October 24, 2005
My chest burns as my lungs suck in the hot, searing air. It is Saturday, and everyone has left church on march to the river for a baptism. I begin to walk fast, and the young guys soon think that I can’t keep it up. They asked, “Aren’t you taking the car?” I said, “Of course not!”

We pass the mud puddle in front of the hospital’s main gate. We round the corner at a fast pace. I am surrounded by young guys ranging in age from 6 years to late teens. We pass through the remnants of a millet field, which, like a ghost town, has just a few reminders of the past prosperity left standing. Past the night watchmen’s hut and through a few more mud puddles we hit the main “road.”

The red road is pocked with massive mud holes and deep grooves from the large transporters. We are still keeping up a brisk pace, and already I’m wishing I’d brought water as the sun bakes my head.

A small Peugeot truck is stuck between a rice paddy and the road where it tried to skirt a mud puddle. The mud is over the tires and into the chassis. I call the boys over, take off my sandals, and step into the muck as I begin to discuss a plan of action with the turbaned driver. The back of the truck is piled with four barrels of diesel and a ton of miscellaneous sacks and plastic containers. I call all the boys over as they pass.

We attach a rope to the back, and some pull while others lift and push on the side facing the rice paddy. I look over and see a well-dressed man hit some slick clay and fall on his back off the bike like a Three Stooges movie.

He’s OK, but getting the truck out has been put on hold as everyone stops to have a belly-rolling laugh at his expense. Soon, we are to follow as the rope breaks, and our boys also end up on their backsides.

We change strategies and unload all the bags, plastic containers, and one barrel. Then with coordinated heaves and ho’s the truck backs out of the hole and back on the “road.” With many “Que Dieu vous guide” following us we take off again—with mud between our toes.

I suddenly feel very energized, and I take off running at a determined pace. The boys gladly fall in line, bragging about how they’ll run me off the road, and how they could run all the way to Kelo if they had to. Unfortunately, I don’t last long, but end up having to slow to a fast walk, which, fortunately, opens up the time for many questions. Most of them are to be baptized today. They pound me with questions about sorcery and ogres and stuff that is a part of their everyday lives, and how that relates now to believing and serving one God. They are smart, and with such stimulating and intelligent conversation we arrive quickly at the river, where I dive in barely missing the fishing net.

I baptize for the first time and couldn’t imagine a better place or way: a muddy river, after pulling a truck out of the mud, in shorts and a plain T-shirt with guys I’ve just been running with and having deep spiritual conversations with. It’s my first time, and I wouldn’t trade it for anything.

It’s probably one of the best days I’ve ever had.

Wednesday, November 2, 2005
Today a woman came in with a change in bowel habits and a large, hard mass right under her sternum that was pulsating. I could think of only very bad things that I couldn’t do anything about, such as cancers and aneurysms and such. I told her she should go to N’Djamena. The husband said he didn’t have the money. I replied that maybe an X-ray would help, but our machine is down one week after our friends from Florida got it up and running. Finally, I told him that we could try an ultrasound, but I didn’t think I’d be able to see much.

I pulled out the portable, laptop-size ultrasound recently donated by General Electric and brought by the Florida team. It runs on batteries, so I can use it without the generator. I turned it on, put in her name, and placed the probe over the mass. To my pleasant surprise, it appeared that the mass was in her liver, and that it was either a cyst or an abscess. After looking in some books, I was convinced that it was an amebic liver abscess, so I hospitalized her and put her on metronidazole.

Technology comes to Béré! Above all, I thank God that He made me think to use the ultrasound. Sometimes I am so used to hopeless situations that it’s hard to get used to having more options.

February 7, 2006
I am fatigued. The weekend has brought a brief respite. For only the second time in two weeks I have had a day without a surgery. All the government health-care workers have been on strike for more than a month. Even the General Hospital in the capital of N’Djamena is closed. Here in Béré the nurses assigned by the government to our hospital have worked only six weeks since June 2005, leaving us more understaffed than usual. Since mid-December the surrounding hospitals have been closed, and for the past two weeks all the health centers have shut down too, leaving us the only hospital in five counties. I am the only doctor for a population of approximately half a million people. Our hospital is overflowing. We have no beds despite a fast discharge rate. And we have been operating like crazy.

As I sink back into the all-too-comfortable couch, I feel the soreness of my shoulders and arms, and I think back . . .

I pull out the bag from the back of the truck and unzip it. Inside, I pull out two halves of a bright-blue epoxy surfboard. I place the carbon fiber tube in the center for strength and cinch the two halves together with the patented Pope-Bisect integrated screw mechanisms. The board is already waxed, and I head down the beach to the water. A gorgeous redhead (my wife) is waiting on the bank with her somewhat scrawny pony. I wade out into the foot-deep water and shove my board ahead of me as I jump on, bend my back up, and feel that oh-so-nostalgic feeling of hands dipping in and out, gliding my stick effortlessly upstream. I hear Sarah mount the horse and begin chasing me, water splashing furiously in the horse’s wake. Yeah, there’s nothing even remotely resembling a wave, but somehow that up-and-down motion, and the pull and drip forward, are comforting and relaxing.

I finish my upstream paddle and gently coast back down with a leisurely stroke now and then. Near the put-in point I call to Sarah and paddle furiously, put my hands on the board and in one motion push off, slide my feet up and am standing . . . surfing? Not quite. But as the board shoots out from under me and off to the side, and I tumble in, I raise my arms in exultation as Sarah giggles helplessly . . .

Life is good!