Grow where you are put

We spend a large quantum of our thoughts and efforts contemplating places that we would like to be, places we wished we could be in, places that we have been in the past. How much time and effort do we spend on  the place we are in now?

“Lillies grow where they are put.” This statement from Oswald Chambers is profoundly simple.  Lillies have been held up as an example to us about the provision available in all of nature, a lovely reminder that the world does go around, despite us. Our whirlwind lives often zip right by this wayside parable. And in our race to move on, get ahead, go places, the quiet beauty of a flower growing where it is put holds out a meaning that we might just miss.

How can we grow where we are put?  Just as provision exists for the growth of that flower, our current circumstances have been provided for. This truth holds, even if our current circumstances are difficult, dangerous, or excruciatingly painful.  Those circumstances might even be desperately boring or seemingly unfulfilling.  Flower petals bedecked with dew should remind us that provision permeates the gaps.

Every day awakens the potential to grow, to read, to remember, to consciously develop  ourselves. Resources exist all around even in seemingly desperate situations.  The internet is a huge resource, readily available. People all around us possess wisdom and experience untapped and unrecognized.  That which is in our hands can hold out hope for others.

I remind myself of an graphic incident from my posting in Jadaghri mission hospital. The hospital was about to close. One hundred beds lay empty, with the water and electricity bills not paid.  For a whole month of my posting there was no work. One day, a patient was brought with head injury, seizing, despite every intervention to control the convulsions. Advice to transfer the patient to a higher centre in Chandigarh was met with despair and blank looks from the relatives who were not able to afford the cost of transfer.  The patient would need a surgery. There was no anesthetist, no neurosurgical tools to operate.  A search of the hospital yielded one metal screwdriver and a metal hammer in the maintenance department. I asked the nurse to autoclave these and calling in an anesthetist from another town, made holes in the skull to relieve the pressure. The convulsions stopped. Even a hammer and a screwdriver can become crude  implements that save life.  This story is a reminder to me never to give up. Never give in.  Search for what is available locally and use it. Grow. 

Gossip

Providing feedback is an essential part of  complete communication. The person who communicates has a responsibility to be clear, but his message may often be misunderstood because of the various barriers that hinder communication. Leaving an avenue open for the completion of the communication cycle is very important to facilitate correct communication. This is the responsibility of the person who communicates. The responsibility of the listeners is to respond constructively.

Feedback given inappropriately is destructive. At work and also within interpersonal relationships, providing feedback often follows patterns of gossip rather than being constructive.

Gossip tends to follow the “grapevine” at the workplace, a network of interlinking relationships based on relationship clusters that cross hierarchies and boundaries. Novelty and not the truth, is the fodder of gossip. The problem is that it continues to seek further novelty in order to sustain the relationship, which is not based on true affection or regard. Hence gossip circles become progressively malevolent  at the cost of those in the immediate environment. It is a sort of cancer, growing and feeding upon itself.

 

Gossip hides in the garb of concern. When examined, the entertainment value overwhelms true concern for people or issues.  It is a selfish habit, that propagates out of selfishness.

Gossip does not own or bear responsibility. When confronted, it disappears into the forest of unaccountability and takes shelter in the woods of irresponsibility.  It  cannot be found to be stamped out or exterminated, burrowing into caverns of camouflaged cowardice.

Gossip is progressively delightful,  and once tasted,  inspires a deep yearning for more. It is like an addiction, shackling the soul. Society frowns on addictions to alcohol and dens of substance abuse, but little recognizes that dens of gossip permeate our workplace shackling individuals and institutions with its tentacles.

What can be done to break this pervasive habit?

First it has to be recognized for what it is.  Its masquerade needs to be uncovered and its malevolence recognized by all. Individuals have to recognize the seeds gossip within themselves and be motivated to exterminate them.  Some ground rules may help:

1.     Truly and sincerely examine whether you seek the best of the other individual and of the institution.

2.     Respect one another enough to confront in love.  When doing this, try and follow these steps:

a.     Protect privacy by confronting in private and not in public

b.     Own responsibility by using the first person, such as “I heard” or “i understood”

c.      Seek clarity by expressing your doubt and inviting explanation

d.     Listen and give the other person the benefit of the doubt always.  We often come at people with preconceived notions, having already judged them prior to them speaking. This does not allow us to listen or understand the other person.

3.     Quench gossip wherever you encounter it by replacing the lie with the clarified truth, and by refusing to listen about another person when the person is not in the room or has had a chance to speak on his or her own behalf.

Unless an institution decides on a “zero gossip tolerance” it will not weed this malevolence out. Some institutions have even decided to terminate employment if this habit is practiced. It is an indicator of how seriously they protect the environment within. 

EMERGENCY - 24 HOURS

Providing an adequate response to any medical emergency round the clock is a formidable task. It involves having a well trained team, being able to mobilise it, and respond quickly and appropriately every time.

We are in a mountainous area, prone to accidents, landslides and varied presentations of trauma. Vehicles tumbling down steep ravines, floods washing bridges away and buses overturning are annual affairs. Though assaults and gunshot injuries are rare, there are enough people getting involved in fights to provide patient material to our emergency room. Besides trauma, there has been a rising incidence of heart attacks, and strokes among the local populace. Organophosphorus poisoning is commonplace, with comatose people arriving having consumed it with a suicidal intent.

In many mission hospitals, there used to be a system of a call book. There was a book in the emergency room. This book used to be filled by the nurse on call, and handed over to the security guard, who would proceed to tramp through snow in winter or saunter to the doctors house in good weather. Usually the doctors quarters would be located within the campus, at a variable distance from the emergency room.  Such a call system is totally inadequate in its response time to relevantly provide timely help in the narrow window period that is available to save a life. Sometimes the security guard may even decide to refresh himself with a smoke under a tree prior to delivering the call.

Telephones replaced that system, with landlines interconnecting the campus. Today mobile phones have come into vogue and even replaced the earlier system of black pagers hooked to the belt which made doctors feel very important. However, even this system is awkward and expends precious minutes waiting for the doctor to arrive, which can mean lives lost.

When we first arrived in Manali, resuscitation was more of a last rite than a genuine attempt at saving life.  Precious minutes were lost in waiting for the doctor to arrive prior to the initiation of resuscitation. We initiated a hands on course in resuscitation for all the nurses in cpr, which did make a difference. A further obstacle was being able to have the resuscitation equipment handy. Older wards often have narrow stairs which are formidable obstacles to the emergent transport of life saving equipment. We filled a plastic toolbox, the kind that is available in any department store with emergency drugs and equipment and provided them at every station. These can be grabbed on the go and made the initial response of the nursing staff much more effective.

At code sites, having enough hands available is an essential component to resuscitation. Tertiary institutions have a “code blue” protocol, where a code pager buzzes madly summoning a multitalented team to the bedside of the patient in minutes. Other institutions have had a system of overhead announcements or lights flashing indicating the emergency.  We provided a siren in different wards, with different tones indicating the location. The siren can be heard all over the campus, and proved very effective in summoning those within earshot to the location of the emergency.

Over time, with each of these developments, we have been able to revive patients who present to the emergency room pulseless or not breathing adequately for whatever reason.  In fact, when when a pulseless patient was revived, one of the nurses eyes suddenly lit us as she realized that “This actually works!”

Mobilising the operating theatre within minutes is also a formidable task. Having the scrub team and the anesthesia person within a few minutes of beckoning means stationing them within the campus. Because Manali is a small place, we have been able to move massive trauma to the operating table within ten minutes, which is an adequate response by any standard. This too has resulted in precious minutes and lives saved.

Though BLS and ACLS and ATLS today are buzzwords with a large amount of documented data on implementation and protocolisation, this does mean different things to different people at varied locations. Each area will have to modify and tweak the practical outworking of the resuscitative attempts. The bottom line being, it has to be efficient, immediate and effective, all the time, every time.

CALL

http://utmost.org/classic/today/  from Oswald Chambers…

God did not address the call to Isaiah; Isaiah overheard God saying, "Who will go for us?" The call of God is not for the special few, it is for everyone. Whether or not I hear God’s call depends upon the state of my ears; and what I hear depends upon my disposition.

It is not a question of God singling out a man and saying, "Now, you go." God did not lay a strong compulsion on Isaiah; Isaiah was in the presence of God and he overheard the call, and realized that there was nothing else for him but to say, in conscious freedom, "Here am I, send me." Get out of your mind the idea of expecting God to come with compulsions and pleadings. When our Lord called His disciples there was no irresistible compulsion from outside. The quiet passionate insistence of His "Follow Me" was spoken to men with every power wide awake.

Call is ongoing. It is not history. It is not just event. It is process. It starts with an event, but becomes process. It requires a mind attuned and ears unstopped to be able to hear to respond relevantly. The call of God goes out every morning with the first rays of sunshine across the dew laden grass. It hides in the whisper of the wind in the trees, and bathes in the soft evening sunlight. Those who have eyes see, and those with ears hear.

Isaiah was able to hear only after king Uzziah died and he saw the glory of God. Sometimes it requires our dependancies to be disconnected to allow us to see. And when we do see, we become aware of a whole world previously unperceived. A world of need, of hurt and pain that is crying out for restoration. The need travels from the heart of God to the heart of man, and the heart of man responds freely.

For us the call came from Luke 4: 18 in which it is written that He came to preach good news to the poor. It was very difficult to justify work among the rich once we have listened to this verse.  We resigned jobs in a teaching hospital to move here in Manali. For different people different things will burn into their brains indelibly and can never be forgotten.  They move us to respond.

The response to call should not stop. Just like the sun does not stop or the moon become bashful and hide the rest of the month. How attuned are we to these calls as each day proclaims them? And what is our response?  Let us listen well to hear well. 

MARY AND INSTANT COFFEE

There were two sisters who invited Jesus into their home. One was busy in the preparation of the dinner. The other just sat down at Jesus’s feet. The first was called Martha, the name of the second was Mary.

We live today in the age  of Martha’s legacy. Being busy has become a way of life as we rush around racing to beat a relentless clock desperately juggling various dishes. We serve up “overwork” as starters, proceeding to “unhappiness” as the main dish, accompanied by “anger” and “frustration.” We drink down “disappointment” and break the bread of “fractured relationships”. We are not satisfied with the cake of “Isolation” and finally drink coffee from the bowl of “being a very nasty person”. Little do we know that this brew is invisible to our own eyes, and only to the eyes of those who behold us.  All that this feast nourishes inside us are fractured homes, fractured relationships, failing health and early death.

How can we change this recipe for disaster? How can we still serve up a delectable meal yet balance our many caps? Dinner does come in a box nowadays, and from where can we order a takeaway that will be equally satisfying? Is instant coffee the solution?

Permanent change happens through choices made in love.  A smoking habit kicked for the sake of the wife. A change in eating habits because of a child.  Intermittent flashes of intention don’t bring lasting change. The change that happens because of love is lasting and permanent. If we are desperately in love with God will we allow Him to change us. Then the one who graces the meal will give us grace to serve it up devoid of the pungency of our own concoctions.