One has to admit, there is something intrinsically humorous about being an obstetrician/gynecologist. Putting aside the prepubescent school boy snickers, dealing with the subject matter of reproduction, intimacy, and “those parts” lends itself to jovial anecdotes and curious situations. I have discovered over the years that laughing at myself and the predicaments I attract is as necessary as peanut butter is to jelly.
A few years back I was working in my home office when I heard my then 5 year old daughter playing with a friend in the hallway. The friend proudly announced, “My daddy is a banker!” Half listening, half working I waited for a response from my daughter. After a few seconds she planted her hands on her hips and stoically responded, “Well, my daddy is an obstruction and groinocologist!” My laughter was only muted by my spewing diet coke from my mouth.
Not long ago I was speaking at a church gathering and concluded my talk with a call for questions. One lady who looked vaguely familiar stood up and said, “Dr. Eaker, I know you won’t recognize my face because I am a patient of yours...” I couldn’t even hear her question as the crowd burst into raucous laughter. She realized what she had said and turned the shade of a blood rose and immediately sat down.
I often shirk going to social occasions simply because I have been told numerous times that some patients are uncomfortable seeing their gynecologist in public. In all honesty, it doesn’t phase me in the least, but I understand how some folks may be a bit taken back thinking I remember every detail of every exam. Indeed I have seen piercings in places where holes were never meant to be and tattoos placed such that they must have been both painful and interesting to obtain. However, there is a group of patients that migrate to the other extreme. They will approach you in public and discuss any manner of intimacies with complete disregard for surroundings or appropriateness. For example, I was lounging by the side of a community pool one summer’s day, lazily watching my daughters splashing and frolicking in the cool water, when a young lady approached me. She was in her early twenties wearing a bikini that was little more than a thread holding together a napkin. She eagerly sat down beside me at the water’s edge and reminded me that she had been in to see me at the office a couple of weeks ago. I vaguely remembered her (not to insult anyone but we will see sometimes 30-40 people a day) yet I feigned recognition and asked her how she was. As my daughter paddled by she recounted the intimate details of her last sexual encounter that led to her visit and, in a voice that I was sure was heard on the next block, inquired about the result of her sexually transmitted disease cultures. I admitted that I didn’t remember her results and that as soon as I got back to the office on Monday I would try to track them down. She seemed satisfied and went back to her boyfriend sitting behind us. He had obviously overheard the conversation, as had most of the county, and looked like he had seen a ghost. I noticed that throughout the afternoon he made several trips to the bottle of hand sanitizer on the life guard stand. My daughter, always the curious one, wasn’t satisfied until she knew why the nice lady wanted to know if she had “chirpies”.
Unfortunately, if you practice medicine long enough you will have patients die. Luckily in my area, that doesn’t happen often, but when it does it is a likely more tragic and untimely. I attended the viewing of one such former patient a while back. There was an open coffin and my wife and I stood respectfully at the edge of the resting place remembering this sweet lady. I startled as I felt a light tap on my shoulder and from behind heard, “Dr. Eaker I’m so glad I saw you here. Do you have a second?” I was too flustered at the interruption to say what I wanted (which was, “No, I don’t you inconsiderate fool) so I just grunted which she took as an opening for conversation. It turns out she had been in the office a few days past and I had recommended a particular medication for a benign condition. She had gone home, jumped on the Internet and become an instant PhD regarding her situation. I am all for patient responsibility and self education, but thinking you have the big picture by pulling up www.KnowItAllDoc.com and reading about some lady in Peoria who treated her problem with beetle dung juice and sandpaper is a mistake. Not only is Internet voodoo not good science, but asking about it during a wake is poor form! If I had been thinking I would have turned to the recently departed and said, “Gee Mildred, what do you think?”
If laughter is the best medicine then I should be immune to about anything!

We gathered in plastic chairs on a cement precipice overlooking the Caribbean. A circle of 16 as diverse as snowflakes yet bonded in a brotherhood of common cause. We had just completed a week of medical mission work in St.Mary’s parish, Jamaica and were tired but joyful. Rev. Scott had suggested we close the week with a communion celebration and we all agreed that was a grand idea, so there we were. Situated in a cathedral that could only have been constructed by a God unlike any other - stars lathered like glitter on felt - frogs belting out their high pitched siren’s song - a welcomed breeze wafting intermittently off the cool waters - we faced each other remembering a few days ago when we arrived. Some new to the team, others veterans of prior excursions, we arrived in Montego Bay eager to experience what God had preordained.

“On the night in which he gave himself up for us,
Our Lord Jesus took bread, gave thanks to you, broke the bread
gave it to his disciples, and said:
"Take, eat; this is my body which is given for you.
Do this in remembrance of me."

The first night was filled with busyness and preparation. We were returning to Hampstead, a blighted, desperately poor section of the parish filled with beautiful children and wizened elderly. The rural areas of Jamaica are a fascinating mix of young and old. Adolescents too young and not yet able to try to escape the poverty, and the aged who have no chance of ever being anywhere else. There is a paucity of middle age folks, either due to their early demise from hypertension or diabetes, or from their migration to Kingston or some other urban area in search of jobs. This is a country where few are committed to returning once they have relinquished their rural, poverty laden chains. This leaves mainly single moms and extended families to work the land and provide sustenance for a burgeoning underclass of children. In Hampstead clinic, a wild west saloon like building, we saw mom after mom, often in their early twenties, with three or four children under six. With an unemployment rate hovering around 85% these children with children must grow their food since there is little money to buy any. And what is available to buy is processed, calorie dense diabetes in a bag. That first day we saw blood sugars in the 400s, enough to buy you a hospital admission in the US, and the best we could do was to provide Metformin, a tablet to lower glucose in the blood, and a rudimentary nutritional education. Even that small effort will save lives, or at least ward off some strokes, blindness, vascular insufficiency, and multiple other complications of long standing diabetes.

Likewise, when the supper was over, he took the cup,
gave thanks to you, gave it to his disciples, and said:
"Drink from this, all of you,
this is my blood of the new covenant,
poured out for you and for many for the forgiveness of sins.
Do this, as often as you drink it, in remembrance of me."


The next day we traveled only a few miles from our base to Albany clinic. We had been in this location the previous year and were warmed with the recognition by some of the citizens. Our dental team, two stalwart extractors and their merry support crew, set up outside as usual with tarps as ceilings and fans as air conditioning. Fueled by a diet of fruits and sugar cane, dental caries is as common as coconut trees on the island. Our dentists would pull close to 500 teeth in four days, numbing, digging, and extracting on kids and octogenarians alike. There is little doubt that dental hygiene and preventive care has to be a priority if future generations of Jamaicans are to be healthy. The locals would explain that having one’s teeth puled actually was a badge of honor as it represented the fact that you had access to dental care. What a different mindset from the US where a pearly white set of choppers signified good dental care in contrast to an empty mouth in the poor areas of the island. By the time we see these folks, extraction is the only option, and one that is met with joy by the patient whose rotting tooth had been punishing them for months.


And so, in remembrance of these your mighty acts in Jesus Christ,
we offer ourselves in praise and thanksgiving
as a holy and living sacrifice,
in union with Christ's offering for us,
as we proclaim the mystery of faith:

Rock River is a rural mountainous clinic that requires a NASCAR like driver to access. The roads in rural Jamaica are as pockmarked as a teen’s face. Barely wide enough for one vehicle and perched tenuously on ledges inches from the embankments, a skilled operator must negotiate washouts, pedestrians, and other vehicles with the dexterity of a machete juggler. Trevor, our friend, bus driver, interpreter, joke teller, tour guide, companion, advisor, and historian guided us through hill and valley to safely deposit us in our daily clinic site. One of the great accomplishments of ACE, the ministry with which we partnered, was their commitment to integration into the St.Mary culture. These folks were a part of the community, not some isolated one facet, in and out approach that some groups espouse. ACE is involved in micro-businesses, education, evangelism, medical, dental, child enrichment, and even provides a place for local swimming lessons for community kids. As their mission statement says, they are the hands and feet of Christ to the people of Jamaica as they impact today for change tomorrow, and trust me, those hands and feet are dirty and calloused from use.


Christ has died;
Christ is risen;
Christ will come again.

The last day of clinics was one of newness and surprises. We had never been to Brainard, a remote collection of agrarian homesteaders in the foothills of the Blue Mountains, and the trip inland was filled with lush landscapes and precarious roads. The clinic was in reality a church building constructed with love and cinder block situated down an embankment from the main road. A gaggle of folks awaited us on our arrival and so did some ominous clouds. Rain had visited with a vengeance the day before, but with our appearance it was as if God had sponged up the standing water and created a dry haven for us and our patients. During the entire four days only sporadic rain showers came, and then simply to cool the air and not hamper the operations. Combined dental and medical we saw around 130 men, women, and children that day with illnesses ranging from sinusitis to malignant hypertension. By this point the team was an efficient organism fueled by compassion and concern, triaging and treating on the minister’s platform at the front of the church. A fitting environment for our cause as we were preaching not with words but with actions. Pastor Watson, local leader of a burgeoning congregation at the Galina Breeze hotel, had reminded us in a sermon the prior Sunday that grace was extended to us from a loving Father, and we in turn could pass that on by what we did. True grace is extended with no strings, no expectations, and no demands. Learning this lesson was not a result of Bible study but of getting our hands dirty in the trenches of need.


Because there is one loaf,
we, though we be many, are one body,
for we all partake of the one loaf.
The bread which we break,
it is a means of sharing in the body of Christ!

And the cup over which we give thanks,
it is a means of sharing
in the outpoured blood of Christ!

Friday arrived with a burst of sunshine like every other morning, but we all knew that we were just a bit different by that daybreak. You can’t be there, or serving in any capacity, and not be changed. Even a subtle difference, one that may not even be perceived until later, is born with a thought or an experience that challenges who you are and what you believe. Most will say that any mission trip will leave you altered in some way, and I believe that is true. It may not be a massive shift in consciousness, or even a minor change of heart, but something changes because, as one person commented after our communion, once you have seen, you can never forget. It is in the remembering that we find that desire to be a better person. It is in the remembering that we realize our own brokenness. It is in the remembering that we acknowledge our commonality. With our communion of festival bread and juice we celebrated our week of service and worshipped a God who loves his children. We came together as the body of Christ, understanding that whether in Jamaica, Augusta, or Katmandu there is reason to both rejoice and rage. Rejoice at what a loving God can do and rage against what a sinful man can create. Sitting under the canopy of stars it’s easy to get lost in the vastness of it all; a universe of light year distances and unimaginable spaces. But then you think of the immediacy of the Infirmary, a place where Jamaicans are left to die, or the hopefulness of the sponsored children in Galina elementary school, and you put aside any concerns about intangible space and time and see only the present. Sitting in nature’s sanctuary, perched on the edge of the ocean, you don’t worry so much about the big questions of theology as much as you do about the needs of the individuals you talked to, held, and prayed with that week. You think about Richard, a long time Infirmary resident, spontaneously clapping and dancing in Sunday worship. You think about the young mom whose crying baby simply needs a round of antibiotics to cure the infant’s raging ear infection maybe preventing future hearing damage. You think of Emmit, weary from a life of farm labor, smiling ear to ear upon receiving a tube of cream to ease his sore and overused muscles, and you think of Alice proclaiming the blessings of God while struggling to walk on a hip broken and improperly set. It is these memories that keep us coming back, not some existential desire to do the right thing or be a good person. We are all in need, and it is just a matter of trying to meet some of those needs in the ways that God has graciously gifted us.

Through your Son Jesus Christ,
with your Holy Spirit in your Holy Church,
all honor and glory is yours, Almighty Father,
now and forever.

Amen