Jack Voelkel
Steve and Mary Hawthorne: Family Medicine
(This guest article, excerpts from a prayer letter written by Steve Hawthorne, M.D., in Oct 06 shares a contemporary missionary experience. Steve and his wife Mary have been serving in Bolivia for 17 years with SIM. They have three children.)
A Gratifying Moment
When our local school hosted a sports invitational, I treated some of the participants’ scrapes and bruises. I was seeing one such 12-year-old boy from out of town when I noticed a note on his chart in my hand-writing from 1998. He came in then with an exposed fracture of his humerus [the long bone of the upper arm]. I had no recollection of him, but when I looked, I found the scar just above his elbow in the inside. For some reason that was an extremely gratifying moment for me – not just to see a good result from a long-forgotten intervention, but to see the trust in the eyes of that Quechua boy and his father, and to realize how long we have survived in this dry corner of the world.
Mary and I have lived here three times as long as we’ve worked anyplace else. Since getting my medical degree in 1985, we were 3 years in Chicago, 1 in western Illinois, 3 in Cochabamaba, 3 in Chilimarca, 2 in Sucre, and now almost 9 years in Yawisla [Bolivia] The babies I first delivered here are sturdy third-graders.
UbaldinaOne of the first Yawisla women whose delivery I assisted in 1998 was Ubaldina. She was 22 then, and it was her second baby. She ran a small produce store on the corner. She always had a cheerful smile for passers-by that I missed when her husband decided to move the family back to his town of origin in a distant part of Bolivia.
A month ago Ubaldina reappeared in my office – gaunt and walking painfully. A distinct smell of something rotting clung to her. My exam revealed a large cancer of the uterine cervix extending into her hip. The health worker in the town where she was living (who never screened her with the PAP test) told her that her case was hopeless. But Ubaldina is a fighter. She has four young kids now and isn’t ready to abandon them so easily, even through she has no health insurance and no savings. In dire pain, she carried her youngest child on three long bus rides to return to me – the first doctor she had ever known.
Through our presence here, Mary and I hope the Quechuas perceive the reality of God in their midst; and so know to “know and rely on the love God has for them” (1 John 4:12-16). I called my friend at the radiation oncology center in the city, and drawing on the financial resources our supporters provide, Ubaldina is in her third week of treatment and responding well.
Some Comic ReliefAny medical practice is in need of some comic relief, and mine is provided by my coterie of Little Old Quechua Ladies. They were born long before there were rural schools, so they never learned to read or write or speak any Spanish. They are the repositories and guardians of traditional folk beliefs and tend to look askance at my way of doing things. So I take it as a vote of confidence when one comes to see me, and I’ve become somewhat of a specialist in their problems.
Mrs. Choque came in with the common complaint of yuyayniy chinkan “my mind gets lost.” This I interpret as dizziness. She added: Manaña sirvinichu rabiakunaypac, which roughly translates as “Doc, I just can’t get furiously angry, yell and scream, chuck a wobbly, throw a tantrum, etc., like I used to. Now when I try, I get a pain right here,” at which point she poked a dirty finger under my ribs to make sure I understood.
I asked her to loosen her petticoats and get up on the exam table. The former operation involves untying multiple knots, so I made a few notes in her chart while she struggled with them. When I turned back from my desk I found myself at eye level with a pair of wrinkly knees peeping out of from under very dirty skirts. My exam table is to average height, but these ladies are quite short, so I have a stepping stool to help them ascent. Not knowing clinic protocol, but anxious to please, she just kept on climbing until was standing on top, looking quite pleased with her accomplishment!
Pediatrics, obstetrics, oncology, geriatrics, anthropology – family medicine has it all!
Opposition Tactics
For school, my daughtert Anne Marie read Arthur Koestler’s 1941 book Darkness at Noon, about the Moscow trials. Rubashov, a leader of the Communist Party since the revolution, no longer agrees with the direction the Party has taken. Reflecting on the options open to the opposition, he sees only three alternatives: to seize power by a coup d’etat; to give up and die in silence; or to continue living as a cog in the system, denying and suppressing his own convictions when there is no prospect of materializing them.
I resonate with Rubashov’s dilemma. I became a missionary doctor because I wanted to make a difference. That means changing things from the way they presently are, which implies not being satisfied with the status quo, which puts me in the “opposition.” I am opposed to cancer, to alcoholism, to family violence, to a local school system that wastes the children’s potential, to a local church more concerned with rules than with the power of God, to a government health care system that values party loyalty over competence.
I’ve considered Rubashov’s options: getting violently angry and attacking the miscreants causing the problems; leaving Bolivia; or staying on but giving up the struggle of swimming upstream and just drifting with the current. None of them appeal, and feeling chronically dissatisfied can breed an ugly, critical spirit in me. What alternatives are there between open war and sullen withdrawal?
Following in Jesus’ Steps
I am teaching through 1 Peter in church, and this Sunday we came to 2:21 – “To this you were called, because Christ suffered for you, leaving you an example, that you should follow in his steps.” Jesus came to destroy the devil’s work. He absorbed abuse and opposed disease, injustice, and hypocrisy without hatred and without resignation. How, exactly? Well, it had to do with little things like hope, love, intimacy with God his Father, abundant life, banquets, and great wine.
We have our struggles in Bolivia, and you stand against the cultural drift in North America and elsewhere. Let us pray for each other that we learn what it means to follow in Jesus’ steps, opposing sin not with frowns and gritted teeth, but with joy in the good news of the Gospel, starting in our marriages, homes, and work relationships.
Points to Ponder (from Jack Voelkel)
1) Why are Steve and Mary in Bolivia?
2) What impresses you about him as he shares his experiences and his thoughts?
3) How valuable is his presence there in Yawisla?
4) What can you learn from his reflections?
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