Mission Iligan Philippines

Working in missions is humbling in so many ways. Just today, we noted on the aspects of daily life that we absolutely take for granted moment to moment. The predictability of presence of things like water, a trash can, an easy restroom to use, and even warm bath water. These things are not absolute givens.

We all take for granted the very things other people consider pure luxury. In life, this may show itself as uncertainty of the time of a meal, the time of a ride home, or maybe even whether or not we will have a meal. When doing surgery in a context different from our daily lives, the little things are all opportunities for stress. They are all variables. Even the person who is responsible for handing you instruments is new and unfamiliar.

All things on mission trips are uncertainties, new experiences, unknowns even. Imagine dancing with a stranger. The first steps or even the first whole dance is a challenge, awkward even, as you struggle to anticipate, or maybe even match your partner’s movements. This is the same in many ways. The anticipation of another’s movements, of their needs, and their thoughts on where we are heading are all real.

In talking with one of our residents today, I asked her what she learned. She learned today that she is not as flexible, or versatile as she thought. She realized that she was much more fixed, and more needy around certain aspects of her work, than anticipated. Such an incredible lesson to learn in the field. There is a reason that fast food chains work. We are all creatures of comfortable habit. Meaning, habits or patterns of behavior, create a façade of familiarity. They create an environment or context with which we are familiar. All of this lowers the levels of stress and anxiety.

The term “preference card” is a misnomer.(A preference card is a wish list of items and supplies that a surgeon puts together for surgical teams to prepare for each surgery.) Many of us might rather call them “absolute or all or nothing cards” because we hold them so close to our minds and hearts. How we work is typically how we were taught, or evolved over time to work. Neither of these things are easily changed. They are kept as a pattern for a reason. We find what works best for us and our patients alike.

This undergirth of stress and unfamiliarity and dare I say instability, is something not altogether different from what people in poverty experience every single day. It has been termed “toxic stress. The uncertainty around finances, food, shelter, safety from violence and maybe even the possibility of employment, all contribute to create a context of multiple stressors for an individual or family. This toxic stress is so powerful that it has been shown to lead to negative health outcomes around infection, hypertension, atherosclerosis and central obesity. Toxic stress in a mother even affects a growing fetus as it is developing in utero.

We reflect on the stress that we experienced today, with a little different set of instruments, with new staff, with unfamiliar operating rooms, beds and equipment, and with patients that look different than our usual Memphians/ Chicagoans/Seattle-ites/Sacramentoans. Now think how this little bit of stress affected how we felt at work today. This work stress is a mere fraction of what our brothers and sisters in poverty experience every single day. These are things we will never understand even just at surface level unless we seek to find out. Maybe this is our lesson of the day: Seek the lessons that teach us to be more sensitive, and increase our ability to recognize, or maybe even anticipate, the stressors the people around us might be experiencing.