i want to be a nurse in africa ... or a ballerina




Archive for June 2008

Irony


posted by Jenn

Comments Off









Sometimes I don't know how to handle it.




The blatant contrast of extreme joy and extreme pain, all wrapped up into one tidy, compact little experience. The vast myriad of emotions that overtake me on a daily basis. Blessing and wealth juxtaposed against utter poverty. Feeling intense bewilderment and compassion towards a person all at the same time.




Friday, we visited Mama Victoria's Kingsville Orhphanage, out in the country. Liberia's countryside is unreal. Lush. Green. Picturesque. As we drive down the dirt road in our landrover, children run to the streets with huge smiles on their faces screaming "White man, White man, White man!".




We arrive and are greeted with overwhelmingly welcoming faces and embraces, mostly from complete strangers. We are given a tour of the buildings, which are already getting run down, a year after construction, from the 80+ children who inhabit them. We see their undressed ratty foam mattresses lying on bunkbeds that were constructed by veteran Mercy Shippers on previous outreaches.




We walk through their "kitchen", where old women are cooking massive pots of rice over open fires, knowing that similar fires have been the source of so many of the burn contractures of our patients.




We listen to Liberian music being blasted over a low quality sound system that we know was bought with money that could have been used to buy rice. Or add to the half-finished school building. The children dance. We make awkward attempts, but even white people who have been in Africa for half a year can't even begin to compete. They don't care. We all laugh and sweat and sing the words to songs we have never heard before. Little girls are dressed in their very best attire and have beads platted into their hair because today is special.




The program begins. One of the older boys recites an alphabet poem that he clearly wrote himself and is quite proud of. It involves the phrase "Kissing is the best part of love" and concludes with the indisputable statement that "Zebra is a member of the animal kingdom". Enough said.




The "Birthday Month Challenge" starts. A fundraising competition, to raise money for the school building project. For ten minutes, prominent people from the community dance around and put money into plastic Walmart bags in front of their respective month representative. Again, the horrible sound system is blaring music.




The nine of us each give probably no more than a dollar. It would be unfair to sway the competition by giving more. The competition ends and it is time for the counting. One younger man tries to collect the bags, which a number of others apparently disagree with. In typical Liberian fashion, they all jump him and everybody begins yelling incoherently all at the same time.




My stomach grumbles because it is 1:00 and my lunch is in the landrover. The child on my lap gets one meal of rice per day.




The grand totals are read. The month of May takes the crown with a grand total of 900 Liberian Dollars being raised (15$ in our world).




My lifelong goal to become friends with a monkey that isn't crawling on top of my car at the African Lion Safari comes true.




My perfectly representative African day.




Feels like home


posted by Jenn

Comments Off

I remember hearing so much in nursing school about how nurses function as the patient’s advocate. I remember starting my career and learning what that meant. I am now learning how universal that feeling is. How you can feel the exact same emotions and heartache and fight standing in a crowded ward with patients and families who barely understand you, make-shift equipment, and decisions being made based on the accumulation of knowledge from a group of doctors and nurses from all over the world with various backgrounds and experiences. It is odd how it all comes back and I am once again reminded that people are people, mothers are mothers, suffering children are suffering children, and nurses are nurses, no matter where they happened to be born or what circumstances they happen to find themselves in.

Baby Greg didn’t have the miraculous post-surgical recovery that we all hoped for. His trachea is “floppy”. Apparently, his little body had become adapted to having the cyst on his neck, and since he has been extubated, he has not yet been able to breathe well on his own. He is now on CPAP (which, for you non-medical types, gives him pressure down his airway and keeps his breathing tube open instead of collapsing shut). And, for you medical-types, we have had to rig it up here on the ship due to Greg’s desperate need.

I spent most of the day Tuesday with baby Greg, watching him struggle to breathe. The boy was absolutely exhausted. Whatever energy he could muster up, he was using to gasp and keep his body oxygenated. By two o’clock, I absolutely couldn’t handle it and we called a meeting to find a solution for our little one. We all knew that Greg was having troubles. The problem is that his issue (officially called “Trachea Malaysia”) will not resolve overnight. Typically, children take a number of years to outgrow it. At home, we would pop in a trach. Not so simple in Liberia.

After an hour of deliberating, the team of brilliant (I mean that honestly, not sarcastically) doctors and anesthetists were at a loss. If we give Greg a tracheotomy, we will solve his breathing problems, but that is a long-term intervention. One that we are not able to follow through with, and most likely would not be able to be properly cared for once the ship sails away.

But Greg was still laying in front of us gasping and retracting and breathing over a hundred times a minute, and it wasn’t ok. There had to be a solution. So Greg is back in the ICU on make-shift CPAP to help him keep his airway open. And that night, I got to see Greg relax and the panic-stricken look from his eyes disappear. For the first time in 36 hours, Greg fell asleep. He stopped sounding like a dying duck every time he took a breath. Nurses have been in the ICU day and night since then doing essentially nothing but keeping the mask on his face that delivers his airway pressure and silencing the ventilator alarm that goes off about every three minutes. I would do it for the next month if it would help his little soul.

It isn’t a long term solution. I don’t think anyone really knows what will happen with Baby Greg. He really needs a miracle.

To be honest, if a miracle is going to happen, I think this is the place. Ali and I were watching “So you think you can dance” after shifts of taking care of Greg and one of the contestants made a ridiculous comment that “they needed a miracle”. Ali laughed and said “You have no idea what a miracle is”.

So, can you pray for one? There is this horrible helpless feeling that nurses get when we want so badly to help and feel so strongly for a patient’s situation and we know that there is nothing we can do. I am there. I hate that there is no solution. So, I will wait for a miracle.

Bob and Greg


posted by Jenn

Comments Off

Playing dress-up with babies is one of the best parts of being a NICU nurse. As long and exhausting as the night shifts can be, I always looked forward to "bath-night" at the NICU at home, which most often involved less of a bath and more of a get-the-baby-onto-the-scale-and-back-into-a freshly-made-bed-as-quickly-as-possible-without-letting-his-sats-drop-uncomfortably-low. However, there was that one perk of getting to choose a matching receiving blanket, hat, crib sheet, and if you were really lucky and your baby was stable enough to get dressed, sleeper. Simple pleasures.

It isn't quite the same here. Unfortunately, there aren't as many old ladies around knitting us multi-coloured toques for our infants. And, I have yet to see a nice receiving blanket so I can properly bundle a baby the way every good NICU nurse desires to do.

But tonight, at the very bottom of a large pile of adult hospital blankets in a cart on D ward, I found a Bob the Builder blanket, which has the same general thickness and consistency of the receiving blankets of my dreams. I brought the blanket into the ICU and introduced mama to the North American phenomenon of Bob the Builder. The blanket was potentially meant to be a wall-hanging, but Greg's mama liked it. So, my little one got wrapped in a frighteningly large replica of a cartoon construction worker. Within minutes, baby Greg was settled and had long forgotten his intense desire to remove the pesky tube from his trachea.



I looked over at mama and saw an uncharacteristically large smile on her face.



"Bob is a handsome man" she said. "Greg is a handsome baby. They should be together".



And together they are. Sleep well baby Greg. In the arms of our good friend Bob the Builder.

The night shift with Greg


posted by Jenn

Comments Off

I am on my second of three night shifts, working in the ICU with baby Greg.

There are three problems that I have found thus far with Greg. One, as I promptly informed his mama upon meeting her: Greg is not an African name. African babies are supposed to be named Darling Boy, or Handsome, or Allusain, or ideally, something that I cannot pronounce correctly. Not Greg.

Secondly, everyone seems to think Greg is five months. If Greg was standing up, I am fairly sure he would be taller than my almost three-year-old niece. Also, rumour has it that before he was intubated, he could talk. My extensive experience with the newborn population has taught me that five-month-olds do not talk. But, whatever.

Thirdly, Greg was born with a cystic hygroma: a very large, fluid-filled cyst on his neck. This potentially is the biggest problem plaguing Greg at present. The name thing he can deal with later in life when all his Liberian school mates with proper Liberian names exclude him from football.

But, five hours were spent on Monday "debulking" baby Greg's hygroma, and now it is gone. Greg has been left with a very large pressure bandage where his neck is supposed to be, and a tube down his throat so that his swollen neck doesn't cut off his air supply. In a couple of days, if all goes as planned, he will be extubated, transferred out of his personal NICU back to the regular ward and will begin to heal and recover. And, whilst I am confident that this goes against some universal rule regarding counting one's chickens before they hatch, I can't help but recognize that this was a "job-well-done" by some incredibly talented, devoted doctors.

I feel like so many of my memories from this time and place will be consumed by the very traumatic, dramatic stories of patients who had near or actual misses. I will never forget Sadie or Benjamin who will forever be entwined in our minds as we remember the beginning of this outreach. I can't help but be overwhelmed by the incredible transformation of Alimou. The picture in my mind of Abraham's little burned face will be one that I will carry with me long after I leave Africa. I tend to be greatly impacted by drama.

But, I want to remember the Greg's. The patients whose stories might not have initially gripped my heart or made a great story to tell when I get home. So much of what we have been doing here has to do, not necessarily with heroic life-saving measures, but with helping people in small, tangible ways. Maybe saving their lives. More likely demonstrating compassion that has been unparalleled in their world by meeting a practical need in their lives. I want to remember the babies who had their little cleft lips repaired and will therefore be accepted into their families and communities instead of living a life of shame and rejection. I want to remember the countless children who had their club feet repaired and will soon be running and playing with their friends. I want to remember the conversations that I have had with patients about the little things. Their lives and their families. I want to remember playing Jenga with Thomas. And how Gbor would want me to tuck her in and lay in her bed with her on the nights she was in the hospital by herself. And how Jennifer liked to sing Christmas carols while her bandages were changed.

Nobody can deny that it is the little things in life that make up life. Sometimes a seemingly insignificant word or conversation can change our entire perspective on a subject. A single act of kindness can change how we view others. If I have had the opportunity to be a part of these conversations or acts of kindness for any person here, than my time has been well spent.

So, hopefully nothing dramatic or life-changing happens on my night shifts with baby Greg. Hopefully, I just get to be a small, forgettable, invisible part of something that will someday positively affect his little life. And in that way, I will get to be a part of a miracle.

A few of my favourite things


posted by Jenn

Comments Off

Blogging really is the "thing to do" for Africa Mercy crew members. I would argue that we nurses have the best job on the ship, because we get to play and spend hours on end with the patients, which, most of the time is purely enjoyable and rewarding, if not incredbly humerous. That's why I like reading my nursy friends' blogs. I love hearing about how other people perceive situations and their experiences with patients.

My friend Ali has quite an eloquent way of portraying what goes on in the wards. On numerous occasions, her renditions of patient stories have left me speechless (a rarity for me).

One of my most favourite things about working here (aside from all of the legitimate reasons a person leaves their life, family, and friends to live on a floating hospital in West Africa) is the things we say and do as health care workers in Africa that just would never ever ever happen at a hospital at home. Sometimes, I stop myself and realize just exactly what it is I am saying and have a hard time not laughing out loud. This week, while reading Ali's blog, I actually did laugh out loud.

http://www.alirae.net/blog/archives/81-mama-....html

And this is why I wonder how life will ever be the same!

Because I am white


posted by Jenn

Comments Off

One week ago Willemetta, one of the translators on the ward, went into labour. Fifteen minutes later, she had a baby.

It is most advantageous when African babies are born quickly. As Westerners, we tend not to consider the various problems that can present themselves during labour and childbirth in Africa. Sometimes, babies are born in hospitals. Many times, not. This eliminates the potential for epidurals, fetal monitoring, or crash c-sections. As I was reminded of by the translators at the baby shower we had for Willemetta on Wednesday: Someday, if and when I am pregnant and go into labour, it will be easy for me "because I am white". The whole "your life is perfect and easy because you live in America" mentality is pretty widespread amongst my African friends. I have to stop myself from becoming defensive when people imply such generalizations. The reality is that at least in this case, they are right.

On Tuesday afternoon, we got word from the outside world that a baby with gastroschisis had been born on Monday and would be coming to the ship. The thrill-seeking, adrenaline-junkie part of me got excited. I have been working on this ship for 4-months now and I can count on one hand the number of times when I have really felt "in my element". More often, I fumble my way through situations that I am slightly unsure of, asking a million and one questions, praying, and hoping that at the end of the day, my patients and coworkers remember only my dazzling personality.

But, disorders and defects in newborns is my comfort zone. So, for a very very brief moment, I was excited.

The most simple explanation of gastroschisis is intestines on the outside, instead of the inside of the baby's abdomen. As rare and visually disturbing as it can be, babies with gastroschisis born at home tend to do quite well. With our knowledge and special toys, we have become quite skilled at pushing the gastrointestinal system back where it belongs. Not to diminish the significance of the condition or imply that all babies do well; But, as a whole, outcomes are good.

The thing is, gastroschisis is still a significant issue. The surgery is a massive strain on the baby's body. Ideally, surgery should be done as soon as possible after delivery. Sometimes it is hard to fit everything back inside. It is necessary to provide IV nutrition for the baby until he can tolerate formula through his GI tract. The baby is at high risk for infection, due to the large opening in his body. The baby should be born in a high-risk delivery center, and have every precaution taken against infection. After the repair the baby's respiratory status can be compromised because there is less space for his lungs to expand. It is a process and a risk; But one that we are quite willing and competent to take at home.

Obviously, a baby born here with a gastroschisis has very little hope of the bright outcome that we offer to babies with the same condition in "America". Even with all of the expensive equipment and qualified professionals that Mercy Ships has to offer, we couldn't have saved this baby. What we could have offered him is nowhere near what it would have taken to give him a reasonable, successful outcome. It sometimes surprises me that after four months the "where you live determines whether you live or die" phenomenon continues to rip my heart out. I guess you aren't supposed to grow accustomed to that one.

Our awaited baby didn't ever arrive. Apparently, traveling in the Liberian taxi system when your intestines are outside of your body doesn't have quite the same efficacy in terms of survival as being wisked away to a sterile incubator immediately upon entry to the world. I know that we couldn't have saved him even if he had arrived. I know that it is better for him that I didn't get to show off my skills. I know that the ship of "Hope & Healing" has a specific goal and purpose and needs to function for that purpose. I know that we cannot transport America to Liberia. It just doesn't seem right knowing what is available out there and knowing that it will never make it here.

Fair thee well


posted by Jenn on

Comments Off


Yesterday, I stood on the dock and bid my bunkmate Megan farewell as she left this place, probably forever. We are solidly committed to meeting up later this year, potentially at Disney World (finally....after I have been waiting my whole life, I am going to meet Snow White. How lovely). That being said, saying goodbye sucked.


Goodbyes suck. Change is difficult. Loss of a person, place, or time in your life hurts.


I think that we tend to believe that whatever time and place we happen to find ourselves in is the best that life has to offer us. I suppose it makes sense. It would be maladaptive to live in the past and always regret that you aren't still there. And we have no idea what lies in the future. The unknown is always a little daunting. I guess that leaves us right smack dab in the middle of the here and the now.


Maybe it is just me. Maybe I am just a little too narrow-minded or self-centered. Maybe I put God in a box. Someday, I hope that I can whole-heartedly embrace change as an opportunity for life to get better.


I will miss Megan. She is one of those people who literally brings joy and fun and an overwhelmingly fresh perspective to life. My favourite type of people are the ones whose presence makes the environment happier and more fun. She wins that contest! This all gives my human self plenty of reason to be sad because our lives have gone separate ways for a time.


Instead, I have chosen to be thankful for the wonderful time that I got to spend with my friend. My ridiculously-valuable obsession with cliche words of wisdom has resulted in the not-so-clever-or-particularly-brilliant-saying "Don't cry because it is over, Smile because it happened" to be brought to my mind. I think that maybe we can choose to look at any situation in this way. Taking from it everything that it had to offer and teach. Treasuring it as a beautiful memory that we can take with us forever. Considering it as a wonderful blessing in our lives.


We are not promised to be blessed in any particular way indefinitely. We are promised to be loved. Loved by a God who is good and knows what is best for us and the exact timing of what is best for us.


So, with that, I will shed a tear for my friend's departure. I will thank God for bringing someone so beautiful into my life to inspire me and to laugh with me. And I will be excited for whatever is to come.


Right Here, Right Now


posted by Jenn

Comments Off

I like to play this game in my head when I am not looking forward to something. Prior to the unwelcome event or time period, I speculate about how horrible it could potentially be and then prepare myself for the worst. Having this healthy does of realism most often leaves me presently surprised. I applied this technique a couple of weekends ago when a group of friends and I went on a camping trip literally to the middle of nowhere. After committing to go on what turned out to be a rather enjoyable weekend, a pang of doom and fear entered my body as I considered how miserable a weekend on the beach at the dawn of Liberian rainy season, for a girl for tolerates camping at best, could be. As the weekend drew to a close, I realized that I had been having a good time, but I refused to admit it to anyone until I was safely back on the ship; clean, dry, fed, and showered. It was just too much of a risk.

I am deciding to take a similar risk tonight. My week so far could be described as nothing less than “brilliant” (my favourite new descriptive term, courtesy of my British friends and coworkers). That feeling of being “in the right place at the right time” has been following me around relentlessly. I think it is worth the risk of committing too soon and I going to confidently declare that this week I have been in all the right places at all the right times.

It started with what had the potential to be a long, drawn-out, “feeling-sorry-for-myself” weekend of working 12-hour night shifts. Not the case. Life is so much about the people you share it with and it couldn’t be more true when talking about night shifts for nurses. Luckily for me, I got to spend my night shifts with my friend Becky, a PICU nurse from Seattle, with whom I share many qualities, including a love for making kids laugh, the office, reheated chicken bread, and what we have chosen to call “prophetic charting”. The company made the weekend for me and all of a sudden I found I was feeling not quite so sorry for myself and just more than a little bit blessed to be in this place.

Already the week was off to a lovely start, but, as humans tend to do, I had my doubts that it could continue in such a truly lovely fashion. Enter God.

Over the past few weeks, I have been saying goodbye to many good friends, including a nice little group of six girls with whom many of my most favourite moments on the Africa Mercy have occurred. As of this week, it was down to just Joanna and myself. This could be a reason for one’s heart to feel a little abandoned. Instead, I got to spend the most relaxing, perfect weather, great food, amazing heart-to-heart conversation, exclusively one-on-one (that so rarely happens here) lunch date with my dear friend. We learned so much about each other that somehow we had missed over the past four months and talked through so many of the issues that are clearly plaguing the minds of young, single, North-American pretend missionaries preparing to go to grad school and enter a world of academia and competition that seems so foreign to us right now. Joanna left me a card when she left the ship that said “Thanks for lunch yesterday. My soul needed it”. Perhaps mine did too.

There are some moments in time where you feel like you wouldn’t want to be anywhere else. Where you almost feel guilty that you are there and other people aren’t getting to experience what you are. Where you feel like the advice you are getting shouldn’t really be free, because if everyone could hear it all of the world’s problems would disappear and we would all just want to hold hands and sing (which would be creepy, so forget it, I am glad it was just a small group of us). Most conversations with Dr.Gary Parker, the medical director onboard the ship, are such moments. The man is truly a legacy. After an entire career and lifetime of serving with Mercy Ships, he has authority. And that was exactly what the group of about a dozen of young wannabe doctors, nurses, pharmacists, surgeons, and Ph.D.’s sensed as we sat around him after dinner last night, soaking up every word and token of advice he had to offer. What was meant to be a goodbye party for a couple crew members turned into a question and answer session with Dr.Gary, who I can say without a doubt, we all aspire to be. He is one of those rare people in life who has all the brilliance, skill, personality, and greatness, yet successfully manages to combine and balance them with grace, humility, and compassion. It truly is incredible, and I believe that the truths he talked about with us last night will not soon be forgotten. It wouldn’t be an overstatement to say that he successfully inspired us to be tomorrow’s leaders reaping eternal rewards.

Finally, tonight we went to the orphanage that a group of us nurses venture out to every Wednesday evening to read and talk about the bible with the nine teenage / early twenties girls. Most weeks, I don’t want to go. I am tired by the end of my shift. Going out into Africa is hot and you get dirty, and anyone who knows me knows how I feel about getting dirty. But, alas, every week we get there and something happens and I know I wouldn’t want to be anywhere else. This week as we were walking towards the car, I told Kortu (my favourite….I know it isn’t ok to have favourites, but I do, and someday maybe I will get saved) that I really appreciate her participation in the discussion and that she makes very valuable contributions (obviously, I phrased it nothing like that, because I don’t think any of those words translate into Liberian English). She opened her notebook and explained to me “Every week, when you leave, I read the chapter for the next week. Then I read the chapter every day until you come back. I think of what it means to me each time I read it, and write something down each day.” I wish I knew what it was like to value something that much. I have wished in the past that my points in Bible Study were a little bit more like 16-year-old Kortu’s points. Now I get. Tonight, I learned a valuable lesson about how much she values her bible and her God. So, I wouldn’t have wanted to be anywhere else in the world.

If it is even possible, I hope my week goes up from here!

What else am I gonna do with my life?


posted by Jenn

Comments Off

In less than six weeks, my intimate relationship with the Africa Mercy will be coming to an end. My bunkmate Meg leaves in less than a week. I have been saying goodbye to many of my friends here over the past few weeks, and it seems that I will continue to do so for the next few. This whole process of everyone leaving has resulted in a lot of discussions about life after Mercy Ships. I would definitely say I am still mentally and emotionally invested in this time and place. As others are preparing to re-enter the "real-world", I am doing my best to apply my new "living in the moment" philosophy.

That being said, I have been reflecting on what it will be like to return to my fast-paced, time-oriented, comparatively complicated world. So many things that play on my mind, emotions, and time in normal life are completely eliminated, simply by living on the ship. Little worries, like why we don't have cheese on a more regular basis and how many times we will have to push start the cab on the way to the beach and whether or not my medication labels will be printed in English or Dutch are relatively minor compared to most of the issues that plague my ever-complex brain at home. I realize that this will take some getting-used-to. I also realize that I will have to relearn proper English. Unfortunately, it seems that the word "small" has completely replaced my need for any other similar word or phrase (like, "a little bit", "sort of", "minor", "kind of", "some", etc) in my vocabulary. This might be a problem in grad school. But, I think the biggest adjustment is one that I really don't want to make.

I feel like it would be far to easy to go home and lose this incredible sense of purpose that I have here. I had spent years before coming here thinking about how all I wanted to do with my life was to come to Africa and take care of orphaned kids. Obviously, over time, that vision became more refined, defined, and less like what you hear ridiculous Miss America contenders say when they are trying to come across as "humanitarian". But, I really do remember the first time I felt like I wanted to do this whole missionary thing. It was actually kind of ironic. Missions were for other people I thought. People needed help on the other side of the world, but so did people in my own community. I would be the one to help the people in my own community.

But then something in my heart changed. I actually remember the time and the place. I was sitting in church about a month before Christmas during my second year of University and we were watching a promotional video for the Christmas Shoe Boxes, organized my Samaritan's Purse. I cried really hard and thought that more than anything I had ever wanted in my life, I wanted to go wherever those people were and work in that hospital. Conveniently, I was in nursing school, and was on the perfect pathway to get there. Life carried on very uneventfully from that time, but from then on, I believed in my heart that my life's purpose was to come and help people in Africa. It wasn't a very dramatic or philosophical purpose. I just knew that there were people out there that needed more help than I could ever imagine and that it was my responsibility to go help them.

I had this idea in my head of what it would be like to hold a baby who had never been held by someone who loved them. Or what it would be like to give medicine to a small child who had worms causing pain in their stomach. Or what it would be like to give food to someone who was hungry. I knew it would be something incredible. I imagined what it would be like to look into their eyes and see thankfulness or joy or hope through the void of hopelessness. I guess I didn't ever realize that it would be indescribable. I don't think I realized how incredibly humbling it would be.

It is a rare occasion when I am without words, but situations like this are difficult to portray. It is hard to be greeted with such wholehearted appreciation when you know that what you are doing is only what God has called you to do. When I know that the only reason I am in the position I am in is because I happened to be born in North America and they happened to be born in Liberia. When I know that I lived a childhood filled with dolls and treats and comfort and love and dance lessons and friends. And they lived a childhood filled with war and poverty and loss. That they have no reason to look at me as some sort of martyr, because I am really doing the least I could be doing after all I have been given. But the things is, even with my heart breaking everytime a baby falls asleep in my arms or a Grandmother says "God bless you" for taking care of her loved one, I still can't get enough. It still is just the most amazing feeling I could ever dream up. I have said this before but there are times when I actually wonder how any moment will ever compare?

Most likely, I will not be a missionary forever. At least for the next few years, I will be a full-time student, and then I really have no idea where my life will go. At this point, I think it is likely that I will live a more "normal" life than I am living right now. Not making any predictions at this point, but the chances that I will get to rock African babies to sleep every night and lead bible studies at orphanages for the rest of my life is slim. I feel that this realization could cause my heart to be discouraged. On some levels, it is less-than-exciting to think about regular old life.

Every night as of late, before we go to bed, it seems that Meg and I end up engaged in a heart-to-heart, analyzing and defining the world according to us. The other night, as we were discussing the various paths she could take once she arrives home she brought up a point that has stuck in my head.

"What else am I gonna do with my life?"

After this, how can I possibly go back to regular life with a regular job in a regular world? In discussing the various options, it was hard to think of anything as seemingly significant as what we are doing now. But as I have put more and more thought into it, I think that she may have hit on something very important.

It is true, I may never again have the opportunity to do something as adventurous or unique as living on a multicultural, hospital-ship off the coast of West Africa. This really is an experience of a lifetime. But, the other options and pathways that my life will follow are, in no way, going to be less purposeful, important, God-centered, or God-oriented. I am going to consciously chose to take the motivation and lessons I have acquired here in this place and bring them to my "regular life". I am going to keep this spirit of purpose, knowing that I can make a difference in individuals' lives. Knowing that there are hurting people out there and that my greatest purpose can be found in serving them. Knowing that hurting people are essentially the same and just as human as the rest of us. Knowing that relationships are the foundation of life. Knowing that investing in others can transform lives. Knowing that no dream is too big. Knowing that "it's a small world afterall". Knowing that a small group of very determined workers can accomplish miracles (or however that quote goes). Knowing that, life, in essence is humorous and joy can be found anywhere. Knowing that making God the absolute center of every decision is crucial for success. Most importantly, the lessons I have learned are, in no way, exclusively to be used here on the ship. Overall, I think that is what I have learned and that is what God has instilled in me through this whole experience. Life is about purpose. My purpose isn't one-dimensional and doesn't end here. Living with purpose doesn't have to be on this ship.

I will be eternally grateful for having this experience and I really do hope that I get to return to Africa someday. But mostly I hope that my spirit of purpose and adventure stays alive well past these few months. I hope that something real and long-lasting radiates from me as I continue on in this journey of life.









Sometimes I don't know how to handle it.




The blatant contrast of extreme joy and extreme pain, all wrapped up into one tidy, compact little experience. The vast myriad of emotions that overtake me on a daily basis. Blessing and wealth juxtaposed against utter poverty. Feeling intense bewilderment and compassion towards a person all at the same time.




Friday, we visited Mama Victoria's Kingsville Orhphanage, out in the country. Liberia's countryside is unreal. Lush. Green. Picturesque. As we drive down the dirt road in our landrover, children run to the streets with huge smiles on their faces screaming "White man, White man, White man!".




We arrive and are greeted with overwhelmingly welcoming faces and embraces, mostly from complete strangers. We are given a tour of the buildings, which are already getting run down, a year after construction, from the 80+ children who inhabit them. We see their undressed ratty foam mattresses lying on bunkbeds that were constructed by veteran Mercy Shippers on previous outreaches.




We walk through their "kitchen", where old women are cooking massive pots of rice over open fires, knowing that similar fires have been the source of so many of the burn contractures of our patients.




We listen to Liberian music being blasted over a low quality sound system that we know was bought with money that could have been used to buy rice. Or add to the half-finished school building. The children dance. We make awkward attempts, but even white people who have been in Africa for half a year can't even begin to compete. They don't care. We all laugh and sweat and sing the words to songs we have never heard before. Little girls are dressed in their very best attire and have beads platted into their hair because today is special.




The program begins. One of the older boys recites an alphabet poem that he clearly wrote himself and is quite proud of. It involves the phrase "Kissing is the best part of love" and concludes with the indisputable statement that "Zebra is a member of the animal kingdom". Enough said.




The "Birthday Month Challenge" starts. A fundraising competition, to raise money for the school building project. For ten minutes, prominent people from the community dance around and put money into plastic Walmart bags in front of their respective month representative. Again, the horrible sound system is blaring music.




The nine of us each give probably no more than a dollar. It would be unfair to sway the competition by giving more. The competition ends and it is time for the counting. One younger man tries to collect the bags, which a number of others apparently disagree with. In typical Liberian fashion, they all jump him and everybody begins yelling incoherently all at the same time.




My stomach grumbles because it is 1:00 and my lunch is in the landrover. The child on my lap gets one meal of rice per day.




The grand totals are read. The month of May takes the crown with a grand total of 900 Liberian Dollars being raised (15$ in our world).




My lifelong goal to become friends with a monkey that isn't crawling on top of my car at the African Lion Safari comes true.




My perfectly representative African day.




I remember hearing so much in nursing school about how nurses function as the patient’s advocate. I remember starting my career and learning what that meant. I am now learning how universal that feeling is. How you can feel the exact same emotions and heartache and fight standing in a crowded ward with patients and families who barely understand you, make-shift equipment, and decisions being made based on the accumulation of knowledge from a group of doctors and nurses from all over the world with various backgrounds and experiences. It is odd how it all comes back and I am once again reminded that people are people, mothers are mothers, suffering children are suffering children, and nurses are nurses, no matter where they happened to be born or what circumstances they happen to find themselves in.

Baby Greg didn’t have the miraculous post-surgical recovery that we all hoped for. His trachea is “floppy”. Apparently, his little body had become adapted to having the cyst on his neck, and since he has been extubated, he has not yet been able to breathe well on his own. He is now on CPAP (which, for you non-medical types, gives him pressure down his airway and keeps his breathing tube open instead of collapsing shut). And, for you medical-types, we have had to rig it up here on the ship due to Greg’s desperate need.

I spent most of the day Tuesday with baby Greg, watching him struggle to breathe. The boy was absolutely exhausted. Whatever energy he could muster up, he was using to gasp and keep his body oxygenated. By two o’clock, I absolutely couldn’t handle it and we called a meeting to find a solution for our little one. We all knew that Greg was having troubles. The problem is that his issue (officially called “Trachea Malaysia”) will not resolve overnight. Typically, children take a number of years to outgrow it. At home, we would pop in a trach. Not so simple in Liberia.

After an hour of deliberating, the team of brilliant (I mean that honestly, not sarcastically) doctors and anesthetists were at a loss. If we give Greg a tracheotomy, we will solve his breathing problems, but that is a long-term intervention. One that we are not able to follow through with, and most likely would not be able to be properly cared for once the ship sails away.

But Greg was still laying in front of us gasping and retracting and breathing over a hundred times a minute, and it wasn’t ok. There had to be a solution. So Greg is back in the ICU on make-shift CPAP to help him keep his airway open. And that night, I got to see Greg relax and the panic-stricken look from his eyes disappear. For the first time in 36 hours, Greg fell asleep. He stopped sounding like a dying duck every time he took a breath. Nurses have been in the ICU day and night since then doing essentially nothing but keeping the mask on his face that delivers his airway pressure and silencing the ventilator alarm that goes off about every three minutes. I would do it for the next month if it would help his little soul.

It isn’t a long term solution. I don’t think anyone really knows what will happen with Baby Greg. He really needs a miracle.

To be honest, if a miracle is going to happen, I think this is the place. Ali and I were watching “So you think you can dance” after shifts of taking care of Greg and one of the contestants made a ridiculous comment that “they needed a miracle”. Ali laughed and said “You have no idea what a miracle is”.

So, can you pray for one? There is this horrible helpless feeling that nurses get when we want so badly to help and feel so strongly for a patient’s situation and we know that there is nothing we can do. I am there. I hate that there is no solution. So, I will wait for a miracle.

Playing dress-up with babies is one of the best parts of being a NICU nurse. As long and exhausting as the night shifts can be, I always looked forward to "bath-night" at the NICU at home, which most often involved less of a bath and more of a get-the-baby-onto-the-scale-and-back-into-a freshly-made-bed-as-quickly-as-possible-without-letting-his-sats-drop-uncomfortably-low. However, there was that one perk of getting to choose a matching receiving blanket, hat, crib sheet, and if you were really lucky and your baby was stable enough to get dressed, sleeper. Simple pleasures.

It isn't quite the same here. Unfortunately, there aren't as many old ladies around knitting us multi-coloured toques for our infants. And, I have yet to see a nice receiving blanket so I can properly bundle a baby the way every good NICU nurse desires to do.

But tonight, at the very bottom of a large pile of adult hospital blankets in a cart on D ward, I found a Bob the Builder blanket, which has the same general thickness and consistency of the receiving blankets of my dreams. I brought the blanket into the ICU and introduced mama to the North American phenomenon of Bob the Builder. The blanket was potentially meant to be a wall-hanging, but Greg's mama liked it. So, my little one got wrapped in a frighteningly large replica of a cartoon construction worker. Within minutes, baby Greg was settled and had long forgotten his intense desire to remove the pesky tube from his trachea.



I looked over at mama and saw an uncharacteristically large smile on her face.



"Bob is a handsome man" she said. "Greg is a handsome baby. They should be together".



And together they are. Sleep well baby Greg. In the arms of our good friend Bob the Builder.

I am on my second of three night shifts, working in the ICU with baby Greg.

There are three problems that I have found thus far with Greg. One, as I promptly informed his mama upon meeting her: Greg is not an African name. African babies are supposed to be named Darling Boy, or Handsome, or Allusain, or ideally, something that I cannot pronounce correctly. Not Greg.

Secondly, everyone seems to think Greg is five months. If Greg was standing up, I am fairly sure he would be taller than my almost three-year-old niece. Also, rumour has it that before he was intubated, he could talk. My extensive experience with the newborn population has taught me that five-month-olds do not talk. But, whatever.

Thirdly, Greg was born with a cystic hygroma: a very large, fluid-filled cyst on his neck. This potentially is the biggest problem plaguing Greg at present. The name thing he can deal with later in life when all his Liberian school mates with proper Liberian names exclude him from football.

But, five hours were spent on Monday "debulking" baby Greg's hygroma, and now it is gone. Greg has been left with a very large pressure bandage where his neck is supposed to be, and a tube down his throat so that his swollen neck doesn't cut off his air supply. In a couple of days, if all goes as planned, he will be extubated, transferred out of his personal NICU back to the regular ward and will begin to heal and recover. And, whilst I am confident that this goes against some universal rule regarding counting one's chickens before they hatch, I can't help but recognize that this was a "job-well-done" by some incredibly talented, devoted doctors.

I feel like so many of my memories from this time and place will be consumed by the very traumatic, dramatic stories of patients who had near or actual misses. I will never forget Sadie or Benjamin who will forever be entwined in our minds as we remember the beginning of this outreach. I can't help but be overwhelmed by the incredible transformation of Alimou. The picture in my mind of Abraham's little burned face will be one that I will carry with me long after I leave Africa. I tend to be greatly impacted by drama.

But, I want to remember the Greg's. The patients whose stories might not have initially gripped my heart or made a great story to tell when I get home. So much of what we have been doing here has to do, not necessarily with heroic life-saving measures, but with helping people in small, tangible ways. Maybe saving their lives. More likely demonstrating compassion that has been unparalleled in their world by meeting a practical need in their lives. I want to remember the babies who had their little cleft lips repaired and will therefore be accepted into their families and communities instead of living a life of shame and rejection. I want to remember the countless children who had their club feet repaired and will soon be running and playing with their friends. I want to remember the conversations that I have had with patients about the little things. Their lives and their families. I want to remember playing Jenga with Thomas. And how Gbor would want me to tuck her in and lay in her bed with her on the nights she was in the hospital by herself. And how Jennifer liked to sing Christmas carols while her bandages were changed.

Nobody can deny that it is the little things in life that make up life. Sometimes a seemingly insignificant word or conversation can change our entire perspective on a subject. A single act of kindness can change how we view others. If I have had the opportunity to be a part of these conversations or acts of kindness for any person here, than my time has been well spent.

So, hopefully nothing dramatic or life-changing happens on my night shifts with baby Greg. Hopefully, I just get to be a small, forgettable, invisible part of something that will someday positively affect his little life. And in that way, I will get to be a part of a miracle.

Blogging really is the "thing to do" for Africa Mercy crew members. I would argue that we nurses have the best job on the ship, because we get to play and spend hours on end with the patients, which, most of the time is purely enjoyable and rewarding, if not incredbly humerous. That's why I like reading my nursy friends' blogs. I love hearing about how other people perceive situations and their experiences with patients.

My friend Ali has quite an eloquent way of portraying what goes on in the wards. On numerous occasions, her renditions of patient stories have left me speechless (a rarity for me).

One of my most favourite things about working here (aside from all of the legitimate reasons a person leaves their life, family, and friends to live on a floating hospital in West Africa) is the things we say and do as health care workers in Africa that just would never ever ever happen at a hospital at home. Sometimes, I stop myself and realize just exactly what it is I am saying and have a hard time not laughing out loud. This week, while reading Ali's blog, I actually did laugh out loud.

http://www.alirae.net/blog/archives/81-mama-....html

And this is why I wonder how life will ever be the same!

One week ago Willemetta, one of the translators on the ward, went into labour. Fifteen minutes later, she had a baby.

It is most advantageous when African babies are born quickly. As Westerners, we tend not to consider the various problems that can present themselves during labour and childbirth in Africa. Sometimes, babies are born in hospitals. Many times, not. This eliminates the potential for epidurals, fetal monitoring, or crash c-sections. As I was reminded of by the translators at the baby shower we had for Willemetta on Wednesday: Someday, if and when I am pregnant and go into labour, it will be easy for me "because I am white". The whole "your life is perfect and easy because you live in America" mentality is pretty widespread amongst my African friends. I have to stop myself from becoming defensive when people imply such generalizations. The reality is that at least in this case, they are right.

On Tuesday afternoon, we got word from the outside world that a baby with gastroschisis had been born on Monday and would be coming to the ship. The thrill-seeking, adrenaline-junkie part of me got excited. I have been working on this ship for 4-months now and I can count on one hand the number of times when I have really felt "in my element". More often, I fumble my way through situations that I am slightly unsure of, asking a million and one questions, praying, and hoping that at the end of the day, my patients and coworkers remember only my dazzling personality.

But, disorders and defects in newborns is my comfort zone. So, for a very very brief moment, I was excited.

The most simple explanation of gastroschisis is intestines on the outside, instead of the inside of the baby's abdomen. As rare and visually disturbing as it can be, babies with gastroschisis born at home tend to do quite well. With our knowledge and special toys, we have become quite skilled at pushing the gastrointestinal system back where it belongs. Not to diminish the significance of the condition or imply that all babies do well; But, as a whole, outcomes are good.

The thing is, gastroschisis is still a significant issue. The surgery is a massive strain on the baby's body. Ideally, surgery should be done as soon as possible after delivery. Sometimes it is hard to fit everything back inside. It is necessary to provide IV nutrition for the baby until he can tolerate formula through his GI tract. The baby is at high risk for infection, due to the large opening in his body. The baby should be born in a high-risk delivery center, and have every precaution taken against infection. After the repair the baby's respiratory status can be compromised because there is less space for his lungs to expand. It is a process and a risk; But one that we are quite willing and competent to take at home.

Obviously, a baby born here with a gastroschisis has very little hope of the bright outcome that we offer to babies with the same condition in "America". Even with all of the expensive equipment and qualified professionals that Mercy Ships has to offer, we couldn't have saved this baby. What we could have offered him is nowhere near what it would have taken to give him a reasonable, successful outcome. It sometimes surprises me that after four months the "where you live determines whether you live or die" phenomenon continues to rip my heart out. I guess you aren't supposed to grow accustomed to that one.

Our awaited baby didn't ever arrive. Apparently, traveling in the Liberian taxi system when your intestines are outside of your body doesn't have quite the same efficacy in terms of survival as being wisked away to a sterile incubator immediately upon entry to the world. I know that we couldn't have saved him even if he had arrived. I know that it is better for him that I didn't get to show off my skills. I know that the ship of "Hope & Healing" has a specific goal and purpose and needs to function for that purpose. I know that we cannot transport America to Liberia. It just doesn't seem right knowing what is available out there and knowing that it will never make it here.


Yesterday, I stood on the dock and bid my bunkmate Megan farewell as she left this place, probably forever. We are solidly committed to meeting up later this year, potentially at Disney World (finally....after I have been waiting my whole life, I am going to meet Snow White. How lovely). That being said, saying goodbye sucked.


Goodbyes suck. Change is difficult. Loss of a person, place, or time in your life hurts.


I think that we tend to believe that whatever time and place we happen to find ourselves in is the best that life has to offer us. I suppose it makes sense. It would be maladaptive to live in the past and always regret that you aren't still there. And we have no idea what lies in the future. The unknown is always a little daunting. I guess that leaves us right smack dab in the middle of the here and the now.


Maybe it is just me. Maybe I am just a little too narrow-minded or self-centered. Maybe I put God in a box. Someday, I hope that I can whole-heartedly embrace change as an opportunity for life to get better.


I will miss Megan. She is one of those people who literally brings joy and fun and an overwhelmingly fresh perspective to life. My favourite type of people are the ones whose presence makes the environment happier and more fun. She wins that contest! This all gives my human self plenty of reason to be sad because our lives have gone separate ways for a time.


Instead, I have chosen to be thankful for the wonderful time that I got to spend with my friend. My ridiculously-valuable obsession with cliche words of wisdom has resulted in the not-so-clever-or-particularly-brilliant-saying "Don't cry because it is over, Smile because it happened" to be brought to my mind. I think that maybe we can choose to look at any situation in this way. Taking from it everything that it had to offer and teach. Treasuring it as a beautiful memory that we can take with us forever. Considering it as a wonderful blessing in our lives.


We are not promised to be blessed in any particular way indefinitely. We are promised to be loved. Loved by a God who is good and knows what is best for us and the exact timing of what is best for us.


So, with that, I will shed a tear for my friend's departure. I will thank God for bringing someone so beautiful into my life to inspire me and to laugh with me. And I will be excited for whatever is to come.


I like to play this game in my head when I am not looking forward to something. Prior to the unwelcome event or time period, I speculate about how horrible it could potentially be and then prepare myself for the worst. Having this healthy does of realism most often leaves me presently surprised. I applied this technique a couple of weekends ago when a group of friends and I went on a camping trip literally to the middle of nowhere. After committing to go on what turned out to be a rather enjoyable weekend, a pang of doom and fear entered my body as I considered how miserable a weekend on the beach at the dawn of Liberian rainy season, for a girl for tolerates camping at best, could be. As the weekend drew to a close, I realized that I had been having a good time, but I refused to admit it to anyone until I was safely back on the ship; clean, dry, fed, and showered. It was just too much of a risk.

I am deciding to take a similar risk tonight. My week so far could be described as nothing less than “brilliant” (my favourite new descriptive term, courtesy of my British friends and coworkers). That feeling of being “in the right place at the right time” has been following me around relentlessly. I think it is worth the risk of committing too soon and I going to confidently declare that this week I have been in all the right places at all the right times.

It started with what had the potential to be a long, drawn-out, “feeling-sorry-for-myself” weekend of working 12-hour night shifts. Not the case. Life is so much about the people you share it with and it couldn’t be more true when talking about night shifts for nurses. Luckily for me, I got to spend my night shifts with my friend Becky, a PICU nurse from Seattle, with whom I share many qualities, including a love for making kids laugh, the office, reheated chicken bread, and what we have chosen to call “prophetic charting”. The company made the weekend for me and all of a sudden I found I was feeling not quite so sorry for myself and just more than a little bit blessed to be in this place.

Already the week was off to a lovely start, but, as humans tend to do, I had my doubts that it could continue in such a truly lovely fashion. Enter God.

Over the past few weeks, I have been saying goodbye to many good friends, including a nice little group of six girls with whom many of my most favourite moments on the Africa Mercy have occurred. As of this week, it was down to just Joanna and myself. This could be a reason for one’s heart to feel a little abandoned. Instead, I got to spend the most relaxing, perfect weather, great food, amazing heart-to-heart conversation, exclusively one-on-one (that so rarely happens here) lunch date with my dear friend. We learned so much about each other that somehow we had missed over the past four months and talked through so many of the issues that are clearly plaguing the minds of young, single, North-American pretend missionaries preparing to go to grad school and enter a world of academia and competition that seems so foreign to us right now. Joanna left me a card when she left the ship that said “Thanks for lunch yesterday. My soul needed it”. Perhaps mine did too.

There are some moments in time where you feel like you wouldn’t want to be anywhere else. Where you almost feel guilty that you are there and other people aren’t getting to experience what you are. Where you feel like the advice you are getting shouldn’t really be free, because if everyone could hear it all of the world’s problems would disappear and we would all just want to hold hands and sing (which would be creepy, so forget it, I am glad it was just a small group of us). Most conversations with Dr.Gary Parker, the medical director onboard the ship, are such moments. The man is truly a legacy. After an entire career and lifetime of serving with Mercy Ships, he has authority. And that was exactly what the group of about a dozen of young wannabe doctors, nurses, pharmacists, surgeons, and Ph.D.’s sensed as we sat around him after dinner last night, soaking up every word and token of advice he had to offer. What was meant to be a goodbye party for a couple crew members turned into a question and answer session with Dr.Gary, who I can say without a doubt, we all aspire to be. He is one of those rare people in life who has all the brilliance, skill, personality, and greatness, yet successfully manages to combine and balance them with grace, humility, and compassion. It truly is incredible, and I believe that the truths he talked about with us last night will not soon be forgotten. It wouldn’t be an overstatement to say that he successfully inspired us to be tomorrow’s leaders reaping eternal rewards.

Finally, tonight we went to the orphanage that a group of us nurses venture out to every Wednesday evening to read and talk about the bible with the nine teenage / early twenties girls. Most weeks, I don’t want to go. I am tired by the end of my shift. Going out into Africa is hot and you get dirty, and anyone who knows me knows how I feel about getting dirty. But, alas, every week we get there and something happens and I know I wouldn’t want to be anywhere else. This week as we were walking towards the car, I told Kortu (my favourite….I know it isn’t ok to have favourites, but I do, and someday maybe I will get saved) that I really appreciate her participation in the discussion and that she makes very valuable contributions (obviously, I phrased it nothing like that, because I don’t think any of those words translate into Liberian English). She opened her notebook and explained to me “Every week, when you leave, I read the chapter for the next week. Then I read the chapter every day until you come back. I think of what it means to me each time I read it, and write something down each day.” I wish I knew what it was like to value something that much. I have wished in the past that my points in Bible Study were a little bit more like 16-year-old Kortu’s points. Now I get. Tonight, I learned a valuable lesson about how much she values her bible and her God. So, I wouldn’t have wanted to be anywhere else in the world.

If it is even possible, I hope my week goes up from here!

In less than six weeks, my intimate relationship with the Africa Mercy will be coming to an end. My bunkmate Meg leaves in less than a week. I have been saying goodbye to many of my friends here over the past few weeks, and it seems that I will continue to do so for the next few. This whole process of everyone leaving has resulted in a lot of discussions about life after Mercy Ships. I would definitely say I am still mentally and emotionally invested in this time and place. As others are preparing to re-enter the "real-world", I am doing my best to apply my new "living in the moment" philosophy.

That being said, I have been reflecting on what it will be like to return to my fast-paced, time-oriented, comparatively complicated world. So many things that play on my mind, emotions, and time in normal life are completely eliminated, simply by living on the ship. Little worries, like why we don't have cheese on a more regular basis and how many times we will have to push start the cab on the way to the beach and whether or not my medication labels will be printed in English or Dutch are relatively minor compared to most of the issues that plague my ever-complex brain at home. I realize that this will take some getting-used-to. I also realize that I will have to relearn proper English. Unfortunately, it seems that the word "small" has completely replaced my need for any other similar word or phrase (like, "a little bit", "sort of", "minor", "kind of", "some", etc) in my vocabulary. This might be a problem in grad school. But, I think the biggest adjustment is one that I really don't want to make.

I feel like it would be far to easy to go home and lose this incredible sense of purpose that I have here. I had spent years before coming here thinking about how all I wanted to do with my life was to come to Africa and take care of orphaned kids. Obviously, over time, that vision became more refined, defined, and less like what you hear ridiculous Miss America contenders say when they are trying to come across as "humanitarian". But, I really do remember the first time I felt like I wanted to do this whole missionary thing. It was actually kind of ironic. Missions were for other people I thought. People needed help on the other side of the world, but so did people in my own community. I would be the one to help the people in my own community.

But then something in my heart changed. I actually remember the time and the place. I was sitting in church about a month before Christmas during my second year of University and we were watching a promotional video for the Christmas Shoe Boxes, organized my Samaritan's Purse. I cried really hard and thought that more than anything I had ever wanted in my life, I wanted to go wherever those people were and work in that hospital. Conveniently, I was in nursing school, and was on the perfect pathway to get there. Life carried on very uneventfully from that time, but from then on, I believed in my heart that my life's purpose was to come and help people in Africa. It wasn't a very dramatic or philosophical purpose. I just knew that there were people out there that needed more help than I could ever imagine and that it was my responsibility to go help them.

I had this idea in my head of what it would be like to hold a baby who had never been held by someone who loved them. Or what it would be like to give medicine to a small child who had worms causing pain in their stomach. Or what it would be like to give food to someone who was hungry. I knew it would be something incredible. I imagined what it would be like to look into their eyes and see thankfulness or joy or hope through the void of hopelessness. I guess I didn't ever realize that it would be indescribable. I don't think I realized how incredibly humbling it would be.

It is a rare occasion when I am without words, but situations like this are difficult to portray. It is hard to be greeted with such wholehearted appreciation when you know that what you are doing is only what God has called you to do. When I know that the only reason I am in the position I am in is because I happened to be born in North America and they happened to be born in Liberia. When I know that I lived a childhood filled with dolls and treats and comfort and love and dance lessons and friends. And they lived a childhood filled with war and poverty and loss. That they have no reason to look at me as some sort of martyr, because I am really doing the least I could be doing after all I have been given. But the things is, even with my heart breaking everytime a baby falls asleep in my arms or a Grandmother says "God bless you" for taking care of her loved one, I still can't get enough. It still is just the most amazing feeling I could ever dream up. I have said this before but there are times when I actually wonder how any moment will ever compare?

Most likely, I will not be a missionary forever. At least for the next few years, I will be a full-time student, and then I really have no idea where my life will go. At this point, I think it is likely that I will live a more "normal" life than I am living right now. Not making any predictions at this point, but the chances that I will get to rock African babies to sleep every night and lead bible studies at orphanages for the rest of my life is slim. I feel that this realization could cause my heart to be discouraged. On some levels, it is less-than-exciting to think about regular old life.

Every night as of late, before we go to bed, it seems that Meg and I end up engaged in a heart-to-heart, analyzing and defining the world according to us. The other night, as we were discussing the various paths she could take once she arrives home she brought up a point that has stuck in my head.

"What else am I gonna do with my life?"

After this, how can I possibly go back to regular life with a regular job in a regular world? In discussing the various options, it was hard to think of anything as seemingly significant as what we are doing now. But as I have put more and more thought into it, I think that she may have hit on something very important.

It is true, I may never again have the opportunity to do something as adventurous or unique as living on a multicultural, hospital-ship off the coast of West Africa. This really is an experience of a lifetime. But, the other options and pathways that my life will follow are, in no way, going to be less purposeful, important, God-centered, or God-oriented. I am going to consciously chose to take the motivation and lessons I have acquired here in this place and bring them to my "regular life". I am going to keep this spirit of purpose, knowing that I can make a difference in individuals' lives. Knowing that there are hurting people out there and that my greatest purpose can be found in serving them. Knowing that hurting people are essentially the same and just as human as the rest of us. Knowing that relationships are the foundation of life. Knowing that investing in others can transform lives. Knowing that no dream is too big. Knowing that "it's a small world afterall". Knowing that a small group of very determined workers can accomplish miracles (or however that quote goes). Knowing that, life, in essence is humorous and joy can be found anywhere. Knowing that making God the absolute center of every decision is crucial for success. Most importantly, the lessons I have learned are, in no way, exclusively to be used here on the ship. Overall, I think that is what I have learned and that is what God has instilled in me through this whole experience. Life is about purpose. My purpose isn't one-dimensional and doesn't end here. Living with purpose doesn't have to be on this ship.

I will be eternally grateful for having this experience and I really do hope that I get to return to Africa someday. But mostly I hope that my spirit of purpose and adventure stays alive well past these few months. I hope that something real and long-lasting radiates from me as I continue on in this journey of life.