Friday, August 28, 2009

Trip to the Pacific

Missy's sister left a week ago and I still haven't posted pictures. I guess that I had better get busy! We tried to take Christa to a lot of neat places here in Costa Rica, and our biggest trip was a visit to the Pacific Ocean. Unfortunately we had to take a three-hour bus trip over VERY windy roads to get there, and on the way I was holding Devin when he got sick and threw up all over the bus. But once we arrived it was beautiful.

The View From Our Hotel

Missy did a good job at taking pictures!

It was so neat how the forest dropped right into the ocean.

Devin just loved the water.

Sunday, August 23, 2009

Tragic Loss

Stephen Delong and I were missionary kids together in Costa Rica and Nicaragua years ago. He and his wife Yvonne were at Penn View while my family lived on campus, and Missy and Yvonne graduated together. Just a little over a year ago our families spent two weeks together at The Summer Institute for Missionary Orientation. A few days ago they went through the tragic loss of their newborn baby daughter and Yvonne almost lost her life as well. We ache for them, and we are praying for them. My mother just sent us this first-hand account of what happened (after sending it to the Delongs to make sure that they didn't mind her sharing it), and I am posting it so that you will be able to pray for the Delong family. Joanna's body arrived in the States this morning, and the funeral will be soon.

Dear Friends and Family,

I’m writing this on the plane on our way back to the United States. I wanted to contact you as soon as possible after the events of the past two days so you would know first-hand what has happened. I know there have been a lot of stories flying around, and thought you deserved to get something directly from me.

As you know, we have been in Honduras for the past seven weeks, where I worked in the EFM maternity clinic in San Luis. Rex taught classes here, as well as in Guatemala and Costa Rica during this time. Jeffrey helped by mowing grass, weed eating, painting, and breaking up rocks on the runway to make it easier to mow.

We were only planning to be here for six weeks, but Jeffrey’s ear infection prevented us from returning on July 11, as we had planned. We were surprised and disappointed at the delay, but were confident that God had everything in control. As Rex’s aunt said, “We will be excited to hear the purpose for God leaving you there an extra week.”

Well, now we know why, though frankly, the events that happened are not what we would have chosen. In the midst of the questions and pain of the loss that has occurred, we still are sure that God does not make mistakes, and we choose to trust His loving care for His children.

Months ago, Stephen and Yvonne DeLong contacted me about the possibility of my delivering their baby while we were here. They are both former students of Rex, and have been serving as missionaries in Honduras for the past several years after graduating from Penn View. Stephen’s parents and we worked together in Nicaragua when he was a boy, and he and his sisters are like part of our own family. Yvonne’s baby wasn't’t due until after we were to already have returned to the States, but we agreed to pray together about it, knowing that if God would be pleased to let them have the home birth that they wanted, then He would work out all the details.

By the time we were scheduled to leave I had delivered 7 babies in the clinic this time, giving me a total of 49 deliveries in Honduras in the six summers I’ve been here. When we knew we would have to say an extra week, I was excited to think that at least maybe I’d get to help one more little one arrive safely, making it my 50th Honduran baby in the year that I turned 50 years old. And of course, we wondered if maybe Yvonne’s baby might be that one.

There was not one birth at the clinic the rest of the shifts I worked during our extra days there, and Yvonne’s baby seemed pretty content to stay comfy cozy inside her mommy. Yvonne called me around 7:30 Monday evening and we both agreed again that, though it would be nice if something would happen in the day that was left, all of us wanted the Lord’s will to be done, and if that meant I would not get to have a part in welcoming their baby into the world, we were sure that He knew best.

We planned to go into San Pedro yesterday afternoon to be sure to be there for Jeffrey’s ear doctor’s appointment this morning. I was still up, repacking the suitcases that we had packed and then unpacked the week before, when Stephen called me at 12:15 a.m. yesterday morning. “Yvonne’s water just broke! She’s having a lot of pressure – do you think you can make it in time?”

Could we make it in time?! I had the clinic’s portable oxygen tank and a large storage container of delivery equipment and medications sitting by the front door. A quick call to Daniel Melton, who had kept his cell phone on and right beside his bed, brought him wide awake and ready to make the flying trip over the mountain. We arrived at DeLongs apartment in a record one hour and 23 minutes.

For the next six and a half hours, Yvonne alternated walking, rocking, and sitting in a warm shower while Stephen and I supported and encouraged her through increasingly stronger and more frequent contractions. Her blood pressure and the baby’s heart beat stayed well within a normal range, and her labor progress was slow but steady.

Around 9:00, she felt an unusually strong pain, and for a minute it looked like the baby was all balled up at the top of her abdomen. I checked the baby’s heartbeat, which was a reassuring 150 beats per minute. I checked Yvonne’s dilation, which was all the way to 7 centimeters. She had a small trickle of blood, but nothing more than sometimes happens at that stage of labor, and it only lasted a few seconds. I felt uneasy, even with the good heartbeat, and my mind flitted to several possibilities, one of which might be the separation of her uterine scar from her C-section four years ago with their first baby. However, their second child was born normally, at home, with a midwife attending, and things had gone fine, even with a 25 hour labor and a 9 pound baby! About three minutes later she had another small trickle of blood, lasting a few seconds, and I again checked the heartbeat. It had been between 130 and 150 every time before that, but this time it was around 100 beats/minute.

“We have to leave NOW for the hospital!” I said urgently, helping Yvonne onto her feet and urging her toward the stairs. Stephen ran to get the keys and to tell his sister Lydia, who had arrived the week before to help them, what was going on. “I can’t go like this!” Yvonne protested, gesturing to her nightgown, as we headed out the door. “That’s not as important as getting you there as quickly as we can!” I replied, jumping into the back seat of their pickup truck and helping her in beside me.

Stephen sped toward the hospital, weaving through traffic and praying aloud fervently. In the 5 minutes it took us to arrive, he had the presence of mind to pull out his cell phone and call their doctor, asking him to meet us. We whipped into the emergency room entrance, he jumped out and ran inside to tell them we were there, and I grabbed a wheelchair for Yvonne. “I’m having another contraction, and the baby’s really been moving a lot,” she said as I rushed her into a curtained cubicle in the corner of the ER.

The ER doctor and several nurses converged on us while I rapidly explained why we were there. They asked all the questions about name, age, where she lived, etc. They checked her dilation: still 7 cms. and she was not bleeding at all. “The baby’s heartbeat was too low!” I reiterated, and the nurse started searching for it with the Doppler. “76…81…83…79…84…” the digital display read. “Where were you hearing it?” she queried, moving the wand around and probably thinking that she was picking up Yvonne’s rate. “Right there,” I indicated, touching the spot. “But that IS the baby. Her heartbeat really IS that low!” Her personal doctor walked in at that moment, took one glance at the heart rate and barked an order to get Yvonne up to surgery IMMEDIATELY!!! Another nurse started to check her blood pressure. “No time for that now,” he snapped. “GET HER UPSTAIRS!” He dashed off to change clothes and scrub up. To their credit, the hospital staff shifted into high gear, starting an IV, transferring her to a gurney, and rushing her down the hall, around a corner, and up two long ramps to the operating room.

She clutched my hand as I trotted alongside the gurney. Stephen had been waylaid in the registration department, and I knew he was aching to be with her. “I’ll stay with you,” I promised, but when we got to the operating room double doors, another nurse insisted I had to change into scrubs before going inside. I dashed into the tiny restroom she showed me and did so with fumbling fingers, anxious to be back with Yvonne. When I ran back out, they were just locking the doors. I peered in through the windows and watched the flurry as first her doctor, then a pediatrician, then another doctor scrubbed their hands and forearms, donned masks and gloves and disappeared through another door.

I learned later that they tried to give her an epidural, but it didn’t work, so the doctor ordered the anesthesiologist to go ahead and give general anesthesia so he could get her opened up right away. Even so, it was still at least 15 minutes from the time we arrived until the surgery was in progress. Meanwhile, Stephen had finally finished up the registration process and dashed upstairs to where I was waiting. “How is she doing?” he asked anxiously. Just then a nurse unlocked a set of side doors and came through. “The doctor promised me I could go in with my wife!” he begged her, but she shook her head. I took his arm and pulled him into the room where the pile of clean scrub clothes was stacked. “Get changed, you’ll get in,” I promised.

A minute or so later he was back, tying the drawstring on the dark blue pants, and asking the nurse once more to be allowed to see Yvonne. “No one can enter,” she stated firmly. “She’s having surgery.” “That doesn’t matter!” I said. “It’s his baby, too; the doctor promised that her husband could stay with her, and he’s going in!!!” I stripped off the paper shoe covers they’d had me put on, and untied my mask and re-tied it around Stephen’s face as he struggled to fit the too small covers over his tennis shoes. “Right through those doors,” I pointed, and he headed through.

I leaned back against a wall, and wearily closed my eyes, grimly waiting for news. The sliding door leading from the hall where we’d come into the operating suite opened without warning, catching my arm and shoulder and knocking me onto the floor. I struggled to my feet as one of the attendants pushing another patient on a gurney turned his head aside, but not quickly enough to keep me from seeing his amused grin. My embarrassment was forgotten as I saw Stephen, shoulders slumped and face haggard, walking slowly toward me.

“They’re working on our baby but they don’t know if she’ll make it,” he said dully. “The doctor told me he’s doing his best to save Yvonne, but she’s lost a lot of blood, and they’re not sure about her either.” He broke into wracking sobs, and I hugged him tightly as he clung to me desperately and we cried aloud together to God for a miracle.

Managing to compose himself, he walked back into the operating suite. No one tried to stop him this time. I called Daniel Melton, who had gone to the mission apartment about an hour after dropping me off at DeLongs earlier that morning, to update him and ask for extra prayer support. I kept sending up earnest prayers while waiting, but when Stephen again walked slowly back out a few minutes later, I knew without asking that he didn’t have good news. “Our little girl didn’t make it,” he whispered brokenly. “The doctor said Yvonne IS going to be all right though.” I held him as I knew his mother would have done had she been there, as Stephen gulped out between agonized sobs, “Lord, I don’t understand why this happened, but I know you know best. Thank you for sparing Yvonne’s life and not taking her from me as well.”

We waited together as people came and went, giving us sympathetic glances in passing. At last we saw a young nurse pushing a wheeled bassinet toward us. Through the transparent plastic sides we could clearly see a tiny form wrapped in a blanket. “Here’s your little girl, Sir,” she said softly. “I’m so sorry.” She stood quietly, tears running down her cheeks, as we looked at the perfect, silent little body, then gave me a hug and left us alone. I gently lifted Joanna Brooke and held her close a moment before handing her to her grief stricken father. He rocked her back and forth in his arms for a long time, gazing at her peaceful face. “At least we know she’s safe in heaven with Jesus,” he said at last, handing her back to me. I put her back into the bassinet, and we stood silently crying, looking down at her. The pediatrician came and talked to Stephen, gesturing dramatically as he offered his explanations and apologies. “I did everything I could, but I couldn’t save her. Both the baby and placenta were outside the uterus when the surgeon opened Yvonne up. The baby bled out through the placenta.” He hugged Stephen. “I’m very sorry.” He left, and shortly thereafter Daniel Melton walked in. Stephen turned to him. “She didn’t make it,” he stated simply. Daniel looked as though someone had struck him. “Oh, no!” he gasped, enveloping Stephen in a strong embrace and starting to cry with us.

Long minutes later, the nurses came to take little Joanna back. “We’ll bring her down to your room after your wife gets out of recovery,” they promised. “The hospital doesn’t have a morgue, so you have 24 hours to decide what to do with her body and make arrangements to bury her.” Stephen asked that they let him break the news to Yvonne, and they agreed to do so.

Down in Yvonne's room, Stephen, Daniel and I discussed options for Joanna’s burial. The certainly of Yvonne's not being able to be present if the burial had to be done within 24 hours was totally unacceptable but Stephen was too distraught to sort through the maze of other possibilities. Daniel, who is blessed with a gift of having friends in high places, and knowing how to get things moving, offered to make some phone calls investigating possibilities, and Stephen gratefully accepted his help. Daniel left, and Stephen began the sad task of calling their families to break the tragic news.

As he was dialing his mother-in-law, the doctor walked in. “She’s going to be all right,” he informed us, “But she was in very grave danger. Her uterus split open vertically, from top to bottom, in a huge jagged tear. She could have bled to death, but not only will she recover, I was able to save her uterus as well, and she should be able to have more children!” At 1:00 p.m., Yvonne was wheeled, smiling bravely, into her room. Daniel Melton was back by this time, and he and I waited in an adjoining room while Stephen and Yvonne had some time alone together. They called us in soon, and still smiling through her tears, Yvonne said, “We won’t ever have to worry about her not making it to heaven now!”

Mid-afternoon little Joanna Brooke, a pan of ice under the thin plastic pad in her bassinet, was brought to the room, and Yvonne got to cuddle her baby for the first time. Joanna’s Aunt Lydia, big sister Hannah and big brother Daniel, Tiffany and Daniel Melton and their three boys, Rex and Jeffrey, and various Honduran friends were in and out, offering prayer, sympathy and love. I went back to the mission apartment around 8:00 p.m. to get my first sleep in over 36 hours. Stephen and Yvonne both hugged me tightly and thanked me before I left, but I was feeling far from good, going over and over in my mind all that had happened, and wondering the agonizing “What if’s” that always accompany such an occurrence.


Now, finishing this up 4 days later at home, I can only conclude that God orchestrated everything, and we have to trust Him. Maybe if the surgery had been a few minutes sooner, Joanna would have lived, but would almost certainly have had permanent brain damage from the oxygen deprivation. Maybe if I had not been there, Yvonne would have been in the hospital when her uterus ruptured, but likely not. She was planning to labor at home anyhow as long as she possibly could before going in to the hospital, because she was determined to not be tied down to a fetal monitor. Without having the Doppler there to monitor Joanna's heartbeat and know to get help immediately when her heart rate dropped, Yvonne might have bled to death, since her hemorrhage was all inside.

Her mother called me last evening, and through our tears we talked about what had happened. She and her husband both assured me that they believe God allowed me to be there so Yvonne's life would be saved. Stephen and Yvonne had said the same thing the morning after it all happened when we stopped in again to see them before leaving the country. Our good friend Steve Height put it this way, "I've been reflecting on the events of the last three days or so and have come to a conclusion: That God worked Jeffrey's ear infections for the good of someone else (the De Longs), even if he doesn't see direct personal benefit at this time. I'm pretty sure that Hannah's being present was to save Yvonne's life, but you'd all have been long gone had it not been for Jeffrey's problem."

We will never know what might have been, but we know what was: God spared the life of a young mother with two little children and a husband who need her, and took to be with Him a precious, perfect, innocent baby who, though terribly grieved and greatly missed, will never suffer the pain of wrong decisions and sin, but is in a far better world, waiting to be reunited someday with her family. For whatever part He allowed me to play in that outcome, I am profoundly thankful.


Monday, August 17, 2009

Sunday With Christa

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Monday, August 10, 2009

Another Honduras Clinic Story

Here is another story that my mother just sent out. As always, it is quite interesting.

...The concept of close knit family was made vividly real an hour or so into one of my afternoon shifts early last week, when I heard a car pull up outside and loud, excited voices chattering back and forth. I headed down the hall as the front door slammed behind the man known in town as “The Shooter” since he has at least two known murders to his credit. (He’s the one who very kindly gave me a lift from the center of town once when I got caught in a heavy rainstorm walking back from buying a week’s worth of fresh veggies and fruit.) The Shooter was supporting another, younger man hopping on one foot, whose face was covered with blood. As he helped me get the wounded fellow up onto our treatment table, The Shooter vociferously declared that, “It wasn’t my fault, he cut right in front of me and I couldn’t stop in time!”

Not sure what he was talking about, but certain that whatever had happened it hadn’t been good, my attention had of course immediately focused on investigating the bleeding from the jagged laceration extending from the wounded man’s hairline down the center of his forehead. I hurried around the table to the side counter and lifted the lid of one of the large round metal canisters of gauze lined up along the wall, reaching with my other hand for the tongs kept submersed in an antiseptic solution, with which we extract the 4x4’s (or a close approximation to that size) that our secretary and cleaning lady hand cut and fold from bolts of gauze fabric, and which are then packed into the canisters and sterilized in our small steam autoclave. Out of the corner of my eye, I caught a glimpse of the man’s ankle, and whirled around to confirm what I thought I had seen. Sure enough, the leg that he was waving in the air had a joint where God had never intended a joint to be. The broken-beyond-a-doubt ankle that he couldn’t hold still kept flopping back and forth at a sickening angle, looking as though the protruding bone could pop through the skin at any moment.

“Please hold still, Sir,” I begged, while applying pressure with the gauze to his forehead, and willing my stomach contents to stay in place as the grotesquely malformed “joint” kept flopping back and forth with his restless tossing and turning.

“My leg hurts,” he groaned, clutching it and raising it off the table.

“I’m sure it does,” I replied. “You’ve broken it badly and you need to quit moving it until I can splint it for you.”

“It’s broken?!” he queried in surprise, straining his head up against my hand applying pressure with the gauze and simultaneously lifting his leg to see for himself. “Flop,” went the new joint, and I winced again.

By this point the room had filled with concerned family and friends, and I enlisted one of them (his mother, I found out later) to hold the gauze to his forehead while I maneuvered through the rapidly growing crowd of people that was filling the hall to get one of the pieces of cardboard cut from the boxes in which our supplies are delivered. The varying lengths and widths of cardboard are wrapped in strips of old sheets and make cheap, handy, disposable splints. Squeezing back into the room, I directed the people clustered around him to move aside so I could work on his leg. I’d taken a few seconds while getting the splint to give a quick phone call to our house to enlist the help of Amanda Byler, a nurse friend of ours who had just the day before arrived to work with me in the clinic for two weeks. She walked in at that moment and together we carefully applied the splint along the non-protruding-bone side of his ankle and fastened it in place with a long length of more of the torn strips of bed sheets wrapped around his foot and leg.

With the floppy ankle finally at rest, and an injection of pain killer starting its work, I could tackle once more the task of cleaning and suturing the laceration. But midway through mopping away the rivulets of sticky, drying blood to better know what needed done, our day guard’s dog wandered in the room to be close to his master (who is the accident victim’s father-in-law). Clapping my blood-stained gloved hands together and stamping my feet I stormed after him, chasing him down the hall and out the front door. Back in the treatment room once more, I pushed through the mass of bodies to get back to my patient, shooing a couple of inquisitive children (cousins maybe?) away from my table of sterile instruments.

While waiting for the lidocaine injection to take effect, I glanced down just in time to see the father-in-law’s dog trotting into the room a second time, and once more the assembled crowd was treated to the comic relief of the foreign nurse’s clapping-hands-stomping-feet-dog-chasing routine. This time I hollered for someone in the crowd out on the porch of those who couldn’t fit inside to please close the door and KEEP THAT DOG OUTSIDE! Two policemen who had stopped in to see the accident victim after determining that he had indeed been at fault in the collision of his motorcycle with The Shooter’s truck stood in the hall peering in over the heads of his aunts, uncles, cousins, grandmother, father, sisters and mother, but I never saw them in my focus on lining up and lacing together with black silk the edges of the wound that had exposed his skull.

Amanda capably taped the gauze dressing in place when I finally finished my painstaking sewing job, while I stretched the kinks out of my back before calling the Red Cross ambulance to take him for much needed x-rays and surgery on his broken ankle. It wasn’t until the ambulance pulled up and the attendants began waving their arms and yelling at the mass of people packing the porch and hall to get out of the way so they could get in that I realized how rapidly the news had traveled and how large a crowd had assembled. Amanda counted over 30 in the treatment room and hall just outside the door, and more than 40 others outside who weren’t lucky enough to arrive in time to have a ringside seat. I wish I could have gotten clearer pictures to share with you, but the brilliant exam light above our treatment table kept my camera flash from working when Amanda snapped the attached photos. At any rate, I found out what “family support system” means in a Latin country!

The unfortunate follow-up to the story is that because the doctors and nurses in the public hospital where he was taken have been on strike to protest some part or other of the political upheaval the country of Honduras has been in since before our arrival, he still has not had his ankle set. That’s been nearly two weeks ago, and as badly damaged as it was, it will be a miracle if he doesn’t lose his foot. So much for the superiority of a socialized medical system!

Wednesday, August 5, 2009


We finally have our religious visas and can now be in Costa Rica for two years without having to leave the country or do any paperwork! It is a huge relief to have completed the immigration process; thank the Lord that it went as well as it did.

Monday, August 3, 2009

Grandpa's Visit to Costa Rica

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