After a glorious nights rest rocked to somnolence by the incoming waves rolling in a short distance from our window, the team arose to whiffs of Blue Mountain coffee, exclusive to Jamaica and rumored to be the richest and most flavorful in the world. The previous night we had made assignments for the day’s clinic and organized our makeshift pharmacy (sans our confiscated drugs) and now, with the sun lapping at the Caribbean waters, we were ready to venture into what was largely unexplored territory for most of us. Many on the team were health care workers from a variety of backgrounds, docs, dentist, nurses, physical therapist, yet few of us had been on a medical mission before, and none of us to the clinic assigned to us for the day. For me, and I dare say many of the team, this was not a leap of faith but a cliff-diving, no net, free fall of faith! We were there with no expectations other than to serve and it quickly became evident that we not only left our medicines at customs but we also checked our egos. This was no place for hubris of the “great American doctors here to save the world” mentality but an opportunity to stretch our limits and be flexible. In fact, Marla had preached early on in our team training that adapting to change was a necessity in Jamaica. Just like the weather, wait a few minutes and every situation will be a bit different. Ready, excited, apprehensive, and full of Ackee (the national fruit of Jamaica) we loaded our van to head to the Hampstead clinic.
To say the roads in Jamaica are a bit rough is like saying Lindsey Lohan may have a little drug problem. Our driver, Mrs.Betty the Invincible, had the stamina of Lance Armstrong, and possibly the booty to match because the pot holes we bounced through placed the same strain on her behind as did the Tour De France on Lance’s! We bounced, weaved, and dodged our way through crevices the size of New Zealand and arrived at Hampstead clinic, shaken and stirred, and began assembling our apparatus. The building itself looked like a saloon straight out of High Plains Drifter with a Jamaican twist. Everything was cinder block (the better to fight off hurricanes) and several of the rooms were without lights. But who needs lights when you have the warm Jamaican sunshine spreading its luminosity and heat throughout! Since I was dealing with the most intimate of patients, I garnished a 5 by 8 foot room with a privacy curtain and laid out my tools for the day. Medicine has become amazingly inundated with technology and this was never more apparent than here. We were reduced to basic diagnostic acumen with a minimum of tools other than our training and our wits. Chills ran down my spine as I realized that I would have to rely on just a history and cursory physical exam to provide care for these precious people. No CT scans, no sonograms, no blood chemistry, not even a quality assurance inspector was available. The thought of depending on basic skills was both exciting and disturbing. All first year medical students learn that nothing should supplant an accurate and detailed history, as the patient will tell you of their disease with a passion and detail like no other. It is the rare instance, except on TV, that requires an extensive diagnostic journey. Sometimes it takes planting yourself in unfamiliar soil to relearn lessons previously understood, like the utility of simplicity. For centuries medical men used more art than science, yet I dare say they were more effective healers than some of the academicians of today. Not to discount modern technology, but all healing begins with physical touch and emotional connection. Some of the most everlasting truths are the most basic, in medicine and in life. The good news written in scripture is one of uncomplicated simplicity...”for God so loved the world...” Like technology, theology is a useful tool, but not at the expense of the essence of the message. A stark, dimly lit room in a Jamaican jungle forced me to remember that healing is mostly about people connecting and caring.
The medical team saw approximately120 people that first day with the unstoppable dental wizard, Dr.Mike, pulling more teeth than the tooth fairy on crack. I was struck by the number of both young and old who were ravaged by chronic preventable illnesses such as diabetes and hypertension. These were lifestyle diseases, much as it is in the States, yet the lack of education and prevention was stark. It’s hard to explain to people that their choice of snacks and sustenance (in this case sugar cane) is killing them.
Assembled back at the hotel, we “debriefed” about the first day with our team leader and resident crazy person, Jesse. A helicopter EMT (that should tell you something right there!) Jesse and his tolerant and wise wife Allison (a family medicine doc) were the heart, soul, and drill sergeants for our expedition and blessed us with their wisdom, humor and knowledge of completely worthless Jamaican trivia. We felt good about the first day, in spite of the ongoing debacle with Jamaican customs regarding our confiscated stool softeners and other assorted dangerous drugs, and I was impressed by the teams willingness to roll with the punches. In fact, this group proved to be more flexible than a Chinese contortionist in meeting the challenges of the week. It was a lesson I desperately needed to learn, as I had entered the week with a corner on the anal-retentive market. I was the one who worried about not having anything to worry about, so learning to have faith and trust in God was like mastering Mandarin Chinese. Yet, through the example of Marla, Jesse, and Trevor (the Jeff Gordon of Jamaican bus drivers) I felt the worries melt away like butter on an iguana’s back in the midday sun. To serve is first to trust, and to trust is to leave your worries in the lap of the great physician.
Day number two found the team bouncing and bounding to the Rock River clinic. This remote site could have been the setting for a Jamaican “Deliverance” movie as it was about as isolated as a liberal at a Sarah Palin rally. As we pulled up to the hillside structure we were puzzled by the stillness. A the previous day’s clinic there were folks waiting for our arrival, some getting there as early as 3 hours before our scheduled start, so we expected the same reception on this day. We unloaded the bus to an eerie quiet, wondering if we had made a wrong turn at Haiti. Jesse and I climbed the hill and found one of the Ministry of Health nurses busily doing paperwork in the front office. Her look of surprise at seeing us spoke volumes as it soon became clear that she was not aware that we were coming to her clinic that day; more importantly, neither were any of the patients! Realizing this was simply another way of toying with my obsessive compulsive nature (remember, it’s always all about me) I thought about asking if any of the team members needed a Pap smear since it didn’t appear that I would be offering such services that day, but decided that might breach protocol. In another lesson in faith and trust, Jesse and Allison calmly (at least on the outside) asked the nurse if it was possible to get the word out that super docs were in town, and we were open for business. Remember, this is in an isolated Jamaica forest nowhereville, where they were fresh out of house phones, Internet, and planes that would fly over with banners telling you which bar had happy hours. In faith we unloaded the vans as if there were thousands waiting on us and prepared for the day. Within minutes it was if the forest opened up and brought forth people like a rabbit on fertility medicine. I learned that day that people in Jamaica still understand the power of community. News and needs travel fast and what one family knows is effectively communicated round about. I don’t pretend to know how the word got out so rapidly, and even more surprisingly how small children and old folks made it to the clinic so quickly, but they did in such a fashion that we saw well over a hundred patients before the day’s end. Mystery is often God’s way of staying anonymous.
On our way home that night we experienced what was to be the most powerful moment of the trip for some people. Trolling along precarious cliffside, semi-paved roads our bus slowed to a crawl at one particular juncture. I suspected that Trevor was stopping to execute one of his patented Jamaican history/culture/culinary demonstrations by harvesting a roadside fruit, slicing it with his ever present machete (that is a story in and of itself) and passing it through the bus to tickle the nose hairs and taste buds of the brave. However, this time there was no low hanging chocolate berries but a lone pedestrian that looked as if he had stepped off the film lot for “The Bob Marly Story.” Here was an old gentleman with dread locks to his waist and a beard to match trudging along this narrow, pock filled road. Trevor addressed him in Patois, the local dialect (a melodic mixture of French, English,and African) and welcomed him on board. He was heading down the road a bit and was most appreciative of the ride. His name was Jeremiah, “like in the Bible”, and Campbell, “like the soup, mon”. I must admit my prejudices were running wild as I surveyed Mr.Jeremiah, imagining him as both illiterate and detatched. Within minutes of his arrival I was proven hopelessly wrong on both accounts. After a brief explanation of the origin of his name, he broke out into a joyful rendition of “This is the Day That the Lord Has Made” and soon had the entire bus rocking in a spontaneous praise and worship that would have made TD Jakes proud. Get this picture in your mind’s eye. Here was a 70 something Jamaican Rastafarian look alike, poorer than any church mouse ever dreamed of being, obviously worn out from a long walk, leading a group of lily white Americans in shouts of joy to a Creator who made us all in His image. I have never witnessed a more spontaneous and sincere expression of joy in my life. Jeremiah was truly joyful, in spite of his poverty, his physical challenges, his lack of designer jeans, and no Internet access. C.S. Lewis wrote a book called “Surprised by Joy” in which he describes his unlikely conversion to Christianity. Watching and listening to Jeremiah, I was surprised by his joy and saw for a brief moment the origins of contentment. Jeremiah was the professor and we were all unwitting students in the hallowed halls of happiness university. Echos of Paul writing from prison bounced around in my head as he admonished his flock to be content in all situations. Mr. Campbell seemed to be living this truth. After a couple of songs Jeremiah spied his drop off point and thanked Trevor for his friendliness and then paused.
“Before I leave you, mon, can I pray for you all?”
“Of course,” we clamored. We bowed our heads and Jeremiah began a prayer that was straight from the mouth of God himself. He blessed us and our mission. He praised a God that would use us to bring healing to his people. He thanked God for his faith and his blessings, and he poured out his words of adoration like a saint filled with the Holy Ghost. His words were heartfelt and genuine and poured from his near toothless mouth with the force of a raging river. His eloquent, impassioned prayer humbled and honored us all and at amen tears flowed as free as the love he showed us in those few minutes. Jesus might not have taken the wheel on that bus like he did for Carrie Underwood, but he hitched a ride that day and we were the better for it.
