May 2010

As has been said several times on our website, we are so grateful to God for the the gift he has given to our family in blessing my brother Randy with his lovely wife, Sylvia. Amongst other things, she is a gifted musician and writer and this weekend she so beautifully put in the words the thoughts that most of us can barely think.

I wrote the following as a result of the journey we’re on with my father-in-law:
Can I put my trust in God’s sovereign hand,
When it looks so dark and I don’t understand?
Why my loved one in hospital must suffer this way,
As he’s tied to a bed and the most he can say
is to plead for his family to please set him free
While his mind is not coming back to reality.

Is God really a part of this very dark puzzle?
Do His filtering hands allow such deep struggles?
What will my hope be for this new day of pain
as the news of the day is that nothing has changed?
The emotions are raw and the grief is so deep,
the tears slip out easily from fountains that weep.

Just what does life mean if I go out today
and sit by the pool while he’s wasting away?
Or off to the store so that life can go on,
Are there two worlds or one? Am I here, is he gone?
The journey of having no power to help
is eating away at my own sense of self.

And so I go numb and I go through the motions
of continuing life while my world is an ocean
of storms and of winds just too strong to endure,
of panic and fear that there will be no cure.
So back to the question of God and His ways,
Is He mindful of us? Does He hear when we pray?

Today will not answer the questions I face,
So I turn and look back on God’s love and His grace.
And I hold to the hope that through dozens of years,
He’s always been there to wipe tears and calm fears.
So today as I choose to re-anchor my soul,
I rest in the God that I love and I know.

By Sylvia Carter (used with permission)

At times it felt like this day would never come but now it is finished. It was early in March when the surgeon decided that the only option left for Dad was urgent surgery to relieve the pressure on a nerve that was causing persistent and excruciating pain.

After a month in hospital and several bouts of life threatening complications, we were happy to have him moved last night to the Neurosurgery Unit, looking much perkier than we have seen him in several years. He had a rough night as they were unable to give him painkillers preoperatively. In spite of severe pain, he made it through a 7 a.m. MRI to map out and mark the key areas of his brain.

At 9 we met with the Anesthesiologist who spelled out that 50% of anesthetists would refuse to do this but they agreed there was no other solution for his pain. He stated that he would be pushing the surgeon to simply go in and cut the nerve and get out as he felt keeping dad under for more than four hours was too risky. He said if things went well dad would go to recovery and then to the floor but if his heart failed he would go to ICU and it would be a matter of days until he was gone. He asked dad if he had any questions and dad’s response was, “Let’s get this underway” and then it was off to the OR.

Dr Parent had estimated the surgery would take six hours but the OR was booked for seven, until 4 p.m. By 4:30 we had not heard a word and were beginning to be very anxious. Fortunately a Porter came by who happened to be a friend of my brother and had access to the OR suite. She returned soon to let us know that dad was in the recovery room and showed us were to stand so we could see if they moved him.

At 5 the surgeon arrived and explained that he was able to insert a teflon pad between the 9th cranial nerve and a blood vessel which was pressing against the nerve thus saving the function of the nerve. It is very uncommon for this particular nerve to be affected and in fact it is only the third time he has performed this surgery, in spite of the fact that he is one of only two surgeons in Ontario who perform this particular procedure.

By 7 p.m. we left Dad in the Neuro Observation Unit on his floor, heavily sedated but stable. It will be at least 48 hours until we will have an idea of the full impact of the surgery but it is a wonderful relief to have this part behind him.

It was a long day and I sat for hours in the waiting room where I saw some people waiting all alone for news of loved ones and others who were obviously of a faith that offered no relationship with a loving God or clear hope beyond this life. I, on the other hand was with three of my brothers and a wonderful sister-in-law, often taking solace in my faith in a God who loves and cares for Dad and for us and an assurance of an eternity with God beyond this life.

Richard Foster in his widely regarded book Celebration of Discipline marks out the territory that Christians need to inhabit in their daily walk with God. One of his most insightful chapters is on the fundamentally important role of prayer in shaping the future of our lives. He writes:

“In our efforts to pray it is easy for us to be defeated right at the outset because we have been taught that everything in the universe is already set, and so things cannot be changed. And if things cannot be changed, why pray? We may gloomily feel this way, but the Bible does not teach that. The Bible pray-ers prayed as if their prayers could and would make an objective difference. The apostle Paul announced that we are ‘co-labourers with God;” that is, we are working with God to determine the outcome of events (1 Cor. 3:9). It is Stoicism that demands a closed universe, not the Bible.

“Many people who teach acquiescence and resignation to the way things are as the fixed ‘will of God’ are closer to Epictetus [an early Roman Stoic philosopher] than Christ. Abraham prayed boldly because he believed his prayers could change things; even once God had made up his mind (Gen. 18:16-33). Moses implored God to ‘repent’ of his planned destruction of the people, and the Bible records that the Lord “changed His mind” (Ex. 32:14).

“This may come as a shock and a genuine liberation to many of us in our prayer lives, but it also sets a tremendous responsibility before us. As Christians we are working with God to determine the outcome of future events. Certain things will happen if we pray aright. Other things will happen if we do not pray. What more motivation do we need?” (Foster 35).

Pam’s Dad is in the final phase of his preparation for surgery on Thursday. Doctors will remove part of his skull and seek to sever a cranial nerve. There are a dozen things that can go badly wrong in such a critical operation. However, if it is successful, he will be free of pain – and the debilitating pain-killers that he is on – for the first time in years. I would ask you to join me in prayer for Pam’s Dad and for those attending him this week for a positive outcome that would leave him healthy, whole, and free of pain.

Having taught ENG 3U twice, 4U this term was relatively easy. For one thing this crop of teachers were a whole lot less demanding. Last year the English team were all driven individuals, with a high degree of competence. There was a friendly, professional competition to outdo the other in terms of preparation and material covered. We were each producing a major slide show per week and then sharing them around the group. As a result I had a great cache of material in my computer that I simply had to retool.

I don’t think this year’s crop produced a single slide show all semester, and after an initial effort to get them going by example, I just accepted the norms of the new regime. The expectations were a lot lower, and the marking a whole lot less strenuous. I remember Natalie last year carting home three classes worth of journals every other weekend, and she had nearly ninety students! This year journals got marked four times all semester, and it was made pretty plain that others did not want you doing more and making them look bad.

We also met a lot more frequently last term, at least every two weeks for a good hour, sometimes longer, with a lot of individual conferencing going on in between. This year we were lucky to get started before 10 when we all had to go teach at 10:30. I do miss the excellence and drive of last year’s team, but I have to admit that this time around it has been a whole lot less stressful. As with any group of highly motivated individuals, my own drive to excel was simply accepted as part of the norm. In this group that drive is seen as being pushy and out of step, and I have had to take a large step backwards and simply let them go at their own pace. As a result I too have become a lot more relaxed.

Since the students have now been in English for two terms, the ISU (independent study unit) essays and presentations are outstanding. The essays are two thousand words, although I have marked several in the 2500 word range, and they have been excellent; well researched and meticulously cited; insightful, witty and wise. Their presentations make my own look sick. Some of these kids have put weeks in collecting slides, videos, songs and games to enrich their presentations and get their thesis across. Each presentation is twenty minutes, followed by a ten minute seminar where they have to defend their thesis in discussion with their classmates.

The presentations take about three weeks worth of class time, and I have three days left to go. Our long weekend is the one coming up (Buddha’s birthday) and I hope to be done by then with all their essays and presentations marked, clearing the decks for next week’s race to the exam.

Happy Birthday, Steve.
In eternity we will celebrate all our birthdays together but in the meantime I rejoice in the life that we live together even when it means being apart. It is such an incredible privilege to be able to serve together at this point in our lives.

I know that you are committed to your students and always give them your very best and I know what an impact the you have on these fine young people. 

Looking forward to seeing you soon in Vancouver.  I love you.

You know when the semester is coming to an end when the marking starts piling up. Tests, essays, journals all have to be cleared out before the end of the term. This semester I had Musical Theatre production responsibilities and a student teacher as well, so the backlog looked pretty daunting for a while.

The fact that I now have enough time to blog about it means that I am whittling down the pile to a reasonable size. The stack in front of me here is the unit test on Hamlet, which I polished off on the weekend. The larger stack is the end of term essays, which is currently a work in progress.

Essays are a much higher hill to climb, as they require grammar and syntax assessment, form and citational references, organization, and of course content marks. I am so happy that the school broke down and bought some anti-plagiarism software, as that used to take a ton of time to check. Now that can be done in minutes. But all the other stuff is still pretty time consuming.

I figure at this level – final draft, having seen the essay three previous times – it takes me about 20 minutes to half an hour per paper. I try to mark six per night. That way I can keep up with the six presentations I hear each day in class. Some coffee and some classical music help get me through. That and the fact that Pam is on the other side of the world and I have nothing else to do in the evening!

On the weekend before Pam left for Canada we stole a couple of days away, rented a car and drove across the Malaysian peninsular to Cherating, a coastal resort on the south China Sea. It is the kind of resort that we have come to call deshi; that is to say, local and a little bit down at the heels (from Bangladeshi).

We don’t mind deshi resorts, and aren’t expecting Western comforts when we stay at such places. At at good one – and this one was reasonably good – you get a clean room with Malaysian only TV, all the noodles and rice you can eat for breakfast, and a decent beach with no chairs.

That doesn’t bother me as I just drag chairs from the poolside down to the beach. The locals freak, but there is nothing that they can do because a) Malaysians just accept whatever you do as the status quo the moment it happens, and even more importantly, b) I’m white. (You can complain all you like about the white man’s burden and the white man’s tax on the cost of goods and services, but I can walk into any hotel lobby just to use the washroom, and no one will ever confront me. At my age, that is a real bonus!)

The beach at Cherating was just flat out gorgeous. It was not Langkawi convenient; that is to say we were not offered all the amenities the moment we parked ourselves in the sand, but the water was clear and the beach was clean and the air was as fresh as a spring morning. We read and swam and chatted the day away, and in the morning did the same again. This is our kind of holiday!

I don’t know if we are mellowing as we age, but we got good and lost several times on the way home and never once argued about the route or how we had both messed up; we just kind of rolled with it, accepting that a lack of signage in this country was a small price to pay for a few more hours together on the metaphorical road we are travelling together. To our credit we didn’t make a single mistake coming into KL, a veritable Gordian’s knot of ramps.

Pam is back in Canada now, reading this web log, and hoping I get it right, so let me say that I am glad we just took a chance on this trip and got some time together. It turned out to be a nice little break, and a decent memory to add to the huge store we have accumulated during our time here. Sorry we didn’t get to see the bioluminescence, but that just means we will have to go again.

When you get to the age that Pam and I have reached, you are going to have parents that are not well. This is true for most of the friends that we have; parents who are old and infirm who need care, with tough decisions to make regarding that care. In this we are not alone.

The situation is somewhat more complicated in that we live on the other side of the world from our remaining parents. My Mom is in England, Pam’s Dad is in Canada, and both are more than 24 hours away by plane, even if you make all your connections. Pam made that trek over the last few days, taking some 28 hours to get from here to there. Fortunately her trip came close to the end of the school year, so the cost was borne by the company I work for as my contract calls for them so fly me and my wife home once a year.

Pam’s Dad has not been well for several years, but his health took a decided turn for the worse in February of this year when he suffered a heart attack and underwent emergency surgery to have a clot removed near his heart. That attack seems to have triggered a new and alarming deterioration in a pre-existing condition known as tic douloureux. He has been in decline ever since.

The attack came as Pam was in Thailand, presenting the results of her work in Cambodia over the last two years to a new group of doctors and community health workers in this part of the world. Their response to what she had been doing was enough to convince her that the time had come to put together a new partnership to deliver Christ-centred health care to the myriad of villages that dot the Cambodian countryside.

She returned to Malaysia to face a tough decision: whether to go back to Canada immediately to care for her father, or remain in Malaysia to put a conference together that would capture this momentum of support for Cambodia’s needy people. Anyone who knows Pam knows that this decision was agonizing.

For a while it looked as if her Dad’s situation had stabilized, so after much prayer she decided to go ahead with the planning for the conference, an endeavour that required the coordination of specialists from Singapore, Papua New Guinea and Phnom Penh, all of whom had prior commitments. This had meant that Pam had to make numerous trips to Singapore and Cambodia and many conference calls on Skype. Meanwhile her Dad’s condition continued to deteriorate.

Finally last week the conference went ahead as scheduled, and the Lord brought all the elements together, and others that Pam had not been aware of, resulting in a new initiative that promises to be a huge blessing to the people of Cambodia. The work is clearly not done, but a map has been plotted for the road ahead, and commitments made that if kept will see a Christian witness throughout Cambodia.

With this major hurdle behind her, Pam was now free to fly home to be at the side of her Dad as he faces surgery in less than two weeks. My prayers go with my faithful wife, who with her every breath seeks to do what is pleasing in God’s sight, though it may cost her. I know that her presence will be a blessing to her Dad, and a comfort to her family who have borne the burden of caring for Dad for many months.

Pam left for Canada early yesterday morning, starting the long trek that is our annual pilgrimage to see family and friends at the end of the school year. I will remain in Kuala Lumpur for another five weeks, which means that some of these posts, like this one, will originate from Malaysia, and those that Pam writes will originate from Canada.

Regular readers of this web log will know that Pam’s Dad has not been well. He suffers – and that is the proper word in his case – from a condition known as tic douloureux, a severe, stabbing pain to one side of the face. It stems from a branch of the nerve that supplies sensation to the face, the trigeminal nerve. The pain usually lasts from a few seconds to a few minutes. It may be so intense that you wince involuntarily, hence the term tic. There is usually no pain or numbness between attacks and no dysfunction of the muscles of the face.

Most people feel the pain in their jaw, cheek, or lip on one side of the face only. Pain is usually triggered by a light touch of the face or mouth on the same side as the pain. The pain is so severe that people can become afraid to talk, eat, or move during periods of attacks. It is considered one of the most painful conditions to affect people.

The cause of tic douloureux is unknown. There are a number of theories as to why the trigeminal nerve is affected. The most commonly accepted theory is compression of the trigeminal nerve, usually by a blood vessel, causing it to become irritated. This irritation causes the outer covering of the nerve, the myelin sheath, to erode over time. The irritated nerve then becomes more excitable and erratically fires pain impulses. Tumours and bony abnormalities of the skull may also press on and irritate the trigeminal nerve. Trauma, infections, and multiple sclerosis can also cause damage to this nerve.

People with trigeminal neuralgia become plagued by intermittent severe pain that interferes with common daily activities such as eating and sleep. They live in fear of unpredictable painful attacks, which leads to sleep deprivation and undereating. The condition can lead to irritability, severe anticipatory anxiety and depression, and life-threatening malnutrition. Suicidal depression is not uncommon.

Her Dad has been taking Tegertol, an anticonvulsant that keeps the pain impulses from firing. It also causes her Dad such shortness of breath that he feels like he is suffocating. As the myelin sheath surrounding the nerve continues to erode, the Tegertol has become less and less effective, requiring the use of morphine to control the pain. For the last three weeks her Dad has been hospitalized in an effort to stabilize his medication and the pain.

There is a new surgery that promises relief in about 85% of cases. The operating procedure requires part of the skull cap to be lifted back and the nerve exposed and cauterized. It is a six hour operation and not without risk for someone who is 86 years old. But medication is no longer an option, and surgery has been scheduled for May 27. Pam has gone home to assist her family in the preparation for her Dad’s surgery. She would appreciate your prayers.

I spent many hours carefully setting up a very full agenda for this week in Cambodia only to have it completely fall apart on Friday afternoon so I admit I was pretty anxious when I arrived in Phnom Penh on Sunday. The other members of the team arrived on three separate flights early Monday morning and we began a marathon of meetings. It was fascinating to watch each step fall neatly into place in a far better and more thorough manner than we could have dreamed.

We met with TWR, RHAC, Mercy Medical Center, had supper with another doctor and then had a late evening meeting with a lovely Indian gentleman before Bill, Annelies and Su Min even saw their hotel room at 11:00 p.m. By 7 a.m. Tuesday we were on our way to Kampong Cham to see a Youth Center and watch an amazing young village volunteer conduct an education session in a “small pagoda” with a group of youth. On Wednesday we met with the managers and two trainers from each of RHACs programs to de-brief and do a presentation on CHE’s holistic approach to health.

RHAC had requested that we help them teach their educators moral lessons which they described as teaching Cambodians about love and compassion. When they saw a sample five day curriculum for HIV/AIDS that contained lessons with topics such as Fearfully and Wonderfully Made, Youth, Love and Lies, Family Violence and Self Esteem they were thrilled. Then they suddenly switched track and asked for training on Family Planning instead. While Bill and I panicked Su Min, a very creative OB/GYN simply went to the computer and created a new program in front of their eyes. I don’t think that this group of very educated Cambodians had ever seen anything like this before.

The last group to get on board was the Cambodia CHE Working Group and we were not even sure that we were on their agenda. No problem getting that group to recognize the opportunity. However, this is new territory for everyone both in terms of working with a large secular organization and in the use of many new lessons.

From the very beginning, this project has only been evident one step at a time and we are all thoroughly enjoying this experience of walking in faith.

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