Here is Paul’s latest prayer letter.  If you want you can have the blogs emailed to you by entering your email address to the left of this post….

Dear friends and family,

Thank you for your prayers this week. I needed them and they were felt. If nothing else, the last two weeks have given me greater insight into what our PAACS graduates will face upon their graduation.  There is so much to be said about having a partner. And I feel more committed than ever in helping to establish our graduates in pairs to assist in their long-term survival.

Please continue to pray for Becca and the kids. Overall we are doing well as a family. Home schooling has been going well with Nathan. It is fun to see him learn and hear him recite memory verses from the Bible. I have not been at home as much as I would prefer, but hopefully this will be for a limited time. Pray for Becca in this time of increased clinical duties.

With Duane, the ortho surgeon, gone, we have primarily been scaling back for emergencies only. Frankly, that’s the bulk of what we do here anyway, so it isn’t much of a change. We’ve done a few semi-elective cases on a selective basis, but we are asking many people to return in a month. Please pray for wisdom about how to balance the various demands and do what God wants us to do.

This has provided me with some better hands-on experience to consider how to live in the face of resource overload. I’ve been talking with the residents about ways to structure life when you simply don’t have the capacity to meet the demands – a situation most of them will live in. I have some thoughts about how to limit the mental and physical load of elective cases. One of the hardest things to both teach and learn myself is the need to recognize all of the demands on your life, not just the surgical ones. There seems to be a trend in the US to use this as an excuse for selfishness. So many graduating surgeons want to have an 8-to-5 job with minimal to no work on nights or weekends; all in the name of family and personal life. But just because a principle is badly applied doesn’t change its validity. And I don’t think there is a permanent, static answer to it. As a Christian surgeon in Africa, I think these guys will need the Holy Spirit’s guidance on a weekly and daily basis to modulate their time. There will be times where you have to hit it hard at the hospital. And there will be times where you have to pull back and attend to your families and social responsibilities. Ah… it’s hard to know! But if you’re not even wrestling with it, if you simply focus all of your time and energy on one area, whether it be surgery or any other, you definitely aren’t getting it right.

A few clinical prayer requests: Please pray for a young woman in our ICU. She has a horrible pneumonia and I operated on her yesterday to clean out her chest of infection (thoracotomy and decortication). She ended up having a wicked lung abscess in addition to having a chest cavity that looked like an outhouse. I was nearing the end of removing the rind of inflammatory junk from her lung when the anesthetist informed me, “Doctor, I don’t feel a pulse…”. So we threw her on her back and began CPR. (For you medical sorts, I was in her right chest and the pleura was way too nasty to contemplate opening her pericardial sac for cardiac massage.) By God’s grace, we got her back, so I quickly flipped her back on her side to finish the operation and get out of the operating room. I had pretty well cleaned up the lung surface, but she still had a bad air leak, primarily from the depths of this lung abscess (it looked like a big ice cream scoop had removed a hemisphere from her lung). I was afraid to futz around too much longer trying to seal the air leak, so I just washed her out and put in our chest drainage tubes. She woke up and we were even able to take the breathing tube out. Post-operatively she was awake and talking to us. There was a nasty air leak immediately post-op (again for you medical sorts), but it seemed to be better in a few hours, though I’m not sure how much of that has to do with her wimpy respiratory efforts. Anyway, pray for her and her recovery. I had a difficult time getting her ready for surgery. Before a major surgery, patients are encouraged to have family members donate blood; she had a blanketey-blank male relative who flat out refused to donate blood for her. Finally some female relatives showed up and donated. There are times when I dream about punching out some people. I’m pretty sure there is a missionary rule against both the action and the fantasy about the action… (I am reminded of a scene from the movie “True Lies” in which Arnold Schwarzenegger’s character is taking a test drive with Bill Paxton’s character, a used car salesman. Paxton’s character has a scam where he pretends to be a spy to seduce women. He is describing to Schwarzenegger’s character, a real spy, of how he is currently scamming Schwarzenegger’s wife. While Paxton is laughing hysterically, the wind blowing in his hair as they drive in the convertible, Schwarzenegger punches him in the face, seemingly killing him. Suddenly the scene shifts and you see Paxton’s laughing face again and you realize the punch was a fantasy in Schwarzenegger’s mind…)

Second, please pray for a young boy, about 13 years old, who needs some sort of flap to cover the side of his head. He was in a car crash and had a horrible injury to the side of his head; losing a lot of skin over the side of his face. He has exposed bone that I need to cover. The wounds are pretty clean now and I need to tackle it Monday. But I feel very nervous about it and have no experience with this. We made a big bite in the surgical deficit this week, but this is one of the main cases that is still pending.

I have invited an orthopedic surgeon from Myungsung to come down and do some cases for a day next week. I have some foot/ankle cases that are simply out of my pay grade.  Please pray that he can make it down.

Please pray for the St. Luke’s Health Care Foundation, the governing board of the hospital.  They had a productive board meeting last week. Please pray that God would help us to grow and mature as He desires. Please also continue to pray for God’s provision of hospital administration.   It would be very helpful to have experienced, godly and committed international administration to assist in building functional systems and educate our national staff.

Last Wednesday, we hosted the leadership from Myungsung, including Chi Chung and Jon Pollock, for a foot washing ceremony to welcome our new residents into PAACS. The ceremony went very well and I think conveyed the intended message. It was also encouraging regarding our partnership with Myungsung.

On a political note, it seems that the acting Prime Minster has been sworn in as the official Prime Minister of the country. I am so thankful for the peaceful transition. Please pray for ongoing peace and development in the nation. It has really been remarkably smooth.

God bless,

Paul and the family

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