Christmas Wishes!

Beth and I had hoped to head south today, but instead it looks like we'll be waiting out a blizzard.  Better safe than sorry, I guess.

We had wanted to get down to Missouri as soon as possible as my grandpa is in the hospital in Columbia, but it's probably best we not get stranded in the middle of Iowa in the process.  Regardless, the folks at MU are taking great care of him and I'm optimistic he's going to end up doing well.

Anyway, Beth and I are pretty stoked about our family Christmas gifts this year.  I don't want to give away any surprises, but let's just say we spent a fair amount of time experimenting in the kitchen, and that all of our gifts will bear this awesome label:

Beth and I want to wish all our friends and family a very merry Christmas.  We're too lame and lazy to send out Christmas cards, but that doesn't mean we don't value each of you!

Real Men Attend (Congo) Baby Showers

Beth and I had the pleasure of hosting a baby shower this past weekend for our good friends, the Mukweges.

They are from Congo so the whole concept was completely foreign to them.  But we had a great turnout and we were able to bless them in a unique way while they are far from family.

Anyway, it was my first baby shower and Beth put me in charge of games.  I had fun with that, of course, and it allowed Beth to focus on the food and gifts and details and stuff.  I suggested we should go into business as a baby shower planning team.  Seriously, ladies, invite me to your baby showers; you won't regret it! (note: please do not actually invite me to your baby shower)

The real point of this post is to give you some background on who the Mukweges (Alain and Deborah) are and about the situation they have lived through in Eastern Congo.

Alain's father, Denis Mukwege, is actually a surgeon and activist that has been repairing victims of sexual abuse for years in Congo.  Rape is a form of warfare in Congo and Dr. Mukwege has become somewhat of a spokesperson against the violence.  He's received all kinds of awards and even been nominated for the Nobel Peace Prize.

A few months ago he spoke before the UN General Council demanding international support.  When he returned home he found his house overtaken, his daughters held at gunpoint, and men intent on killing him.  Shots were fired and a man gave his life protecting Dr. Mukwege.  Fortunately, Alain's family escaped the assassination attempt unharmed.

Anyway, I've written an essay about this whole situation and my relationship with Alain that is currently undergoing review for publication (so I can't actually post it here).  My hope is that it will increase awareness of the situation in Congo.

Here are some links if you'd like to learn more:

http://kristof.blogs.nytimes.com/2012/11/02/dr-mukwege-fights-back/
http://www.nytimes.com/2012/10/27/world/africa/human-rights-doctor-in-congo-eludes-gunmen.html?_r=0

Who will it be today? #5

Who will it be today?  Me.

What a novel concept.  Sometimes it's not about who we can encourage or bless, but who can bless us.  We all need our "sponge" to be saturated, after all, before we can ever wring it out.  For me, this sort of encouragement usually comes through a message or a small group discussion or a word from scripture, but a couple weeks ago it came in the form of a complete stranger.  I haven't been able to get the image of that experience out of my mind so I decided to preserve it as part of this series.

I was waiting for some prescriptions to be filled at the hospital (something I find myself doing on a weekly basis).  They weren't quite finished yet so I took a seat there in the lobby.  About this time I heard a faint, singing voice coming from the direction of the gift shop.  I readjusted my position to get a better view.
Sure enough, the information desk attendent was singing.  She was a volunteer, a petite Asian woman standing behind the desk with a hymnal in hand.  Her voice was quiet and her demeanor was timid, and yet it was obvious she was singing because she wanted people to hear.  There was nothing spectacular about her voice, only her courage; indeed, she was either very sweet or very odd.
As people walked by, some would stop and smile.  Others seemed to feel sorry for her and the awkwardness she was creating.  One man finally stopped and started singing with her.  It wasn't until that point that I could even make out what was being sung...

"When we all get to heaven, what a day of rejoicing that will be!"
"When we all see Jesus, we'll sing and shout the victory!"

She had taken it upon herself to encourage the patients and families in that hospital.  And it was beautiful.  As I later realized, she could barely speak English, but she knew a few hymns (and, apparently, how to give decent directions to the cafeteria).  She didn't care what she couldn't do and she didn't intend to rely on her own abilities to make anything happen.  She just trusted that her God would use her in some way to help some people.  I think He did.

Who will it be tomorrow?

2012, In Review

I haven't given an update on my clinical situation or personal life in a long time.  So consider this a way overdue summary of where I'm at as we finish up 2012.

As most people know, I started this year struggling with graft vs host disease and hopeful to begin my medicine residency here at Mayo in July.  Beth and I were married in May but the GVH never really left so residency was, once again, postponed.

The summer was enjoyable but I developed a pretty severe infection with cytomegalovirus (CMV) that continued to keep me sidelined.  I started doing some part-time research through Mayo (mostly from home) and that turned out to be useful in helping me feel more productive.

About the time we got the CMV under control, we realized my thyroid was shot.  My TSH continues to be way out of whack (86 currently) and is not responding to increasing doses of oral thyroid hormone supplementation.

Ultimately, there seems to be a severe malabsorption problem that keeps a lot of my medicines from doing their job (I take over 13 unique meds/day, multiple doses of some).  And it's a catch-22 because if I increase the steroids to help cut down on the inflammation and increase absorption, it makes me that much more susceptible to the CMV and it really messes up my bones.

As things stand in December 2012, I've got a lot of things wrong with me.  I effectively have no thyroid and will probably require some special subcutaneous form of levothyroxine to address this.  My energy is low as a result of the thyroid issue and also anemia that is caused by the medicine I have to take for the CMV.  Unfortunately, the CMV medicine is not working perfectly and I may actually be developing some resistance to it.  I continue to deal with GVH which causes a fair amount of nausea, vomiting, and colitis.  The steroids that I take for this have officially weakened my bones to the point of osteoporosis.  I take vitamin D for this but, once again, I'm not absorbing it as well as I should be.  My heart and my lungs are working great, and my liver seems to be doing better.  My kidneys are losing a little bit of protein which causes me to swell up sometimes but it's probably just a medication side effect and we're watching it.

Anyway, I remain hopeful some of this stuff will work itself out.  Certainly, I'm cancer-free and that's a blessing.

And although this all sounds like it must be horrible, life is really pretty good.  Being married to Beth is the best part and she brings a lot of joy to my life.  She is enjoying teaching at the high school and I'm proud of how hard she works.  We have a lot of friends here and have made so many more meaningful connections with people than we would have predicted just a year ago.

As far as major life changes, I've decided (with the support of Beth, our families, and my doctor) that internal medicine is probably never going to happen for me....and, quite frankly, I don't think I want it to.  I have certain priorities for my life and working 80 hours/wk just doesn't align with them anymore (not that I could ever physically do it anyway).  I've put in an application for a part-time science tutoring gig at the community college which I think I might enjoy.  I'm also continuing to do some important research here at Mayo and am trying to become a more productive writer.  I have mostly decided that, if I do decide to pursue a residency and career in medicine, it will probably be in the field of pathology....but that wouldn't happen until July of 2014 at the earliest.  I suppose there's no rush; I've already passed all my boards.  In the mean time, I'll be exploring opportunities in teaching and research and possibly writing a book!

I'm going to try to keep this blog up to date (I never was a facebook fan) so feel free to follow it for info on how I'm doing, what I'm up to, and where you can buy the book ;)

Who will it be today? #4

Who will it be today?  The cancer patient.

My year's supply of Toppers' pizza has come in really handy.  Beth and I have enjoyed being able to bless people with all the pizza we can't possibly eat.
One of the advantages of living and working around a place like Mayo Clinic is that there's no shortage of visitors in need.
I was walking through Methodist Hospital's lobby today and saw a woman who was clearly a cancer patient.  Aside from a lack of hair she seemed to be relatively well and capable of enjoying some pizza.  I introduced myself and asked if she was in town for a while.  "Couple days," she said.  I asked her if she liked pizza, gave her this week's coupon and a copy of my letter, and wished her the best.  Easy peasy.

Maybe it was too easy.  I think I actually dodged my assigned appointment for something more convenient.  As I was walking downtown I came across an elderly person raking leaves across the street.  I couldn't make out whether the individual was a woman or a man, but I could definitely tell he or she was too old to be raking leaves.  I think that's the person God wanted me to approach and, as much as I hate to admit it, that was the person God wanted me to rake leaves with.  I actually stopped in the middle of the sidewalk for an awkward amount of time and considered the situation.  I "reasoned" with God that I had to get to work (I didn't really), I wasn't dressed to rake leaves (there wasn't really much raking left to do), and that if God wanted me to help the person He should have put us on the same side of the street (not exactly a high-traffic area).

I truly hope the cancer patient is blessed by the pizza, but I know in my heart I dropped the ball.  I hope God will give me another shot and that I'll be more faithful.  This whole process is about learning lessons.

Who will it be tomorrow?

The Cancer Chronicles, #5

*The Cancer Chronicles is a re-posting of blog updates I gave during my initial diagnosis and treatment*

June 16, 2011:

Everything is going more or less as planned from a treatment standpoint.  My marrow is recovering nicely and I will soon be stable enough to head north (could be discharged by the weekend).  I really have no indication of the timeline required to complete the transplant, how difficult it might be to find a donor, or how much sense it would make to try and work at all this year.  But all of those things should get cleared up once I get to Rochester and have a chance to meet with my transplant physician, Dr. Litzow.  For now, I'm watching a lot of History Channel and Netflix and enjoying the company of lots of special people.

Aside from being tired often and generally short on energy and ambition, I feel mostly well.  I have managed to read about half of The Problem of Pain.  To this point, the book has mostly focused on setting the stage for how pain and suffering can exist in the Creation of a good God, and less on how we should respond when we encounter it (that comes later).

Lewis is as insightful as always, but I especially like how he describes our world as a neutral "playing field" of sorts; one that has its own set of governing principles over which we have no control.  Similar to how we might think of a video game "world" or "level," the point of the place is only to give the players a context in which to interact and do things that matter.  The rules of the world are the same for everyone (fire is hot, gravity pulls down, etc); but not everyone plays the game the same.  The necessity of this sort of set-up is beyond the scope of this note, but it's well-described in the book.  Suffice is to say, there is no sensible way to allow free will and simultaneously maintain a world that is equally convenient to all souls at all times.  It's an academic argument, admittedly, but it's sound. 

Of course, the concept of disease itself does not seem intrinsically necessary in this model (especially disease that could not have been prevented by alternative individual choices).  Lewis chalks this one up to the fall.  He believes, or perhaps just surmises, that we were originally created with the ability to control our physical body and all processes therein through our spiritual self.  When man Fell, he chose himself over God.  It was then that God relinquished this unique control and turned the direction of our bodies over to the laws of nature.  These laws include imperfections and inefficiencies that make us susceptible to disease, give us all a lifespan, and remind us of our mortality.  Of course, this is just Lewis' best guess and one of many possibilities so it's hard to know whether or not this is actually how it played out.

The truly important thing to realize is that this existence is simply not the point.  For centuries, a foundational component to the enlightenment of the Christian worldview has been a belief that we were made for something more and an awareness that this is not our ultimate home (in many ways, it really is little more than the first level of a video game).  But we probably say this sort of thing without fully believing it more often than not and leukemia, if nothing else, is helping me to grow in my dependence of this truth.

Ultimately, reconciling the "problem" of pain with the character of God is probably not something that we will ever be capable of on intellectual grounds alone--we just aren't smart enough.  And this is why faith is so necessary.  After all, no amount of intelligent argument in God's defense will ever be more compelling to me than what I know in my heart to be true about Him--that He's real, that He's good, and that He loves me.  But I realize not everyone has that knowledge and many have chosen to believe other things about God.  And that's the tragedy.  Not the fact that pain and suffering exist in the world, but the fact that there are so many people without the means to explain it, understand it, or cope with it. 

Here's to hoping my next update is from somewhere other than a hospital bed...

Who will it be today? #3

Who will it be today?  The hitch-hiker.

I don't normally pick up hitch hikers.  In fact, this was my first one.
Beth and I were on our way back to Missouri for Thanksgiving and, somewhere in central Iowa, we came across a gentleman trying to flag down a ride.
For whatever reason, I felt like we should turn around and see what he needed.  After we talked to him for a while I had a peace about helping him get to Interstate 80.
Turns out he lives in California and was trying to get back there.  He had been in Iowa because his mother had lived there and had recently died.  He was a nice guy.  Almost child-like in his innocence.  He has PTSD, apparently, but I don't know any details about the trauma he has experienced.  It doesn't matter really.  It's a devastating condition and, I'm sure, it is the main reason he finds himself in such undesirable circumstances.

I wanted to give him a letter but I didn't have any on me.  In this case, though, I never got the impression God wanted me to share knowledge with him.  I got the feeling he's heard all he needs to hear.  What God wanted for Beth and I was for us to be hands and feet.  We had been divinely appointed to take a man that mattered to the Father from Nowhere, Iowa to a random Pilot Truck Stop on Interstate 80.  We prayed with him, filled his belly, and became his facebook friend.

Who will it be tomorrow?