Thursday, June 11, 2009

Made to Serve: Lessons Learned in Kenya

It’s early June in Boston, and it’s one of those years in New England, where summer seems to be having a difficult time arriving.  It is cold and rainy today, more like an April day should be.  I sit in an apartment in Beacon Hill, one of the most affluent neighborhoods in Boston, and I look out of the window, where I see busy Bostonians hustling about on their way to work looking quite harried.  There seems to be no joy on anyone’s face even though they all live in this wonderful community of abundance.  It causes me to pause and wonder why we are in such a hurry, and so focused on our problems, when over all there is so much to be thankful and hopeful for.  I start to day dream about the wonderful community I have just left.  Kijabe was not free of problems…in fact there was an ever present climate of need and lack in this small town, especially during the drought when people were hungry.  But despite the problems, there was so much joy in the residents of Kijabe.  People were thankful for the smallest things, and most wore a countenance of hope across their faces, even when they were facing obstacles.  There was always a spirit of collaboration, and no one was allowed to suffer alone, even if the only help that could be given was an encouraging word or a willing ear.  A smile broke across my face as I began to think of my friends who I had just left in Kijabe.  My heart warmed as I thought of our moments of shared laughter and tears.  Then suddenly, my deep thoughts are interrupted by the sounds of the loud garbage truck coming down the street to remove the trash, and as I am startled back into reality, it hits me that I am not in Kenya anymore. 


Last September, I left Boston with great anxiety about what would happen to me in Africa.  In my spirit, I knew I was doing the right thing, but it is difficult to silence the doubtful voices in ones head, when one endeavors to walk by faith.  My mind was racing with a thousand “what-ifs”: “What if I get sick?”  What if I am not well trained enough to be a surgeon in Africa?”  “What if I run out of money?”   “What if I am lonely?”  I thought of all the things that could go wrong, and I just could not see how I was going to have a productive, safe, peaceful trip.  My mind would just accelerate with worries until finally, I would just take a deep breath and pray that everything would work out.  

Well…600 operations, 1500 clinic visits, and 300 inpatients later, I am happy to report that it was a wonderful trip.  I really had no major problems.  Financially, I did not have to go into debt to complete the trip.  I did not get seriously ill, and my PPD is even still negative.  I was able to thrive professionally, and most importantly teach many trainees and students which is probably the most crucial activity to helping change the quality of health care in Africa over the long term.  And I was never lonely…I made so many wonderful friends, and even though I was 10,000 miles away from home, I never felt like I was any further away from my family than when I am in Boston.   

And now as I look back on the entire experience, I can say that I learned some very valuable lessons about life:


We will never regret any decision to serve others.

We often regret decisions we make in life.  Sometimes those regrets are because we make decisions out of wrong motives.  For me, I still regret a decision I made over 15 years ago.  The decision eventually hurt several people, myself included.  And when I think back to what motivated me to make the decision, it was very selfish.  On the other hand, I cannot think of one time that I made a decision to do something for someone else, selflessly, that I regret.  I am not suggesting that nothing bad happens to us when we attempt to serve…actually, we can be used or taken advantage of when we try to help others, but even if our efforts to help are taken advantage of, we will not regret trying to help.  We may have to alter our approach or even abandon our work all together, but there is no shame or guilt in that.  Regrets only come when we do something and we should have known better.


What we do is not as important as how we do it.

When I moved to Africa, I was pre-occupied with the possibility of clinical scenarios that might overwhelm my skills and knowledge.  I thought that the most important thing for a doctor (especially a surgeon) is to know what to do…especially in an emergency.  But in actuality, knowing what to do is of less importance than knowing how to show respect for colleagues and care for patients.  A surgeon can be technically very skillful, but rude and condescending to co-workers or distant and unavailable to their patients, and that surgeon will be ineffective.  On the contrary, a good doctor leads by example first and foremost.  Other doctors can be consulted if one does not know what to do, but we cannot regain the opportunity to inspire our colleagues or make our patients feel important, and this is key to being an effective physician, or an effective anything for that matter.  Albert Schweitzer, the famous African missionary, once said “Example is not the most important thing in influencing others…it’s the only thing.”


Our financial problems are not as bad as we may think.

I used to believe that I had financial problems.  I used to believe that if I could just get a couple financial breaks, my life would be good.  I thought driving and old car, and not owning a home made me financially disadvantaged.  Living and working among the truly poor made me realize how wealthy I am.  Living in rural Africa has helped me to simplify my life and learn the value of a dollar (or a shilling at least).  Even now, as I re-enter life in Boston, I realize what I really need to be happy and healthy, and I have more than enough financial resources to meet those modest needs.  Plato said it well: “the greatest wealth is to live content with little.”


The collateral damage of love is more love.

Often times, my attempts to help patients while I was in Africa failed to achieve the desired outcome.  Even with my best efforts, some patients died.  And even with the patients I was able to help, there was always such a long list of people who I could not help.  People with incurable disease, or problems beyond my expertise to help.  Sometimes, I felt so impotent to make a difference, but what I learned was that even when my attempts to do good fell short of the immediate goal, the effort often had some unexpected benefit.  A co-worker might have been inspired by my dedication to a patient, even though the patient died.  Or a family member was able to renconcile with their loved ones, in the time we were able to delay the progress of their incurable disease.  There are so many unseen blessings that come when we serve.  So even when it seems that our service is in vain, it is not.  I believe that love is infectious this way, and can spread beyond the direct act of love we attempt to commit.  Love does not die…it multiplies.


The cure for a broken heart is to love.

Mahatmas Ghandi said “the best way to find yourself, is to lose yourself in the service of others.”  I understand this now.  We often say to ourselves that we are going to get involved in some charitable activity or community service project as soon as we get our own lives straightened out.  Many of us are focused on our own pain and problems, and we don’t think we have anything else to give away.  But ironically, one of the best ways to deal with our own hurt, is to serve someone else.  We were created to love one another…it should be our primary occupation.  And when we “lose ourselves” in the occupation of serving others, our problems are able to come into proper perspective.  It turns out that we don’t have to be perfect to love other people, but loving other people will serve to perfect us.


I am thankful for the many lessons I learned in Africa.  My life was so enriched by this mission trip.  It’s a cliché to say that it was a “life-changing” experience, but that is exactly what happened to me.  I have been transformed.  I look the same on the outside, but my heart is alive in a way it never was before.  And now, as I look to the future, I know what I need to do to continue to enjoy this peace, joy, and fulfillment…even in America.  I have to continue to serve.  Perhaps I will not always be able to serve overseas, but I can have a servant’s heart no matter where I am and what I am doing.   

We were all made to serve.  The golden rule that is common to almost all religious faiths is “to do to others as you would want done to you”.  But it’s not simply something we should do, because it enhances the lives of those around us.  When we follow this simple rule, we are doing what we were designed to do…and when we do what we were designed to do, we experience fulfillment of our purpose…we feel complete…we know peace.  And what is most beautiful about this truth is that this wonderful way to live is accessible to anyone…not just doctors, or educated people, or the rich.  Each and every person has the capacity to love and serve someone in their life. 

I’m not suggesting that a life of service is always easy.  It can come with sacrifice, suffering, and in some cases even death.  But I can tell you from my own experience that those sacrifices that I had to make to work in Africa were well worth it.  I have no regrets, and I look forward to returning to Africa knowing that there are risks involved.  I would rather endure suffering on my own terms as a servant than to live a “safe” life, but not fulfill my purpose.  And I am not suggesting that we rush foolishly into dangerous situations in the name of doing good.  We have to exercise wisdom in our efforts to serve, but at some point we may have to put ourselves at some risk to meet the needs of others.  And of course, we cannot all move to a developing nation or a refugee camp…most of us have to serve at home.  But we can all find ways to serve effectively, whether it be raising money for good causes, mentoring someone in our community, or even paying a visit to a lonely elderly family member.  It is not really important how we serve, but just that when we see a need that we have the ability to meet, that instead of turning a blind eye to the problem, that we be willing to give of ourselves to meet that need.  That is where our own personal fulfillment lies…being willing to put ourselves someplace we don’t have to be…or give something away we could have happily kept…or fixing something that was not our responsibility to fix.  It’s what we were designed to do, and when we do it, the blessings are immeasurable.


As I have sat here in this Beacon Hill apartment thinking an writing, the sun has found a little crease in the clouds, and squeezed through for a moment of sunshine.  The weather in Kijabe was very similar.  Often, days that started off looking like they were going to be damp and dark would transform into gorgeous days with the sun streaming down over the beautiful valley below the town.  As my mind wanders back to those days in Kijabe, I realize why I was so happy there.  I was in a continuous state of service.  I have never been so eager to go to work in the morning, and even a late night consult was an excuse to breathe the clean crisp air and look at the multitude of stars in the beautiful African sky as I walked to the hospital.  It never felt like work…it just felt right.  My body was tired, and I got frustrated at times, but those were always fleeting moments.  The overwhelming feeling I had most of the time was serenity.  It’s ironic, because there was so much happening around me, and so many demands on my time, and so many problems that seemed insurmountable, but all the while I was content.  I felt at home in Africa…I knew I was right where I was suppose to be.  It’s a feeling I pray everyone get to experience in their lifetime.

Peacefully yours,



“I don’t know what your destiny will be, but one thing I know: the only ones among you who will be really happy are those who will have sought and found how to serve.”

 ~Albert Schweitzer


At Mon Jun 15, 04:11:00 PM, Blogger Intellectual Insurgent said...

Absolutely beautiful. Godly.

We will be in Boston at the end of September and hope that we can meet up, at least for a quick hello.

At Tue Jun 16, 11:19:00 AM, Blogger Cherise said...

That was a gorgeous and sincere posting! Thanks for sharing.

At Sun Jun 21, 08:11:00 PM, Blogger Joanne Wilson said...

Amen :)

At Sat Jul 11, 04:03:00 PM, Anonymous Anonymous said...

My friend convinced me to read your blog and I just want to say thanks for some very much needed encouragement from so many different perspectives. I can say I got a recharge for some issues and I am ready to move on.

At Mon Oct 05, 09:30:00 PM, Blogger Tha Mello 1 said...

Hey Chad. I wanted to get your thoughts on healthcare reform. Give me a shout when you can.

At Sun May 02, 08:16:00 PM, Blogger Smally On The Rocks! said...

Doc, thanks for this amazing read. Again, few people realize that even third world countries might actually have something to offer, let alone be transforming a life. But that's precisely what's happened to you. Again, it's God's absolute grace that instead of pining about your decision of going to Kenya, you have realized how much you gained. :)

As you said, "What we do is not as important as how we do it". I thought countless times why people don't understand this simple fact or even if they do, they try to undermine it. Is it our society that makes us think the other way? I am not sure. However, there are some excellent sources on this. One that readily comes to my mind, is a Hindi comedy movie, "Munna Bhai MBBS". This movie is an epitome of "What we do is not as important as how we do it". Really, as you pointed out, the "what" part can be relegated to others, but the "how" part, which is actually far more important, cannot. And the "how" part actually defines who you are, NOT the "what" part.

It's divine grace that you understood money is NOT what makes us wealthy, but our inherent happiness, quality of relationship with others, and what others think about us. These are the real currency of life. And as I said, to get this currency or even to appreciate its value, requires divine grace. You are one of the lucky persons, I think, who have been endowed with this feeling. I'll term this innate wealth "divine wealth". And truly, if you are sufficiently wealthy in "divine wealth", then money and other pleasures find little room in your daily thoughts. People can find true and limitless happiness that way. It's unfortunate that we pursue the opposite path - the path of selfishness, greed, flattery, and yet more money, totally oblivious to the fact that money can never make us any happier than we already are. In fact, it makes us more anxious and concerned. Same goes with competition, selfishness, greed and pleasure. They are NOT the key to happiness - they are not meant to be. Happiness, on the other hand, lies with "lose yourself in the service of others", to help others, to love others. Love is the key to happiness. Love others, and you'll be loved. Love others, and you'll be happy. Love thy neighbors as thyself. Love is God, and yes, God is love. Deus caritas est. Let love be your weapon in the war against ignorance!


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