Joy through Suffering

After personally witnessing what Heather describes as “the most difficult labor of the five,” I have been reflecting on a subject that has honestly perplexed me over the years: pain and suffering.   In the weeks leading up to the birth of our new baby girl, Josie Grace, our two main prayers were for (1) a healthy baby and (2) a quick and relatively easy labor and delivery.   With the myriad of potential problems that could possibly occur during pregnancy and delivery, we were so thankful for the answer to prayer #1.  But prayer #2 was a different story, as in the end, the labor was certainly not quick, nor easy.  Heather pre-decided that this birth would be completely “natural” (or un-medicated as it is described in 2013), not because Heather has some amazing pain tolerance (her words) but because of a previous complication from an epidural when Emma was born.  In her mind, the pain experienced during child birth was nothing compared to a week-long spinal headache from a botched epidural.  Levi was also born “naturally” but his labor and delivery were within a few hours of arrival at the hospital.  So we were figuring little Josie Grace would come in the same way.

Heather was admitted to the hospital the afternoon of the 13^th with fairly regular, but light contractions.  After several hours, we decided with the midwife that it would be best to “break her water” to hasten the process.  Shortly thereafter, hard labor began, and Heather spent almost the entire night laboring in the shower, with contractions coming fast and hard.  At 6am, exhausted, the midwife suggested that Heather get in bed so that she might check her progress, and we were distraught to discover that after all that work, she was only 3cm dilated.  “I can’t do this any longer,” Heather whispered, clearly discouraged at the slow progress.  “God help her,” I thought as I had her roll onto her side to continue this trial of labor.  What happened next was quite amazing.  Hooked to the monitor, I was able to see the baby’s heart rate and the onset, strength and duration of each contraction.  Lying on her side, the contractions became widely spaced (approx. 8-10 minutes apart) which allowed Heather to sleep soundly during each interim.  When each contraction came, however, Heather would abruptly awaken and work, with difficulty, through each extremely long and hard episode while I rubbed her back and helped her breathe.  This continued for the next 5 long hours, and what I thought was a slowing of the process with widely spaced contractions, was actually God allowing Heather to rest and prepare for the last “final push.”

When the time for pushing began, we discovered that the reason the labor had been so long (aside from the fact that she was the biggest baby Heather had delivered), was because Josie’s head was turned 180 degrees.  As such, pushing was no easy task either, and after what seemed like an eternity, Josie finally arrived, almost 24 hours after admission, with a massive cone-shaped head from being squeezed through a disproportionately small space.  As the midwife placed Josie on Heather’s chest, her face radiated sheer relief and joy.  “You did it!” I exclaimed, personally trying to hold back my own tears of joy and relief. 

As I reflect on this incredible and almost surreal experience, what impresses me is the fact that God did not answer prayer #2 in the way I thought He should have.  He did NOT deliver Heather from suffering, but delivered her through it.  He did not lessen the pain, make it go away, or even shorten it.  It was all there in its full, visceral, unbelievable “glory.”  But God did provide the help she needed, when she needed it, so that she might persevere until the task was complete.  And the relief and joy that resulted was indescribable.  The analogy to our spiritual lives is striking.  God never promised to shelter us from trials, suffering or pain (contrary to the teaching of many well-meaning, but incorrect Christians).  In fact, Jesus communicated clearly and with absolute certainty that pain would come, and that when it did, it would not be easy.  So where then is our hope in the center of our pain?  Only one place...Jesus.  After all, he had his body scourged, his beard plucked, a crown of sharp thorns crushed on his head, and his hand and feet nailed through to a cross, not to mention being betrayed, ridiculed and abandoned.  And somehow, I don’t think that He was shielded from any bit of that unimaginable pain.  But He persevered through it, overcame, and arose to utter and complete joy.  Jesus, God in the flesh, overcame, and as we put our hope and trust in Him, so will we, and thus, experience that same intense joy that can only come through suffering.  We may not understand it, but we can have the faith to believe God at his Word, that He will cause us to persevere, that (somehow) there is purpose in the pain, and that the end result will be joy unspeakable.

 

Welcome Josie Grace!

 

Heather and the girls, a few weeks before Josie's birth.  With such beauty, why not add another?

 

Long labor (almost 12 hours) and a natural childbirth completely wore out mom and baby (and me, but to a lesser degree).  What an intense, almost surreal, experience!

 

Letting Josie know she is loved by God and by her parents.

 

Heather's sister-in-law (also Heather), took some incredible pictures right after Josie's birth!  Thank you Heather (and Birdie Girl Photography).

 

 

Well hello, rosebud!

 

 

 

 

 

The Galat kids first meeting of Josie.

 

 

Jeremiah with grandpas x 2.

 

 

Emma and Josie.

 

 

Claire and Josie.

Levi and Josie.

 Grandmas x 2

 

 

Going home outfit, replete with clip-on bow.

 

 

 Josie's first passport photo (taken at 2 days old!).  We are leaving for Kenya in just 6 short weeks as a family, to continue the work God has called us to at Tenwek.

 

Thank you for all the love, prayers and support you have given our family!  

 

“Is it worth it?”

After several weeks of intense preparation and (literally) thousands of practice questions, I finally took the written exam for the American Board of Orthopedic Surgery last Thursday (for the second time).   Having already passed this exam directly after finishing residency in 2008, I remained “board-eligible” for the past five years while we continued our work as orthopedic medical missionaries at Tenwek hospital in Kenya.  However, since I have not been able to work in the U.S. for the required two full years in order to sit for the second half of this exam (to become “board-certified”), my eligibility expired; hence, the reason for the distinct pleasure of taking this brutal exam for a second time.  Round three will come in another five years if we continue our work in Kenya, and the Board maintains its policy regarding the requirements for “step two.” 

Post-test celebrations where cut painfully short, as I had to begin collecting all the documentation required for my next certifying exam, which I am scheduled to take in six weeks.  In September, Dr. Kiprono (my Kenyan partner) and I will sit for the written fellowship exam for the College of Surgeons of East, Central and South Africa (COSECSA), in preparations for the new orthopedic residency program set to start at Tenwek early next year.  As part of the “collection process” for this exam, I was required to catalogue all the cases I have done at Tenwek into a master “log book."  As I reviewed each of these procedures individually (1700 in total), I was struck with the severity of the injuries of so many of these poor patients (multiple open fractures, etc.), and sighed at the thought of the workload that awaits me when I return.   Contemplating the recently-re-completed ABOS exam, the upcoming exam in Kenya, and the prospect of returning to significant difficult work, the thought went through my mind, “Dan, is all this worth it?”  

The following day, I received an email from Dr. Shawn O’Driscoll (a good friend and colleague from the Mayo Clinic who had visited Tenwek last November), which reset my perspective.  He had just received a phone call from a patient in Kenya whom we cared for during his visit.  This patient, named Helen, called to let him know that she had fulfilled the promise that she made to him last year after her injury: She would dance at her daughter’s wedding in July 2013.   Helen called just after the wedding, and told Dr. Shawn that she was dancing with all her might, praising the name of the LORD right from the middle of the dance floor!

Helen was one of several women who arrived at Tenwek simultaneously, all from the same matatu (bus) crash.  She and two other women sitting in the second row behind the driver were pleading with him to “slow down,” because his driving was so reckless and they feared for their lives.  The driver rebuked them harshly.  Literally a few seconds later, while trying to pass a semi, the matatu was forced off the road by on oncoming SUV, and crashed into a ditch.  The second row seat (where the three women sat) was not appropriately attached to the floor and was driven by decelerated momentum into the back of their legs, creating six tibia (shin bone) fractures, five of which were severely open (compound), with bone protruding out the front of their legs.  The driver escaped somehow unscathed, and the women pleaded with him again, this time for his help, as they were pinning to the floor by the faulty seat.  But the driver ignored their cries (and all the others who were injured), grabbed his coat, and walked away from the scene of the accident. 

Several hours later, Helen and the other victims arrived at Tenwek (including a patient with a broken and dislocated cervical spine which required surgery).  After several operations, including using local muscle flaps and skin grafts to cover exposed bone, Helen was on the mend, and always upbeat on morning rounds.  Dr. Shawn and Helen formed a strong spiritual bond, and we prayed with her (by her request) daily while she was in the hospital.  It was during this time that she made her promise…she would dance at her daughter’s wedding in July. 

I was blown away (yet again) at God’s patience with me, even in my unbelief at asking myself the “worth it” question.  He provided what I needed (Helen’s story), at the right time (in a valley of doubt), to keep me focused on who matters most (Jesus), reminding me to “run with perseverance the race marked out for me” (Hebrews 12:1-2).   But even so, this is a valid question to ask ourselves, as Jesus himself encourages us all (who would call ourselves His disciples) to consider the cost of following Him (Luke 14:25ff).  And following Jesus can be hard, uncomfortable, lonely, exhausting, alienating, sacrificing, requiring constant faith, and perseverance. But the joy comes in realizing that what we “give up” (i.e. stuff) can’t even be compared to what we receive (i.e. Jesus, freedom, eternal life).  As Jim Elliot (missionary-martyr to South America) was quoted, “He is no fool who gives what he cannot keep, to gain what he cannot lose.”  So, is following Jesus worth it?   Easy?...not always.  Worth it?...absolutely!

All I have it Christ by Jordin Kauflin

(Click to view on You Tube)

I once was lost in darkest night

Yet thought I knew the way

The sin that promised joy and life

Had led me to the grave

I had no hope that you would own

A rebel to Your will

And if You had not loved me first

I would refuse you still

 

But as I ran my hell-bound race

Indifferent to the cost

You looked upon my helpless state

And led me to the cross

And I beheld God’s love displayed:

You suffered in my place

You bore the wrath reserved for me

Now all I know is grace

CHORUS Hallelujah! All I have is Christ

Hallelujah! Jesus is my life

Now, Lord, I would be Yours alone

And live so all might see

The strength to follow Your commands

Could never come from me

O Father, use my ransomed life

In any way You choose

And let my song forever be

“My only boast is You”

How Two Calves and Les Mis Revived My Tired Soul

One of the calves...

The taunting look of one of the heifers...

Branding calves at a roundup a few weeks ago...perhaps their elusiveness today was payback.

Desert Cattle Ranching

Emma with Abby

Jeremiah on Abby along the dirt road to the ranch.

Jeremiah and Emma are both becoming quite proficient with horseback riding.

Two nights ago, while anxiously cloistered in our bedroom studying (yet again) for my upcoming orthopedic board exams, my father-in-law, Steve, came to me with a favor to ask.  “The cows got out,” he said, “and I was wondering if you had some time to help me rustle them back in.”  A little background…Heather’s parents own a ranch called “Coon Creek” in the high desert of Arizona which is surrounded by the Tonto National Forest.  A small, spring-fed creek runs directly through the middle of the ranch, supplying precious water, and with it, the ability to grow fruit and nut trees, and have cattle and horses.  My father-in-law received word that some of the cattle which reside on the ranch busted out of the fence, and were grazing in the national forest.  I’m sure I had a bewildered look on my face as I thought to myself, “I know absolutely nothing about herding cattle.”  But thinking I might need a break from intense studying and that an interesting diversion might be fun, I agreed to go.

This morning, Jeremiah, Levi, Steve, Marko (my nephew) and I left at the crack of dawn for the ranch, a beautiful two hour drive through the desert mountains.   As I watched the sun rise over the Superstition Mountains, sipping a fresh cup of Guatemalan Organic, and sitting in a comfortable air-conditioned pick-up truck cab, I had no clue how painful it would be to rustle a mere 5 head of cattle back on the property, inside the fence.  As we drove the last 10 km on the dirt road to the ranch, there was absolutely no sign of the cattle, aside from a smattering of cow patties in varying degrees of age.  We started our search by driving around the 80 acre property on quads looking intently, but with no luck.  We finally surmised that they must have traveled south, along the lush creek bed, in search of fresh water and grass.  I began tracking them along the creek, following a subtle trail of flattened grass.  As I followed the creek bank, the patties appeared (and smelled) more and more fresh, and I began to be tormented by the accompanying flies, signaling that I must be near.  Finally, a few hundred yards up the creek, I spotted a grey cow, quietly chewing her cud.   I doubled back, calling out to Steve and Jeremiah loudly that I had found them.

By the time they made their way to where I was, the stealthy cattle had somehow disappeared.  So we spent the next hour or so looking again.  I kept saying to Steve and Jeremiah (who, I am sure, were wondering if the heat was affecting my brain), “I promise you, they were just here.”  Finally, we discovered that the cows (spooked by my loud calling to Steve and Jeremiah) drove themselves up the steep creek bank, onto the dirt road, and back to the main entrance.  They would have just gone in themselves had we left the gate open.  After re-grouping, our brilliant plan was to flank them on either side while funneling them through the gate.  I took the high ground on a steep slope above the gate, determined to let nothing past.  However, two yearling calves ran fast and sure-footed directly past me, up the mountainside.  I ran after them, hooting and hollering, thinking that perhaps all this noise would help.  Rather, the more I yelled, the faster and further up they ran, periodically stopping to tauntingly look back at me, as if to say, “you will NEVER catch us.”  And I never did.  I lost them at the top of the ridge, panting, lightheaded and parched in the 100+ degree heat. 

I made my way back through the maze of cacti and brush to the main gate.  Thankfully, at least Jeremiah and Steve were able to get the three other cows through the breach in the fence back onto the property.  I broke the bad news that I had failed to corral the other two calves.   So after taking a short break, eating a few apples and drinking some cold water, we headed back out on the quads to continue our search.  As we drove along the property edge, we spotted the three cows that had just been driven back inside the fence.  Amazingly, along with them, was one of the calves!  The other calf was about a hundred yards beyond, but still outside the fence.  I thought I would redeem myself by trying to drive him, by foot, along the fence line back to the main gate.  However, I lost sight of him (again), and made the hot, rocky, prickly trek back (a second time) to the main gate.   Now firmly worn and overheated, we gave up, and decided to head back to the ranch house for a cool rest.  However, along the way, we again spotted the herd of newly-rustled cattle, and  somehow, the other calf had joined them too (I am certain he was looking, smugly, directly at me).  So now, after all that striving, the cattle were safely accounted for.  

When we arrived back in Phoenix later this afternoon, I was exhausted and laid down, intending to take a short (few-minute) nap.  I must have been out for some time, as Heather woke me from a deep sleep, in which I was having some intense (but not remembered) dreams.  The kids wanted to watch Les Miserables, and needed help in setting up the sound.  Still in a fog from the nap, I thought I would sit down and watch with them for a few minutes.  However, I was quickly engulfed in this incredibly beautiful and tragic story of law vs. grace that is portrayed in the two main characters.  By the end, I was deeply touched (perhaps primed by the cattle wrangling, subsequent mild heat stroke, and deep, interrupted sleep) and struggling to hold back tears that seemed like they just needed to flow.  

After the movie was finished, I went on a walk, and poured out my heart to God, asking Him what all this was about.  What he showed me was surprising:  I have recently been trying to live my life much like I tried to “round up” those two calves earlier today; by my own strength, and without God’s help and grace.  And this has left me frustrated, and incredibly dry.   I have been trying to “round up” managing my family, being a missionary, running an orthopedic department, garnering equipment and supplies, managing a team of people, planning a symposium, studying and passing an upcoming exam, buying furniture, packing a container, and having a new baby, ALL on my own strength, without grace.  And it’s no wonder I am feeling so worn!  God has not made any of us to live by our own strength, or to say “I got this…I can do it on my own…I don’t need help.”   But the truth is that none of us can “do life” on our own.  We may be able to for a time, some longer than others; but eventually, we will crash and burn. The danger in this type of independence is that we can miss grace, much like the dutiful and law-keeping Inspector Javier (who actually thought he was doing God's work).  Our only hope is God’s incredible grace, embodied in His Son who died for us on the cross!  We all need Jesus, and He is what our hearts are longing for.   The "calves" will take care of themselves (like they did today despite all my striving)...we just need to place our trust in Him and receive His grace!

 

Quick May 2013 Update

Just a brief update on the latest news from the Galat Family.  We have been in the states since late February and much has happened!

Career Missionaries with WGM

Our family spent the month of March traveling, visiting churches, supporters, family and friends, and we were so blessed everywhere we went.  Out first stop was at World Gospel Mission headquarters, in Marion, IN, where we were commissioned as career missionaries!   We are thankful for the ministry God has given us at Tenwek, and look forward to our return.  Aside from the orthopedic service at Tenwek, we plan to continue our focus on resident discipleship, orphan ministry and church leadership.  Thank you to all who have joined “Team Galat” in prayer, support and love over the years!   For information on how you can partner with our family, and in the work at Tenwek, you can click here.

New Orthopedic Residency in the Works

One of the most exciting new developments in orthopedics at Tenwek is plans for a new orthopedic residency!  We will be partnering with the Pan-African Academy of Christian Surgeons (PAACS), a U.S. based organization which supports surgery training programs in Africa, to provide education and discipleship for African Christian orthopedic surgery residents based at Tenwek.  Our tentative plan is to interview prospective residents in October, and begin formal training in January 2014 (a full one year earlier than I had been hoping and praying)!  For information on joining us by helping to sponsor future orthopedic residents, please email me directly.

The Orthopedic Team at Tenwek just prior to my departure in late February. 

 

Mama and baby

Heather is now officially in the third trimester at 28 weeks and feeling well.  The “short list” of names for our baby girl continues to grow with the help of eager cousins here in Phoenix, including but not limited to Charlotte, Ruby, Hattie, Darcy, Willow, Harriett, Daisy, Cora, Collette and Lulu.  Do you have any suggestions?    

 Jeremiah – Joined us in late March, and we love having him around.  He is my workout partner in the early AM, and is determined to keep me fit…yesterday we worked the punching bag.  When not doing on-line school, he is busy earning cash by doing projects for grandpa.    

 Jeremiah and his g-pa.

 

 New table Jeremiah built himself, others soon to be available on Craig's List. 

Emma – Continues to sing, and is now starting private voice lessons.  Additionally, she was invited to practice with a choir at All Saints Episcopal Church here in the valley.  Mostly, she misses our dog Chuma who we left behind in Kenya.   

 

Claire - Excited to celebrate her 12^th birthday this month and for her upcoming, extended “daddy-daughter date.”   Next weekend, Claire and I will travel together to Florida to organize a huge donation of orthopedic suppplies (and perhaps slip away to a water park for a few hours!)

Levi - Loves his cousin Marko, and together they scheme how they can obtain more Legos.  Marko came to me today with a 1000 Kenyan Shilling bill, wanting to sell it for some quick cash for a new Lego set.  He said he “found” it in his toy box…hmmm…

Thanks again for all your prayers and support!  We couldn’t serve at Tenwek without your partnership.

Blood: Post-Easter Reflections

As an orthopedic surgeon, I am often chided by fellow colleagues from other “more refined” surgical specialties that I am a mere “blue collar surgeon,” with marginal intellect, who uses barbaric tools such hammers, nails and screws, to fix broken bones through large, bloody incisions.  More than once I have heard the quip about orthopedic surgeons being “strong as an ox and twice as smart” and I try to take it in stride, replying with my standard rebuttal about being glad that at least I don’t have to operate on the colon or some other "less-glamorous" body part.   I love the banter, and surmise the reason it exists is to help us lessen the stress in our high-stakes profession as missionary-surgeons at a busy mission hospital in rural Kenya.

 While I understand that most of what is said about orthopedic surgeons is solely in jest, it is true that our surgeries are significantly bloodier than the average general surgery case (such as a thyroidectomy where blood loss can be measured in a few cc’s).  It is not uncommon for a hip fracture case to have 500cc or more in blood loss.  Once, during cleanup of the operating room after a particularly extensive and bloody orthopedic case, a suction container filled with about a liter of blood slipped out of the hand of one of our team members, and hit the floor, spraying the wall and ceiling and covering our poor anesthetist in blood.  And more than once, I have finished a case only to find that blood has soaked through my surgical gown to stain my scrubs underneath, or that blood dripping from the operating room table has completely soaked the hems of my scrub pants (especially if I forget to wear my rubber boots).  And I wonder why Kenyans are staring at me, wide-eyed, as I walk obliviously through the courtyard of the hospital wearing bloody scrubs or why my wife refuses to give me a hug at the end of the day until I have taken a cleansing shower. 

For the average person, the sight (or even the thought – sorry!) of blood can be sickening. But for those daily exposed to the sight, smell and feel of blood, the visceral reaction blood evokes can be lessened, until it becomes quite mundane and unremarkable.  Perhaps, like the desensitized surgeon, we as Christians have also lost our appreciation of the significance of blood.   We forget that our forgiveness was bought not with our “good deeds” but with the literal flow of blood from the hands and feet of God Himself (Hebrews 9:22: “Without the shedding of blood there is no forgiveness”).  And we forget that the price of our freedom from sin was literally paid with the currency of blood (Revelation 1:5: Jesus “freed us from our sin, by his blood”).   During this post-Easter season, let us encourage one another to ponder the incredible sacrifice that Christ paid for us on the cross, and pray that God re-sensitizes our hearts to the wonder of Christ’s blood that has set us free.

“Amazing Grace, how sweet the sound

Amazing Love, now flowing down

From hands and feet that were nailed to a tree

As Grace flows down and covers me”

The Mysteries of Life, God’s Sovereignty and Free Will

Heather is now 18 weeks pregnant, and today, we had an extensive ultrasound of our new baby.  As we watched with amazing clarity the intricate anatomic details of this new little life unfold before our eyes (current technology is absolutely amazing), we couldn’t help but worship God for this miracle: toes, fingers, and details of other “parts” all being perfectly knit together by a sovereign God who wills, as he chooses, to create, in a truly mysterious way.   Our baby has no choice as to its sex, body shape, hair or eye color, the family it will be born into, its nationality, or even aspects of its personality.  But, like all of us, as per God’s mystery and perfect design, our baby will have a choice (despite these “non-options”) what to do with them, and whether or not to follow the One who willed to create this life.  In the end, we are all stewards of the life that God gives us, and we will be responsible to give an account of what we have done with the gifts He has given.  Yet, all is completely by Grace, so that in the end, any good that comes from our choices will be turned back as praise to Christ, who made everything possible by his sovereign death on the cross for our sins.  As is the mystery of new life, so is this mystery of God’s sovereignty and our free will.

By the way…it’s a girl!!