Becoming a Surgeon on-mission
From Calling to Crisis
It had been less than an hour since I had arrived at Kibogora hospital, Rwanda. The names of the theater staff were fresh in my mind and I was scrubbing up to perform an emergency operation. The patient had been in a motor vehicle accident and sustained a broken arm, left femur fracture and was bleeding internally. With ultrasound I estimated there were two liters of blood in her abdomen, and she was HIV positive. As I rhythmically washed my hands outside the operating theater I prayed out loud “Jesus, I thank you that I am here and can serve you and this patient. Guide the team and my hands, give us the courage to perform your healing work, all for your Glory, Amen”. Now was the time for the team to rise to the challenge to save the life of the patient currently bleeding on the operating table.
I made the incision and plunged into her abdomen. This moment wasn’t by chance. This was a moment made possible by God’s faithfulness. A moment filled with presence where God’s heart and my calling came together.
Fourteen years previously I was lost deep in worship at Citygate Church on the outskirts of London. There, as a teenager I had an encounter with the Lord where I was left without a doubt that I, Matthew, would become a doctor and be sent to serve His people, with my mind, heart and hands, where the need was greatest.
I knew that the calling I had received was true, but my current circumstances didn’t allow me to see how the vision could become reality. I came from a broken home and had average grades. I was even discouraged from applying to medical school. The wounds of my childhood wanted me to live a reduced life, but in Christ there is wholeness in His presence and he calls us higher.
The struggles were numerous; financial and personal, but through all of it, He was, is, and always will be faithful. I completed my medical studies in Prague, Czech Republic and was even a visiting student at Oxford University. After six years becoming accustomed to the tall, gray, functional-realist, concrete-flat blocks in Prague, I yearned for wide open spaces and adventure. I started my surgical training on the Helgeland coast in the Norwegian arctic. There my soul drank deeply of mountains rising next to fjords, the midnight sun and raw beauty of pristine winters. Having gained a few years of surgical experience, the deep desire of serving with my hands had deepened and could soon be lived out.
“Seeing her rapid return to health after such a life-threatening injury was staggering for me, and deepened my belief that the human body was made resilient, and made to be healed.”
Through the eyes of faith, I now can see how the Holy Spirit wove the threads of my past together, forming me for His purpose. The path was sporadic, confusing and full of trials. However, God never said that it would be easy or logical. No, instead he promised Joshua: “As I was with Moses, so I will be with you; I will never leave you nor forsake you. Be strong and courageous…”
Now, as a 30 year-old surgery resident I was finally in a position to live out these well prayed words: “God, use me”.
Back in the sweltering Rwandan operating theater the team managed to control the source of bleeding. Alongside me was Venuste, a Rwandan surgical resident, and Bjarte, an experienced missionary-surgeon and mentor. The operation was successful, the fractures were immobilized and the patient was smiling and sitting up in bed a few days later. Seeing her rapid return to health after such a life-threatening injury was staggering for me, and deepened my belief that the human body was made resilient, and made to be healed.
The experience made me think about what minimum resources are required to get a patient safely through an operation in an austere environment. In the West, everything is optimal. We have cutting edge equipment, a well-stocked pharmacy and a surplus of over-qualified staff. In Rwanda, the supplies available vary day-to-day. This goes for anesthetic drugs, blood transfusions and surgical sutures to name a few. Advanced imaging such as a CT was not available.
The staff are masters in how to save and use resources as appropriate. Rationing in the medical world is a new concept to me. Practically this meant facing dilemmas like “Does this patient really need this unit of blood? Perhaps obstetrics will need it tonight for an emergency c-section” or “Can I get this suture? We only have this one.” Despite these constraints, so much good can be done with so little. I am all the more in awe of my Rwandan colleagues for serving patients through these challenges.
Ambroise Pare, a French battlefield surgeon in the 16th century famously declared “I cut, God heals.” Pare understood that we, as humans, are limited. We are not the authors of life. We don’t create, we don’t give and take away. If we think we do, then that is our own pride talking, not God. In Pare’s time, and even now in 2022 we know a finite amount about the inner workings of the body. We cannot heal everything and the majority of a doctor’s work is really an attempt at healing. This is a lesson that hits a young doctor hard when facing a dying patient, with no options for treatment and empty hands.
I have come to learn that all healing is God’s work, by a surgeon’s knife, a chemist’s drug, a psychologist’s words and behind all that is God’s hand. Paul said, “I planted, but God gave the increase”. My role in healing is to partner with the Father, apply my surgical knowledge to the best of my ability and trust Him. To act in faith, steward what I have received from the Father and live it out for His glory. Healing was designed to be in fellowship with He who heals.
Our attempts at healing in the western world are too clinical. All too often, we see patients as work. Another name on the list to get through. We are told to have professional distance with our patients and to not get emotionally involved. Even the process of operating is geared towards de-personalizing the patient lying on the table. The surgeon is called to the operating room once the patient is put to sleep and drapes cover the entire body from the view of the surgeon. The thought being, It’s much easier to operate on an organ than it is a person.
However, at Kibogora Hospital I began to receive a re-education for what it looks like to be a healer. The doctors and nurses taught me how to meet the person behind the illness. A usual day starts by rounding on the eight bed intensive-care ward. There are no fans, the floor is cold concrete which slowly warms up during the day. Patients and their families sit around. The nurses bustle around in pressed white clothes. An IV bag might hang from a mosquito net, a practical solution. Despite having curtains separating the beds, many patients pull them aside to see and be with each other. There is a distinct lack of beeping from machines which characterizes the ICU at my home hospital. Only three of the intensive care beds have vital sign monitors.
As we round on the patients the head of surgery, Ronald Tubalisme, sits beside a patient in their bed, he lays an arm around them whilst chatting with their family. This relational aspect would often take longer than the medical part of rounds. The chat would then continue into prayer done in unison with the nurses, doctors and family present. By the laying on of hands and engaging with the patients’ stories we are by nature emotionally involved. Thus the joy when a patient overcomes all odds and is restored to health is all the sweeter when shared and celebrated together. Likewise when a patient succumbs to their illness, we grieve, together in fellowship. We shout, cry and console each other – together. Through our vulnerability it feels healthier this way by sharing with our brothers and sisters in Christ. It’s one of the beauties of living out faith with others. If we only treat the physical we leave the soul spiritually wanting. If suffering can indeed have a purpose, – and I by no means claim it inherently does – one of its lessons would be to show us our need for others and for God, to call on His name and duly be comforted and healed by His presence and the presence of community. He is indeed close to the broken-hearted.
Hospitals can really be houses of God. A place where miracles happen. Where suffering is reduced. Where Christ’s hope in us, shone out, creates hope in others where there was no hope. For the patient in front of us in pain, we are called to be strong and courageous for them. Not through our own self will, but by the power of the Holy Spirit upon us. How can this be lived out? The following are true stories of two of my patients in Rwanda where I walked in the tension of tragedy and healing, knowing God is present in both.
Check back next week for the next installment in my story with two true stories of my patients in Rwanda where I walked in the tension of tragedy and healing, experiencing God’s presence in both.