A Day In A Mission Hospital...And Not Growing Weary

 If you’re married, the following scenario might be familiar to you.

A husband is on his way home from a long day of work, perhaps not a bad day, but full enough that he’s looking forward to sitting down and leafing through a newspaper or journal while waiting to be called to the dinner table. He further imagines enjoying his family’s company and a good, home-cooked meal before settling in for the evening around family devotions and other worthy family activities. Ultimately, he is looking forward to his bed, a place of rest and retreat, to charge up for the following day’s work.

However, all of that hopeful anticipation is sometimes dashed the moment father opens the door…. On some occasions, the homefront stage is set as follows. There is no place to sit because toys and cereal are strewn about the entire house, and all the furniture cushions, probably once fashioned into an excellent hideout, are now only the remnants of a great territorial battle. A half-hearted attempt at cleanup sits at the welcome mat with something that looks remarkably like daddy’s underwear rolled in a mess of either cat vomit or a mixture of paint and who-knows-what.

There is no call to dinner; rather, shouting rings through the house as children argue with one another, and someone is howling somewhere – whether upset by having something taken away from them or literally dying is anyone’s guess. Dinner, in fact, was burned to charcoal half an hour ago, and we’re on to plan B, a hasty mix of smelly leftovers popping heatedly in the microwave and an old box of macaroni with half the powdered cheese already spilled and smoking in the fire of the stove.

The wife, probably red in the face and already crying, does not have any mascara streaming down her cheeks because she never got so far as makeup today. Her hair is undone, and if she’s not still in her pajamas, she at least has a healthy portion of flour down the front of her blouse. If anyone thought the bedroom was a retreat, that’s where half the children are currently bouncing on the bed or falling to break their heads.

If any of you husbands were ever so foolish as this man, you too might have sometimes come up with helpful questions such as, “Why didn’t you set a timer?” or “Are you aware the children made a mess in my office?” No, hopefully even the slow among us will learn that these sorts of pointers aren’t ever helpful in the moment. These are the times when a good husband will step into the world of his wife with love and, after a good, long hug, tell her she’s beautiful, correct a child or two (possibly involving a well-aimed swat), and then wash some dishes.

Fortunately, days like this, or at least days quite so rough as all that, are rare. And even so, such times in life are a season. If I had to make a guess at the situation of the above family (and I do have some experience in the area), I’d say they probably have between two and four children under the age of seven. Certainly, those were the most likely years for us to have such days.

All of that to say, ladies, I see you, at least to some extent. I think we can all relate on some level to the idea of a day where we spin our wheels and yet seem to accomplish nothing. Perhaps we were busy all day at home or work, but we stall out if we’re asked to show what we have accomplished. That isn’t to say nothing was accomplished. Perhaps excellent and valuable tasks we completed, or if not finished, moved forward, yet sometimes this is hard to quantify.

Many, many of my days in a mission hospital in West Africa are like this.

I was recently asked why some of my teammates were stressed, seeing as we didn’t actually have too many patients in the hospital. It was a good question, and though I knew that I had been busy and essentially everyone on the team had likewise been kept occupied, I didn’t know how to express why we were all so given to stress and weariness. So, I decided to keep track for one day and see.

Here is a day in the mission hospital (skip past the italicized portion if you want to move beyond the many details of the hospital day).

My day started early with some exercise and personal devotions. I drank my coffee quickly because I needed to run some cash up to the hospital before starting my day (a kind donor had sent some money to be used for patient needs).

After depositing the money in the benevolence cash drawer, I decided to spend some time knocking out a few emails. I had been behind on my emails since returning from furlough and hoped to play a little catch-up before morning report.

I opened my computer and waited ever so patiently while it booted, only to find that it needed to update before I could do anything. Sadly, the hospital's internet wasn’t working for me at that moment, so I went to see if I could find the one and only IT man employed by the hospital.

Before I could reach him, a hospital clerk brought me a death certificate to sign, so I went out to see who had died in the night and what the circumstances had been (both so I could fill out the report and be aware if anything medical was missed). I couldn’t get to the IT guy before it was time to go receive the 8 am medicine sign-out from the night call physician assistant.

Sign-out can take anywhere from twenty to forty minutes, depending on how many patients we have in the hospital, so it was about 8:30 am before the group of four doctors was given their assigned patients and dispersed. We only had eleven patients, so I planned to see only three of them myself. I hung back in the doctor’s office because a teammate needed a word of encouragement before we headed out to see our patients.

It’s important in this culture to take a few minutes to greet people, so once at the nurse station, I bid multiple nurses and other employees a good morning and asked after their families. Then I was on to the task of finding my first patient’s chart…not always a straightforward mission, but fortunately, my patient’s chart was readily available that day. I started by reviewing the chart: how were the patient’s vitals? Was he making urine? Were there any particular concerns through the night?

A short-term visitor needed some help, so I put down my patient’s chart to assist with the patient of the visiting doctor. Before I was able to return to my chart, a nurse approached me to ask me to restock the narcotic medications at the nurse station, so I took the requisition form in hand and walked over to the maternity ward to see if they too needed any narcotics at their station.

I found the maternity nursing station empty, so I looked around the hospital for a few minutes before finding the nurse back near the emergency room (a corner of the hospital). She let me know that they don’t need any narcotics at their station that day. On my way to get the medications, I walked past the patient whose chart I started in to say hello – he seemed to be improving!

Finally, the narcotics were stowed safely in their box at the station, but at the same moment, an urgent case was brought into the hospital, a referral from another clinic up on the mountain. There was no urgent care nurse on duty yet, so I glanced at the patient and saw that they were stable for the time being. I went to find the on-call physician, one of our visiting volunteers, and asked if he could see the urgent case.

As I turned back to the nurse station, a lab technician came to me and asked for the spare key to his supervisor’s office, as they needed to restock some of their reagents, so I went and retrieved that for him. On my way back, I stopped by my patient’s bed again just to say that I expected he and his family could go home later that day.

Just then, a two-week-old baby who had recently undergone a complicated surgery and had been struggling to breathe was receiving masked ventilation from a nurse. The nurse called me over to see the baby, as no other provider was nearby. I found that the baby did not have a heartbeat, so we began CPR and resuscitation efforts. I left a nurse running the code to help our visiting anesthesiologist also acquire medications for the operating room.

On my way back to the resuscitation situation, I was stopped by another volunteer needing advice on how to manage a patient. When I returned to the baby, they had gone through three appropriate rounds of resuscitation efforts, and, sorrowfully, I called the time of death for the child. I then went to look for the surgical team who had been managing the baby to share the sad news.

Before I could get to the operating room, I was stopped by the urgent care nurse who had arrived for duty but couldn’t locate their urgent call phone, so I helped them to locate that before continuing on to break the news to the surgical team. My next task, even more difficult, would be to communicate with the family of the infant who had all gathered now near the nurse's station. I had to let them know that their little baby boy had died despite all the efforts of the team. After offering them consolation amidst their tears, I went to bring one of our chaplains to continue comforting the family.

On my way back to the hospital from the chaplain's office, I was stopped by an employee who wanted to have a conversation, so I asked him to meet with me later in the morning when I hoped to have some time. Once at the station, one of the visiting doctors needed to run a few things by me regarding the new patient – all good medicine and good calls, but he needed to know what we have in Togo and what we can do in this context.

Then it was about 10:45 am, and I was able to open my first patient’s chart and write a discharge order and note. Just as I started to look for my second patient’s chart, the pharmacy supervisor came to me to ask for keys to the backup medication cabinet because the pharmacy had run out of a few medicines.

As I opened my chart, I was stopped by one of the surgical residents who needed to communicate with me regarding a patient that surgery and medicine shared. Then, a volunteer asked for help regarding two of his patients, and another visiting physician came up to ask about how he could make a hospital admission from the clinic. At this point, I was asked to fill out the death certificate of the baby who had just died.

Once I was able to turn my attention to my second patient’s chart, I found that the lab tests I had ordered for this patient the previous day were not there in the chart. Fortunately, it appeared as if the labs had been done, so I looked them up on the computer, but the printer wasn’t working for me, so I went to look for the clerk to print the labs for me. Since the clerk was away from his desk, I went to look for his supervisor. Upon finding the clerk supervisor on the far side of the hospital, it turned out he needed my help to fill out some benevolence account forms, so we went to the doctor’s office to do that.

The employee who had arranged to meet with me later found me there in the doctor’s office, so we sat down for a few minutes so he could ask me for a financial loan (a common occurrence here). I let him know that I would consider his needs and get back to him. After all that, I ended up never printing the laboratory results for the patient’s chart, but rather wrote the most important results in the chart with my progress note.

Our sending church VBS had previously raised support for us to buy guitars for local pastors, so I walked to our storage container on my way home for lunch to collect a few of those for a pastor who would be stopping by to retrieve them the next day. I had to attend an online meeting from noon to 2 pm, so I listened to that while taking notes, responding to the most urgent emails on my list, and eating a little something for lunch.

Once I was back at the hospital, I agreed to cover the call phone for the visiting physician so he could run an errand. I spent a little bit of time in the doctor’s office refilling the coffee pot, putting soft drinks in the refrigerator, and tidying up a little. I found an opportunity during this time to offer encouragement to a visiting doctor who was struggling after the loss of a patient (the Lord is so good to give these moments!)

Before finishing up in the office, I was called by one of the clinic nurses to help admit a new pediatric patient to the hospital. On my way to see the child, I was stopped by our sonographer to discuss my third patient from the morning (who I had not been able to see yet). He let me know that the ultrasound seemed to show a pleural effusion on the lung (a collection of fluid). So, I took a moment to review the patient’s X-ray and started the patient on antibiotics for pneumonia. By this time, it was about 2:45 pm, and I had finally seen my three patients for the morning.

Ultimately, I was able to go and open the new pediatric patient’s chart, but I was stopped by a clinic nurse to discuss a difficult case, and I offered advice and direction. Even as I turned to read the chart in front of me, another urgent case was brought into the hospital. This time, a child with a sickle cell crisis. I made sure the patient was stable before reviewing her orders with the nurse and then turning again to the chart in front of me.

The family of the non-quite-as-urgent pediatric admission was a Fulani family, an unreached tribe with a significant language barrier. Communication was therefore difficult, but this appeared to be a case of malaria, and I was able to review the chart and make the appropriate prescriptions in short order.

Then, by about 3:45 pm, I signed some paperwork for the supervising obstetric nurse before returning to the doctor's office to try to get to those remaining emails and some paperwork. On the bright side, the internet was working, and I was able to finish my computer update. However, my email wouldn’t allow me to log in at this point (sometimes logging in overseas is touchy).

The maintenance crew stopped by the doctor’s office to give an update on some repairs and ask about financial assistance for one of their Togolese workers. Once they were on their way, I took some money over to the administration office as a favor to another missionary, only to find that the administration secretary needed me to sign some paperwork for them while I was there.

Back in the doctor’s office, I answered some questions for a visiting volunteer before returning to my computer. By now, the internet had given out again, so I went to collect the clinic charts for the day so that I could review the work of the nurses and sign off on their notes. I went back and forth between charts and trying the internet until all the charts had been reviewed (about 50 charts), and the internet was finally functional, and I was signed back in to my email.

I worked for a little while longer, communicating with upcoming volunteers to the hospital via email, and started working on the next month’s call schedule. Around supper time at 6 pm, I signed back out to the on-call doctor as he had returned from his errands, and I made my way home for supper as we were hosting people in our home that evening.

Not every day is like that. That, for example, wasn’t a call day or a clinic day for me, just a filler day. A regular, no special ministry or assignments kind of day. Also, sometimes there are more or fewer visitors, or else more or fewer of my regular team around to help with some of these tasks.

I hope, if indeed you read all of that, that none of my ramblings come across as complaint. Nothing I’ve shared here is meant that way! It’s a joy and a privilege for me to do the work I do. Yet, sometimes, I find myself wearily asking myself at the day’s end, did I really do anything today? Was any of my work helpful? Were these various chores truly ministry?

I shared a morning devotion with my colleagues here on the field, probably more than a year ago now, and it touched on this point.

Galatians 6:9 says, “And let us not grow weary of doing good, for in due season we will reap, if we do not give up.” It’s important, first of all, to acknowledge the truth of God’s word, that doing good can cause us to grow weary. Otherwise, we would not be commanded to not grow weary from doing good.

The context of this passage discusses “sowing” in the flesh versus in the spirit. In either case, we use our physical beings to do physical things in this physical world, but some things, such as sin, are fleshly. We can live and act only in the flesh, investing in the physical world, while other things that we physically do turn out to be spiritual and of eternal value.

Paul warns us again in 2 Thessalonians 3:13 to “not grow weary in doing good.” The context here is similar. There are those who are idle, who are lazy, and don’t work. Also, “busybodies” who are equally useless in practice – the things they do are as useless as nothing. Paul also seems to warn against the idea of being weary in giving or showing mercy, then he goes on to give the above command to not become weary of doing good.

What shall we do then? How can we toil for good but also not become tired of our good work? In Hebrews 12:3, we get a clue regarding our antidote to weariness. It states, “Consider him who endured from sinners such hostility against himself, so that you may not grow weary or fainthearted.” Essentially, we are to look to Jesus to bolster our strength as we continue to do good. He has, like us, gone through this kind of suffering and difficulty, and his suffering, far greater than our own, has resulted in our own salvation.

We see again in 1 Corinthians 15:58 that the Christian life can be wearying, or at least that we can be tempted to weariness and think that our labors are useless, but they are not in vain: “Therefore, by beloved brothers, be steadfast, immovable, always abounding in the work of the Lord, knowing that in the Lord your labor is not in vain.”

Note the “therefore” and look at the preceding passage. All that takes place in the flesh only is actually of no use. Jesus said as much when he spoke of life in John 6:63, “It is the Spirit who gives life; the flesh is no help at all.” The flesh is useless. By itself, it is. Yet in the greater context of 1 Corinthians 15, we see that all that is useless, the flesh and mortality and sin and death, are subdued by what is real and purposeful and alive and victorious, Jesus Christ. We are therefore made useful, even our labors in the flesh, by the Holy Spirit of God, who causes us to labor in this physical world for things which are spiritual and eternal in nature.

Look at the words of Jesus in Matthew 11:28-30. “Come to me, all who labor and are heavy laden, and I will give you rest.”

On one hand, this is a message to the unbeliever, who toils under the slave masters of sin and Satan, but it is also a call to us who trust in Christ already. Yes, for us to also stop sinning, to be free of that burden of sin as well, and again. But also, to work and toil in a different way and for a whole new purpose.

We and the lost sinner alike might be tempted to think at times that we must work to purchase our salvation. The sinner is to be pitied, as his debt is infinite and he would have better success building a bridge made of pudding to the moon. While we, God’s children, throw paupers’ pennies into a golden fountain when we think we can add to the immeasurable purchase of our salvation.

No, the work we are called to is spiritual work of the kingdom, though we yet toil in our flesh. Christ further says, “Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden light.”

This is not to say that the work that we now do on behalf of the king isn’t difficult. Again, scripture indicates that we should expect to be tempted to weary of this work. No, this easy yoke and light burden include such works as sharing in Christ’s suffering (as in Philippians 3:10) and becoming like Christ in his death – even to the point of martyrdom! This was certainly true of the apostles as well as many Christians through the ages since. No, the ease and lightness here are something other than an absence of difficulty.

As was hinted from the passages from Hebrews and 1 Corinthians, the ease and the lightness come from the one to whom we are hitched. It is not our own yoke we take upon us; it is the yoke of our own master. He shares this yoke with us; indeed, he is the one who carries the entire load, and all we do is walk beside this gentle and lowly one. We find rest in Him because he has carried the burden and carries it still.

In Hebrews, we are told to consider Him – the one who endured so much on our behalf, and in the fifth verse to not despise his correction, his gentle nudge to show us the correct path. In 1 Corinthians, we see that our labor is not in vain because of the victory that Christ has already won over the flesh. And here in Matthew, we are reminded that we find rest in Jesus even as we toil for him.

Need you better proof of his presence as you toil? Christ’s parting words to his disciples in the last verses of Matthew are these from chapter twenty-eight, verse twenty: “And behold, I am with you always, to the end of the earth.” He is literally with each and every saint right now. Neither you nor I are alone or outside the presence of our master. What was the context? Jesus was giving us work to do…. The great commission preceded that promise.

So, perhaps you’re the frazzled mother today. I pray you see the eternal value of striving in your home, serving your husband and your children, even when nothing came together the way you would have liked. Look up, young mother, to the master who occupies the other half of your yoke. Find Jesus there, carrying the weight and choosing for you the right path. You have kingdom work, and the enemy would dissuade you from it by tempting you to weariness. Look to the Lord.

Are you in ministry? Are there a thousand mundane tasks that keep you from the work of “true ministry?” Follow in the footsteps of the humblest king. Be a servant and count every interruption as an opportunity to do something, though large or small, as if unto our very Lord. He carries the weight of our burdens when we cast those cares on him, just as we are commanded in 1 Peter 5:7. John Piper put it this way, “When you feel like you can’t take any more, look to Jesus and take a little more.”

There are scores of situations that will lead to the temptation to weariness. Christ is the only solution.

We know from Ephesians chapter six that there is a spiritual battle at every turn. We are encouraged in that passage to literally clothe ourselves in all that is Christ, to take up the all-powerful truth of God’s word, and to pray. Ask the Lord to uphold you, no matter what your situation. Sin is sin, but there are many deeds that are not clearly evil or good in themselves. The difference in carnal futility versus work of kingdom value so often rests in the shelter of our hearts. Turn your weary gaze upon the Christ and see him as your strength, but also as your prize. Make your work fervent in his regard, and you will find that he is the one who carries your load.

“Whatever you do, work heartily, as for the Lord and not for men, knowing that from the Lord you will receive the inheritance as your reward. You are serving the Lord Christ.” Colossians 3:23-24