Liberia?

Throughout the summer, we McCropders have continued to ponder long-term locations: Sudan, Swaziland, Niger, Zambia, Equatorial Guinea, Liberia? Each option presents its own interesting mixture of situational intricacies.

One of the countries we have discussed is Liberia, a post-conflict nation in West Africa. The medical need is great, and the post-war situation affords opportunities to positively impact the rebuilding process. We have entertained the possibility of pursuing faculty positions at the medical school.

I, Jason, was recently presented with an opportunity to work in Liberia from September 14 to October 4 as a surgeon with Mercy Ships. I jumped at the opportunity, eager to help and excited to explore future McCropder possibilities. I also anticipate stretching my surgeon wings on what should be some interesting and challenging cases. Like a cantaloupe-sized thyroid for example.


I am looking forward to a stretching, exciting, and enlightening three weeks with Mercy Ships!

Paradigms - Part II: Henri Nouwen Book Titles

As the ideas discussed in the prior posting swirl around in my head and heart, a phrase climbs slowly out of the fog, giving itself an extra prominence: The Wounded Healer.

The Wounded Healer is a book written by Catholic priest and contemplative writer Henri Nouwen in 1972. Nouwen was a fascinating man, and the book a worthwhile read, though the title itself has more bearing on the present discussion than does the content of the book. The phrase, of course, makes me think of Jesus, and Nouwen uses it to describe us as we imitate Christ. It does not at all remind me of the medical institution’s image of its own practitioners. There, the two pervading images are, either the healer who needs to be whole himself/herself before extending help to others, or the healer whose personal condition has no bearing on his/her healing work.

How is Christ a “wounded healer”, and in what sense are supposed to imitate this? I can think of two ways. First, Christ’s wounds are substitutionary, as Isaiah wrote centuries before Christ, “The punishment that brought us peace was upon him, and by his wounds we are healed (53:5).” Because he was wounded, we no longer have to be. I can envision a few glorious human examples where one might imitate this (such as the end of A Tale of Two Cities), but overall this provides little in the way of guidance for my own medical practice.

But there is a second and more subtle way that Christ may model the “wounded healer”. The unknown writer of the letter to the Hebrews writes that part of the reason Christ is the greatest “high priest” (able to mediate perfectly between God the Father and mankind) is because he “has been tempted in every way, just as we are – yet was without sin. Let us then approach the throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need (5:15).” Did these temptations “wound” Christ? I do not know. But what is evident is that the personal story of Christ (both its ebb and flow) enables his healing of others, instead of detracting or even distracting from it. There is potential here for an appropriate guide for us to model. But how?

I do recommend Ellen's comment from the first post for more food for thought.

Paradigms - Part I: Medical Care for Friends

We were asked the other night how we felt about being the medical provider for our friends. This is hardly a theoretical question, as Rachel has agreed to provide obstetrical care for a good friend of ours. The institution of medicine does not provide a definitive stance on this, but it does provide a thought framework that lends itself to a certain position: We are uncomfortable with it, because though it may be enjoyable and rewarding as long as everything is straightforward, the possible threat to our personal relationship that is created by a possible bad outcome is a risk most are not willing to take. You are caring for a friend, and they are diagnosed with late-stage cancer. Will you ever be able to forgive yourself for not finding it sooner (even if there is nothing to forgive)? What will become of your friendship and the relationships you hold in common?

We recognize that we had better make peace with this. If my appendix ruptures in a couple years, Jason Fader will become intimate with my colon, and will have to deal with the responsibility of operating on me. If little Elise Cropsey gets malaria, it will likely be my treatment plan that will recuperate her. This is part and parcel to a desire to work in an area where there are minimal other medical providers.

The medical paradigm that creates these (and other) levels of discomfort with treating friends seems to be this: You are the patient. You are coming for help. I am the doctor. To best help, I need to be disconnected, and thus objective. I should not be bringing my personal story into yours, because this is about you, not me. And from this comes a separation between your patients and your friends, for friendship requires a give and take, an intermixing of personal stories. I think that our pastor at Knox was correct is stating this is likely an outgrowth of medicine’s modernistic bent.

And so I question this: Is it really possible to separate yourself personally from the patients you treat? If so, does this really provide objectivity? Does objectivity lead to healing? (If a person can be treated as a scientific physical specimen, then perhaps.) Is this a paradigm that will make a drop of sense in Africa? Is this consistent with Christianity?

More to come, but I would appreciate any thoughts from those who may read this.

The Devil Came On Horseback

At the recommendation of the Cropseys, we, the McLaughlins and Faders, got together with some friends last night and had a viewing of The Devil Came on Horseback, a documentary about a young retired US Marine who travels to Darfur and ends up with a photographic exposition of the atrocities there. It is a fine film, chosen for the Sundance Festival last year. We thought it would be an interesting way to learn more about this conflict and engage some of our friends on a situation dear to our hearts.

Jason's brother Caleb, who is heading out next week for 2 years with the Peace Corps in Uganda, spent 2-3 months in Darfur drilling wells last year. Thankfully he was in town and able to be there, and provided some very personal perspective to an already personal documentary.

David Durham (my brother-in-law's father) wrote that much of the sentiment over Africa can be summed up in a single letter: "O". As in, "O Africa!" The tragedy, the joy, the horror, the need, the gift.

As eight young Americans sat around after our movie last night, it seemed that everyone's heart was crying out "O!", but when we tried to decide what to do, the complexity of any solution loomed large. I do not claim any exhaustive knowledge of world affairs, but it does seem that the greatest world crisis currently is Darfur, with millions displaced, and over 400,000 killed. What to do? Be aware? OK, we can do that. Tell others? We can do that, too. Support sending in armed forces and be involved in another nation-building event? Maybe, but our collective wisdom seems not to be sufficient to answer that definitively.

Pray? Yes, we can pray. God, help Darfur. Help us to know how to act justly. Bring healing, wholeness, peace.

Medicine and the 4 Levels of Happiness

Several years ago, I heard John Patrick speak at a conference, and he talked about the 4 levels of happiness. The first and lowest level is animal happiness, that is, our hungers, thirst, physical drives. The next level is discipline happiness, or the happiness that comes from applying yourself and acheiving that goal, such as in athletics or academics. The third level is that of needing to be needed, which can result in altruism. The highest level is that which comes from knowing and loving God (and, I would say, being known by and being loved by God). It's a very Neoplatonic idea, in the sense that we strive to aim for the higher levels, while de-prioritizing but still enjoying the lower levels.

At first blush, I didn't see much more than an interesting thought exercise in this, but later my friend James (of the Lyntelnosters) gave me pause to think how the work of medicine fits into this. I think two things can be gleaned:

1. Medicine is fundamental: This is the gravity of what we do. When physical and mental health deteriorate, the ability to pursue any of the happiness mentioned above is seriously challenged. This is the reason people will drain all their resources to pursue a cure; because what good are all these resources if I'm not alive or functional to pursue any other happiness?

2. Medicine is foundational: To me, this is the other side of the coin. What we do gives people the lowest level of happiness mentioned above, but that's it. Whether anything higher is achieved is up to them. Yes, physicians can help people to pursue higher happiness, but at that point, most people would say they have gone beyong the limits of medicine and into some other service more common to friendships than doctor-patient relationships.

So, in this light, medicine becomes humility and honor. It reminds me of a scene from Lewis' Narnia: "'You come of the Lord Adam and the Lady Eve,' said Aslan. 'And that is both honour enough to erect the head of the poorest beggar, and shame enough to bow the shoulders of the greatest emperor in earth.'" Those of you who didn't think this was going to come around to CS Lewis ought to have known better.

Jason Graduates from Residency

Another step towards Africa: This week marks the end of my (Jason's) quarter century of education required to become a general surgeon. Last Saturday I officially graduated from general surgery residency. I was thankful to be surrounded by wonderful family including Heather, in-laws, grandmothers, and siblings, as well as some good friends.

Another highlight from the graduation event was definitely having Eric play the piano during the cocktail hour before the ceremony.

Now I begin a one-year "fellowship" in which I will learn various skills to better prepare me for operating as a surgeon in Africa. This will include learning a wide variety of operations such as C-sections, fracture repair, urological procedures, plastic surgery, and various ENT procedures. The light at the end of the tunnel is certainly getting brighter, as I look forward to getting my first "real job" next year, at the age of 32!

Country Profiles on Sudan & Liberia

Sudan & Liberia are two countries that we have considered as long-term locations. Both countries have recently gone through lengthy civil wars and are in desperate need of help on many levels. To find out more about these countries, click on the links below to view country profiles created by BBC News.

Sudan:

Interesting Facts:
*Largest country in Africa

*The two-decade civil war between the north and the south claimed the lives of 1.5 million people and an estimated 200,000 people have been killed in the Darfur conflict which began in 2003

Liberia:

Interesting Facts:
*Founded by freed American & Caribbean slaves

*250,000 people were killed in the civil war that ended in 2003

*President Ellen Johnson-Sirleaf became Africa's first female head of state in Jan '06

Drs. Kuhn and "The Impact Factor"

Drs. Ted and Sharon Kuhn, medical leads for Mission To the World (MTW), graciously made the trip up from Atlanta, GA, to meet with us and we really appreciate it. The "Lyn" and "Tel" were also present. MTW is an organization within the Presbyterian Church of America (PCA), a cousin denomination to our home church, Knox, that is involved in sundry ways with medical mission work across the globe. We all met at Jessica's parents' home (a.k.a. Rivendell), and Rachel, Eric, and Jason were a few minutes late due to an incredible amount of wind, which delayed their bike ride precisely 26 minutes.

We all sat down and the McCropders, via spokesperson Eric, gave a brief overview of where we're at. The conversation lasted quite a while, and probably posed more questions than answered, which we consider to be a difficult but wonderfully necessary feature of this early stage of our planning. Obviously, a complete recap of this meeting is not possible, but here are a few highlights.

Per the Drs. Kuhn, the two main "first things" questions for us at the outset are the following:

1. What is the relationship between Word and Deed in our overall mission model? As the title of this blog makes quite clear, we are committed to the marriage of these two ideas, but how will this really play out in a day-to-day scenario?

2. What will be the relationship of the church to our work, both the local African church, and churches with which we have relationships in the US?

These questions hint at something we have, in our discussions with each other, come to call "The Impact Factor", which is very dear to us. In short, "The Impact Factor" is the ability to bring the most benefit and blessing to those whom we will serve. One of the ways in which this Factor has continued to guide our thinking through the present time is that the more medically underserved area, the better. And yes, some parts of Africa are more than the others, though need is overall quite pervasive. The spin the Kuhns placed on this was in thinking more long-term about Impact. Should we head to a larger city with established hospitals, in order to maximize Impact by working in medical education? Should we be in a similar area in order to take advantage of the increased accessability to maximize Impact?

These questions are not answered, but are a necessary flavoring to our "question stew" as we plan out our overall mission model. Thank you Kuhns, and we look forward to sharing more time and conversations in the future.

God, grant us grace to serve You well.

Zimbabwe

I suppose there are continually many places of great need in Africa, thus part of our interest. However, hearing the latest from the Zimbabwe elections, we ask that you would be in prayer for that country, that they would be spared war and find justice.

Team Picture, Birthday Pictures

The Faders walloped the Cropseys & McLaughlins at "10 Days in Africa". It's a good game. We recommend it. We also recommend that you all someday spend an actual 10 Days in Africa. Or more. With us. :)