Saving a Life through Preventive Medicine, May 2023 Update

“My appointment with you two weeks ago saved my dad’s life.” I had seen this patient once before, and I had cared for his mother, but I couldn’t remember even meeting his father. I quickly flipped through my notes. He came in for a study of his heart, which was normal, but I had performed a study of his lung function, and diagnosed him with asthma, which I thought could explain some of his shortness of breath. I gave him an inhaler, and this was my first time seeing him again, definitely not the way I expected to start the consultation, talking about his father who I had never met.

“My father had been coughing all night,” he continued. “The next day, when we started our fast, he was having some trouble breathing. I remembered what you told me about how asthma worked, and it seemed like that was what he was going through. He had been diagnosed with asthma in India, but never had an attack like this. And his medications weren’t working.” My patient proceeded to explain how he called our clinic to advise them that he was bringing his father in, and that he would need oxygen and a breathing treatment. He got his father in his car to drive him, because he knew an ambulance would take 20 minutes and he was sure he could drive faster. But as soon as his father was in the car, he started looking panicked, like he couldn’t breathe at all.

“I could see his eyes rolling back in his head,” he told me, “he was starting to lose consciousness.” At that point, my patient grabbed the inhaler I had prescribed for him and gave a couple pumps to his father. “It was like he came back to life,” he told me, at which point both of us were choking up a little. He went on to describe his race to the clinic, how the staff were ready for him at the door, and how his father received oxygen and treatments and started breathing again. “But if I hadn’t seen you, doc, I wouldn’t have known, I wouldn’t have been able to help him.”

Some parts of this story continue to amaze me. An inhaler can save lives, but someone who is about to pass out usually can’t be revived by a pump or two of an inhaler. And most individuals who are still coming to terms with their own diagnosis don’t have the wherewithal to respond quickly to an emergency for their parent. If my patient had gone to work earlier that day, or if we had not taken the time to discuss his own preventive treatment with me, the outcome might have been different, and he wouldn’t have known what to look for or how to help his father.

As a preventive medicine doctor, it’s not always easy to see disaster averted or lives saved, at least not in the adrenaline-surging way that a surgeon or emergency room doctor might see. If I do my job perfectly, disaster is avoided and patients don’t even need to come to the hospital. But this story reaches deeply because it was the discovery of a diagnosis of lung disease in a patient who came in asking for a heart evaluation, and a bit of extra time explaining treatment in one patient which saved the life of his father. Of course, I still believe this was a miracle – God orchestrated much more here than I ever could, but it is still an affirmation of the work being done in this clinic, and that taking extra time to diagnose and explain things makes a difference.

After making plans for follow-up for the patient, I met his father in the waiting room. I gave some brief advice about what to look for as he adjusted his medications, and made a plan to follow up. As I prayed for the patient at the end of the visit, we thanked God together for the miracle of his father’s recovery and for God’s provision for this family.

This month, please pray for upcoming opportunities in training and helping patients. Keep us in mind during the NTCCA graduation on May 13th.

Thank you for your prayers and support,

Christina and Greg

April 2023 Monthly Details

Village and Pastoral Trainings

We’re working with Thoko, Nixon, and The Word Transforms to plan additional trainings in development for pastoral leaders, in composting for the village, and various healthcare topics, but especially cholera. We are excited about upcoming opportunities such as partnering with a retired nurse for translation and expanding our impact area, for Greg’s opportunity to speak about practical theology at seminary prior to NTCCA graduation, and for opportunities for Nazarene leadership to include transformative content in their extension program for village pastors. Christina may even be talking about health at a bridal shower next month! But all plans are held lightly around here, so please continue to pray for us and the teaching ministries.

Grant writing and Consulting

Christina has helped Loma Linda win a new 4-year grant for training preventive medicine doctors, and our proposal supporting Hawaii pastors in development of Missionary History curriculum for Christian schools was also awarded funds. We have advised Africa-based groups in programs ranging from healthcare and advocacy to art and wellbeing in recent months. We are in the process of creating a new nonprofit, Cornerstone Group Consultants, so that we can build teams of doctors, writers, subject experts, and administrative assistants from around the world to help plan excellent programs and build sustainability across many important projects.

Christina’s “Sabbatical”

April held our 11-year anniversary and Christina’s 37th birthday. Christina has been praying over some new ministry opportunities in Malawi and in the US, and has taken lots of time in her new backyard retreat room reading, praying, and just breathing deeply. Christina worked 60% more hours than planned this month, but she did rest most weekends, and two out of three national holidays. She also took a day away at Barefoot Lodge for a prayer retreat, spent some time in the gardens at local cafes, and read through 10 more books. We had friends over for tea about twice a week, and Christina has enjoyed brewing delicious cups of tea, baking sweets, and basking in our flowers and gardens.

Questions from a Cholera Training: Miller's April 2023 Update

“Is this going to be a training about cholera, or a training about the Bible?” asked Mr. Nzunga from the front row. It was a fair question, since I had started our day with a reading from John, about a woman coming to draw water from a well who asked for the living water after she met Jesus. “It’s about both,” I begin, Thokozani animatedly translating for me. “God cares about health, God cares about how we love one another, and how we love Him. The Bible says that we should love God with our heart, soul, strength, and mind. As a doctor, I believe that being healthy helps us to have more strength to love God. It also helps us to have a stronger mind and a stronger heart. And it helps us to love our neighbor, which is the second greatest commandment.”

I understood that teachings in Malawi usually kept spiritual things separate from academic things which were separate from physical things. But I wanted this half-day of teaching to bring transformation in the 13 churches and villages they represented. I knew that many churches taught people that true Christians didn’t get sick, and people who trusted in God shouldn’t go to a hospital for treatment. I knew that people were afraid of cholera, and because of all that, people in Malawi were dying from the disease at a rate alarmingly higher than anywhere else in the world.

One pastor relayed a story of how a man was protected from cholera through prayer and eating mangos. I was able to affirm the power of prayer, but I also reminded the group that even the Bible talks about doing things to protect a community from infection and to prevent disease. So we talked about hand washing, about purifying water, and about using latrines far from water sources. I also talked about the danger of dehydration with cholera, and how to know if someone was getting so sick that they needed to go to a treatment center right away; those with severe cholera can die within a couple hours.

“But what if the doctor in a hospital gives an injection instead of a medicine and kills the patient?” asked a woman from the back right. Shocking as it sounded, everyone, including me, was prepared for this question. Recently, a child died suddenly in a cholera treatment unit and the people from his village, convinced that he didn’t actually have cholera but was killed by the doctor, burned the treatment center and the police vehicle which came to help. And I couldn’t dismiss the accusation that a hospital worker might kill a patient – some months ago, a nurse with mental health issues had come in after his shift and intentionally killed a child through an injection. Healthcare workers I knew and respected had been impacted by both situations.

I expected the question, but the answer still wasn’t easy. I talked about how evil could find its way into a hospital just like it could be present in a village. I reminded the group that God doesn’t guarantee that Christians will be free from pain and danger. I shared that I was a Christian and a doctor, and although I always tried my best to help patients and honor God, I knew that someday something bad, like a patient death or a riot or someone wanting to harm me, was possible as I served here in Malawi. But I reminded the group that we as Christians were called to trust God and to love others.

For me, the impact of a training is reflected in the final minutes, in the final comments and summaries from the participants. I’ll never forget today’s closing comments from a pastor in the middle, sitting right next to a chief. “Today we have learned how to prevent cholera in our communities and how to care for patients with cholera. We will share this with our churches, so that they will be able to show God’s love to our community during this time.”

This month, please pray for Malawi as it recovers from Cyclone Freddy; pray for protection for its people who have lost homes, food, and access to clean water. Please pray for me and Greg as we seek wisdom for future directions in ministry. And pray that we will use Easter break wisely, finding time to rest and refocus.

Thank you for your prayers and support,

Greg and Christina Miller