Language struggles are a part of our everyday life. After many years, you become comfortable with French, but your patients only speak Kirundi. The students can interpret for you, but not if they are from Cameroon, or not if the patient comes from Congo and only speaks Swahili.
Yesterday, I had a patient who struggles with language. She is 43 years old. Through the help of my student interpreter, I learn that, a few months ago, her speech started to become harder to understand, and this gradually evolved to where she can now only grunt. She can understand Kirundi. She can write without difficulty. But she cannot pronounce anything. She also cannot swallow. Jason put a scope in her esophagus and all looks structurally fine, so he sent her to me with the idea of a neurological problem, maybe a mass growing somewhere in her brain.
It's hard to imagine what that's like. To watch your ability to speak (in such an oral culture) slip away relentlessly. I ask her to sit on the table, in order to check some other basic neurologic function in the face. Fung'amaso. I fumble on close your eyes, but she gets the idea. Uravyumva? I touch her forehead and ask if she can feel it. Next, I want to see if her mouth muscles have any weakness, so I ask her to smile. Now, in Kirundi, the word for smile (gutwengatwenga) is a form of the word for laugh (gutwenga). Twenga, I say. I think she understands what I'm asking, but her smile bursts into an embarrassed laugh.
Then she continues to laugh. She puts her head down on her knees and laughs until tears run down her cheeks. She can't stop laughing. Her sister laughs. The med students laugh. I attempt a whole sentence in Kirundi: Uratwenga kuber'iki? (Why are you laughing?) She looks up at me and bursts into a fresh round of laughter. It's unclear at this point whether the roots of her tears are from humor or from sorrow, but somehow it's clear that there is joy in there, regardless.
This moment is a pretty good picture of our lives here. I doubt we can find a diagnosis for her. Even if (1) one of the three CT scanners in the country is working, and (2) she can find the $100 plus transport to get a scan, then (3) it is extremely unlikely that she could find anyone to fix it, even if we found something.
And yet, she laughs. Her yellow teeth are bright against her dark face, and she makes me laugh.
There is sorrow, and in the midst of it, there is great joy. And often, like yesterday, there is one of us random Americans in the middle of it, not at all sure what's going on, but finding the grace to enjoy the moment nevertheless. In a nutshell, this is our life at Kibuye.
It could be better. Yes, it could, and we long for redemption and for healing and for all the barriers that keep us from knowing each other well to fall away. We long for God to fulfill his promises to save us utterly and completely.
But it could be worse. I wish I could have helped this lady more, but I'm quite certain that, when she and her sister return home, and her family asks how it went, that along with more tears and more frustration, there will also be more laughter. God's redemption and his grace are already at work among us. They are the rip in the curtain that the light shines through. These peals of heart-filled laughter from a woman who can no longer speak a single word are the first fruits of the fulfillment of the promises that God has given, and that he will, in the end, keep.
On a somewhat related theme (I feel like there is a connection here, and maybe you'll find it better than me), here is a great quote from Frederick Buechner's conversion (from The Sacred Journey):
And then there came one particular sermon with one particular phrase in it that does not even appear in a transcript of his words that somebody sent me more than twenty-five years later so I can only assume that he must have dreamed it up at the last minute and ad-libbed it and on just such foolish, tenuous, holy threads as that, I suppose, hang the destinies of us all. Jesus Christ refused the crown that Satan offered him in the wilderness, Buttrick said, but he is king nonetheless because again and again he is crowned in the heart of the people who believe in him. And that inward coronation takes place, Buttrick said, "among confession, and tears, and great laughter." It was the phrase great laughter that did it, did whatever it was that I believe must have been hiddenly in the doing all the years of my journey up till then. It was not so much that a door opened as that I suddenly found that a door had been open all along which I had only just then stumbled upon.