The Hem of Jesus
Overcoming challenges of any kind has its own rewards. When we offer a medical treatment that leads to full recovery in a setting with limited resources, a deep sense of satisfaction stirs within. Together with a dedicated team, we overcame the challenges. Against the odds, we brought high quality healthcare to the entropy of the jungle. For one person, we beat the chaos. We won. And even if only temporarily, we get to celebrate that victory.
When our team steps into a dangerous setting and intervenes for someone spiraling towards death, especially for someone who has no other options, the rewards are that much more intense. The most painful, the most terrified, the most grateful moments of a person's life—and we are with them lending a hand, breathing deeply. To be part of that team, partaking together in those sacred moments is food for everyone's soul.
But just as important, are those times where our best efforts don't change the outcome. A 19 year old young man stepped on a landmine. We gave him 10 units of blood, a laparotomy, an amputation, IV antibiotics—everything we had. And still, after two days he died.
Or when we do palliative surgery for cancer. The surgery relieves some immediate symptoms and prevents others that would be hard to tolerate, but we know it won't change the outcome. Time and again, something subtle but important happens.
Recently, a 60-year-old lady came to RTC with obvious jaundice and terrible itching over her entire body. On ultrasound, our staff saw dilated intrahepatic ducts, a distended gallbladder, and a vague pancreatic mass. They suspected the pancreatic tumor was likely malignant and obstructing the common bile duct, leading to elevated liver enzymes, bilirubin (causing jaundice), and bile salts (causing the itching). Initially, they planned to do a triple bypass surgery to reroute the bile duct, the stomach, and the pancreas—not a small operation, especially for the jungle. But after consulting with our hepatobiliary surgeon friend, Dr. Augustine decided to follow the international trend and skip the pancreatic bypass. Over the course of a week, they prepared special instruments and located potential blood donors. During the actual surgery, Dr. Zu provided general anesthesia. One of our PA surgery students, Sai Sai Po, assisted Dr. Augustine in the four-hour surgery. Unfortunately, they did indeed find cancer of the head of the pancreas. They rerouted the plumbing as planned and removed her dangerously dilated gallbladder. Now the patient is 10 days post-op. She is doing well and has just been discharged. Her prognosis has not changed, but at least her jaundice and itching are gone. She can spend her last days resting without that torment.
Another time, while moving our Mobile Surgical Hospital near active fighting, we came across an old man collapsed on the side of the road. His elderly sister sat helplessly next to him. We stopped and examined him. He hadn't eaten well in months and was clearly dehydrated. So, we tanked him up with some IV fluids right where he lay, then sent him back to RTC. It turned out, he had a malignant gastric outlet obstruction. Constant bloating, nausea, vomiting and pain for months is a slow, agonizing way to die. Dr Augustine did a gastric bypass surgery and explained to the sister that it would not cure him. Still, all he wanted was to eat a few more meals of rice and fish paste. I saw him a few weeks after the operation—thin but able to walk around and eat. He wore a big, kind smile. In my mind, all we had done was relieve some symptoms. So, I was surprised by how genuinely grateful he and his sister were. She started taking care of us at the Mobile Surgical Hospital in every way she could—cooking, cleaning, even offering to do our laundry. I got a hot cup of water from her every morning for my coffee. She knew we hadn't changed the outcome. But she also knew we had done our best. We had stopped at the side of a road, even though the fighting was close by. We had put our hands on her brother and done what we could. Somewhere during that process, a profound gratitude was born.
Often, it is decidedly NOT dramatic. And yet I'm coming to believe that one of the most important things our medical staff does in the jungle is simply this: to be with patients and to offer each one our best. We talk about our faith and openly pray all the time. But honestly, our actions carry more weight than the words. It feels like by being present and doing our best, together—patient and healthcare provider can reach out from the crowd and touch the hem of Jesus. Something holy happens in that moment. And sometimes it is miraculous. You can't do a a Hepaticojejunostomy-gastrojejunostomy-cholecystectomy in the middle of a jungle war zone without a few very skilled people being present and many, many others giving their best; donors, people who pray, administrators, drivers, engineers, builders, PAs, nurses, doctors. Somewhere in that collective offering—regardless of outcome—a portal opens. Subtle. Quiet. But real. A breath of eternity woven into time.
As humans, we are not supposed to give into hopeless situations. The hero always finds another way to reach the goal. As healthcare providers, we are never supposed to give up on hope. Yet here it is—a hopeless situation. A palliative surgery would give only a few more meals to enjoy. Not more time. We could honestly offer no hope for that. In fact, the sense of hopelessness threatens to overrun us all.
A war is going on here—into its 4th year now. Our staff are getting tired. China and Russia, and the indifference of the rest of the world, seem to be empowering the dictator to continue atrocities with no end in sight. Even Christian organizations are lending credibility to a brutal regime in the name of earthquake relief, empowering him to bomb the very people he claims to be asking aid for.
In the gospels, when the poor widow dropped two small copper coins into the collection, Jesus said she had given more than all the rest—because she put in everything—all she had to live on. Sometimes, I imagine Jesus meant that literally. She gave more than the rest. Not just comparing the percentage of what she had given with others but in terms of what those two actual copper coins went on to accomplish with Jesus’ ability to amplify gifts so given.
Certainly other, all-in gifts with Jesus, had far reaching consequences. The boy who gave his five loaves and two fish ended up feeding several thousand people. The disciples left their nets, boats, income—everything—to follow Jesus and changed history. I think of David running towards Goliath with his five smooth stones. The cancer patient above indeed died a few months after his surgery. As with the fate of the widow’s coins, we don't really know where our gift to these patients ended. Our offerings didn't feed thousands. History hasn't changed. The giant still lives. Yet, I can say: we held a space open for mercy and grace—while peace and joy flowed into a hopeless situation. One patient can smile and enjoy one more meal of rice and fish paste. Another can sleep without itching. Somehow, sharing these sacred moments with others makes all the difference in a world being overrun with hopelessness. Together we touch the hem of Jesus.
You kneel by the broken
and offer your hands
not to save, that’s not yours
but to hold space
for mercy and grace
to find its way in.
And later, in the dark
when it’s quiet and alone
you feel it in your bones
something sacred
passed between you.
