Here you will find the somewhat random musings of a pediatrician in Watkinsville, Georgia. Some of my posts will involve medical topics, some political (maybe), and some spiritual. I will probably throw in an occasional comment about UGA athletics, or some other sports-related topic, as well.

Your comments are invited.


Walking with Rhinos

Monday, September 12, 2016

Memories of 9/11

I know it is now 9/12, but I wanted to take a moment to share my memories of 9/11/2001.
I was in my first year of residency in Greenville and was on an inpatient pediatric rotation. We residents had done our preliminary rounds and were meeting in the pediatric workroom with our attending physician discussing patients when someone told us to turn on the news.
We turned it on just after the first tower had been struck and watched for the next several hours before continuing our rounds.
While watching, our attending physician Robbie Robinson (possibly the smartest person I have ever met) said "This was Osama Bin Laden". We all said, "Who is that?" and he proceeded to educate us.
I will certainly never forget how I watched the firemen and policemen heroically heading into the chaos to try to save anyone they could as multitudes ran in the opposite direction
I remember the unity we saw among Americans. I remember that our nation sought God as a result.
I remember the leadership of George W. Bush and Rudy Giuliani, despite their personal faults, in the weeks and months following that terrible day. Whatever criticisms you may have of them, they were the firm and reassuring hands our nation needed during those uncertain days.
Never forget the heroism of that day.
Never forget that America has enemies.
Never forget that we all have an enemy.
Never forget that there is a Hero who will defeat that enemy permanently.

Sunday, August 10, 2014

Thin Places

Thin Places

I love to travel.  I hate sitting in a cramped airplane, but I love to travel.  I love to see new places.  I love to explore.  I love to see all the amazing places that God has created.

My wife and I recently went to a continuing medical education course in Colorado.  About once a year I go to one of these conferences.  I have only gone to the same place, to my memory, twice.  I went to 2 CME conferences in Atlanta because it is nearby and it just fit our family schedule best.  I have gone to CME conferences in San Francisco twice.  Why twice to San Francisico?  Well, there are tons of things to do, it is near the Pacific Ocean, it is near Napa Valley, it is near Alcatraz, it has great food (no, not Rice-A-Roni), and it has several major professional sports franchises.  San Fran is a cool city and the weather is fantastic.

But, back to my point.  We recently attended this conference in Colorado (Vail, to be precise) for two reasons.  First, I needed to acquire my CME hours.  Second, and probably the greater reason, I had never been to Colorado.  Oh, I could sing to you about Colorado (if I could sing), via the lyrics of John Denver, but I had never been.  I was, at least partially, in search of a thin place.

Why do I like to go to places I have never been?  Why Colorado?  Why San Francisico?  Why Outer Banks a few years ago?  Why did we take a road trip from Georgia to Arizona (yes, the Dawgs were playing in Tempe, but, really, the Dawgs play 6 road games each year)?   Why have I traveled to Boston, New York, New Orleans, Amelia Island, Phoenix, Acoma Pueblo, Santa Fe, Memphis, Shamrock (Texas), the Grand Canyon, the Painted Desert, the Petrified Forest, Louisville, Cincinnati, Hermosillo (Mexico), Margarita Island (Venezuela), the Bahamas, the Virgin Islands, Puerto Rico, Cyprus, Italy, Kenya, and Ethiopia?  I have,in my list, undoubtedly missed some places, but why do I continually seek out new places?

I believe at least part of the answer is that I am seeking out thin places.  Not all of the above locations qualify as thin places, but my desire for finding thin places probably precipitated some, if not all, of those trips.

There were other reasons for going some of those places.   We went to Kenya as a medical mission and went to Ethiopia to adopt.  I went to Mexico as a college student on an evangelical mission.  I went to Louisville and Cincinnati to see Widespread Panic, the Kentucky Derby, the Louisville Slugger Museum, and to see a baseball game.

I believe that most of us desire to be in thin places.

What is a thin place?  I'm glad you asked.  A thin place is a place where the distance between heaven and earth seems to disappear and where "we're able to catch glimpses of the divine".  There is a Celtic saying that heaven and earth are only three feet apart, but, in thin places, the distance is even smaller.

Whenever I have arrived at a thin place, my soul immediately has immediately known it.  When I stood on Haleakala and snorkeled in Hanauma Bay, my soul knew these were thin places, though I did not yet know the term.  When I walked the pink beaches of Bermuda with my new bride, my soul knew I was in a thin place.  When I viewed the rocky coast of Massachusetts and imagined what the pilgrims must have experienced, I knew I was in a thin place.  When I looked over the colorful, alien wasteland of the Petrified Forest, I knew I was in a thin place.  When I surveyed the enormous expanse of the Grand Canyon, and thought that "grand" was too little an adjective, I knew I was in a thin place.  When I stood in the Muir Woods and looked up, up, up, at the majestic redwoods, I knew I was in a thin place.  When I stood in the Uffizi, and gazed upon masterpiece after masterpiece, I knew I was in a thin place.  When I stood in the Maasai Mara and viewed thousand upon thousand of gazelles and zebras and witnessed a lion attempting to down a wildebeest, I knew I was in a thin place.  When I looked down upon the Great Rift Valley from Kijabe, Kenya, I knew I was in a thin place.  When I looked upon the same rift from Mount Entoto in Ethiopia, I also knew I was in a thin place.

So, the recent Colorado trip.  It was indeed a quest for ongoing medical knowledge, but it was more.  As my wife and I hiked the steep and rocky trail to Hanging Lake, we were driven by a desire to find a thin place, to find a place that would, once again, renew our awe in God's creation and would draw us nearer to Him.  After my wife had returned to Georgia and I remained in Colorado for the rest of the conference, why did I venture 10 miles off paved roads to Piney Lake, despite the very real possibility of significant thunderstorms and maybe even flooding?  I sought another thin place that would draw me closer to my Creator.   Why did I hike up and around Vail Mountain despite the ongoing thunderstorm threat?  To see more of my amazing God's creation and come yet closer to Him.   The hike with my bride of 18 years and the lone hike up and around Vail Mountain were indeed highlights of the Colorado trip.  I have an amazing God who has created incredibly beautiful things.  My God is an awesome God.  May I (and you) continue to find thin places.  Look for them.  Follow that pull toward thin places.

Thursday, April 25, 2013

Update: Settling in

Wanted to give a very brief update (since it is 1 a.m.):

We have now been home for about 2 1/2 months and everyone is adjusting.  Overall, things are going well, though the adjustment period has been demanding in a number of ways.    We are beginning to emerge a little from our "cocoon" and start to return to some of our "normal" activities.    Although I was a little skeptical of the cocoon concept when I first heard it, I can honestly say that I am a believer in the wisdom of the cocoon period.  Your adopted child needs to attach to YOU.  If you have adopted or are considering adopting, I strongly recommend The Connected Child by Karyn Purvis. The information and strategies are invaluable.

I will backtrack and give more details about our time in Ethiopia and events since our return later, but just wanted to let everyone know we are still here and are doing fine.  Our days have been very full and time to write has been scarce.

On the list of things that would have been nice to know before we got home, I would like to add the following:
It would have been REALLY nice to know that there is an Amharic word for "dead" that sounds tremendously like the English word "safe".
When you, as a parent, tell your new child that you want him to be safe, you would like him to understand that you mean safe, not dead.  Just sayin'.

Wednesday, March 6, 2013

Gotcha Day

Upon our arrival Monday night, we were informed that we would be picking up our son in the morning and taking him with us to see his birth family in a town about 3 hours away.  We had expected the birth family interview to take place on Saturday, which meant we had to stay up late Monday night to get everything ready.  Amy and I both had less than 4 hours of sleep following our approximate 26 hours of travel since leaving our home Sunday.

We arose early, got everyone ready, and went to breakfast.  The agency social worker arrived as scheduled and took us to the orphanage to pick up our son.  He greeted us with hugs and was excited to meet his siblings for the first time.  When we went back to the vehicle, he immediately jumped into the backseat with his new siblings.

How did we know he was the one?  The ray of sunlight that followed him around helped.

 We journeyed about 3 hours up into the mountains, much of the journey on an unpaved (but gravel) road.  We eventually came to the town of Ankober and found his grandmother, aunt, cousin, and uncle walking along the side of the road.  We went with them to a small cafe and made our introductions.  His family greeted him with hugs and kisses and then greeted us by thanking us profusely and kissing our hands.  We felt so unworthy of this gesture and were greatly humbled.  This family, who had risen at 3 a.m. and WALKED for 6 hours to reach this town, had experienced much greater hardship and loss in their lives than I ever have.  We, on the other hand, have been blessed tremendously in our lives and it was only the blessing of being born and raised in the U.S. that made it possible for us to be there to adopt our son.  We definitely did not deserve such profuse gratitude from this wonderful family.

Reunited with his grandmother

His family's love for him was unquestionable
 We spent about an hour or so with his family, learning as much as we could about our son's past.  His family clearly loved him very much and expressed joy that he was healthy and that he was going to become part of our family.   We then said our "ciao's" and headed up the mountain to the Ankober Palace Lodge for lunch.  The beautiful but weathered faces of his sweet family will be forever etched in our memory, the sculpted ridges and valleys of their faces reflecting the terraced mountainside from which they had emerged.

We then hiked to the Palace Lodge (elevation about 9600 feet) and had an excellent meal of traditional Ethiopian fare for the adults, and spaghetti for the kids.  It's always kind of nice to burn off your meal before you even eat it, and we did so on that hike.  The kids enjoyed playing on the traditional drums in the dining room while waiting for our food.
It was a tiring hike
Always reassuring!

All four of our kids with A's cousin and aunt
The drums were a hit (pun intended)
After finishing our lunch (at about 4 pm), we began the journey back to Addis Abeba, our heads nodding along the way as we struggled to stay semi-awake.  Our new son must have thought we were a bunch of narcoleptics since his siblings were falling asleep on his shoulders as his parents were nodding in the other seats.  We made it back to the guest house, arriving about 9:00 p.m., eating dinner, and then unpacking before finally getting to bed about 2 a.m. (the kids were asleep by midnight, though).  Our embassy appointment would be the next morning at 9, which meant breakfast would be at about 7:30 and that we would have another short night of sleep.  We were exhausted, but thankful to finally be together as a family.

Friday, February 22, 2013

Looking for Career Opportunities?

Change of pace here, but had to share this one.

Had a drug rep visit the office today (at an inconvenient time; I know, it's shocking) to share the great new coupon program that gives patients $100 off every prescription and can be used an unlimited number of times.


1.  How big is the profit margin on this drug if you can give $100 off every prescription?
2.  I asked if they needed a medical director, since it is apparently far more profitable to sell drugs than to prescribe them.  She didn't answer.
3.  If you ever wonder why your insurance premium is so high, look at the profits and executive salaries of insurance companies, drug companies, hospitals, and EHR companies.  Paying your doctor is a rather small fraction of your healthcare costs.
4.  If your career goal includes earning money, try to move up the corporate ladder in one of the above 4 industries.

That is all.

Brief Update - Ethiopia Travel Days

For those who have been looking for updates, I apologize for not posting in a while.  We have been in survival mode for the past 4-6 weeks and are just now emerging a little.

We returned to Addis Abeba, Ethiopia on January 21 to pick up our son.  We had a little anxiety on the way over since our flight left Atlanta 40 minutes late and we only had an hour and a half layover in Frankfurt.  On top of that, snow and ice were bad in Frankfurt at the time and we spent a little extra time circling in Germany before we could land (although the captain was nice enough to let us know that we had enough fuel to circle for "a while").  Our flight attendant (I will not use the word stewardess) told us we would not make the connecting flight, but that the airline would take care of us since we would have to spend the night in Frankfurt.  Not that I would typically mind a day of sightseeing in Europe, but we were supposed to pick up our son the following morning and we really needed to make the connecting flight.  Once we did land, we had about 30 minutes before our connecting flight was supposed to leave.  Unfortunately, there was no one manning the gate and we had to wait for airport crew to come open the doors.  We had Amy move to the front of the airplane so she could exit quickly and run to the next gate and ask them to wait for us before departing.

Once the doors opened, Amy sprinted to the next gate, but had to go through security again before she could proceed.  She made it through and got to the gate with about 10 minutes to spare.  They told her they would wait, but to hurry and get the rest of us there.  She quickly bought the water bottles with squirt tops that we wanted to take with us to Ethiopia (easier for tooth brushing) and ran back to security to meet us.  I had hustled with the kids to try to get to the gate, but we were slowed down by security.  They ended up looking through two of our bags before letting us through.  We ran to the gate with about a minute to spare, boarded the airplane a bit out of breath (which was only about 1/3 full since so many flights into Frankfurt had been cancelled) and then waited about 2 hours before we finally took off.  We waited on the tarmac so long that we had to be deiced again before leaving.

The late departure caused us to arrive in Addis around 11 pm instead of 9 pm.   Because there were significant delays getting our visas in Addis, it took about 90 minutes to finally get out of the airport.  By the time we got to the guest house, got the kids settled, and unpacked enough for the next day, it was about 3 a.m. and we were scheduled for breakfast the next morning at 7:30 a.m. so we could pick up our son early in the day and travel to meet his family.  Amy and I each got about 3 hours of sleep that night and hoped we would not be too exhausted when our son joined us the next morning.

Monday, January 7, 2013

Time Flies

Has it really been a month since I last posted?
     It has been a difficult month to do any writing for a few reasons.  First, it is winter and I am a pediatrician, so work has been pretty busy and the work days have been long.  Second, my partner was out of town for a couple of weeks, making work even busier (it's o.k., though, because she will have to cover for me when we return to Ethiopia to bring our son home).  It was actually a blessing to have the extra busyness at work, since that will help as we are facing the last chunk of adoption expenses.
     One of the other large reasons that it has been hard to write is the waiting.  We are anxious to bring our son home, even more so since we have been to Ethiopia and spent time with him.  It is strange to have a child halfway around the world.  There have been a couple of delays since we passed court in early November, but we now seem to be getting close to getting U.S. Embassy approval and being able to return for him.
     I'm sure I'll have more to write soon.

Monday, December 3, 2012

Between Court and Homecoming

Our family sits in limbo for the next few weeks.  We legally have a new son, but we can not bring him home yet.  When we traveled to Ethiopia, we were required to present ourselves to an Ethiopian judge who would decide if we were going to be able to adopt our son.  She had already reviewed all of the paperwork and had a few questions to ask us before approving the adoption.  Once she had asked her questions and was satisfied with the answers, she informed us that we had passed court and she was approving our adoption.  We were, at the same time, relieved, overjoyed, and saddened.

We were relieved and overjoyed that we passed court and it was now certain that A was going to be our son.  We were saddened because we now knew that we would leave a part of our family in Ethiopia until the U.S. Embassy was ready to allow us to bring him home.

Over the course of the adoption process, I have loved seeing how adoption mirrors God's plan of salvation.  There are numerous places in scripture where we are described as becoming children of God when we receive God's gift of grace and mercy through our trust in Christ's sacrificial death on our behalf.  Most everyone is familiar with John 3:16, which states that Jesus is God's only "begotten" son.  So, if Jesus is God's only biological son (to use adoption terminology), how are the rest of us children of God?  We are adopted.  God has adopted us as his children.  He has one biological kid and millions of adopted kids.

Romans 8 (from biblia.com) describes exactly where our family is in this adoption process:

 14 For all who are eled by the Spirit of God are fsons6 of God. 15 For gyou did not receive hthe spirit of slavery to fall back into fear, but you have received the Spirit of iadoption as sons, by whom we cry, j“Abba! Father!” 16 kThe Spirit himself bears witness with our spirit that we are children of God, 17 and if children, then lheirs—heirs of God and fellow heirs with Christ

23 And not only the creation, but we ourselves, who have uthe firstfruits of the Spirit, vgroan inwardly as wwe wait eagerly for adoption as sons, xthe redemption of our bodies.

We, as a family, are in between verse 15 and verse 23.  We have now legally adopted our son, but we can not yet be with him.  The legal adoption has occurred, just as the moment of salvation is our legal adoption as children of God, but the adoption has not been completely fulfilled.  The adoption of our son will be completed when we return to Ethiopia and take custody of him so that we can bring him home to be part of his forever family.  Our adoption as believers will be fulfilled when Christ returns to this foreign country, Earth, and takes us home to be with the Father as part of His forever family.  May God speed the fulfillment of both adoptions!

Sunday, December 2, 2012

Our Day in Court: Final Day in Ethiopia

Ethiopia day 5

Our final day in Addis Ababa had arrived.  We certainly had conflicting emotions.  We were a little nervous because our court appointment, where we would hopefully be approved to adopt our son, would occur after lunch.  We were looking forward to getting home to the kids and seeing them again.  We were sad to leave the other adoptive couples whom we had gotten to know, as well as the wonderful guest house and agency folks who worked so hard to make us feel at home in a foreign land (truly living out Leviticus 19:34:  you shall treat the stranger who sojourns with you as the native among you, and you shall love him as yourself...).  There was a chance we would get to see A again, so we were excited about that possibility.

Our day started with yet another wonderful breakfast at the guest house.  After breakfast, we returned to the Bethany office for our cultural training, which covered history, food, politics and the wonderful olfactory and gustatory experience that is the coffee ceremony.  I had the pleasure of meeting Tendai, the Bethany director for Africa.  He talked with me about possibly helping out with some medical training for some of the orphanages.  I hope to have the privilege of serving in that capacity.

We then had the opportunity to shop for crafts and spices from local vendors before heading back to Lucy restaurant for lunch.  Today, I decided to try their ravioli, which turned out to be just the right amount to satisfy my hunger.  My appetite was a bit limited since court was still upcoming and I was a little nervous because I did not know what to expect.  The fact that our family might expand by a seven-year-old depended on this court date.  

We arrived at the court building about 2 minutes after our scheduled time.  Since we are American, our group was a little worried about the fact that we were not early.  The Bethany staff don't seem to be surprised by this American anxiety with time.  On Friday, when our new friends Mitchell and Teresa were scheduled for court, Teresa asked, "It's 1:45 now, what time do need to be at court for our 2 o'clock appointment?".  Abel, always gracious, answered with a smile "2 o'clock".  Having had previous exposure to the flexibility of African time, we had a little laugh with Abel over the question.

We arrived at the courtroom and were struck by the fact that less security was in effect at court than when we went to dinner at Yod Abysinia.  We had to go through metal detectors to enter the restaurant, but there was no such security at the courthouse.  After a short wait, all four couples were called in to the judge's chambers at once.  After answering a number of brief questions, the judge proceeded to inform us that we passed, along with 2 of the other 3 couples.  The third couple did not pass simply because a particular piece of paperwork had the gender of the child listed incorrectly.  After court, Firew, the Bethany worker took us to a coffee shop for a celebratory macchiato while we waited to be picked up again.  You periodically have to take a leap of dietary faith while in Africa, and this was such an occasion.  Foods and beverages that have been boiled or cooked are generally safe, so coffee is usually o.k.  The debate with a macchiato is whether the milk is pasteurized and, if not, did it reach an adequate temperature to take care of any bacterial organisms.  Four weeks later, I can say that no problems have yet arisen from this particular leap.

After our macchiatos and coffees, which collectively (for 4 couples and Firew) cost around 5 bucks, we all went to the hospital to visit Jay and Noelle's boy, who was doing better.  Following the hospital, we returned to our son's orphanage and were able to spend another hour or so kicking the soccer ball around.  Amy thought that A had figured out that we were going to be his family and noted that every time A got the ball, he kicked it to me.  Being male, I am much less observant and did not catch that fact.  I was aware, though, that my lack of soccer skills became obvious.  When it was time to leave, we were able to tell A good-bye and give a quick hug.  

We returned to the guest house to finish packing and ate dinner again with group.  Since we didn't have the chance to print the medical letter for the embassy earlier in the day, I handwrote a letter, to which Chris added his thoughts and concurrence.   We gave our handwritten, notebook paper letter to Jay and Noelle and then finished our final preparations to leave.  We had a group prayer before heading to the airport.  Birtukan prayed for us this time.  I couldn't understand a word of her Amharic prayer, but it was powerful and passionate.  Three (couples) of us were on the same flight and had a little extra time at the airport to socialize before boarding the flight for the trip home.  

As we boarded and settled in, we wondered how long it would be until we could return to this beautiful country and be reunited with our new son.  We wondered how difficult it would be to wait for the invitation to come back, knowing that A was now legally ours.  We have discovered since our return that it is definitely not easy to know you have a son halfway around the world that you cannot yet be with.  A few hours into the flight, I looked over at Amy to find her in tears.  I knew what was wrong, but I questioned what triggered the tears at this point rather than at takeoff.  She told me that she had just looked at the map tracking our flight path and our plane was just exiting the African continent. 

Once we reached Frankfurt, we had a short opportunity to say good-bye to our friends before we all headed to our respective flights home.  It was terrific to get home and be with our kids again, but we cannot wait to return to claim our son and have all of our family together for the first time.  We hope our kids will be able to make the second trip with us, but we are not yet certain if that will be possible.

Tuesday, November 27, 2012

A Church, A Shop, A Hospital, and A Letter: Ethiopia Day 4

Ethiopia day 4

Our fourth day in Ethiopia was a Sunday.  We awoke and had another wonderful breakfast and were then taken to the International Church by Abel (whose shoulder was still hurt and who still promised us he was going to go to the doctor that day).  We were blessed again to worship with believers from around the world that morning and met a number of interesting people after the service.  Following the service, Abel took us to the market so that we could shop for souvenirs (still in obvious pain, but with his ever-present smile as he patiently waited for everyone to finish shopping).  Abel encouraged us to haggle with the shop owners.  The best negotiator by far was Noelle.  My favorite quote: "I love to shop!  If you give me a good price, I will come back here and buy more."

We returned to the guest house for a traditional lunch of injera and wat.  Shortly after lunch, we received the news that the child of Jay and Noelle had made it to Addis Ababa and was ready to be admitted to the hospital.  Brandi, Chris (the other pediatrician with us), and I joined Jay and Noelle for the trip to the hospital.  Along the way, we picked up the social worker from Bethany.  We continued toward the hospital and then pulled over after the driver and social worker said they saw the baby and the orphanage workers.  It turns out that the person who drove them from the orphanage in the south had agreed to get them to Addis, so he let them out (in the median of a 4 lane highway!) once he got into the city.  The orphanage director, the nanny, and the baby crossed the street and hopped into the van with us to ride the rest of the way to the hospital.

The hospital is the building on the right

The gate to the hospital
We arrived at the hospital and were quite quickly taken upstairs to a "private" room (Privacy in Africa is not the same as privacy in the U.S.  We had several people spend time in the hospital room who were either random strangers or who really had no good reason to be in the room). The admissions process was tremendously more efficient that an admission here in the U.S.  Once the child was checked in, we waited for the pediatrician to arrive after church.  Chris and I were able to take a peek at the child and share our thoughts with Jay and Noelle.  Hopefully we were able to give some reassurance. 

What you do when you don't have a stethoscope.
I will not include any medical details, but I will make a few observations.  First, it really is a luxury to have a private room, even if it is not always private.  When we were in Kenya, there would be 8 beds in some of the rooms with each bed being shared by a child AND his/her mother.  There was no privacy at all in those rooms.  Second, I felt like the pediatrician was very good and that the child was in good hands.  Third, you could tell that the nanny really cared for the child.  As a parent who is adopting, it is a great relief to know that the people caring for your child before you adopt them are truly caring for your child.

We returned to the guest house and had a tasty spaghetti dinner.  I composed a letter after dinner to the U.S. Embassy in hopes of being able to help expedite the rest of the adoption process for Jay and Noelle.  My plan was to print it at the Bethany office on Monday and sign it, so they would have a physician letter in hand when they went to embassy.  More on that in my next post.  After finishing the letter, we headed up to our room to start packing, since we would be leaving the next day.  Our time in Ethiopia was drawing to a close, but our day in court would have to happen first.