I have to admit, I don't even know how to start this entry. Mostly because I have good things to say, though, and I want to do them justice.

I could tell you about how I failed to thread an IV on a patient that just doesn't get any easier- thin, young, and hydrated with veins like ropes. I could make excuses telling you how the skin of the Africans is thicker (honest- ask any nurse here) and makes a smooth poke difficult. I could describe to you how the vasculature itself differs with the Africans- they have more valves than I've ever seen. Ali hypothesizes it's because of the chronic dehydration, and I suppose that's as good an explanation as any, but it still doesn't excuse my IV failure. Neither does the fact that our needles are 24 millimeters long. Twenty-four, people! The fact is that I still had to poke a thirteen year old with an 24 mm, 18G needle... unsuccessfully. As she shielded her eyes and bravely didn't make a peep.

I could tell you how frustrating it is to watch a baby struggle to gain the precious weight needed for a critical cleft palate surgery. A struggle compounded by a young, overwhelmed, detached mother and strong cultural beliefs about demon possession with cleft lips/palates. And, yes, I would be wrong if I didn't tell you about the spiritual warfare taking place in that very ward where broken babies and overwhelmed mothers struggle though, minute by minute, day by day. I could tell you how much we fear that for any successes we may have here, the broken babies eventually go home- either to the arms of God or the arms of their villages. Neither is an easy end.

I could tell you about these things, about my day, and more. But I won't.

This entry is very important to me. I want to tell you about how God made his presence known intimately to me today in perhaps a subtle but no less forceful way. I felt drier than I've felt in a long time. Drier than working CVICU. Drier than working PICU. I woke up from a poor sleep- physically tired, emotionally exhausted, and desperately homesick. I was undeniably depressed. And yet I felt clearly that this battle to get out of bed was important. So I did get up early to observe surgery this morning. I saw life altering cataract removals in the familiar environment of the OR. I saw hernia repairs (on hernias that only pictures can describe) done by a practiced hand with a play-by-play by the surgeon who likes to teach and an OR nurse who likes to chat about Culver.

Feeling a little better but still dreading the next shift, inevitably closer with each passing minute. And so I decided to eat lunch, realizing I hadn't eaten anything of value since yesterday at lunch... and that was probably contributing to the problem. And then as I was sitting at a table by myself, another of the ship's many saints sat down across from me. I could see she felt put through the ringer too, and yet she wanted to know how I was doing. It was a genuine question that deserved a genuine response. How am I doing?

I'm homesick. I want off the ship. I am frustrated being here because, well, maybe I just shouldn't be. Maybe I'm not cut out for it. Maybe God didn't want me here after all. Maybe I'm just a drain on resources here both as a nurse and as a community member. Maybe they won't like me. I don't understand the complexity of interacting and trying to help in a world I know very little about with a set of skills that may not even be useful. I don't know, maybe I'm just depressed. And of course, maybe I just miss Peleke and our future we're so looking forward to. I just don't understand any of this.

I just couldn't help it, I just started crying right over my plate there at lunch with poor Ursula who was fighting back her own tears. We danced around it a while- do we continue this conversation now when we're both so low in front of everyone in the dining hall? For my part I wanted to because I needed something, anything to prevent me from collapsing in on myself, to get me through the next couple of hours. I started to think that's why Ursula was there, but then I realized, that's what God was there for. He was just allowing her to express his love.

So there we sat, now crying together over the unspeakable, unexplainable frustrations of our current lives. And then she said something that, yes, made me cry more, but also was the point where Jesus spoke the loudest. Ursula reached across the table, grasped my hand, looked me in the eye, and said simply, "I am glad you're here, and I will pray for you." It was so matter of fact, and I simply believed her. With that sudden relief found only by the gift of somebody giving what you hadn't realized was being withheld, I felt the slightest bit lighter and maybe even a bit stronger- almost ready to take on D Ward anyway.

Giving a tear stained, half smile, we parted for a few hours to do our various things before meeting up at work in a few hours. I decided to sleep, or at least lay quietly in bed. Back in my bunk, the loud, overwhelming fears and thoughts started to take over again, nearly debilitating. Only the thoughts of the previous conversation and of rising up to a challenge I'd been praying for kept me sane. I drifted off into a fitful sleep for less than an hour and yet woke up just long enough before my alarm to hear the words of a song floating quietly through my mind.

Here I am, Lord. Is it I, Lord?

I have heard you calling in the night.

I will go, Lord, if you lead me.

I will hold your people in my heart.

Here I Am Lord. It was one of my favorite songs we'd sing at Culver, but I never felt that I could relate to the words. I song it more longingly than earnestly. And yet here I was years later waking up to it. Consciously pushing the fear and anxiety out of my mind, making those verses my mantra, and deciding how aggressively to take over control of my shift so as not to push God right out of the experience, I got out of bed and walked tentatively twenty seconds down the hall to D Ward.

By the lay of the land, it seemed to be as busy or even more so than yesterday. I pushed the negativity back out. I sat purposefully in report just breathing in the experience, beginning to enjoy it. I prayed with the offgoing shift, everyone lifting up their frustrations, fears, and anxieties about working here, pleading for guidance and faith. Let us be the work of Your hands. Let us know we are the work of your hands.

And the shift began. It was better. Truly organized chaos, at least for my part. I missed things, I made babies cry unnecessarily, I frustrated mamas with my demands and pitiful French, I fumbled with IV tubing, diapers, and IV's (always a humbling experience)... multiple times. I probably didn't always inspire confidence in either the patients, families, or fellow staff. I even lost the mama of the boy with an extreme case of Yovophobia and couldn't even begin to help find her as he sat screaming in bed, nobody able to come near or console him. But I got to cuddle the crying babies. I got to get slobbered and puked on. I got chemo up, running, and finished with incident.* I got to help one sweet boy overcome his Yovophobia. I got to make a mama laugh (and I don't think it was at me). I think I got the important stuff done- and hopefully charted.

The evening changeover prayer bordered on irreverent, but we all agreed that if Jesus were sitting right there that he'd be laughing too at the absurdities of the day. At the blind girl contorted on the bed over her mom's legs, finally sound asleep. At the screaming Burkitt's girl finally passed out in the next bed over with her matchbox car on her chest, rising and falling with her snores. At the previous Yovophobe playing drums with the Jenga set, chemo coursing through his small veins. Because Yovophobia is funny. And insisting to everybody and the volunteers that we don't feed the babies is absurdly funny. Because that's the mama's job.

We pleaded for discernment about the mamas of the cleft palate babies. Then Ali ended the prayer stating, "and God, please let us boldly proclaim in Jesus' name that Satan has no power here."

That was also God's small gift to me because I already knew that. He already showed me that from the time I woke up until the moment I lay my head down on the pillow tonight for another fitful night of sleep. He called, I followed, and I'm trying, desperately trying, to hold his people in my heart.

*Well, almost without incident. If I develop a small spot of cancer on my right thigh, it may or may not be related to the drops of cyclophosphamide that may or may not have escaped.