“I am falling. Deeper and deeper I am falling, and the light recedes in the distance. Everywhere else is a darkness so black that it feels like a weight pressing on me from all sides, as I fall farther and farther from the light. I hear my heart racing, then slowing rapidly, slower and slower. I know that I am dying and I WANT TO LIVE. But I cannot make a sound. I cannot pray. I can’t even breathe. My last thought is, ‘maybe someone is praying for me.’…. That is all that I can remember.”
These were the thoughts so powerfully passing through Wilfredo’s mind. But only the Lord could hear them. We were on the outside doing all we could to bring his ship back on course, a ship which seemed to have capriciously and inexplicably decided to turn and run onto the rocks. What he somehow sensed about dying was true. He was dying, and dying fast. When nothing we were doing seemed to be making any difference, we stopped and prayed…again… and so did at least one someone else. I’ll get to that.
It had begun as a pretty routine operation about a month ago, one of many in Wilfredo’s past history. OK, Wilfredo is not exactly his real name. Though I doubt he’d mind, I do generally try to consider people’s privacy. About 4 ½ years previous to this story he had been hit by a car while riding his motorcycle in one of the larger cities in Honduras. In the Public Health Hospitals he underwent a series of operations on his distal tibia (just above the ankle). We almost never receive records from Public Health Hospitals, so we’re not sure what was done. But we know that there was infection and very significant bone loss.
When Wilfredo had first come to us there was about a 7.5 cm (nearly 3 inches) gap of missing bone. That is pretty difficult to overcome and end up with a functional foot. It requires a series of exacting operations, the right kinds and combinations of wound care, physical therapy… and God’s providence in healing all of your best efforts in order to ultimately end up with a functional foot. But so far, this long process seemed on the road to success. He had come to the point of what might be the last operation. The last gap of missing bone, the final residual non-union site, needed to debrided, grafted with bone graft, and then the tibia plated.
Wilfredo had come in with his devoted and level-headed wife and his Mom (whom I don’t think we noticed at first), showing up in “Preoperatorio” first thing in the morning. He had been through the drill before, with at least a couple of previous operations done here at Loma de Luz. Rosanne took her usual thorough anesthesia and social history (no current meds, maybe had some unknown reaction to Penicillin when he was 8 years old), and prayed with Wilfredo and his wife. The OR was all prepared, he was wheeled back and positioned on the table, all IV’s and monitoring lines and sensors in place. He was induced, intubated, and initially showed some soft signs of a little hypersensitivity with a bit of bronchospasm, but this was quickly recognized and dealt with. By 15 minutes into anesthesia, he is stable, prepped and draped. We pray again (which we do at the start of every operation), leg tourniquet up, and I begin the surgery. He’s relatively stable for the next 45 minutes though he continued to demonstrate reactive airways which required a bronchodilator 3 times. Were his lungs so sensitive from prior exposure to certain anesthetics? Was it post-COVID lung hypersensitivity or the COVID vaxs he’d gotten just a few months earlier? Still, though he never seemed to quite settle down and fly straight, I was paying attention to the surgery, and hardly noticed how busy Rosanne had been. She said he was “a bit rocky, but in control.” I’d made steady progress and was just at the point of harvesting the graft when his pulse spiked, his pressure dropped, then his pulse ox dropped out the bottom…. I stopped operating and paid attention to what Rosanne was battling.
“All inhalationals off?” “Sure, O2 only.” “Tube placement re-checked?” “Yeah, kind of tight but bilateral breath sounds, and a good CO2 wave form. He’s moving air when we bag him.” “What pressors have you given?” “Phenylephrine, no response. Ephedrine, no response. Epi 200 mics IV… didn’t phase him.” “Squirt some Epi down the tube.” “OK…..pressure’s still 80 over nothing.” “What is it?” “Don’t know… he bronchospasmed at induction but half responded to albuterol. Pulse is dropping…no read on the pulse ox.” “Try another oximeter.” “Already did, he’s got ’em on both sides.” “Malignant hyperthermia?” “He’s afebrile.” “Anaphylactic?” “Maybe, but to what? Ceftriaxone? But he’s had it before.” “Try Ephedrine again. I’m just going to close, but I can’t let the tourniquet down with his pressure like this.”
Right about then he started to brady down. His pulse went from 140 bpm to 70 in about a minute. When someone is already hypotensive, that is not a good sign. With blood pressure and pulse ox not measurable, not knowing what was causing this nose dive and not knowing what else to do, just before starting chest compressions, I said “Let’s pray.” So, we did. Admittedly it wasn’t much of a prayer. I can’t remember whether it was in Spanish or English, but it was kind of rushed and with eyes on the monitors… and I think Rosanne gave him another 200 mcgs of Epi while we prayed. … But somewhere in there, around 1:00 PM, he started to turn around…. or at least he stopped dropping like a rock. At least he had a measurable blood pressure and O2 saturation. Still, he was so unstable I just closed his leg, operation half finished. In 40 years of surgery, I can’t remember doing that. Then, like a plane in a movie, pulling out of a nose dive at the last minute, Wilfredo skimmed the tree-tops for a few minutes, then slowly began to climb.
It took another 30-45 minutes before all signs were normalized, but he came back, with no lasting ill effects. Now I know that is a lot of medical jargon, but that is kind of how you talk in a situation like that. And, I wanted to convey that this guy completely and unexpectedly went from routine to circling the drain, then something pulled him out. Maybe the point is best illustrated by comparing these two partial anesthesia records.
Medications in use are above, graphic vital signs charted below… and how the lungs are working in between. The day Wilfredo nearly died (about 1:00 PM) on the left, and the one on the right, the following day completing the operation under a spinal anesthetic. The spinal anesthetic course of the following day shows just one medication given (and that was optional). The vital signs graphics look like a pair of two-toed crows carefully side-stepping a straight path across a muddy field. This anesthetic course of the second day was what you want to see… Boring! And with anesthesia, boring is good. The day God sent Wilfredo back from that tunnel with the dying light, that was NOT Boring. There are a dozen medications charted in the course…. And the vital signs graphics look like the crows had too much to drink at the outset of their journey and got into a fight in the middle. The day of the troubles looks like a battle.
The backdrop to this one story represented on two dimensional charts and photographs is that Loma de Luz was going through a really terrible time just then. So much so, that this unexpected challenge was both a reminder and a point of tremendous gratitude. In the ensuing dark days when we, along with so many at Loma de Luz, were really hurting, we would look at each other wondering “How can we survive this?” Gratitude and the reminder of those pivotal two words which begin Ephesians 2:4…”But God”… were a lifeline. “At least Wilfredo didn’t die” was the beginning of a gratitude list. That Wilfredo didn’t die is also a story about another lifeline in times of great trouble. When you can’t pray (like Wilfredo felt falling in the darkness) or when it is hard for you to believe your prayers are effectual (like me in the midst of these troubles), make sure someone of faith is praying for you. In between the one operation (with the anaphylactic storm), and the next operation (which was smooth sailing), there is a key vignette which connects this rambling story. Rosanne was again pre-oping and preparing to pray with Wilfredo and his family for the completion operation. There was a long discussion about the troubles of the first one (which was when Wilfredo revealed what he had been sensing/hearing/seeing in the tunnel). Rosanne said, “Someone must have been praying for you.” Wilfredo pointed at a quiet woman sitting on a stool off to the side. Rosanne asked, “What were you doing yesterday at 1:00 o’clock?” She answered, “Praying for my son” and nodded toward Wilfredo. For the day of troubles, when you can’t even cry out, or it is hard for you to believe your God hears you, make sure someone of faith is praying. For “the effectual fervent prayer of the righteous availeth much.”
Epilogue: “And how shall they believe in him of whom they have not heard?” (Romans 10:14) Remembering that our calling at Loma de Luz is soul before body, (“Or what will a man give in exchange for his soul?”[Matthew 16:26]), as he was healing, the question was gently and privately posed to Wilfredo of “what would’ve become of you if you had kept falling down that black hole all alone and estranged from God’s presence in your life?” He shared that he had been struggling with God about that, and that friends had also come to talk with him about this very thing.
And there in a quiet hallway in Hospital Loma de Luz, Wilfredo made a decision to turn over, as he put it, “his hardened heart” to the one who answers the prayers, the one who pulled him out of his fall. I wanted to encourage you that God is still at work at Loma de Luz, that there are still things worth fighting for in this world, and ask that you remember Wilfredo and all those he represents in your own prayers….to the one who listens.
In Christ Jesus,
Jefferson McKenney, M.D.
A Word from the Cornerstone Board:
Over the past several years, Loma de Luz began putting structures in place to carry us into the future, beyond its founders. This included building infrastructure and general expansion of the hospital, as well as codifying the existing governance of Hospital Loma de Luz, Casa Santuario Children’s Home, and El Camino School. This restructuring includes selecting sending agencies that were a good fit for our model. After thoroughgoing consideration and prayer regarding differences in perspective, priorities, and methods, the Cornerstone Foundation disaffiliated with one sending agency. This change requires those missionaries with that organization to transfer to another of our five sending agencies and continue to serve at Loma de Luz or to find a different field supported by their original sending organization. In addition, several medical missionaries decided the Lord was leading them elsewhere. These missionaries did an excellent job and will be greatly missed. These recent losses in medical staff at Hospital Loma de Luz present a real challenge, but while services at the hospital may be reduced for a time, we are committed to continue. Some physicians are staying, and visiting specialist physicians continue their plans to come to help. The Cornerstone Foundation, the Asociación Piedra Angular, and the missionaries and staff of Loma de Luz are committed to doing all we can with the resources at hand to meet our commitments to patients and employees, and our commitment to continue to share the Good News of the Gospel of Jesus Christ.
The Children’s Home and El Camino School ministries and missionaries are going strong (we have not lost any personnel here). Pray for God’s direction and provision for the hospital going forward and for all the work at Loma de Luz. This work has always been completely dependent upon the grace of our Lord and God, and the generosity of His people, not dependent upon worldly circumstances or hurdles. Loma de Luz has weathered many trials over the decades. And, with God’s support, this trial will also pass. In faith, and in the Hope of the Lord who is both The Ancient of Days and The Dayspring From On High, Loma de Luz is committed to continue to serve Christ through serving others. Please keep us in your prayers.
Dick Lidgard—In Memoriam
Emeritus Cornerstone Foundation Board Member Dick Lidgard passed away in September. He was 87 and will be greatly missed. From the very early years of this ministry, Dick worked hard to help in every way he could. He served on early work teams while the hospital was being built, he gathered and delivered supplies and donated materials tirelessly—anything he could find to do to be helpful. He lived by and exemplified Paul’s exhortation to the Colossians “And whatsoever ye do, do it heartily, as to the Lord, and not unto men.” He truly had a servant’s heart. We are remembering him fondly and gratefully.
News & Needs
20 Year Celebration
In late August, we held the 20 Year Anniversary Celebration of the opening of full service at Hospital Loma de Luz (and the 30 Year Anniversary of Cornerstone Foundation’s founding) and had much to be grateful for. We were truly thankful for those who came to celebrate and those who joined us in spirit. Most of all we are grateful to God for this most improbable work that could not have happened without Him.
El Camino School—
After 11 years of prayer, persistence, and steady work, the school has received its final, official accreditation and licensure from the Honduran Ministry of Education. We gratefully rejoice!
Land Invasion—Invasions of private land is a massive problem in Honduras, and under the current administration have grown to epidemic proportions, with (according to government sources) nearly 30,000 acres of private land invaded in Honduras, roughly 18,000 acres invaded just in the Department of Colón where Loma de Luz is located. Many of you know that one of the threats we are facing is an invasion of nearby land. APAH is now leasing that land and providing security on the portion not yet invaded. This has helped stabilize the situation and is blocking further incursion into the rest of the land adjacent to the Hospital and Children’s Center and the watershed upon which Loma de Luz depends. But it is also expensive, and the situation on the ground where invasion has already taken place (adjacent to the Children’s Center) is slow to resolve. There is a definite criminal element and a dark spiritual element in these invasions. So please keep praying for the spiritual atmosphere in the community as a whole, for successful legal restoration of the invaded land and for the funds to continue the lease and security services protecting the water supply.
Daneli—Daneli, whom you read about in the spring 2022 newsletter, with Xeroderma Pigmentosa…as this goes to print, we have to operate to remove part of her tongue, her lower lip, and a large lesion on her scalp for aggressive cancers. Please pray for God’s healing and restoration for our special girl.
Mike needs help–Mike Yost, our so faithful, capable, and hardworking Construction and Maintenance Director, needs help. With Mike facing a number of serious health challenges, we need a Maintenance Manager to step in to help. … With something @ 75 buildings scattered here and there, that is a lot of maintenance. And while we can hold off on construction until we are staffed for it, one project at a time, maintenance can’t wait. So, if you or someone you know senses God’s leading, we are looking for one or two good men (and/or women) with a penchant for hard work and a willingness to both learn and to serve.
Finances—We have increased financial burdens which include the new cost of the land lease to protect against further land invasion, inflation pressures both in Honduras and in the USA, and decreased hospital revenue paired with increased hospital costs until the places of the departed missionaries can be filled. So please pray for wisdom and for God’s provision.
Thank you for your prayers, which have so often made the impossible happen. We are so thankful that Wilfredo lived and thankful for all the patients, children, and students whose lives your prayers and support have touched.
–Sally for Cornerstone