Finding the plane

It is Saturday morning. I am resting in Santa Cruz after dropping Wendy at Viru Viru for a long flight home to a still snowy upper Midwest. Francis' two year old daughter, Melina, is snuggling next to me, not so secretly hopping for something more exciting to appear on the iPad screen. Her 6 year old sister has already put on a gymnastics performance for her distinguished audience and tutored me a bit in Spanish. We enjoyed a breakfast of huevos, queso, and jugo de manzana. Makes me miss my own ninas.
I will miss Wendy much this week - the whole team will. From a practical standpoint, she put her multi-tasking skills to good work and became an integral part of all the different aspects of our project. Her servant's heart and smile were more infectious than the local protozoan could ever hope to be. It was wonderful to have her here again as she becomes a part of my Bolivian family as well. Personally, she has been a steady and durable companion, one who has walked the fine line between listening quietly in my moments of frustration and admonishing me to regain my focus when these frustrations prove to be born of selfishness, shortsightedness, or a lack of faith. Did I mention that I will miss her?

When one operates, whether it be on a stone-filled gallbladder or an orange-sized thyroid lobe, the difference between a smooth case or a bloody mess is often a matter of a fraction of millimeters. Organs are separated from adjacent tissue by fine planes where blood vessels are few and what one sees looks more or less as it is shown in the anatomy textbooks. Find that plane and the operation will proceed quickly, safely, and with almost no blood loss. The mood is light during such procedures. We can make small-talk, joke about each others' Spanglish, discuss the next case. All is copacetic. Miss that plane by less than a millimeter however, and things are different. Bleeding ensues. Blood loss is generally frowned upon. First of all, it's blood; we each only have so much of it to lose. Though stated as an axiom: "all bleeding stops eventually," the truth is that I would prefer it to stop sooner rather than later, preferably right now, thank you. Bleeding also obscures one's ability to see what is what. It is as if a child came and smeared red fingerpaint all over those nice, precisely illustrated anatomy textbooks I mentioned - except the paint is precious blood and I am the child. Frustration builds as one tries to find his way back into the correct plane - a good surgeon will be able to stay calm through this time - walking the line between haste and efficiency, between confidence and careless bravado. Sometimes, this is when a more experienced surgeon can be of great assistance, not by actually doing anything different, but simply by being there with the knowledge that he has been there and done that and that the bleeding did and will stop.

Similar planes are to be found in other aspects of these projects. Do I constantly push for process improvements/ increased efficiency, or do I "go with the flow" and adapt myself to the normal pace of San Carlos? After all, the more procedures we can do, the more people we can help. But we can also do so at the expense of the people we are serving with, and this must be taken into consideration as well.
Do we take on a long, difficult procedure - one with higher risk and reward? Or do we transfer them to the bigger city and instead do four or five simpler procedures where the outcomes are less in doubt? In doing so, I am showing a lack of faith and missing an opportunity to transform a life? If we take on the challenging case, are we turning away others and missing the opportunities to serve them? It is difficult sometimes to find the bloodless plane between faith and stupidity, between caution and doubt. Sometimes it seems this plane does not exist, just as it does in some operations. A good surgeon will calculate the risk, remain calm, and complete the operation, risks notwithstanding. As I have said, all bleeding stops... eventually. The surgeon who is not able to proceed in such scenarios - he will soon become paralyzed by the fear of even missing the plane in the first place. He will take on less and less risky procedures until he can do very little at all. And God forbid a lawyer ever get involved.
I think the same applies to our role as servants of God and our fellow human beings. I once thought faith was essentially trusting that God would always work out or correct the outcome of our misadventures to one that everyone would find acceptable. I can easily quote some Bible verses (out of context) to support this theory. Unfortunately, this theory falls apart quickly when real life gets messy. One's vision is obscured. One's confidence wavers. Will the bleeding really stop?
I am nowstarting to learn that faith is not the assurance of a particular outcome, but rather the assurance of God's acceptance and partnership as we serve, even though the outcome of our service may remain an indefinite mystery. Two things are certain: we will mess up (probably more often than we'd like to admit) and God is still with us if we ask Him to be (which I do less often than I should). He wants us to serve in spite of the risks. He wants us to negotiate those planes. After all, He has infinite experience, as we know He can handle bleeding.

*Please note: No patients actually bled to death in the creation of this blog post. Everything is hemostatic in San Carlos.


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