Too Much?

As medical professionals, we usually fantasize about wild and improbable situations: someone collapses in a restaurant – we splice them open with a butter knife, replace a valve with a hollowed our stick of carrot.

Most of our fantasies dissolve when we wake, banished to the back of our mind. But sometimes, we’re sure, if we try hard enough – we can live the dream.

The fantasy is simple, pleasure is good, and twice as much pleasure is better. That pain is bad, and no pain is better.

When you were a kid, it was Halloween candy. You hid it from your parents and ate it until you got sick.

In college, it was the heady combo of you, tequila, and… well… you know.

But the reality is different, the reality is that pain is there to tell us something. And there’s only so much pleasure we can take without getting a stomachache… and that’s ok. Maybe some fantasies are only supposed to live in our dreams.

As a medical professional, you take as much of the good as you can get, because it doesn’t come around nearly as often as it should. Because good things aren’t always what they seem. Too much of anything, even love, is not always a good thing.

How do you know how much is too much?

Too much too soon?

Too much information?

Too much fun?

Too much love?

Too much to ask?

And when is it all just too much to bear?

Crossing The Line

As medical professionals, we are trained to be skeptical – because our patients lie to us all the time. The rule is: every patient is a liar, until proven honest.

Lying is bad, or so we’re told, constantly, from birth. Honesty is the best policy, “I chopped down the cherry tree”… whatever.

The fact is: lying is a necessity. We lie to ourselves because the truth… well… the truth freaking hurts. No matter how hard we try to ignore it, or deny it, eventually the lies fall away – whether we like it, or not.

But, here’s the truth about the truth… it hurts. So, we lie.

In surgery, there is a red line on the floor that marks the point where the hospital goes from being accessible to being “off limits” to all but a special few. Crossing the line is not tolerated.

In general, lines are there for a reason; for safety, for security, for clarity. If you choose to cross the line, you pretty much do so at your own risk.

So why is it that the bigger the line, the greater the temptation to cross it?

We can’t help ourselves, we see a line – we want to cross it. Maybe it’s the thrill of trading the familiar with the unfamiliar, a sort of personal dare. Only problem is – once you’ve crossed, its almost impossible to go back.

But, if you do manage to make it back across that line, you find safety in numbers.

Benin - 161

Human Development is a development paradigm that is about much more than the rise or fall of national incomes. It is about creating an environment in which people can develop their full potential and lead productive, creative lives in accord with their needs and interests. People are the real wealth of nations. Development is thus about expanding the choices people have to lead lives that they value. And it is thus about much more than economic growth, which is only a means —if a very important one —of enlarging people’s choices.

Fundamental to enlarging these choices is building human capabilities —the range of things that people can do or be in life. The most basic capabilities for human development are to lead long and healthy lives, to be knowledgeable, to have access to the resources needed for a decent standard of living and to be able to participate in the life of the community. Without these, many choices are simply not available, and many opportunities in life remain inaccessible.

This way of looking at development, often forgotten in the immediate concern with accumulating commodities and financial wealth, is not new. Philosophers, economists and political leaders have long emphasized human wellbeing as the purpose, the end, of development. As Aristotle said in ancient Greece, “Wealth is evidently not the good we are seeking, for it is merely useful for the sake of something else.”

In seeking that something else, human development shares a common vision with human rights. The goal is human freedom. And in pursuing capabilities and realizing rights, this freedom is vital. People must be free to exercise their choices and to participate in decision-making that affects their lives. Human development and human rights are mutually reinforcing, helping to secure the well-being and dignity of all people, building self-respect and the respect of others.

The 2009 Human Development Report

1. Norway
2. Australia
3. Iceland
4. Canada
5. Ireland
6. Netherlands
7. Sweden
8. France
9. Switzerland
10. Japan
11. Luxembourg
12. Finland
13. United States
14. Austria
15. Spain
16. Denmark
17. Belgium
18. Italy
19. Liechtenstein
20. New Zealand
21. United Kingdom
22. Germany
23. Singapore
24. Hong Kong, China (SAR)
25. Greece
26. Korea (Republic of)
27. Israel
28. Andorra
29. Slovenia
30. Brunei Darussalam
31. Kuwait
32. Cyprus
33. Qatar
34. Portugal
35. United Arab Emirates
36. Czech Republic
37. Barbados
38. Malta
39. Bahrain
40. Estonia
41. Poland
42. Slovakia
43. Hungary
44. Chile
45. Croatia
46. Lithuania
47. Antigua and Barbuda
48. Latvia
49. Argentina
50. Uruguay
51. Cuba
52. Bahamas
53. Mexico
54. Costa Rica
55. Libyan Arab Jamahiriya
56. Oman
57. Seychelles
58. Venezuela (Bolivarian Republic of)
59. Saudi Arabia
60. Panama
61. Bulgaria
62. Saint Kitts and Nevis
63. Romania
64. Trinidad and Tobago
65. Montenegro
66. Malaysia
67. Serbia
68. Belarus
69. Saint Lucia
70. Albania
71. Russian Federation
72. Macedonia (the former Yugoslav Republic of)
73. Dominica
74. Grenada
75. Brazil
76. Bosnia and Herzegovina
77. Colombia
78. Peru
79. Turkey
80. Ecuador
81. Mauritius
82. Kazakhstan
83. Lebanon
84. Armenia
85. Ukraine
86. Azerbaijan
87. Thailand
88. Iran (Islamic Republic of)
89. Georgia
90. Dominican Republic
91. Saint Vincent and the Grenadines
92. China
93. Belize
94. Samoa
95. Maldives
96. Jordan
97. Suriname
98. Tunisia
99. Tonga
100. Jamaica
101. Paraguay
102. Sri Lanka
103. Gabon
104. Algeria
105. Philippines
106. El Salvador
107. Syrian Arab Republic
108. Fiji
109. Turkmenistan
110. Occupied Palestinian Territories
111. Indonesia
112. Honduras
113. Bolivia
114. Guyana
115. Mongolia
116. Viet Nam
117. Moldova
118. Equatorial Guinea
119. Uzbekistan
120. Kyrgyzstan
121. Cape Verde
122. Guatemala
123. Egypt
124. Nicaragua
125. Botswana
126. Vanuatu
127. Tajikistan
128. Namibia
129. South Africa
130. Morocco
131. São Tomé and Principe
132. Bhutan
133. Lao, People's Dem. Rep.
134. India
135. Solomon Islands
136. Congo
137. Cambodia
138. Myanmar
139. Comoros
140. Yemen
141. Pakistan
142. Swaziland
143. Angola
144. Nepal
145. Madagascar
146. Bangladesh
147. Kenya
148. Papua New Guinea
149. Haiti
150. Sudan
151. Tanzania, U. Rep. of
152. Ghana
153. Cameroon
154. Mauritania
155. Djibouti
156. Lesotho
157. Uganda
158. Nigeria
159. Togo
160. Malawi
161. Benin
162. Timor-Leste
163. Côte d'Ivoire
164. Zambia
165. Eritrea
166. Senegal
167. Rwanda
168. Gambia
169. Liberia
170. Guinea
171. Ethiopia
172. Mozambique
173. Guinea-Bissau
174. Burundi
175. Chad
176. Congo (Democratic Republic of the)
177. Burkina Faso
178. Mali
179. Central African Republic
180. Sierra Leone
181. Afghanistan
182. Niger

Mercy Ships 2009: Benin - 161

Mercy Ships 2010: Togo - 159

Mercy Ships 2011: DR Congo - 176

(or) Angola - 143

(or) Ivory Coast - 163

(The three countries listed for 2011 all being rumors... nothing is set in stone for 2011 as of yet.)

Just one more reason to be here, doing what we're doing, living the dream.

Human Development Reports. (2009, Oct 23). Human Development Report 2009, Overcoming barriers: Human mobility and development. Statistics of the Human Development Report. Retrieved from http://www.hdr.undp.org/en/statistics/

There's No Where Else I'd Rather Be

I was born on Friday, October 21st, 1983 at Blessing Hospital in Quincy, Illinois (with a life expectancy of 74.6 years) under the President of Ronald Reagan and Vice President George Bush. I assisted in making the U.S. population 233,791,994 that year, and the World population 4.690 billion. Not only was I born this day, but at the 17th General Conference on Weights and Measures, the metre is defined in terms of the speed of light as the distance light travels in a vacuum in 1/299,792,458 of a second. I know, right!

Some of the hit singles that year include – “Africa” by Toto, “1999” by Prince, “Thriller” by Micheal Jackson, “Cut Like A Knife” by Bryan Adams, “New Year’s Day” by U2, and “Sharp Dressed Man” by ZZ Top. The top 5 movies of 1983 were Return of The Jedi, Terms of Endearment, Flashdance, Trading Places, and War Games.

Price of things in 1983:
Average Cost of new house $82,600.00
Average Income per year $21,070.00
Average Monthly Rent $335.00
Dodge RAM 50 Truck $5665.00
Gallon of Gas $0.81
First Class Stamp $0.20
Dozen Eggs $0.86
Gallon of Milk $2.24

Other highlights of 1983:
Unemployment rose to 12 million, the highest figure since 1941, hurricane Alicia hit the Texas coast killing 22, the U.S Embassy was bombed in Beirut killing 63 people, a 5.2 earthquake hit Central New York, Richard Noble set a new land speed record of 633.468 mph driving Thrust 2 at the Black Rock Desert, Nevada, and Sally Ride became the first American woman in space on the Space Shuttle Challenger.

The Super Bowl was Washington vs Miami (27-17), World Series was Baltimore vs Philadelphia Phillies (4-1), NBA Championship: Philadelphia 76ers vs LA Lakers (4-0), Stanley Cup: NY Islanders vs Edmonton (4-0), Wimbledon Women: Martina Navratilova vs A. Jaeger (6-0 6-3), Wimbledon Men: John McEnroe vs C. Lewis (6-2 6-2 6-2), Kentucky Derby Champion: Sunny's Halo, NCAA Basketball Championship: N.C. State vs Houston (54-52), NCAA Football Champions: Miami-FL (11-1-0)

Crack cocaine was developed in the Bahamas, and soon appeared in the United States. The FCC authorized Motorola to begin testing cellular phone service in Chicago. The El Niño phenomenon disrupted global weather patterns. Henry Taube showed research on how electrons transfer between molecules in chemical reactions. Subrahmanyam Chandrasekhar and William A. Fowler showed complementary research on processes involved in the evolution of stars. Barbara McClintock discovered mobile genes in the chromosomes of a plant that change the future generations of plants they produce.

All of this, the day and the year I was born. In my 26 years, what have I learned? After careful consideration, immense sleepless nights, here’s what I’ve decided…. There’s no such thing as a “grown-up”. We move on, we move out, we move away from our families… and form our own. But the basic insecurities, the basic fears – all those old wounds, they just grow up with us. We get bigger, we get taller, we get older, but for the most part – we’re still a bunch of kids, running around the playground – trying to fit in. I’ve heard that its possible to grow up, I’ve just never met anyone who’s actually done it. Without parents to defy, we break the rules we make for ourselves. We throw tantrums when things don’t go our way. We whisper secrets with our best friends in the dark. We look for comfort where we can find it. And we hope – against all logic, against all experience. Like children, we never give up hope.

Hope for a great year, because right now, there's no where else I'd rather be than celebrating my 26th birthday.... on a ship.... in Africa.

To Be Someone Tomorrow

Janviera can recount the afternoon with precision – it was a Thursday, the 23rd of October, 2008. She recalls how her children came home from school a little late, how they sat by lamplight with their tutor, and how the kerosene ran out.

Carole, the only girl in a family of five children, was always by her mother’s side. She helped take care of the other four children and helped clean the house. When Janviera needed things from the market, Carole would go and buy them. She helped cook – even the very difficult local cuisine, fufu. She helped with everything.

So that evening, as usual, Carole helped by refilling the lamp. She began to pour the kerosene, which they later guessed had been mixed with gasoline. Because Carole could not see very well, she called to her mother, and Janviera took over. Suddenly, the lamp exploded, and everything went black.

“I woke up on the other side of the room,” Janviera says. “I looked down and saw my arm was burned. Then I looked across the room and saw Carole. She was unconscious, and her school dress was still burning.”

She grabbed a blanket, threw it across Carole’s body, and immediately rushed her daughter to the hospital. Pictures taken there show Janviera disheveled and tired, holding her arm out stiffly. And they show Carole – lying on her back, her face swollen and blackened, her body covered in bandages and talcum powder.



“As a mother, I had to put my own pain aside,” Janviera recalls, glancing at the mottled scars on her left arm and hand. “I could only think about Carole. I was always crying, constantly asking God to save my daughter.”

It was three weeks before Carole was able to eat any food. Her mouth and eyes had been burned shut. Each day she received dressing changes, removing dead skin and applying ointment to the wounds. She was in extreme pain. Sometimes Carole’s wounds would stick to the sheets of her bed, and they would have to soak her in water and separate her from the fabric – agonizing bit by bit.

“We spent so much money for the treatment,” Janviera said. After three months of treatment, Carole’s arm was frozen, unable to extend past a right angle, with her palm turned out like a question mark. Her right cheek and arm, as well as her side, stomach, and chest were covered with raised scars of shiny, inflexible skin.

At school, her burns became an opportunity for cruelty. “If Carole did something that one of the kids didn’t like, they would say, ‘You have a burned face. You have a burned body.’” At home, she could no longer help her mother around the house because of her contracted arm.

Janviera heard about Mercy Ships through a radio advertisement, and she brought Carole to Cotonou for an operation onboard the Africa Mercy. The surgical team released contracted scar tissue and placed skin grafts at her elbow and wrist.




Kim Shankland, an occupational therapist from South Africa, worked with Carole after the surgery to help improve the range of motion in her arm and wrist. Kim says that without surgery, Carole would have struggled her whole life with basic self-care – “just eating, braiding her hair, brushing her teeth, and dressing would have been a huge problem.”



Later in life, she would have faced obstacles in supporting herself. Common jobs, like selling yams and tomatoes at the market or pursuing a trade like sewing, would have been impossible. She would have been forever dependent on family or a husband.

“As a mother, knowing what sort of difficulties your child would have – not being able to do the things you do – must be quite frustrating,” Kim says. She believes this has spurred Janviera in making sure Carole uses her injured arm and performs the rehab exercises. Janviera’s encouragement and insistence has been a major part of Carole’s successful recovery.

“I hope that she can be my helper again,” Janviera says. “But what I want most is for her to be able to use her hand, to write, to be someone tomorrow.”

While In Benin, Togo Smiles

The Mercy Ships Dental Team recently travelled to Lokossa, Benin, in order to run a two-day dental clinic at a nearby refugee camp. The camp of Agame was formed in 2005 to accommodate Togolese refugees who fled neighboring Togo shortly after violence erupted during elections.

Agame became home to more than 12,000 refugees, most of whom had lost all their possessions in fleeing the escalating hostility. The population has since decreased to around 3,000, with many of the refugees either resettling in Benin or returning to Togo.

The United Nations High Commissioner for Refugees (UNHCR) has had a prominent presence within Agame since 2005, helping with the provision of shelter, basic health, water, and sanitation, as well as facilitating the establishment of a refugee-led council to manage social issues.



Though the camp has become self-sufficient in the past four years and no longer requires aid, several organizations still assist where they can. Mercy Ships was requested by the UNHCR to visit Agame and address the need for dental care.

Jessica Campbell, Dental Team Coordinator, and her team of 22 happily agreed to travel the three-hour journey from the port of Cotonou to the camp of Agame. “We performed only extractions and saw every person that requested treatment, which was around 160 people,” she said. “Some required the extraction of frontal teeth. With the assistance of the UNHCR, they will be brought to the Africa Mercy within the coming weeks to receive dentures.”

Cooperation between Mr. Ebri Koku, Health Administrator for Agame, Mrs. Florence Fassassi, UNHCR Facilitator for Benin, and Mr. Nicaisse Satoguina, Camp Manager and Benin Government Representative, ensured that the Mercy Ships Dental Team was provided with accommodation, food, and a suitable area of operation, as well as organizing the names of refugees that required treatment.



“Everything at the camp was very organized. We had no problems,” said Campbell. “The whole team loved the experience. It was great to get back to the basics of dentistry without all the fancy equipment and to help people who are in serious need and have no other means of help,” she added.

Belinda, a refugee who fled Togo with her husband and four children, was one of many patients who had their lives improved by the free service provided by Mercy Ships. Suffering from a severe cavity in one of her molars, Belinda required a tooth extraction. “It was not too painful when they took it out, but I feel free now,” she explained. “I can laugh again. I feel free.”

Mr. Koku expressed his gratitude for the work done by the Mercy Ships Dental Team: “Since Mercy Ships has come, we have been made aware of the need for oral hygiene in our community. We are very happy about the treatment we have received. We want to thank Mercy Ships for all the work they have done here in Agame.”

This brief partnership between Mercy Ships and the UNHCR has provided 160 struggling refugees with relief from toothache and has educated hundreds more on the importance of oral hygiene. With the 2010 Field Service planned for Togo, Mercy Ships hopes to continue bringing hope and healing to the Togolese people and their country, and indeed all of West Africa.

I Want Nothing More Than To Be In Your Shoes

"I turn 26 in three weeks... which really isn't a big deal... but then I realized that I'm definitely on my way to 30... and that scares me. I mean... I don't have a life. I'm single, homeless.... don't really have alot going for me (other than I'm debt free!)".

I was quoted saying this in a recent e-mail to a friend. I say this because... well, the dream is this: that we will finally be happy when we reach our goals. Find a guy, have a good job… that’s the dream. My goal has always been Africa, but its funny how much that loses meaning once reached.

He then responded by saying, "I'm sorry to hear you're feeling so unsettled. I've been thinking about your e-mail since I read it a couple of days ago, marveling at how little we appreciate what we have. I've got everything you say you want-I'm in a relationship, with a house--and I want nothing more than to be in your shoes."

Then, when we finally reach our dream, and if we’re human… we immediately start dreaming of something else. Because, if this is the dream… then we would like to wake up… NOW, PLEASE!

At some point, maybe we acknowledge that the dream has become a nightmare. We convince ourselves that reality is better. We persuade ourselves that its better that we never dream at all.

But the strongest of us, the most unwavering of us… we cling on to the dream... or we find ourselves with an unmarked dream that we in no way considered. We awake to find ourselves against all odds – feeling hopeful. And if we’re lucky, we realize – in the face of everything, in the face of life, the true dream is being able to dream at all.

My dream, my instilled desire to be here... its been renewed. Sometimes, sharing dreams... sharing struggles... sharing feelings... it can change everything.

You Can't Script October

My college campus has a magic statue, it’s a long standing tradition for students to rub its nose for good luck. My friend really believed in the statue’s power and insisted on visiting it before every exam. Studying, might have been a better idea – she flunked out her sophomore year.

But the fact is, we all have little superstitious things we do. If its not believing in magic statues, its avoiding sidewalk cracks or always putting our left shoe on first.

Knock on wood

Step on a crack-break your mother’s back.

The last thing we want to do – is offend "the gods".

Superstition lies in the space between what we can control, and what we can’t.

Find a penny, pick it up, and all day long you’ll have good luck. No one wants to pass up a good chance for good luck, but is anyone listening?

And if no one is listening, why do we bother to do those strange things at all?

We rely on superstition because we are smart enough to know that we don’t have all the answers… and that life works in mysterious ways.

October is, by far, my favorite month... for countless reasons really, but mainly because all the things that I love about the month are unpredictable.

I enjoy the arbitrariness of the weather that comes with the season of fall: the warm days, crisp nights. I love Love LOVE Halloween!, and we all know how erratic that can be...

When in America, I frequent The Apple Barn where you can find unsurpassed apple cider, caramel dipped apples, pumpkins, and all the finest Halloween decorations.

And most of all - The World Series. There is nothing more fickle than The World Series... and as the saying goes, "You can't script October!"