A Tale of Two Babies

It was the best of times, it was the worst of times… it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair…

These are some of the opening lines of Charles Dickens’ classic novel, A Tale of Two Cities. They capture the not infrequent juxtaposition of very good things and very bad things in our lives, without giving either more weight than the other. It reminds me to hold the two  in balance – and allow myself to feel and know the bitter sweet reality of life between the first and second coming of Jesus Christ.

Case in point, we have recently had two babies who required intensive care in our hospital; one has done very well, and one did not do well. The first baby is named Estephanie, and the majority of her medical care was provided at the direction of Drs Anne and Isaac Hotz. This is also the infant that I previously mentioned for whom Bethany has supplied breast milk. She was born premature. And while that may not seem like a big deal – it is.

Imagine being in a rocket ship, and telling ground control that “All systems are not go for launch, repeat, multiple critical life-sustaining systems are not functioning.” Only to hear, “We are go for take off.”

Premature delivery shares a similar level of disaster potential as the above scenario. Our lungs, skin, eyes, brain, gut, and fat reserves, are all essential systems that don’t come fully on board till late in a pregnancy. And being born without anyone of these systems can result in a cascade failure reminiscent of Apollo 13.

With Estephanie, we knew from her mom’s first prenatal visit that she was at risk for early delivery, because Estephanie was sharing the uterus with a birth control device called an IUD.

Anyways, with advance notice that the baby might be born premature we were able to give the mom timed steroids to rush the baby’s lung development. We do this whenever we suspect preterm delivery because once a mom’s body goes into true labor, there is precious little that doctors can due to stop the process (especially in rural Honduras). 

Ultimately, Estephanie was born at 29 weeks and 3 days of gestational age. At that stage of developmental, with our resources, it was a Herculean task to keep baby nourished, breathing, and avoid sepsis. Remember the brain and fat reserves that aren’t fully developed yet? That means that most premature babies don’t have the coordination or energy to consistently breath or eat independently. So we place a tube down the mouth to allow us to put food directly into the baby’s stomach, and a CPAP over their noses to augment and remind them to keep breathing

But tasks such as feeding, breathing, and keeping baby warm are easy compared to the biggest hurdle that Estephanie faced.  About a week after birth, when the basic problems inherent in preemies began to seem surmountable, Estephanie suddenly started showing signs of sepsis or an abdominal emergency called neonatal necrotizing enterocolitis (nicknamed nec). The only known preventative medicine: breast milk (having had Bethany’s milk may be one the reason this baby went on to survive).

The treatment for Nec: no feeding, support the baby, try antibiotics, and wait. The treatment for sepsis: remove any possible sources of infection, give antibiotics, support the baby, and hope. In the case of Nec, if you have to wait more than a day or two you need to order a custom tailored formula called TPN that can be put directly into the baby’s blood stream (bypassing the gut completely which could rapidly necrose and kill the baby if food is put through it). This must be given through a central line (like an IV, but going through a major vessel dumping directly into the heart).

X-ray of a baby’s distended abdomen due to nec

In the case of sepsis, any central line that you have in place is a potential source of infection. So we pulled the old line, ordered the TPN, and tried to put in a new central line. “Tried” being the operative word. Over two days, we tried every possible access point, multiple times, for hours at a time. We prayed, we dripped sweat, we got frustrated with each other, frustrated with ourselves, frustrated at having ordered and transported the expensive TPN from the across the country only to be unable to deliver it the final few inches.

Ultimately, we were unable to get a central line. Without a central line we had to decide when we would allow the baby to have tube feeds- the sooner we fed her, the higher the risk of complications from nec, the longer we waited, the higher the risk of complications from starvation. In the end because baby made a quick turnaround soon after we stopped feeding her we were able to compromise between the two ideal intervals and resume feeds after 48 hours We started slow and praise be to God, Estephanie was able to tolerate tube feeds.

Today, by the grace of God, Estephanie is doing well. She’s coming up on 36 weeks gestational age, and has been discharged from the hospital after almost 50 days. She is no longer needing help breathing and she is able to take a bottle. She is the youngest preemie to have survived at our hospital. Praise be to God.


Our second baby, would have been named Genesis. She was brought in late one evening when I was on call. I was already in the emergency room, monitoring a young boy I had just medicated for an ongoing seizure. I looked up to see a mother being shown in to our ER with a silent bundle in her arms. Typically I let out nurses locate a patient’s chart, get initial vitals, and ask basic questions, but something in this mother’s defeated demeanor prompted me to make the initial evaluation.

I quickly, explained to the parents of the boy with a recent seizure how to monitor their now sleeping son, and crossed the room. The baby’s mom seemed reticent to put her baby down, and when she did I saw a frail, pale, recently born baby girl who appeared dead. She was floppy and unresponsive as she laid in the bed, and I thought she might be dead. But on further evaluation she was taking shallow breaths had a weak pulse.

I urgently called for 2 other doctors to help, and tried to obtain vital signs and figure out what had happened.

The baby’s diaper was full of black and coagulated blood, and her mom said that her baby was 8 days old and had been doing well until she suddenly began vomiting and stooling blood that morning. Immediately her mother started trying to get her baby daughter to the hospital. (She does not own a vehicle or know how to drive, almost all taxis and public transport are not allowed to operate due to COVID, and road blocks are set up all throughout the country to decrease the spread of COVID)- so it took most of the day to get her baby to us.

When my colleagues arrived, and verified that the baby was still alive despite appearances we had enough information to determine that we had a baby on the brink of bleeding to death- who we might be able to save. We called ‘CQ Belfate – Rapid Response to the ER’ over the radio – signaling all available clinical staff to come in and help.

As help came pouring in, we inserted a needle into the baby’s leg bone to begin giving fluids and as soon as our lab personnel arrived we drew off some of her precious remaining blood to check her blood type. More than anything else, the baby needed blood, we later estimated that she had bled out three quarters of her blood volume, prior to arrival.

Under ideal conditions, after attaining her blood type we would simply request the appropriate purified and pre-screened components (packed red cells, platelets, or plasma) from our blood bank, cross match those to insure she would not react, and then transfuse. In our case, we do not have the $20,000-30,000 centrifuge needed to separate blood products. And our blood bank is a list of all hospital personal and community members under their respective blood types (We also test all willing family members who come with a patient to see if we can use them first).

As we were waiting on blood typing, we gave the maximum amount of IV fluid, continued to give oxygen, and, as it seemed likely she was still bleeding internally with an undetectably low blood pressure, we decided to try for a central line (medicines that force the heart to increase blood pressure are called pressors and must be given through a central line).

This was only about a week after our failure to get a line on Estephanie. But miraculously, Dr. Isaac managed to get a blind subclavian line in with one of his first tries. The baby and her uncle were a blood type match so we drew a unit of whole blood from him and started giving the baby 4 teaspoon boluses of blood at a time.

Honestly, we were all a little shocked that she survived that first few hours, and not only did she survive, she awoke to start fussing and kicking soon after her transfusion!  Nevertheless, that night I explained to her mother that Genesis was not yet out of the woods, and that if she did survive it would be a miracle from God.

On days 1 and 2, we continued to be amazed at Genesis’ resilience, and started to hope that God might heal her. After her first transfusion, we gave her her first vitamin k shot. We became more and more convinced that Genesis had gastrointestinal bleeding due to at least a vitamin k defeciency (pretty much all babies are born with some degree of vitamin k defeciency).

You know those 2 shots that we give babies right after they’re born? One is a Hepatitis B shot that prevents fulminate liver failure in case of infection, and the other is a Vitamin K shot that prevents rare but terrible events like this one.

Unfortunately, Genesis had been born on the way to our hospital rather than in our hospital. As she was born precipitously in the vehicle before arrival and their family had no money to spare, they turned around and went home, never recieving the vitamin k shot.

The next morning showed that although Genesis’ brain, heart and lungs had bounced back remarkably well, her liver and kidneys were not so quick to bounce back. Those organs showed signs of severe shock and only time would tell if they would recover quick enough to allow her to live.

On day 3, Genesis had completely stopped bleeding into her belly, and her liver seemed to be making a slow recovery, but her blood pressure and oxygen were wavering and she still had not made any urine. Her mother was exhausted from staying by her baby’s side, and afraid to hold her daughter with all the tubes, lines, and devices we had afixed to monitor and respond as needed. At one point, while my colleagues and I were discussing her poor prognosis and worsening situation, baby Genesis had several very low blood pressure and oxygen saturations, her belly was swelling ominously, and I along with Dr. Isaac and Dr. Anne decided to prioritize allowing mom to comfortably hold and love on her baby who seemed to be dying.

We explained to the mom what we felt was inevitable and she was agreeable to not prolong her baby’s suffering. With heavy hearts we disconnected several lines and took off the blood pressure cuffs and pulse oximeter. We were able to comfortably put Genesis in her mom’s arms. Mom asked that we discontinue the oxygen-CPAP so she could just hold her baby and see her beautiful face. I prayed with mom while holding mom’s arms as she cried and gently rubbed Genesis’ head with my other hand. I prayed for God to be with us and baby Genesis. I prayed and cried, I had several words of comfort and hope I wanted to offer, but those words wouldn’t come out. So I swallowed down a sob and simply concluded, “Help us Lord, Amen.” And then waited in silence for a time with mom and Genesis.

But, about one hour after we moved to what we call comfort care (stopping everything that doesn’t make baby more comfortable including oxygen, fluid, and pressors), Baby Genesis went from gray back to pink, from struggling to breathe back to breathing comfortably, and started becoming more active. Genesis really liked being in her mom’s arms!

With such an improvement we talked with mom about keeping the priority of her holding her baby but at least giving some fluids and oxygen to keep Genesis confortable. Mom agreed and Genesis did much better over that night. But still Genesis did not urinate.

I remember coming home that evening to find Ruthie running around with a diaper so wet that it was sagging under its own weight. As I changed that diaper I thanked God that my babies make lots of wet diapers.

The next day I didn’t know what to do. Should I continue to pursue the goal of comfort care, or should I revert to full active treatment? I prayed for wisdom, but didn’t feel like I received any. Ultimately we felt we owed it to this baby who kept hanging in there to give her every chance to survive. Even though she still hadn’t urinated, we were approaching the limit for how long a newborn can survive without nutrition.

She agreed (with some relief), so we again needed TPN (baby probably had a gastric ulcer and was uninterested in eating). TPN takes time to custom formulate and ship, so we had to order it ASAP that morning. After ordering it we needed to change out our central line to prevent sepsis. Given our recent frustrations, Dr. Isaac and I decided to use a process that uses a guide wire to hold the old line’s position while the old line is removed and a new one is placed. In the midst of this procedure the guide wire slipped out of position because it wasn’t quiet long enough.

But mom was in favor of comfort care, mainly because she was concerned that her family would already be unable to pay for what the hospital had already done. (This is a sensitive cultural intersect- in the developed West we are blind to the cost of our healthcare, and never speak about money as part of developing a care plan, in Honduras people want to know how much a life saving surgery will be before they are rolled back). Trying to compromise between the two worldviews, we asked mom to give us one more day to give Genesis every possible chance and we promised to work with her to bring the cost of the hospitalization down to something she could afford. (Our prices are set to be manageable by most Hondurans, keep our lights on, and pay our Honduran staff – for instance a 24 hour hospital admission costs about 20 dollars.)

We were crushed, literally I felt God-forsaken. Once again we had TPN ordered and we’d lost access. We tried briefly to get another line in but in a baby who could not easily stop bleeding who already had a very low chance of survival, we did not feel it was safe or right to keep sticking her.

When I explained the situation to the mother she was incredibly gracious. Her response more than anything else that day assured that we were not forsaken by God. He was right there. In the mother who bore the roller coaster of her infant’s hospitalization with dignity and grace. Even though this was her second child and her first had died mysteriously a few days after birth; she was kind and appreciative of all our efforts, thanking us and praying with us. Shortly after, she asked us to discharge Genesis so she could take her home to die.

The day after Genesis’ mom returned to our hospital to tell us that Génesis had died and to start making payments, we celebrated the discharge of Estephanie to her home, in good health.

It was the best of times, it was the worst of times..

Grace & Peace,

Nathan Gilley

Who is Worthy of Our Fear?

Lydia was crying again, it was 3 o’clock in the morning and her crying broke through the heavy silence of our home rousing me from sleep. I slowly woke up, even as I made my way to her bed, where I knelt tiredly and spoke to my still crying child, “Lydia… Lydia…”

I paused to allow her time to respond but her crying did not calm. So I reached out to pat her back and called out quietly (her sister slept in the upper bunk), “Aravis.”

Aravis is Lydia’s favorite imaginary character to pretend to be (the heroine from The Horse and His Boy, one of the Chronicles of Narnia) and she is almost always motivated to listen and cooperate if we engage her as Aravis.

Suddenly she broke off crying, and began taking a deep calming breath before looking up at me – her lips quirking into a smile – spent tears still on her face.

“What’s going on?” I asked

“I had a bad dream and I was afraid,” she answered in a pitiful little voice.

I stroked her gently as I thought about how to encourage her. I had a similar period in early childhood, lasting about a year where I had regular terrifying nightmares as a child. This came very soon after I felt called to be a missionary (see previous post), and through it my mother taught me, with steadfast love and patience, to pray; in the darkest and most scary places – she taught me that prayer is how we cling to and know God’s presence – even when we feel alone.

As I tried to decide how to respond, I reminded myself that I want my own child to look back and remember the same steadfast love, patience, and power of prayer that I learned from my mother (but I also want to sleep and need to leave for work in 3 hours). We have tried Bible memory (Joshua 1:9), singing songs (Jesus Love Me), saying prayers, and all of those seem are hit-or-miss regarding whether or not she’s able to sleep well thereafter. Reflecting on a conversation Bethany and I recently had about anxiety being misplaced fear, and that our fear should be directed to God, I turned to my daughter and asked, “Aravis who is worthy of your fear?”

-No answer.

I elaborated, “Who should you fear most of all? Dragons, or Jackals, or bad men, or Aslan?”

“Aslan,” she said hesitantly.

“That’s right, Aslan is fearsome, he has sharp claws and a terrible roar, you have heard his roar and even felt his claws before, haven’t you Aravis?”

Lydia’s Wide-eyed little face, remembers, and slowly shakes her head to signal yes.

“Remember, ‘he is not safe – but he is good.’ So what should you fear: scary dreams, loneliness, darkness, or Aslan?”

“Aslan!” she said with fierce excitement.

“And in this world, when you are Lydia, and you awake from a scary dream, who is worthy of your fear here?”

A contempative pause then, in a solemn whisper, “God.”

“That’s right. Now lets pray to Him, because he worthy of our fear but he is also good and loves us…”

Good God,
Guard us in your will – in fear.
Keep us in your will – in love.
Till our love is your love,
and every fear abolished.
Amen


As my family prepares to abandon our positions of financial and physical security – and follow God’s calling on our lives to move to Honduras in a few short months. I have found myself reflecting on my own question, “Who is worthy of our fear?”

Luke 12:4-5 tell us what Jesus told his disciples – in regards to the danger and death they might face for proclaiming the gospel, “I tell you, my friends, do not fear those who kill the body, and after that have nothing more that they can do. But I will warn you whom to fear: fear him who, after he has killed, has authority to cast into hell. Yes, I tell you, fear him!” Jesus goes on to assure his friends that though God should be feared- He is a good and caring God who values and watches over them.

When a perfect, holy, all powerful God chooses to love and redeem insignificant sinners like you and me – the right response is both love and fear. The love part is palatable, but our culture rejects fear and its Biblical relationship to love (and so do we if we are not careful).

‘Fear of God’ expresses the depth of caution, respect, responsibility and carefulness for which our relationship with Almighty God calls. God’s forgiveness and intimacy should not abolish fear, it should enhance both love of the forgiver and fear of the forgiver – a holy God whose nature demands and extends such a costly grace.

Remember Jesus’s parable of the debtor who was forgiven so much by the King, and afterward went out and fearlessly ordered another man who owed him a small sum to be thrown into prison (Luke 7:36-50). It did not, and will not, end well for any man who is not moved to awe, loyalty, worship, and a desire to never disappoint the King. The German martyr Dietrich Bonhoeffer expressed a similar fatal disconnect, in The Cost of Discipleship:

Cheap grace is the preaching of forgiveness without requiring repentance, baptism without church discipline, Communion without confession, absolution without personal confession. Cheap grace is grace without discipleship, grace without the cross, grace without Jesus Christ, living and incarnate… Such grace is costly because it calls us to follow, and it is grace because it calls us to follow Jesus Christ. It is costly because it costs a man his life, and it is grace because it gives a man the only true life. It is costly because it condemns sin, and grace because it justifies the sinner. Above all, it is costly because it cost God the life of his Son: “ye were bought at a price,” and what has cost God much cannot be cheap for us. Above all, it is grace because God did not reckon his Son too dear a price to pay for our life, but delivered him up for us. Costly grace is the Incarnation of God.

So, fear has a good and appropriate place, it is a place holder in the seeker or maturing believer, it takes the place of displacing all other fears and reminding us of the cost of God’s love (for God and ourselves). In view of our fearsome God our earthly fears become weightless. When we fear and love God rightly our lives should beg these questions for others: ‘Towards what are they living? Where is their fear? Why do they love so vulnerably and recklessly?’ Christian hopes and fears are outside of the watching world’s purview, so they cannot quiet make sense of why we do what we do.

As an example, Samaritan’s Purse is one of only 2 organizations in the world that will respond to the Ebola pandemics. Franklin Graham, the president of Samaritan’s Purse, says, “We run to the fire.” Who but a follower of Jesus would volunteer, go to an epidemic hot zone – to work on quarantining an evil with unmatched virulence and a 50% mortality rate? To be Christ ministering to children and adults facing horrific death and disease? The movie trailer below previews the story of another Post-Resident Medical Missionary, Dr. Brantly who responded to God’s call on his life and contracted Ebola while ministering in Africa.

We call ourselves followers of Jesus. Jesus, who did not hold onto power or security, rather he gave it up and became a weak and vulnerable human – the incarnation of God (Philippians 2:6-8). When we follow Christ we may look like fools to the world, but the Bible tells us the proper placement of fear results not only in the displacement of earthly fears, but also in wisdom (Psalm 111:10). Incorrectly placed fear is paralyzing and stupefying. But when our earthly fears are displaced by the awe and fear we have for almighty God, and that fear is balanced with the knowledge that God is good and loves us, we will have the ability to gain true wisdom. Wisdom can flourish when we are equipped to face trials with discernment and peace – making decisions that draw from the precepts of God’s word, are guided by his Spirit, and rooted in the security of his providence.

As our fear of God displaces earthly fears, our obedience and love for God can grow, this allows development of our wisdom and maturity until the love of God grows perfect in us, in perfect love we know perfect peace and every fear is abolished (1 John 4:18).

Almighty God,

Displace our fears
By filling us with fear of You,

Conquer our loves
By binding us with love for You,

Disrupt our peace
By giving us peace with You,

Overwhelm us Lord,
By making us holy to you,

Amen.


The views and opinions expressed in this blog are not the views of Samaritan’s Purse or World Medical Mission.


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Is Sunshine Sacrament?

Sometimes, I’m exasperated by the sheer number of times my daughter asks “why?”

Yesterday, after a long day, I asked her to go outside and play just before supper. She asked, “Why?”

Knowing my logical answer would be a bit raw I went the whimsical route (for sanity’s sake). I dutifully explained that over the course of the day, due to a lack of sunshine, argumentative imps had began growing and multiplying on her shoulders. At first whispering in her ears then climbing into her ears and finally crawling out her mouth and attacking her sisters. The only easy cure for this problem, I explained, was sunlight, which melts argumentative imps into nothingness.

This brought out enthusiastic and playful obedience as my daughter went outside with me and asked me to flesh out this new imaginary game.

And as I played in the evening sun with my daughters. Watching with my imagination as the little murky figures on their shoulders dissipated, and their attitudes and dispositions truly transformed, I wondered how much truth my fiction spoke.

Notice the lack of argu-imps on the subject’s shoulders!

In our missionary training we discussed how world view differences that can be so difficult to overcome. Particularly the gulf between the scientific and the animistic world views.

In general my culture adopts a scientific view of the world that is largely mechanical, and completely compartmentalizes the spiritual reality (when it allows for one). The animistic worldview is one of myth, magical thinking, and indivisible interplay between the spiritual and physical world, with all creatures, things, and ideas having spiritual essence. Christians who attempt to submit even their worldview to the truth of scripture have the tricky task of trying to look through the lens of their own worldview at scripture, spot the defects within the lens through which they’re looking, and correct it.

One such defect in my own worldview is an artificial compartmentalization of the spiritual – especially when it comes to medicine. In my worldview there is scarcely any overlap between the physical and spiritual causes and effects. But when that overlap does occur, when the physical and spiritual realities are obviously present together, (in a consistent manifestation of God’s grace) , as in the case of the Lord’s Supper or baptism, we call those nexuses sacrament.[1]

So what if sunlight is not just a calculable photon bombardment, what if it exerts a spiritual force. What if just as it catalyzes reactions in our bodies, triggering the release of chemicals in our brains, it’s does something at the soul level? Or what if, as in my imp explanation, it negatively affects the powers that war against us that are not flesh and blood?

Either way, as a doctor and minister, I recommend at least 10-15 minute of sunshine each day for its salutatory effects.

Whimsically Yours,
The Reverend Doctor Nathan

 


[1]- Sacrament can also be more specifically defined as specific actions that were instituted by the Lord, and commanded to his followers in perpetuity. Clearly, the sacraments that conform to this more narrow definition sacrament are to be performed and reverenced above all others.

 


 

The views and opinions expressed in this blog are not the views of Samaritan’s Purse or World Medical Mission.


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A Blessing – Graduating Residency

Last night my family medicine residency came to its completion. My formal training as a physcian is done (at long last – praise be to God). It still feels surreal. I offered this blessing last night at the beginning of our graduation dinner and ceremony.

DSC_5526

Father God,
We give you thanks:
For long hours, hard work, difficult patients, and demanding training,
For by them you have refined us into ready and resilient physicians.

We give you thanks:
For short days, simple tasks, grateful patients, and gracious teachers,
For by them you have freed us to be refreshed, faithful, and fun.

We give you thanks:
For 3 years of hospital food – that we may have neglected to bless,
For 3 step exams – we’ll never have to sit again,
For 3 years of family medicine residency – completed.

And now we ask your blessing:
On tonight’s food and friends –
may the calories be short-lived and the friendships eternal.
And on tonight’s graduates –
May the Lord bless us and keep us,
With grace, guide our service and attitudes,
With peace, guide our actions and our stillness,
With joy, guide our hopes and dreams,
With love, guide our hearts aright,
Send us forth in your spirit of healing and love.

In Jesus’s name,
Amen.

-Nathan Gilley, Murfreesboro TN, June 29th 2019

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My Family –  Celebrating the Completion of Residency.

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The faculty and graduates of UT – St. Thomas Family Medicine Residency, Murfreesboro, 2019

 

St. Patrick’s Shield

This is a prayer I wrote to be prayed when rising for the day. It is based off of an old prayer called St. Patrick’s Breastplate – a prayer that Celtic Christians often use to start their day. I painted this new prayer onto a sheild that I recieved when I was knighted as an eighteen year old (bit of a story there – we’ll save for later). And hung it over our breakfast table to remind us to open our day with prayer.

Here it is:

We bind ourselves today, in life and love, to the Trinity in unity,
By the power of the spirit, and this example:
Christ before me.

We arise today, in the power of Christ’ baptism,
dying to sin and living into Godliness;
Christ when we go down,
Christ when we arise.

We bind ourselves today, in faith and hope, to the Church;
Taking up the obedient disciplines of the faithful;
Christ over us,
and partaking of communion, the body of Christ;
Christ with us.

We arise today, in a world of God’s creation – fallen in sin,
Inspired by the invisible attributes of God in creation;
Christ all around us,
embracing opportunities for laboring in redemption;
Christ on our right,
Christ on our left.

We bind ourselves today, by the love of God for His glory;
Christ in the heart of everyone who thinks of us,
Christ in the mouth of everyone who speaks of us,
Christ in the eye that sees us,
Christ in the ear that hears us.

We arise today, for He is risen,
Christ is risen indeed.

Alpha – Omega; A Scripture Compilation for Kingdomtide

“I am the Alpha and the Omega,” says the LORD,

“who is and who was and who is to come, the Almighty.”

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Chi-Ro Alpha Omega – Brompton Cemetery, London, England, UK.

In the beginning, God created the heavens and the earth, now the Word was with God, and the Word was God and all things were made through him. And God said, “Let there be light,” and there was light- the true light, which enlightens everyone, was coming into the world. But sin came into the world through one man, and death through sin, and so death spread to all men because all sinned. For we all like sheep have gone astray; we have turned–every one–to his own way.

But when the fullness of time had come the Word became flesh and made his dwelling among us, though he was in the form of God, he did not count equality with God a thing to be grasped, but made himself nothing, taking the form of a servant, being born in the likeness of men. So Mary gave birth to him, her firstborn son, and wrapped him in swaddling cloths and laid him in a manger, because there was no place for them in the inn. He had no form or majesty that we should look at him, and no beauty that we should desire him. He taught, “Love your enemies, do good to those who hate you, bless those who curse you, pray for those who mistreat you. Do to others as you would have them do to you.” Yet He was despised and rejected by men; a man of sorrows, and acquainted with grief;

He said to them, “I am the bread of life; whoever comes to me shall not hunger, and whoever believes in me shall never thirst.” So he was pierced for our transgressions, he was crushed for our iniquities; the punishment that brought us peace was on him, and by his wounds we are healed. He humbled himself by becoming obedient to the point of death, even death on a cross. For as in Adam all die, so also in Him shall all be made alive. And when He had been crucified he said, “It is finished.” With that, he bowed his head and gave up his spirit. But three days later he was declared to be the Son of God in power according to the Spirit of holiness by his resurrection from the dead.

After that he was taken up into heaven, and the LORD said to my lord: “Sit at my right hand until I make your enemies a footstool for your feet.” Thereafter, He who is seated on the throne will say, “I am making everything new!” Then he will say these words that are trustworthy and true “It is finished. I am the Alpha and the Omega, the Beginning and the End.” And behold, God has exalted him to the highest place and given him the name that is above every name, that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue acknowledge that Jesus Christ is Lord, to the glory of God the Father.

Edited by Nathan Gilley using the English Standard Version (ESV)

Rev 1:8, Gen 1:1, Jn 1:1,3, Gen 1:3, Jn 1:9, Ro 5:12, Isaiah 53:6, Gal 4:4, Jn1:14, Phil 2:5-6, Luke 2:7, Isa 53:2, Luke 6:27,28,31, Isa 53:3, Jn 6:35, Is 53:5, Phil 2:8, 1Cor 15:22, John19:30, Ro 1:4, Mrk 16:19, Ps 110:1, Rev 21:4,5, Phil 2:9

The idea for compiling this reading was inspired by the two divine utterances of “It is finished.” Once on the cross and once at the end of all things.

Prayer for a Newborn Baby and Mother Immediately after Birth

[Lay hands on infant and mother]

Naked we come from our mothers’ womb
And naked we will depart;
Blessed be the name of the Lord,

The Lord, who with this mother, and through this labor,
has brought forth this miracle of life;
Blessed be the name of the Lord,

[Make the sign of the cross on the infant’s head with the blessing below]

The name that we now put upon this child and family:
The Lord bless her and keep her;
The Lord make his face to shine upon her and be gracious to her;
The Lord lift up his countenance upon her and give her peace.

Blessed be the name of the Lord,

[Prayed over the mother]

The Lord, who knitted this child together in your womb, who creates and sustains all things, uphold you and go with you in the good work of motherhood that you have begun. May He fill you with all faith, hope, and love; causing you to delight yourself in Him, forevermore.

Blessed be the name of the Lord,

The name by which we are saved- Jesus Christ,
Amen.

 

My newest daughter is now almost 3 months old, but in the weeks preceding her birth, I was motivated to finish working on a concise prayer to be prayed over newborns with their mothers. I completed my first draft a few days before my wife, Bethany, went into labor. After my wife gave birth to our baby girl, Ruth was immediately given to her mother- to snuggle on her chest. Then, as things calmed down, and the necessary nursing and physician tasks were completed, I placed my hands on the head of my newborn daughter and on my wife to recite this prayer.

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The idea for this prayer was born out a desire to have a practical and particularly Christian way to celebrate and mark the joyous occasion of a child’s birth. As a physician I often attend a mother during delivery and become so engrossed in the physical task of guiding, monitoring, and running anticipatory scenarios that before I even think about it, my job is done and I have left the room with a sigh of relief that nothing went off the rails. But I have neglected to acknowledge that God has worked a miracle and allowed me to bear witness. I have missed one of the great opportunities for which I became a physician. To be Christ – in word and deed, at the extremes of life – when our hearts are so naturally ready to receive the grace of God.

Hopefully, this prayer can become a part of my routine, and allow my patients and myself to celebrate, give glory to God, and start a pattern of prayer over each child. I plan to memorize this prayer and routinely ask expectant mothers if they would like for me to pray this blessing over their child after the birth.

Now I just need help translating this into Spanish (because that is the language that the majority of my obstetric patients speak – already (I am presently a resident family physician in Murfreesboro, Tennessee in my third and final year), and although my Spanish is adequate to communicate, it is not eloquent).  For anyone endeavoring to translate this, please note that three scriptures are being drawn from for the above prayer: Job 1:21, Psalm 113:2, and Numbers 6:24-26.

 

Vigil with a Crying Newborn

God Almighty,
Who longs to wipe away every tear, and bring this world to right.

Make me your hand of steadfast love to the distraught,
Make me your voice of peace to the suffering,
Make me your embrace of consolation to the helpless.
Make me Christ to my child and make my eyes see Christ in my child.

Hear our prayers, O LORD,
and give ear to our cries;
Do not be silent at these tears;
For the sake of your Son, Jesus Christ, who sojourned here with us,

Amen.

Even so, come, Lord Jesus.

(Revelation 21:4, 2 Corinthians 3:18, Hosea 11, Ephesians 4:2, Colossians 3:12, Psalm 39:12, Revelation 22:20)

Ruth Crying in Daddy's arms
Ruth is 10 days old, and a wonderful baby. She occasionally wants to nurse more frequently than is possible – and find’s her father’s lack of breasts to be very upsetting.

Prayer is a powerful form to reframe our thoughts and expectations into Christlikeness, as well as a call for God to transform this reality into kingdom reality. This prayer is a lot of the former and a little of the later.

Newborns were made to cry, and crying is a good, God-given, form of communication for them. And in the mature human is a complimentary God-given motivation to do something about a crying baby. But when all the actions have been taken and your baby still cries – it time to join with them, and cry out to God. This prayer is meant to be a prayer spoken over or with the urgent and inconsolable cries of a newborn who is fed, changed, swaddled, burped, held – and yet still crying (as Ruth was for 2 hours last night).

After writing this prayer I followed these directions to afix the prayer to battery powered wax candle that we use as our nightlight during these long first nights while Ruth sleeps in our room. I was able to present this to my wife for our use.

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Grace and Peace to us all,

Nathan Gilley, Murfreesboro, TN, USA; October 14th, The year of our Lord 2018