Jungle Bunks, Jungle Funk, & Jungle Fever: Pt 1

"For your kingdom" was my simple and yet heartfelt prayer as our team of surgeons, physician assistants, physical therapists, students, staff and hundreds of pounds of equipment took off headed south into the Amazon basin of Peru. The snow and single-digit temperatures of Minnesota were in sharp contrast to the 80+ degrees and humidity of Lima, the Peruvian capital and home to millions spread out along the coast of the Pacific Ocean. A few hours in a hotel and a short flight over the Andes Mountains placed us squarely within the Amazon Basin and the humidity of Pucallpa, a city of 300,000 literally at the end of the road, made me miss Lima. As we exited the plane to walk to the terminal, we were greeted with a bright sun, lush vegetation, and a perpetual sweat that would be our constant companion for the remainder of our time (thus the jungle funk - you fill in the gaps). :)

Feb 2015 Scalpel at the Cross Team @ Amazonico Clinic

The Amazon, perhaps the wildest and most untamed place on the planet, is a fascinating place that is ever changing.  In fact, the water levels during the rainy season rise 30 feet or more! A gorgeous place with plant life and critters galore, some of them more pleasant and attractive than others, was be our home for the next week. According to statistics, the Amazon produces 20% of the world's oxygen and hosts > 50% of the world plant and animal species. The plants, animals, and people of the region are accustomed to this natural ebb and flow of change and have adapted to both its blessings and challenges.

Peruvian Amazon from a float plane ride

We lived at Jungle Bunks, a beautiful house/lodge built to house visiting teams and part of a larger dream that began with two couples - Peter & Nancy Cole and Craig & Heather Gahagen - decades ago that materialized into a ministry called Scalpel at the Cross [www.scalpelatthecross.org] devoted to bringing orthopedic care to the people of the Peruvian Amazon in the name of Jesus.

We spent most of Saturday in clinic examining patients, reviewing xrays, listening to people's stories, and trying to decide who we could help surgically with the implants and supplies we had available. We celebrated with those we could help who had so patiently waited months and years for help. We also teared up with those we could not help or had to offer unpopular treatments because there was nothing else to do (i.e. amputation).  In eight hours of clinic there, our team saw 80+ patients with a level of pathology that most orthopedic surgeons do not encounter in a career. Nonunions (unhealed bones), broken hardware, failed prior surgeries (some of them unique), malunions (bones that healed crooked), infections, and combinations of all of the above filled the x-ray box as the surgeons could hardly contain our amazement and excitement over how interesting the pathology was.  We marveled that some people could walk at all with their level of pathology and yet express such little discomfort (compared to American patients) as they quietly persevered. 


We often refer to trips like this one as headed to the 'third world.' However, to look them in the face removes the tendency to talk abstractly about 'people in the third world' and reminds me that we both live in one world, not three.  Though they live in a low- or middle-income country, we share the same world - one world, God's world, a world where we are all equally created in His image. Though the Peruvian people are typically short-stature and small-framed, their perseverance, gratefulness, and joy in the face of difficult circumstances overwhelmingly indicted our western, self-centered worldview. Just as Jesus touched the leper, our purpose is to see others, regardless of circumstance, as fully human and to restore dignity to the best of our ability.

 'The notion that some lives are more important than others is the root of all that is wrong in the world today.' - Paul Farmer, MD

Sunday morning was spent at church with local missionaries and then that afternoon we took a boat ride through the canyos (sp?), a stretch of swamp-like, dense foliage present only during the rainy season that allows small boat access from the lake we lived on to the main Ucayali River, one the largest tributaries to the Amazon River. During that trip we spotted several iguanas, sloths, eagles, orioles and host of other birds.

Of note, a few of us (me included) go for a swim in the river back by the camp but only one of us was bitten by a piranha (wasn't me!)!! 

 Monday, Tuesday, and Wednesday were the bulk of our days of surgery. Depending on the size of the cases, we did anywhere from 2-4 cases per day per operating room. Believe it or not, the operating rooms were air conditioned!!! Wow was that amazing!! The level of orthopedic pathology was phenomenal and the majority of the cases we performed were very large complex surgeries, all performed without the use of live xray (a definite perk here in the USA).  The best thing about operating in developing countries is that you use what you have to do what you can for best possible outcome possible for the patient. No whining. No complaining. No excuses. Everyone is there for one purpose and it has nothing to do with  being pampered.

Reviewing an xray preop

Gia, Joe, Me, Dr Schmidtz

Working in OR

'It Is What It Is'

In the Company of the Poor (2013) continues to challenge me in ways never imagined. Paul Farmer and Fr. Gustavo Gutierrez, the physician and the priest, accompany one another on a journey toward "a preferential option for the poor," a phrase born in Gutierrez’s writings that shaped the mission of Dr. Farmer's NGO, Partners in Health (www.pih.org).  Gutierrez, the father of liberation theology and priest to the impoverished of Peru, argues that God consistently takes the side of the poor, the powerless, and the oppressed throughout the story of Scripture and thus the church is called to do likewise. 
 

If I define my neighbor as the one I must go out to look for, on the highways and byways, in the factories and slums, on the farms and in the mines - then my world changes. This is what is happening with the "option for the poor," for in the gospel it is the poor person who is the neighbor par excellence.  - Gutierrez, The Power of the Poor in History 

Farmer, an infectious disease physician, asserts that medicine inherently makes a preferential option for the poor because the pathogens themselves - HIV, TB, cholera, malaria, Ebola, etc. - are most at home in the midst of stifling poverty. The poor are sicker than the rich. "Follow the pathology and it will lead you to poor" he argues. Both men unapologetically take the side of the poor but reject simplistic answers as to what causes such conditions, particularly from ‘experts’ perched in academic ivory towers.  Poverty, particularly global poverty and all its sequelae, is a far more complex issue than economics alone.  There are much larger systemic forces at work and the ‘experts’ on such matters, per Farmer and Gutierrez, are its victims.
  
The priest 

Fr. Gutierrez refers to this systemic complexity as "structural sin" (Farmer calls it ‘structural violence’) noting that sin is not contained within the heart and mind of the individual but is inherent within the socioeconomic structures that allow the wealthy to get richer and the poor to get poorer, certainly references to the political corruption and dire poverty of his Peruvian homeland.

The poor person does not exist as an inescapable fact of destiny. His or her existence is not politically neutral, and it is not ethically innocent. The poor are a by-product of the system in which we live and for which we are responsible. They are marginalized by our social and cultural world. They are the oppressed, exploited proletariat, robbed of the fruit of their labor and despoiled of their humanity. Hence, the poverty of the poor is not a call to generous relief action, but a demand that we go and build a different social order. - Gutierrez, The Power of the Poor in History    

The physician

Dr Farmer recounts a story about his time in Haiti working alongside a young Haitian physician who lamented how much he hated his work and compared it to a "mediocre medical factory." Farmer notes that this young doctor also made no effort to change anything about his circumstances.

Not yet thirty (years old), the doctor had been socialized for scarcity and failure...even as I [Farmer] had been socialized for plenty and success. In other words, poverty had worked its way into the doctor's life too, even though he was not poor. This is exactly what is meant by the concept of structural violence: inequity that is "nobody's fault," that is just "the way things are," that we live with because we cannot or will not or do not know how to address the conditions that create unequal outcomes for rich and poor. (p.16-17) italics mine 

‘It is what it is…’

We (me included) have used this statement many times about a myriad of situations and issues, some of which matter very little and others that matter a great deal.  Yet, this statement says so much more than the five words uttered.  “It is what it is” acknowledges the realities of the situation around us (or at least how we perceive those realities) that we either unknowingly or knowingly acquiesce to.  There are things we can change and there are things we cannot…so why bother with the latter.  “Give us the wisdom to know the difference” ends a famous prayer – the Serenity Prayer - that addresses this tension we all live with trying to leave the world a better place than when we found it.  This tension infiltrates every corner of our lives – our relationships, our health, our politics, our religion/theology, our finances, etc.  ‘That’s just the way things are.’ ‘That’s just how he/she is. They can’t help that.’ ‘It is what it is. Deal with it.’

Discerning what is under our control and what is not isn’t an easy matter.  Many problems (i.e. global poverty, human trafficking, sexism, racism, etc) are so large and complex that we instinctively label them ‘out of our control’ because they are what they are – problems that require so much time, effort, and sacrifice that it is often easier to convince ourselves they are permanent fixtures of our world and ask God for the serenity to accept them rather than the courage to face them. We pacify our unwillingness and/or inability to act - whether from uncertainty about the next step, lack of courage, or whatever reason – with the same attitude as the young Haitian physician with Dr Farmer.  "It is what it is" is the mantra of 'structural sin & violence.'  It is a victory cry for the status quo.  It is a profession of our fundamental priorities and values and a pledge of allegiance to maintaining a world where injustice, in whatever form, is allowed to persist.   Farmer argues, “The idea that some lives matter less is the root of all that’s wrong with the world.” Certainly our attitudes are well within our control.
  
Such an attitude is most disappointing, however, when it is found within the church.  The central message of Jesus’ teaching was the presence of the kingdom of God – a kingdom where God’s will is done on earth as it is in heaven with justice, love, generosity, and peace for all, particularly the powerless and oppressed.  Jesus’ life, death, and resurrection redeemed the effects of sin – both individually and structurally - and in so doing offered the world an alternative to ‘it is what it is.’  We are free to see the world as He sees it, not as it is.  Thankfully we have many examples of those who have courageously and humbly confronted injustice on behalf of the marginalized, poor, and oppressed - Martin Luther King Jr, William Wilberforce, Mother Teresa, etc. However, there are countless others (me included) who have for too long bought the lie that ‘It is what it is’ is an acceptable answer in the face of staggering injustice affecting our/my neighbor(s) rather than offer an alternative of justice, dignity, and love.  For that I repent…

Stephens Family Transitions

Updates on our journey....

• Residency is Over! : On June 30, I officially finished my residency training in orthopedic surgery thus drawing to a close a five-year step in my quest to one day have a real job!!  I am slated to have such a job by the time I am 35 years old (I'm 33 now) and yes my parents are thrilled at the possibility.

• Said Goodbye to Michigan:  We have so enjoyed our time in Michigan over the past five years and developed so many wonderful relationships, especially through the kids' school and through church at Rochester. We have been blessed to sink some roots into the lives of some wonderful families that have worked their way into our lives. We deeply miss those friendships and are deeply grateful.



Bryan with his buddy Camden Brown

• 

  Luke Nicholson - 1 year old birthday party. Awesome little dude with an awesome family

  
  

• Moved to Minnesota: On July 1, we moved into our rental house here in Woodbury, MN (right outside of Saint Paul / Twin Cities area) and we are getting close to having all of our boxes unpacked and pictures hung on the walls. Our neighborhood is wonderful with a ton of kids for the boys to play with and we are settling in nicely (remind you it is summer here now) and excited about living here for a year. I will begin a one year fellowship (extra year of training) in spine surgery at Regions Hospital (St Paul, MN) in August and really excited about the training ahead of me.  

Three dudes and a Moving Truck!!

• Baby #4: For those of you that don't know, Jenn and I are expecting our fourth child in early October. We are very excited and yes it's another boy! Poor Jenn is sentenced to live in a boys' locker room for the next couple decades!! Tests thus far have shown the little guy to be healthy and big. :)  

Family pic when we told the boys!

• Samuel is Home: Our friend Amber Ratliff recently brought her son home from China after over a year of praying, fundraising, stressing, and preparing for all that goes into becoming a momma! We have followed her journey for a long time and are thrilled that they are finally together. We will miss our trips through Louisville. Her story is on her blog at www.aperfectlyperfectgift.blogspot.com. 

Amber and Samuel

• The Boys! : The boys continue to grow up like crazy! Garrett turned 8 years old a week ago and will enter 3rd grade this fall. He is a Lego-maniac . Luke is now 6 years old and cannot play enough sports to satisfy himself. He will be in 1st grade this fall. Bryan is 4 years old and growing like a weed with more energy than we know what to do with! We are blessed!  

Garrett's 8th birthday party, complete with his 8 chocolate chip cookie 'cake'

Luke