and on...

OK you have checked and nothing new is here. You know that life isn't static so you wonder why?

The bottom line is that I lack inspiration. We are heading into a darker zone than we left.

We were with Ben and Andrew this week at his farm outside Syracuse. (He came back for his sister's wedding with Andrew and we took the moment to go see them). The night was stormy and thick clouds covered the moon and stars. We went to bed and I couldn't see a thing--rather unlike Baltimore where the darkest night has plenty of street lights and security lights shining in the window. In the middle of the night the thunder rolled and the lightening lit the room as if the switch were thrown.

Well, there it is. A dark night. Yeah we get them too. Surgery is Monday, we don't have any idea what to expect.

I enjoyed the storm of lightning and thunder. It has always been for me the voice of the Almighty reminding me that He holds the heavens and earth, they shake at His command, they become still by his voice.

I should have been listening, but my head was buried I guess.

The journey goes on...

Rare adj
1. not often happening or found
2. particularly interesting or valuable, especially to collectors or scholars, because only a few exist
3. unusually great or excellent
4. thin in density and containing so little oxygen that breathing is difficult


Our journey goes on. It is a rare journey in all the meanings listed above.

You know as we do that Paget’s disease of the nipple is not often found. I suppose that makes it of particular interest to the medical community.

But suppose that Deb had not just one form of Pagets disease but two? In that event, then God’s grace would have to be unusually great, and we would be left a bit winded.

So it is and so we are.

Tuesday Debbie went for a second biopsy for a lesion that we have been watching for a number of months now. There had been some other tests and treatments but nothing really made it better. Hence the biopsy. Three deep conical excisions removed from three areas that should have represented the center, the edge and normal tissue. All came back with a positive confirmation of gynecological Paget’s disease. Debbie learned the results on Thursday and phoned me. I was in Los Angeles on my way to Indonesia. So here it is:

Gynecological Paget’s disease is an extremely rare form of abnormal cells that are either a precursor to cancer or indicate an underlying cancer. There is no relationship between the breast cancer Paget’s disease and this gynecological form. There are only four other known cases reported in medical literature of women with both. Deb will undergo a “wide excision” surgery to remove all the abnormal Paget’s cells along with a margin of safety and a sampling of lymph nodes in the groin. The pathology report will indicate the extent and staging of cancer, if in fact there is indication of cancer beyond the presence of the Paget’s cells. Her recovery period will be about three weeks. We will have a well renowned doctor who trained and works at Johns Hopkins in addition to Mercy Medical Center where she will have the surgery

Yes, I went on to Indonesia. You probably wonder why? Of course by the time I heard I was already 8 hours into the trip that lasted for about 42 hours. But that was not a reason to carry on. The reason to carry on is that in times of rare air, you have to carry on. If you are swimming at the bottom of a body of water you don’t stop swimming or you drown. If you are climbing Mt Everest you don’t stop or you freeze. So we decided to go on. The conference here is short, and my part is over by Wednesday. Perhaps I will be able to make an early return.

It is a unique moment here. Indonesia is the country with the largest Muslim population in the world. Significant violent conflict has occurred between Muslims and Christians here. As usual there is a history of significant conflict in the church among leaders. This conference begins with the government blessing, the Muslim community will be represented by a highly respected leader. Over forty denominations are already represented, and over 2300 attendees are here. The seminary dean is in my DMin program in Manila and has helped bring this gathering of church leaders, Indonesian missionaries, Muslim and national leaders to a conference on biblical peacemaking. This too is rare air.

Tuesday Debbie has an appointment with an unusually excellent doctor. He will advise and plan for a surgery sometime in the near future that will not only take the “wide excision” but attempt to redo some of the pelvic surgery that did not “take” six weeks ago. By the time I get back we should know when that might happen and what it might involve. Right now we are just holding our breath.

Genesis says that the Creator God exhaled into Adam the “breath of life”, and he lived. He lived to labor. He labored to show God’s glory. God’s glory was reflected in Adam’s love and obedience. It was even better reflected when God provided for redemption when Adam made the choice to sin. That sin infected the world and we now live in that infected world. But the Redeemer lives. He breathes into us the breath of life that neither Paget’s nor any other presence or power can take from us. That is rare air—nothing is greater or better. Breathe it with us.

7000 emails

7000 emails.

Actually probably about 7100 since there are some in my inbox for Debbie that she has not read yet.

If you have to manage a hefty email account you know what a burden that is. And it grows every day. So Deb went back to work this week and was dreading going in—you can understand why. Of course those emails had not all accumulated just from her time out for surgery and recovery.

Some have wondered why she doesn’t stay out longer—but the month she had has gone by already, and extra days will be needed again towards the end of the year for the final reconstruction surgery.

Exercises? Some days more than other days. With a return to “normal” it has been hard for her to build in time for regular post-surgery rehab exercise. In fact since she is not walking to work now she doesn’t get that either. For people like us the regular disciplines of life are some of the most difficult to maintain. We don’t eat on a schedule, don’t travel on a schedule, don’t play on a schedule, don’t sleep on a schedule (but usually it is at night!) and I guess work is the schedule—which we tend to put in to a lot of different time slots.

So, before heading back to “work” Deb managed to pull the 7,000 down to 6,000. The practice here is that when you don’t answer after a certain period of time, then an email is either too old to be of importance, forgotten by the sender, or the matter needing comment was resolved, ended or missed. I suggested that I could cause her computer to crash and it would be faster to just say “my computer crashed and I lost your email” but she figured that it would take more time to remember the 7,000 and write them the message than to sort through the stack. Probably after a week she is back to 6500.

We have had some very interesting visits from folks this past month. Some have been work-related and some have been reconstructing and building on long friendships. We are deeply privileged to have friends that understand and love crazy people like us. These are blessings of the Savior who walks with us in the valleys and on the mountains, and in the skies.
Two more sets of good friends expected in this week. It is a good thing that all our emails don't sit in the box unattended!

"normal"

Ever wonder what "normal" means? For us, "normal" means "the way we usually are". I find that sometimes I want to be "extra ordinary" and I tend to contrast that with "normal". Now just what is "extra" about extra ordinary you wonder?

"Extra" ice cream would mean a bigger portion. "Extra special diet" would mean more diet with a better taste, I guess. Life in general for Karl and Debbie is somehow not back to normal yet. It is however, extraordinary.

You know the way we usually are--flying just above the ground and in several directions, often different directions. Book projects, teaching, program supervision, planning. That would be in Indonesia, China, Philippines, Africa or possibly the US. It might find me doing a mediation or Debbie visiting a funding office in D.C. Probably it would be receiving special guests. Definitely it would find us in an international student Bible study every Friday and a church small group every Monday when we are in town.

So the way we have been in this last week is sort of like that normal, but a bit extra ordinary. We have not been flying around or supervising or teaching or writing. Nor have we been to California or Florida or Chicago (Karl did run off to Montana for a week though). The International students have still come and the small group met in our home for the last month. And we have been together for the last two months, and that is extra ordinary, and special.

Sunday after church we took a walking tour of the gardens in our "Charles Village" part of Baltimore. Mind you, in the city you tour these micro-gardens from the alley because that is the only place that has more than a 144 square feet without concrete (although our alley garden consists of a few green things around the base of a tree surrounded by brick and concrete). We have had a good supply of wonderful friends from many different eras of our lives come to visit us. That is VERY special and reminds us of God's love through deep friendships that pick up where they left off years earlier. Most folks don't quite know how to relate to either dogs or humans that run frenetically just above the surface of the ground, so when we stop we find that we still have friends who love us.

If you have not yet put the picture in your mind, then let me just say that Debbie is healing wonderfully and will start to wade through the 6,000 emails in her inbox (that is not an exaggeration). We had a wonderful planning meeting with a friend and colleague from Nairobi that might actually get us on a plane to Nairobi together in July. Karl's medication has been changed and he is well, a bit more normal. The new medication takes 45 days to get up to full blood level, so we will see what happens. Deb went to the doctor yesterday for some additional "filling" and came back complaining of the pain. Actually the pain was a good sign that at least sensation and feeling was starting to return to operation site. She "normally" does her three times a day exercises once a day. (NOT GOOD--can you tell who is writing this?)

I was starting to catch up on my email yesterday and settled to write a prayer letter when I noticed that the house behind us was putting in a new concrete parking pad, so I quickly went and asked if I could have a wheelbarrow or two. I was informed that there was just about that much left, so I carried a bucket into the basement to fill a trench cut for a new sewer line. Upon my return I found that the "normal" concrete left over had been placed in the middle of the drive area from which I had removed all the old concrete. I looked at the "normal" and my jaw dropped. It was a mountain. The driver said, "there was more in there than I thought, they must have weighed wrong, looks like about two yards". For those of you who don't know what that means, it is about the cubic equivalent of your washer, dryer and stove combined. But not to worry, I had no form boards, no concrete tools, and only myself to do the work. Not a problem? Concrete sets in about an hour.

Oh yes. Back to normal.

pa·thol·o·gy (n)

pa·thol·o·gy n
1. the processes of a particular disease, observable either with the naked eye or by microscopy, or, at a molecular level, as inferred from biochemical tests
2. any condition that is a deviation from the normal

Our lives seem to illustrate the importance of this significant word with both of its definitions.

On the positive side, we have received the pathology report from Deb’s surgery. The breast tissue as well as the sentinel lymph node were diced and sliced and scrutinized. Thankfully everything showed that the affected areas were all fully removed. So the disease is over, for which we thank and praise God. We are now eight days after the surgery, and today the next surgery for reconstruction was set--early January 2009!

So there is still a deviation from normal. We are still counting the amount of fluid drained from the operation site. Deb is still working on exercises that would make her grandchildren giggle, but they are painful for her. We are enjoying the presence of many friends—some of whom we have not seen in many years. We are basking in the confidence and knowledge that so many are praying for us particularly at this time. All of that is a deviation from the normal—and it is sometimes good to be outside the normal range.

One deviation from normal that is complicating things right now is the impact of the anti-seizure medications that Karl is experiencing. At this point a day in the hospital or a loss of memory of a few hours would be preferable to the frustration of feeling unable to focus, continually exhausted, just not really interested in people, and snapping at the most simple complication. Yes, the medication is having side effects that are devious, not just a deviation.

So, while Debbie is mending normally, Karl is bending away from normal. It raises the question of who is helping to heal and who is a healing helper. What we do know about our pathology is that the Healer made us whole and is still intervening in our lives to bring us wholeness. The “normal” of our lives misses the mark of His wholeness--which makes our lives pathological.

Pathology in most cases and certainly in our case, leads us to theology. Seeing our sickness helps us see and understand our Savior/Healer. One day all things will be made new. Today we are happy to have a step toward newness.

When we feel lopsided or loopy we remember that Jesus came not for those who were already whole, but those who needed to be made whole. We have some big holes that need filling.

Life support

Surgery is always a complicated process even when it is minor. This has been a full 30 hours!

By seven AM Wednesday, Deb was given a radio-active dye which was to help in locating the sentinel lymph node during surgery. She had several hours to wait then before it had moved through the system and was ready for the parade to begin. Since there were three surgeries, there were three surgery teams. Add to that the anesthesia crew, the nursing crew, and the recovery room crew. For most the routine was the same: check the name band on her wrist to be sure it was the right person. Then repeat all the processes that were to be done--that litany started to feel cuttingly cruel after only the second time. Do we HAVE to be reminded of everything that had to be done? But then I began to watch the story in a new way. All these people were part of the support system, each doing their j0b and each needed to be sure they had the right person and were doing the correct procedure.

So when the surgeon drew her lines on Debbie's chest it was to be sure everything was in the correct place. When the anesthetist looked into her throat it helped to ensure that the correct alternatives were in place when they had difficulty during intubation. All those on every team were well aware of the long list of drugs that could not be considered because of her Long QT. Finally the last nurse finished the routine and said "we are ready, lets go..." I watched as Deb walked with confidence into the surgery area with IV bag in tow. It was just before 11:00 AM.

By 12:30 the mastectomy and the plastic surgeon was finished and came back with a good report: everything had gone smoothly, quickly, and she was buttoned up--well zipped up might be a better description. Good skin preservation had been accomplished, the expander was in place, and the third procedure had been started in the pelvic area. Two hours later that too was finished--repairing and repositioning organs that had been jumbled by three children and infections of the past.

By 3:45 I was in the post-op recovery room with Deb and she was very much awake, but not quite as perky as she had been at 11:00 AM. All three procedures had gone well. The life support systems had sustained her as the doctors did their redemptive cutting and stitching. Although she did not FEEL better, and although there was a very little blood loss, the Life Giver was working in her body to knit it together again.

As the day wore on the pain grew more intense and movement became more difficult. The pain pump alleviated much of the pain, and slowly the shifting of position helped the movement to be less difficult. Hannah spent the night next to her bed and was available as her blood pressure dipped low and then returned to normal.

By 7:30 AM today the doctors had made their rounds and began removing tubes that had siphoned off body wastes or infused life-nurturing liquids. As her body gains strength those other life support systems become less needed, and we are reminded of the single life support system that does not diminish nor become redundant: God's grace supplied with His strength and often through His people.

As this afternoon comes, We await the doctor's decisions about whether Debbie will return home today to be embraced by support there--Donna, Rebecca and Hannah plus many others who have enlisted to encourage and help. We anticipate seeing people who have passed through our lives long ago as we receive visitors. They remind us of God's faithfulness through the years in His supply of life through His body.

Deb has started her exercises! A little head-rocking and arm-movement to there and back. Not much you know, but life movement begins with the regular and faithful demonstration of what we can manage. Call it a mustard seed approach to life.

The glory of God and of Kings

Yesterday morning awoke with misty eyes. We had picked up Hannah from Dulles Airport in DC and drove a short way to retreat in a friend's W.Va. mountain home. The Shenandoah valley at one point was simply filled with fog. From my view in bed I could barely distinguish a single tree in the early morning mist. But I knew the landscape was filled with early spring green and the river curled past the view point. An hour or so later the breeze had blown away the clouds and made even the distance seem near.

So with a hot cup of coffee in hand, Debbie and I waited for Hannah to arise out of her jet-lagged sleep. As I peered over the tree tops and allowed my heart to settle in the beauty of the majestic mountainside, Deb read from Proverbs 25. "It is the glory of God to conceal a matter, and the glory of kings to search it out." At first that seemed odd and hard to understand. Why would God conceal a matter? Even more, why would that reflect glory to him?

We thought of our own life journey and those we have known and in whom we have sought to sow the seeds of the Kingdom. So many matters of our own lives remain a mystery. With us so many have sought God's face and mercy to intervene at our point of need. We have sought wisdom to understand and choose the right way forward. We have sought strength to accept the things we could not change. But even now we peer into the circumstances of our lives and see only mist and fog. Of course "why cancer?" has an understanding in the nature of a fallen world and the existence of evil and sickness. We thought about people we have known and loved who have chosen to leave Africa or Asia or some other global point of need to find employment in the U.S.A--a land of plenty. We are puzzled as to why God would have us of all people working out of this country. I thought of the thirty boxes of books that just left our house last week to start their journey to Sri Lanka. It represented the finest of two lifetimes of theology and pastoral library collection. The fog is ever so thick.

But I know that beyond the fog is the beauty of the River of Life even when I can't see it. I didn't create the roads, I only followed the map given by Someone Who Knows. I can only observe trees that are planted and grown by Someone Who Creates. And so the glory of God is seen when the questions are too big for me. God conceals the matter not out of some mean spite to hide understanding from me, but because the matters are beyond my comprehension. Can I fathom the pathway of the kingdom among the nations? Am I able to understand why God uses some people in magnificent ways and others in common ways to forward His reign of righteousness? Am I really able to comprehend even the pathway of my own life and know where my voice should be heard or my feet tread so to nurture seeds of life that He has planted? Can I know in advance the lessons that he has for me to learn through pain or loss? Would I choose the painful pathway even if I knew I would see His glory more clearly on that pathway? Certainly not.

So His glory is the greatness which conceals the smallness of my moment. And my glory? My glory is in seeking out some small part of that greatness.

We took a walk on the Appalachian Trail. For the first time I saw what I knew was true for much of my life. In the middle of the trail was a small acorn, it had sprouted and its tiny two-inch stem was reaching from the acorn toward the sunlight above in the midst of the mighty oaks all along the trail. Its glory was to stretch out its arms and absorb the light.

If I am that acorn, my glory is not to know that one day I will be sawed into pieces to make a grand banquet table for the king. My glory is to reach for the Light and allow the miracle of life to be seen in me.

It is that simple I guess. Cancer. Surgical removal of treasured body parts. Being pulled like a weed out of the garden of Africa. Books that represent aspirations of understanding and learning just heaped onto a truck and shipped half the earth away. Perceived opportunities to impact people and nations that get struck from the travel schedule because of economic realities. Visions of accomplishments quickly eclipsed by other's agendas.

I could feel sorry, or angry, or ashamed, or depressed. But this weekend I saw an acorn in the midst of the mighty oaks. It simply reached up for the Light.

Me too. How about you?