Injured Elephant Driver

At the age of 64, I volunteered to work at a Thailand hospital for nine months, while its only doctor, Phil McDaniel, was in America. I closed my office in Idaho and semi-retired. For the next eleven years I would work whenever I chose, as a locum tenens or “rent-a-doc”, filling in for doctors who were on leave for one reason or another.

Kwai River Christian Hospital has 30-beds, complete with lab, X-ray, and operating and delivery rooms, and some very competent Thai nurse-midwives. It's in a rural setting much like other Asian hospitals I have worked in. I am not a fully trained general surgeon, but have had a couple of years residency, plus forty years experience. At KRCH, it would soon be tested.

Many Thai sawmills still employ elephants to move the logs. The driver sits astride the animal's sturdy neck, steering it by jiggling his bare feet behind its ears. One night, after I had been at KRCH a month, a sawmill's pickup truck brought in a 25-year-old Karen man who had fallen off his elephant, striking his left lower ribs on a log. He had severe left-sided bellyache.

The situation is the same as a car accident in USA: any ER doc knows that left-sided rib fractures can signal a tear in the spleen, a delicate, fist-sized organ serving as a filter for the body's blood supply. The treatment is emergency surgery to remove the torn spleen and stop the internal hemorrhage. Trouble is, I had never done that operation, and had only seen it done once.

In such emergencies, I have found it useful to quietly pray as I work, and this seemed like a good time to do so. “Please, God, don't let this be a ruptured spleen! I've never done that operation, and there is no anesthetist; if I operate, he'll die on the table!” As I took his blood pressure again, the next unwelcome words came to mind unbidden:

He'll die if you don't.

That made me realize that I was stalling for time, and I gave the orders to call out the team. (No phones, but the night watchman knew which houses to go to.) A lab tech to get blood ready, three extra nurses, one to scrub and assist, and one to circulate, and one to monitor the man's vital signs after I injected a spinal anesthetic, and during surgery. The sawmill boss had brought the man and his family in; and he agreed to round up blood donors – no easy job in Asia. A nurse aide translated my Thai into Karen language, explained to the man what we had to do and had him sign the permit. She asked him if he had any medical allergies (Hkui hpae yaa rui plaaw?) He said no.

I operated, with a surgical textbook on a music stand nearby, opened to Removal of the spleen. Opening the man's abdomen, I found a belly full of blood and a torn spleen, still bleeding. I carefully clamped its blood vessels and removed it, avoiding damage to the nearby stomach and pancreas, conscious of God's help in remembering the steps I had once learned. (Readers wanting the details of the drama can find them in my novel Flame Tree, chapter 8. . . . fiction is often based on fact.)

The operation was successful, and a week later, after 3 pints of blood, the man went home. When they left, his wife had her small son place palms together, the Thai way of saying thank you. He had his daddy back.

So why am I adding this chapter to a book about pure chance versus the presence of God?

I do it to add my testimony that I believe that God exists, cares about us humans, and offers help when we ask and are willing to listen. In my experience, that seems far more likely than a mythical lady luck, or blind chance, or what-have-you. If that is true, we ignore him at our peril. Granted we have freedom of choice, our insisting on choosing our own path is arguably the cause of much of our ills, and those of the world's.

One postscript: On a coffee break last week, I chanced to get to know an acquaintance better. As often happens to a retired doctor, he turned the conversation to a recent health episode of his own. He has been diabetic for years, taking a modest dose if daily insulin. He described a recent personal “aha moment”, when he discovered that his bed-time blood sugar tested 380 for no apparent reason. He was debating how much insulin to take, when he received an unbidden thought: Sit on it. Puzzled, he continued to prepare his shot. Again came the emphatic thought, Sit   on   it. Not knowing why his sugar was that high in the first place, he interpreted the thought to mean Wait. He laid the insulin aside and went to sleep. When he tested his blood sugar again next morning, he found it to be 40, very low. Neither of us could discover any reason why it was so low, but if he had taken the night dose of insulin, his morning blood sugar level might well have been even lower, low enough to produce coma (a.k.a. “insulin shock.) Potentially fatal.

The question arises, how do we tell the difference between a presumed message of God's Spirit, or some other source? The first thought that comes to my mind is, prayer and practice.

Mass Response to Genocide: Part 3

Everywhere there were volunteers who came in from Bangkok on a day-to-day basis. The American Embassy sent a daily bus; others came by car. Some volunteers took over the job of keeping the diarrhea patients clean (There were new clothes and blankets now); Some spoon-fed the weak. Others ran errands, or helped discharged patients get settled out in the camp, or passed out food. One afternoon I found each patient holding a hard-boiled egg (which not all stomachs were up to handling); another day each had an orange or a loaf of French bread. One elderly European man, with whom I could speak only in Thai, stayed in the tent next to ours all night watching over an especially sick Khmer whom he had sort of adopted.

A few came only to sight-see. The French ward got a group who wanted to feed patients lunch. The doctor explained that they had already had their lunch but some were badly in need of a bath. The visitors said they didn't come to do that kind of work, they just wanted to feed people. We had a couple of Thai student volunteers who mostly just drank our pop. But another Thai girl student stayed with an old lady who was too listless to eat, and kept gently spooning gruel into her. “She's not going to die is she?” the girl kept asking me nervously, “I don't want to see anyone die!” But three or four days later when another patient died, it was the student who rounded up stretcher bearers and escorted the body over to the morgue tent, where a group of Buddhist monks took care of burials. The Khmer refugees themselves had teams of girls (Khmer army medics, we were told) who helped bathe and feed people. Like the volunteers from Bangkok, some were very good, and others not very useful.

As time went on, CAMA sought other temporary help. A Brazilian doctor and his nurse wife arrived, a couple of doctors from USA, and a young Khmer girl now living in New Zealand (who was at first terrified that the Khmer Rouge would murder her.) We now had at least two doctors in tent number 8, and sometimes three. We still received about ten new patients per day, but many others were getting well enough for discharge out into the camp, so our patients no longer had to lie shoulder-to-shoulder.

Cameras and reporters were everywhere. As I worked with an unconscious kid a man with a microphone squatted down beside me and asked me to describe the case. I'm told I was on Voice of America that night. Another night I was on NBC-TV all over both America and Europe as a “malnutrition expert”. I tried to send them to the camp's nutrition doc, but it turned out I was the only doctor in camp that day who had been in Asia a while and who had an American accent. Probably my audience in the next 24 hours totaled around one hundred million. I remember struggling to explain how starvation of the degree seen after six months in the jungle was like being isolated in a blizzard. When the firewood was used up, you will burn the furniture to keep life alive, and finally you burn the house walls themselves. And I remember that my main concern was to keep the TV cameras from showing the folks back home how swollen my own legs had become after a week of twelve to fourteen hour shifts.

Not everyone realizes that Lois was also on TV, her back to the camera as President Carter's wife, Rosalyn, walked through our tent and talked with her briefly. Lois' most memorable utterance was about the horde of reporters, who kept shouting “Get down! Get down” at her while they tried to get the First Lady's picture. Lois finally said, “If they just moved back a little, they wouldn't be standing in the patient's latrine ditch.” And a Secret Service man in the group grinned to Lois, “Say it louder. We're being recorded.”

That second week,we were still dog-tired but felt we could probably make it till more help arrived. Lois and I, with another nurse and Tann, our interpreter, even took our turn at night duty – fourteen hours watching over the whole hospital. There's not much you can do for a thousand unfamiliar patients. Most of the ward aides were sound asleep. We toured all the wards every three hours, restarting a few IV's, carried out a couple of dead bodies (whose beds were shared with other patients) cleaned up one teen-age boy covered with bloody diarrhea from the waist down, watched over a couple of women in labor. Took a 2 am break to visit with the Israeli doctor in the emergency tent – the only other doctor permitted to stay through curfew. He and I watched a Thai construction crew digging a deep-water well and erecting tall poles to light the area. I looked up at the poles and said meditatively “Haman built a gallows, fifty cubits high . . .”  The startled Israeli looked at me; “How did you know what I was thinking? Where did you hear that story?”

“Hey, the story of Queen Esther is in the Christian scriptures too.”

We left ward 8 in the hands of a Dutch lady, Eva Hartog, a TV personality who brought a team of eight Dutch nurses to work with the three American doctors who would inherit our tent. A letter from our Brazilian doctor friend several weeks later said the whole hospital is now in more permanent buildings, and there had been a day when there had not been even one death in the whole hospital. New waves of refugees were coming in then, some with war wounds on top of their starvation and diseases. Sa Kaew now had a small surgical unit, he wrote.

The day we left, several cases of epidemic meningitis (meningococcemia) threatened the camp, but I guess it did not develop. Most of the patients were visiting back and forth. Kids were playing games, or standing in line for milk, wearing their tin bowls on their heads as helmets. The girl on the TV spot who couldn't walk squealed in pretend terror and ran, when her sister told her I was coming to give her a shot. It's good to know we made a difference, but I don't mind admitting that all of us were glad to get away and rest.

A week or two later, my colleague at Maesariang, Dr. Bina Sawyer and two more nurses went down to another refugee camp. Even being the only doctor there, in her absence, seemed leisurely in contrast to Sa Kaew.

But once in a while I still reflect on how much difference a single piece of mail can make when it carries the right offer.

Mass Response to Genocide part 2

The dead bodies were still there or, more probably, new ones. What struck us most about the hospital was the lack of conversational background noise. Just coughing, in a constant undercurrent.

Our new tent, Ward 8 (someone later altered the numeral to depict a snowman-like figure gripping his belly) was ninety feet long and twenty feet wide, open sided, with 150 sick human beings, everyone crowded in at random, lying on bamboo mats on the ground. About fifteen more outside the far end of the tent were under lean-tos of plastic and sticks. Some had tags noting treatment given at the Thai border; others had letters inked on their arms standing for medicines they had received; Q for quinine, F for fansidar (another anti-malaria drug). We had no idea what some of the other letters meant. We had no translator the first couple of days, and the patients spoke only Khmer.

If any of them had education, they weren't about to let the Khmer Rouge soldiers among them know about it. It is said that Pol Pot's government summarily shot anyone wearing eyeglasses. The Khmer Rouge's brave new world had no use for any schooling other than their own indoctrination. Those first few days, no refugee wanted to call attention to himself by being the first to do anything.

Lois and I, with a clipboard and basket of medicines, started on the nearest patient. We marked a number 1 on her arm, listened to her chest, felt her abdomen. Started her on

anti -malaria treatment, B-complex for beri-beri, and iron for anemia, made a note on the clip-board, and moved on.

Patient number 4 had diarrhea. There were no bedpans. Those patients who were strong enough crawled to the 8-inch-deep latrine ditch at the edge of the tent. Weaker ones lay where they were. There were no clean clothes to change into; that first day there wasn't even a rag to wash them with. We found some old newspapers to put under her, gave her paregoric and an antibiotic, started a bottle of intravenous fluid, hanging the bottle from the tent frame on a bent piece of wire.

We moved slowly on down the tent. Some had massive swelling of their legs and bellies from protein deficiency; many were burning with fever. Many were pale from severe anemia, or too weak to stand, from lack of vitamin B. Both the Khmer (Cambodian) and Vietnamese armies, seeking to win their war at any cost, destroyed each others farm crops. Many of these people had had nothing to eat for months, except leaves from the trees in their forest refuge; no protection from malarial mosqitoes and other jungle fevers. Several had deep ulcers, bed sores from lying for days in one position out in the jungle. Many children lay listlessly, or having a futile try at their mother's dried up breasts. Children and some adults had arms and legs not much bigger around than my thumb.

      I felt a dull, bitter anger inside me toward leaders who make war and make other people pay the price. But mostly there was only time for squatting down again to listen to another chest, feel another abdomen, start another IV bottle. My muscles ached with the constant bending, kneeling, and stooping. We drank quarts to replace the sweat. On later days we ate all the lunch that Winnie and Aree packed for us, but that first day the scene was all too new for us, we weren't hungry. Somewhere in that day, an American Embassy doctor pitched in and helped; but by sunset, when it was time to go, we still hadn't seen everybody.

      Bob Jono and I had to stay after dark to attend the nightly staff meeting, where the day's problems were ironed out. When I learned that each group had to provide a doctor and nurse every five days to cover the whole 1,200-bed hospital from 6 pm to 8 am, I thought I'm finally getting too old to take it anymore! We got back to town about 7:30, ate supper and fell into bed.

But as we weathered he first few days, things got better. We got a small tent to keep our medicines and eat our lunch. We built up our stock of medicines, and what we didn't have we knew where we could trade. Bob found us a refugee who spoke fluent Thai and a little English, and we could finally communicate with our patients instead of practicing veterinary medicine. Weena mass-produced a gruel of milk and protein food made by Thailand's Kasetsart University and passed it around, a cupful to each patient twice a day, to supplement the food from the camp kitchen. We got so we could finish morning rounds by 3 pm, and one afternoon we cleaned out the dirtiest mats and had the patients lie in three rows, with space to walk between. We discharged enough healed patients into the larger camp (now numbering 35,000), bringing our tent's count down to 100, and moved all the outside patients in under the tent. We shared medicines and nurses with tent 9 next door, where a couple of American doctors on loan from some research group were getting acquainted with clinical medicine.

      And the tent grew noisier. People had enough strength to talk now, and sometimes even smile. One little girl with diarrhea and pneumonia and no family to look after her, whom we left each night not expecting her to survive till morning, sat up one day and began shouting something. Tann, our translator, grinned and explained, “She' s saying she doesn't want that old soup, she wants a fish!” We not only found her that, but a banana too.

Excitement broke out at the far end of the tent one afternoon. A girl who had been separated from her family a year ago suddenly spotted her father and sister walking by outside.

      There were discouraging things too. People who couldn't be persuaded to eat, the comatose who sank lower and lower and quietly died a few days after reaching camp. (Miserable as the camp was at first, it was a big step up from starving unattended in the hills.) Our ward averaged about one death a day now, as did other wards. The record for the whole hospital and camp was 42 deaths in a single day.

      We got to know many of our patients after a fashion. (Asking their personal history was taboo; there were still Khmer Rouge agents among them.) There was the mother who hated shots more than her three kids did. The one-legged man on crutches who led his blind friend with a stick. The young man with TB. The comatose girl with cerebral malaria who developed a bed sore overnight when there was no one to turn her. The old man with gradually healing leg sores.

In our second week there, an Israeli team arrived to take over the tent next door from the departing American researchers. Wearing green scrubs emblazoned with a red star of David, they soon developed a receiving ward and accepted all new hospital patients around the clock for emergency treatment before distribution to other wards. The Israelis were a friendly bunch, but we were embarrassed to have only ham sandwiches to share the day they arrived.

      The hospital as a whole, now down to 1,000 patients was under the joint direction of the International and Thai Red Cross, but we other groups operated under them almost independently: the French “Medicin Sans Frontiers”, World Vision, C&MA (us), and the Israelis. A group of Catholic sisters took care of about 400 orphans; a German doctor had a special nutrition unit, and a lab technician from somewhere opened up a blood bank. He drew blood from the many visitors to the camp and split each unit into two two half pints. (When your hemoglobin is down to 2 grams, even half a unit of blood can double it. The French unit delivered two or three babies a day. Even at full term, they mostly weighed only 3 or 4 pounds.
     to be continued . . .

Mass Response to Genocide

Fall harvest time was never very busy at Maesariang Hospital in northwestern Thailand. Patients don't want to leave their fields unless they are practically dying. Seeing some of the refugee horror stories in the Bangkok newspapers, and having time on our hands, we wrote a letter to the mission refugee committee, offering some time if they needed us. A telegram from committee member Pat Coats asked for as many as possible to come right away to work at the Cambodian border, 500 miles to the southeast.

Half the hospital wanted to go, but of course our hospital in Maesariang had to be kept running too. Five of us finally went, Rosa, a Puerto Rican nurse; Mala, a Karen nurse; Weena, a Karen aide; and my wife, Lois and myself. We got the telegram October 25 and were on our way next morning, taking the bus to Chiangmai, and the overnight train to Bangkok.

We would be on loan to CAMA services, Inc., the service arm of the Christian and Missionary Alliance mission, which has long worked in Cambodia. We drove over to their offices to meet our co-workers and learned that the Thai military had just opened a large refugee center at Sa Kaew. The International Red Cross had set up a hospital there with several hastily gathered medical teams. CAMA had a permanent medical team forming in the Netherlands, but it would not arrive for two weeks.

Some of their workers had helped in the search for refugee groups along the border near the Thai border town of Aranyaprathet,and reported thousands scattered here and there in the bush, many dying or too weak to walk. They were being moved back away from the border to cut the risk of hot pursuit into Thai territory by the advancing Vietnamese army tanks. These refugees were mostly people pressed into service by the Khmer Rouge, whose army remnants were backed up against the Cambodian forest border with Thailand. 

 

It's a three-hour drive by mini-bus from Bangkok to Sa Kaew; good highway through farm country, where the pervasive vinegar-like smell of the drying tapioca crop permeated the air. Our guide said we might as well stop at the camp before going on to our living quarters in Sa Kaew town, ten miles further on, so we pulled off on a dirt side-road, where armed guards checked all traffic, and handed out passes for those authorized to enter the camp.

Our first impression was of barbed wire and mud. The camp was only in its fourth day of operation, bulldozed out of swampy rice fields, sheltering about 30,000 black-clad people behind a fence. We had to step from grass hummock to tree root to get around. At one point, Lois had to reach elbow-deep into the mud to retrieve a shoe.

The hospital area was on slightly higher ground but otherwise chaotic. We were introduced to someone who said, “Fine, go to work in that tent over there.” We had been up since 5 am, some of the girls needed a toilet, and we hadn't even seen where we were supposed to lodge. But the word was “Work a little now, so you'll know the problems by tomorrow.”

I entered the indicated tent, where a harried-looking doctor was carrying a large cardboard box. Motionless patients lay every whichway on bamboo mats on the mud floor. We had to duck to avoid the bamboo cross-pieces in the tent frame. His box contained a jumble of paper cups of pills, syringes, bottles of liquids, bags of intravenous fluids, six-by-eight inch cards and so forth. The first thing that happened was the bottom dropped out of the box and everything slid among the patients. I went to find another box, finally dumping some bottles out of a carton I found in a supply tent. A patient needed a shot. I borrowed one from the more organized tent next door. The doctor himself had only started work that morning. Two Red Cross doctors had already quit after working only two days. He looked at another patient. “The A on his arm means he's been given ampicillin. We'll give him another shot of it now.”

“That's an every-six-hour drug,” I said, “Who gives it at night when we're gone?”

“Nobody.”

Most of my three-hour stint that afternoon was spent looking for things. The doctors in the far tent spoke French. The British lady presiding over a card table full of medicines in Tent No. 1 was having enough trouble supplying her own patients, so I hunted among the unattended supply tents. I began to get dizzy every time I stood up. The heat was oppressve, and I was wet with sweat. The other members of our team were presumably off with other doctors. Several dead bodies, rolled up in the mats on which they'd lain, were in a row between the tents. No one paid them much attention. It began to rain lightly.

At dusk, our guide found us and told us to round up and move on. I found Lois way over in the orphans' tents, following a doctor with no more idea than I where to find the medicines he was ordering. Then the word word went through the hospital, “They're unloading another convoy. Come and help!”

Out on the road we stood in back of several large Thai army trucks, helping down emaciated people who couldn't have weighed more than sixty pounds apiece. Most needed help to walk, and held on to small bundles or cooking pots. Several husky young volunteers scrambled up into the truck to hand down a half dozen people who made no effort to move. Some felt very hot to the touch. I found myself trying to hoist the mid-section of a rather large unconscious man onto a piece of cardboard. Four of us struggled through the mud to the fence and pushed apart two strands of barbed wire to hand him through to volunteers inside.

We were all bone-tired on the 10-mile ride into town. I admired the two Red Cross doctors who had managed to last two whole days. We got Chinese food at a restauurant, and finally arrived at the house rented for us by CAMA. A lady introduced herself as Winnie, and said there was plenty of bath water and clean beds ready, dormitory style. It was Winnie, and later her husband and Aree the cook, who made life possible during those next two weeks. Other teams told us later about their grungy hotel rooms and worse food, and coming home too tired to fix any dinner, but after our second day we always had a hot meal waiting.

Up next morning at sunrise. Our team leader, Bob Jono, told us we would have our own newly established tent to work in today. Remembering the disorganization of the day before, we stopped in town to buy a couple of folding card tables, plastic baskets, cups and tea kettles to carry water in, and five-gallon cans to carry it from the camp's water tanks.

We looked like we were on safari, moving through the hospital gate. On subsequent days we also carried cases of pop and big containers of crushed ice to combat the heat exhaustion we had felt the first day.

To Be Continued

New book coming

My blog posts have been infrequent lately, taking second place to a new work in progress, as yet untitled.
It is non-fiction, an inspirational collection of brief profiles of actual people I know - or have known - personally. Probably 1,000 to 3,000 words each, in final draft. They are people who have touched other lives around them, whether in their local community, or on a much broader scale.

Some of them I discovered by merest chance; others were my colleagues for several decades whose work took unexpected turns. I will try to discover how those lives did take that turn and, where applicable, because any of us might find such possibilities in our own future.

I think you will find them interesting, with occasional surprises. Deo volente, it will be ready for market this fall.

I am also trying to improve this blog and the nearly defunct website from which it sprang. I am a klutz with computers, so it may take awhile before I get two-way comment capability.  Come visit.

My Kind of Poetry

Many poets nowadays tend to be as obscure as possible. Individual preferences differ, but I have met poets who contend that meaning doesn't matter at all; poets who eliminate prepositions and connecting verbs, or who want the listener to "feel" the work rather than comprehend it. Playing such mind games is all right as an exercise, I suppose; I find the individuals themselves entertaining (and I mean that in a positive sense); I enjoy them as people, but when they finish their reading and look around the small group expectantly, I panic. Each obviously expects some comment.

What reaction is best? To say,"I haven't any idea what you were talking about" seems rude, even when true. "Impressive imagery" can be used only a few times. "Wow" or "Fantastic" rarely measure up to even low levels of sophistication, and are too likely to invite further questions.

But whatever happened to meaning? When I take the time to travel to a writers' group, the literary equivalent of strobe lights or aroma therapy aren't enough to satisfy me. I want something I can retain and ponder, perhaps even recall word for word while I use my exercise bike, or lie awake in the night. Meter and rhyme used to have purpose, not only for any pleasure they bring in themselves, but as a means to imprint the poetry on my mind, to be recalled days or years later.

A poem need not have meaning, meter, and rhyme, all three, to make it memorable. Like the body's physical sense of balance (derived from inner ear, eyesight, and awareness of body position), one can be removed without loss. Remove two out of the three, and the mind in the one instance, or the body in the other, begins to stagger.

The time has come, the Walrus said, to talk of many things;

Of shoes and ships and sealing wax, of cabbages and kings.

And why the sea is boiling hot, and whether pigs have wings.

(Lewis Carroll, Through the Looking Glass.)

Utter nonsense, unless you suspect satire about pompous professors the author, Lewis Carroll, may have known. But Carroll descends further into meaninglessness in his poem Jabberwocky. It starts:

'Twas brillig, and the slithy toves

Did gyre and gimble in the wabe;

All mimsy were the borogoves,

And the mome raths outgrabe.

Even though there is little meaning in the words, the mind constructs a picture, carried on by the perfect rhythm and rhyme of his lines. The poem goes on to tell the tale of a man sending his son to kill a forest monster, and the poem became so famous that it has planted several new words in the English language (e.g. chortle, galumphing, beamish.)

Ancient Hebrew poetry, translated into English, has no rhyme, and no definite rhythm,but depends instead on a repeat of a phrase in different words. But the meaning has inspired readers for three thousand years: 

 

Whither shall I go from thy Spirit?

Or whither shall I flee from thy presence?

If I ascend up into heaven, thou art there.

If I make my bed in hell, behold, thou art there.

If I take the wings of the morning, and dwell in the uttermost parts of the sea;

Even there shall thy hand lead me, and thy right hand shall guide me.

(Psalm 139)

Contemporary poetry, on the other hand, is easier to remember because the similarly inspiring thoughts also scan and rhyme. Consider:

Though the cause of evil prosper, still 'tis truth alone is strong.

Though her portion be the scaffold, and upon the throne be wrong.

Yet that scaffold sways the future, and behind the dim unknown

Standeth God within the shadow, keeping watch above his own.

(Lowell, Once to Every Man and Nation)

Finally, poetry can be simply enjoyed for its wit and humor. Starting as nursery rhymes long ago, limericks were made popular by Edward Lear in the nineteenth century. He, however, usually ended the first line and last line with the same word, robbing the verse of any surprise. Later limericks are more imaginative, greatly improving their popularity:

The humor may be gentle:

A Canadian fisher named Peck

Fell through the ice up to his neck.

When asked, "Are you froze?"

He said, "Yes, I suppose,

But we don't call this cold in Quebec."

Or merely ridiculous:

There was a young lady from Natchez

Whose garments were always in patchez.

When comment arose

On the state of her clothes,

She would drawl, "When ah itchez, ah scratchez."

(author unknown)

In our writers group in Kellogg, Idaho, there is a man, Jeff Simonson, who can produce original limericks almost without effort - sometimes as a narrative poem of five or six verses, each verse a faultless limerick, expressing his mood or a recent event. I envy his skill, but poetry is not my major literary interest. I have rarely tried to compose any poetry since high school class assignments long ago.

My favorite form remains the limerick. It permits satire, surprise, rhythm and rhyme, and is brief enough to memorize. Mind games and cross-cultural poetry have their appeal, but I still treasure the traditional forms that can be easily recalled and retained in the mind.

Midpoint on My Pacifist Journey

I thought about peace a lot, there in 1961 and 62, living in Kengtung in the middle of the Shan rebellion. After Burma expelled all the foreigners, and my family and I moved to Thailand to start the medical work at Mae Sariang, I thought still more. The Chinese Communists had a news broadcast in English each night and we would listen once in a while. They boasted about the coming liberation of Thailand. Thailand is the only country in Southeast Asia that has never been anyone’s colony, and I wondered whom the Chinese wanted to liberate Thailand from.

The Vietnam War was also starting up about the same time. Vietnam had been partitioned, and the Communist North was beginning to invade the non-Communist South and were behaving there much like I had seen the Shan insurgents behave. And I decided that there were times when the pacifist position is not enough.

It was not that I feared for my family. In Burma my three-year-old son used to crawl into bed with Lois and me for reassurance when the rebels set off dynamite to destroy bridges, as they sometimes did, but the explosives were not directed at us. And in Thailand we kept a bag packed in case we had to walk out across the border but we trusted God for our safety then as we do now. But although I still saw a need for pacifism in the world, I realized that in the immediate situation, people in the villages sometimes had to defend themselves.

And so, after I came from Asia and lived in Idaho, I often sided against those who protested the war in Vietnam. At the Baptist Convention in Seattle in 1969, some delegates organized a public demonstration for peace in Vietnam. I asked if anyone could carry a sign. Sure, the demonstration leader said, everyone has the right to free speech. So I made a sign that said, “Peace will come to Southeast Asia when North Vietnam gets out of South Vietnam and Cambodia and Laos” and I got into the line of marchers circulating around the Seattle Center grounds. Nobody read the signs, they just saw the marchers. Two soldiers walking by criticized me for marching. I asked them, “Hey, have you even read my sign?” They looked at it a moment, said, “Oh. Okay,” and walked off. At that, a fellow peace marcher amiably peered over to see what I had written, uttered a shocked expletive, and moved as far away from me as he could get.

And that’s kind of where I stood, for a couple of decades, gaining a prickly reputation during twelve years on the American Baptist General Board. I and another Board member who was an Air Force colonel were the Board’s token hawks in those years. It was during that time that I went back to work in Thailand for another four-year term. That time included a spell giving emergency medical aid to the refugees coming out of Pol Pot’s Cambodia in 1979, tens of thousands of refugees, eleven hundred in the hospital tents of our camp, with up to forty deaths per day following their months of starvation and disease. More about that later.

But in the nineties, I thought some more. By that time, we had seen the Gulf War, the Rwandan genocide, Somalia, and of course the Irish civil war had been going on a long time. The fighting in Burma, which had begun in 1947, was still going on fifty years later, with neither side winning, and the nation in a long slide into economic and political chaos. And I began to wonder: not only, ‘Is peace worth the price’ but ‘Is war worth the price?’ Is there not some third alternative, besides battle and surrender?

A possible answer showed up in 1996, when Lois and I were invited back into Burma after thirty-five years’ absence. A Seattle-based volunteer group named World Concern had a project training village health workers up in the Kachin State. The Kachins used to be an American Baptist mission field from around 1890 to 1965, and even after all the foreigners were expelled from Burma, the Kachin church kept on growing rapidly. For thirty years, the Kachin Independence Army had been fighting the Burmese government. They are good fighters, these Kachin Christians, but in thirty years neither side could gain victory. Travel and trade were almost impossible, and most of the men had fled from their farms to escape the Burmese. Many people did not have enough to eat.

Finally, the Kachin leaders said, “This is not the way God wants it to be.” In 1994, working with other Christian groups in Asia and Europe, and consulting with the Carter Center in Atlanta, they finally reached an armed truce with the Burma government. According to the truce terms, neither army may enter the other’s territory, but postal workers, medical workers, and other unarmed people may go back and forth. Our medical training teams, in fact, were approved by both the Kachins and the Burma Government as part of the truce agreement. Snipers no longer fired upon trains and river boats. Farmers began working their fields again and bringing their crops to market.

Present-day Burma has certainly not solved all its problems. The government is still a dictatorship; the legally elected parliament still cannot meet, and dissenters still go to jail. And just lately, the Burma army has started moving hill tribespeople out of their villages and setting up free-fire zones. If anyone returns home to harvest his crops or to get something he forgot, the soldiers shoot to kill without further warning. (Where do you suppose the Burmese learned to do that?) But the Kachins have decided they are going to get on with their lives again. Many still privately disagree with the way the country is being run, but they have decided that killing is not the solution. I admire them for that.

2003: The more I read, the more I am uncertain that I have anything to say that other people need to hear. Granted, there are a vast number of books on subjects more trivial than mine, and even authors who can't write as well as I think I can. But who am I, to be telling others the way to peace? Any particular nation, including Burma, has a great many authors more experienced and more involved than I. But no one has had the same experiences that I have had (except maybe my wife), and some of mine are probably interesting, but may not be of earth-shaking importance.

The peace theory behind my writing the novel Flame Tree has been that the Kachins chose to get on with their lives despite a dictatorial and corrupt government, and that this decision could have wide application in other troubled countries. So far, the Burmese dictatorship has shown little sign of changing the destructive path they have been on for forty-one years. And some of the ethnic groups, Karen, Shan, and others see no alternative to armed defense except extinction. Economic and political sanctions have not had much effect on those in power. There are neighboring nations—China, India, Thailand, Singapore—who are still quite happy to sell weapons and other supplies to the Burma army.

Faced with all this, what can I say? Pray? Yes, certainly, for only God can have the ultimate answer to this impasse. But while waiting for God's answer, what? Stand idly by while families and whole towns are "ethnically cleansed" to the cheers (perhaps orchestrated) of the group in power?

Some people say why get so upset about people who have warred with each other for hundreds of years? What about Sudan, what about Congo, what about Burma, Ireland, Afghanistan, Liberia, what about injustices here at home?

The more such hot spots, the less effectively any nation or alliance can remedy them by military means. We must acknowledge that we can't fight them all. But I am reminded of the motorist who was pulled over for speeding who complained, "Officer, what about all the cars that were passing me?"

The officer continued to write out the ticket as he said, "Buddy, if we could catch them all, we would. This time, I caught you."

Police action alone is not enough, of course. There must be more or less consensus that speeding has bad consequences, there must be education of the public about the needless deaths, good design of highways, general acceptance of the dangers of drinking and driving, and of road rage, and of running stoplights, and many other facets of the problem before the mayhem is assuaged.

More to the point, the spirit of the law must be within the hearts of the citizens, before anything is really accomplished.

In this era of the worship of power, pride, and economic force, we have a long way to go before the spirit of peace is in our hearts.

So back to writing about peace. The Kachins say, "We don't care who governs the country down in Yangon; the weaker their governing is, the better."

That can sound a lot like, "**** you, Jack; I'm all right." But I don't think that is what they mean. What they are saying is more like, "For thirty years we fought the Burma army, and we had a land where no travel was possible, villages were depopulated of men, fields untended, the women and children hungry and sick. This is not what God intended for us. If the Kachin Independence Army standing by in the hills is enough to allow us to live at peace with the government, we will cooperate and get on with life, despite the government corruption."

  It took faith to say that, and restraint, diplomacy, and self-control. Not every group is ready for that. It takes faith to write about it.

Peace is not the primary work of the church or any other group; peace is a by-product. Peace involves laying aside ego and power trips. If a peace advocate is too busy with protest movements and politics to pay attention to those who are spiritually lost, or if the peace advocate is too preoccupied to participate in the church family, then his or her spiritual foundations are likely to be unstable.

             I myself really know very little about war. I have seen the edges of it. I have seen hungry children; I have watched soldiers burn a village. I have seen thousands of people in a refugee hospital, too weak to make any sound except a cough, and I have watched some of them die. I can’t tell you if peace is worth the price, or if war is worth its price; that’s something each person must decide. But I can say that something is badly wrong when there are hundreds of thousands of refugees. Something is badly wrong when people are driven from their homes so that free-fire zones can be set up. And I felt a dull anger mix with my fatigue at that refugee camp as I watched the Cambodian people silently die, nameless, with no friend or family nearby, slipping away so quietly that the only sign of death at first was the lice leaving the cooling corpse.

Something is badly wrong with us when our daily concerns are for higher income, more amusement, a more patriotic America, while we dismiss the deaths we have brought about in Afghanistan, and Iraq as mere “collateral damage.”

Is the struggle against overwhelming greed, pride, and violence worth the price? Jesus said so, and I know no greater authority. He said, “In the world you will have tribulation. But be of good cheer, I have overcome the World.”

Faith means acting on one’s belief, even when no peace is in sight. Even when “the other side” shows no inclination to change. Peace begins in one’s own heart, giving up the demand for vengeance. Vengeance only leads to escalation. How many more suicide bombers and fanatics will be needed to convince us?

There has been a saying, “Don’t get mad, get even.” But getting even is only another term for vengeance.

A better concept is, “Get rid of the enmity, not the enemy.