Looking back at 2015

I’ve started to write this on December 30th, sitting on a train in Lincolnshire at 7:30am, on my way to work. It’s still completely dark outside, and half the country is still on holiday. I feel slightly jarred, like the alarm clock went off, but no one else has had to get up.

Feeling disjointed is somewhat appropriate – it aids my reflections on the last 12 months.

2015 has been a year of experiences. We’ve lived in three continents; I’ve had an epiphany in healthy living, exercise & weight loss; my medical skills, for the first time, feel formed; and, as a family, we’ve started to have some clarity about how we want to live.

Home

This year has shaken my understanding of home. In many ways, “home” still means “Epping” to me. My parents live there, I grew up there – the streets feel familiar, comfortable and safe.

“Home” is any place that has touched your heart.
Leaving doesn’t stop that.

But in a much more practical way, our lovely house on Woodthorpe Avenue in Boston is home. It’s the place we can best exhale. We can kick off our shoes, settle comfortably onto a high chair on the breakfast bar, and watch the chickens, dogs and children flap around in the garden.

YEditedGroupPhotoet Restore Church, full of our friends, is also home. We seek the heavenly realms together, we drink moderately bad cups of tea together and we laugh about the projector turning everything purple again. This whole year has been a mess of realising that “Home” is any place that has touched your heart. Leaving doesn’t stop that.

If you’ve read Harry Potter, there’s a concept where Voldemort tears apart his soul and stores it into objects that have emotional value to him. That’s not quite how I’m feeling – home is not a horcrux – but there’s no doubt that putting roots down involves investing a part of oneself.

Now I’m coming home
I’m coming home to you again
I hope things haven’t changed
New Found Glory

Many homes

This year, “home” has been Mseleni hospital in South Africa. It’s been Sea Point in Cape Town. Jackson in Missisippi. Alterna community and Koinonia Farm in Georgia. QC Family Tree in North Carolina. Grace & Main in Virginia. The Simple Way and Inner Change in Philadelphia. A little bit of us still lives in the homeless shelters of the Catholic Worker movement in New York City

IMGP3158

Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring.

Our idea of home is shaped by the setting and society we live in. This year it’s meant our children sitting naked, in dusty mud, next to the road. It’s meant seeing giraffes on the drive to the shops. Getting excited about a visit to the town café that pretty much only sells chips. Friends who have never had – and will never have – the life opportunities that I take for granted. Patients who have never slept in a bed, and thus don’t know how to sleep when they are admitted to hospital. Evenings without a TV, without electricity, without water, spent cooking pizza on a wood fire, and laughing. So much laughing.

John M PerkinsAnd it’s meant eating sweet potato wedges with John M Perkins. Jugs and jugs of sweet tea. Contemplative silence in LaGrange, and board games late into the night. Cooking pizza for the entire residency of Koinonia farm. Shaving heads and eating chocolate.

In Charlotte, it meant reincarnation through recycling, through gardening, through relationship, through reimagining an unloved locality. And a little girl doing a poo in a public water fountain. It’s meant permaculture, community gardens, ultra thick milkshakes and sitting on porches in Danville. In Philadelphia it meant pizza (home == pizza), and gunshots, and an understanding that all of us need our home to be sustainable. New York meant $1 pizza slices, enjoying glorious mess surrounded by healing people, and my first ever visit to a board game cafe!

Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring. In common with many others who have crossed cultures, there will always be a discomfort in us, even in situations that have been familiar to us for years.

wp-1451644198031.pngHealth

Alongside learning more about the mental framework we use to fit into the world, I’ve also come to terms with my physical existence here.

For the first time, I can say I genuinely love exercise. I even hate running a bit less!

Sure, 2013 was the year I decided to start losing weight. And 2014 was the year that I realised healthy eating is going to be a life long commitment. But 2015 was the year I started to understand the link between health and happiness.

For the first time, I can say I genuinely love exercise – I even hate running a bit less! I’m more aware than ever how rubbish I feel after an episode of gluttony – Ben & Jerry’s, I’m talking to you here – and I’m starting to have the self control to just not go down that path.

I’ve hammered out a few personal milestones, such as my first Triathlon, my first sub 25 minute 5k, and consistently dropping below 70kg. I’ve also managed sustained periods of exercise, accountablity and weight management – see my blog series: six kilos in six weeks.

Medicine

babychris-800x817Working in South Africa was a privilege – a scary one at points. Having a baby named after me was a highlight, as was being signed off as competent to perform caesarian sections without supervision. It was also the first time I’ve ever worked with a degree of autonomy, and the only time I’ve been at a grass-roots level in the midst of the community I live. Being a doctor… at home.

When I was 17, I made a decision to apply to medical school. I’m now 29.

As I look towards the end of my training, I know that the only way I’m going to be able to sustain the enthusiasm and purpose I need is for my career to have integrity. When I was 17, I made a decision to apply to medical school. I’m now 29. It’s only at the end of this year that I will no longer be on a training scheme. I’ll actually be an adult, able to apply for a job where I get told in advance where I’ll be working, what hours I’ll do and how much I’ll be paid! I’ll be able to raise concerns and suggestions for improvement without putting my entire career at risk! Brill.

In 8 months, I’ll be able to choose my hours, select my workplace and start to explore my sense of vocational calling. Medicine needs to line up with our life goals, my heart and my sense of home. Who knows exactly what shape that will take, but its an exciting prospect.

Next

The bible is full of phrases like this:

“And calling the crowd to him with his disciples, he said to them, “If anyone would come after me, let him deny himself and take up his cross and follow me. For whoever would save his life will lose it, but whoever loses his life for my sake and the gospel’s will save it.”
Mark 8:34-35

When I read a passage like that, I think: “I’m not really doing that”. I’m not saying that I believe God calls us all to martyrdom; but I do believe a luke-warm 50% lifestyle simply doesn’t cut the mustard.

SAM_0952I’ve become certain of one thing this year: we desire to live out the gospel. Really live it. Not half live it, tacking on a bit of grace and love to a plastic Western lifestyle, but LIVE it. Our hope is to explore, sacrifice, pray and practice until “The Kingdom of Heaven is near” starts to resonate with us.

“Home” this year has meant common threads: friends, community, adoption, Jesus, vegetarianism, pizza, board games, fitness, laughter… shared values in others that reflect the hope we have for this life.

One of our mentors, Colin, recently said to us “You need to find your tribe“. As we continue to explore what and where “home” is for us, I think God will make it clear to us who our tribe is. Maybe it’ll be through pulling on some of those common threads, and more importantly, following back to the heart behind them, one that says “My God; my neighbour; our life together.”

Thanks for reading this, and thank you to everyone who has been part of home for us this year. Have a great 2016!

PS. I leave you with a song that is very much on the same page as us…

Crispy Potatoes Recipe

We all have Christmas traditions, and often that revolves around food. Katherine and I have spent our 6 years together slowly perfecting our Christmas selection.

I thought I would share how we make our awesome crispy Christmas potatoes (you can eat them when its not Christmas too, if you want!).

Disclaimer: I am a proud member of the chuck-it-in-it’ll-be-fine school of cooking. I firmly believe a happy cook just throws stuff in a pan, rather than measuring 18g of this and 3.5 medium egg yolks of that; so take my measurements with a pinch of salt, so to speak. This recipe makes as many potatoes as you need. I usually plan for 1-2 large potatoes per person.

Cooked Crispy PotatoesIngredients

  • Potatoes.
  • Flour.
  • Olive oil.
  • Salt and Pepper.

Recipe

  1. Peel and chop up your potatoes. You want biggish lumps – cut big potatoes into 4 pieces, small ones into halves.
  2. Boil up your potatoes with a little salt in the water (helps them get softer).
  3. Check them after about 15-20mins: you should be able to stick a knife in them, but you don’t want them completely soft either.
  4. Drain the water.
  5. Chuck some in a metal colander, so there are about 8 pieces of potatoes in it (use a big bowl if you don’t have a colander). If you have lots of potatoes, you might want to do them in a few batches, 8-10 at a time.
  6. Jiggle the colander for about 10-20 seconds. This bashes up all the edges of the potatoes, making them uneven. This leads to lots of extra crispy bits.
  7. Have a bowl with olive oil in, and one with flour in.
  8. Potatoes before BakingRoll each potato in the oil, so its covered, then roll in in the flour. Oil + flour = more crispy.
  9. Sprinkle a little more oil on top, and grind loads of salt and pepper all over it.
  10. By now, your potatoes should look something like the photo on the right (click for bigger picture).
  11. Cook them at 180°C ish in the oven. You’ll want to take it out a few times and stir it around with a spatula so that it gets cooked evenly.
  12. When they are golden, with some crispy brown bits, cover them in gravy and eat them all up.

If you don’t like gravy, then I’m afraid you are a bad person, and you are not allowed to make my potatoes.

Take some Pudding home…

Thanks for all the friendly offers of a home for our dog. Pudding has been given a home over the next year, so please – no more offers, its heartbreaking having to keep saying no!

This is a heartfelt plea to see if anyone would be able to provide a home for our dog Pudding over the next year.

Myself, Katherine and our children are all off to South Africa from the end of August until July, working in a hospital, and trying to avoid being eaten by hippos.

Unfortunately, its too difficult and expensive to take our two lovely dogs with us for this period. Hezebelle, our 8 year old collie, has a temporary home with a friend for 11 months, so we just need somebody who would like to support our work over this year… by looking after a slightly annoying Labrador.

IMGP1455Pudding is 6. She is half collie, half Labrador, and 75% moron.

She plays well with children, and other dogs – there might be a settling in period for a day or two with dogs – she loves to be with people and animals.

She is a scaredycat – we have chickens, its funny to watch her run away from them round the garden. If you don’t have a chicken, we can lend you one. She will bark at your front door, but she shuts up pretty quickly, and there’s no aggression in her, she’s just saying “OH NO, THERE’S SOMEONE AT THE DOOR?!”.

She is fully housetrained. That said, she is still an animal, and she is known to eat ridiculous things like sticks and frogs, so I can’t guarantee that you won’t have one or two accidents in 11 months – but it shouldn’t be more than that.

She is a food lover. She will eat anything you offer her – and the occasional poorly guarded thing that you don’t – but she is reasonably well behaved. For example, if you put cake on a table and said “Pudding, do not eat that cake!”, you can be pretty sure the cake is fine. If you put a tub of butter on a chair, and just wander away… there’s a reason she is called Pudding. We will pay for her food whilst we are away.

She is lazy. She is happy with 5 walks a day, but she also manages with 2 a week. Half the time we have to call 3 times to wake her up in the morning to go out. She will likely not even notice if you leave her alone for the majority of the day at work, and has been threatening to become wider than she is tall ever since we got her.

She is a much loved part of our family, and I’m confident that she would settle into yours too. If you think this is something you would be able to take on, please give us a call, an email, or whatever. In looking after her, you’d be supporting a young family as they go on mission to help those in need in Africa.

IMGP1453IMGP1457IMGP1456
IMGP1458IMGP1452
IMGP1454

Snakebites and sad goodbyes

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Dermatology. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

A final morning chapel followed our joyful late night escapades last night, with a combination of Amazing Grace and We Are Marching to get a bit of the African clapping vibe working. The photo below is from earlier in the week, but since its the last day today, it seems appropriate to share it…

Beautiful_photo_DHC_2014

Dermatology

Clare Fuller showed us lots of very interesting graphs. Dermatology complaints are known to under present, be poorly treated and lead to people avoiding healthcare for other important issues.

In some studies, more than 60% of Dermatological prescriptions were inappropriate in a Developing world setting.

Also, distance effects health seeking behaviour in Dermatology more than other conditions: if there is a clinic within 1km, people attend with their fever, their pain, their rashes. If the clinic is 10km away, they will only go with their fever or pain, according to one study.

Apparently 10-20% of children with scabies will still have haematuria 10 years later! That’s terrifying, and only something that’s recently coming to light.

Skin lightening products

Using topical steroids for skin lightening leads to low birth weight and vaginal bleeding in pregnancy.

Generally dangerous

Cutaneous bacterial infections

Very common in the tropics, can be difficult to identify which one in particular.

Treating cutaneous bacterial infections

  1. Wash skin – clean water, disinfectants
  2. Remove crusts, debris, necrotic tissue
  3. Topical anti-inflammatory/anti-biotics, honey, etc.
  4. Oral antibiotics

Eczema

Acqeous cream should not be left on the skin – can inhibit barrier function.

Otherwise the greasier the better.

Snakebites

Approach will vary depending what snakes you have in your area.

I saw a snake on my balcony, and was concerned, so asked a colleague what to do.

Their response, “Have you tried the exposure test?

“What is that?“, she replied.

Let it bite you, and see what happens

Fond goodbyes

I was feeling desperately sad by the end of the day, but it was time to say goodbye to everyone. I got bullied into starting a Developing Health 2014 facebook group, so feel free to join if you came along – it’d be great to stay in touch.

Thanks to everyone who came along, everyone who donated their time to teach, and the course organisers: I’ll be processing everything I’ve learnt for months…

The Ladies are Dying

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Women’s Health. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

why are  women dying?Maternal death

Afghanistan – “One of the worst places in the world in which to be pregnant”
UNICEF

Has a Maternal Mortality Rate of 6,500 per 100,000. Which is the highest ever recorded, anywhere in the world.

Reducing those MMR stats is simple: we know the answers…

  1. Improve access
  2. Ensure skilled staff at deliveries
  3. Increase Utilization
  4. Education and Family Planning

Female Genital Mutilation

Studies have shown that it is not really a religious tradition but a cultural one. It is barbaric – and the pictures and case studies just confirmed that. I’m pretty proud of our country that they have made it illegal for UK nationals or residents to perform FGM anywhere in the world. Maximum sentence 14 years!

There were some interesting discussions about this though: if you deliver a baby, and the mother gets a tear, relating to her FGM, you breach the law if you repair it to how it was previously, rather than trying to reverse the FGM – regardless of the patient’s choice!

Women, depression and domestic violence

There is a big correlation between depression and suicide in women in the developing world – in the UK, men are about 3 times more likely to be successful in suicide. In Bangladesh, there is no statistic distinction between the two.

Being poor, worrying about family, about health, about money, about social insecurity, domestic violence: all these things are stressful.

In some studies, 20-36% of women in Asia suffer from post-natal depression.

Group work

We had a range of group workshops, where we talked through loads of case studies. Very informative, very useful. Just like yesterday, where I ended up teaching a group how to perform a spinal anaesthetic, today I realised that I actually have something to contribute, based on my professional experience. Last time, I knew very little about gynaecology, but this year I had 4 months on experience, and was able to participate actively in the discussion.

Joining bones (and mission partnerships)

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Orthopaedics. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

New Relational Partnership…?

We started this morning with a meeting with the missions agency that phoned me last week. Katherine, Joen and Neriah all came out to Oak Hill college with me, ready for the meeting. We met with a lovely chap with an accent that can best be described as “miscellaneous”, since he has lived in about 5 countries for significant periods of his life. His wife was also there.

Just that little fact made me feel more comfortable: if you meet with a corporate CEO, or similar, there would never be such an immediate focus on relationship, on meeting our family as we meet theirs.

UBurn Contracture Healednderstanding the concept that he is not alone in working – as a married couple, all our work, to some extent, is done in partnership.

Anyway, it was a thought provoking meeting, that may lead to a long term partnership: more on that as it develops…

Orthopaedics

Due to our meeting, and my general tiredness, I missed most of the morning, by the earnest, funny and heartfelt Chris Lavy (I sat with him at lunch, he was awesome). I did catch two recommended websites for finding recommended physio techniques and general reference material: Summit Medical Adult Health and WheelessOnline.com.

However, I managed to attend most of the afternoon sessions with tutorials and workshops on fitting people for casts, putting legs in traction, and how to splint burns.

I think the biggest take home message for me was that burns need appropriate splinting, for at least 6 months to prevent developing significantly disabling contractures (see right).

Ideally you want a burn to heal within 2 weeks, as that makes risk of contractures much less likely.Burn Contracture Healed

The Hidden Introvert

The Mission Agency asked us to identify our Myers-Briggs types: Broadly, Katherine is an INFJ, and I am ENTP. Which is nice, as the conventional wisdom is that having 1 field the same (possibly) makes for stronger relationships. It’s interesting to read through – not a massively evidenced based approach, but an interesting window to use to inspect your own mentality.

Unsurprisingly, I am classified as an Extrovert. But, I have a hidden Introverted side that I never knew existed…

This week has been socially intense, making instant, deep, wonderful friendships with people from all over the world, but with fairly similar visions and life views to me. I’ve had a fantastic time, but it has been hard work. For the first time… ever… I had to go and spend an hour in my room on my own this afternoon!

I was excited about this: Vicky Lavy pointed out that the fact that after an hour I was back out, talking to everyone, means that I’m unlikely to be at risk of reverting to total extroversion…

Africa and Zulu

The evening talk was a chat with Peter Saunders. His story was slightly haunting for me: around 20 years ago, he felt called to work in Africa for a year, went to work in Kenya for a year with his wife, a 1 year old and a 3 year old. They felt convinced they would end up in Africa long term: but never lived there again…

My last activity before bed was my first Zulu lesson with my SA friend Linda. I discovered my first concepts of Zulu prefixes, and learnt to say Kubu Hlungu Ikhanda (My head hurts).

I am not fluent yet.