It has been one week since we returned to Soddo. We are trying to get our “sea legs” back, so to speak, as we get used to life here again. We arrived on a Friday afternoon and planned to spend the weekend getting settled back in. My first reminder of life in Ethiopia came on Saturday morning when I started to attack my meticulously planned day. I entered the bathroom for a shower and, while I was turning on the cold water, the knob fell off in my hand and water began spraying uncontrolled from where the knob used to be. No attempt to put it back on worked. Now, our toilet is annoyingly close to the bathtub on the side with the knobs. It is a humbling moment to huddle buck-naked in a narrow space while trying to control spewing water and yelling for your wife to bring a bucket. Anyway, after two and a half hours of amateur plumbing and a new faucet, the problem was fixed. And I was not-so-gently reminded that man makes his plans and God directs his steps.

We also said good-bye to two good friends here in Soddo. Sam Hartman and Noah Frank spent the last year working at an orphanage in town. These young men have been a welcome part of the community and we are sad to see them go. They have strong hearts for the Lord and have been an encouragement to both of us. I know that they will return to the United States as servants of Christ, just as they have lived here. But we’ll miss them nonetheless!

It has been a busy return to clinical practice. By God’s grace, it was a quiet weekend and, despite the plumbing comedy, we had ample time to settle in. On Monday morning, though, we rounded on a woman with a difficult problem in the ICU. She had an enormous thyroid goiter that hung onto her chest. What was unusual, though, was that she clearly had a tight narrowing in her airway. Her x-ray showed a specific area of narrowing that isn’t normally explained by this type of goiter. However, it was clear that she would not survive if we didn’t do something. So we talked it over with our anesthesiologist and we decided to attempt removal of the thyroid and hopefully discover what else could be done.

It’s interesting to me to observe how I’ve been changing as a surgeon in the last two years. Two years ago, I don’t think I could have done this. Well, based on the first few times I tackled goiters of this side, I’m pretty sure I couldn’t have done it. But I think two things have been happening since then. First, and simplest, I’ve gained a couple years of surgical experience. No matter where you practice in the world, it takes some time to get comfortable in the OR. But second, surgery in Ethiopia has persistently forced me into tough situations where I’ve had to pray, trust God and move on. Sometimes you find yourself in the deep end of the pool and there simply isn’t anyone to call. I certainly don’t say this to sound puffed up, because I have a long way to go. But I can see God’s grace and provision of the last few years and it is helping me be a better missionary surgeon.

Anyway, we took her to the operating room and the anesthesiologist was able to get a breathing tube in without much difficulty using a flexible scope to look in her airway. We then tackled the goiter. As we expected, the goiter itself was not the only problem. It came out relatively easily (hard to believe I can say that now…), but it only involved half of the thyroid. The other more normal sized half had what appeared to be a cancer. It came out well and did not seem to obviously involve her airway. We never could find a definite tumor in the airway. Because we were concerned about her preoperative breathing issue and the possibility of her trachea being weakened by the large goiter, we did place a tracheostomy tube. She did well post-operatively and the tube is now out. She is breathing relatively well and we’re thankful that she is doing as well as she is. We will await the pathology result.

There have been several other challenging cases, including a very sick baby with a type of intussusception (telescoping of the bowel) that I’ve never seen before. But God is helping us and I’m thankful to be back at it. The administrative demands of the hospital are as urgent as ever, so we have plenty to keep busy. It was a pleasure to see many of you in the States this year and we certainly miss you. Keep the prayers coming and we will continue to pray for you back home as well!

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