The World Turned Upside Down

While the world subjugates the goodness of Creation to pain and suffering,
…the cross converts despair into hope.

While the world spins on an axis of pride, retribution, and self-reliance,
…the cross stands on a firm foundation of humility, acceptant peace, and trustful surrender.

While the world continues to be ravaged by violence and storm,
…the cross withstands all bloodshed and torment.

While the world views dying to self as sorrowful self-deprivation and failure,
…the cross reveals its true joyful fulfillment and victory.

While the world lives on false pretense, crowning itself with an unmerited band of gold,
…the cross is sustained by true integrity, undeservedly crowned with a ring of painful wounds.

While the world consumes without ceasing,
…the cross imparts its everlasting blood of redemption and water of life.

While the world continues to breed division,
…the cross invites all to unity.

While the world teaches us to fend for ourselves,
…the cross reminds us we do not suffer alone.

While the world puts wayward man and woman on a pedestal,
…the cross elevates our constant, one true King.

While the world tells us, “you only live once,”
…the cross tells us, “you will live forever.”

While the world exists for the “self,”
…the cross exists for the “other.”

In a world of sterile, senseless hostility,
…the cross is fruitful, transformative love.

It has been said that the cross is symbolic of the world turned upside down. During this season of Lent we are invited to contemplate, accept, and enter into the significance and the power of the cross. Though encountering the cross is difficult and uncomfortable, trust in its fruitful reality brings us the paradoxical ease and comfort that can only be found in bearing the heavy burden of its evident desolation and cruelty.

Another hot and muggy afternoon puts me in my reclining rocking chair. I am kept cool by a series of well-aerated gaps between the chair’s thin, interlocking plastic bands and the fan on full blast. All of a sudden I hear a call from the security guard standing outside my window, winded from his run up the stairs leading to our house. “Doctor, emergency,” he says. Though I hear this phrase many times throughout any given week, his tone is marked by an uncommon sense of concern and urgency. The sense of urgency grows with each word and facial expression I encounter on my way down to the hospital. As I enter the emergency room, a teenage boy lies lifeless on the hospital bed. His stiff extremities and bluish skin are surrogate markers of the absent pulse soon discovered by palpation of his wrist. In the battle against time my hands soon find themselves on top of his chest, each compression into his chest a hopeful attempt to give him another chance at life. Five minutes, multiple pairs of hands, and a vial of epinephrine later, a life-sustaining pulse returns, his eyes are opened, and death seems a more distant reality.

One of the observers of the accident begins to tell us the story. The boy and his friend were riding their bicycles down a very steep hill which ends in a sharp curve. Upon turning the corner on his bicycle with no brakes, the boy violently collided with a set of ion bars. In an instant an unexpected tragedy became the halting reality in front of me amidst an already stifling afternoon.

Shortly after his resuscitation a late afternoon referral to the city of Iquitos is declined by the flight operator as dusk ominously approaches, the water plane’s pilot unable to safely fly in the dark. The boy still has not regained full consciousness and cannot breathe on his own. The remainder of the afternoon and evening finds a group of volunteers and hospital workers taking turns breathing for the boy as we pump oxygen-rich air into his lungs with a bag mask. Over twenty pairs of hands functioning as a human ventilator come together to save one life. Then, the morning’s hopeful sunlight is quickly displaced by a torrential rainfall- the flight evacuation is further delayed by the storm and each passing minute is filled with increasing doubt. The water plane finally departs on its fixed trajectory to Iquitos, all the while containing a life whose worldly fate is all too uncertain. Shortly after his arrival to Iquitos we learn the boy has passed away.

***

The brokenness and despair is palpable that day, a subversive sense of defeat lurking in the shadows with no possible worldly explanation to understand how this child’s life was so quickly and unjustly uprooted. And as the now broken and barren soil is disturbed by the uprooting of this once living and growing tree, the seeds around it are now stirred up. Once dormant, now awakened. Once stifled in packed soil, now set loose with the freedom to flourish. Once trapped in darkness, now invited to bathe in the sunlight. Once content to be contained within themselves, now anxious to sacrifice themselves- to be stripped of the comfort and protection of their shells and to blossom into the flowers they had been destined to be from the very beginning.

In the cross, the world is turned on its head. From the uprooting of a tree emerges a wooden cross, carved away by the brokenness of human hands. I am reminded that in our cross- in our individual and collective pains and sufferings- we find the only possible response to the world’s indiscriminate cruelty. Where the world means evil, only He means good. Only He is capable of bringing about a greater good from the adversity that surrounds us. Only in trustfully surrendering to His permissive will do we have the freedom to truly love. Only in our redemptive suffering do we gaze upon his face with His Mother at the foot of the cross. Only through the cross is found eternal life.

“A seed’s life is inside, yes, but it’s a life that grows by being given away and mixing with the soil around it. It has to crack open, to be destroyed.”

~ Bishop Robert Barron

Carried to Shore

 “Do not let the flood waters overwhelm me, nor the deep swallow me, nor the pit close its mouth over me.” 

~ Psalm 69:16 

The Amazon rainforest is an incredible, ever-changing, and living phenomenon. In it I stand within the warm embrace of its evergreen foliage and under the protection of its towering canopy. I inhale and exhale its sometimes stifling, but always life-giving, hot and humid breath. I observe its waking amidst its fog-dispersing sunrise and its falling asleep amidst its spellbinding sunset. I assess its nourishment in the rise and fall of its rivers’ waters. I listen to its voice in its natural chorus of harmonious birds, steady rain drops, and guttural toads. I sense the reality of its brokenness as I carefully dodge its multitude of disease-carrying and venomous creatures. And I am reminded of its hope when its colorful rainbow peaks out above the transient dark, gray storm clouds. In its dynamic, complex existence I see vessels of a broken world colliding with the current of God’s magnificent Creation. This current of infinite truth, beauty, and goodness always brings us back to shore where we encounter the fruits of faith, hope, and love. 

It can be tempting to let the brokenness of the world swallow us up by giving in to its untamed waters or by attempting to navigate the storm as the captain of our own ship. But in each of these approaches lies a degree of uncertainty that we will make it through the torrent. Reflecting on this past year I see an ocean of uncontrollable waves violently crashing against a calm, unwavering shore. Thankfully, I’ve discovered, we have been gifted another way to navigate these turbid and tumultuous waters that are far beyond our control- the way of faithful, trustful surrender. And though it might be unnerving to let go of the ship’s helm and countercultural to allow oneself to be guided by an invisible sonar, it is often the only way to make it safely back to shore. 

In the waves I see a new mother lose her life to a venomous snake bite. Distant access to care and corrupt government policies that neglect the country’s most vulnerable communities attempt to drag me under. Shortly after on the shore I see the priest come to give her earthly body a final blessing and I am reminded of the peaceful, everlasting life yet to come. 

The next wave carries a young boy who fell from a tree; he is now paralyzed from the waist down. A deep wave of depression pulls him under, and from the depths of these dismal waters, he doesn’t see the sun for months. While acceptance brings him to the surface, hope and courage carry him to shore. I see the sun illuminate the smile on his face as he takes his wheelchair outside for the first time. 

A mother watches her ten month-old daughter with Trisomy 18 take her last breath; in the same tumultuous wave I see thousands of other unborn children with her same condition who were never given the chance to take even one breath at all. Her mother stands brightly on the shore, a light of love and truth to all of those who never thought life was possible. 

I see a man sustaining his sister above the waters; she suffers from terminal cancer, each passing moment that much harder to stay afloat. As cancer consumes her body I see faith nourishing her soul. When the last of the stormy waves envelops her body, she is already on the shore looking out over tranquil waters- not a single wave in sight. 

Unable to stay afloat, a young child loses his sense of balance from a growing brain tumor. He is spotted from afar by an astute observer who brings him to shore where he now walks without fear. 

An elderly woman sits abandoned in the middle of a sea of loneliness. Tethered by an oppressive anchor of pain and suffering, she is unable to move. A humble friar brings a doctor and her family out to meet her; a ray of hope calms the stormy sea around her as the others help carry even the smallest portion of her heavy burden. 

I observe hundreds of people lost at sea, unable to see beyond the blinding mist kicked up by the crashing waves. A group of eye doctors volunteer their time and talent to open their eyes, the shore now clearly visible and not too far out of reach. 

The violent waters carry a multitude of disempowered women unable to seek care because of fear and oppression. A team of doctors from thousands of miles away delivers shelter from the storm- their compassionate care provides women with preventative screening for cervical cancer. These women are now empowered to take their first step on secure land. 

A young man is held under water by the stigma surrounding his medical diagnosis. He is only able to come up for air when doctors and nurses care for him in the hospital. Though the waves toss him around relentlessly, they cannot strip him of his dignity. When he finally washes up on the shore, he sees himself for who he truly is, all manmade labels and constructs dried up by the sun’s gentle, all-consuming warmth. 

A tumultuous wave presents a family with the difficult decision to pursue palliative care for their loved one. Just as the waters rise so too does our friendship grow despite our differences. On the surface of the shore I am nourished and sustained by their gift of a pineapple, a symbol of their joy and gratitude. 

A sudden wave crashes down on a mother who gives birth to her child with an unexpected defect. She is heartbroken as she realizes her infant is unable to feed at the breast due to a cleft lip and cleft palate. When, after a team of strangers rallies together to ensure she receives support and her child receives enough nutrition, the wave of despair subsides. In the end, I see a newborn just like any other lying on the calm shore of her mother’s embrace. And as the child learns to drink her mother’s milk from a bottle, a smile of hope returns to her mother’s face.

I witness a slow and steady wave of cancer suddenly separate the physical bond of husband and wife. As he floats away, the lives of all of those he has touched draw near. And though the despair of death is evident in the dark waters, the hope of resurrection is even more visible from the sunlit shore. 

And in the midst of this dark and stormy sea often filled with hopelessness, fear, anxiety, disappointment, injustice, apathy, and suffering, I remember the group of carefree children who invited me to join them for a swim in the murky waters of the Napo River. In their humility, fearlessness, and sincerity, they remind me of the joy of a simple leap of faith. 

“My hope is that when next New Year’s Eve approaches, the “tick” and “tock” of the clock rings less with the sounds of doubt and control and more with the sounds of faith and trust.” 

More than one year has passed since these thoughts left my heart and mind only to land as words on a blank page in front of me. And reflecting on my first year in mission in Santa Clotilde, Peru, I realize these thoughts-become-words are now permanent, colorful realities blended together on the canvas with which I first embarked on this journey. Each pass over the canvas a singular and permanent mark, together all the brushstrokes comprise a complex and evolving picture. Despite this work in progress-the uncharted periphery of the canvas’ borders, the myriad mistakes clearly visible with careful attention, and the multiple attempts to reconcile its blemishes with new paint-its Author has already revealed to us the final product. All that remains is to acknowledge the imperfections, persevere in their restoration, willingly relinquish control of the brush, and patiently wait for His finishing touches. For it is faith that protects us from being swallowed up by stormy waters and trust that brings us back to the shore where we were meant to be all along. 

Seeking Refuge

A blanket of dark, heavy clouds quickly passes through in the afternoon, the muddy ground, damp air, and majestic rainbow byproducts of its relentless deluge. Miniature “Mary” and “Joseph” prepare their makeshift costumes and the local ensemble of children’s voices, the acoustic guitar, the charango (typical Andean stringed instrument), and the guiro (typical Latin American percussion instrument) begin to play familiar Christmas tunes. Yesterday this symbolic group of pilgrims climbed a series of steep hills to seek refuge in the school where they were greeted with hot chocolate and panetón (sweet bread). The day before yesterday they departed from Santa Elisa, one of Santa Clotilde’s most distant communities. Today’s destination is a different neighborhood where, again, weary pilgrims will graciously be offered refuge after traveling by foot. Along the way the group prays the Rosary while reflecting on the mysteries of the soon-to-be born Messiah. Our prayers interspersed with traditional Christmas songs are heard among the town, and as we pass each house en route to our next landing place, more parents and their children begin to follow behind the group of wandering pilgrims. The crowd grows larger and the voices louder with each passing step and sounding note.

“Mary” and “Joseph” arrive at the door of their anticipated shelter. Then begins the singsong exchange of Pidiendo Posada, a traditional song imagining the conversation between Joseph and the innkeeper in his search for a place for Mary to give birth to Jesus. The song begins with a desperate plea: “In the name of Heaven I ask of you shelter, for my beloved wife can go no further.” The innkeeper responds and Joseph’s heart is filled with little hope of respite: “I don't care who you are, let me sleep. I already told you we’re not going to open.” The song continues with a series of Joseph’s persistent supplications and the innkeeper’s unwavering refusals to provide them much-needed refuge. Finally, a sudden conversion in the last stanza fills the crowd with hope. “Enter, pilgrims; I did not recognize you” is sung, the host’s doors open, and “Mary” and “Joseph” followed by the crowd of carolers and passers-by eagerly enter the home. The smell of chocolate, cinnamon, and cloves fills the room while the priest celebrates the Liturgy of the Word. And after a short reflection on the day’s Gospel passage, the community partakes in a chocolatada, a sharing of hot chocolate and panetón prepared by the receiving home and neighborhood. This tradition continues every day until Christmas Eve after passing through each of the town’s principal neighborhoods and major institutions. By the end of the Christmas season, all of Santa Clotilde has heard, seen, and tasted both its spiritual and physical goodness.

After Christmas Day the joy of the Christmas season travels by boat to a small community about thirty minutes away. When we arrive with a handful of young carolers from our youth Christmas choir, a guitar, and various bags of goodies we are welcomed into a home decorated with red and green balloons and fluffy, plastic garlands hanging from the ceiling. A group of men, women, and children sit in a large circle and a white cloth hangs over the center table to welcome baby Jesus. A giant pot with a wooden spoon larger than most of the children in the room rests over a fire, everyone eagerly waiting to taste the sweet hot chocolate brewing inside.

Despite the evident joy and excitement in the room it doesn’t take long for my eyes to recognize the visible suffering of a young infant lying on the wooden floor. The combination of his emaciated body, somnolence, sunken eyes, and weak cry quickly communicate his illness. And a brief discussion with his mother and grandmother soon reveals the cause- two months of a diarrheal illness and poor nutrition after stopping breastfeeding. Though it is difficult to see him struggle while the other children in the room happily dance to cumbia music, drink hot chocolate, eat panetón, and line up to adore baby Jesus with a symbolic gesture, I am hopeful and relieved that his family has agreed for him to return with us to Santa Clotilde.

A few days later the numbers on the scale begin to rise, his diarrhea subsides, his sunken eyes begin to take form, and his weak cry becomes a feisty fight with each physical exam. I think to myself, “this infant has found refuge,” and I remember what a blessing it is to work in a hospital that is exactly that- a refuge for the infirm, the poor, the homeless, the maltreated, the forgotten. And although we only celebrate Christmas once per year, every time we receive one of the “least of these” under our roof, the Christmas spirit is re-kindled in our hearts: in each living soul we encounter the Savior Himself, God become flesh.

***

Later as I contemplate the significance of the posada, I am reminded of its mirroring of a lifelong process inherent to all mankind. In the posada we find His persistent and unremitting pursuit of our hardened hearts, our reluctance to accept His invitation in our brokenness, our perseverance in change of heart, the peace that comes with humbly opening our doors and welcoming Him into our home, and the true joy and true love of selfless giving. Just as He was once a peregrino pidiendo posada, a pilgrim begging for shelter, so too are we pilgrims searching wearily for our true home. A mysterious and beautiful paradox comes to light- in welcoming Him into our hearts, so too do we find our refuge in Him.

Wishing all of you, my family and friends, a happy and blessed Christmas and New Year! Thank you for all of your continued thoughts, prayers, and support!

The Burden of Hope

 

“‘Hope’ is the thing with feathers -

That perches in the soul -

And sings the tune without the words -

And never stops - at all -

And sweetest - in the Gale - is heard -

And sore must be the storm -

That could abash the little Bird

That kept so many warm -

I’ve heard it in the chillest land -

And on the strangest Sea -

Yet - never - in Extremity,

It asked a crumb - of me.”

~ Emily Dickinson

It’s another hot, humid, sunny day on the shores of the Napo River. The heat becomes unimaginably more oppressive as we ascend to the uppermost level of Santa Clotilde, the town known to locals as the “Pueblo de Tres Pisos” or the “Town of Three Floors.” I recall the incessant, melodic chirping of the birds to which I awoke in the cool morning and the current absence of their song- they, too, seem to have been afflicted by the day’s warmth, retreating into their shaded arboreal shelters. We begin our climb, leaving behind the lowest level which boasts the town’s riverside outdoor market and various housefront shops. The second tier is home to Hospital Santa Clotilde, the boarding school, and the obligatory municipal soccer field, all exceptionally quiet on this Sunday afternoon. We reach the apex of our journey passing the central plaza studded with “sand” volleyball courts, the town’s largest school, and Santa Clotilde’s fanciest pollería or “chicken restaurant." Some grueling steps and many winded breaths later, we arrive at our destination- a stilted, wooden abode thatched with dried banana leaves. I have been invited by one of the Franciscan friars from our parish to visit an elderly woman in her home- he asks me to evaluate her as she is no longer able to walk.

As we enter the doorway I take in the sights and smells of a typical Napuruna (of, or pertaining to, the Napo River region) home. To my left lies a small canoe containing masato, a staple food of the people living in the Peruvian Amazon. This fermenting yuca has a distinct smell, and its sharp odor dances alongside the less obtrusive smell of the smoldering wood-burning stove where her daughter stands preparing her mother’s lunch. Two cats scurry about the array of wooden planks and maneuver in and out of the maze of holes and crevices carved out by nature’s untamed jungle elements. The house’s thoughtfully-designed stilts keep out many of the earth-trodding creatures, the lurking cats take care of the unwelcome mice, and the scrambling lizards feast on pestilent flies and mosquitos. A bench lines one of the walls, a table sits undisturbed in a remote corner, and a donated air mattress adorns the rafters up above. I am instantly confronted with the uncomfortable juxtaposition: the woman’s undeserved material poverty and physical isolation and my own undeserved material plenitude and personal freedom.

My eyes are then drawn to the elderly woman lying on the floor under a mosquito net. Her bed consists of a one-inch-thick piece of plywood topped with two sheets and a pillow. We later learn that the well-intentioned, donated air mattress hanging above our heads resulted in multiple falls off its unprotected raised edges- a hard slab of wood being the lesser of two evils. Upon hearing our voices she struggles into a cross-legged position, an all-too-familiar posture which she has maintained for two years after falling and never regaining the ability to stand and walk. Her stiff joints and non-pliable muscles corroborate her story. Behind her stoic gaze lie years of unaddressed and untreated pain- only when prompted does she disclose the discomfort in her knees, hips, and shoulders. And in her terse speech dwells the long-unaccompanied solitude and abandonment. Unsettled by her physical state and her current living situation, we lament the perceived “absence" of her eleven adult children. I doubt the neglect is intentional- they too are working to survive.

Over the course of our conversation the storm she has weathered falls into our radar with each passing cloud of memories and reflections. For two years she has sat on a harsh and unrelenting surface. For two years she has slid along the floor on her now-calloused bottom to use the restroom. For two years she has waited patiently for hours each day for her children to come and provide momentary companionship and bodily nourishment. For two years she has only recalled fleeting images of the glistening Napo river and the diverse, expansive Amazon rainforest that surround her. For two years she has born the physical pain of natural aging compounded by exceptional trauma. And for two years the burden of her hope has grown taller as the comfort in her stark surroundings has slowly dwindled. When she finishes sharing her story with us I am tasked with easing her physical discomfort, and the friar commits to find a more suitable mattress and meet with her children to develop a care plan for their mother.

                                                       ***

We visit her again one week later. This time I am prepared with a handful of anti-inflammatory medicinal remedies- a few blisters of acetaminophen and naproxen and a handful of vials of local anesthetic and injectable steroid for her knees. She finishes her lunch of fish, rice, and chapo (an Amazonian beverage made with softened sweet plantains, cinnamon, cloves, and anis). Meanwhile the friar recruits one of the neighborhood boys running around outside to help lift her onto the table so I can inject her knees in a relaxed position. I sit down on a stool and position myself at eye level with her knee joints. As I examine her knees for the ideal “window” to administer the medication and playfully instruct her not to kick me, one of the cats proceeds to weave in and out of my legs. We all burst out in laughter- an unintended but sufficient anesthetic prior to the impending poke of a sharp, unpleasant needle. This is the first time I’ve seen her smile, and I think to myself- “even this silly, obnoxious cat has a purpose.”

In the instant our two unparalleled worlds collide, the mutual blessing becomes apparent- a song is sung without the words. The song of Hope. I have heard this hymn many times before- its voice resounding and clear at a time when it is least expected. To have hope is not to live or witness a life free of pain and suffering but to know that the weight of the world’s iniquity and sorrow does not fall on our backs alone. To receive Hope and to be Hope to others is to help one another carry our unique and often incomprehensibly disparate burdens which were never meant to be carried alone.

And as I leave her home for the second time I am overwhelmed with my subliminal encounter with Hope, the Hope to which Dickinson so intimately alludes: “And sore must be the storm - That could abash the little Bird…Yet - never - in Extremity, [She] asked a crumb - of me.” Though the way back home is downhill and not even a crumb rests on my back, I feel the weight of my hope grow heavier. I am reminded that true Hope “is the thing with feathers,” whose “yolk is easy, and…burden light.” And when the load becomes too heavy to bear, I am reminded that only He can fully bear the burden of our hope.

“I’ve come to trust the value of simply showing up and singing the song without the words. And yet, each time I find myself sitting with the pain that folks carry, I’m overwhelmed with my own inability to do much more than stand in awe, dumbstruck by the sheer size of the burden, more than I’ve ever been asked to carry.”

~ Fr. Gregory Boyle, S.J.

***

The Art of Walking

“Walking is an art; if we are always in a hurry we tire and cannot reach our destination…Yet if we stop and do not move, we also fail to reach our destination. Walking is precisely the art of looking to the horizon, thinking about where I want to go, and also coping with the weariness that comes from walking…the way is often hard-going. And this is beautiful: it is working every day, it is walking humanly. It is terrible to walk alone, terrible and tedious. Walking in community, with friends, with those who love us: this helps us, it helps us to arrive precisely at the destination where we must arrive.”

~ Pope Francis

The idiom “walk of life” traditionally refers to the distinct social class and background of a person, the unique circumstances and experiences by which one is formed. In this expression lies the significance of life as a pilgrimage, a journey actively traversed rather than passively observed. Though we all come from different “walks of life-” some with sturdy shoes and others with bare feet, some with a lengthy stride and others dependent on another for movement, some with a head start and others with numerous road blocks- a well-lit path is always on our horizon. When our distinct “walks of life” converge, this narrow path that is perceived uniquely, though incompletely, by each human heart, becomes all the more visible, all the more spacious, all the more accessible, and all the more traversable.

***

Our boat pulls up to the precarious cliffside lining a small indentation in the vast and winding Napo River. We have come to deliver wound care supplies and medications to a family whose daughter fell from a tree about one year ago. After sustaining permanent injury to her spine she is paralyzed, bed- and wheelchair-bound, rarely able to leave the confines of her stilted house which overlooks the passing river and seemingly never-ending rainforest on the horizon. Taking in the surrounding scenery as we near the top of the hill, we are greeted by a group of smiling, playful children and the girl’s father. The kids laugh uncontrollably at our meager attempts to communicate in Kichwa and our careful navigation of the trail of cow dung carpeting the jungle floor. And upon finishing our adventurous ascent to the family’s humble abode, we are graciously welcomed into their home.

Together with our hospital’s pediatrician, a group of visiting doctors enters the girl’s dark, wood-paneled room where her mother sits cleaning her daughter’s pressure wounds. She lies on a thin mattress on the floor, and noting the absence of a window, one of the doctors illuminates the scene with her phone’s flashlight. A brief look reveals a large wound on her backside, the result of hours spent lying in the same position. Despite the presence of the wound, however, she is clean and there is no evidence of infection- it is clear that she is well cared for. Across the room I see her father looking out the window- I recognize his face. Our team took care of him in the hospital a few months ago for complications from HIV infection. I ask him how he has been, what he is cultivating in his “chakra,” or farmland, and how he is responding to his treatment. We discuss the weighty process of the building of his home and the even heavier process of caring for his paralyzed daughter after her accident. Behind the strength and resilience of his sincere answers and unrelenting facial expression I sense the paradox of emotions: sorrow yet joy, worry yet peace, remorse yet gratitude, pain yet healing. Some moments later we work our way back to the boat. We depart with a generous gift- a large stalk of bananas, a testament to the gracious and humble family walking forward one day at a time even when paralysis attempts to hold them back.

***

He approaches the clinic with an unsteady gait. A constricting wrap around his knee and an expanding smile on his face, the young boy limps his way up to the health post as his mother guides him by the hand. In his carefree smile I recall the well-appearing child who visited us in Santa Clotilde a few months ago. In his unstable step, however, the boy appears noticeably different. Though a few months ago the X-rays of his knees provided orthopedic reassurance, this reassurance is soon dispelled by newly discovered exam findings and more advanced imaging tests. Later, I will feel grateful for the community health worker who encouraged the mother to bring her child to the health post and the pediatrician who evaluated this child as our health brigade passes through for the day.

After a consultation with our visiting pediatrician we learn that what began as a mild bout of knee pain has now progressed to something more concerning and serious. In addition to his physical suffering the child has also endured bullying and learning difficulties in school. When asked to stand on one leg he begins to cry- though his mind tells him he can, his body violently resists any potential threat to his balance. A thorough neurological exam reveals that the child has ataxia, an inability to control his movement especially while walking. There are a number of diseases and disorders that can cause ataxia- structural, infectious, inflammatory, nutritional, and cancerous. As we close clinic for the day, together we watch him sway down the hill. The possibilities race through our minds as we await his transfer to the city of Iquitos for a confirmatory diagnosis. En route to Iquitos the boy’s consciousness begins to wane and recurrent episodes of vomiting suggest a malignant process in his brain. A few days later, a CT scan reveals a brain tumor compressing the cerebellum of his brain. I recall this child’s outwardly regressive walk, a physical sign of the progressive cancerous process occurring within.

***

It is our last hot and muggy morning on our ten-day health brigade to the outlying communities along the vast Napo River. We set up our makeshift clinic in a large, empty building surrounded by a still, grassy field stippled with cows. The pace of the day picks up quickly- seventy patients later, the morning seems to have moved at a speed much faster than that of the unheeding cow pacing outside our window. As I look up and call the next patient over to our pop-up consultation “room,” the hastiness of the morning comes to a sudden halt. From the corner of my eye I see a group of physicians and students surrounding a patient lying on a table. Quickly it becomes clear that the woman is ill as I see the group accompany her to a private room in the back. One of the nurses mentions the woman’s name- a name so unique that I immediately match it to her face and the aggressive, rigid tumor that has been invading her submissive, compliant abdomen over the past year. I enter the room where the somber atmosphere penetrates the senses more intensely than the heat and humidity on our skin. I listen and watch as her direct, unwavering speech and indirect, vibrant gaze command a weak, emaciated, and increasingly featureless body. After a long conversation we encourage the patient to consider palliative care at our hospital since her symptoms of pain and vomiting are becoming unbearable at home. With an unclear pending decision, we part ways.

As I board our hospital boat to return to Santa Clotilde, I see the patient being carried in the arms of her loving brother as he trudges down a treacherous, mud-laden cliff that clings to the river’s edge. I see the beauty and concern in his taxing and selfless walk, his arms clinging to his dying sister’s body, their bond infinitely stronger than that of the wavering cliffside falling into the unperturbed river below. A few minutes later I learn that her arrival to the rural health post was an even more arduous journey. Unable to walk, she was carried by her brother for just under an hour to reach the river whose forward-moving current would facilitate the remainder of their hope-seeking trajectory.




“The people who walked in darkness have seen a great light; upon those who lived in a land of gloom a light has shone.”

~Isaiah 9:2

***

A few days later we begin our northbound trip to the “alto,” or upper, Napo. Recognizing the family’s need for a new, protective surface on which the paralyzed child can sleep, one of the volunteers on our brigade suggests gifting them one of our portable mattresses. Our boat makes a quick pit-stop to the same riverbank we approached only a few days earlier- only this time the precarious cliff looks much less formidable as the child’s mother quickly descends to receive the mattress. Though we know a new mattress is not the solution to all of their difficulties, we hope it will ease the child’s discomfort and provide some needed rest for the family’s continued journey ahead.

As we depart for the second time I see her mother walking steadily uphill, the visible mattress grasped tightly in her hands and the invisible burden and sacrifice carried humbly in her heart- I am reminded that it is only in descending that we will ascend again.

***

It’s been a long week of uncertainty, imaginably longer and more uncertain for the worried mother awaiting her child’s brain surgery. As the days drag on, the reasons for the delay become evident- the necessary supplies are unavailable, there is no anesthesiologist present to assist with the operation, etc. The realities of a resource-limited area and broken health system again turn their heavy heads in our direction. Despite the barriers and challenges, however, the child eventually and successfully undergoes surgical removal of the brain tumor some days later. After a medical-induced coma in the intensive care unit for three days we hear good news. The child is now in the normal pediatric ward- awake, talking, and eating again. We later learn from the pathology results that the tumor is benign, and the boy’s prognosis is very favorable. He will only require therapy to recuperate the neurologic function he has lost and develop those skills in which he has fallen behind.

There is no doubt their journey will be long and difficult. Equally without a doubt, God has been and will be with them every crooked step of the way- for this we are grateful, hopeful, and unafraid. I am reminded that when our impeded, wayward steps signal the expansive malignant process within, His blessings and our cooperation with His grace will make our collective steps unfaltering and our path straight.

***

From the hospital nurse’s desk I hear the moans of a patient in significant pain. A wheelchair bolts toward the emergency room entrance while the woman’s familiar face and the memory of our not-so-distant encounter slowly lingers in my mind. Only a couple of weeks ago her body deceptively told me her earthly journey was coming to an end. While the rest of her body conveys a sense of powerlessness, her voice and eyes convey her steadfast will. Without needing me to investigate she asks me for exactly what she needs- medication to alleviate her pain, relief from an extensive stool burden, and a blood transfusion to replace the life-sustaining substance consumed by the ruthless cancer within her abdomen. Her three school-aged children stand at the foot of her bed, and I wonder what they think about the physical changes taking place in their mother’s body- her sinking eyes and her protruding abdomen, her wasting arms and face and her swelling legs, her fading autonomy and her growing dependence, her new role as the one who needs cared for and theirs as her caregivers.

The rosary draped around her neck is an outward symbol of her faith and trust, and as the days go on I begin to see her sense of peace and acceptance- she tells me she is ready to go home and be with her family. And though her physical body can no longer walk, I can see that her soul moves forward. I am reminded that the human person is not defined by what he or she can do, what he or she has to offer, or who the world makes him or her out to be, but rather by who he or she is- a beloved child of God.

“When you walk, your step will not be impeded, and should you run, you will not stumble.” 

~Proverbs 4:12

The Blind Will See

“Once you let go of the world in a spirit of detachment, once you remove the things of this world from your grasp and see them without distortion, you will really have them. They will appear as they are, as God intended them. They will no longer be objects for your manipulation or possession but beautiful realities in themselves.”

- Bishop Robert Barron

“Word is starting to get out” I think to myself as I look into the pair of eyes staring back at me. From the white corner of her eye an invasive, fleshy growth extends its unwelcome branches over her once colorful and perfectly symmetrical iris. In the eyes of the last patient, I recall, the pupils were barely noticeable behind this intrusive stranger known to medical professionals as a pterygium. The next patient, an older man guided into the office by the hand of his wife, complains of progressive blurry vision over the past few years. A quick look into his eyes reveals a cloudiness that obstructs even my own vision- in it I notice the absence of my reflection. He suffers from the infamous cataract. Then arrives a child who struggles to learn in school- she cannot make out the words and formulas on the chalkboard. Her parents worry about her future without an adequate education. By the end of the month a notebook boasts a list of over two hundred names of men, women, and children whose lives have been affected by failing vision, more than two hundred persons eagerly anticipating a clearer view of the world around them.

***

Age and atmosphere eventually take their toll on the human senses, especially here in the remote and wild Amazon rainforest. Callused hands and feet are slowly desensitized by arduous days of manual labor and barefoot journeys on rocky, uneven ground. Monotonous taste buds are reluctantly summoned by the salt- and sugar-limiting ailments of high blood pressure, heart disease, and diabetes. Deafened ears are repeatedly sounded by the constant noise of a restless, moving world slowly inching its way into the farthest stretches of the undisturbed tropics. And foggy eyes are progressively faded by years of unprotected sun exposure while harvesting land and traversing the reflective waters of the Napo River. Upon first glance, the inevitable deterioration of the senses appears to be a rather bleak reality. However, it is precisely in this distortion of the human senses that we encounter within our hearts the one sense capable of perceiving an unseen, deeper, and more fruitful reality. Faith. It is this sense that allows us to feel the intangible, savor the subtle sweetness in the overwhelming bitterness, listen attentively in the deafening silence, and walk blindly in the uninviting darkness. Through faith we see truth, beauty, and goodness in the world around us- as they are, as God intended, beautiful realities within themselves.

***

The long-anticipated Ophthalmology team from Spain finally appears in our narrow field of vision. In an instant, a small hospital perched along the banks of the Napo River, practically invisible and unknown to the rest of the world, transcends the gap separating two distant continents. With a long list of patients and only two weeks to accomplish their vision-saving operation, the team makes no delay and gets to work right away. Just as the Ophthalmology team has traveled the wavering air currents over the Atlantic Ocean, so too have patients traversed the calmer waters of the Napo River to arrive in Santa Clotilde. Community health workers from rural health posts begin to arrive with boatfuls of people who, for some, may be experiencing a once-in-a-lifetime opportunity. Special eye equipment survives the 24 hour boat ride from the city of Iquitos, and the hospital anxiously prepares extra beds and food for the imminent rush of patients. However, the challenge doesn’t stop there. Despite torrential rainfall, intermittent electricity blackouts, a faulty generator, and anywhere from twelve to sixteen hour work days, the visiting Ophthalmology team attends to 340 patients, performs 84 eye surgeries, and prescribes 223 pairs of glasses. Three hundred and forty lives seen, heard, touched- transformed.

Two weeks pass, and it is no coincidence that the departure of our Ophthalmology team aligns with the feast day of the Assumption of the Blessed Virgin Mary. On this special day the Church recognizes and celebrates the culmination of our holy Mother’s grace-filled life- her Heavenly entrance into God’s kingdom. Fully human just like us, Mary teaches us how faith transcends all limitations and defects of the human senses and gives us access to this same Heavenly reception. In listening without understanding, she is attentive to the request of a spiritual messenger of God even when such a task seems impossible. In feeling without touching, she nurtures new life within her womb without the intimate embrace of man and woman. In savoring without first tasting, she urges and trusts the conversion of water into wine. And perceiving life after death without seeing, she walks alongside her only Son to His death on the cross where she accepts her role as the Mother of us all. Through faith her human senses become undistorted, her gifts unpossessed and freely given, her soul fully surrendered to God’s beautiful reality.

A few weeks later a patient arrives with good news. “I can see again.” After undergoing cataract surgery, he sees the world differently, more clearly. And as he explains his experience of transformation I, too, begin to see more vividly the reality staring back at me. I sense the work of faith. It is faith that first brought a group of missionaries here decades ago to share and know God’s love. Faith that built a hospital to serve a suffering and abandoned people. Faith that formed an inseparable bond of trust and friendship between natives and strangers physically separated by space and time. Faith that sustains a hospital’s mission amidst the face of immense physical and emotional human suffering, interpersonal violence and injustice, and government corruption. Faith that brought the father of an ophthalmologist to serve long-term in Santa Clotilde and his daughter to offer her gifts and talents for the sake of others. Faith that attracted hundreds of patients to place their trust in someone and something outside of themselves. Faith, the hidden yet life-sustaining roots beneath the surface, the gateway to restored and unobstructed vision.

And in the blink of an eye, I am reminded that in the distortion and corruption of our human senses, the gift of faith renews us into the image in which we were created. As He restores our vision in His image, we appear as we are, as we are intended to be- fully surrendered, truly free, and beautiful in ourselves. I am reminded that only in letting go can we truly have that which is worth having.

“Faith is the virtue upon which Christianity rests and is the capacity to see beyond the senses to a deeper or higher reality…To be a person of faith is to know that the universe of the senses is but the tip of the iceberg, a gateway.” 

- Bishop Robert Barron

When Joy Becomes Flesh

I remove the plastic cutting board from the kitchen cabinet, a sharpened knife in one hand and a freshly-picked pineapple in the other. Though my taste buds desperately await the juicy, yellow fruit lying within, the less-inviting but protective spines remind me that once cut open, this gift can only be enjoyed once. One last glance at the pineapple in its wholeness sends my heart and mind on a journey to its humble beginning- a person- the seed of a fruit now flowered, gifted, fully grown, and resting in my hands.

I recently learned that a pineapple plant dies once it produces its fruit- it spends its whole lifetime (about three years) nurturing and protecting its fruit until it is finally ready to share its sweet treasure. Its main pollinators are the whimsical, colorful hummingbird and the erratic, nocturnal bat. During its growth it remains unattractively green, hard, non-fragrant, and even noxious if ingested before it matures. The ripening process is marked by the withering away of its dry, dead spiny leaves and the transformation of its pulp into a yellow, soft, and aromatic delicacy. Though each plant produces only one fruit visible to the human eye, the pineapple is actually a collection of multiple fruits which coalesce together to form a single mass in a process called inflorescence. And as I slice through the hardness and bitterness of its rind and into the softness and sweetness of its flesh, this particular pineapple paints for me a portrait of the man for whom I cared during the dark, heavy, withering moments of his life and the transformation we all experienced into a brighter, gentler, and sweeter-scented end. 

He first presented to the hospital with progressive swelling of his legs, yellowing of his skin, and difficulties breathing while walking. After a quick physical exam and some basic laboratory studies it was clear that his liver was beginning to fail. His first hospitalization, however, resulted in a hopeful discharge- with a few medications on board to help remove the fluid from his body, he left the hospital a few pounds lighter and a few breaths deeper. One month later the swelling returned, only this time expanding into his chest and filling his abdomen. His disease resisted any medications and even the removal of four liters of fluid from his abdomen. Soon we decided to pursue palliative care during what would become the last few days of his life. In this paradoxical process of dying, its life-giving fruit was beginning to make itself known. Day after day of exchanging words and gestures, working together to alleviate his symptoms of pain and restlessness, and being present to the needs of their loved one, his family and I formed a unique bond. And as the days after his death went by, the unripe, hard, scentless, and noxious reality of his death soon withered away.

A few weeks later his daughter appears outside the clinic. To my surprise, she hands me a gift wrapped in a plastic bag. She tells me they cultivate a variety of fruits and vegetables on their land, and she wants to share with me a portion of their “cosecha,” or harvest. I gratefully open the bag and inside lies a pineapple- a symbol of the fully-developed, resilient, fragrant, and healing fruit produced during one of the most difficult moments of their lives: joy. I am reminded that joy is not a fleeting sentiment nor a reward for the ambitious spirit. Just as a pineapple is planted, grown, and harvested in fertile soil, so too is joy sown, cultivated, and garnered in the ready, willing human heart. Ultimately, to choose joy is to cut through the hard, resistant rind in which it is contained and partake in the fruit hidden beneath its bitter surface.

***

This past month I had the unique opportunity to participate in a brigade to Angoteros, a small riverside community about seven hours up the Napo River. The last time I set out to this town it was a quick there-and-back trip on our ambulance boat to retrieve a woman who was dying from a severe snake envenomation. As I traverse this route a second time with a more joyful end in sight, I am reminded of both the challenges and the wonders of living in such a remote area of the Amazon rainforest.

The purpose of this trip was to train and prepare local community health workers to attend to the basic and immediate health needs of their neighbors. These community health workers are volunteers of varying ages often nominated by their communities to take on this important role. After a series of discussions on the importance of childhood vaccinations, prevention of anemia, identification of obstetric emergencies, and safe management and administration of common medications, over thirty community health workers walk away with a certificate of achievement in their hands and an incentive basket full of household necessities. We all leave refreshed, hopeful that they will make a difference in their communities.

Arriving back at our jungle “bungalow” in the afternoon, I am invited by one of the long-term Polish missionaries and a group of children to jump in the river for a swim. A moment of hesitancy dominates my thoughts as I anxiously recount the possible creatures, diseases, and exposures that lurk beneath the river's surface. However, with the sight of the cool, inviting water contained by the river’s bank, the hot and humid air manifest in the overactive sweat glands all over my body, and the Polish missionary’s testimony to never falling ill from a dunk in the water, I agree to jump in…

I am grateful to have gone for a variety of unique and beautiful swims in my life ranging from a frigid dip in the crystalline rivers and lakes of the Rocky Mountains, a peaceful float in the turquoise blue of the Caribbean Sea, a starlight soak in the sulfury hot springs atop the majestic Andes mountains, and a daring jump into the river of a pristine Costa Rican rainforest surrounded by a canopy of monkeys, hanging vines, and colorful avifauna. Yet, despite the splendor of all of these aquatic experiences my adventurous plunge into the Napo River with the Polish missionary and the five wawakuna (“children" in the indigenous language of Kichwa) was a unique and special gift.

As soon as the first splash emanates from the murky water’s surface, the joy that surrounds me emerges clear as day- the smiling faces eagerly anticipating the next courageous jumper, the contagious laughter spreading from one child to the next, the relief from the cool water enveloping our parched skin, and the playful juggling of a volleyball that, though separated in space and time, eventually unites all of our hands in this one memorable moment. Joy. I am reminded of this special gift that children so readily accept, embrace, and share with the world joy, a gift often unacknowledged and unwelcome in the adult’s complex and tireless pursuit of a life of success. In this simple yet purposeful moment an unseen void within me is instantly filled. Amidst this void carved away by difficult weeks of witnessing severely advanced yet preventable diseases, deaths both unexpected and devastatingly premature, and difficult situations in which I felt helpless and unheard, these children were placed in my path. I am reminded that even amidst the suffering, the helplessness, the fear and anxiety, the disappointment, the injustice, and the apathy, that joy can be found. And while the world promises a deceptively happy life free of trial and suffering hidden beneath the guise of possession, distraction, and selfishness, He promises a truly joyful life full of trial and suffering revealed and fulfilled in a transformed and everlasting joy.


I am reminded that joy, even in its most spontaneous and unexpected forms, sometimes requires a leap into murky waters, only to emerge cleansed, refreshed, and ready to continue the arduous journey with the heart of a child.


“Count it all joy, my brethren, when you encounter various trials…” 

                                                                                                                     ~ James 1:2

 

Thank you for your continued prayers and support. Please know you continue to be in my thoughts and prayers as well!