Respite

Last month, we had some really incredible times of rest – an unexpected night on the beach, a spa day with some colleagues, a manicure with family, and a couple nice hotel stays while traveling. But each time we had a nice time of rest, it felt like I was still at the end of my rope, just barely catching up. My eye continued to twitch, that has been pretty constant this year, but my feet started hurting. The pain was consistent with plantar fasciitis, and I was not happy about that, because walking and running has been my way of releasing stress. By the end of the month, I even noticed that I was getting an upset stomach from the stress. Even on the other side of the world from my usual work, I wasn’t able to rest.

I still can’t pinpoint what was actually causing so much stress. We were traveling a bit, and not sleeping well. There were changes in time zones and changes in weather, public speaking and deadlines with work in the US. In some ways, I wonder if I was having a hard time adjusting to life back in the US – the pace is more hectic here, the prices are higher, and it’s hard to get healthy food. It might also have been the environment, most nights sharing space with family or friends, adjusting our schedules to theirs. Maybe it was the time for reflection – being far away from the work I usually do, having space to think about our potentials for long-term impact, wondering where or if we should be changing directions.

What I can say is that I’m doing better now. A big family get-together in another state was canceled, and we found ourselves in a house just for us, in a small town, with not much to do and not even much internet. I read books, I rested, I started practicing mindfulness and stretching more. I enjoyed the fall colors. I would say that I still wasn’t sleeping great and still had some stress at the end of that week, but I finally felt like I wasn’t at the end of my rope. And then, after a 3am wakeup and 17 hours of traveling, this week we are in Hawaii. This place really is magical. I can wake up before sunrise without even trying thanks to the time change. Nobody expects a lot of me and everyone is living at a relaxed pace. I can run by the ocean and breathe deeply as I watch the sun rise and set. I sip tea. I get a lot of sleep. I work less than 8 hours each day.

For all that I’ve studied, for all that I try, I’m still prone to anxiety, I still border on burnout. When one appointment or coordinating detail goes wrong I start to unravel. Sometimes Greg has to pick me up off the floor. I wonder what life is like for people who don’t get the chance to get away and unwind. I am thankful for the space. We have a few more weeks here, me and Greg and his family. My feet still hurt, but I will try to balance physical activity with rest and stretching, and maybe some better insoles. I hope to work just enough to reduce my workaholic withdrawals from productivity. I mean, I’ll probably log over 40 hours this week, but next week maybe I’ll take more than a day off. But for now I will enjoy rest. I will breath deeply. I will sip a cup of tea. I will read one more book.

Preparing for Furlough: Greg and Christina Miller's September Update

Our last week in Malawi was even more of a whirlwind than usual as we prepared for 14 weeks back in the US. I had carefully written out the things that needed to be finished before we left, and most of those were done already, but somehow each day brought opportunities I couldn’t turn down. Monday we drove to the refugee camp to evaluate the last few months of our medical outreach with YWAM. We enjoyed one last meal at Rifiki’s restaurant, and I thought that would be the end of my work with the camp for a while, but I was surprised to receive a message from the leader of the government clinic who serves the camp. He wanted to discuss some things, including some upcoming stressors from limited resources and strained staff. Our conversation led to some ideas forward, which resulted in another meeting with a leader of a nonprofit and advocacy group helping at the refugee camp, which in turn led to a time to work with Greg pouring through grants and options for fundraising and problem solving to help current stakeholders work together to solve needs in the camp.

I was glad to have time to help with those projects, but there was also the need to discuss upcoming trainings in the village of Mngwangwa -a training in animal husbandry but also a training to show the chiefs in the area what the church was doing to bring hope and healing to the community. Much of that communication was done by texts, but it did include one long morning of teatime and vision casting with Thokozani and Nixon, and a quick review/write up from the work in the community so far. I didn’t finish as much of the work that I usually do, but we got packed and I met my most pressing deadlines, and I even had time for some meetings helping to give perspectives for the new leadership at ABC clinic. And our friends gathered around us to help us finish well. One came for tea and left us with lunch which lasted a couple other meals, then brought us another dinner on our last night. My mentor invited me to lunch while Greg was at his Bible study. A patient of mine, who is now a good friend, invited us to dinner and we had a wonderful, life-giving time. And another friend came to our house for dinner, and brought a delicious soup with her so that we had food through the weekend. At least four people asked if we wanted a ride to the airport, and three others went walking or jogging with me in that last week, so we could visit and keep fit even as time was limited. Greg and I left on a Monday, so we had a full weekend to rest before we left. It was good because we heard about the sudden but not unexpected death of a woman we had been helping in the refugee camp, so it was nice to have some time to process and grieve with our friend. Another friend brought us a delicious dinner on our last evening, so that we had plenty to eat as we finished preparations. And then we were at the airport, and then we were on a plane. We praise God that there were no unexpected issues with our immigration paperwork, and the flights were all on time. It always feels like such a switch when we go from one continent to the next, like we are living two different lives in some ways. But we were blessed to have a strong finish in Malawi, and to be able to hit the ground running as we connect with friends and family and try to refresh back here. This month, please pray for improved health and healthcare infrastructure in the refugee camp, for traveling mercies for us as we go to various states, and that this will be a time of rest and fresh perspectives. Thank you for your prayers and support, Greg + Christina

Patients

This afternoon would be my last day in clinic until I return from furlough in December. Some of my favorite patients were scheduled, and I was excited to see them one last time. First was a woman in her 60’s who came with her son, who was just barely younger than me. She had a high blood pressure, so high that I had asked her to take a strong medicine, but she just wasn’t ready. Interestingly, her son had a similarly high blood pressure five years ago when I met him. Since then, he has controlled his blood pressure by eating a vegan diet and walking one or two hours a day. He sat by his mother and told her that he was willing to show her what he did, to help her try to control her blood pressure just like him. I reminded them that not every patient could expect a miracle, but we prayed together for strength and healing, and celebrated that she had at least improved 17 points since Tuesday. I prescribed the medication and asked them to pick it up in case she still had high pressures by next week, and gave a form for lab tests that they would email me in a couple months.

My next appointment was a couple, I last saw them six weeks ago, had recommended some lifestyle changes for their high blood pressure and high cholesterol, and hoped that they were doing well. The wife had improved her blood pressure incredibly, from 178/115 to 111/78 without medications. She also had improvement in all areas of her cholesterol panel and in her sugars, simply with diet and exercise. After I celebrated her improvement, her husband smiled and switched to the seat closer to me. “I had even more improvement” he said. He was right, each of his cholesterol measurements had improved by 30-50%, and the risk to his heart had decreased by 40%, putting him in the intermediate-low risk category now instead of the high risk category. We had started a very low dose cholesterol medication last time, but that would, at most, only explain 10-20% of an improvement. I told the couple that I felt like a coach whose athletes had both just won the Olympics. Our prayer was a prayer of thanksgiving for miraculous improvement, and for wellbeing in the months to come.

When I called my next patient, I didn’t even recognize her coming in from the waiting room. She used to visit every month for about a year, during which time she lost 44 pounds and 20% of her body weight. I hadn’t seen her for the last 10 weeks. She hadn’t lost any more weight, but she lost an additional inch from her waist and two inches from her hips. “None of my clothes fit me anymore” she said with a smile, and showed off a bright, fitted floral dress. She looked like a different person. We celebrated her success and talked about her life goals – finishing a current building project, then going back to school and obtaining an associate’s degree. “Who will I see while you are gone?” She asked. That was easy for me to answer: “In July I gave a presentation to all the doctors, nurses, and clinical officers about healthy weight loss.” I said. “I explained best-practice measurements and diet advice, and I even used your story as an example of how to lose weight steadily and to keep it off. No matter who you come in to see, they will know what to advise, and they will even know a bit about you, even though they won’t know your name or that you are the one from the story.” In reality, the only reason this woman needs to come in regularly is because she doesn’t have a scale at home and wants to make sure she is on track. Other than that, I feel like I just celebrate and congratulate her each time. Our prayer is a prayer of thanksgiving, and a prayer for wisdom as she embarks on her other goals.

My final patient of the day is a 9-month-old child. He doubled in size since I saw him at his 6-month visit. His medical records were lost in a current family move, but it was easy enough to piece together his past vaccines. He was meeting all his developmental milestones, so we talked about things like introducing table foods and preventing accidents. The family confided that they might have a next child sooner than planned, and that they might choose to travel to a different country. I volunteered to help them sort out a vaccine record which conformed to CDC guidelines. I prayed a blessing for the child, and then my appointments were over for the day.

It took me almost an hour to finish things up in clinic. I stapled together the pages in my appointment book so that the front desk wouldn’t be confused and book someone while I was gone. I wrote 12 prescriptions and 2 lab request forms and left them stamped at the front desk for the proper individuals, since there are no verbal orders or automatic refills here. I took a pen and wrote on the hallway whiteboard “Dr Miller – Away until 6 December.” I already had most of my appointments booked on that day, and I would be very ready to see my patients again. But for the next few months, I would need to use email to answer questions and trust my colleagues to do the rest. But what a fantastic last day. I felt blessed to have such wonderful patients who were experiencing blessings and healing, and I get to be part of their journeys.