Welcome to Our World

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Greetings

Saturday, December 31, 2011

Cow spit

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New Year


New Year
Living in Cambodia one faces several dilemmas.  My current one, with the New Year upon us our thoughts center on takes us in different venues and cultural phenomena.  January multiple New Years celebrates the international New Year.  February the Chinese take the stage with their New Year.  Then comes March with a very small segment of the society celebrating the vernal equinox as New Year as takes place in Iran and other parts of the world.  The biggest New Year event comes in April with Khmer New Year.  Since 4 New Years are celebrated in one 12-month period, I wonder does time here in Cambodia speed by 4 times faster.  Or perhaps since four month of the year are new year celebrations maybe time goes by at 1/3 the pace of other countries.  Then one has more opportunity to create new years resolutions and subsequently fracture the resolve.  So now I look to resolve my dilemma from Cambodia by wishing you a Happy Happy Happy Happy New New New New Year Year Year Year.  

Friday, December 16, 2011

LEFT, RIGHT?




Left, Right?
If you do not come right now you will be left out.  Turn left, right?  .  
 In the human body ordinarily the heart is on the left, the spleen is on the left, 
the liver is on the right and the appendix is on the right.   
So as physicians examine a patient they expect the heart to be in the left chest.   
When the heart is not heard on the left one wonders several things.  
 Is my stethoscope working correctly?  Is the patient so obese that the sounds are difficult to hear?  
 Are the lungs so expanded that the heart sounds are inaudible?  
 Then the surprise comes when the heart is heard on the right side.  
 Dextrocardia-, I am not sure of the incidence in the population, 
but many physicians never see a patient with such.   
So the other day I had a little fun mentoring a couple of medical students who 
examined a patient who heart was on the right.   
One of the students rather quickly identified the situation.   
The other student thought the stethoscope was not working properly.
As we look around our world we become accustom to the commonplace and orderliness of life.  
 On occasion we get zingers that make us think, wake us up or send us on a different path.   
We often think we are so right that we can be left behind. 
Butt then my right behind is right so why should it be left?
 

Tuesday, November 22, 2011

Gifts
Bound by a wheel chair with multiple painful joints, but expressing joy.  What a a paradox.  (By the way a paradox is two doctors in consultation.)  A couple of weeks ago when I saw this patient he was miserable-Pain in almost every joint, post hip bilateral replacement and unable to move his neck.  Rheumatoid arthritis treatment with limited resources is great challenge.  After prescribing what I thought was reasonable medication he was seen by the physical therapist who encouraged him to keep active. Between visits he busied himself with his prescribe exercises to the point he is now able to stand for a short moment.  Even though his neck in particular has limited movement and most other joints have more movement he now has great joy.  Now the humbling part for me-a gift, a small gift but a gift of a local sweet rice cake.  The very patient I expected to complain bitterly is rejoicing and giving gifts.  How am I to respond?

Monday, November 21, 2011


On the Visit to Kampong Thom
Have you ever been called Jesus?  There are several versions of the Jesus film that is shown in many part of the world.  As you may know the actors who play Jesus have long hair and a beard.  I have a beard and my hair was getting a little long.  During our time of giving aid to the church in Kampong Thom, some of the children saw me and thought Jesus had appeared to them.  An elderly lady expressed the idea that Jesus had come to heal the sick.  Thankfully, I was not aware of these expressions until we had finished the clinics.  I am not certain how I may have responded if knew the name I was given during the clinics, but I know for certain that I am not any where close to emulating Jesus.  I hope they were not too disappointed.  As the people left the clinic they heard who Jesus really is-the Son of God who became flesh and dwelt among us.  He died for the sin of mankind and has paid for the sin of mankind.  He offers the gift of salvation.  I do not desire to be called Jesus, but I invite you to call upon the name of Jesus.

Friday, September 30, 2011

Get the Point

Medical Student leaving pigs in stitches
Mercy Medical Center present an all day training for medical students with practical experience.  This included CPR, Suturing and Injury care.  Many of the doctors from MMC participated.  I had just returned, so I went to observe and meet again with students I had not seem in a few monthswww.mercymedcambodia.org/

Medical Screening

Doctors, nurses, midwife and physical therapist gathered in Phnom Penh to begin service to the people of Kampot Province.  They worked in two different locations.  The team worked together joyfully and with great interest in the people of the villages.  The last brought an intoxicated accident to the clinic.  He crashed his moto in from of the venue.  We are grateful for their care of the patients.www.plantingcambodia.com

Friday, August 19, 2011

Who Cares??


Who Cares?
In recent days the erratic stock market gives ones mind and heart a workout.  Reports of a double dip recession scream across the headlines.  Now I begin to wonder how these events will shape the future.  I find myself becoming concerned, yes, maybe a little worried.  To where does my heart and mind go for comfort?  As I talk with patients in Cambodia I sense that many live in constant fear.  Often and possibly too quickly and casually, I will point them to the scripture in I Peter 5:7 “casting all your anxiety on Him (Christ), for he cares for you”.  I pass this on with great ease.  My life has been rather mundane and I find my life path has been rather smooth.  However, in recent weeks as I see the potential for my income slowing and my investments dwindling, I must recognize I have pangs of anxiety.  I wonder have I really owned the scripture (I Peter 5:7) I quote to others?  Do I really believe that Christ will take my anxiety and actually care for me?  I must admit that much of the time I feel as I have worked hard for the resources I possess and I am the one who has cared for those resources.  I effect am caring for myself and really suppress my anxiety, thinking my plans will come to pass.  Since my prostate cancer operation, I have a greater sense that my plans owned by me with minimal thought of God accomplishing his purposes.  In my reflective moments, I am beginning to understand I must depend upon my Creator who provides for me and sustains me.  I can plan and scheme, but God knows His purpose and will accomplish His purpose irrespective of my plans.  I need to learn to cast my cares upon Christ and truly rest in His grace and mercy.  The cares of this world should remind me that God is in charge and I am not.  He has conquered the very things I fear.

Overwhelmed

Overwhelmed, not by prostate cancer, but by the many who have expressed their concern for Nancy and me during the time we dealt with my prostate cancer.  We have received messages from people around the world who are praying for us and encouraging us along the path of life.  During this time I have heard from high school and college friends many with whom I have had recent contact through facebook.  Those with whom we have made friends over the years have also graciously sent words of encouragement as well as expressing their remembrance of us in prayer.    Acquaintance in other countries also gave us encouragement.  Others fellow travels along the rode of prostate and other cancers gave their insights into their journey.  Many have expressed our mutual bond in Christ that brings us together as we encourage one another to remain faithful to the call of Christ in our lives. 
Facing the reality of prostate cancer has been a challenge.  Prostate cancer grows very slowly without any initial effect on ones body.  The bad effects from prostate cancer come as the cancer spreads outside the prostate.  My cancer thankfully was confined to the prostate and gave no evidence of spreading.  As a result my cancer showed no symptoms to remind me of my condition.  My only reminder was couple of pieces of paper indicating a positive for cancer biopsy.  So since I felt healthy it was difficult thinking I had cancer.  Now after the surgery, I have no question in my mind that something happened in my body.  With the pain of recovery and the attached tether (catheter), I now have vivid memories of my cancer.  My prostate cancer was moderately aggressive (Gleason 7) but no evidence of spread.  If I had waited for surgery a few years down the road the cancer very likely could have spread.  Presently I wait for my body to heal and the function to return to normal.  I am now cancer free.  At the moment I have good energy.  A few weeks from now I will be back to full activity with only minimal side effects from the operation.  I anticipate for the rest of my life to be free from the effects of the cancer.  End stage prostate cancer has the potential of precipitating deep excoriating bone pain. I am grateful to the doctors who encouraged me to test my PSA, scheduled me for the biopsies and used their skilled hands to man the robot to remove my prostate where the cancer was contained.  May I encourage men to have their PSA followed and submit to biopsy if necessary.  Short-term misery can terminate long-term chronic pain.
Through all the steps Nancy, my beloved wife has stood with me.  Her encouragement has been phenomenal. Her ability to anticipate my needs and respond to them with loving kindness is deeply appreciated.  During our visit with the doctors she stood by me asking question that I would not have anticipated having answers that would impact my care to a significant degree.  She sat at the hospital waiting for the surgery to be accomplished and spent a sleepless night watching over me in my post surgery state.  The morning I collapsed on the floor with unceasing abdominal muscled spasms she calmly called the ambulance and got thing ready for me to have in case I needed them.  I truly do not deserve her gentle touch and loving care.  She is teaching me that I must realize I am a dependent person.  I am dependent upon her.  I am dependent upon my children who offer words of encouragement.  I am dependent upon those who have ministered to us during this time.  I am desperately dependent upon God’s grace and mercy towards me.  I rejoice that such loving people surround me.  May this experience help me develop tenderness towards other people!
My mind’s journey has been interesting.  Looking back from the time the biopsies were scheduled until after the final removal of the catheter, I now realize the gravity of my status weighed on my mind more than I admitted. Apparently my ability as a physician to view pathology from a clinical perspective did not take into account my emotional state.  My pride leads me to think that I can adjust to things as the situation dictates.  With surgery as the defining step in ridding me of cancer I began to feel more relaxed indicating that my pre-surgery status and state of mind showed some anxiety.  Since my cancer was a small cancer I choose not to be real concerned.  I slept well in the night, which indicated to me my good frame of mind.  My recovery pace is beyond my expectations.  I am much more relaxed and my energy level has increased, apparently due the fact I am now declared cancer free.  I like to think that I have placed my confidence in Christ.  He is the one who has allowed the cancer to come to my life to give me insight into what others with similar circumstance endure.  Intensity in my journey thus far is minimal compared to many.  I am grateful that through the years many people have taught and shown me what it means to be given life in Christ.  Through my journey I know that I am held by God’s hand and He will accomplish His purposes in His way.  Right now my heart is filled with gratitude to the people who have and are helping me and to Christ for delivering me from the bondage of my depraved heart.


Originally written July 22, 2011

Monday, May 2, 2011

Momemnt


Moment
A while back I began this blog, to which I make intermittent entries, called Dusty Puff.  In addition to being a mist or puff, the scripture indicates that our bodies come from dust and return to dust.  Thus we are dust that has life for only a moment- that is a puff in the time line of eternity.
In the book of James in the New Testament we read 13 Come now, you who say, “Today or tomorrow we will go into such and such a town and spend a year there and trade and make a profit”— 14 yet you do not know what tomorrow will bring. What is your life? For you are a mist that appears for a little time and then vanishes. 15 Instead you ought to say, “If the Lord wills, we will live and do this or that.” 16 As it is, you boast in your arrogance. All such boasting is evil. 17 So whoever knows the right thing to do and fails to do it, for him it is sin.
The reality of a dusty puff entered my life with the diagnosis of prostate cancer.  Even though the cancer is small I must examine my mindset and what the future will bring.  Since my cancer is low grade, the mechanics of moving forward appears to be matter of fact.   Moment-to-moment living deals with the attitude of my heart.  My prideful self-abasing heart leads me to believe I can conquer what will come all by my self.  My bent is to downplay the encouragement from friends and family.  Since loving friends and family surround me, I apparently have taken much of their love and encouragement for granted. 
How will my diagnosis and treatment of cancer impact those close to me?  How will they respond to the news of cancer albeit seeming a minor inconvenience?  Together we must know and understand that God through is accomplishing His purposes.  We must realize that as God has brought us to this place find our peace and rest in who He is-the Savior who came to earth to reconcile the earth and mankind to himself.
Without having the constant reminder of scripture read to me by others and as I read the scripture myself my thoughts take me in the direction of relying upon my own knowledge.  Reading the scripture reminds that the message of God gives knowledge that I take to heart to soul issues.  I know that God gave good news; my heart is transformed as I realize that God through Christ has forgiven me and my soul because the work of Christ on cross will one day rest with God in eternity.
Now timeline stuff-the mundane of the life.  I am pursuing treatment modalities.  Therefore, no definitive treatment plan is in place.
These events were not anticipated when we came to the states for a respite.  Now we will find our rest and sufficiency in Christ.

Sunday, March 6, 2011

Question Me the Answer






Questions with easy answers pass quickly.  Questions, which have convoluted answers or no obvious answers, pass slowly.  As one enters a different culture many questions come to mind.  Often the initial easy answer becomes a question as one gain experience in the culture.  Or perhaps the certainty of the answer becomes less assured.  As time passes easy questions decrease and an attitude of acceptance begin to prevail.  The frequency of superficial questions of the why’s and wherefore’s of life decrease.  Now deeper questions come with some answers but quite often-additional questions supersede these questions.  Finding answers to difficult questions gives one the opportunity to evaluate ones motivations. 
The ability to see has major benefits.  As one looks around, one sees people constantly wearing glasses or from time to time will see a particular individual intermittently wearing glasses.  From childhood onward, I wore glasses.  In order to see, I needed glasses.  I wore very thick and heavy glasses.  It was not until close to adulthood did I realize that one of my eyes had no central vision.  I had the impression that I with my glasses allowed me to see very clearly.  I discovered that when I covered one eye my vision was markedly decreased.  While taking organic chemistry in college, I discovered my depth perception needed assistance.  When I attempted to pour the content of one test tube into another I poured the liquid on the floor or lab counter.  I thought I could see very well, but alas my vision was deficient.  About 2 years ago an intraocular lens was placed in my “good” because deteriorating vision.  I presently do not wear glasses making it appear that my vision is very good.  But I suffer from the residual of a vitreous hemorrhage, which cause occasional blurred vision. 
In a cross cultural situation one may believe he sees the culture clearly with help from those in the culture.  The understanding of the culture becomes less certain when one see the culture attempting to look around a blind spot and see the culture through another eye or perspective.  As one discovers his blind spots he may not see the culture as clearly as he thought.  As one makes adjustment his thinking about a new culture the weight a strong desire to gain understanding of new the culture may overwhelm ones perspective to the point where he benefits from thinking the culture in new and different ways.  The process of entering and understanding a new cultural is ever changing.  One makes corrections in ones thought process about the culture, but new information blurs ones understanding.  Changing glasses or points of view will help to keep in desire to see more clearly the new culture
Just as we attempt to see with our eyes the natural world, through glasses, intraocular lens implants or corrective surgery or medication, we who live in a cross cultural setting constantly must examine our view of the culture in which we serve.  Just as my eyes have changed over the year and they seem to be continually changing, my insight and understanding of the culture must also change, as I desire to see Christ glorified in the culture where I serve.  Asking questions, getting answers that precipitate more questions will help me open my eyes to better understand the people of Asia and sharpen my motivation for engaging a new culture.  

Monday, January 24, 2011

Road's Scholar



Alert and focused are the watchwords when we travel the roads of Cambodia.  This is especially true while driving at night.  Any sort of movable entity may move or park on the darkened roadway. Trucks of all sizes and shapes moving faster than the normal traffic, moving along with normal traffic and moving slower while swaying and dancing along.  The road often becomes a parking lot. Trucks park anywhere in, near or on the roadway.  These trucks may or may not have illumination. 
Two wheel vehicles present a different challenge.   Whether the two wheels are side by side or one in front of the other these vehicles are found anywhere along, across or in the roadway.  Two wheeled vehicles may carry passengers with produce on top, on the side or in front.  The movement of the two wheeled vehicle may be at the pace of a snail or faster than normal movement.  Passengers will ride anywhere space become available.  Occasionally a passenger may be seen several feet above the driver seated on produce.  In the darkness an astute driver must look for moving shadows to avoid an undesirable incident. 
The illumination of oncoming vehicles may virtually blind a driver so that the roadway cannot be seen.  Or an oncoming vehicle may have no lights.  A single light may or may not mean a two-wheeled vehicle.  Very bright lights outshine the dim lights leaving the driver wondering about the number and style of vehicle making their rapid approach.   Multiple lights of several colors most often indicate an approaching a very large trunk.  White light most of the time means a vehicle will pass soon hopefully on proper side of the road. 
Pervasive darkness of the roadway illuminated by scattered light reminds one of the chaos of life.   I wonder if the light I bring to the world is as erratic as the lights I see while driving in Cambodia?  Maybe I need to make a studied approach to both the path I take and the roadways of Cambodia.  Would I the be a Road’s Scholar?