Thursday, December 31, 2020

What a Year!

As we move into a new year, it is hard to believe that in January, we will have completed six years of work at Tenwek Hospital. This time of year is often a time of reflection: on the passing year, the coming year, successes, failures, goals, hopes, dreams, losses. In essence, we reflect on life. This year has been the most taxing of our life in ministry and probably the hardest since we have been married. We find ourselves reflecting on that realization, recognizing that we got married at the beginning of a grueling five years of surgical residency and have certainly had plenty of struggles in the past decade. This year has been difficult.

Madison and a friend on the beach in Rhode Island.

One of the things that we have tried to balance, as missionaries, is how to be honest and open in our struggles while wrestling with the idea of maintaining the confidence of our friends, colleagues, and supporters. It is easy to become fearful about showing struggles, conflict, or pain. Fearful that others will not understand. Fearful that if supporters know we struggle, our support will wane. Fearful that if our organization becomes aware that we are flawed, we will be asked to leave Tenwek. Fearful that those we love and serve will know our inadequacies, and if they do, that will make our lives even more challenging.

Yet despite always wanting to be better, we are still just us. We understand in our heads that we are inadequate, but at some deep heart level, we want to be more adequate than we are. We want to say that we have welcomed the challenges and thrived. We want to embrace the idea that God is using hardships to refine us. We want to report that we enter this year with a new sense of calling and purpose.

But the truth is that, as for many of you, this year has been hard. We are tired, worn down, and have questioned our purpose. We have been hurt, we have experienced grief and loss, we have felt the loss of control (or what we thought we controlled), we have been abandoned and betrayed, we have felt incompetent and ineffective. And for those of you who know us well, those are not feelings we relish! Further, we have endured the harsh reality of not living up to expectations, others’ and our own.

This year, the costs of medical missions and cross-cultural ministry seem to have piled up. I read the following statement in a blog. “When people said missions was going to be hard, I assumed that meant I’d be cold or face difficult living conditions or struggle with the language. But for me the hardest part is what goes on in my head—like feeling discouraged or getting frustrated with companions or not liking talking to strangers—just dealing with all the ups and downs, the rejection, the change.” This resonates deeply with our experience. It is hard to have these struggles even while we feel a (mostly self-imposed) need to maintain a fa├žade that conveys that we have it all together. At some level, we had the expectation that after some years, things would get easier. Maybe not easy, but easier.

And still... 

This year, we were scheduled to be back in the US for our home assignment or furlough time. While most of that time was in Rhode Island, it did not look at all like we had planned. In coming back, we arranged a time of debriefing and counseling at Alongside, an organization that works with those in ministry and missions, mainly pastors and cross-cultural missionaries. Our family was able to spend 3 weeks of intensive time there, an experience that was validating, educational, thought-provoking, affirming, full of truth and wisdom, and allowed us to begin the process of healing and moving forward. The staff of Alongside were both genuinely compassionate and really good at what they do. This allowed us to hear the truth that they spoke into our lives. We spent mornings in seminars about a variety of topics: grief and loss, anxiety, anger and forgiveness, moral injury and burnout, and conflict, as a few examples. We participated in both group and individual counseling times. We rested and processed in a way we had not been able to give ourselves permission to do. We wrestled with hard questions. Is this just a stressful season or is this unsustainable? Would it be the right time to leave or would we be giving up? Can we be effective and healthy in the work we are doing? Is it about effectiveness or obedience? What might it look like to move forward in a healthier way? What sacrifices are good and right? What sacrifices are damaging? How do we develop Godly grit without falling into the trap of Godless grind? We struggled knowing that we needed to make some immediate decisions based on Madison’s return to in-person school in mid-January. Tough things to contemplate, and it was good to have the time and space to begin to do so.

This last month has been a roller coaster, but in the messy and uncomfortable process, we have begun to glimpse hope, which is no small thing. In acknowledging and allowing ourselves to experience the grief, we have been able to begin the healing process. And after prayer, thought, and wise counsel, we decided to book our tickets back to Kenya in January. We have identified some tangible changes that we believe will help us to thrive rather than to simply get through the crises. One, we identified a need to strengthen our community. Despite the fact that we live in a community, we have not had true or real community. Being strong introverts, we tend to minimize our need for others. We need to do this life with others in a desperate way. Two, we need to work at not conflating our worth, or inherent value, with our significance, or the work that we do. The work that we do is good, but it does not define our value as people. The clear danger in this error in thinking is that when we fail in the things we do, we feel as though we have lost our worth and meaning, and this leads to shame and disappointment. Three, we need to strive for sabbath and margin. Over the years, we have read and heard so many thoughts about the importance and purpose of sabbath rest. We have not embraced these ideas. We tend to use days off from the hospital for more work, to catch up on things that we have neglected, or to prepare for things upcoming. We cannot continue this trend. This will mean changing some of our clinical, educational, and administrative structures. This may mean we are not as productive. We hope it means that we better honor Christ in our lives. Four, we need to learn to grieve and lament the losses we experience. Whether it be patients who die, colleagues who leave the field, or our daughter moving to boarding school, we need to lament in a way that acknowledges the pain of loss and the hope we have in moving on.

Even in the midst of the pandemic, we were able to enjoy times of refreshing together as a family.

We write all this to you, those who love us, pray for us, encourage us, and support us, in an effort to be vulnerable and humble. We need you to know that we have been and are still, (though to a lesser degree) struggling. We believe this sort of honesty is desperately needed, and we realize that will never be possible unless we try. We need prayer. We need encouragement. We need accountability. We need love and acceptance. We need hope that the path is worth the cost. We want to thank each of you for standing with us and giving us the space to share these things. We want you to have permission to be honest and share, as you desire, your own struggles as we pray for you.


As we move forward into this year and return to Kenya, here are some ways you can continue to support us and care for us as you have so well these past years.

1.      Pray for Madison as she returns to RVA. This was a tumultuous year for her as well (as I mentioned in our last blog). It will have been 10 months since she was last in in-person classes. Many of her friends from last year graduated, and some of her closest friends are not returning to RVA. This will be a time of transition for her, much like starting over 

2.     Pray for Bob and me as we work out our roles, positions, and responsibilities going forward. We want to make good decisions, not only for ourselves but for our colleagues and co-workers as well. Pray that we would be able to implement the changes we have identified.

3.      While for many of us this has been a difficult year financially (we very much understand this), if you find yourself in a position to allow some extra financial support, would you consider Alongside? We would love others to have the opportunity that we have had there. They subsidize the cost of their programs through donations and have scholarship funds for those who need extra assistance.

4.      Hold us accountable in those changes we have identified. We love emails (or even snail mail) that lets us know you are thinking about us. Feel free to ask the hard and probing questions, but give us grace in our responses. We enjoy encouragement as well!


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