I had no desire to be a nurse. Honestly, when I heard the other nursing students giving their reasons for choosing nursing, mine felt shallow. No one in my family was in health care. I come from a long line of engineers, teachers, and postal workers. I said I wanted to be a nurse because I had an interest in science and liked helping people. The actual reason was because my sister picked it. She picked nursing because she thought I had. We had no idea where it came from. Being only a year between us, we entered nursing school a semester apart. I have no great story for why I because a nurse. I just chose it on a whim. Considering I had never been past the doors of an ER (Emergent, acute or emergency room to my international friends), I had no idea what I got myself into.

Nursing is one of those careers that will let one know real fast if they are meant for it or not. Thinking the tough part was over when I graduated, I started working three years ago. Little did I know. I knew nothing about what life was really like for a nurse. Nursing school could not prepare me for it. In three years I’ve managed to get kicked, punched, jumped, almost bitten (on Christmas no less), yelled at, hugged, threatened, and grabbed. If you are curious, I worked in cardiac telemetry, not a psych unit (though that was in serious debate at times). I’ve been with people as they die, as they were born, at their darkest times, and at their most joyous. I’ve seen how dark or pathetic people can become and I’ve seen bravery and courage I doubt I could have. This career has shown me humanity in its full spectrum. It’s aggravating, beautiful, annoying, and humbling at the same time.

When I came on board the ship, nursing and I had a strong love/hate relationship. While loving the autonomy of being a nurse, I could not agree when I was in charge of a 36 bed unit with six patients of my own, one coding, on the way to ICU, and two total cares. This place has been rehab from nursing for me. Is it tough? At times. But the difference is the people here. There is an enthusiasm to help here that is both contagious and comforting. I was nervous when I got here. Imagining my hospital on a ship, I thought this was potentially a bad idea.

We come from a variety of specialties. Some of us are ward nurses at home, others ICU, ER, or labor and delivery. We have nurses of forty years working with those a couple into the profession. It works out though. In the beautiful (though chaotic sometimes) tapestry of the nursing here, it all comes together. One of us knows Pedi patients, another has incredible bed-side manner, one may act calm and focused during a code, and another may have the gift of patience. It’s amazing it all fits together.

I had people at home ask why I came here. Before I could think of anything eloquent to say, I’d tell them it was something I always wanted to do. It was just vague enough to answer their question, whether or not it made sense. Over the last few months though, I’ve been given the chance to consider that question again. There is always something behind what we see. Something is always behind our thoughts and decisions, behind me and behind Mercy Ships as a whole.

The question is:

Why would anyone want to live on a ship to take care of strangers on the others side of the world?

It is because of the love of Christ.

Let me explain.

Two thousand years ago, Jesus Christ came to earth as the salvation for all mankind. Being both God and man, Christ lived the perfect life man could never hope of achieving. On a certain Friday, Christ walked up to Calvary and allowed himself to be nailed to a cross. That cross could not hold him down, nor the nails hold him up. He chose His cross. As God in the flesh, His most glorious moment was when He humbled himself to allow us to crucify Him on the cross. Jesus willingly drank the cup of His father’s wrath against sin in its entirety. For every evil deed we will do in this life, He already paid the price in full. Three days later He rose from the dead, sealing the covenant, and saving us from our sin.

With His resurrection comes the new man. Just as we fell into sin by the actions of one, now we are saved by another. Any belief we have, any faith bestowed, any good deeds we do, all of them are Christ living in us. All we have is Christ doing them through us. We take no credit for them; they are given by God. We cannot do them on our own, by any means. While it is true that we should be imitators of Christ, the most important thing our Lord teaches is that He came to call sinners. He came to show us what we are, and how much we need a savior. For the first time, we are not focused on whether we are doing too much or too little of the law. The curse the law has been lifted. Now we are given the chance to see our neighbor in need.

This love is why Mercy Ships is able to serve. The love of Christ causes the surgeons to operate, the nurses to care, the health educators to teach, housekeeping to clean, the cooks to cook, the crew to take care for the ship, and the Gospel to be spread. Behind all the thoughts and actions of the crew of this ship, that love pulses with the love of Christ, moving us to act, even when we do not feel or see it’s presence. The love of Christ frees us from our sin, and allows us to see our neighbor in need.

It’s comforting to know our place in all this. It’s not a struggle to please God. It’s the change to be used as an instrument of HIS hope and healing. We have come for numerous reasons, some good, some shallow, some incredible, and others boring. But we are here. Regardless of our feelings we are being used by a loving creator, as instruments of His peace. We have been given the chance to see His glory and majesty.

“For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in creating, will be able to separate us from the love of God in Christ Jesus our Lord.”-Paul in his letter to the Romans

“For it was by grace you have been saved, through faith—and this not from yourselves, it is the gift of God—not by works, so that no one can boast. For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.”- Paul in his letter to the Ephesians

And lastly in John’s letter to the early church.-”We love because He first loved us.”

To Christ be all Glory!

-This has been an incredible three months. Even though I am happy to see family and friends again, I’m not ready to leave Africa yet. This has been a delightful adventure. I wish I could somehow convey how it feels like to leave here. It’s surreal. In 12 hours though I fly to Paris, beginning the long journey back to Houston. Thank you again to all the people who have supported me this last few months. You are all a blessing. Thank you to my new friends on the ship. I will miss you all.

Myles

To say I was at a loss for words was an understatement. During the night shift, I called home to find out how my Mom was doing. The last week she had learned from her doctor that a CAT scan done in February had shown a cancerous growth on one of her kidneys. The empty PACU unit all the sudden felt huge. I was a kid again; nervous about news I did not want to hear.

I heard her use words like PET scan, Echo, Stress test, Bone scan, and surgery. All of them were familiar to me, but not in the context of the patient I was hearing about. This was my mother.

Having no history of cancer before, a nephrectomy (the removal of a kidney) would be possible, as long as no cancer had spread to the rest of her body. Still, I’m a nurse. I’ve seen patients come in for stomach problems, only to leave with weeks to live and the news that cancer had metastasized to many areas of their body. I’ve seen patients in their thirties die. I’ve seen how quickly death can take those around us. I’ve been the one to call a daughter and tell her that her mother had passed away only minutes from her leaving the hospital.

But I’ve never been on their side.

As she continued, she began to cry. That was too much. Feelings of guilt, anger, and bitterness for being here welled up inside. All she could tell was a difference in my voice.

“Myles, are you sick?”
“Yeah, I went to the clinic yesterday, they said it was allergies.”
I lied. I’d been to the clinic, but it was a while ago. Considering I was having a hard time speaking, I mainly listened for the rest of the conversation.

C.S. Lewis described grief as feeling like fear. In his reflections following the loss of his wife to cancer (only three years after they were married) he said:

“I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. At other times it feels like being mildly drunk, or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says. Or perhaps, hard to want to take it in. It is so uninteresting. Yet I want the others to be about me. I dread the moments when the house is empty. If only they would talk to one another and not me.” -(A Grief Observed)

I think the same holds true in reverse. Fear can feel like grief. The unsteady voice, the subtle lethargy, the pain in my eyes, not from tears, but from the urge to shed them, but knowing I would not. I’ve noticed it at funerals. I’ll hold in my emotions, feeling them burn on the inside, as I stand there composed on the outside. I remember feeling alone in the midst of 400 people on the ship.

After my call, I went back to the ward. Having a slow night, I was thankful my books were with me. I could pour into them with a new found urge to ignore the world around me. Once six o’clock came, I was busy enough at the end of the shift to keep my mind occupied.

Over the next week, I remember feeling bitter. I would see all these life changing surgeries, yet silently burn on the inside. The Lord was doing amazing things here, but what about at home? As I would walk on the dock, all I could think of was how much I wanted to leave. The ship felt suffocating and small. I had no interest in being here. I had a month left before my departure. I still did my work happily though. I’m a nurse, hiding my thoughts and judgments are a large part of my career.

I was angry with God. Instead of the thanks I had for the chance to serve here, my thoughts were more, “Seriously? I ask for the chance to serve you for three months and you cannot keep my family safe for that long?” Thank goodness I had sermons, books, hymns, and Bach to calm my thoughts. I was reluctant to see the cross given to my family. Christ told us to pick up our crosses and follow Him. Luther reminds us that we do not choose those crosses. They choose us. That is much easier to say when one is a third party though.

As the days continued, I remembered the conversation between Job and the Lord. When the Lord finally speaks to Job, he does so in the violent torrent of a storm. In the rain and wind, fully lamenting the depth of his loss, Job’s exclamations are answered by the Lord.

Who is this that darkens my counsel
with words without knowledge?
Brace yourself like a man;
I will question you,
and you shall answer me. (Job 38:2-3)

And then God shows Job how expansive, deep, glorious, and almighty His dominion is.

- Where were you when I laid the foundation of the earth?
Tell me, if you have understanding (38:4)
-Have you commanded the morning since your days began,
and caused the dawn to know its place (38:12)
-Have you entered into the springs of the sea,
or walked in the recesses of the deep? (38:16)
-Have the gates of death been revealed to you,
or have you seen the gates of deep darkness? (38:17)

The Lord continues to list just how much he does. He tells how he cares for his creatures, rules nature, and he shows the might of the creation he directs in His Gracious Mercy and Power. His questions read differently to me. His words more resembled this:

-Was it not Gracious that I found the cancer in the first place?
-Considering it was a random test, is it not my hand that pointed the cancer out to the doctors?
-Did I not train the surgeons and nurses to care for her?
-You and your family have always been in my hands, do you not still realize this? All it takes is this small cross to anger you?

And I ended up pondering the words of Job. His response seems the only one suitable to the questions the Lord asked him.

“I know that you can do all things,
and that no purpose of yours can be thwarted.
‘Who is this that hides counsel without knowledge?’
Therefore I have uttered what I did not understand,
things too wonderful for me, which I did not know”- (42:2-3).

Over the next couple of weeks, Mom gathered as much information as she could. Blessed with her wonderful doctors, she was much calmer as I talked with her the week of the surgery. Meanwhile, life on the Africa Mercy continued for me. Working on the ward gave me a chance to keep my mind occupied.

Wednesday I worked on A-Ward. As I got on the ward, I called reception to let them know my sister would call when Mom was out of surgery. After shift prayer, I got report on all my patients. Two patients were multiple days post-op, one was a new admit, and another was in surgery. I got a suction canister on the wall, as well as an oxygen set-up as I waited for my patient to come back from Surgery. I put a blood pressure monitor in place by her bed. I was ready for her. My patient would arrive in a couple of hours.

As my patient returned from surgery, I got her comfortable in her bed as I checked her vitals. I got report on her from the PACU nurse. She had a total thyroidectomy for removal of a goiter (a swollen thyroid) half the size of a basketball. The PACU nurse left as I took the JP drain bulb off to attach the tubing to low wall suction.

When I finished, I went to write down my patient’s meds. Sarah, the charge nurse, told me my sister was on the phone. Mom had just made it to recovery. She was doing excellent with an uneventful surgery. After getting off the phone with my sister, I emptied the drains from my patient. All the sudden one of our children began to have a seizure. The nurses and doctors came together in a great display of teamwork as we monitored him, got IV access, and gave the kid medication to stop the seizure. His seizures stopped and the rest of the shift went calmly for him. The last couple hours of the evening shift went comfortably busy.

After work I walked on the dock. I remember thinking how the Lord uses us as his instruments. While I thought of my mom during her surgery, some family member was thinking of my patient. As I wanted the best care for my loved one, so did they. Just as I took care of my patient as she came back from surgery, so did some nurse back in Texas. The assessments I did were done at home, as well as the orders, report, precautions, and pain management. My mother was in the hands of strangers, just as my patient did not know me. The whole time she was in the hands of our Lord. If anything would go wrong, he would prompt the nurses to act on it, as he had with our child on A-Ward. He guided the surgeons, as well, using their craft to heal my mother. And just as my patient saw the chaplain before surgery, so my pastor sang and prayed with my mother before hers.

I had no reason to be critical of the Lord for how he acts. Before all, He says He is Gracious and Merciful. Even though I try to interpret what that would mean, I can never know how he will act. He is not a tame God. Though He is always there for us, he reminds us that life presents itself to us in crosses he allows us to bear, giving us the chance to take part in his sufferings. In his Chronicles of Narnia, Lewis repeatedly has characters exclaim how they are ready to see what adventure Aslan has in store for them. It is a light-hearted look at the serious world we live in. The Cross is why His Son came. He faced all our sufferings, here, abroad, and ever, and took them on Himself, nailing them to a tree two thousand years ago.

After my walk, I called Mom in her hospital room. Other than the obvious voice of a person on pain medication, she sounded great. She told me how the doctor had found no other evidence of cancer. Her bone scan had also shown no areas of metastasis. It had all gone smoothly. The God of all Creation had been Gracious enough to remove the cancer from my mother, using the surgeons and nurses as masks of His loving care for her.

May the Lord bless all of you.

To Christ be all Glory!

-Myles

I had a shocking realization that my time on the Africa Mercy is quickly coming to a close. In little more than four weeks, I will make the same journey to the airport, only to end this adventure as I began it. I love it here. It’s crazy how this ship can feel like home. I’ve grown comfortable with my cabin, the hospital, and my new friends. Recently though, I’ve noticed many more new faces. Every couple weeks a few more of my friends leave, all returning to where they call home. Friends I’ve talked to late into the night, worked long hours with, watched movies and played games with, worshiped and prayed with have departed. And the process begins again. New faces come with new stories and other backgrounds, all interesting, but the knowledge of my own departure makes me hesitant. I don’t know how the long term crew can do it. It must be wonderful to meet all these new people, but watching them leave must be tough.

I’m only short-term here. In two months life will be how it was before. Cabin 3428 will have one less crew member. I’ll be back in Houston, reacclimating to life in the States. My bunk will have a new person sleeping in it. He will probably have many of the same thoughts as he first unpacks his luggage. His journey will start after mine is complete. New nurses will work in the hospital. They will open the same cabinets, and walk the same hallways I walk now. It’s a strange thought.

Christ has given me the chance to be here. He has orchestrated the whole opportunity for this ship to sit in this port right now. He trains the crew, collects the donations, moves other nurses to come, creates surgeons willing to serve him, cleans, paints, and repairs the ship, He gives to the needy, He moves the hearts the wealthy, and He pulls the patients towards His arms for care and healing. I am thankful to have the opportunity to even work with these people. As a nurse it has been refreshing, as a Christian it has allowed me to grow, and as a son, brother, and friend, it has shown me what I truly cherish at home.

In just two months I’ve seen more than I had in three years as a nurse. I’ve witnessed new life, true healing, and seen Christ in my fellow nurses, friends, the surgeons, patients and their families. I stand as an observer of the Glory working through this ship. Sure I’m a ward nurse, but I’m only a small tool on this ship, a part that will be replaced as I leave, allowing for the healing of Christ to continue.

I’m excited to have another month on this ship. As life continues on at home, I look forward to my return, but want to cherish every day I have left here in Africa. Thank you again to all who helped with this journey. As I am an instrument used by Christ on this ship, every one of you has been used by Him to bring his Mercy. Through donations, support, and prayer, you have brought hope to West Africa.

May the Lord bless you and keep you.
May the Lord make His face shine upon you and be Gracious upon you
May the Lord look upon you with His favor and

give you peace.

In Christ,
Myles

“Present yourselves to God as those who have been brought from death to life, and your members to God as instruments for righteousness.” -Romans 6:13

“For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast. For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them.”-Ephesians 2:8-10

Last week was a perfect example. Converting back to a day schedule after working night shifts, I went to bed around 11:00pm. Considering I had been going to bed at seven in the morning, this was impressive. I went to sleep as usual, climbing into my bunk, and shutting off the light.

I’m not sure why, but I woke up at 12:40am. Glancing at my clock, I thought I had slept in till the next day. Knowing I was working evening shift, I knew I had only twenty minutes left till they stopped serving lunch. I climbed out of bed and started putting on my clothes.

When I turned on the light, I saw my bunkmate still sleeping. Instead of looking at my clock again, wondering why he would still be sleeping, I woke him. Being the great roommate I am, I said (in a somewhat crazed, just-woke-up type voice), “Geoff! Geoff! Wake up! It’s 12:40pm. You slept in SIX HOURS!”

Instead of asking if I had lost it, my roommate jumped out of bed. Eyes still red from sleep; he exclaimed over and over again that he had no idea how this could happen. That’s interesting to note because it would be impossible to sleep in six hours here. They have called me before when I was five minutes late. Six hours would be on an entirely different level of neglect. As he dressed, he looked at his clock (which also said 12:40) and continued to berate himself for sleeping in. Waking up in the middle of a deep sleep is never conducive to logical thinking. The contagious alarm of my voice added to the confusion.

All of this happened in the matter of a few minutes. I got my scrubs on and went out in the hallway. I looked at my watch. It read 0:40 (Military time for 12:40am). Staring at it like I had learned to tell time yesterday, I still was not convinced it was night time. I probably also should have noticed the lack of people in the hallway. Usually there are a few people during the day. There was no one. Walking towards the stairs, I turned the corner and ran into one of the other nurses.

“Is it day time or night time?”
She gave me an odd look and replied, “Night time.”
“Ohhh…”

Walking back to my cabin, all the clues I had missed slowly entered my mind. I returned to the cabin to find Geoff half dressed, still perplexed as to how he managed to sleep in six hours.

“Geoff.”
“Yeah.”
“It’s night time…Sorry bout that.”
“It is?”
“My bad.”
“I was wondering how I could be so tired after sleeping that long.”

We laughed as we went back to our bunks. That is something that can only happen in a windowless cabin setting. All of us have gotten up in the middle of the night, not realizing the time. It was just different for me because I convinced someone of my own confusion. As I laid there, I remember thinking how strange it was to wake up like that. Geoff was probably thinking the same. He also must have been questioning the intelligence of his roommate, which was understandable considering the last few minutes. I went to sleep content that I had hours to sleep still, unlike Geoff, which was waking up four hours later.

Coming off of night shift feels similar to jet lag. While others slept, my body was convinced the day was just beginning. I tried to force sleep, but found myself just looking around. The latex mattress in eighty five degree heat probably did not help. When I looked at the moon, I had a strange thought. Six hours from then, my family would see the same moon. Six thousand miles away, my parents would see the same beacon I was looking at. Strangely nostalgic thoughts of home swirled in my mind, wandering between the world of conscious thought and dreams.

The little things are what I miss. Talking with my parents or playing with my nieces, catching a movie with my sister or carving with my brother, eating Mexican food with my friends or conversations with my pastor, petting the dogs or kayaking on the lake, and especially Whataburger at two in the morning. Life is so different here. Don’t get me wrong, I love living on the Africa Mercy. It’s just some of the comforts I had in Texas will always be close to my heart.

Eight in the morning we headed for Kakum National Forest. Imagine rope bridges two hundred feet above the rainforest floor. We walked through the forest at the canopy level. There were shades of green I had never seen before. The bridges would rock with each step, making for an enjoyable trek between the trees. The actual floor of the bridge is made of a board about a foot wide. Every time we would arrive at a new tree, the board would loudly smack the bottom of the platform. It is an ominous sound if you did not realize it was normal. The scenery itself was gorgeous though. Trees as thick as red woods surrounded us, while much of the time we could not even see the floor of the forest below.

After lunch we went to Cape Coast Castle. Along a scenic coastline of southern Ghana, an old fort sits upon the rocks. The whitewashed castle almost looks beautiful, that is till you hear its history. Three hundred years ago the castle was a holding area for slaves before ships would take them to Europe and the New World. Dehumanized to the point of property, people were kept in dungeons till the ships arrived. On closer examination, the castle is the definition of austere. Our tour guide did an amazing job trying to convey how terrible life was for the slaves. At one point all of us were in the male slaves dungeon. In a room the size of a large garage, two to three hundred slaves were kept, with only a small window twenty feet up for light. With little room to move, let alone sit or lay down, the conditions were breathtaking. Standing there in a group of sixty, it already felt overcrowded. The darkness, along with the heat mixed with the stale air and musty odor to give an idea of what the dungeon was once like. At one point we stood at the Door of No Return. Slaves would leave the deplorable conditions of the castle, only to enter a new world filled with darker trials. Through the door the coastline was visible, filled with colorful fishing boats, calm waves, and children playing in the ocean. It’s strange to see something beautiful, foreboding, and austere all at the same time.

That night we went to dinner on the beach. We found a restaurant that was located about thirty yards from the ocean. As we sat at the table, beneath the thatch roof of the patio, the waves could always be heard, mixing with the sounds of stimulating conversation and laughter among new friends. About twenty yards further in was the main building of the restaurant, open on three sides. By the stage, a keyboard and tenor saxophone serenaded the dinner crowd with smooth jazz. As the tenor saxophone would solo, its deep voice tied together the waves, conversation, African food, and slight breeze into an evening I will never forget. It was one of those moments that demands remembering.

This last month has been humbling. I have been given opportunities many will never have, many of which I may never have again. I’m thankful to everyone for the chance to be here. I’m thankful for my family and friends I have at home. I’m thankful for my new friends on this ship. I’m thankful for the God of all Space and Time, Gracious enough to allow me the chance to serve Him.

Note- For anyone who has been following this blog, sorry I have taken so long to post any pictures. Here is the link to check out my photos so far. Have a great night everyone!

Long ago I read those words, stunned by their boldness. Quoting the prophets, Paul told how death no longer had victory. In Christ, death was swallowed up. I remember how I quickly agreed with what he said. Of course death had no victory! Of course death had no sting! What did I know about death at thirteen? Now that I’m a nurse, I still agree with Paul, but find the second part of those words harder to swallow. Does death lose its sting?

When I came to work Monday, I was given a reminder of that sting. During the morning shift, Anicette, one our babies, had passed away. I had never taken care of her, but many of the nurses had. Anicette was in our infant feeding program. This program helps malnourished infants receive the nutrition they need in order to get them to a healthy weight for their age. Following her from last outreach in Benin, the nurses knew her and her mother well. Having trouble digesting any of the formulas they had tried, it was thought she had a serious malabsorption disorder. When Anicette arrived on the ship, she was already quite sick. She had lost weight, despite her mother working with Mercy Ships over the last year. Several of the nurses had grown close to the mother and baby. Anicette slipped away in her mother’s arms around eleven in the morning. She was only fourteen months old.

During the shift prayer, there was a different feel. There was a stark reminder as to why Mercy Ships would always be needed. There was the cold truth of a young life lost in a ward surrounded by life changing surgeries, new bodies, and rebuilt spirits. In the back right corner of the ward, her body was behind a pulled curtain, still on her bed, awaiting her father to come take her and her mother home.

As the shift progressed, I watched as nurses came by to pay their respects to Anicette. Some would silently walk in and go behind the curtain. I did not even notice them except for the quiet prayer coming from their lips. A few of the nurses, as they stood there, remained silent. Others would stop by, go to her bed, and leave the room quickly, eyes wet with tears. An hour into the shift, I went behind the curtain. There she was. Wrapped in swaddling clothes, both eyes shut with a slight smile, she looked like any sleeping baby. A look of quiet peace was on her face, such a calm expression. As I stood there, I could not help but wait, subconsciously hoping for some sort of breath, some stir, some sign of life. But she remained still. I’ve seen older people die before, even family and friends, but this was different. How do you tell a mother who lost her baby death has no sting?

Continuing with my day, the shift went on smoothly. There was a couple new admits, but nothing pressing. All the sudden one of my patients began to have serious trouble breathing. Without disclosing patient information, she was quickly unstable. Within minutes we had all manner of doctors and nurses helping with my patient (they did an amazing job!). My Mercy Ships experience quickly felt like home again. On the unit I work on in Houston, we have many patients who are unstable, who end up going to the ICU in a similar manner. I was nervous. Being a telemetry nurse on a cardiac unit, I know my role in an emergency, but I still hate it when it happens. Seeing death come after my patients is always terrible. But in the same room that Anicette was lost? On the same day? After my shift ended, I went on the dock to walk for a while. I needed some distraction, time to go over events in my mind. As I walked, Paul’s words came to mind.

Throughout his ministry, Paul became well acquainted with death. Along with numerous attempts to his own life, he had many friends killed for their faith in Christ. It is not with ignorance that Paul says those words of defiance. Does death rule in the world we live in? Yes. Does it still have its sting? Of course. In Christ though, death loses its power. Death becomes of little significance. Paul goes far enough to say that, “we wait eagerly for adoption as sons, the redemption of our bodies. For in this hope we were saved.“ (Romans 8:23-24) He even says how his, “desire is to depart and be with Christ, for that is far better.” (Philippians 1:23) Death may rule on earth, but it is not triumphant. Our victory over death was nailed to a cross two thousand years ago, on a rocky hill outside of Jerusalem.

When I started my shift on Tuesday, new life was on the ward. After shift prayer, one of the translators had pulled out the guitar. As he began to play, caregivers, patients and translators joined in song. Within minutes there were sounds of loud singing, shuffling feet, clapping hands, giggling children, beating drums, a strumming guitar, and behind it all the contagious spirit of joy and happiness. Instead of running to help with an emergency, nurses were coming from the hallway to join in the song and dance. Where the curtain had been now sat Yaovi, playing the guitar. In the same spot where I was standing the day before, watching my patient struggle to breath, sat a set of African drums, played by one of our other translators. The room was bursting with life. Standing in the front of the ward, I thought about the day before. Paul’s words came to mind again. In a place where death presented itself, where was it now? Though it had such a claim on A Ward yesterday, could I still see the sting?

Anicette dances in heaven with those who have passed before us. I like to think of my Grandpa Buie rocking her on his knee, singing to her gently as he did when I was little. Death separates us from those we love. As long as we live on earth, it will be present in our lives. It will come after our loved ones, our friends, and our patients. Every moment we are free from its grip, we thank our loving creator for the opportunity to enjoy it. With each chance to treasure life, in any way, shape or form, we have reason to be thankful. We relish every moment we have, for life can present itself in any way. And when death does come after us, we remember the cross. We remember a Savior, who knows what we’ve been through, who took on death in our place. To Christ be all glory!

For to me to live is Christ, and to die is gain.
- Paul, Phillipians 1:21

In the world you will have tribulation. But take heart; I have overcome the world. - Jesus Christ, John 16:33

Last night I had to stay up through the late hours. Working nights this week, I wanted to switch to a nocturnal schedule. After most of the crew starts toward bed, a handful of people are found on the ship. It’s only the people working nights, the others preparing to do so, or those unable to sleep. Around midnight I went up to the top deck.

A good friend of mine gave me a lot of country music before I left home. Growing up in Texas, I’ve come to enjoy some country over the last few years. Listening to my IPod, I spent time going through the music he gave me. It was when Johnny Cash’s “A Boy Named Sue” started playing that it hit me. How random can life possibly present itself? I’m lounging on the top deck of a hospital ship, in a West African port, listening to country, while reading C.S. Lewis. I remember putting my hands behind my head, laying back and relishing in the peculiarity of the moment.

There is much randomness to life on the Africa Mercy. I go to lunch and sit with people from New Zealand, Holland, or Germany. Others times they may be from Ireland, Britain, Ghana, Benin, or Texas. We have over thirty nations represented here. The other day I went with a group to the Ghanaian Embassy (in order to get my visa for travelling there this weekend). In our taxi I rode with people from North Carolina, Switzerland, and Italy. It’s wonderful to talk with people from all over the world. Along with learning about West Africa, we can learn about each other, learning all the variances in the places we call home.

Living with other cultures is entertaining. I live in a six berth cabin with two Americans, two Dutch, and a Norwegian. A few days ago, one of my Dutch roommates and I had the realization that we listened to the same music from the band Focus. Being a progressive classic rock band from Holland, Focus never had a large following in the States. They are an acquired taste. As we were going through my music, we found many more bands and artists we both enjoyed. By this time the rest of my European roommates were in the cabin. That gave me an idea. I had them listen to a song by Roger Creager (a Texas Country Singer). I was curious what their reaction would be. It got a mixed response. I could tell from their faces that they were trying to hide their dislike for the music. Apparently Texas country is not very popular in Northern Europe…

Being here for the last few weeks, I have thoroughly enjoyed the international company. It’s encouraging to see Christians from every walk of life, from every part of the world. It’s humbling to see the wonderful community the Lord has given me the chance to live in the next few months.

Back in the lounge chair, I went from country to Bach’s Mass in B Minor, then to Irish folk songs, to Classic rock, then finishing with Lutheran hymns. Some of us thrive in a random environment. Others of us seem to search for it as a goal in itself…

“Myles, how would you feel about giving blood to an 11 year old?” Ali asks. Being the day charge nurse, she is making sure I am comfortable giving blood to a pediatric patient. I tell her I do not mind as long as someone shows me how they do it here. She proceeds to tell me their process for transfusing blood.

The Africa Mercy has a walking blood bank. All of us are potential donors. Crew members can sign up with lab to donate blood. Since there are not the resources for a blood bank onboard, blood is donated as needed. Crew members are called whenever there is a need for their blood. Another nurse, Hannah, is called to give blood for my patient. With a low hemoglobin (the oxygen carrying capabilities of red blood cells), he needs some blood before his surgery tomorrow.

While I’m taking care of other patients, Hannah has her blood collected. They take her blood in lab, cross match it (to make sure it’s compatible with my patient’s blood), then give it to the charge nurse. Then the process resembles what I’m used to. We check the blood, patient ID band, chart, and recheck the orders. When I first learned how they gave blood here, I could not stop thinking how incredible it was. The crew actually gives their blood to the patients if they need to.

I check his vital signs.

102/68, 76 bpm, 36.7º C, 22 rpm (respirations per minute)

I think how strange this is. Blood that was flowing through one of our crew, pushed through the body with each heart beat, was now flowing in another, pushed in a different body, with another heart, beating at its own rhythm. With each beat, the given blood mixes with the patient’s. Now the patient receives the gift from our nurse. Her blood carries oxygen for him, helps him fight infection, hydrates him, and increases his strength. What was meant for her is now his.

After spiking the blood (in nursespeak that means to connect the IV tubing to the bag), I attach the tubing to my patient. I look to my right. His father sits at the bedside. Seeing him, I think of my Dad. My father has donated blood throughout my whole life. He’s given over 18 gallons during the last few decades. And to think, each pint is used for another person. To some it is for surgery, for others it saves their life. The boy’s father has been there the whole time he’s been our patient. In this culture, that is not common. Many times the father has a distant role in raising his child. Care for children is left to the women. His father has not left his side in SIX days. I think of my dad again. Watching this father care for his son, I see another similarity with the kids I care for. I’m watching the father-son connection in a West African context. He’s there taking care of his little boy, like a good dad does.

It’s been 15 minutes. I check his vitals again, and I’ve increased the infusion rate to 30 drops a minute (note: we only use pumps for morphine and some medications, for everything else I use drop rate calculations to find the rate needed…welcome to old school nursing.)

100/65, 75 bpm, 37.0 º C, 20 rpm

As the blood continues to flow, I have another thought. Is this not amazing imagery? Let me explain. Christ by His blood has saved us from the punishment for our sin. His blood once flowed for us. His red bone marrow produced blood to keep his earthly body alive. His heart pumped that blood. His vessels carried it around His body. The difference is He chose to give that blood for us. He allowed himself to be beaten, hit, pushed, stabbed, to be sacrificed. All of this caused that blood to flow. That blood saved us. It has redeemed us. It has sealed the covenant. By His blood we are healed. I remember it is lent.

I check his vitals again; it’s been another 15 minutes…

99/68, 100 bpm, 36.7 ºC, 20 rpm

With the translator, I ask how my patient is doing. He has no pain, but he does not like the IV. None of the children like having IV’s. In fact, I have not seen many patients in my career that enjoyed having an IV at all.

As the blood continues over the next couple hours, I spend most of the time running around between the other patients. One has pain, one needs education, another wants a balloon, and one is throwing up. It is a hospital still. I think, this blood of Christ, does it prompt us to do this? Yes, it does. By His sacrifice, by His love, now we are given the chance to serve our neighbor. By that love, He gives us the chance to give our own blood. In any good deed we are given, Christ’s love flows through us.

I think too much…

The blood finishes around 1800. Lab will check his hemoglobin in the morning before surgery. One of the translators helps his father string up the guitar we have on the ward. It only has four strings, but it still plays. The translator plays a couple songs. He sings in a language I do not understand. I think it is Ewe, not French. What an unusual place.

After the shift ends, I’m walking on the dock for a while. Other than the rats and the occasional security guards, I’m left to myself. As with the rest of the day, my mind continues to wander, late into the night.

   It’s amazing how quickly I’ve settled in here.  I have been on the Africa Mercy only 10 days now.  I have all the little places I like to hide out.  I have places to socialize.  I know my way around very well now.  In this short span I have met many new people, explored this huge ship, completed my orientation (Ward nurses get two days), and have become part of this community. 

   The ward has given me a different perspective on nursing.  At home, nursing and I have a love/hate relationship.  I love the people side of the profession.  Many of my patients were fascinating just to have met.  I’ve seen a 65 year old in bed 356 come to life as a former tug boat captain who would tell me stories of his pet spider monkey (and many similar stories).  That is what I love about this profession.  People are so incredibly unique.  Watching how they interact in the world can be beautiful in itself. 

Then there is the other side…

   I am a Charge nurse on a busy Cardiac Telemetry Unit.  That means on a given day I have 5-6 patients, and being the charge, I am responsible for 6 nurses and the rest of the 36 patients.  When I get on the floor at 0700am I hit the ground running.  Usually it’s a handful of visits to my patients in the course of the day.  Add to that people above and below pushing for my attention (help with this, fill out that, do these orders STAT), emergencies, understaffing, unstable or demanding patients, and 12 hour shifts.  No wonder there is a nursing shortage. 

   Here it is different.  I work on a pediatric ward on the ship.  Most of my patients are between the ages of 3-16.  Being an orthopedics unit, most of the kids are stuck in bed, bored to tears as they heal from their surgeries. (including tendon lengthening, club feet repair, fixing backwards knees, etc.)  This is where it shifts from nursing at home.  When I have a free chance, being caught up with paperwork and meds, its fun to play with the kids.  They actually remind me of my nieces and nephews (vaguely, considering we are in West Africa on a surgical ward).  Some of the nurses play jenga, blow bubbles, or play a version of mancala (I have not caught the local name of it here) with the kids.  Others will build with legos and put together puzzles.  There are kids playing in the beds as well as little ones with toys they can pull around on the floor.  It’s a different work environment.  Even though I cannot speak French (or any of the other languages here), I know what it’s like to be a kid.  Playing jenga with a Togolese 9 year old does not mean you have to know French, it requires basic communication skills as a fellow human.  It requires seeing the humanity of that patient.  It’s the human connection I love in this career.  That is what I’m learning to do all over again here.  

   With many of my patients, their society has made them outcasts.  In West Africa, children with disabilities are thought of as cursed, ending up on the fringes of their community.  I heard one of the speech therapists talking about a girl who had been beaten by her teacher for a speech impediment (that had to be fixed surgically here on the Africa Mercy).  Patients have been put up for adoption, forgotten, left by family, and tossed aside.  And these are children!  Thank the Lord he has built this Mercy Ship. 

   Last night I worked the evening shift.  Getting off at 1030pm, I showered, then went up to Deck 6.  After reading Perelandra for a couple hours (part of C.S. Lewis’s Space Trilogy, I STRONGLY recommend), I went to the internet cafe to send a couple emails.  Right as I was heading to bed, one of the nurses told me it was raining.  Ten minutes later I was standing on Deck 7 watching the storm pass by.  I walked along Deck 7 for a while relishing the weather.  After I was nearly drenched, I headed back to my cabin.  With the thunderstorm outside, and the ship rocking back and forth, I went to sleep a happy man.  This has been an incredible couple of weeks.  Thank you all again for allowing me the chance to be here.

Seeing how great the weather was (by Togo standards, 70’s with a slight breeze), I got up early, ate breakfast, and was walking by 07:00am.  After I cranked up my IPod I started walking around the dock.  Considering I was going to work the evening shift, I figured getting out early to exercise would feel great.  Thirty minutes into the walk, one of the nurses came down the gangway reminding me I was supposed to be on the ward. 

Huh?

Apparently I did not realize that I was actually going to be on the DAY shift for today and THEN switch over to evening tomorrow.   Considering the shift began at 07:00am, I was starting a good half hour late (add ten minutes to run to the cabin and change to scrubs!) on my first day.  When I got on the floor, I had a deer in the headlights look for probably the first hour and a half.  Once I got to know some of the nurses I was working with, it went much better.  I trained with a lady named Maika from Holland (pronounced Micah).  The only reason I point that out is that tomorrow I train under a guy named Micah from Florida.  I found that entertaining enough to mention.  The morning was a blur. 

I was impressed with how the ward works.  With every mission trip I have been on, it’s always a task to see just how to maximize the resources we have.  This hospital is the most efficient version of this I have ever seen.  Nothing is put to waste.  Everything is useful.  Everyone works together.  All the nurses have this sort of MacGyverish style of nursing (terribly fascinating to me).  While it is still a hospital on a ship, it manages many aspects of care better than my home hospital. 

To give you an idea of what it’s like…The ward is about the size of the average classroom (maybe 12’ by 15’).  In this room there are beds for 10-12, a bathroom, an anteroom connecting to the other side of the ward (with another room of equal dimensions).  Along with the patients, there are family members (of the children and babies), translators, doctors, physicians assistants, tons of nurses, and other healthcare professionals.  The crowded atmosphere was intimidating at first, but once I saw my role in the chaos, it went much smoother.  One of the stranger parts of my day was using two translators in order to talk with my patient.  Speaking only Fon (a tribal language), she had to have someone who spoke Fon translate along with our French translator.  The shift came and went as quickly as I ran there this morning.  It’s so strange to be a new nurse again.  I almost feel like a nursing student.  Tomorrow is my last day before I am on my own.  Thank goodness these nurses are so willing to help out new guys like myself. 
I almost forgot.  My luggage arrived!!!  One cannot fully comprehend my joy of seeing that ugly duffle bag sitting in my cabin.  It took a while to get situated, but now I am officially moved into the ship.  I’ll start posting picture soon.  For those reading this, take care. 

And by the way, I was able to do my walk, just twelve hours later.