Monday, June 27, 2011

Perilous Passion

“Is he always this passionate?”

The inquirer was making a site visit from the Department of Health and Human Services, Maternal-Child Health Bureau, checking us out regarding a federal grant we sought. The question was rhetorical, more a commentary on my exuberance and enthusiasm regarding the needs of women and children in San Bernardino County and our proposed solutions than a request for information, but the answer Vanessa Long, our most capable program manager would have given was a decided “yes”. Today the answer haunts me.

My just-completed four days in an excellent South African hospital revealed several key pieces of information about me and my little stroke. First, there is no evidence that the stroke was caused by a clot or bleeding inside the brain. It was deep in the brain in an area called the thalamus, not on the surface as many more debilitating strokes are. Speech and thinking are not at all affected, thanks be to God, and there is little if any weakness. I’m numb on the left side of my body and a little uncoordinated on the left. And my head feels spacey (good medical term, “spacey”). While there’s no plaque or fat deposits in the walls of my arteries, their muscles are thicker than average. But the most important information was that my blood pressure tends to go through the roof (192/106) under any emotional situation, positive or negative. The nurses caught it up there several times, though 130/80 was more common. The high pressure probably caused spasm in a small penetrating artery serving the affected area leading to hypoxia and maybe then “terminal” spasm. Intense reactions to normal stimuli? Perilous Passion!

The passion that got me here (“Something has to be done to help our brothers and sisters in Africa deal with HIV.”) could well take me out. And yet it has always created difficulties. Beginning probably in grade school, some of you will remember the kid on the front row who got C’s in conduct in part because his hand insistently waved to answer every question. That passion has suggested to some that emotion has clouded reason, though I think it usually follows a reasoned conclusion. Some people resist the causes that passion supports just because of its intensity. “For every reaction there is an equal and opposite reaction,” and that may be true even within the body of this passionate individual. The current question is whether that passion can be controlled, modulated to avoid its destruction of the body which gives it expression. Putting it in a box will not likely serve its cause.

A few years ago I was invited to a prayer retreat put on by Randy Harris, Rhonda Lowry, and the then youth minister at the Malibu Church of Christ. It was to run from early Friday evening until Sunday afternoon. Getting across the LA basin took more time than I had allowed, and the retreat was beginning as I turned off Interstate 5 and headed into the Santa Monica Mountains. I relished the challenge of the mountain curves in my Honda Civic with the V-tech engine, and I got there, stoked, ere long.

What I remember most of the retreat was my feeling at the end after nearly two days of mostly praying, together and alone, with a little talk of prayer and meditation sprinkled in for guidance. First I didn’t want to leave. The place was not of paramount importance, but the rural setting was conducive to our goals, and the things that normally intruded were not there, so I loaded my car after lunch on Sunday so as to prolong uninterrupted the open-ended afternoon session in solitary prayer—just me and God. When I finally did leave, I felt no reason to rush, so no screeching of tires or exhilarating turns going down the hill, quite in contrast to the drive up. I felt no pressure to get home, not just because I had no appointments that evening, but none of the usual pressure that appeared within me raised its ugly head, created by my own internal demands to be busy, to do something. And so I was content to stay amongst the big rigs at 55mph easing down the interstate toward LA in the right two lanes. I was at peace. I was convinced of the value of what we had done, but I was contrastingly almost reluctant to speak of it. That passion was somehow different.

That peace remained largely intact through the night. I made some changes in my behavior that were suggested at the retreat, spending more time in the Word, especially the Psalms, changes that have been largely maintained to this day. But, those things gradually became one more part of the “to-do” list, the must do list and over a few weeks that deep inner peace gradually slipped away, crowded out by the press of a plethora of commendable activities, unprotected by my reading of the verses in the Psalms.

Today I am convinced that what happened at that retreat is a big part of the solution to the problem my self-destructive body is presenting. Don’t get me wrong. I am quite aware that we all must die, but 60 is relatively young, even (or maybe especially) for our family. In addition, more than sixty years of resistance training for my arterial muscles probably will require medication to assist in the task of keeping the BP down (and I’m on it), but learning to approach life on a little more even keel will probably reduce that medication requirement, and medication alone probably won’t do it. Finally, it was and is a good thing, that peace, in and of itself, and my colleagues in the kingdom would probably get along better with a Bruce no less committed but with a little less edge.

Thursday, June 23, 2011

Death of a (small part of the) Brain, Observed

I suddenly felt light-headed and my left hand was tingling, then my toes. I was sipping a coke at one of our favorite cafes, waiting on my lunch. As they brought Beth’s plate, then mine, I shifted my weight, moved my shoulder, but it got no better. The left side of my mouth felt like I was at the dentist, but also the rest of my left face, top, middle and bottom (that’s not supposed to happen). There was no headache. Something was amiss, terribly amiss inside my head. A parasite (I recalled that pork kabob at Momma Mia’s, a little too rare, about a year ago) or a tumor had decided to manifest itself, or I was having a stroke. My left arm felt heavy, wanting to fall to my side, and when I eventually tried to stand, I had trouble walking. I needed help to stay on my feet.

“A stroke?! I’ve no risk factors for stroke.” My mind rebelled against the reasoned judgment of my new friend and colleague Jerry Koleski whose number I had at hand, an American internist at Partners in Hope hospital, a major HIV project in Lilongwe which helps with other medical needs in some circumstances. Denial was working hard, but my entire left side was still tingling. Lunch in Lilongwe was being interdicted by life, or maybe impending death. The owner of the Cappuccino CafĂ© rushed for aspirin suggested by my doctor friend who called back as it arrived: “Don’t take it. If you’re bleeding it’ll make it worse. Come on over to the house. I’m just three blocks away.” After an exam confirmed his suspicions of probable stroke, several hours of negotiating with insurance companies, led by Jerry’s wife Elizabeth helping Beth, an air evacuation to South Africa was arranged as Malawi didn’t have what we needed. It would be no less than 12 hours later and maybe as much as 22, but it all fell through when the chosen company called at the hospital late that night to say they didn’t work with our insurance company. Our missions minister visiting Tanzania en route to see us the next day with his wife and children got on the web (to which we had no access) and got us tickets on the commercial flight the next day at noon.

The 3 hour flight was relatively uneventful, and wheel chair assistance whisking through all immigration and customs stations got us into a taxi and out to Milpark Hospital the Malawi-based docs had used several times. An MRI followed our ER visit, confirming the stroke, an area of tissue about the size of an olive in the brain’s right thalamus being affected.

A stroke. Part of my brain dying, starved of blood, glucose and oxygen. How much will I lose? Is my work finished? I’ve not really gotten started. Am I finished? Will it get worse? Will it get well? Lord, what’s up? Why? What will I do? Will this eventually help in some strange way with what you want me to do? As we’d gotten into the car that first day to see our friend I’d given Beth messages for our children. As I went to sleep that second night I again had a little talk with the Lord. I knew he was there, but like Jonah, who didn’t find the presence of the Lord as manifested in the storm or the fish too comforting, I didn’t either. I thought my wife would've been more comforting, but she'd gone to stay with other new friends in Johannesburg.

I’m out of the hospital now. I’ve had a “lacunar” stroke, deep inside my brain. They often leave no symptoms (at least with the first one), and I’m walking better, but my whole left side is still tingling, including my left chest and belly, front and back. I’ve learned that my blood pressure tends to go up really high when I’m stoked or stroked. I’m on some meds for that, and one aspirin a day, though there’s no evidence that a clot played a part in this one. I left the hospital two days ago, and will fly to Malawi tomorrow, God willing.

I have no more idea “why” this happened than when it first began, but I am much more aware of my dependence on God for everything, including this breath. I am more humbled as to my place in the universe, and the importance of “my plans” in the will of the Lord. While I have no doubt the Lord is willing to work with me, to use me, in fact is working with me and using me to bless others through me, aware that I can and do have some part, however small, in the cosmic story he is unfolding, I am also more aware than ever that he doesn’t really need me. He is not dependent on me to complete the story or even to do “the task” that I’m currently called to do. Rather when he calls, my task is to answer “yes” to whatever he wills, even if the call is, “Come home.” If nothing else, I’m much more aware that, as the hymn says, “Today I’m nearer to my home than e’er I’ve been before.”