with all the eyes staring at us. It was unfamiliar. It was different. It was terrifying.

As a American and even in Europe my knowledge and exposure to different religions and cultures, especially Islam was minimal. Muslims were people in long dresses, chanting in tongues, and admittedly maybe dangerous. What I knew of Islam came mostly from the Western media, post 9/11, and the war on terrorism. In retrospect, my exposure was biased and narrow.

But the life that I've found is very different. We've been welcomed here. White, American, Christians welcomed in a Muslim community. I have found kindness in the small village we have begun to serve, sweet in offering for us to join in traditional celebrations. I found have it in the families, stopping to smile at my crazy boys. I have found it in my medical students eager to learn with the same altruistic attitudes I've had. There is no hate. There is no fear. I live my life openly. I wear a cross. I share my faith. I serve in God's name. I am a Christian living in a Muslim country.

I sometimes ask myself why we are living this nomadic life. The mountains in front of me are huge sometimes. And then I remember the necessity. I don't want my kids to know that fear. They don't see differences in color, language, culture or religion. They see people. I wish we could all see that.

I can understand the fierce protective reaction and fear of threats in light of the world today.  What I don't understand is how that fear becomes big enough to overshadow compassion. When we come to God, he doesn't ask for background checks. He doesn't judge where we've come from. He doesn't question our authenticity. He opens His arms and loves us. He comforts us when we're scared. He welcomes us with mercy.

I hate labels. I hate how we use those labels to make assumptions and judge. Let's be clear. These attacks have been carried out by terrorists. Period. They may hide behind Islam but they are not Muslim. It doesn't matter what they call themselves or what twisted verses they proclaim. They could call themselves Jewish or Hindu or Christian and it wouldn't change. Their ill intents have nothing to do with religion.

And yet we place people in desperate need of help in the same category. We ask them to wait at borders without homes or schools or safety while we figure out if we should be scared of them. This isn't a liberal argument or American argument or even a Christian argument. This is about humanity. We are all the same. "Do unto others as you would have them do unto you." Are we comfortable being treated, in our most vulnerable moment, in this way or are we simply so far removed, in our privileged state, from truly understanding the struggle? Even in the face of fear or uncertainty, we are called to love.

God is love. Whoever lives in love lives in God and God in them. 1 John 4-10.

My Singapore hospital experience

Several people have asked me about medical care in Singapore. Since I've gotten an up close and personal tour, I thought I would share a few things I've seen with my medical friends.

Singapore is known for its excellent healthcare. It has been a model for efficient and quality service. There are public and private hospitals and both are meant to be very good. I was in a private hospital, so I can't speak to the differences in the public system.

1. In the ER, the MD evaluation is almost more like a triage. Patients are called into a proper doctor office for evaluation. The ER is primarily staffed by house officers, basically graduates that have not chosen a specialty. Residencies are not required. The physician decides how to disposition the patient-either discharge, observe, or admit. Then the patient is moved to that area. The doctor I saw immediately decided I should be admitted and I was moved to a bed.  I was admitted directly to the GI specialist who gave orders for initial labs and IV fluids.

2. The admission nurse brought me a list of rooms and prices and asked me to choose my room. It was like a hotel list with room sizes and amenities ranging from double room to extravagant presidential suites. I ended up in a basic suite where my specialist was already there waiting for me, even though it was 11 pm on a Sunday night. (He told me he lives across the street from the hospital). The whole process from door to done took less than 2 hours.

3. Being a private hospital, a deposit or insurance was required on admission. I asked what happened if you are unable to pay and was told you are discharged to the public hospital. Every test was discussed associated with a price. Every test from routine bloodwork to colonoscopy was a choice with agreement on the price. It reminded me a bit of a car mechanic. The mechanic calls to tell you what they found and how much it will cost to fix each thing. It was odd but honest. Luckily, our overseas insurance takes good care of us and we had no concerns.

4. That being said, few tests were done. The only bloodwork I had done was on admission. No cat scan. Only the basics. When I would ask something specific, my doctor relied on the good ole physical exam to lead his decisions.

5. Back to the room choosing, the first night I heard a baby crying. I asked the nurse about what I heard and she told me the woman in the next room had just delivered. So there's obviously no separation of wards. Not sure how I feel about that-a brand new baby next door to a terrible infection and common nurses caring for both. Infection control is obviously a necessary priority.

6. The nurses on the ward work as a team instead of assignment to a patient. Each nurse has a role-medication nurse, vitals nurse, discharge nurse, etc. The medication nurse wears an orange construction looking vest that says "do not disturb" and makes rounds dispensing all medications from locked cabinets in each patient room.

7. This may be related to my suite, but my experience was like staying in a hotel. Food comes on tableclothed trays, coffee maker and hair dryer in the room, even high end toiletries in the bathroom. Amenities including reflexologist, masseuse, and acupuncturist are available as well (I did not partake.)

8. On discharge, patients are expected to make their payment in full. No billing. No outstanding debts. Private local insurances aren't a thing here so there are no insurance company talks, except for pesky expats like us. Prices are prices and are non negotiable. Simple.

Overall being the hospital sucks but this was the best of a bad experience. Maybe my experience is specific to my quirky, sweet Dr. Leong, but I felt very lucky to be cared for here.  It's a different system, but it seems to work well. Singapore is small, so it's difficult to argue that some aspects could be applied on a larger scale, but interesting to see there might be another way.