Read an Excerpt
Still Listening
How to Hear God's Direction at Life's Crossroads
By Susan Vitalis Elevate Publishing
Copyright © 2017 Susan Vitalis
All rights reserved.
ISBN: 978-1-945449-25-3
CHAPTER 1
CONCEPT 1
Go Deeper to Discover Your True Potential
We know we were made for so much more Than ordinary lives It's time for us to more than just survive We were made to thrive
— Casting Crowns, Thrive
If you would have asked me during my first year of college if I would ever be a doctor, I would have laughed and snorted, "No way! I'm going to be a high school math teacher." However, my first calculus class quickly changed my sights from becoming a math teacher to a biology teacher. I was good at math, but quickly found that I enjoyed biology much more. Why did I laugh at the thought of becoming a doctor? I am a great minimizer. During the summer between my second and third year of college at Concordia College in Moorhead, Minnesota, I worked with a friend who was pre-med. By this time I was questioning my desire to be a teacher, and my favorite classes were Anatomy/Physiology, Biochemistry, Genetics, and Biomedical Ethics. Hmm ... I started to see a pattern there. My friend asked me why I wasn't interested in becoming a doctor and I responded, "I'm not smart enough." Now it was her turn to laugh and snort, "What are you talking about? You're as smart as all the pre-meds!" Huh. Maybe I could get into medical school.
Deciding to go to the homecoming football game my fourth year of college ended up being one of the most pivotal days of my life. Ann, the friend I was sitting with at the game, asked me where I was applying for medical school to which I responded, "I'm hoping to get into the University of North Dakota." Fargo was my hometown at the time. She casually said, "You ought to apply to Johns Hopkins." My turn again to laugh and snort, "Are you kidding me? There's no way I could get into the best medical school in the country!" She was serious. "My uncle graduated from Concordia and then went to Johns Hopkins. He liked it so much that he stayed as a Pediatric Orthopedic Surgeon. I'll have him send you an application." Fine. I changed the subject, figuring she wouldn't follow through. Two days later I received a package from Dr. Vernon Tolo with an application and letter that said something like, "Ann told me you're interested in applying to Johns Hopkins Medical School. My family and I love it here. I sent the application by overnight mail because the deadline is soon. I hope to see you in Baltimore next year!" Oh, my goodness. Now I was in a conundrum. He went to all the time and expense to get me the application, so how could I not apply? And yet, it cost $50 to apply and the questions were all in-depth and personal, which would take time. But Dr. Tolo and Ann went to so much trouble, I couldn't let them down. So, in my mind, I spent a lot of time on an application that would get me nowhere and wasted $50. Once again, I was minimizing and underestimating myself.
When I received the acceptance letter to Johns Hopkins School of Medicine, part of me was excited, but a bigger part was terrified because I knew they must have made a mistake. It's the only thing that made sense to me. Ultimately I decided to accept the offer, and resolved to spend every waking minute for the next four years studying medicine. On our first day of orientation, when there was a short pause between speakers, one of my fellow classmates said, "Do you know what they call the person who graduates last in their med school class? M.D." That broke the ice for all 120 of us as we realized we were all terrified to some degree. And, as we looked around us, we were surrounded by the people who would help each other get through the next four years on the path to becoming lifetime friends.
Underestimating our ability is, in reality, the same as underestimating God's ability. Philippians 4:13, "I can do all things through Him who strengthens me." And we know what God can do. He can move mountains, calm a raging storm, raise the dead, perform any miracle imaginable, do more than our minds can even grasp. And we have that same power within us. John 15:7 says, "If you abide in Me, and My words abide in you, ask for whatever you wish, and it will be done for you." So if we underestimate what we can do, we are underestimating what God can do. And He can do anything and everything. So how do we tap into God's power? We have access to it all as long as we have faith to receive it. Sometimes it takes something dramatic to bring us to our knees and ask for power and strength because when things are going well, we take the credit and forget that it's really not us in control.
There was another defining moment in my life when I underestimated myself. However, this time I came to realize that by doing so I was underestimating God at a time I needed Him in all His glory and with all His power. I will set the stage for you. I was in Kenya on my first mission trip right after finishing my Family Medicine Residency program. It was the longest day of my 29 years on earth.
The day started in the usual way: Dr. Roger Lindholm and I made the uphill walk to Tenwek Hospital in rural Kenya, from our "home away from home." Roger and his family are dear friends from Minnesota who slaved through Residency with me. While in Kenya, I lived with Roger, his wife Joan, and their two young daughters, Leah and Jamie. Roger and I arrived for doctors' report at 8 a.m., short of breath from the exertion. My body never fully adjusted to the altitude of 6,800 feet, and my lungs could never seem to find enough oxygen in the thin air, particularly on this day since I had been in the country for less than a week. Morning report was a time for all the doctors to meet and hear what had transpired during the previous night from the on-call physician. After report, we would pray together and then spread out to our respective wards, where we were quickly swallowed up and immersed in work.
Around 8:30 a.m., after seeing only a handful of patients on my ward, there was an overhead page for any doctor to go to the outpatient department STAT. At least that's what it sounded like. The hospital was made up of several buildings, but they did not all have speakers, so people would shout loudly into the audio system to make sure they were heard by all. A combination of poor-quality equipment that created more static than distinguishable words, plus a frantic Kenyan trying to speak English, but in panic often reverting to the local Kipsigis language, made it difficult to understand the pages. But I thought I caught the words "doctor" and "STAT," and this was confirmed when my Kenyan nurse pushed me out of my ward and pointed to the outpatient department.
I ran there with Wendy, a nurse from the United States, close behind. When we arrived we saw a man who appeared to be in his early 20s collapsed on the floor. Since we were the first to arrive, we started CPR; soon Roger also arrived and jumped into action. Initially we didn't have an interpreter, but someone wheeled in a crash cart for us. To say that we bumbled through the code is an understatement. I don't think the crash cart had been updated for a decade or two, a conclusion I came to quickly with one glance at the cart. There was no defibrillator, and the equipment that was there was ancient and rusted. At least we could figure out most of the medicines since the names were, for the most part, recognizable. We worked on this patient for about an hour, but could not revive him. All we knew about him was that he had walked into the outpatient department, unaccompanied, and collapsed. I have no idea what led to his death.
As we were cleaning up the mess we had made during the code, there was another page: "Dr. Susan Vitalis to Ward 118, STAT!" Ward 118 was my women's ward, so I sprinted down to find the nurses doing CPR on a 16-year-old patient with asthma and congestive heart failure (CHF). In the United States, when we hear that someone has CHF, we picture an elderly person. But in Kenya and other African countries, that is not always the case. This patient had congestive heart failure that could be traced back to an episode of strep throat that went untreated. The streptococcal infection traveled from her throat to her blood, causing rheumatic fever, and then the infection seeded on her heart valves, causing rheumatic heart disease that eventually led to CHF. Her asthma led to respiratory arrest, and her heart was having difficulty keeping up with the increased need for oxygenated blood throughout her system. We tried to resuscitate her for about an hour, but were unable to revive her.
As I was explaining to her parents what had happened, I was overcome with the feeling of defeat. How could I convey to them, through a translator, why their 16-year-old daughter had died? I took a chance by taking their hands in mine; not knowing if this was culturally acceptable. After all, I had only been in their country for a few days. But they squeezed my hands and held on tight, so I figured it was the right decision.
I knew that if the girl would have had access to the medical care we provide in the U.S., she would not have died from asthma and CHF. For one, the strep infection would have been treated either at the point when she had strep throat or rheumatic fever. And her asthma could have been managed with inhalers and other medicines if treatment had been started earlier. Occasionally we had inhalers available that were brought in by doctors coming from the States, but there were never enough for the large demand. At that point in time, we had eight inhalers in the pharmacy, and that was only because I had brought six with me. I don't remember what I told her parents, but I vividly remember the feeling of inadequacy.
Just as we attempted to start rounds again, Roger's voice came over the loudspeaker: "Code in Ward 3," Roger's female ward. Once again, I found myself sprinting across the hospital grounds to another crisis. As soon as I arrived, Roger sent me looking for a mask and breathing bag since his patient was unable to breathe on her own. Both fortunately and unfortunately, I knew right where they were, since I had just used them on my ward. I darted back to Ward 118, grabbed the equipment I needed, and ran back to Ward 3. Thankfully, adrenaline allows our bodies to do more than we could under normal circumstances. I would normally be jogging, but adrenaline kept me sprinting. I found myself thinking of my hurdling days in high school track because I was jumping over wheelchairs and beds, some unoccupied and some piled with people, all of whom were wearing a universal startled look on their face. The distance was never more than 100 yards, but the obstacle course made it feel longer.
When I returned, Roger filled me in on this patient. She was a 38-year-old pregnant woman with nine children who had come to the hospital that morning with a nine-day history of headache. She was completely alert and communicative when she first arrived, but subsequently stopped breathing while her heart kept beating.
We intubated her in order to provide her lungs with the most oxygen possible while we hoped and prayed she would come around. Her heart was beating fine, so if we could just get her breathing again on her own, we could start looking for a cause for her headache. We knew we couldn't stay and bag her all day, but we kept at it for about an hour. By then her pupils were fixed and dilated, which suggests irreversible brain damage, and she was not showing any signs of breathing on her own. So we quit breathing for her and then waited for her heart to stop beating from lack of oxygen; this took about ten minutes.
Our guess was that the patient had an abscess, tumor, or something else in her head that gave her headaches and eventually got big enough to start pushing the brain down the foramen magnum (the hole at the base of the skull) into the spinal canal. In the States, we could have put her on a respirator and then obtained a CT scan to see what was going on in her brain. But we weren't in the States. I was starting to learn that the only way to survive working in a country without the same resources available as in the U.S. was to separate myself and see them as two separate countries instead of trying to make comparisons. This was a tough lesson that didn't totally sink in until subsequent trips to various African countries.
By about 4:30 p.m., I had seen all the patients in my wards. I headed to the outpatient clinic to see if they needed my help, hoping they would not so I could catch my breath. Unfortunately, the patients were terribly backed up and they desperately needed me. Are you kidding me? When will I have time to breathe? I somehow managed to swallow these questions before they came out of my mouth.
The clinic is entirely a walk-in clinic, so there are no appointments. We had no control over how many patients were seen in one day. The first patient I saw in the clinic was a 15-year-old girl who had come to the clinic because she had been raped twice by the same man. Understandably, she was an emotional wreck. (So was I, for that matter.) Once again, it was very difficult to talk through a translator about highly emotional, sensitive issues. As I was talking with her, I heard a brief moment of static on the loudspeakers and knew, even before the words came out, that there was another crisis somewhere. "Any doctor to Labor and Delivery, STAT!" I thought to myself, "Please, not Labor and Delivery."
For the fourth time that day, I found myself sprinting across the hospital grounds, not knowing what I would find. I soon came upon a midwife delivering a baby that was in the breech position (feet first instead of the normal head first presentation). She had the baby's body out of the birth canal, but the head was stuck. Another doctor arrived at the same time as I did, so we each took a side; he pulled on the baby from below, and I pushed on the abdomen from above. We weren't making much progress, and the baby was getting bluer and floppier. We tried pulling her out with forceps with no success. The other doctor said, "The baby is not going to survive. It's time to use the destructive instruments to get this baby out."
I didn't know what these instruments were specifically, and I wasn't ready to find out. After all, this baby still had a heartbeat. We compromised by giving it another minute before getting out the despised instruments. I went back to pushing on the uterus with renewed energy; I did not want to destroy this baby. Finally, with all of us drenched in sweat and breathing as though we had just finished a marathon, the head popped out! Hallelujah! But our work wasn't finished. The baby had a weak heartbeat and wasn't breathing on her own. So, for the fourth time that day, we started resuscitative efforts.
I thought, "No problem. Babies are born with weak heartbeats all the time. And many need help breathing initially. She'll come around." To my great disappointment, she didn't. My feelings of inadequacy continued to mount. She was a full-term baby who was healthy in every way except that her head didn't fit through the birth canal.
This was the fourth death of the day — the fifth when you count the three-month-old fetus that died with her mother who, at the age of 38, was the oldest person to die so far that day. It was 6 p.m., and I knew I had to return to the outpatient clinic to finish talking with the rape victim and continue to whittle away at the people left waiting.
As I was walking to the outpatient clinic, I was overcome with a sense of inadequacy, powerlessness, and weariness. I questioned how I could survive the next three months. I pictured myself decimated, piece by piece, left in the middle of Africa to die. Okay, this may sound a little melodramatic; however, at the time, not so much. It was then that I realized my belief had to dig deeper than it ever had before or I would be crushed — especially since I was on call that night, which meant my day was actually just beginning.
I was in over my head. There was no way I could keep on going. Maybe I wasn't cut out for mission work after all. However, God had been preparing me for this moment for years. And then it hit me. It was God who directed me to Tenwek Hospital. Not me. I was looking at my situation through my limited brain with my limited resources, again underestimating what I could do. But God has no limits and, through Him, I can do anything. I knew I couldn't survive on my own without turning everything over to God. What a relief!
(Continues...)
Excerpted from Still Listening by Susan Vitalis. Copyright © 2017 Susan Vitalis. Excerpted by permission of Elevate Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
