Happy Thanksgiving! I hope you have all had some good time with family. We enjoyed an evening meal together on Thursday and everyone contributed to the food. No turkey, but we had some good chicken. And it’s the side dishes and pumpkin pie that make the meal anyway, right?

The kids seem to be doing very well. It has been such a joy to watch Nathan learning how to read. Becca has been going through a reading book with him and he really is getting it. He is sounding out words and reading small, two-sentence stories. Each story has an associated picture and Nathan gets so excited to read the lines and then see the picture.  

This is yet another difficult prayer letter to write. So many things have happened this week that I struggle to know how to share it. I started by just describing the week, but at the rate I was going it was going to take six or seven pages to get it all in. Surgically it has been very difficult. Nearly every day has involved difficult cases, most of which I’ve either never seen before or at least never done before. It is hard to describe the weight of this and how it compounds all of the other stresses. It is also hard to describe how little comfort knowledge is. I know that God has called us to a task too big for our abilities and that we must trust in him. I know that He is sufficient and continues to prove Himself sufficient. I know that I need to rest in His refuge. I know that all I can do is my best. And on and on and on. But when it comes down to it, I still lose sleep over anxiety, I’m still the one making all of the clinical decisions and bearing the consequences, I’m still the one cutting people open, I’m still the one watching people die, I still feel the weight of a training program, I’m still looking down the barrels of several guns that might kill it, etc.

When I got married I often heard the advice that women don’t always want advice. Sometimes when they share their challenges, they just want you to listen and not pipe in with a fix. I’m kind of going “woman” on this prayer letter. I deeply appreciate your prayers, but would gently ask that you don’t send advice about this. Frankly, I’ve probably heard it before and wrestled with it already. It isn’t a knowledge issue and I don’t think it is an obedience issue. I don’t know what it is beyond that I need to sit here and wait for God. I am seeking Him daily and earnestly begging Him for wisdom and joy and peace and trust. But, for now, this seems to be where He wants me.

We held our strategic planning time for the hospital last weekend and your prayers were very much appreciated. God blessed us during the time and we really made some progress. We were able to make some important decisions and we were able to wrestle through some issues. There is still quite a bit more to do, but I think we made significant headway. And there was a sense of unity and peace about the time. I am very thankful for that. It was a long weekend, though. We met on Saturday from nine in the morning to nearly five in the afternoon. And then we meet for a few hours on Sunday as well.

Please pray for our patients. I have several big operations today, including another chest surgery where I have to peel the inflammatory rind of a young woman with a completely collapsed lung from pus-filled chest. She is rightly afraid of surgery given how weak she is and her poor nourishment. We are also concerned about additional heart problems, but don’t have much in the way of either diagnostics or treatment. From her ECG, I think she has had a heart attack already. And I will probably only have two units of blood available. On Tuesday, if the guy shows up for surgery, I will tackle a kidney operation I’ve never done/seen before that will involve clamping the blood flow in and out of it, packing it with ice, and splitting it down the spine to remove a bunch of huge stones.

The PAACS apartment building is coming along. The building should be done by the first week of January at the latest. We are excited to get our residents and their families here on the compound with us.  

I swear this place feels like a television show, there is so much going on every day, if I really explained it all you would have to read 20 pages every week.  I long for some simplicity and pray that God would lead us into it even in the midst of these storms. I rejoice that Jesus was able to sleep in the boat during the storm. Just as his righteousness is imparted to me through faith, I rejoice that his peace and faith in the midst of chaos is also imparted to me through the cross. I pray that I would live more consistently in light of that reality.


Paul for the gang