Thursday, August 22, 2013

An Ambulance Ride in Jordan

[Disclaimer: this post is written as a nurse and if there are any unfamiliar terms or you have any questions, just let me know!]

A friend and I were talking not long ago about skills we appreciate in other nurses.  One of the most important things in the ER is being able to ascertain “sick” and “not sick.”  Granted, this is not super objective nor easily measurable, but some nurses I trust to know just by a cursory glance which patient needs to see the doctor…like nowish. :P

The patient admitted yesterday was sick. Several noted it. Her x-ray showed bilateral pneumonia, her lungs sounded junky.  We started her on IV antibiotics, breathing treatments, etc, but today she was satting 65-70% on room air, 80% with 5LPM BNC, barely 90% with a non-rebreather.  Febrile, tachy, and breathing 62 times a minute.  I asked the doc to come and he looked at me and said, “I think she needs critical care.  Would you be able to take her to the government hospital ER in the ambulance?”

Would I?!  Yeah baby I would! *grin*  I was so pumped to be able to play paramedic, see the local ED, and, oh yeah, get the patient the care she needed. ;)

I asked the doc if he had called ahead for admitting and he chuckled. “Oh no, if you let them know then they never accept.  Just show up.”  He did, however, know that the ED had opened back up following a fire a couple days ago (longer story, things are okay now, will share that later :P).

The ambulance is basically a van with a stretcher and oxygen (hey, if you have to have a couple things, those are good ones ;).  I took David, a new RN grad, with me on this jaunt, but he rode in the front with the ambulance driver because it would be inappropriate for guys to be in the back with the difficulty breathing female patient, of course. :P  But it was really great to have him along because not only is it nice having a couple medical people when you have a sick patient in an ambulance, but he’s also fluent in Arabic!
I’m also not being derogatory when I use the term ambulance driver. The guy knew how to turn the siren on, but was NOT a paramedic, EMT, or medical at all, just drives hospital staff to and from town with a bus and drives the ambulance as needed. :P

I strapped the 39-year-old fast breathing lady onto the stretcher, connected her to the portable oxygen, and found a place to nestle the IV bag (thinking of my Southern Hills and paramedic friends the whole time!).  It was a relatively uneventful drive there, praise God, as I could jack the portable O2 flow higher than her bedside O2 so we were at a WHOPPING 92% (even though she was still gasping quickly with every inhalation). 

We pulled up to the hospital and I told David to get a wheelchair and oxygen (ours weighed like 80 pounds). He was informed that there were no wheelchairs, but we could get a stretcher.  They rolled a stretcher out with – I kid you not - fresh blood splattered it.  I was like, okay, I’m not putting my lady on somebody else’s blood.  So we figured out how to unleash the cot from the ambulance and took her in. 
Cots sectioned off by drapes lined the ER wall.  I, of course, glanced in each open one to 1) see what kinds of patients they had and 2) look for the bleeding person.  There were a bunch of police in one area with a patient I couldn’t see  Maybe that was the bloody one. Who knows.

What I do know was that all of a sudden not only was I the one checking everything out, but everyone was staring at me. Whether it was because I wasn’t wearing a head covering (I normally do in town but not at the hospital), or was the only fair-skinned on there, or because I had on awesome teal scrub pants, I’m not sure, but I was definitely cognizant that it was one of those “all eyes on the foreigner” moments. :P

We put our patient in a bay and asked if they had a non-rebreather mask so we could take ours back.  The closest they came was a regular face mask.  Heading out to the nurses’ station, we gave report to the doctor who appeared to be about 23-years-old.  She said it was her first year there and was very impressed with the report (“Such a good history!”), so I thank all my paramedic friends who have been examples to me these years on that.

The day got even better when we realized we missed the lunchtime window at the hospital and stopped for shawarma on the way home and then an hour later my Yemeni patients cooked for me. *grin*

So please pray for S*, this woman with pneumonia that appears to be going into ARDS, that God would heal her and receive all glory for it!

I love you all!

Cara :)
Titus 3:3-7

Sunday, August 18, 2013

Jordanian Pick Up Lines

No, seriously. You won’t hear this first one anywhere else in the world.

#1: Man: “Do you know why the Dead Sea is so good?”

Me: “No.”

Man: “Because you are in it.”  He smiles and winks.

What?! That doesn’t even make sense. I’m in my scrubs at the hospital, mister, not my swimsuit at the Dead Sea!  But anyhoo…the days are always interesting. :P  (See how happy he looks with the two of us here? Definitely snuck his arm around at the LAST moment before the pic was taken - reminded me an awful lot of THIS happening - ha!
#2: “I will take my medicine now, but when you leave I will have a problem.”  Oh really?  “Yes, I will have a problem taking my medicine because not only are you beautiful on the outside, but you have a beautiful heart.”   Again, illogical. My beauty has nothing to do with whether or not you should or can take pills. Keep taking ‘em, mister, and be healed.

#4: “Hello.  You think I jest.  The Arabic word that sounds like helloa means “you’re cool and beautiful," so when you think you’re just getting a greeting… ;)

#3: “We should get married.”  No frills, straight to the point.  This one’s the most common and just might be my favorite. Lol. And I guess this one’s Syrian and Yemeni as well as Jordanian. :P  The guy on the right asked me this one, the guy on the left is a fellow volunteer nurse. :)
My patients make me laugh.  Which is incredible when they are going through so much.  Thank you guys so much for praying for them.  N*s abscess is healing beautifully, but a large open wound on her elbow is not, so if you could lift that up, that’d be great. 

PTL relationships among the staff are going well.  The maintenance crew, teachers, lab tech, and nurses came over for an American meal tonight.  We’ve done fried chicken and homemade pizza nights already, but this time I made chicken pot pie and they were astounded.  “THIS is a traditional American dish?” One asked. “I thought Americans only ate hamburgers like from McDonalds!”  Ha ha ha. 
I also got the neat opportunity to go out to a town on the Iraqi/Jordanian border.  There are many Bedouins out there without access to medical care, so once a week a doctor, director, and nurse go out and put on a clinic.  It’s a 5 hour bus ride, apparently, that the Palestinian director did in 2.5. Wowza did we go fast.
The scale at the clinic cracked me up because it’s so Arabic – right to left and of course in kilos!  The director bought Aileen (below) and I both an extra stuffed shawarma and a cold coke for the trip home, so I was one happy and satisfied girl. ;)
This woman is one of the founders of the hospital and she is amazing.  We ended up bringing one of the patients home with us.  He was diagnosed (in another city) with diabetes a month ago and his blood sugar was almost 500 when we checked it.  Basically any time he starts to feel bad he drinks sugary juice and eats packaged cookies.  Let’s just say a little education is in order!  He’s at the hospital now and, in true Bedouin fashion, doesn’t like rules or confinement so I often have to search for him in order to give him his insulin. :P
My dear friends, may “The LORD bless you and keep you; the LORD make His face shine upon you, and be gracious to you; the LORD lift up His countenance upon you, and give you peace” Numbers 6:24-26.  He is so good!

Friday, August 16, 2013

The Attributes of God

I love reading.  I feel like I’ve been quite social here in Jordan, but have found the time to consume a dozen books.  There’s just something so wonderful about being curled up with a good book.  I saw this little gem in the library and picked it up because I’ve heard good things about Arthur Pink.  Those who say such things are not wrong. :P

I hesitate to even post an abbreviated review of an already short book, but maybe it will inspire some of you to go ahead and read the whole thing (it would be well worth your time).  I loved how he used Scripture and quotes from old Puritans and the like along with his own thoughts to encourage me to have a high view of God.  As he manifests God’s character it proved to be simultaneously inspiring and convicting.  All quotes are Pink’s unless otherwise noted:

The Solitariness of God – God was under no constraint, no obligation, no necessity to create.  That He chose to do so was purely a sovereign act on His part, caused by nothing outside Himself, determined by nothing but His own mere good pleasure; for He “worketh all things after the counsel of His own will” (Eph 1:11). That He did create was simply for His manifestive glory.

The Knowledge of God – The whole of my life stood open to His view from the beginning. He foresaw my every fall, my every sin, my every backsliding; yet, nevertheless, fixed His heart upon me.  Oh, how the realization of this should bow me in wonder and worship before Him!

The Foreknowledge of God – What controversies have been engendered by this subject in the past!  But what truth of Holy Scripture is there which has not been made the occasion of theological and ecclesiastical battles? … Yet the controversies which have been waged over them did not close the mouths of God’s faithful servants; why, then should we avoid the vexed questions of God’s Foreknowledge, because, forsooth, there are some who will charge us with fomenting strife?  Let others contend if they will, our duty is to bear witness according to the light vouchsafed us.

The Supremacy of God – There is no other possible alternative between an absolutely  supreme God, and no God at all…. Were all the denizens of heaven and all the inhabitants of the earth to combine in revolt against Him, it would occasion Him no uneasiness.

The Sovereignty of God – There is no attribute more comforting to His children than that of God’s Sovereignty.  C.H. Spurgeon

The Immutability of God – Herein is solid comfort.  Human nature cannot be relied upon; but God can!

The Holiness of God – Power is God’s hand or arm, omniscience His eye, mercy His bowels, eternity His duration, but holiness is His beauty.    This is the prime way of honouring God. We do not so glorify God by elevated admirations, or eloquent expressions, or pompous services of Him, as when we aspire to a conversing with Him with unstained spirits, and live to Him in living like Him.  Stephen Charnock.

The Faithfulness of God – Blessed are all they that wait for Him!  Is. 30:18, Ps. 27:14. From a hymn written by William Cowper:
     Judge not the Lord by feeble sense, but trust Him for His grace,
     Behind a frowning providence He hides a smiling face.
     Ye fearful saints, fresh courage take, the clouds ye so much dread,
     Are rich with mercy, and shall break in blessing o’er your head.

The Goodness of God – [Gratitude] is often withheld from our great Benefactor simply because His goodness is so constant and so abundant.  It is lightly esteemed because it is exercised toward us in the common course of events.  It is not felt because we daily experience it.

The Patience of God – God is slow to anger because great in power. He has no less power over Himself than over His creatures.

The Grace of God – [Grace] is the favor of God shown to those who not only have no positive deserts of their own, but who are thoroughly ill-deserving and hell-deserving.  It is completely unmerited and unsought, and is altogether unattracted by anything in or from or by the objects upon which it is bestowed.  Grace can neither be bought, earned, nor won by the creature.  If it could be, it would cease to be grace. …  The Gospel addresses men as guilty, condemned, perishing criminals.  It declares that the chastest moralist is in the same terrible plight as is the most voluptuous profligate; and that the zealous professor, with all his religious performances, is no better off than the most profane infidel. … The grace which the Gospel publishes is his only hope.

The Love of God – It is not simply that God loves, but that He is Love itself.  Love is not merely one of His attributes, but His very nature. …  How little real love there is for God.  One chief reason for this is because our hearts are so little occupied with His wondrous love for His people.  The better we are acquainted with His love – its character, fullness, blessedness – the more will our hearts be drawn out in love to Him. …  The love of God is gracious.

The Wrath of God – Faithfulness demands  that we speak as plainly about Hell as about Heaven.

The Contemplation of God – The incomprehensibility of the Divine nature is not a reason why we should desist from reverent inquiry and prayerful strivings to apprehend what He has so graciously revealed to Himself in His Word.  “Nothing will so enlarge the intellect, nothing so magnify the whole soul of man, as a devout, earnest, continued, investigation of the great subject of the Deity” C. H. Spurgeon.  True happiness consists only in the enjoyment of God.  His favor is life, and His lovingkindness is better than life.

Just a sneak peek at the whole of the book, but my beloved friends, be encouraged in the awesomeness of WHO GOD IS today! To end as Pink did, "Now unto the King eternal, immortal, invisible, the only wise God, be honour and glory for ever and ever. Amen" (I Tim. 1:17).

Tuesday, August 13, 2013

The Hard Truth

I’ve been putting up a lot of pictures on Facebook of fun things.  Visiting archeological sites, hiking a wadi, cuddling cute babies, but the reality is that things are not all happy-go-lucky here.  How could they be, so close to a war zone?!

Oftentimes I hear bombs going off in Syria since we’re so close to the border.  After hearing several of the refugees' stories, it’s easy to imagine what’s going on a few mere miles away.  What’s not so easy is the knowledge that I don’t always care.  Sometimes the realization of what is happening hits me and I’m on my knees praying for them, but other times I’m enjoying a meal with friends or reading a good book or doing laundry.  How strange to go about everyday tasks when there is a war so close, yet how normal it has become!

Some friends and I went to visit a refugee family last week.  Of the three moms in this home, only one had her husband there.  One’s husband is fighting in Syria and she hasn’t heard from him in a long time.  The other’s was wounded by a gunshot to the kidney and he is awaiting an operation in Lebanon.  Not only is she taking care of her three kids aged 4, 3, and 1 without him, but she is due to have their fourth baby any day now.  Can you imagine not only knowing that your husband will miss the birth of your child, but also not being able to be with him when he is in critical condition?!  These are the types of stories people share with me.  

                                                       -Refugee area of town-

A common burden of the refugees in the city is the not knowing.  Not knowing if their friends and family made it out.  Not knowing if they are alive.  My patients here at the hospital have all the “normal” stressors plus the stress of being chronically ill.  Most have drug-resistant tuberculosis.  The treatment is harsh.  Many get painful injections every day, and all take scores of pills that cause nausea, lack of appetite, fatigue, and more.  Please pray for these dear ones.

There are distractions from the monotony of chronic care – dance parties, surprise desserts, Eid celebrations, entertaining conversations – that help, indeed.  But the truth will help the most.  The truth of the grace of Jesus.  The truth that though this life is hard, it is not the end, and though they may feel very alone, they need never be.  It may be difficult to believe, but when one places their faith in Jesus, it is possible to be content in every situation.  Being a Christian does not mean a life of ease, but it does assure that Christ will never leave us.

“For He Himself has said, ‘I will never leave you nor forsake you.’ So we may boldly say:  ‘The LORD is my helper; I will not fear.  What can man do to me?’ “ Hebrews 13:5-6

What an amazing comfort from the most terrible of situations to the most “normal” of days.

One thing shocked me while visiting this last refugee family.  Traveling to third world countries, working in a crazy (yet wonderful) emergency room in America and having other random life experiences, I must admit that not much shocks me these days.  It even took 27 years before someone was able to throw me a surprise party  - and not for lack of trying!  But in this home one thing did.

Y’all have probably heard that the Middle East is very conservative in dress.  This is a true statement.  When I leave my compound I am generally covered collarbones to wrists to ankles and often am sporting a head covering, as well.  Men and women do not normally mix company...but we did on this day.  Amazingly, the three women and one’s husband, nearly a dozen kids, and my friends (two men and one woman) visited together in one room.  Not only that, but we all talked together.  I was impressed at this very fact, but not shocked UNTIL I looked over at one of the women and saw her pull out her breast to feed her baby.  Now, I lived in a country for years where it was okay for people to go around topless and am not surprised to see people breastfeed in many places in this world, but this is the MIDDLE EAST, for cryin’ out loud!  It’s the middle of summer and I’m having to be careful to shield my ankles from the sight and cover my head - and out pops her breast with several MEN around!?  What in the world!

Like everyone else in the room I pretended nothing happened, but inside I was making a very shocked face.  I guess I don’t have this culture all figured out after all. ;)

“Now may the God of hope fill you with all joy and peace in believing, that you may abound in hope by the power of the Holy Spirit”  Romans 15:13.

Sunday, August 4, 2013

I Have a Baby and Another on the Way!

Surprise!  Ha ha, no, neither one is from me nor mine to keep, but I will be spoiling them for a few weeks. :)   It is a happy thing for me to cuddle the little twins, but a sad story overall.  From their mom’s perspective:

“My husband is not a good man.  He is does not try to provide for our family.  I worked very hard in the fields to save some money to feed the children and maybe send them to school.  I sewed the money under the mattress so he could not take it and spend it on himself.  He found it and went out and bought himself a second wife.  Now he lives with her and just comes here to make me have more children.”

My heart breaks for this woman.  How terrible to not be protected and loved by your husband! 

A couple friends and I went to visit these infant twins a couple weeks ago and it was so hard to leave them in the squalor in which we found them.  Their mom tries to take care of everything, but she can’t.  These new babies are kids #9 and #10.  You can’t feasibly provide for ten kids and watch them all at the same time – especially with as much attention as the little ones need!
The babies were covered in flies and had dirt in every little wrinkle of their tiny hands.  The mother obviously favored the healthier looking twin.  Maybe as a defense mechanism?  Only giving her affection to the one she thought would survive?  I don’t know.  What I do know is that she is a woman hurt and drained by difficulties of this fallen world.

The hospital I am working at was started by a couple ladies about 60 years ago.  One of them still works here, is in her 80s, and has a heart for taking care of babies in these kinds of situations.  She shelters and feeds and loves them for a few weeks or months and then gives them back healthy and happy to a grateful family.  She saw that the mother was favoring one twin, so she brought the favored baby to the hospital and will return next week for the other (thus hopefully giving the mom time to bond with her).
This favoritism reminds me to ask you to pray for relationships here at the hospital.  People have been incredibly welcoming to me and it seems like everyone is friendly to one another, but I know that relationships (especially between believers) are a key thing Satan attacks because, as Jesus said, “By this all will know that you are My disciples, if you have love for one another” John 13:35.

In The Attributes of God, Arthur Pink talks about the well-known verse God is love. “It is not simply that God loves, but that He is Love itself. Love is not merely one of His attributes, but His very nature… The better we are acquainted with His love - its character, fullness, blessedness – the more will our hearts be drawn out in love to Him. His love is without limit.”

Love among Christ followers is a testimony to His name. We can only love because He first loved us (I John 4:19) and as we learn to love Him more every day, His love naturally overflows to those we come in contact with.  Pray that we here at the hospital would love each other limitlessly, speak the truth in love, and that our love for one another would be a witness to those who have yet to know our Saviour!

I pray for you, my friends, that you “may be able to comprehend with all the saints what is the width and length and depth and height – to know the love of Christ which passes knowledge; that you may be filled with all the fullness of God”  Ephesians 3:18-19.  Oh how filling is His love!

Oh the deep, deep love of Jesus
Vast, unmeasured, boundless, free
Rolling as a mighty ocean
In its fullness over me
Underneath me, all around me
Is the current of Your love
Leading onward, leading homeward
To Your glorious rest above

Oh the deep, deep love of Jesus
Spread His praise from shore to shore
How He came to pay our ransom
Through the saving cross He bore
How He watches o’er His loved ones
Those He died to make His own
How for them He’s interceding
Pleading now before the throne

   - S. Trevor Francis

Thursday, August 1, 2013

Bedtime with the Bedouins – Part Two

I’ve been putting off this blog because there is just no way for me to let you experience exactly what I did.  I wish I could teleport you here for a day so you could hear, feel, smell, taste, and touch what I do!

So where were we?  Oh yes, it’s late afternoon and I’m driving up to a Bedouin tent with my very new friend Margaret…

The women, and children came to greet us as we got out of our truck.  We held hands while kissing once to the left, three times to the right (although I’ve since learned that it can be four if you really like the person). :P 

While we were doing all the hand-holding and kissing, the men came home with the flocks and herded them into the pen.
The ladies helped with the stragglers. :P
Margaret and I were then ushered into the tent where an elderly woman came at us with cups of boiling coffee.  I say “came at us” because 1) it was late afternoon – hot – who wants a hot cup of anything at this time? and 2) although the smell is delightful, I don’t like the bitter taste of coffee, but am not about to turn down someone’s hospitality when they offer it.  To clarify: someone from another culture.  If I come to your American home I am turning down your coffee.  Ha ha!

That trial over, the men went into their area of the tent and then women and children came into ours and we talked until supper.  One lady wanted us to help her read the Qu’ran that she had, but when she brought it out to us we discovered that it was actually the book of Luke from the Bible, so we helped her understand the difference.

During our conversations, kittens pranced around the sitting area, flies were buzzing everywhere, and two sheep walked through the tent.

Supper was delightful.  This is a picture from another day of some Jordanian food.  I didn’t take any in their home because I didn’t want them to feel like they were a spectacle or anything, just wanted to build good relationships and show them we cared enough to spend time with them.

After supper a 7ish-year-old girl came up to me shyly and asked to brush my hair.  Now, I love people playing with my hair, but brushing it dry would make it a frizzy mess.  I decided it didn’t matter and let her brush and style my hair while her mom cuddled up beside me and petted my arm.  As they prepared the mat for sleeping, it appeared that the physical touch may not be over for the night because five of us ladies were to sleep on a mat in the middle of the floor (I was #2 of 5 in the sandwich, ha ha).

We waited till the men had settled into their area for the night before venturing outside to go to the bathroom. We went far enough away to where we had some privacy (no outhouses, lol), but not too far that the guard dogs thought we were intruders and mauled us.  Interesting balance.
Inside again, I settled into my area of the mat where I slept peacefully for most of the night.  I was awakened once by something biting at my back.  My first thought was that it was a rat so I reached down there to grab it and throw it against the burlap wall, but at the last minute I remembered the kittens.  Sure enough, it was a kitten, so instead of walloping it across the room I just brought it up to my pillow where it started purring and we both slept soundly till morning.  :)
Those are birdhouses on the poles.

On the way home we saw the ruins of Umm Jimal (“mother of camel”) which was a city from thousands of years ago and mentioned  in the Bible (I believe in the book of Jeremiah).  It’s pretty neat getting to see these ancient places that I’ve read about for years.

Anyway, thank you for your prayers.  Things at the hospital are going very well, and I’ve gotten to visit with some more refugees outside the hospital, as well.  God has been so faithful to draw me to Himself this past week.  I thank and praise Him for that because it’s so easy to get caught up in all this doing that I neglect the most important thing which the Westminster Catechism says is “to glorify God and enjoy Him forever.” :)  Please continue to ask that I keep Him first in all things!

Also lift up the mental / emotional state of our patients.  Not only have a great number of them been through so much, sickness is a constant drain on not only your body but your mind, and some of the TB medications have depression as a side effect, as well.  Living in a hospital for months at a time can be very hard.  Pray that they would find encouragement, contentment, and joy in God.    

"But let all those rejoice who put their trust in You; let them ever shout for joy, because You defend them; let those also who love Your name be joyful in You" Psalm 5:11.

I love you all!