What ifs

              Last week, we rested with my family in South Carolina. My mom and dad brought  together the men and women who have loved me from the day I was born, and they surrounded us with the peace that comes with unconditional love. I soaked in bits of wisdom on the waves of the lake, laughed so hard my sides hurt around the dinner table, got up on skis for the first time on a dare from my daughter,  and shared in the joys and struggles of my sisters, aunts, and uncles.  I paused for a moment, reveling in the humbling and certain reality that we are surrounded by phenomenal people who love us fiercely.

             From there, I headed north to Bristol for the beginning of our Samaritan's Purse Orientation. As I flew into Tennessee, the news flooded with the story of Dr. Brantly's fight with Ebola.  The risks involved in our journey confronted us on every screen and in every story. Kent Brantly is one of us -  literally - a Samaritan's Purse Post resident who had sat in our seats only 12 months ago. 

             Our colleague faced the crisis we feared, and we watched Samaritan's Purse mobilize -  seeing first hand the passion and love of the organization that has adopted us . We talked about replacing fear with strength, replacing worry with trust. I called David in tears and we played the "what if?" game.  What if the risk became greater?  Would we still go? And we rested in the insanity of the answer - Yes.

           Sitting in orientation, I listened to the stories of doctors who had come before us.  My heart resonated not with the stories of the best days or sunsets or safaris, but in the moments where God's strength resonated in weakness. Where He met them in the Rwandan genocide or the Kenyan bush or in the clefts of the Sudanese cliffs - the stories when the impossible was solved with the perfect plan,  the dilemma was reconciled with improbable schemes, and where provision came in desperate need. 

           The one thing we know for certain is that we are loved, and that whatever happens, this love is bigger than any illness or danger we could encounter in the world.  This love is so amazing that we don't want to miss a second of it because of fear.  So we go, not because it is safe or noble or even known, but because this is next for us and He goes with us.

-ari

Closing Time

We finally closed on the sale of our house this week. We are relieved, but too emotionally and physically exhausted to respond with much as far as tears or celebration.

Four months of hyper-vigilant cleaning, endless repairs and showings to make everything presentable and perfect are exhausting.  But, for all the stress and work, it was a wonderful home for us - absolutely beautiful and full of character and love.  There wasn't a single room where I didn't build or paint or tear out a wall. . .but it was a labor of love and will forever be a cherished place.

Now we are on to a new temporary home, an absolute blessing.  Chris, a nurse and friend of Arianna's  from the hospital, has given us the upstairs of her house. It is wonderful to have a new, safe, happy place in Birmingham for the next two months.  

Our girls have grown up what seems like years in the past weeks, spending time with their grandparents and best friends in South Carolina and South Georgia.  Annabelle, our strong-willed girl, taught herself how to swim, Madeline rode roller-coasters, body surfed, and caught crabs with bare hands.  

The biggest marker of the change was our last round of rabies shots today.  The first time, Annabelle screamed bloody murder and Madeline almost passed out from worry.  The second time was a little better.  Today, both girls hopped up on the table, didn't even flinch, and volunteered to hold Arianna's hand when it was her turn to be stuck.  

The coming weeks will be a blur of weddings, visiting family, and Samaritan's Purse orientation.  We will live out of suitcases and make memories and do more laughing and crying.  And then we will go, leaving home for home, leaving friends for friends, family for family.  Goodbye and hello are now sharply real.  We are nervous, excited, overwhelmed, optimistic, and all other emotions rolled into one.  Most of all we are grateful, for our family and friends who have absolutely saved us in the past weeks, and who are quite literally sending us on this crazy journey.  You who have fed us, clothed us, moved us, taken care of the girls, showed up when we didn't know we needed help, and prayed without ceasing -  thank you so, so much!

Madeline's poem: I Am

I was going through Madeline's paperwork from school today, sorting things as we pack, and I found this poem she wrote at school . . .a precious glimpse into her head:

I Am

by madeline

I am smart and kind

I wonder if I am fun

I hear birds sing about me

I see visions of angels

I want a good life

I am smart and kind

I pretend I am a bear

I touch a four leaf clover, wish

I worry that I will lose my school

I cry when I feel alone

I am polite and kind

I understand I will not always live in Birmingham

I say the oldest works hardest

I dream for happiness

I try to help - I hope I live in peace

I am smart and kind.

This is the first week the girls have expressed trepidation about moving and not pure joy - it's interesting to maneuver the situation, to listen and respond, to reassure but not dismiss. . . This move will  be wonderful for our children, but it is also going to be terribly hard.

Need. . .

Four  months from now we're moving to another continent. . .

Our house has been on the market almost 2 months now, and my day is filled with to-do lists about insurance and  licenses and packing and house projects. I am trying not to worry  - not about logistics and details and what-ifs, as I am prone to do. Those things will work themselves out.

 I worry about leaving well. I worry about securing bridges that span an ocean - about trying to express to my friends how much they mean to me and that I need them. And I feel I am failing daily.

I am struggling - struggling to be real, to be selfless, to reach out instead of retreat into myself. Leaving involves seeing my fallibility - the dichotomy of my desire to be a perfect friend and my inability give and receive generously in every direction. I struggle to not meet offers for help with the  inaccurate rebuff that we have it under control.

Admitting need is not something I do easily. I'm more the  - "help is great, and I appreciate it, but I would like to continue to spin these 17 plates at once and prove I can do it while trying to help you spin your plates too" kind of person. But these days, every moment has a way of pointing out  the impossibility in this. . .

Every day is a step in the direction  of me admitting that this move is really hard - that dismantling one life to build another risks watching everything crumble around my beautiful family.  Deep down, I know that nothing will crumble - that God is building our story and our bridges and our safety net with deftness and perfection. But some days, I know that with more clarity than others.

So, thank you for walking with us, and thank you for  having patience with me. Continue to laugh with us at the dichotomy each day brings. . oh, and hugs, lots of hugs. I need them.

-ari

Preparation

Our days are filled with packing and sorting, prioritizing, culling, and whittling down to the bare essentials.

This week, we organized massive piles of memories for our yard sale on March 1st. Today, we put Belle's nursery bedding up for sale, and I smiled through tears as my too grown-up girls played in the next room.  In 4 weeks, our house goes on the market.

This home, where Madeline learned to talk and climb, where we brought Belle home, where our marriage became stronger, where I crashed after countless nights of residency and fellowship calls learning how to be a doctor,  and where we became a family. Our yard - with its rocks that Madeline insists holds fossilized T-Rex prints, with its perfect light and memories of snowball fights, violet fields, safari expeditions, princess knights and tadpole parties. 

I am excited about the adventures that lie ahead  - about new homes and new yards with monkeys and views of the Great Rift Valley. We bought our plane tickets on Friday, and we fly from Birmingham on September 22, 2014.  Today, though, I am just so grateful for this life we have built -  for the joy and struggle and triumph this place and these things represent.  

Where is Kijabe?: frequently asked questions part 2

I've combed through the earlier pages of the blog several times this week to try to give people a better picture of where we're going, so I thought I'd put together a post that paints a picture of Kijabe a little more concisely. Some of this is repeat if you've been following closely, but other info might be new

First things first, where is Kijabe?

It's about an hour Northwest of Nairobi, the capital of Kenya. There's actually a satellite image on Google Maps if you want to see the detail. We'll be living at Kijabe Mission station, not the town with the same name about 2 km away. In the Maasai  language, it means "place of the wind" and the town sits perched at about 7,200 feet above sea level on the edge of the Great Rift Valley. You're not going to find it in any books on Kenya, because its a little collection of houses, hospitals and schools down a 6 km dirt road off the main highway, but we're excited to call it home.

What is the hospital like?

Unlike a lot of doctors in the post-residency program, we have the advantage of having been where we're going, so we have a general idea what to expect. AIC Kijabe Hospital is a 320 bed mission hospital that takes care of adults and kids that was established in 1915 (so we'll be there for the 100 year anniversary).

Here's a picture from a house when it was being built we received from on of our friend's husband's grandfather who helped found it. . . 

I didn't venture much into the adult side of things, but the pediatric side consists of  a simple and efficient concrete building with common wards, an OR, a nursery, and an ICU. It is a training hospital with residents and fellows assigned there to learn  general specialties as well as pediatric neurosurgery and pediatric surgery (giving us the amazing advantage of being able to address those issues quickly, which is no small miracle). 

We have a wonderful pharmacy, and the pathology lab does tissue diagnostics for 37 mission hospitals in East Africa

hospital entrance

ED and Maternity/Pediatric Clinic Entrance

Intensive Care Unit (this is half of the 5 bed unit)

General ward with 6-8 beds per room and oxygen on the walls in between beds

Bilirubin Lights in the nursery

Code cart that we made while I was there for the clinic

Pharmacy

Rounds with the Residents

View from outside the Children's Ward

What kind of things will you be treating?

A little bit of everything, it seems - from well newborn babies, to premature infants, to infants with severe birth defects, to meningitis, bronchiolitis, asthma, pneumonia, tuberculosis, AIDS, severe malnutrition, gastroenteritis (both bacterial and viral), heart disease of all sorts,  infections, birth defects from viruses mostly prevented by vaccines here, children waiting to have shunt placed by neurosurgery or to get healthy enough to have a corrective surgery by the pediatric surgeons, malaria (although not as much as you would think because of our elevation), and then countless other things I can't even begin to imagine. Like medicine in the states, the body is an amazing thing both in the way it manages to get sick and the way it heals. Every day was filled with surprise, failure, small victories, and constant learning. 

What other doctors will be working with you in Kenya?

When I get there, 4 pediatricians will make up the team of doctors taking care of the kids in Kijabe.

  Jennifer Myhre has been in Africa 20 years and Kenya for 4. She and her husband are American, but they carry the weight and wisdom of having created a home in Africa for so many years. She has 4 fantastic kids, and I can't wait to begin to learn from her. She's also an amazing writer, and you can probably learn more about what we're going to be doing from reading her blog than from mine. 

(http://paradoxuganda.blogspot.com/)

Sarah Muma and Imma Kariuki are both Kenyan pediatricians working at the hospital. They are both moms, wives, and amazing role models.  Imma is there now (although currently on maternity leave with her son), and Sara will be moving back about a month before us with her husband who is a pediatric surgeon.

Mardi Steere is a pediatric emergency medicine doctor from Australia who did her EM training in Florida. Right now, she's the medical director of the entire hospital, so I won't get to work with her directly in patient care at first. She was the doctor that greeted me during my meltdown at the end of my first call weekend, and she already has a knack for knowing me a bit better than I know myself. We loved our time with her, her husband Andy, and their two kids that are close to Madeline and Belle's age, and we can't wait to get to know them better.  Their blog is amazing as well, and Mardi's husband is a jack-of-all trades engineer theologian and his perspective might give you a better idea of things David may find himself doing.

(http://www.steeres.com)

Eric Hansen is the pediatric surgeon that we'll be working with (along with Sara's husband, whom he trained) - and the reason that we found Kijabe in the first place. He was a surgery fellow when I was a resident and may be one of the most generous, caring, down to earth physicians I have ever met.  4 years ago when he and his wife sat on our couch and joked that they needed a pediatrician for their kids in Kenya, we had no idea where the road would lead us. Their kids are also close to the girls ages and we are looking forward to learning from them as well. 

(http://uncommonroad.blogspot.com/)

What will your schedule be like?

Between the four of us, we will need to cover the wards, consults, ICU, outpatient, and nursery/NICU. Most days will be 8-6ish and then I'll take call  about once a week and every 4th weekend. We have some wonderful other physicians that help split call to make that possible, but as people come and go, have babies, or get sick (one of the pediatricians there now had a ruptured appendicitis last month) it will probably be bit busier than that sounds. I'm excited to be working with women that have families, and who, even in my short time there, reminded me of the importance of balance and boundaries. More sick children and more work always exist, and it will be a constant struggle and challenge to find the place where I can be mom, wife, physician, and friend with grace and joy.

Road to the market and church outside the hospital

Road to our house about 1/4 mile from the hospital

Kijabe sunset over Mt. Longonot

Okay, perhaps there will be a part three to the this post, but there's a glimpse of the next phase of our lives.