Motion in the Stillness

One of the most notable differences moving to Santa Clotilde is the absence of lane-marked roads, busy freeways, and four-wheeled cars. In the US it is nearly impossible to live without a car; here in Santa Clotilde, it is entirely impossible to have a car. In the US, 5G networks extend into suburban and rural lands; here in Santa Clotilde, one’s cell phone only occasionally registers a futile one “G" signal. In most of the US electricity currents run twenty-four hours per day; here in Santa Clotilde, it is necessary to plan your phone charging, laundry washing, and blender mixing operations between 8AM and 2PM and 6PM and 11PM (assuming the power doesn’t unexpectedly cut this time short). In the US, fingers of physicians and nurses quickly sweep across keyboards to record pertinent patient details; here in Santa Clotilde, the pressure of the tip of a pen glides over a tinted film sandwiched between an original and a carbon-copied document to chronicle a patient’s story. 

Upon first impression, the town of Santa Clotilde may appear to be a stagnant puddle resting on the outskirts of the rushing river of the “constantly progressing" world. A still pool of water overshadowed by the roaring waterfall cast down by the “developed” global reservoirs extending far beyond its reaches. But first impressions can be deceiving. A deeper dive into the still waters of this isolated Amazonian pueblo reveals the clearer reality of a unique and subtle dynamism. Even stagnant puddles boast an immense kinetic energy present in their invisible molecular bonds and cascade-fed pools a strong, hidden undercurrent capable of sweeping even the strongest swimmer into their depths…

Motion takes a different form here in the daily stillness of the Amazon rainforest. I first become aware of this upon awakening each morning. The cyclical passing of time from night to day is announced by the crescendo crow of overeager roosters and the staccato song of their aerial accomplices. Shortly after, I am spurred into motion with Mass at dawn. From the chapel window of our hospital’s convent I see the steadily arching sun rising from the east and the slightly faster current of the Napo River patiently crawling its way down south to meet the Amazon River. Within the chapel walls I hear our hymns and prayers soaring upward to our Creator while, at the same time, I see and feel His real presence coming downward to meet us in the form of bread and wine. After the morning nourishment of the Holy Mass, I make my way to the hospital with a persistent, though often difficult, intention: to share this sustaining bread I have received with others. Depending on the mercurial mood of the tropics, fog rises up, gratefully consumed by a hungry, bottomless atmosphere, or rain plunges down, received with open arms by a thirsty, porous earth. A quick glance into the horizon reveals patients approaching slowly, but surely, as they climb up the hill to register their appointments. Alongside the patients, hospital staff conspicuously clothed in an array of scrubs and Ministry of Health uniforms set a quicker pace, signaling the forthcoming start to the work day.

The day seems to be picking up speed, but only for a moment. Uninhibited, absent-minded motion is shortly overcome with a single-minded stillness as all staff come together in one large circle. It is here that our multidirectional daily motions are united in a unidirectional trajectory originating in the Sign of the Cross, a brief reflection, the Lord’s Prayer, and a prayer to our Holy Mother.

As the day goes on, I am reminded of the stillness that surrounds me here. It is in this stillness that I discover a beautiful, necessary, and carefully designed paradox: motion in the stillness.

I have been in Peru for just over one month now, enough time to witness this paradox in full force. Sometimes the stillness is more difficult to bear and understand and the motion more difficult to see and appreciate. But one thing I know for sure- God is always active, working even if and when we don’t see it…

A child with a swollen abdomen arrives by boat from a community eleven hours away. The doctor orders a stool exam to check for parasites. Through the lens of the microscope, the lab technician recognizes the dormant egg of a round worm named Ascaris. The diagnosis becomes clear, the culprit of the child’s swollen belly a load of mobile parasitic worms. The lab technician gives us more valuable information. The boy also has a condition in which his kidneys are dumping out protein, causing fluid to shift into his tissues; this better explains the swelling around his eyes and in his legs. After two weeks of daily exams and frequent ultrasound evaluations it’s time for him to leave the hospital. Only this time what is usually our quick friendly exchange of a daily high-five turns into a firm grasp of my hand that doesn’t let go. Motion in the stillness.

At the break of dawn the hospital administrator and I set out on a “rapid” boat to evaluate a pregnant woman with bleeding who lives a couple of hours away. When we arrive her bleeding has stopped, but, as Doppler soon communicates to us, so has the heartbeat of her unborn child. The woman accompanies us on the boat ride back to the hospital. Though we are gliding over the water too quickly to make out the various animals swimming in the murky river waters, I feel the stillness that is present in the fruit of her womb. But I need to see it, confirm it with an ultrasound, before we decide the next steps; so, we keep moving. A while later, an ultrasound divulges the secret: the hidden motionlessness of her child’s heart. Motion continues- tears stream down the mother’s face, inadequate words of consolation depart from my mouth, a boat arrives to take her to the city of Iquitos to induce labor where replacement blood is more readily available. In a moment of stillness I recognize God’s guiding hand in it all- the rural health post was getting ready to send her home; had we not been sent that morning, the mother may have suffered from severe infection, bleeding, and possible death. Motion in the stillness.

I am in the outpatient offices when I receive a message that an elderly woman has arrived at the emergency room with severe abdominal pain. I make my way to the ER where the woman is writhing in pain and a gentle touch of her abdomen is met with a rigid jolt. With a sure sign of what health providers call an “acute abdomen” and without any words she tells me to get an X-ray. My US-trained mind secretly wishes for a CT scan, but I know that’s not available here. A quick review of the X-ray by my novice eyes reveals an obstruction of her bowel. We try to arrange transfer to the city for definitive surgical evaluation and management but distance and weather present themselves as a logistical shield to any forward movement. I consult our visiting gastroenterologist from Spain who reviews the still black and white image of her abdomen. Edema, swelling, in the walls of the intestines, he explains, is the X-ray’s way of communicating to us that her bowel is already dead. After a brief moment of hopeless inertia, I soon recognize this encounter as a working blessing in disguise. If it were not for the standstill imposed by inclement weather and transportation limitations as well as the gastroenterologist’s expertise in X-ray interpretation, we likely would have sent the patient out by water plane to Iquitos. In transport, or far away from home, she likely would have died without her family at her bedside, without a spiritual blessing from the priest in her last moments of life. We are able to alleviate her pain and distress with medications, and she passes from this life the next day. Though her body appears lifeless, she lives on in the life of her great-grandchild present at her bedside and with the reconciliation of her soul, she begins her journey along a celestial path. Motion in the stillness.

Just when I think the day can’t get any busier, a mother runs into the emergency room carrying her daughter in her arms. Though I am easily distracted by the abnormally-shaped skull of the infant in front of me, I try to focus my attention on the emergency at hand. The infant suffers from a rare condition called pancraniosynostosis, a result of premature closure of the spaces between her skull bones. The nurse determines the infant has a fever, I quickly recognize the infant is having a seizure, and the mother explains the unresponsive infant has been having abnormal movements for more than thirty minutes. Together we arrive at a diagnosis: complex febrile seizure with status epilepticus. I scramble to determine which anti-seizure medicine and its proper dose to give while the nurse scrambles to place an IV. An injection of anti-seizure and anti-fever medicine into her muscle does nothing. The pediatrician happens to walk by and begins to assist me with additional medication dosing. Only after one hour and three additional doses of anti-seizure medication does her predictable, rhythmic jerking finally come to a relieving halt. Tranquilizing stillness slowly replaces distressing spasm. Only now the stillness brings uncertainty- how will the infant recover from this prolonged cerebral attack? The next morning, the infant is heard joyfully cooing from behind the curtain as her mother gratefully welcomes another day to love her child. Motion in the stillness.

An elderly woman arrives to the emergency room in her wheelchair. She has a history of severe heart failure and an abnormal heart rhythm. As my stethoscope touches he chest the frantic beating of her heart makes me nervous, and I see a similar feeling in her face. She can’t get enough air to speak in a full sentence, but her body gives us enough information to act in full force. We give her some oxygen, try to remove some fluid from her body with medication, and start her on antibiotics for suspected infection. An ultrasound reveals a perpetrator of her heart’s chaotic motion, an unwelcome and dangerous pocket of fluid surrounding her heart. Unfortunately our hospital does not have the medicines to slow her heart down or restore its normal rhythm or the equipment to relieve the fluid around her heart. Her heart continues its solitary race despite the silent protests of its exhausted teammates: her worn out lungs, frugal kidneys, and stiffened blood vessels. I explain to her and her family that we are doing all we can. Her body cooperates just long enough to say, “Thank you, doctor, and God bless you.” With her last words to me, the life-taking motion of her heart moves my heart in a life-giving way. Motion in the stillness.

“The Lord will fight for you, and you have only to be still.” 

- Exodus 14:14

It is common for the power to go out here unexpectedly (like at Mass one evening in the picture above). Fortunately, the light always works its way into the darkness just as His motion works its way into the stillness of our lives.