Author: togowithlauna

Things I have learned after being here in Togo for one year.

• Always turn the light on if you are getting up at night. Guys… you just don’t know. Two weeks after I arrived there was a snake in my bedroom so this is a quintessential rule. No way am I risking being surprised by anything in the middle of the night no matter how much it hurts my eyes. 

• Sometimes buying frosted mini wheats for $20 is worth it.

• I actually literally have some of the best friends and family in the world. I’m sure everyone says this, but for me its actually true. I have never felt so supported and loved as I have going through hard things 4,000 miles away and having people “show up” for me however they can.

• Basically, you can learn anything on youtube. Either how to do a complex sphincter repair, or become a dog trainer.

• Getting a roommate has positives and negatives.
  • Positives
    • They might be Great British Bake Off level bakers which will lead to delicious treats after a hard day of work
    • They can listen to all of your rants
    • Accountability for ab workouts
    • While living with someone, it’s harder to hide your true feelings so you are forced to actually confront and deal with them…. which I guess is a good thing.
    • You have someone to do half of the dishes. (she probably did more than half, lets be real)
  • Negatives
    • You will likely gain 20 lbs
    • You may forget how to take care of yourself at all when they leave you for 6 months.
    • There is someone to argue the opposing view and hold you accountable during your rants (if I was a better Christian I would put this in the positives)
    • You will get behind on your podcasts
    • You cant leave your stuff all over the place, which, people who know me know I love to do that.

• It is remarkable what you can do with just some suture, some pickups and a needle driver. Surgery is truly an incredible profession.

• God can do a lot with a good attitude and availability.

• Sometimes, you might not know how to do something, but if you know the first step, start there.

• I am capable of more than I thought.

• Use your resources! I used to joke with people I met in residency that I would call them some day when I was overseas and I meant it. My urology friends and pediatric surgery friends have answered the phone at whatever hour to help me problem solve and walk me through something. They have all been more than happy to be involved and usually go above and beyond.

• Drink water. Seems obvious. But important.

• Be quick to say “I don’t know, but I will find out”

• Freeze mangoes during season when they are $1 for 6

• Don’t get a dog. Or get a dog. I still can’t decide if it’s the best thing or worst thing I did. Usually depends on the day. Today as I sit here typing in my house alone and she is curled up next to me, I’m thankful.

• ALWAYS refill your ice trays when you finish them…. You will not remember the next morning and you will regret it later.

• Throughout many situations this year, God has reminded me of why he made me the way I am. He made me bold and loud and passionate and on fire. He made me to push boundaries and ask hard questions. He made me thoughtful and inquisitive and creative and boisterous. However, this year He has also taught me the value of gentleness, of quiet kindness, of listening to other opinions and of deciding that sometimes a relationship is more important than being right.

• And finally, my current mantra every morning… we can do hard things.

What I’m Reading/Watching/Listening to

1. Field Notes for the Wilderness – Sarah Bessey
2. Kingdom of Ash – Sarah J Maas
3. My mom’s 2nd book 
4. Iron Chef – Netflix
5. Slow Horses – Apple TV
6. Last Week Tonight  – HBO
7. Podcast- Theology in the Raw 
8. Podcast-  Sermon Series from Northpoint “What the World Needs Now”

March

The end of March brought a little bit of rain and a big surgery. Last blog I sent, I had asked for prayer about a little girl named Afi. The surgery was a great success, the tumor was completely removed, and she recovered well. I just saw her in clinic this week and she was smiling and almost completely healed. The pathology came back negative for cancer. This is a huge win. I got to tell her mom that her daughter will get to have a normal life and we got to thank God together for bringing the pieces of his Kingdom together to “leave the 99 to seek out the 1” (paraphrased). God truly did move mountains. Thank you for the prayer

April

April brought a push towards Greece as our entire medical team left the compound to head to the CMDE conference in Kos. I got to see old friends and eat Greek food and see the acropolis. 

I learned multiple things that I have already put into practice here, which, medical people know, anything that changes the way you practice is a pretty big deal so those lectures were indeed fruitful. 

Mostly I felt refreshed by rekindling sweet relationships, meeting new people and swimming in the Aegean Sea any chance I could get. 

I ate an incredible amount of tzatziki and my goal was mostly achieved that my blood was more tzatziki than RBC by the time I left. 

I got to horseback ride in the ocean (stay tuned for photos) and got to hang out with my mom a little bit on either side as she was in Togo again helping out with Bissap and a monkey. She truly looked like a zookeeper when I arrived home.

May

May has brought mango season! yay! AND birthday month. Which I have been milking for all it is worth. 

I have also started looking forward to the next steps. In reflecting on the future, I have decided the next season of life will take me back to the US. Maybe for a short while or a long while. In all seriousness, only God knows. I am currently interviewing for Trauma/Critical Care surgery fellowships to see if that is a good option for my transition back to the states. Please pray for guidance and discernment in that. (more on the next post)

Bissap is doing well. She is keeping me busy with walks and playing and personality. But also an excellent snuggler and a lot of fun to play with. She will be one year old next month!

In other updates, a few posts ago I told everyone that I had been praying for God to “breathe life into an anal sphincter” and I am happy to report that HE DID!! Our rectovaginal fistula repair now has a normal life back with control of her bowels and I did a lot of fist pumps and screaming, which the patient and staff found very entertaining

What I’m reading/watching/listening to….

• Field Notes For The Wilderness, Practices for an evolving faith, by Sarah Bessey
• Beyonce’s album on repeat
• Just a lot of surgical textbooks right now……
• Rewatching Friends, and some new cooking shows.
• Hacks
• Loot

“There isn’t anywhere you’ve been and there isn’t anywhere you’re going where you’re not at home in God’s love. The wilderness is home to God, even the wilderness inside you. Your life is already a place where God is quite at home.” Sarah Bessey

Moving Mountains

Let me tell you a story…. About a month ago, a little girl, Afi, came to see me. She is 4 month old and a very happy little girl. Her mother and grandmother brought her in. She was born with a mass near her sacrum, and it had grown significantly. As soon as she was born, her father left the family and said that he wanted nothing to do with her. The family spent 4 months scrounging enough money together to come see us in clinic. 

When I saw her, I honestly didn’t know exactly what I was looking at. I had a few guesses, but as many of my medical colleagues who know me have found out in the last year, I pooled my resources and sent photos and the story to some pediatric surgeons I know. They responded that we needed further imaging but likely this would be a very complicated surgery to do, too complicated for me to do. 

I sent the patient with instructions to get a CT scan and come back to clinic, not knowing that they had barely enough money to get here, let alone enough to get further imaging. 

One of the pediatric surgeons I had contacted continued to ask me about how she was doing and I had said I was waiting on a CT. She, the peds surgeon, then happened to see that a specialist pediatric surgeon she met was on a Mercy Ship in Sierra Leone, down the coast and a 3 hour flight from me here in Togo. We were put in contact and the specialist had said he would be willing to do the operation if I could get the patient to him in Sierra Leone.

At that point I felt like this was unlikely to happen. To get this baby and mom passports, visas, etc… seemed completely insurmountable. Worse… we had lost contact with the family and their phone was shut off. We had no way to find them or contact them. 

As this pediatric surgeon was nearing the end of his stint on Mercy Ship, he contacts me again to try and get the child to him. I reply with all of the problems and the unlikelihood of getting passports etc…. in almost a complete joke, I float the idea that if we could get someone here, that would be much easier. He responded that he would look into making a “pit stop” on his way home from Sierra Leone to Montreal. I was speechless. Anyone who knows me, knows how rare that is. I was dancing around the room. 

But now…. I REALLY need to find the patient. So I contact my Togolese colleagues and rally the forces to find this child. The next day, I get the news that we found her and she is. coming to clinic on  Monday (2 days ago). I see the patient and confirm that the mother would be agreeable to surgery. She agrees with tears in her eyes. 

I informed the pediatric surgeon who I had initially contacted and she immediately sent me the money to cover this child’s complete surgery, hospital bill and imaging. 

When I tell you the the Lord was opening doors, man did I feel it. I kept thinking “this cannot be possible” but God kept opening the next door and I just kept walking forward.

Long story long., the surgery will be this Saturday, the day before Easter. The surgeon is flying in on Friday, operating Saturday, and flying out on Sunday. Can you even believe this? I only can because I know how much God loves this little girl. Please pray for me and the team as we operate on Saturday, pray that they feel cared for, loved, and that they matter in the eyes of the Kingdom of God. 

It’s been a while.

Do you hear the song by Staind every time you read that? I do. Anyways I digress, it has been a while because I have been busy and also went on a vacation. My parents visited for a month, I went to South Africa on vacation, and we started a surgical residency! A pretty big start to 2024. 

My parents were able to come and visit for Christmas and I appreciate all of the people who were praying for their time. They managed to survive the heat and the mosquitos mostly unscathed. They got to meet Bissap, which was mostly a positive experience (more on that later). They visited church, met my community, went on some hikes, ate fufu, abused the A/C in my house….. All of the African staples. It was really a sweet time sharing my life here with them. 

I then went on vacation to South Africa for a safari! It was really incredible to experience creation and get to see some of these animals up close in their environment. Stay tuned for some cool pictures. I will say it’s the first time I’ve been on a vacation where I chose to wake up at 4am multiple times!

Also in big news, we started a PAACS program! (Pan African Academy of Christian Surgeons) whichis a surgical residency program. I am beyond excited for this, teaching is one of my favorite things so I’m thrilled to get to pour into the next generation of African Surgeons. What a treat to be part of this special occasion. God is good. 

Life Stressors

I’m at the 7 month mark, which I have heard is kind of a marker where things get harder and I am feeling it. I’m through the honeymoon period and into the wilderness. Jesus spent a lot of time in the wilderness so I at least know I’m not alone in it. There are a multitude of things going on: starting a new residency with a new schedule, I’m moving houses in the next two weeks, and most stressful, my dog has developed some behavioral issues. Man guys, is this what having kids is like? I don’t know about that. I can at least put Bissap in a crate and control the situation that way. 80% of the time she is wonderful, but her african wildness has come out a little bit and we have had to take some steps back from playing with children and gotten into serious training. Sounds kind of petty as I type this, but it is a huge part of my life right now so I am including it. 

What I’m Reading/Listening to/watching

• I was watching the Detroit Lions in the playoffs…..
• Rewatching Parks and Rec as a comfort blanket, watching new Queer Eye season
• Reading Perelandra and The People’s Hospital
• Watched Barbie, loved it.
• Listening to: Motown playlist, No Bad Dogs podcast, Renee Rapp

This is hard. I am tired. Did someone warn me that this would be hard? I’m sure they did.  Two months ago, I was the “glass half full” team member. I would say “Yay! no fevers!” and someone else on the team would say “But white count is climbing.” I would say “No signs of a leak!” and my team member would say “Not yet…. it’s only POD 1”. And I have found over the past two weeks that I have been moving that direction. I am starting to say and feel the “Not yet…..” in my heart. It has been a string of hard cases, a string of late days, a string of patients that continue to deteriorate no matter what we do or maybe we made a hard call and it didn’t go well. It’s hard not to feel the mounting of all of these negative outcomes. (Why is it so much easier to remember the bad cases?) And it’s harder when the “negative outcome” likely for me means that someone died or is going to die. How do I move past coding a 23 year old who had a tiny hole in his intestine but waited too long to come in and 3 days later he’s dead…to the next patient and not letting all your past experience taint how you are going to treat them. How do you continue to have hope when hope keeps burning you at every other turn?  And it’s so much harder to keep hoping than to just not hope at all. And how do I have any confidence in my decisions when things keep ending badly, wounds keep getting infected, people keep getting sicker?

So is this all an exercise in failure? I’m coming around to the understanding that it is not.

This probably requires a re-framing of success and failure. In the states, success was healing people, fixing problems, cutting the bad stuff out and getting people better. Here, I can do the surgery for the infection, but they have bad diabetes so they can’t heal the wound, so it gets infected again. And their diabetes is so bad because all they eat is rice, but they can only afford rice and their nutrition is terrible so they need to eat, but all they can afford is rice, which worsens their blood sugars and makes it impossible to heal a wound. So what do I do now. Well. What can I do? It may sound trite, but what I can offer is love. Compassion. A hand to hold. A person stepping in and saying “I care about you because there is a God who created you and you matter just as much as anyone else.” And I guess the question is…. is that enough? And I guess we will find out.

So where does that leave me. How do I make decisions when I feel like it wont even matter?

I will take heart knowing that God knows my trouble, but encourages me to continue taking heart anyways. 

And, I will borrow words from the wise Anna of Arendelle and just “do the next right thing”

This post is maybe sounding a little more dramatic than necessary. I am actually happy and doing well and happy as all of these photos will suggest. I just need a good sleep, a nice thanksgiving meal tomorrow, and to watch “The Holiday” on Friday to kick off my Christmas spirit. All will be well. 

What I’m Watching/Reading/Listening to

• Reading Out of the Silent Planet
• Watching Love is Blind. (listen… I know it’s trash, BUT I value honesty and vulnerability so I’m going to be honest and vulnerable… this is a safe space)
• Also watching: Lessons in Chemistry and College football
• Listening to Shania Twain’s album “Come on Over” as requested to be added to my OR playlist by my colleague Drew. 

This last month has been a lot of ups and downs. Some really high highs and some lows. Luckily the lows have mostly been short-lived with a good cry, a danceparty, and some deep prayer. I think there is a part where you start to feel settled and like you have things under control and then a wave just crashes into you and pulls you under for a bit. In those moments, I am learning to take a moment and be real with God and my team with where I’m at. I think I sometimes have tried to hide being “too emotional” or having a hard time, but am constantly reminded that that is how I was created and it’s ok to feel my feelings. God has been really faithful with putting people into my life to speak those truths, and remind me that He is in those moments. He has also been faithful to give me some good wins this month to sustain me through the losses. 

Drawing Circles

Two of my separate studies this past month have focused on the story of the woman at the well. I have really appreciated reminding myself of Jesus, who steps out of the “cultural norms” and makes a woman feel seen. Pretty crazy to think this is the first time He actually reveals to someone who He really is, and reminds me that in that moment, He did not want her to have any confusion about who was offering her living water. No parables. No stories. He just clearly says “I am He”. And her response is to immediately forget all of the reasons she was running away from society and hiding. Meeting Jesus was revolutionary enough that it upended everything for her. In a culture where I feel like we are obsessed with drawing lines between people (even sometimes in churches, maybe even mostly), I am reminded that Jesus was always drawing circles, including more people. I hope I can continue to be more like Jesus and keep drawing my circles bigger and bigger.

What I’m watching/listening to/reading

1. Gators Football (obviously) chomp chomp
2. Dog training youtube videos
3. Great British Bake Off
4. Out of the Silent Planet by C.S. Lewis
5. All the normal podcasts, Andy Stanley, Faith Adjacent, For the Love.

Prayer requests

• My grandmother has had a couple of falls recently, so prayers for healing and stability
• Connectedness- feeling like I can still stay connected to my friends and family back in the states
• We have an 8 year old girl with a bad abdominal fistula. Prayers for weight gain, good nutrition and guidance for how our team can best help her.
• Continued team support and that we can get things ready to have residents start in January!

But, like, what do you do for fun?

I get this question a lot. And it is a fair question. I have been reading a lot more books, also still watching Netflix (yes, I get Netflix here…. I’m not THAT far off the map). I cook, we have game nights and ice cream Saturdays. We go on some local hikes around to waterfalls and local lookouts. We walk “up the mountain” near the compound and watch the sunrise. We  play sports. We go to market. Not a lot of restaurants, but do have guest house chef’s who, I hear, make a mean fried chicken for Sunday lunch that I will probably try out tomorrow. 

Also just keeping in touch with my people. Trying to still be present in their (your) lives even if I can’t physically be there. Video chats and phone calls and sending memes and videos back and forth. It seems simple, but I really do still cherish those little connections.

Also, keep reading for the other thing keeping me busy….

Patient Spotlight

It’s honestly hard to choose just one. The first who comes to mind is a patient who I saw in clinic. I did an exam which was honestly confusing…. So I called for help and backup. Another surgeon also did the exam and was equally perplexed. She was boarded for multiple different things, basically a possible this possible that, depending on what we found. She ended up having a fibroma in her uterus which had prolapsed completely through her cervix, basically like an hourglass. We ended up doing a hysterectomy and piecemeal removing this fibroma (benign tumor of uterus) slowly but surely. We kept remarking at how this woman was walking around with this tumor the size of my head in her pelvis. People here have a remarkable tolerance of pain and discomfort. I just got to discharge her yesterday and she had the biggest smile on her face. She was always up walking out of bed like I had told her to do and always so thankful. I got to pray with her and her husband and it was a great day. 

Made it

I have finally made it. After planning to come here almost two years ago, I am finally in Togo. 

The travel was as seamless as possible, it was a long journey, but overall very smooth and easy. Customs was a cakewalk, I didn’t even get stopped for all of the sutures (it helped that it was super busy at the airport! Blessings in disguise) I promptly met my contact in Togo and we went and got cheeseburgers. It was lovely.  I got to see the beach and all of the ships at port before grabbing some groceries and heading up to Tsiko, which is where the hospital is. 

I had a lovely little welcome party. A friend from medical school, Liza, is currently here too and all of the kids made a sign to welcome me. They also gave me a bunch of groceries, including but not limited to: caribou coffee (!!!!), flour, honey, Ranch dressing and Reese’s Puff cereal. I have never eaten Reese’s Puff cereal, but I have thoroughly enjoyed basically having dessert for breakfast for the past week.

Back at it.

I arrived on a Friday night. I promptly went on Saturday morning to round at the hospital, anyone who knows the work version of me is not surprised by this. I got to meet a bunch of people at the hospital, everyone was very gracious and kind and complimentary of my French (albeit they are likely too kind to say otherwise).

I have now been at the hospital two weeks. I have already had some very hard cases, some really incredible cases, and some cases I’m feeling hopeful about. It has come back much easier than I expected. I really didn’t believe people when they told me it was just like “riding a bike”…. But I have to say, it kind of is. There have definitely been some humbling moments and I’m definitely dealing with some imposter syndrome, but I’m fairly certain that that is par for the course when you become an attending and move across the world. 

Seeing God’s faithfulness in getting me to this point has truly been a joy. The people here care deeply for each other and this community and I’m very excited that I get to join them. 

Patient Spotlight

I’ll try and highlight at least one case when I write these blogs. I’ll start with a young man who seemed to have a bowel obstruction. 26 years old, no hernias and no previous surgeries which are the most common reasons. We were concerned about some sort of bowel perforation or twist so we went to the OR. When we got in the abdomen, I had no idea what I was looking at. Everything was stuck everywhere, I could not make heads or tails of where anything was. There were abscesses everywhere. The scrub techs said this is what typhoid looked like. When it became apparent that the more we tried to separate everything, the more damage we were causing, we decided to put in drains and get out of the OR. I was fairly concerned that he was not going to do well. 

I was glad to see him doing ok the next morning, definitely sore, but alive. Fast-forward to 2 days ago when he was doing laps around the hospital with a huge smile plastered on his face. He’s still not out of the woods completely, but I’m still so surprised at what the body is capable of enduring. 

What I’m Reading/Listening To

• He Loved Them – Discovering Jesus’ Heart for Seekers, Sinners, Doubters, and the Discouraged by Jessica Thompson
• Always everything on The Bible Binge podcast
• Andy Stanley’s current series “The Fundamental List” is still giving me life.
• The Fate of Africa

Prayers

• Settling in. It has still been a huge adjustment and I am oscillating between being overwhelmed and thrilled.
• Developing community and relationships: with my medical team but also with the other hospital staff as I am trying to develop good relationships as a newcomer
• A difficult case coming up with a young women who has a complication from a difficult birth a month ago
• Transitioning back to living alone again and not feeling too isolated. 

Jetting off.

Ok guys. I know it’s been a million years since I posted, but I also have a million things to do. SO. I will. be channeling my surgeon side and this post is going to be short and sweet.

• I finished French class, it was a whirlwind. I don’t know how good I am, however I was able to order shrimp in France, so, 8 months well spent.
• I went on a family vacation through France and Spain. It was absolutely wonderful, we saw so much, hiked, chatted and of course played Euchre.
• I leave Thursday June 15th at 8 am.  I am actually heading to Geneva today to check my bags and to make sure I can catch my flight.
• What I’m listening to/reading: Beth Moore’s book “All My Knotted Up Life” was incredible. Listening to The Bible Binge podcast and Andy Stanley’s latest sermon series. Both are *chefs kiss*

Prayer Requests

• Safe and efficient travels. Specifically that all of my medical supplies arrive intact and the customs process is easy.
• Good goodbyes here in Switzerland.
• A good start to new community!
• Continued healing of my left thumb (mostly back to normal, but starting to operate again soon!)
• Honestly, I have no idea what exactly to pray for, full honesty…. I just keep saying “God, you know what I need, so I’ll just let you handle that.”

Thanks for all of the prayers! Next update, I will be in Africa!

Lent Season

This season still feels weird. I still feel unsettled in Switzerland and the closer I get to finishing, the antsier (don’t know if that is a word) I am to get to Togo. I am finishing my B1 French class this Friday, which is very exciting, I can now share all of my thoughts and opinions in French, which I’m sure everyone around me also loves. 

For Lent, I am doing a study through Ecclesiastes called “Every Broken Thing”. If you are unfamiliar or haven’t thought about Ecclesiastes in a while, it starts… “Vanity of vanities, says the preacher, all is vanity.  Vanity of vanities! All is Vanity” in the ESV version or “Meaningless! Meaningless! says the Teacher. Utterly meaningless! Everything is meaningless.” in the NIV version. (Ecclesiastes 1:2) Oh the drama. A real upper. But of course I think we have all likely been in this headspace one time or another. 

I have very rarely practiced or participated in lent, giving something up, or if I did, I thought it was really great accountability for a new diet; however this year I decided to step a little deeper. This book of the bible is no joke. It asks hard questions and gives few answers. Many of us would likely find some solace in these pages that maybe we aren’t the only ones feeling this way, others may find it unnerving. The writer of this book (maybe Solomon, maybe not) did not know the end of the story, but we have the benefit of hindsight and knowing the story leads to Jesus.  And while this book says things like “nothing is new”, we know that that may have been true… until Jesus made all things new.

I am obviously less than one week in to the study, so I’ll keep you posted on how it plays out. Call it, reader retention.

Where I’m finding meaning lately is in relationships. Whether a friend willing to leave the beautiful mountain and take pictures of you in urgent care, or a group of friends thousands of miles away praying that I don’t have to have surgery, to my mom offering to fly here if I needed the support. I am constantly seeing God through the people he has placed in my life. 

Bob Goff says: “God doesn’t pass us notes, He gives us each other”. 

I am very thankful for all of the people in my life who show up. *

* Metaphorically, I did not need anyone to fly to Switzerland, and plus I live with another surgeon right now so in good “hands” <– both literally AND metaphoricalIy