Unless the Lord Builds the House: Homeschooling, Flaps and Cut Tendons

As part of Tenwek Christmas tradition, the kids all gather together to make gingerbread houses in one huge event. Fueled by excess sugar and unbridled creativity, Emma, Claire and their new friend Mercy created a masterpiece that unfortunately crumbled into a pile of rubble by the time I arrived home from the hospital. “That gingerbread house symbolizes how we feel right now!” said Heather.

Heather and I were both struck square in the face by the words of Psalm 127 last week: “Unless the LORD builds the house, its builders labor in vain. Unless the LORD watches over the city, the watchmen stand guard in vain.” We realize that unless our sovereign LORD intervenes in the work we are called to here at Tenwek, that our labor will be in useless. Moreover, unless all we do is infused with love for other people, all our efforts and good intentions are meaningless. “If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing. (1Cor. 13:3)”

Heather’s work here is primarily homeschooling, and she is doing an outstanding job, trusting the LORD to build, provide, and enlighten….all a direct result of your prayers, so please continue! There are a myriad of other opportunities for ministry, especially to orphans, that she is also beginning to explore.

For me, I am reminded daily of my dependence on the LORD in every way for every case. In two weeks time, I have done 32 cases, many complex, that I would never have attempted without God’s direction and wisdom. But since I am the only orthopedic surgeon here, who else will do it?! During my training at Mayo, whenever a patient had a soft tissue defect in the leg after an open tibia fracture that needed to be covered, we would call the plastic surgeons to isolate and swing a piece of muscle tissue (called a “flap”) over the defect. Just last week, I thought to myself, “It would be so valuable to have a plastic surgeon visit Tenwek and show me how to do a flap…I will likely need to know how to do that some day.” Well, that day came last Friday, perhaps a little earlier than I had hoped, aided not by a visiting plastic surgeon, but by prayer and a few good textbooks…so far so good.

Another patient had a small laceration over the undersurface of her thumb and was unable to flex the distal joint, signifying a tendon laceration. I knew that the hardest part of repairing the tendon is first finding the cut ends. This sometimes requires a large dissection, and I am not a fellowship-trained hand surgeon! I took her to the operating room and enlarged the laceration a bit to get a better view. I found the distal end easily, but the proximal end was nowhere to be found, retracted far proximal into the palm of the hand. At this point, a tendon grasper would have been helpful, but Tenwek unfortunately does not have one. So for several frustrating minutes, I blindly (but gently) tried to “fish” it out with forceps and hemostats (not ideal instruments)…no luck. I was dreading the next step. Just then, a visiting minister from Alabama who enjoys watching surgery entered the room. “What are you doing?” he asked. “Trying in vain to find this cut tendon,” I said. “Well then, let’s pray!” said Earl. He offered a simple prayer that God would allow me to find this tendon. Right after he finished, I (again) blindly stuck the forceps about 2 inches down the sheath. But this time, I felt something, and no kidding, I pulled out the tendon! After this, the repair was easy.

Again, unless the LORD builds the house, unless he provides wisdom, and unity in the orthopedic department, and love for our patients, and all the necessary equipment and supplies, our work at Tenwek will be in vain. After all, this is His work. But dependence on God, no matter who we are, where we live, or what we do, is such a good place to be. God is the master builder, and although the process can be painful, and will require faith that seems impossible, the end result will be perfect. Let the LORD build your house. Thank you for all your prayers and support!