NU 45 KU 35

Today I went to my first Husker game in about 4 years. It was a great time with sweet seats! The game was really exciting, and I got to go with my old buddy from high school James Shada, his wife, and his dad who was my boss all those years at the rec dept in Bellevue. I was glad they took me again (see #2 and 3 below), since my previous record of games is really not too impressive.

1. NU wins 56-27. But it was Frank Solich's first as head coach, Bobby Newcombe tore his ACL, and a quarterback/receiver combo Tim Rattay and Troy Edwards from LaTech looked unstoppable. Rattay had almost 600 yards passing, over 400 of those to Edwards.

2. Loss to Texas 16-20 which ended a 47 game home winning streak, though I did get to see Ricky Williams play.

3. NU 21-7 over TCU. Pretty run of the mill game, but this was the 2001 opener, the year of the infamous get blown out by Colorado then somehow inexplicably make the title game and get blown out by Miami.

4. Loss to Colorado 26-20, the last game in Bill Callahan's inaugural season which ended 5-6. This was the game that ended the NCAA record bowl streak and non-losing season streak. I did get to sit in the student section for this game with my brother John, which was a good time and quite the experience.

For those of you who follow college football... check that. For those of you who are Nebraska fans (because we are no longer relevant in the broader college football world), you know what a big game this was for NU. We were sitting at 5-4, coming off a blow out loss to Oklahoma, and desperately needing a win against a quality opponent. It was definitely a big win, and I had a great time with the Shada family. Hopefully my jinx is over!

Quick story about how I got to go. Mr Shada (my boss all those years in the recreation dept) called me during work yesterday to let me know he had extra tickets to today's game. I was quite torn. Weekends (this month) are when I get to spend a lot of time with Stephanie and the boys, and she really looks forward to them as a break for her as well. I came home and had basically decided I would probably just stay home and have some quality time with the newborn, the 3 year old, and the wife. I still wanted Stephanie to know what a big sacrifice I was making (of course), so I told Stephanie that Mr Shada had offered me tickets. She immediately responds "Oh, that's great! You should go!" To which I reply, "You know, I would feel bad leaving you alone with the two boys." She then reminds me that her mom and sister were coming for the weekend. Score one for the in-laws!!! I can honestly say I've never been so excited to see them :)

You gotta love a fresh baby

Even though they come out all bloody/cheesy/swollen/funny looking, there is just something about a newborn that makes me smile everytime. That first little cry is something else, and when it's your own baby, the whole thing sure is pretty special.

Meet Nathaniel "Thane" Bruce Kumor, born on the 24th weighing a whopping 6 lbs 13 oz. A little guy by Kumor standards, but sure a lot chubbier than Caleb was. He and Stephanie are doing great! I'll let Stephanie tell the labor story if she wants to, but suffice it to say that we went in at 7:30am to be induced and he was screaming by noon. It was a great performance by the wifey, but I can't say the same thing for the CRNA-in-training who did, or tried to do, her epidural! It all turned out well in the end, though, which is all we could hope for. Here's Stephanie and her two little boys when Grandma and Grandpa Quimby brought Caleb up for a visit.

Caleb is doing great with Thane and is uber-excited about him being around. The thing he is most excited about, though, is that "Mommy can crawl around on the floor to play and run around with me now!" Well, buddy, maybe in a few days. I know if I passed something the diameter of a human skull from my body, I'd be out of commission for a little while. Caleb does love to give his baby brother kisses and "gentle touches."

Thanks for all your thoughts and prayers throughout this whole pregnancy! It has been quite a ride, and it is nice to be safely on the other side. There is not a greater blessing in the world than a fresh baby!

Hello Out There

So, an interesting thing happened to me the other day in my clinic. I walked into the exam room to greet a man I had never met and talk with him about his health. Now, I like to talk with my patients about other things and get to know them a bit. I think that's one of the really enjoyable things about Family Medicine. I have been assuming that they know as little about me as I know about them when we meet, but we all know what assuming can do! You see, the first thing out of his mouth was "So, has your wife had the baby yet?" I'm sure I had a pretty interesting look on my face. At first I was trying to think of any way I might know this man... church, a friend/relative of a friend, saw him before in clinic... nothing. Then I thought about who in the office might have filled him in... receptionist? nurse?... who knows? I'm not sure, but I think I just asked him point blank who told him. His answer?

It's all right here baby. Yep, turns out when he scheduled his appointment, he Googled my name and read my blog! Kudos to you, sir, if you're still reading! (By the way, feel free to comment on just how goofy I looked.) I really hadn't thought about it before, but Google-ing your doc is probably a pretty good move. You never know what you'll find, right? Anyway, he had read all about Caleb, Stephanie, little Thane, and also about our trip to PNG! Let's just say he had a definite leg up in the getting-to-know-you department.

So, I decided to Google myself and see just what I could find. Turns out it's a little suprising what makes its way into cyberspace. I was reminded of some pretty poor wrestling performances at the State Tournament, relived my exploits in Olivet intramurals, and learned that there's a guy with my name who was a helicopter pilot in the Korean War. There were also links to my Facebook and MySpace profiles (which haven't been updated in eons) and, of course, a couple of links to this blog, one via a story in the Olivetian.

Just how many of my patients have read about me? I really have no idea. This gentleman was the only one who has said anything. It really made me stop and think, though, about what I have written. I don't think I've posted anything I shouldn't have or don't mean, but I wonder what impression of me this blog gives people. Well, he didn't cancell his appointment, so I guess the picture of me and Caleb with pull-ups on our heads isn't too alarming!


In other news, Stephanie is still pregnant. She's a whopping 38 weeks and 4 days! Neither of us even dreamed she'd make it this far. I think for Stephanie, though, it's turned into more of a nightmare! The poor thing has been banging out contractions like nobody's business for a solid 2 weeks. Now, I've seen a few ladies in labor, and there were a couple of times, including Friday, when I thought we were in business. But in the end, it was 'Sorry folks, show's over.' All she had to show for it was some lost sleep and an appreciation for the epidural she's going to get. The good news is that she'll be induced at the end of this week if she hasn't popped by then (39 weeks!). There is an end in site! Who woulda thought we'd be saying that... We are pretty darn blessed.

Not a whole lot going on

The title pretty much sums it up. Sure, life is busy with residency and family stuff, but it sure seems like not a lot of life changing stuff is happening. My grandpa died a couple weeks ago, which I guess is a pretty big deal. My brother wrote a nice post about it. Funerals like his were, I think, about how things are supposed to go. Everybody gets together and has a good time, remembers an elderly guy who had lived a long, full life, and enjoys a nice lunch together. I hope that doesn't sound too cold. I feel badly for my dad and especially for my grandma, but I really think that in the grand scheme of things, this pretty much fits the ideal plan. Maybe I've just seen too much death in general and premature death in particular to look at it like a normal person. Maybe being in medicine does that to people, I don't know. Anyway, I really had a good time hanging out with my siblings and my grandma. I was also very proud of Caleb, who spent a good deal of time playing with his cousins without me anywhere near him. He's a pretty timid/paranoid/social-skills-lacking kind of a guy usually, but hopefully he's starting to come out of it. He is also pretty darn funny, saying lots of the kind of things that I guess kids say. Stephanie has written a couple of blogs about that, I think.

As far as residency goes, I'm now in my fourth month, and if nothing else I've gotten more used to people referring to me as "Dr Kumor." Still a bit weird though. After my orientation month (July), I spent a month catching babies on the OB service, then had a month of clinic and dermatology, which was a pretty good time. Now, I'm on a general surgery service at Methodist, and it's going really well.

I guess the big news is that I've got the clearance from my program director and the guys at Kudjip to spend another two months there in Papua New Guinea! We are still working out the details, but it looks like spring/summer of 2010. I'm really looking forward to it.

Sorry about the lame-o post. Read Stephanie's. Much funnier. She, by the way, is full term!!! Who woulda thunk it? She made 37 weeks last Thursday! So, everybody can quit praying... we're ready for him to come now!

At least I'll leave you with a picture. It's similar to the one Joe mentioned of all the Frank's, except this one has two Frank's, a Ben, and a Caleb. We'll miss you grandpa!

Things are a changing

In this case, we're talking about Stephanie's cervix. She had an appt at the OB office today, where she was told she is starting to dilate, currently 2cm. Sorry for those of you who think that's TMI. At any rate, this was not entirely suprising. Stephanie has been pretty uncomfortable for about the past day and a half, with the contractions becoming a bit stronger.

What does this mean? Well, it's hard to say, but it seems as if baby Thane is coming sooner rather than later. Contractions like Stephanie is having tend to move things along. It's possible for a woman to hang out at 2cm for weeks, but if things keep going like this the munchkin will be making an appearance by the end of next week for sure. The "if things keep going like this" is the key. Stephanie was instructed by her doctor to, and I quote, "Take the bedrest a little more seriously." :)

Will it make a difference if she stays chained to her bed? Probably not too much, besides driving her crazy! In spite of all the razzing I do about the Wal-Mart trips, Stephanie really has done as good a job as possible of limiting her activity while caring for a 2 year old and a 26 year old (i.e. me). She is now a full 34 weeks and 2 days, so they won't try to stop her labor this time. Statistically, otherwise healthy 34-36 weekers do just as well (in the long term) as their 37-40 week counterparts. The only drawback is the requisite NICU stay for breathing, feeding, and body temp issues. For her part, though, Stephanie seems pretty determined to keep this kiddo baking in her belly as long as possible.

6 weeks ago, I was pretty sure we were gonna have that kid any day. A couple weeks later, it seemed like our new boy would never get here. It's a little odd switching back and forth. We mentally prepare for one thing, only to readjust our plans, then readjust again. I guess that's life!

No News is Good News

I've sort of been waiting to write another blog until I had some sort of exciting medical story or new happening on the home front. Well, it seems that cool stuff just doesn't pop into my clinic rooms as often here in Nebraska, and someone would probably try to sue me for telling you anyway. Just kidding... well, sort of. As far as the home front goes, I must say that things are pretty boring (in a good way, of course). No news is, as they say, good news. Stephanie's still pregnant. Caleb is still learning new things and trying (or, trying not) to socialize with other people. Me, I'm still plugging away at the hospital, enjoying a pretty chill month of clinic/derm.

Those of you who follow my wife's blog have already heard about my sweet schedule these first two weeks. She exaggerated a bit, but you get the idea. I honestly didn't quite crack 40 hours either week, which is probably the only time that will happen, but I'm not complaining. I've been at my family medicine clinic, which is limited in how many residents can work at a time by nursing staff, patient rooms, attending physicians, etc. This is why I wasn't scheduled all the time. These next couple weeks will be a bit longer hours, but I still will have no call and no weekends! It really is a nice time for this as Caleb knows a big change is coming and Stephanie is supposed to be taking it easy.

Which brings me to my next topic. I present to you Exibit A

Yep, that is Stephanie pushing around a cart at Wal-Mart. Now, some of you will say, "Well, why in the heck are you letting her do that?!?" To which I humbly respond, "Have you ever tried to stop that woman from doing something she wanted to?" I did drop her off at the front door and encouraged her to get one of those sweet motorized wheelchair/shopping carts. She obviously didn't respond well to said advice. Okay, you say, at least she can lean on the cart and take it nice and slow. She can let her boys get the stuff she needs and she can stretch her legs for a bit.

To that, I say, look at Exibit B.

This was taken without her knowledge, as I walked around looking for Caleb and Stephanie. You see, I had gone to the back of the store to get something so that she wouldn't have to walk all that way. Here I find her a significant distance from our cart (that one in the background isn't ours) and practically crawling under the clothes rack looking for the right pair of pants. Needless to say, I had to put my foot down and get her back in line. Doesn't she look happy about it?

In a bit of unrelated news, Officer Kumorski and his wife just had their third kid, little Gabriella. Congrats guys, we can't wait to see her! You can check out his blog for a picture.

We also learned that another of our friends from our Olivet homegroup are pregnant. Stephanie and I are pumped that we won't be the only ones with screaming kids at the next homegroup reunion!

Life is good

I'm just sitting here tonight reflecting on what a blessed guy I am, and I thought I'd put a few of those thoughts down on paper... er, I mean a screen, I guess. You must forgive me, I'm sort of into lists right now. It helps me keep my day straight at the hospital, which leads me to #1 (these are in no particular order)

1. I have a job I really enjoy. Looking back, I really don't know how I ended up in medicine except that the Lord must have had a hand in it. I mean, I didn't even want to go to college for goodness' sake. The only job I had before this was in a concession stand! Now, I have just today finished my first clinical month of residency. I was on the OB service and worked a good amount of hours, but I never got sick of it. In fairness, a better test will probably be how I feel in February after not seeing the sun for a few months, but things are going really well right now. As a bonus, I've been talking to several people within the program, and it looks as though I'll be able to spend at least a month or two overseas in my 3rd year of residency -- perhaps back in Papua New Guinea!

2. I have a great family. Stephanie and Caleb are great, end of story. I wouldn't change a thing about either of them. Okay, so maybe that's not quite true, but I sure do love them both exactly as they are. I am so happy to see them at the end of a long day, and they are happy to see me. Stephanie is still pregnant, and getting bigger by the day! We are now all hopeful she can keep this up for another couple of weeks, which will significantly shorten little Thane's NICU stay.

3. I have a great family. I have really enjoyed being back in Nebraska the past couple of months with my dad, his wife, and all my brothers and sisters. I've kind of given my dad a hard time in the past about not being super involved when we were kids, but the guy did his best and loves us all, even if he doesn't always come out and say it. He and Pat have been real supportive of us and great to Caleb, and Caleb sure loves them for it. It has been so much fun hanging out with all my brothers and sisters and their kids. Now that Andrew and Brittanie are all moved in (great wedding by the way! and here's a shout out to their pastor Jonathan. What's up man!), everybody but Joe and his family are in the Omaha area. We always seem to have a fun time when we're together, and it is great for Caleb to get to know his cousins. Hey, we all know the kid needs a little more social interaction!

4. A God who loves me, and Everything else. To be quite honest, I'm getting tired, so I'll have to cut this blog a little short. I could go on and on about our good friends, a place to live, my wife's cooking (which has improved significantly in the past 6 months!), and a bunch of other stuff, but I'll spare you. One thing that amazes me more everytime I think about it, though, is the way the Lord keeps loving me and reaching out to me. He really is with us all the time, which I guess is why life looks so good and full of promise right now. Crappy stuff happens and life deals some big disappointments. I think everybody and their dog understands that. As I've mentioned in a previous blog, though, it's just really nice to know I'm not in it alone. And, if I keep my head up, I might just learn something.

Yep, I'm a lucky guy. If you'd ask just about anyone in Papua New Guinea, all of us are pretty darn lucky.

Oh, and for some icing on the cake, Nebraska beat Western Michigan on Saturday. You gotta love all the new T-shirt slogans: Bo knows football; Got Bo?; My Bo Friend's back; Boses leading us to the Promised Land. Great stuff. Go Huskers!

"Bed Rest" - well, sort of

Well, Stephanie made it home on Tuesday, and things seem to have quieted down. You can check out her blog for her take on the whole matter. We are glad to have gotten things calmed down and her out of the hospital, but I think this whole inactivity thing is going to be especially tough on Stephanie. Caleb will manage (with the help of his trains), but Stephanie has trouble sitting still for 5 minutes, much less 5 weeks. When I got home from work, I caught her hauling laundry around. She says she is just trying to get a good handle on how much she can do and still keep her uterus quiet. I feel bad for her, but we all know how important it is to keep this kiddo in as long as possible. We'll see what happens!

Deja vu all over again

Well, in spite of all our hopes and plans, Stephanie is in preterm labor again. It all seemed eerily familiar as Stephanie had a really uncomfortable night Friday and woke me up in the wee hours of Saturday to take her to the hospital. She was banging out contractions every 2-3 minutes at one point, but the docs got all that quieted down with the dreaded mag sulfate. It hasn't made her quite as loopey this time, which is nice. The steroids for baby take 48 hours for full effect, so she's just chilling out at the hospital now, hoping things stay calm tomorrow after they shut off the mag (at the 48 hr mark). If so, she'll be able to come home on some modified bed rest, but if not.... well, we may end up with a baby this week.

The downside? This is even earlier than when she went into labor with Caleb. He was a 30 weeker (she went into labor at 29 weeks, then spent almost a week in the hospital). This little guy is only 28 weeks, which doesn't sound like much of a difference, but a lot changes in a week or two for those little babies. We'll see how it goes, but this might signal the end of biological children for the two of us.

The upside? Well, she's not had any issues with blood pressure this pregnancy. Many of you will remember that with Caleb, she had pre-ecclampsia, which is basically high blood pressure in pregnancy and some associated badness. That is not the case now, so at least we have one less person to worry about this go 'round. This also means that we can pull out all the stops to keep the kid in. With Caleb, Stephanie was in such rough shape it just couldn't wait any longer. Here in Nebraska, there is also lots of family around who have been great about offering to help with Caleb while we get through all this. And there's always the advantage of working where she's staying, so I can pop in throughout the day and see how things are going.

The other thing that worked out so well was just the timing of it all. My little brother, his fiance, and her dad just happened to be staying at our house Friday night, and I just happed to be home with the weekend off. As a result, Stephanie could wake me up without worrying about me working the next day and Andrew et al could be at home with Caleb while he slept. Makes me wonder how much of life, at least at times like that, are coincidental vs orchestrated. There were also a few "coincicences" that brought us to the doctor when Stephanie was in labor with Caleb that very well could have made the difference for both of them. It all just serves to remind me that even when things happen that are less than ideal in our minds (to say the least), the Lord is always there in the midst of it, letting us know we're not in it by ourselves. He has showed over and over that whatever the situation and whatever the outcome, He will be by our side, sharing our joys and our burdens. That is what He promised. It is more than we need, and infinitely more than we deserve.

Hotdog Heaven!!

I've decided to finally end my blogging drought with an experience of a lifetime: All You Can Eat Seats at a KC Royals game. Yeah, baby!! My big brother Joe, who happens to live in Olathe down near KC, sent me an email a bit ago making me aware of this opportunity, and I've been licking my chops ever since. Stephanie and Caleb tagged along to my brother's house to hang out with his wife and the kids, and my oldest brother Brent met us down there to take part in the gluttony.

It was set up to be a showdown for the ages, with Brent out to prove he's no old fart, Joe defending his home turf, and me trying to out do my big bros. Let me tell you, folks, it did not disappoint. Brent came out of the gate with masseters blazing, downing four hotdogs and a nacho before the first pitch! (of course, we did get there reeaally early to get our money's worth) Alas, he could not keep the pace, and I emerged victorious with the following consumed:
7 hotdogs
1 nacho
2 bags of peanuts
1 bag of popcorn
5 fountain drinks
1 cup of water

At around the 4th or 5th inning, a thunderstorm came and play was stopped, so we decided to call it a night before any vomiting could get started. All in all, it was a successful night, and one I hope to repeat before the season is over.


I am almost done with me first month of residency, which comes with some mixed feelings. I am really looking forward to getting my feet wet on the hospital side of things (this month I've had clinic and tons of lectures and certifications), but on the other hand, the hours have been so nice!! I've gotten to spend a good deal of time with Stephanie and Caleb, and I know it will be awhile before I get to see them this much again. But, this is what I signed up for, so here we go! I will start Friday on the OB service run by the family medicine residency, so I'm hoping to learn a lot and catch some babies. We are fortunate in this program to have a staff physician who is double boarded in Family Medicine and OB/GYN, so the teaching and experience should be great.

This past month has also been a good time of getting to know some of the other residents who are starting the program with me. There are a few people from the far reaches of the globe - Niger, Malaysia, India, Venezuela - and there are several from here in Nebraska. Add to this the Air Force residents, and you have a pretty good mix of folks. It should be a fun three years getting to know everyone and having the chance to work with everyone.

I'm an intern! Well, sort of

I just completed my first week of my intern year of residency, a week I have been dreading as long as I have known about it. This is the week you start in a brand new hospital with new people, a new computer system, new lingo, and of course, the new responsibility of actually ordering tests and medicines... basically saving lives vs killing people. This is the week the new doctor is thrown into the fire of sleep deprivation and intense scrutiny, hoping only to make it out alive.

Turns out, it's not so bad for a family medicine resident at the University of Nebraska. Here, we have an entire month of stuff like orientation, occupational medicine, lectures, and clinic to sort of ease us in to the whole thing. The hours are GREAT! This has come in quite handy because last week, while moving into our house, a storm came and knocked out the power to approx 125,000 people in the Omaha area. Our neighborhood got trashed with trees down everywhere, even blocking a few roads. A tree branch in the yard next to ours fell on our power and cable lines and ripped them out of our house, which was quite exciting as we unpacked boxes.

No worries, though. We just stayed an extra several days with my dad and Pat and moved in little by little in the daylight hours. Now we finally have a permanent (at least for three years) place to stay with furniture, electricity, and internet (as of yesterday)! We are pretty pumped, and Caleb is happy to see all his old toys that were packed up for 6 months while we traversed the globe. I'll leave you with a shout out to my brother John and our old friend Tim who worked their butts off loading all our stuff up and getting it in the house. Well done guys!

The Name Game

Many of you know by now, but I am pleased to report that we are going to have another baby boy! I'm glad I don't have to join Deputy Kumorski into the uncharted waters of parenting females (yet). It would have been nice for Stephanie to even up gender teams, but I am glad Caleb will have a little brother. Now, the name debate starts in earnest. Naming a kid is pretty intimidating in my book. I thought it'd be easier the second time around, but no dice! We'll see how it goes.

It's Official

I am now "Dr Ben Kumor, MD." Weird. Ask the 10-years-ago me or any of my family if they ever saw this coming in a million years. I mean, I used to hate school, love sleep, and was terribly lazy. Some things never change, but at least now I'm done with school! My style has been severely cramped in the sleep and laziness departments, though, and it doesn't look like that's changing any time soon.

At any rate, a full 20 years of school (21 if you count kindergarten) has culminated in a pretty cool degree. The hooding ceremony was nice, and some folks even came out to see it. Stephanie and Caleb were there, of course, with some of our good friends from our time in Ohio: Paul and Sheila Majewski and James Lee. Stephanie's folks and her brother David were there as well, and I have always appreciated the way her family makes occasions like this a big priority. My family was represented by my oldest brother Brent, who was a real trooper and drove the 13+ hours all the way from Nebraska in the middle of the week. Like I said, the ceremony was nice. We all had our names read as "Dr So and So" for the first time, got our hood (a goofy piece of academic regalia worn around your neck and down your back), and recited a cleaned up version of the Hippocratic Oath - no swearing by Apollo, no promising to educate other doctors' kids for free, no forbidding surgery or abortions - along with an oath some members of the class came up with basically promising to do right by our patients and be good doctors.

Do I feel any different now? Nope. Should I? I hope not! Maybe it's the 3 years of training I still have left, or that I didn't really pour my heart and soul into med school like some of my classmates, or because I haven't dreamed of being a doc my whole life, but whatever the reason it seems a little anticlimactic.

I think one reason might be a post PNG hangover. I finally got to see there what I got into medicine for. It wasn't a bunch of rich people looking for a pill to make them skinny and happy and full of energy. It wasn't doing every test remotely related to what is going on so you don't get your butt sued. And it wasn't even doing a darn good job practicing medicine to get a nice paycheck and help a few people along the way. Medicine at Kudjip Nazarene Hospital is all about doing a ton with very little to help out needy, hurting, sick people and pointing them to the Lord while you do it. What more could a young, not-yet-jaded doctor want? If you asked my fellow classmates, I think you'd get a lot of different answers. I guess I'm just not looking forward to American medicine again. I've got a ton to learn, though, and this is the best place in the world to learn it. I just hope I can stay objective and do a good job of picking out the good and the bad of how things are done.

Where am I going with all this? I guess I am reminded during this graduation time that life really is a continuous process. Even though there are these milestones along the way, there's still a lot of work to be done in every aspect of my life before I can look at myself and be satisfied with what I see. So, even though this is a big milestone, what I really need to do is get back to the work of serving and growing so I can be prepared to serve better.

A house, family, and Memorial Day

After we got back from PNG, my wife and I had two pretty different views on our housing situation for the next three years. To boil it down, I wanted to buy, and she wanted to rent. I thought, there's no time like now to buy, right? I mean, everyone is always saying it's a buyer's market, and the internet can make places look pretty sweet, especially when you're in a "least developed nation." Stephanie, however, had a different perspective, largely due to her parents' current situation involving a house that won't sell and renters who don't pay rent. Understandable. So, we came to Nebraska determined to look at all our options and make a good decision.


In situations like this where big decisions are involved, I think it's beneficial to have differing opinions on what to do. Well, at least as long as both are not too attached to their opinions. I mean, I knew I was going to have to have pretty good reasons to buy for Stephanie to feel good about it, and vice versa. Otherwise, we might just brush over the reasons against, and go ahead with something that may not be the best for us.


In the end, we went house hunting, couldn't find anything worth buying for a price worth paying, and settled on a nice little house for rent. It is owned by an outgoing resident at UNMC and her husband, and it is less than 5 minutes from the med center. They are giving us a sweet deal on rent, and are going to hire a lawn service to mow once a week. Score! So, even though I "lost," I think we ended up in a really good situation. Here's a picture of the place.
Nothing flashy, but very well taken care of 3 bedroom, 2 bath, finished basement, with appliances that stay and a nice backyard. And yes, the Wii will go nicely in that basement! The only hang up will be when we can move in, but once we do, you're more than welcome to visit.


Since I don't blog too often (sorry Officer Kumorski) I've got a couple more topics to touch on. It's been really nice to spend time with my family since we returned to Bellevue last Friday. I've been staying at my dad's house, so I've gotten to see quite a bit of him and my step-mom. It's been really nice to get to chat with my dad, and even nicer to see Caleb have lots of fun with his grandparents. Elizabeth helped me unload our moving truck, even with her bum elbow, and I had a great time just laughing with her again. I've also gotten to hang out with John and Brent, and then all three of them together along with some of Brent's friends on Memorial Day. I haven't seen much of Rebecca and her kids yet, but hopefully we'll get to hang out soon. It's been nice to kind of catch up a bit, and it just reinforces to me that even though we are very different people with some differing views on life and what constitutes acceptable beverages/entertainment/behavior, I love them all and look forward to the next three years of being (geographically) close.


As far as Memorial Day goes, I've got to give a shout out to my brother. Check out his blog for a good commentary on the holiday, especially in light of current politics. I really don't have much to add, except to say thanks for your service to all our guys who have been involved in making and keeping our country and world a better place.

back in the US

Thankfully, the trip home was pretty uneventful. We left Kudjip on Friday morning for our flight from Mt Hagan to Port Moresby, where we stayed at MAPANG, a missionary guest house. It was nice and relaxing, but much hotter than in the highlands! Saturday we flew to Tokyo and spent the night in a Holiday in by the airport. Once again, a nice relaxing night. On Sunday, we made the marathon plane flight to Chicago. We left around 4:30 in the afternoon, but crossed the international date line on the way, so we arrived at 1:30pm on Sunday. The weirdest thing about the flight was watching the sunrise at 11:30pm. Caleb did well, and managed to avoid any "accidents" the whole way! We were awful proud of him. The last few hours on the way to Chicago were a bit hard on us all, but we made it.

I've tried a couple times to write a nice summary blog about our experiences in PNG and how it has affected us, but it just isn't coming out right. I think that's going to have to be a process. It will have to suffice for now to just say that it was the time of our lives, and we really won't ever be the same. When Caleb was looking at pictures while we traveled, he just kept saying "I wanna go back to Papua New Guinea!" It was tough for all of us to leave, but hopefully we'll have a chance to go back some day.

Since being home in the States, I have been struck by a few things.
1)It is indeed possible to be in amongst a group of people and not be overcome by the BO
2)Public bathrooms are amazingly clean
3)Most folks really do wear shoes
4)Fast food really isn't as good as you remember it
5)Jetlag is a bugger, especially with a 2 year old

As a reward for Caleb doing his business in the big boy potty, we have been promising him a new Thomas the Tank Engine train of his choosing when we got back to the States. He always insisted he wanted a Diesel 10. Now, this is not exactly a main character, so we kind of doubted that we'd be able to find it. Chalk one up for Wal-Mart! The three of us made a trip at 4am on Monday (mid afternoon for us) and there he was. Caleb was pumped, and has been playing with him almost non-stop since.

The reason it was "almost" non-stop: Caleb drew blood from another child for the first time last night. He was playing with his cousin Katy (6 year old) in the living room unsupervised. We hear Katy crying from the other room, and when we get in, she's got a nice little 1cm cut over her right lateral cheekbone and is bleeding from it pretty well. Caleb is standing there with a large train flashlight in his hand saying "Katy has ketchup on her." He was just as suprised as everyone else, I think. That was the end of playing with trains for the evening. Thankfully, Katy's cut was nothing I couldn't fix with a little superglue!

Katy and Caleb don't exactly play well together, and usually both of them end up pretty ticked off. Katy wants Caleb to be her doll, and Caleb wants Katy to stay away from any toy he lays eyes on. Not a great combination. Who knows what led up to The Incident, but it looks like they'll be restricted to only supervised visitation for awhile.

A PNG cave adventure

It's hard to know exactly how to begin this epic tale and just how detailed to be in my description of it. I could honestly write for hours about everything that happened, but I will spare you most of it. For those who want a more in depth version, we can sit and chat about it over a cold root-beer and some beef jerky some evening when I get back to the States.

Speaking of, I now have only 3 full days left here before we start our long trip home. The time has gone by so fast, but in this short time I have learned a great deal about a lot of things, not just medicine. I will really miss being here, but that is another topic for another blog. Back to the story.

There is a cave in the mountains near Kudjip that Scott Dooley has been wanting to explore for some time. He has previously been lowered inside the rim, far enough to see the bottom and to realize his rope was not long enough to reach it. This last furlough, though, he bought a new, longer rope and the gear necessary to ascend on the rope out of the cave. In Sam and I he found willing accomplices, and the adventure was on. Now, the nationals here have no interest in descending into caves. In fact, they believe that spirits inhabit caves, especially this one, and they are easily angered. Even some of the Christians here can't shake some of the old tribal beliefs. More than once we were warned or cautioned by nurses at the hospital to be careful about such things.

A legend regarding this particular cave goes something like this: A long time ago there was a man who was trying to catch a pig. In the process, he fell over the edge of the cave to his death. Some villagers wanted to retrieve the body for a proper burial, so they connected lots and lots of bush rope and lowered one man down into the cave. When he neared the bottom, he saw an old man sitting and making a belt and an old woman sitting and making a bilam. Between them laid the dead man. The man on the rope was so frightened by this he yelled loudly and was quickly pulled out of the cave. Our guide said this was only a tale, and nobody really thought it was true. Evidently it is just one of those stories to keep people away. He also said that no one had ever been into the cave in his time or his father's time or his grandfather's time. Basically, whether for fear of their safety, of spirits, or of old folks weaving clothing accessories, people steered clear of this place.

We, however, are crazy white-skins, so we were all about it. I have very little experience with repelling and ropes in general, and Sam has none, so we practices a couple times in Scott's tree. This went pretty well, and we were all planning on a smooth operation. Saturday came, and we all met in front of the hospital to set off on our journey. After a quick prayer at the gate, as is customary for all treks off the station, we drove about a half hour on very uneven roads to a town called Konduk about 30 minutes away. We got the truck stuck, unstuck, then parked, and made the rest of the way on foot. What a hike it was! The terrain was a bit difficult at times, but the view from the top of the mountain was amazing. There's definitely not anything like it in Nebraska! Along the way we picked up our guide, John. We got to talk quite a bit on the trail, where he informed me that lots of folks call him Papa John. This of course led to me trying to explain pizza and restaurant chains to him, probably in vain.

We made really good time and reached the cave after about 2 hours of hiking. The cave is actually a large 150 ft deep hole in the ground, roughly 10 x 20 feet wide at the mouth. There is a small shelf maybe 6 or 8 ft back and 10 ft wide right at the mouth, and another 8 or 10 feet above that is the rest of the mountain. After we got down on to the shelf, Scott set up all our safety ropes, we got all our gear on, and we were all pumped and ready to rock. Okay, I was a bit nervous, being as I'm afraid of heights and was standing in front of a 150 ft drop, but that's besides the point. Scott repelled down first, followed by Sam, then me. It was a pretty sweet ride down! There were bats everywhere, huge fruit bats that people here call "flying foxes." None of them got too close, but hearing their shrieks and seeing their huge wing span was pretty impressive. The cave opened up pretty quickly into a large cavern with a few large cracks in the walls where the majority of the bats were. We had to repel right past one such crack/crevasse, which was a little nerve wracking! Everyone made it safely to the bottom, and what we found there was about as expected: a huge mound of debris and tons of bat crap. What we didn't expect was just how many bats were in this cave. When all of us shined our lights at the far wall, all the bats' eyes made it look as if the wall was on fire! It was incredible. After looking around for a bit, we all decided it was time to head back up.

I was to go first, and so I got all settled in and started up the rope. We were using what's called an ascender and a shunt, basically two one way rope valves that would allow us to make slow and steady progress up the rope safely. I was about 100 ft up when for a brief time I was in pretty significant danger of falling due to an equipment malfunction. For the next hour, I hung there praying intensely and trying to rectify the problem, only to eventually (and with much difficulty) return to the less than ideal situation I found myself in an hour earlier. I must give the Lord credit for answering my prayers for calmness and strength. There were a couple occasions I didn't think I would be able to get myself out, but God was with me in that cave. Oh, how glorious it was to finally make it out! I was exhausted, but there was a definite feeling of relief and accomplishment.

I sent the gear down to Sam, who was up next. He never really felt comfortable with the shunt and ascender even in the tree, and the cave proved to be to difficult for him. The ascender was also not sliding up the rope quite like it should have, which made things even tougher. After a lot of effort and not much to show for it, the decision was made to get him back down, have Scott ascend, then have Scott, John, and I pull Sam out.

Scott made it out without too much difficulty, then we set about trying to get Sam up. Turns out it was a heck of a lot harder than we thought it would be. After trying several different set ups for close to an hour, we decided to call back to the station for help. We also sent the ascending gear back down to Sam, hoping he could make it out on the second try and we could call off the cavalry when they reached Konduk. Unfortunately, that didn't happen. To make things worse, evening came, the walkie-talkie batteries went dead, Sam's headlight went out, and the bats were waking up and making a horrible racket. Praise the Lord it didn't rain!! Poor Sam was stuck hanging there for around 2 hours, but help came in the form of Jeff , several native nursing students, and a couple of Konduk men to help pull Sam out. With all the manpower, we got him out pretty quickly.

It was pitch black by this point and we had quite a hike in the dark ahead of us, but the worst was over. Word spread pretty quickly about everything, and there were lots of people waiting for us both at Konduk and back at Kudjip. Sam has done a really good job of assimilating here and the natives all love him for it. When we dropped him off at his house on the station, there were at least 30 people there waiting for him.

I got home, took a long hot shower, cleaned out all my cuts and scrapes, and ate my first real meal of the day. It sure was nice to see Stephanie and Caleb! Needless to say, I don't think Stephanie will be approving of any more spelunking trips, but I definitely got the taste of some true PNG adventure.

Pictures to come!

Softball, town, and more water adventures

Last weekend, everyone got together and decided to play some muddy softball. I know, a little late, but I finally downloaded the pictures off our fully-functional camera and couldn't pass this one up. This is after a pretty darn muddy afternoon of softball in which I failed to make Baldwin Fields proud... sorry Mr Shada! I think my wife out hit me at least half the time, and I definitely had to make use of the "nobody strikes out" rule at least once. All in all, though, it was a great afternoon of fun with our friends here. I was on call last weekend, but I was able to be there for almost the entire game before being summoned to the hospital for an inning and a half or so.

While Stephanie and I played softball, Caleb was having a grand old time with Priscilla Radcliff (Dr Jim's teenage daughter) and the younger two Dooley girls (Emma and Olivia). Caleb has really warmed up to the people here, especially Priscilla, and it is really nice to let him go off and play with the other kids. It seemed like in the States he only felt comfortable if Stephanie or I was within arm's reach... it is nice to see him spread his wings a little and really enjoy himself. Another thing he has been working on recently is saying hello to people as we walk by. Now he says "Apinun!" (like saying afternoon here) loudly and then says, "Daddy, I did a good job saying 'Apinun'!!" He is a funny kid.

As I mentioned in a previous post, we went to town a week ago last Thursday where we got some grocery shopping done, got some much needed cash from the ATM's, and went to the Highlander for lunch and a dip in the pool. Here's a picture of the boy and I there. The pool is really nice, and the food is good too. If you ever are visiting Mt Hagen, PNG, this is definitely a good place to stay.

Now, outside the grocery store are some old men who we affectionately call the Basket Men. They sit out and weave cool baskets and coasters and pot holders all day. When they see us white skins, their eyes turn to dollar signs and they pounce. They are really nice about it, but they bring over all their stuff and start telling us prices. We have bought a few things from them, and the missionaries see them quite often, so these guys feel pretty comfortable around us. Anyway, here is a picture of one displaying his wares. There really aren't too many people who sell touristy-type souvenirs. In fact, the only ones I've seen are at the Highlander Hotel. I guess there just aren't many tourists here. There are two local guys - one who does wood carvings named Joel and one who does wood/bamboo burnings named Gideon that have been by our house at the station to sell us things, but that's about it.

This past week, (getting a bit more recent) we did another ultrasound of our little guy/girl. You might be able to make him/her out on the ultrasound screen if you look hard and use your imagination. Like I've said, it is pretty cool to be able to have a look at your unborn baby whenever you feel like it. I'm always amazed by how active those kids are! It's a wonder you pregnant women get any sleep at all with a little kid doing somersaults in your womb all night.

Just to inject some medicine into this blog entry, I'll tell you about the most common procedure I do here: incision and drainage (I&D) of abscesses. As Niles (visiting doctor who recently returned to the States) said, this is the land of puss. People here generally have poor hygiene and are also pretty hard on their bodies, which I'm guessing is the reason for all the skin infections. In the States, we see mostly staph abscesses on legs or buttock that seemingly come up from nothing. Here, I've seen abscesses mostly on the feet of adults, but also a couple in the legs of babies from immunizations. Kids here also get a lot of septic joints and osteomyelitis, which is kind of a different beast, but from the same general problem. People here just have bacteria floating around in their blood (bacteremia) a lot more than we do due to their hard life and poor sanitation. If they get a bruise, be it in their bone or joints or anywhere else, the bacteria can seed those little hematomas and form abscesses. Here's the picture of a really nice kid I saw in clinic with an abscess that was not typical of what I usually see. He presented originally with painful swelling just above his elbow. There is an important lymph node there, so he was given antibiotics and told to follow up. I saw him at his follow up appointment, and took this picture. An infection had seemingly traveled up his lymphatics to his axillary (armpit) nodes. The poor guy was in some pretty good discomfort, but the nodes were pretty firm and didn't feel really fluctuant (fluid-filled), so I gave him different antibiotics and had him come back in a couple of days. This time, the swelling had gone down a bit and the lumps were much more fluctuant and there was lots of fluid on ultrasound, so we decided to stick a needle in and see what I could find. Well, it was definitely puss. I took the needle out and set up for the I&D, but there was so much pressure in there it was just pouring out of the little needle hole. I finally was able to cut it open and get all the infection out, rinse it, and put in a wick to keep the hole open and let it drain. The same day, I saw a good old American style butt abscess that had been let go far too long. The guy said he had seen a private doctor three times since it came up, but all they had done was give him pain pills and had never even looked at it. Well, I had to knock this guy out with ketamine and Valium to do the job, because it was the biggest abscess I'd ever seen. Poor guy. To top off the afternoon, I saw an old lady who had a more typical abscess of the foot. Typical, except that this had gone waaaaay too long without care (as opposed to the typical way too long) and I really think she is going to lose her little toe over the deal. Looking back on a day like that, it's not hard to see why Niles gave me the title of Dr Puss.

After that appetizing conversation, here is a picture of our dinner Friday night. Homemade pizza, some freshly cut pineapple, canned corn, and some freshly squeezed lemonade. Pretty darn good. I must take credit for the pineapple and lemonade, but Stephanie has really done a good job of keeping us fed in circumstances she is not accustomed to. I think she used real yeast for the first time here. Everything has been really good, and today she even got some compliments from the missionary wives at a potluck. Way to go Stephanie!

After having to spend a good chunk of last weekend at the hospital, it was really nice to relax and do some fun things with Stephanie and Caleb yesterday and today. On Saturday (yesterday) we took a walk down to the river again to play in the water and have a little picnic. This picture is via the timer on the way down. I know I've said it before, but it seems like pictures just don't do the scenery justice. Anyway, we got there without too much trouble, except that Stephanie was watching a mother pig with her piglets along the path. The sow evidently saw Stephanie as a threat and followed us all the way down to the river. At that point, I decided enough was enough, so I decided to man up, protect my family, and... throw rocks at it like the natives do. Hey, it worked. Caleb and I had a great time playing in the water and Stephanie got some much deserved rest on the river bank. The only dark spot on the afternoon was Caleb's first sunburn. Yes, I am the worst parent ever. Before we left, Stephanie mentioned the sunscreen, but it was really overcast and it was even sprinkling a bit, so I said not to worry about it for now. Stephanie did get some on him after we got to the river and had played a bit, but it was too late for his little neck. I never did put any on and got absolutely fried. Just goes to show you really can get burned through the thickest of clouds, especially a mile high and near the equator!

Also yesterday, we met the woodcarver Joel, who was selling pigs. I am proud to say that I am a real Papua New Guinea man now that I own my own pig. I told this to Thomas (the native guy who takes care of the hydro power) who we hung out with last night along with two of his kids, Samuel and Nancy. He got a good laugh out of that. We had a chance to talk a bit about PNG culture and American culture, which was neat. At one point, he asked if there was any crime in the US. I guess all the Americans he's ever met have been missionaries. He was a bit surprised to find that, yes, there was crime, and even murders in the States. And the fact that police are generally trustworthy and not terribly corrupt was even more surprising for him. We also talked about bride-prices, how weddings work, the gardens that everyone keeps, and the importance of pigs. It was a pretty good time.

Today, being the first Sunday of the month, was the big English service at the hospital chapel. All the English speaking missionaries from around here are invited to come and worship together. Today was also the day for the potluck, which is only every other month. We got to meet several people from nearby from other denominations, like a couple of British families who are working on Bible translation in a tribe across the Waghi River. Stephanie made a cheesy, meaty, pasta bake type of thing and an apple crisp desert that were both really good. Then it was time for church, where a man who does short term work all over the world spoke out of John 12:20-26, basically encouraging all the missionaries that they were doing exactly what Jesus asks all of us to do: give our lives to Him and do His work.

After church, Stephanie, Caleb, and I along with Scott, the Dooley girls, Jessica, Ethan, Sam, Lydia, Cassie, and Kristyn (not sure about that spelling) went to the Rock Slides, which is just what it sounds like. Lots of waterfalls with some pretty smooth rocks that make good slides down into calm, shallow pools. It was gorgeous. Here is a picture of Scott and I talking in front of one of the falls. We took tons of pictures, and the camera stayed dry, which is always a good thing. We all had a great time, but the place was awfully slippery and Sam and I were pretty clumsy, both falling a couple times. Both of us had slips involving kids, but everyone turned out alright and I think we felt worse than anyone about it! Caleb had a good time, and learned that daddy can be a bit clumsy at times. By the end of the day, he was encouraging me to take Sam's hand up some steep slippery inclines so that we wouldn't fall. "It's okay Daddy" he would say, "Sam can help us up." So much for me being the big tough guy! It was a really fun time.

Thoughts on our 2nd baby

To depart a bit from the running theme, this will be a bit more introspective.

Pretty much my whole adult life, I've looked forward to being a dad. Caleb has definitely not disappointed. He and I have a great time together just laughing and playing and being goofy. It is also pretty cool to be able to teach him things and talk to him about God and other important topics. This week, he has even been pooping in the toilet, which is freaking AWESOME!! I love being Caleb's dad, and I am really looking forward to meeting the baby that's inside Stephanie.

That said, I am also scared to death. I am really not looking forward to the rollercoaster that was Caleb's birth and NICU stay, not to mention Stephanie's blood pressure and stay in the hospital. Caleb was born at 30 weeks, so I just keep telling Stephanie our goal with this one is 33-34 weeks. If we can make that, things will be relatively smooth. It is a nice thought, but I worry about what will happen if things are worse this time instead of better. I will be in my intern year and we will have a two year old at home, so that immediately complicates things. We were very blessed to come out of things without complications the first go round, but Stephanie could have very easily had a stroke or seized or been left with kidney or liver damage. Caleb did remarkably well, but could have had any of the complications of prematurity like brain/eye/gut problems. Was it selfish of me to want another baby? Am I risking my wife's life here? Stephanie wanted one as well, though, and we both agreed Caleb needed a sibling. I guess I just don't want to be second guessing myself later if things go bad.

Sometimes I think about what life would be like if Stephanie or Caleb hadn't made it, or what life will be like if Stephanie or baby 2 doesn't make it through this time. All these fears that I tell myself aren't worth thinking about or are only semi-rational keep popping up. This is probably because I really can't do anything about it. That is the worst part. If I could give Stephanie some medicine or be extra vigilant about her blood pressure (which I will, starting right at 20 weeks), I might feel better. All we can do, though, is sit and wait. I feel a bit bad for Stephanie, because it is hard to just enjoy being pregnant and looking forward to the baby. I don't think being in a 3rd world country is helping in that aspect either. I will say, though, that it is nice to be able to do an ultrasound here whenever we want.

Through it all, I must keep reminding myself about how well God has taken care of us. Now, I don't believe that Christians have a pass on suffering. I've seen and heard of enough suffering here among our brothers and sisters in Christ to be doubly sure of that. If something terrible happens, that doesn't change who God is or my relationship with Him. I just know that whatever happens, good or bad, that God promises to bear our burdens with us and share in our joys. As Caleb's VeggieTales movie has reminded me, God does not give us a spitit of fear.

The conclusion from all of that? I'm still excited, and still nervous, about baby #2. Hopefully things will all work out smoothly. But, even if they don't, it will be okay. At least we'll be close to family in Nebraska!

Our life in New Guinea

Babies, big and everywhere!

Hey all, time for another quick post. The week has kind of flown by, so I'll just give you a couple of highlights.

I started in "B" ward this week, which is all things OB. I have now completed two weeks in Peds (A ward) and three in Medicine (C ward). It's hard to believe I've almost been here 6 weeks already! I have been feeling bad for my friends Josh and Sarah who were only able to be here such a short time. A lot has changed for me in the past 3 weeks since they left, and I just hope they can make it back sometime to get the full experience. But back to the OB ward. Rounds in the morning go pretty quickly, because if a mother is just a routine post-partum recovery, they aren't seen by a doctor. In fact, if a mother is in normal labor and has a normal delivery, a doctor may never see her at all. The nurses in this ward are very capable, and handle everything that is routine. Part of the reason for this is that, let's face it, women have been giving birth successfully for ages without doctors around. Why let us in and make things complicated? The second reason is the sheer number of births. With everything else to do in the hospital and all the outpatients to see, there just isn't time for a doc to sit back in B ward and deliver babies all day. This brings me to the best story of the week, which is actually two in one.

There I was on Tuesday morning, my second day on B ward, when we saw a woman who had a bit of slow progressing labor. She had also had a problem with retained placenta (placenta was not delivered within 30 min after baby) with her last delivery, so it was a patient we needed to be aware of. We had just finished rounds, and after checking the woman, Dr Niles let me rupture her membranes, my first AROM. We were then about to leave for clinic, and Niles said, "Hey Ben, why don't you stay and deliver that baby?" I was more than happy to, since I didn't get too many deliveries in the States. Sister Sylvia, the head nurse, was going to be there and help me out if needed, so I was feeling okay about the whole thing. Pretty soon, though, it started getting crazy. Women just kept coming in, all in very active labor. Before long, there were about 5 women ready to have their baby any minute, and only 3 birthing stalls! The plan was then to just deliver as fast as possible and get the place cleaned up and ready for the next in line. My lady was cooperating, and as soon as Sister Sylvia came back in the stall with me, the lady started pushing and the baby was out in no time. This was my first unassisted delivery. No picture, though, because our camera was still on the fritz. It was a shame, too, because that was the biggest baby I've ever seen! The final weight was 5.4 kg! (or 12 lbs for you metrically challenged) Fortunately, the actual birth was very smooth, but she once again was having lots of difficulty with the placenta. After about 10 minutes, the placenta started to separate, but didn't completely, so she started some pretty significant bleeding. When the placenta still could not be delivered, I called Niles back to help out. By the time he got there, she had lost probably 2 units of blood, so Niles manually extracted the placenta from the uterus. In other words, the guy was about elbow deep, pulling out pieces of placenta. He told me that now that I've seen it done once, I'm up next. (in medicine, there's this "see one, do one, teach one" thing)

So anyway, we finish with that lady, who is not helping the crunch on space, and we have to hurry to the stall next door where a lady had just delivered a baby, but no one knew she had twins, and the second was coming out breech! Niles wanted some equipment to resuscitate the baby after it was born in anticipation of a difficult delivery, so a nurse went to quickly assemble what we needed. While we were waiting, I noticed the woman standing by the bed begin to moan. Now, I had just assumed she was the watch-woman (wasmeri) who was accompanying the woman giving birth. I quickly realized my mistake when she squatted down and began really moaning. Then she started screaming, "It's coming! It's coming!" Someone threw a clean tarp down on the ground for her to lay on. When she did lay down, the baby's head was almost out already! Niles jumped over and literally caught the kid, cut the cord, and hurried back over to deliver the breech baby. I just stood there flabbergasted saying, "the things you just don't see anywhere else..."

Sorry, that story turned out to be a little longer than I expected! I was a bit disappointed in the lack of pictures as well, but I don't know how many of you would appreciate a picture of a baby's feet sticking out of a vagina. (You must forgive me, it's getting late.) So the other major news is that our camera is now fully functional! Well, almost. The date and time don't really work, but hey, it takes pictures. I definitely won't complain. I learned after the fact that the thing to do when your camera gets wet is 1)don't turn it on immediately to see if it works, and 2)take the batteries out ASAP and open it up to dry. If you are unfortunate enough to drop it into salt water, you're actually supposed to take all the batteries out and then rinse it in fresh water before drying it. Well, we did just about everything wrong. We definitely did turn it on right away (it actually worked for a few seconds) and we forgot about the little watch-type battery that is for saving date/time for about a day before finally taking it out. Somehow, though, it has pulled through and it's condition has been improved from critical to stable. I'll take it.

Today, Dr Andy was kind enough to give me a real day off to go to Mt Hagen to drop off the Batdorff's at the airport and do some grocery shopping. (Dr Niles and his wife Patti, a PT, who were here volunteering for almost three months. I'm not sure who will be in B ward with me tomorrow... probably Scott Dooley who just returned from furlough.) Stephanie, Caleb, and I went with our good friend Judy Bennett (Andy's wife and Sam's mom), and our new friend Gail Dooley and her daughter Olivia, who is just about 5 or 6 months older than Caleb. All in all it was a good day. The ATMs weren't working this morning, so we had to borrow money from Gail for groceries, who was very gracious about the whole thing. At BestBuy (the grocery store), Stephanie and Gail did the shopping while I walked around Caleb, which was fine with me! After one lap around the store, Olivia decided to hang out with the cool kids and came with us. Caleb actually held Olivia's hand (those of you who know big-personal-bubble-Caleb can appreciate the magnitude of that breakthrough) and the two of them had a great time running around the store. Caleb informed me that Olivia has brown eyes, just like him and mommy. Sniff... my little boy's growing up!

We again went to the Highlander for lunch, where I had a burger complete with a fried egg and a piece of ham that was intended to be bacon. It was delicious! Caleb and Olivia had fun in the shallow part of the pool, and fresh off my liberating Suicide Rock experience, I put on my trunks and joined in the fun. Hopefully soon I'll get those pictures loaded up and on here. Stephanie went off with Judy to run some errands while Gail and I watched the kids at the pool, where they discovered the ATMs were functional. So, fortunately, we were able to pay off our tabs we had accumulated since Stephanie's last fateful trip to town where her bank card and money were lost. After that, it was off to the open market and then back home. It was a really weird sensation pulling up to the station this afternoon... this place really has become home to us, albeit briefly.

In other news, two weeks ago there was a huge landslide not too far from here that cut off the only supply line for a very large chunk of the highlands. As a result, there are all sorts of problems coming up, mostly as a result of diesel shortages. The implications are huge, starting with doubling or tripling of prices for public transportation vehicles, meaning people can't afford to come to the hospital or transport their home-grown coffee or vegetables to sell. There are also now starting to be food shortages in Hagen, with increased prices, limits on how much of certain products we can buy, and nil stock of a few things. This will soon affect the hospital, especially with regards to things like oxygen and medication. When the hydro power goes out, the hospital is powered by a generator that runs on diesel. Thankfully, we have adequate stores for now, but that will run out eventually as well, especially if diesel cannot be purchased and the vehicles on station are needed for various things. There is lots of mixed news about the progress being made towards starting to find a solution. This is when some parts of Melanesian culture can get a bit frustrating. Remember these people in your prayers.

More adventures

This was a pretty busy week here for me, so there is plenty to write about. As mentioned earlier, Caleb is feeling better, but I think now he has caught a little cold from me, so he's been wiping his nose on everything! We got together with almost all the missionaries on Friday night for a "game night," we went to Suicide Rock this afternoon, and I saw the worst chopchop injury of my short time here. I suppose I'll start with the medical stories.

I was on call Friday night, hanging out at the above mentioned game night, when I was called down to the ER by Graham, the nurse who was staffing it at the time. I've gotten to know Graham a bit, and I always kid him about making a mess of the ER with blood and pus and people everywhere. He is (at least in my limited experience with him) what we in the States would call a "dark cloud," meaning he is always busy with more/sicker patients than usual. Well, that night was no exception. Graham said a guy came in, was pretty unstable, bleeding quite a bit, and that a limb had almost been amputated by chopchop. Now, in medicine here, everything from the nurses on the phone is understated, so I expected to see someone half dead when I walked in.





He was actually not looking too bad, except for a blood stained shirt with vines wrapped tightly around his right arm. He also had some makeshift bandages on his left forearm and right foot. He was, of course, covered from head to toe in dirt and blood. I asked Graham what had been amputated, and he said the right hand, though he hadn't seen it yet. One reason he was so worried was that his blood pressure (per Graham) was 60/40, and there was no way to know how much blood he had lost. When I came in, though, he was screaming in pain, and I knew pretty quickly that his bp wasn't nearly that low. At any rate, we got an IV going pretty quick and started assessing his injuries. His left forearm was open with his ulna broken and clearly visible. His right foot had a large lac across the bases of his toes, cleanly breaking all his metatarsals (long thin bones connecting the ankle to the toes). He also had some more superficial cuts on his face and fingers. Nothing terribly exciting. Finally, though, it was money time, and we took the homemade bandage of his right hand. What we saw was straight out of a horror movie. He had a cut from a bush knife (a.k.a. machete) that almost completely severed his entire right hand from his arm, save his thumb. The guy had obviously tried to catch or stop the (evidently pretty hard) swing with his hand, and his hand lost. The chop went diagonally down from the webspace between his thumb and first finger all the way through his ulna on the opposite side of his wrist. It was hanging on by just some skin and sub-q tissue. At this point, it was just full of old clotted blood, and was not really bleeding. I called my backup and subsequently the surgeons, and we got the thing cleaned off and packed for surgery the next day. Normally, even with open fractures and pretty severe chops, we just assess the patient's wounds, clean them out, stop the bleeding, and loosely sew them shut so the surgeon can look at them in the morning and do a definitive repair later. The big question with this guy was whether we should just amputate what was left of his hand right there, do the usual clean and sew, or just pack it and bandage it together. The final verdict was to just pack it and see in the morning what was alive and what was dead. For the other wounds we did the usual to await repair sometime this week. Internet is extra slow tonight, so here is a picture of his hand after we cleaned the clots out a bit. Ask me later if you'd like to see the rest of his injuries.



We all thought the hand would die for lack of blood supply, save for a strip of skin we could use to help close the wound after amputating. The next morning though, the family was insistent that they wanted him to keep his hand if at all possible, even if it would be non-functional. Now, I must take a little time out to say that in the States, this guy would have gotten a STAT surgery consult and a hand specialist, if he were at a big enough hospital, would have operated on him for untold hours repairing all the tiny nerves and arteries and tendons, resulting in (possibly) a mostly-usable hand. Sorry buddy, but this isn't Johns Hopkins. So on Saturday morning, after rounds, I went over to watch part of the surgery. There are a few more good pictures from that, including the finished product, but time tonight is limited. As I was saying, the family wanted to keep the hand, and amazingly, there was a reading from the pulse oximeter in his middle finger. so, it was decided to make an attempt and give the hand the benefit of the doubt. In a pretty delicate surgery, Kevin and Felix (a native doctor doing the equivalent of a fellowship month) repaired a major nerve, artery, and tendon, hoping to give him the ability to feel and pinch with his thumb and first finger. They also pinned some of his wrist bones back together and sewed his hand together. The end result actually looked pretty good. However, the pulse ox was not getting good readings from his fingers in the OR after the surgery, so we'll have to wait and see if it survives.

As to why/how the chop happened, it was apparently relatives who were quarreling pretty seriously with this young man about land. I will never understand how in a culture where family is so important, it is not uncommon for family to chop each other in pretty brutal and life-threatening ways.

In another call Friday night, I saw a woman who was in a state of shock, almost catatonic. She had put her one-year-old twins to bed in the customary way, hanging a few feet off the ground in a large bilams from a hook on the wall. It is a bit like a hammock, but the kids are snuggled in there pretty well with cloth or blankets or things. Well, the little girl twin somehow managed to get out, and fell maybe a meter onto a mattress (in PNG, this = straw mat). The family said she heard the noise and went in to find her little girl dead. At this, she started wailing, then collapsed and went into this semi-responsive state. I felt just terrible for this poor lady and her family. There was nothing I could do for them but offer to pray with them, which they accepted. Especially with such terrible loss, it is nice to be at a mission hospital where I can offer God's comfort even when there is nothing medicinal to offer. After praying, the woman slowly began to respond and went home to with her family shortly after. If you think of it, remember this poor broken family. I hate to think about what life would be like if we lost Caleb.

In other news, the man with TB and HIV whose chest xray I posted earlier did end up coming back to the hospital, but he died in the middle of the week. (And no, it wasn't from the pneumo) I don't know if starting TB meds earlier would have helped him turn the corner soon enough or not, but he was looking pretty ragged when he came back. I think the worst thing for him was finding out he was HIV +. After that, I think his will to live kind of dwindled.

Moving on to the non-medical, we have really been enjoying our time with the missionaries around the station. They are without exception good, honest people who are doing their best to live out the calling they feel in their lives. Most of them also have a pretty good sense of humor and are fairly laid back, perhaps from living in this culture. Even though I missed much of the game night, it was really fun to have everyone together playing games. One nice thing that's not as common in the states was all the kids and teenagers playing games with us. It is just really nice to see families enjoying leisure time together. See Dr Erin's blog for some pictures.

Today, as mentioned earlier, Stephanie, Caleb, and I made the trek out to Suicide Rock with a couple of the missionaries. It is a spot a couple miles from our house where the river has cut a nice little waterfall out of the rock with outcroppings on either side. There you jump into the river, and the current takes you a couple yards down stream where you pop up and can stand shortly after. Then you make your way to the edge and climb back up some pretty darn slippery rock. We all made it back safely with the help of Sam, one of the missionary kids (he's a senior in high school... kind of hate to call him a kid). Even swims-like-a-rock Ben jumped in and had a pretty good time. Caleb, of course, stayed only in the calm water and definitely did not jump off any cliffs. Our camera, unfortunately, did take the plunge as Stephanie was taking pictures of our friends with their camera. She stepped back and kicked the darn thing off the ledge and into the water. I was already down stream with Caleb, so I was able to hand him off and jump in, rescuing our camera with Herculean effort. I'm not sure it was worth it, though, because as of now it is still drying and refusing to work. We'll see what happens, but I don't think there will be any more picture posting for awhile!

And now, I would just like to give a couple of shout outs to our friends who sent us packages with snacks and treats we are thoroughly enjoying! The Huebners, the Majewski's, and the Olathe Kumors: you guys rock!

quick Caleb update

Hey everyone, just wanted you to know that Caleb is feeling better. He was finally without fever yesterday (Monday) all day but was feeling pretty darn cranky. Today he was well on his way back to normal. Tomorrow he should be feeling pretty good. I'm not too sure what it was that he caught, and I guess malaria is still a possibility, but my bet is on some good old fashioned butt-kicking virus.

While I'm here, just a few tidbits about PNG culture
-Polygamy is still very culturally acceptable in tribal culture. It's one of the biggest obstacles to Christian living here by the natives
-Wives of the same husband are brutal to each other! Chopchops aren't only for drunk men.
-No one in the hospital stays alone. Everyone travels and stays with a watchman, usually a relative. Many times, security has to ask people to leave, since we have to limit the watchmen to one per patient (for lots of reasons)
-People have a given name and the name of their father. In the case of men, this is handy and works fine for medical records. In the case of women, many times they take their husband's name as their last name, or their husband's last name, or keep their father's name. Sometimes, they will give different names at different visits. Since there are no social security numbers, female medical records are often alphabetized by first name.
-No one here has any clue about cause and effect when it comes to health. I can't tell you how many times I've gotten a complete history about a car wreck or something, only to find out that it was 10 years ago and really has no bearing on the cough the patient is now experiencing.
-Every man here is expected to own a pig. If you have no pig, you're not a man.

There you go.

tupela pikinini for the Kumors

Well, I must apologize for my lack of updates in the past week. Part of the reason is that I have just been quite busy. I was on call last weekend and then this past Tuesday, so I have been turning in a bit earlier than usual this week trying to catch up. Combine that with Stephanie wanting to check out the housing situation back in Omaha, and you have not a lot of internet time for me. Another thing is that I am finally getting into a good routine and things just don't seem as strange to me anymore. I have to keep reminding myself to take pictures of weird chest xrays or rare (to me) conditions, because it just doesn't shock me anymore. Along with that, though, comes a comfort level that allows me to just enjoy it a bit more.

Before we go any further, I need to announce some good news (for those who hadn't heard): Stephanie and I are expecting our second child sometime around Oct 30th! We wanted to keep it a bit quiet until an ultrasound had been done, and today the three - or four, I guess - of us stopped by the hospital on our way home from the river and I got a good look at the kid. Now, my ultrasound skills are improving but are still limited, and are not helped by an U/S machine that is dated and a probe that has seen better days. That said, I could see all the major body parts, and could even see the little hands and feet waving and kicking. Of course, the heart was visible as well, and it was beating like crazy. So, Stephanie is around 11 weeks, and intern year should be very busy indeed! We are looking forward to being near family in Nebraska, and we're hoping and praying that this one can wait until closer to the due date to come say hello. We will welcome your prayers in that regard as well!

With that out of the way, we can move on to more of the experiences PNG has to offer. One thing that is fairly common here is the keeping cassowary birds as pets. Cassowaries are the PNG equivalent of the Ostrich or Emu. Basically a really big, flightless bird that kills people in the wild by jumping at them and tearing out their bowels with huge claws. Sounds like definite pet material to me. Well, they are commonly used in some parts of the country to pay the bride price at weddings, and are supposedly very sought after and tasty to eat. One of the ladies who works at the hospital, named Anna, has the biggest cassowary around. She invited us out to her village to have a look and take some pictures, which is exactly what we did. This doesn't really do the bird justice in terms of size, but you can see a bit of the color that makes them pretty distinct and cool-looking. Anna's bird was around 5 ft tall and pretty intimidating. It is kept in a little bird shed that is probably 4x4ft and 6ft tall. The funny thing was, they were just handing it bananas and grabbing its beak like it was nothing! That's Anna's husband, Joel, in the background feeding the bird. He told us he was very grateful for our willingness to come and help the people of his country. He said he had nothing to give us, but is sure God is pleased with the missionaries who come and will bless them accordingly. That was pretty humbling to hear, and it gave me just another good example of how appreciative and warm the people of this country are. Quite a bit different from what we're used to in the States. After this, we took a picture with their family, and they gave us each a pineapple from their garden to take home with us. We had some snacks in Stephanie's bilam (knitted purse) that we gave to their kids, and then we were off. Caleb, however, was not too happy with giving away our snacks, and proceeded to throw a fit as we left the village! Oh, well, he'll learn sometime.

I'm trying to pick out some of the good medical stories from the past week, but they're sort of blending together. There was one gentleman who actually spoke very good English and is pretty well educated, but it turns out has TB and HIV. He also has the distinction of being the first person in whom I caused a pneumothorax! A pneumo (for short) is basically when air gets into the chest cavity between the inside of the chest wall and the lung. Now, when I admitted this dude, he had pretty much a white-out of his right lung. We ultrasounded it, and sure enough, there was a ton of fluid in there. I was working with Dr Erin, who is in her first year post-residency, and she is really cool about teaching and letting me get my hands dirty, so to speak. We did a procedure to take some of the fluid off, called a thoracentesis. Now, we don't really have all the nicely packaged kits and sets all the time like back home, so we were doing this under less than ideal conditions. I stuck a needle into his back and pulled back the plunger on the syringe, evacuating a good amount of fluid from this poor guys chest cavity. Then, when we were pulling the switch to empty the syringe, we told the guy not to breath. Well, he did, and he got a pneumo. So I guess it was only partly my fault! We did have some stop-cocks available which I should have been using, but I guess that's a learning point for next time. In spite of all this, the guy was actually breathing better after the procedure than before it thanks to all the fluid we got off. Another satisfied customer! Here is his post-thoracentesis CXR. The nice white plateau in the right lung is all fluid, and used to take up almost the entire right side. The thick white line that is more vertical is the edge of his lung tissue. Outside of that, my friends, is the air. Hey, nobody's perfect! The effusion has recurred, however, leading us to believe it is probably TB. The positive HIV test I ordered, as mentioned earlier, added further weight to the TB theory, along with the quality of the fluid we drained off in the first place. Here, we unfortunately have to rely a lot on clinical judgement regarding who has TB and who doesn't. Anyway, before we could start this guy on TB meds, he left the hospital AMA (against medical advice) to go testify in a court case regarding recent elections here. He promised to be back Friday, but I won't know if he made good on it until I'm back in the wards on Monday.

Okay, now I need to get to the story that some may have heard from Stephanie's emails. She may have stolen my thunder a bit, but I promised the pic and story in my last post, so here it is. Josh, my good friend and fellow med stud, was on call a couple weeks ago with Erin as his backup. They were called to the labor ward for a preterm labor. They had just examined the lady and were standing outside the curtain talking briefly about what was going on, when they were quickly called back in by the nurse. This is what they saw. The baby and placenta were lying there on the bed, still contained in the amniotic sac! What you're seeing here is mostly placenta, with the baby's head and face pressed up against the membranes. The woman had (evidently) abrupted, meaning the placenta had separated from the uterus prematurely (i.e. before the baby is born) and the little baby came out in all his glory. They snapped this picture quite quickly before then breaking the sac and resuscitating the baby. This little guy was around 28 weeks gestation and weighed about 100 or so grams (~3-4 oz) less than Caleb when he was born. Unfortunately, this guy didn't make it, and died about a week after he was born. It probably would have been a different story in a major US hospital with access to TPN, ventilators, continuous monitoring, etc. We have lost a few premies here recently, some bigger than Caleb was. It's just a good reminder of how blessed we are back home, and how much further we have to go here.

Now for some happy stuff. This is a little guy named Nathaniel. Erin saw him in clinic about a week and a half ago, and this is the picture she took. He has what's called Burkitt's Lymphoma. Common in Africa and PNG, it is a cancer caused by the Ebstein-Barr virus, the same one that causes mono, the "kissing disease." It primarily affects the face in a characteristic way, and is pretty easy to diagnose. Untreated, this tumor will take over his face and eventually kill him. Fortunately, it is also highly sensitive to chemo, and the chemo used is pretty easy to get our hands on and not too technically challenging.

This space gives me a chance to comment on his mom's tatoos. Evidently, they don't really have any significance at all. No relationship to what tribe they come from or who they're married to or anything! They just sit around and tatoo themselves for fun.

Back to Nathaniel

Thus, 10 days later, he looks like this. Granted, he still doesn't seem too happy to be in the same room as a white skin, but his tumor is down, and after several months of chemo every few weeks, he has a good chance at a normal life. The problem is really going to be making sure he completes his chemo course. People here don't have a good concept of medicine or how the body works. As soon as he is looking normal, there is a chance the family will quit taking him to the hospital. Hopefully he will complete his course, or do well regardless.

In more domestic news, Caleb has learned a new trick. I think the picture says it all. He just busted out the eye brow at dinner one night totally unprompted. I, of course, was thoroughly impressed and made sure he knew it. This pleased him greatly and provided an entire evening of entertainment. He is honing his skills, and will be ready to flash the eyebrow upon command when we return home to you all.

Shortly after the eyebrow trick, Caleb came down with some hopefully not too exotic disease and has had a good fever for the past 3 days. We're not on malaria prophylaxis, so that is always a possibility. I'll keep you posted on this front. While he's on Motrin, he's been a pretty good sport, and we all ventured down to the river in the valley this afternoon. It was quite muddy, and Stephanie about lost her flip flops on numerous occasions! I was carrying Caleb's stroller - it's a loner from someone around here - and unfortunately missed a couple of good photo ops of Stephanie ankle deep in mud. There were some native boys there fishing that we got pictures of, but I'm not sure how indiginous nudity is handled on this site, so they will remain omitted. Until next time!