Missions Surgery: Serving God in the O.R.
When our family first considered going overseas on a medical missions trip, we searched for a way to put our Christian faith into tangible practice to help in underdeveloped third world countries. It sounded good, but in reality it was more than a bit scary. Could God use a regular guy like me? What about in darkest Africa? That was the question that my family and I were to find out as we settled into the mission hospital at Tenwek for a month. We made a leap of faith to combine our desire for service with a short term support trip for an active surgical practice at a mission hospital. We weren’t sure if we would survive the malaria, strange cuisine, lack of sanitation, or the hectic schedule, much less provide an effective ministry outlet in such a spartan facility.
The first weekend started off with a bang. As a general surgeon, I would not only be responsible for elective and emergency surgeries, but also for any trauma that came in. When that first patient was unloaded from a pickup truck Friday night and carried into casualty, he had massive crush injuries that did not come from a simple tribal skirmish. His labored breathing had the wet, stridorous wheeze of a crushed larynx, and the flattened facial bones and indented skull segments indicated severe trauma. This simple laborer had the entire south wall of the rock quarry come down on top of him. His coworkers were surprised to find him still breathing when he was dug out. Even though they didn’t give him much hope, they brought him to the daktari at Tenwek.
Although the expectations may not have been very high on the part of the nationals, I was shaking in my boots at the thought of having to resuscitate and deal with so much that was in sub-specialty areas that I didn’t normally work with. However, the team paused briefly to pray over the man (which I thought probably helped me more than him), and then settled down matter of factly to begin whatever treatment I would direct. We worked much of the night, stabilizing, intubating, setting broken bones, elevating bone fragments and taking pressure off the swollen brain, suturing lacerations, and fixing things as best we could. A refurbished ventilator had recently arrived, and we were able to set it up and get it running after surgery. Otherwise there would have been no way to sustain his ventilation day in and day out until he regained consciousness. When we were all done, he was still alive and seemed surprisingly stable for what he had just gone through.
His course was rocky over the next few days. We hovered over him closely and did what we could. Had we done enough? I pored over Neurosurgery texts, Orthopedic books, and trauma manuals to find any other tips for better management. But we just didn’t have much more medicine or technology to offer. The Chaplaincy team came around and prayed over him each day, counseled the family, and prayed with the staff. We continued IV fluids, antibiotics, dressing changes, and ventilator support as we watched and waited.
I didn’t have much hope that he would ever come out of his coma with the severe craniofacial head trauma he had sustained. But surprisingly he woke up after about two weeks and started talking a bit. The Chaplain talked with him and told him that God had shown him great mercy in allowing him to live, and then explained the plan of salvation through Jesus. He apparently made a profession of faith, as there was much celebrating and clapping by the staff, with singing of hymns in the Kipsigis dialect by the entire ward. Then, just as mysteriously he faded a few days later, and later succumbed to pneumonia and sepsis. While I was frustrated that we hadn’t saved him, the locals seemed pleased that he had had that brief lucid interval and was allowed to embrace the grace of God before passing. I realized that God had given him a second chance, however briefly, to make a choice that mattered for eternity.
Much of our work during that time seemed frustratingly inadequate by comparison to modern medical standards. But what seemed like so little to me was welcomed as an abundant blessing by the patients and staff. Certainly the fact that we had any successes at all in such primitive surroundings seemed to be a great miracle to me. I learned to pray diligently for each and every patient, and I felt that God’s mercy was abundantly shown to me as well as to each one of the patients. But what I came to realize was that the real miracle for the people who were fortunate enough to get care here was firstly about finding that someone else cared enough about them to try to help, and secondly, that this care was here for them because of Jesus and his love for them.
We found that these people were not unlike those in underserved communities back home. They appreciated the efforts made on their behalf, they responded to our love and concern, and they certainly had a strong desire to survive.
We found that salvation through faith in Christ was a source of great hope for many who had no other prospects for life here or in the hereafter. And the ministry staff was greatly encouraged and renewed by having someone come alongside to help share the burden and workload. The relief was evident immediately in the attitudes as well as the functionality of the staff. We were really surprised at the depth of reaction and emotion to even very small acts of encouragement, kind words, and offers to help be involved in activities around the hospital compound while we were there. It brought new meaning to Jesus’ words about giving even a cup of cold water in his name.
The take-home lessons for me were very practical. I find myself praying for my surgery patients in pre-op. Most of them genuinely appreciate the concern and feel a spiritual connection. I try to interject faith flags into discussions about terminal illnesses, cancer, and critical care situations, because they are especially urgent in the lives of these patients. And in spite of the veneer of civilization we hide behind, I have begun to realize that we each want compassion and acceptance when we’re ill, and long for the strong hope of a future when we fall into despair. The Christian faith holds this out to whosoever will, and offers real value to those in need.
The exciting part of our involvement in the fields of health sciences is that we can directly participate in God’s healing ministry by virtue of our vocation. We can also provide a platform for witnessing and counseling to our patients as they choose to utilize our services. I think this fulfills part of God’s purposes for our personal lives as well as our vocations, as we reach out in sacrificial love to provide care to those unable to obtain it otherwise.
At Tenwek I found that I could depend on God’s provision for our family in all sorts of circumstances, for his help in taking care of patients that needed a greater physician than myself, and in working out even the small details of daily life in a foreign place. I realized the importance of valuing the life of each and every patient, of praying for every case as if their life depended on it, and of praying with and for the whole team that you are partnering with. I found that God would indeed use someone ordinary such as me, if I would only put myself in a position where he could show himself strong on my behalf. While these were things I knew before, by working cross-culturally with a people where the need was so great, I learned to put them to work in my practice every day.
Dr. William Rucker is a general surgeon on staff at East Carolina University in Greenville, NC who has served several times at Tenwek Hospital in Kenya.