The Very Busy Day (3/15/2002)

People often ask, “What is missionary life like? What is a normal day for you?” 

There is no such thing as a “normal” day!

It is kind of like a television medical drama. People used to ask me if life in the hospital was really like the television program “ER”. I never even once watched “ER”, but from the accounts I heard, one episode may have represented in one hour the events that may have transpired in reality over two or three months, compressed into a short period of time. But who would really want to watch the boring routine of one day’s events? Occasionally a day may contain a cluster of events that produces a “very busy” day

So, this is kind of like “ER” giving you a glimpse into missionary life. This just so happens to represent a true, exceptionally busy day in the life of a missionary doctor.

The backdrop was a warm day just at the end of rainy season. Several new missionary families had just joined us, but were not yet settled in and oriented enough to enter fully into the work. The clinic had just moved from our temporary location in our staff housing building, where it had begun two years before, into its permanent location in the front half of the hospital. Our operating room had moved into a temporary spot until the permanent OR’s were constructed. We were still unsettled, learning a new routine that fit the new location, working around the ongoing construction. More patients were showing up than we could attend. Sick people were being turned away because of the limited ability of our staff.

We were moving in to the “team season”, which means lots of planning, preparation, and logistics. We host about 25 teams a year. There were many medical and dental teams coming, with the “main event” of the year being the Christian Medical Dental Associations gynecologic surgery team. With this team we planned to open our surgery wing, do our first major surgery, use our new operating and recovery rooms for the first time, and to have our first in-patients. That was my primary focus for the first half of 2002!

As a “type A” person, to say the least, I was under self-imposed stress, setting myself deadlines that were going to be tough to meet, and a bit frustrated that there weren’t enough people or hours in the day to do everything needed.

My particular “busy day” was a surgery day. Surgery is usually my high point of the week. I usually have an emotional high after doing a good day of surgery. I enjoy “healing with steel”, “cutting to cure”!

The first case started late. The Honduran staff was having difficulty with the new routine. The equipment had not been checked nor the patients checked in until I arrived to facilitate the process. I allowed this to irritate me a bit.

Our staff is made up mostly of poor country folks who have had limited opportunity for education and experience. Even as adults, they at best have had only what would be equivalent to our junior high education. Problem solving is not taught, so anything that occurs out of the routine tends to paralyze them! For example, if a North American had a leaky roof, he would quickly have it repaired. The typical Honduran in the rural country would simply move his chair and live with the leak!

Hondurans are intelligent, but have lacked the opportunity to learn. Teaching them is a challenge, but one of the most rewarding parts of life in Honduras. It has been a joy to watch these young people develop professionally. Most of them are young ladies. Their futures probably would have consisted of becoming single mothers at a young age, trapped at home in a cycle of trying to find a man who will stay around and help raise their ever-increasing number of children. Instead, these ladies have learned skills in patient care, computers, sterile technique, and even assisting in surgery

We finally started the first surgery case, a toddler with an inguinal hernia! He was the youngest that I had ventured to do thus far, and it was a bit of a challenge. Since we don’t have an anesthetist or anesthesiologist, I need to supervise anesthesia as well as do surgery. Therefore, as I operate, I need to keep one eye, so to speak, on the surgery site, and another eye on the patient’s vital signs. Fortunately the case went well, and my adrenaline was sure flowing!

The second case was an older man with a recurrent inguinal hernia. Recurrent hernias always present a challenge, and much more so in Honduras! As is typical in Honduras, the recurrence had been ignored for many years, and was very large and complex. The patient was anesthetized and prepped and I was gowned and gloved. I hit the foot pedal to elevate the OR table to bring the patient into a comfortable focal distance for me to operate. The table refused to move, only making a metallic grinding noise. The staff attempted to remedy the problem unsuccessfully, so I pulled up a stool and started to work in an awkward, uncomfortable sitting position.

As soon as I made the incision, there was a knock at the door. One of the new missionaries wanted to know how to turn the water on! Evidently water pressure had fallen and no water was available at staff housing where teams and visitors stay. It apparently was off in the hospital as well. Pad, our builder and facility manager was away in the city for a few days and no one else around knew the system. I gave him some preliminary instructions on what to check out, and returned to surgery.

As I tried to untangle the anatomy from the patient’s first hernia repair I found that the scar tissue was firmly adherent to intestine. This was not going to be easy! The dissection was slow and tedious, requiring care and attention to avoid cutting into the intestine. A wound in the intestine would prevent me from using mesh, a plastic screen material, to repair the hernia, and probably would require admitting the patient into the hospital. Since we don’t yet have in-patients he would need transferred to a hospital in the city. Furthermore, he would need yet another surgery in the future to fix his hernia correctly with mesh. Therefore, in an awkward sitting position, already running behind for the day, wondering as well about the water problem, my adrenaline pumping, I continued dissecting, praying for God to guide my hands.

Then I heard a commotion in the hall! A staff member opened the door and announced that a seriously injured patient had just arrived and needed immediate attention! I indicated that there was no way I could leave surgery at this point and sent Chrysti, our nurse to evaluate the situation. She came back in about 15 minutes, visibly shaken.

A young Christian man from the area had been helping build a house. A concrete wall fell on him, crushing him badly. He was in shock, and coughing up blood. Chrysti instructed his friends who had brought him in a vehicle to immediately take him to the emergency room at the closest hospital in La Ceiba. His injuries were beyond our ability to treat.

As I continued with my dissection, I struggled in my mind. Should I have gone to see him or should I have stayed with the patient I was working on? Both would have required significant time and effort. I was already committed to the man in front of me, and had to see it through. (This decision still haunts me in 2025!)

About 15 minutes later, there was another knock at the door. Chrysti left, and returned a few minutes later, upset. The man had died shortly after leaving our hospital. His friends returned to have one of us verify that he indeed was dead.

A dark mood descended on us all. In the past I had operated on two of this man’s children. He was a vibrant lay leader in his church. Should I have gone to see him? Could I have done something to save him? Probably not, but I will never know.

As we finally were finishing the successful repair of a most difficult hernia, there was another knock on the door. Another missionary informed us that a group, which included my wife, Becky, was stuck in the river and needed me to come with the winch to pull them out.

A visiting team that was ministering in La Ceiba had wanted a “rural experience”. They were looking for a particularly needy area to distribute clothing. Our new host family. Brad and Kanda Carey offered to bring them to our area to visit a poor village. Brad and Kanda asked Becky where would be a good place to go. She suggested a small village of poor squatters between the two rivers near our house. It was easy to reach by car, and an area often neglected by teams and other visitors. Becky planned to accompany them. That morning Becky and I talked about the need to be cautious of the river. Since the end of rainy season, none of the missionaries had yet ventured up the river to our favorite swimming hole. We were waiting for the sand to become sufficiently packed down to support our vehicles.

The team had heard about the poor people living up the river by the swimming hole. By the tracks, it looked like some vehicles had safely made the journey, so they decided to try. The driver was unaccustomed to fording rivers. Despite Becky’s directions to follow the tracks of the other trucks, he soon left the path and buried the vehicle in soft sand up to the undercarriage.

So, I finished giving instructions for care of my surgical patients and headed for the river. I really wanted to be alone at home, but needed to do my duty as the only winch owner-operator in Balfate. With difficulty, we managed to extract the car getting my own car stuck twice in the process. I was declared hero for the day by the team, but didn’t feel much like one.

A few days later, I was still feeling a bit down and overwhelmed. As I was preparing a devotional for our missionary meeting, I came upon Matthew 14:13. I noticed that Jesus himself was having a bit of a down day! In the preceding chapter we see that the people of Nazareth, his hometown, had rejected Jesus. They were offended by him, and lacked faith. He was not able to do many miracles there.

After that, Jesus heard about the death of John the Baptist. He wanted to be alone, and withdrew to a solitary place. But the problems followed him there! In verse 14 we see that the crowds followed, wanting him to heal the sick. And of course, they didn’t plan for food in such a lonely place. Jesus ended up supplying food for more than 5000 people! It says that Jesus had compassion on them.

So, even when we have a “down day”, Jesus understands. He’s been there too! And he shows us how to deal with it. Reach out with compassion to others! Don’t become self-absorbed.

Actually, as for Jesus’ busy day, my busy day led to some very good things. As I evaluated my goals and responsibilities, it helped me reestablish priorities and delegate some responsibilities to others.

I hope that my “busy day” has helped you see a bit of what missionary life can be like, and that it helps you understand better how to pray for missionaries!

I also hope that you can find strength in your busy times and in your down times, from knowing that Jesus has been there too! He knows what it is like, and has set us an example of how to deal with it. Even better than that, he is right there with you, to guide you and give you peace when you most need it!

Despite the challenges, being a missionary is a rewarding life! It is what God has called us to, and we wouldn’t trade it for the world.