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September Newsletter 2020

Be strong and courageous. Do not fear or be in dread of them, for it is the Lord your God who goes with you. He will not leave you or forsake you.  –Deut. 31:6 

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.  –Joshua 1:9

The LORD is my light and my salvation; Whom shall I fear? The LORD is the strength of my life; Of whom shall I be afraid?  –Psalm 27:1

           Iris. I’ll just call her that here. Like the flower.  Because it is one of her names. But when you say her name in your head you should be thinking in Spanish like this: Eereese.  I’ve examined Iris, and reviewed her biopsy results and Mammogram, and Ultrasound and chest X-Ray, and now she’s clothed again and sitting with her friend beside her in a more private corner. Now we’re talking about what to do with this cancer. What is she hearing? What is she thinking? What has collected in those tears that gather in her eyes but refuse to fall?

           Is it something like this?

            “I am so scared I think I’m going to throw-up.  But there is nothing inside but acid and hollowness.  I haven’t eaten since yesterday.  And the pain never goes away. I can’t sleep. What’s he saying? The surgeon with the gray hair. Go to San Pedro? No, I can’t do that. Chemotherapy first? No. They’ll say they’ll be open, but they won’t be. And I’ll just get sicker, and this cancer will keep growing, and they won’t let me back here. They won’t let me pass on the road, and who knows when they’ll let the buses run, and I don’t have any more money. I can’t pay for a car to take me back. And I can’t stand the pain. No, he has to operate now.  I know I’ll never be the same. I’ll never be the girl I once was. But it’s too late for that. He has to take this cancer in my breast. What’s he saying? He seems sad. He seems tired. He says if we can’t shrink it with the quimioterapia, he has to take the whole breast. I know the cancer is so big. And the chemotherapy and the radiation therapy, he says they might work and they might not. But I know, and I think he knows, that I’ll never get the chemotherapy now… Not with no money…not with the toque de queda [Covid public movement restrictions]…. not with all the buses still shut down… not with everyone so scared of this virus and all of the clinics are closed. No, he has to operate, and I can’t leave the way I am now. What’s he saying?  He says if I can wait until the rest of the surgery is done, we can do this at the end of the day. Oh, thank God. Thank God. But it’s so sad to be happy to have him take my breast with the cancer. Maybe I’ll never be pretty again. I know. But I have to live… for my babies.  I’m so scared I want to throw up. And the pain never eases. But thank God they will help me. Maybe I’m terminal. Maybe I’ll die on that table. But maybe I’ll live… so be brave. Be brave like the first day of school. Be brave like when Mama died. Be brave like when you had your babies. Be brave for them. Be brave because you have to.”

 Iris holding her mask with photos of her children

           Was all of that concentrated in the tears that slowly gathered in her eyes but refused to fall?   I’m left wondering. For all she said was: “Sí, debemos que hacerlo… Gracias!  Esperaré. Estoy en ayunas. Sí, gracias y que Dios le bendiga!”  [“Yes, we have to do that….Thank you!  I’ll wait. …I’ll keep fasting… Yes. Thank you and God Bless you!”]

           I know what I was thinking.  Some of it I won’t say. But… “Good Lord, they should have to answer for this.  They should have to imagine what is in those tears and see and feel and smell this massive cancer and listen to this poor woman who last February! had a breast cancer big enough that they couldn’t miss it in some Doctor’s office with a true cut needle. Now six months have gone by while they’ve kept this country locked down from tending to anything else… if one virus was the only danger in this world ….. as if they could hide from that anyway. For six months she has carried this diagnosis of biopsy-proven, aggressive breast cancer, and she has done everything she could to try to find help somewhere while this cancer grew. ¡Ai Diós!  She’s 38 years old!  And, she has pictures of her kids on her mask, for crying out loud.  The youngest one looks like he’s six years old. And I don’t think I can get this cancer off without taking part of her chest wall, without taking ribs or cutting through cancer… or both.  I don’t know how I’m going to even get this closed.  What is SINAGER or the NIH or the CDC or the WHO or the politicians and the desk doctors and the talking heads on the evening news going to say to her? ‘Social distance, stay home and stay safe’? No, I don’t think they’ll ever recognize the collateral damage. They’ll never even hear about Iris.”

           I didn’t say any of that, of course.  I didn’t even say it to you (out loud). Those are just thoughts.  And, as far as I’ve heard, thoughts are still free. No, I didn’t say any of that. I did what you are supposed to do. I told her with tired but heartfelt compassion that we would do all we could to help her. I carefully spoke with her about her options (which are all bad… and pretty much limited to radical surgery here and now in a locked down country). I told her we were going to do the best we could to help her today, to get all the cancer that we could. I told her that it was going to be difficult to get things closed and that I might need to do flaps and skin grafts… and maybe a chest tube…and transfusions…that she would likely need chemotherapy and radiation and we would try to help her to get that.

           Then, like so many of our patients who are brave because they have to be, she kept her chin up and looked me in the eye and said, “Thank you, and God bless you.”

           Makes you want to cry.

           At Loma de Luz these days, we daily see the collateral damage from blanket governmental lockdown policies in reaction to fear of Covid-19. Antonio (another middle name) here is another one. He’s just the second of this morning. Antonio is 14 years old. Last January he had a sore lump in his leg below his knee, attributed to a minor soccer injury.  But the lump didn’t go away. It began to grow, and his Mom said she “took him to the hospital, but they said it was nothing. They didn’t even take an X-Ray. They didn’t give him an aspirin.”  His Mom kept trying to find someone who would look into why this mass kept growing, but then March 15 happened. With a couple of test-positive Covid-19 patients in the country, the Honduran government pulled the panic trigger, and locked the country down; all “non-essential” business prohibited, all bus transportation (the poor person’s lifeline) locked down, hardly any movement allowed on the roads, most clinics and labs closed, and only certain designated hospitals allowed open for limited medical problems. Many public health and government employees took the crisis as an encouragement to do essentially nothing. For most of the poor, even if there were healthcare facilities that would care for them, they couldn’t get there with the buses shut down. That was the case for Antonio. His Mom, like the great majority of the poor, did not have access to a private car… and regulations in place these past @ 6 months only allow anyone to be on the highways if the last number of their cedulla [ID card] matched that day’s authorized number. Even as I write this, any one person is only allowed to be on the roads once every 14 days.  How could her ID number and Antonio’s ID number and the driver’s ID number and a medical appointment all coincide?  Besides, they only let 2 people in a car, and she can’t drive.  Still, she persisted any way she could.


Antonio’s X-Ray

           Now, more than 6 months later, Antonio and his Mom heard about us from another patient (who also had a 6 months’ neglected sarcoma until he found us the week before), and they made their way here to Loma de Luz. All of that marbled-looking mass below his knee on the X-Ray is tumor… almost assuredly osteosarcoma.  We will biopsy tomorrow and rush the pathology report, but he will almost certainly require an above the knee amputation… and the cancer is almost assuredly already spread to the rest of his body, so he will need chemotherapy to have a reasonable chance of survival.

           But I’m not writing about crying or neglect or being angry with the decisions made by the authorities of this world or even expressly about Iris… or Antonio…. or collateral damage.

           I’m writing about courage.  Iris was just the first example I bumped into today, and Antonio and his Mom the second. The thought began when the 52nd junk mail banner of the morning came across my laptop screen from unknown parties wanting me to click to allow their cookies and wishing me to “Stay Home and Stay Safe.” At first I thought You don’t even know my name; you don’t care for my safety.…Then I thought, “Stay Safe“!!?? Are you toddlers? Are you delirious? I can’t remember being young enough to think the world could be a safe place.  I moved from a childhood with nuclear weapons aimed in my general direction, to a young adulthood with shoulder-fired RPGs aimed in my specific direction, to raise my children running a mission hospital in the jungle on a shoestring budget in the murder capital of the world, with more robbers, kidnappers, murderers, and bandits than buzzards (and we have a lot of buzzards) in our neck of the woods, and I KNOW I’ve lived a protected life compared to most of the world.  Yet you’re enjoining me to stay at home and stay safe… from a respiratory virus?

           OK, maybe I haven’t been getting enough sleep lately and I’m a little cranky…but again, these are just thoughts. I wouldn’t actually be so gauche as to say them out loud. I expect you don’t need any convincing that this world is not a safe place. If you’ve lived long enough to be reading this, you’ve been through some hardships. You’ve seen some stuff. And if you need any more convincing that the world is no safe place, you can just ask Iris…. Or Antonio and his Mom.

           No, it is not that the post-modern world is short on evidence that it is a dangerous place. It is not that the authorities running this post-modern world are not looking for “Safe Spaces” for themselves. They are obsessed with it. On a personal level. Half the world seems flat-out, bug-eyed terrified, and all they can think of is safety. The world searches madly for “a Strong Tower.”  They just deny the existence and have forgotten the name of the only Strong Tower mankind has ever had.

           A benedictory interjection is meant to say a lot in a few words. That is the closing wish or prayer or admonition one parts with at the end of a letter, or when you are sending your six-year old out the door. When I was a six-year old, toward the end of the last ice age, Moms said things like “now, mind your manners” or “be good” or “have fun” or “don’t be late for supper” or “write when you get work.”  If you were leaving to face something kind of scary like going to the dentist, or to have to dance with a girl, or to hop a train for the first time, they might say “be brave.” At least my Mother would.  But “Stay Safe!“… I don’t think that was anywhere in the Mom’s Official Handbook of Sayings.

           Now, however,….multi-billion-dollar tech companies close with it in mailouts to their millions of prospective customers.

            “Stay Safe!: Expression of a wish for the continued welfare of another (with the inference to avoid risk). …early online writings dating to @ 2000. … Highest online usage in 2020, since Urban Dictionary began following usage frequency in 2012.”

           Benedictory interjections don’t just say a lot about your wishes in a few words, they say a lot about a culture.

           The Apostle Paul’s closing benedictions tended to last for a chapter, in one run-on sentence. It was always understood that any parting words could be your last, so I guess he wanted to make them count. The benedictory interjection of his first letter to the church at Corinth essentially went on through the entire 16th chapter. The windup took the first half of the chapter, and the pitch took the second half.  But he began the pitch with this theme: “Be watchful, stand firm in the faith, act like men, be strong” (I Corinthians 16:33). Wordy maybe, but this was the Paul who was in labours more abundant, in stripes above measure, in prisons more frequent, in deaths oft. Of the Jews five times received I forty stripes save one. Thrice was I beaten with rods, once was I stoned, thrice I suffered shipwreck, a night and a day I have been in the deep. In journeyings often, in perils of waters, in perils of robbers, in perils by mine own countrymen, in perils by the heathen, in perils in the city, in perils in the wilderness, in perils in the sea, in perils among false brethren; In weariness and painfulness, in watchings often, in hunger and thirst, in fastings often, in cold and nakedness” (II Corinthians 23-27).  This was a man who had the credentials to tell you to “stand firm in the faith.”  For Paul and the culture of the first century church, “to live is Christ, to die is gain” (Philippians 1:21).  What would they fear?

           For a millennium and a half, the core of the culture of Christendom, shaped by war and weather, plague and famine, held to the certainty that in this dangerous world “The name of the Lord is a strong tower: the righteous runneth into it, and is safe” (Proverbs 18:10).  It is imbedded in our languages.

           Throughout the middle ages, when the English took leave of one another, the parting phrase was “God be with ye.” In the late 16th century this began to be contracted to “Godbwye” and ultimately became “Goodbye.”  The French stayed closer to the original: “a dieu vous commant”; and, at least in formal partings, they still say “adieu.” And the Spanish equivalent, “a Dios vos acomiendo” (I commend you to God), is still commonly intended with “adiós.”

           “A Dios vos acomiendo.” This is the Spanish that was still spoken formally in a forgotten little backwater country like Honduras when Don Natividad was born. Don Natividad was admitted into the hospital, I think, the day after we discharged Iris (who was happy and positive, and healing up from the operation… but not yet from the cancer by any means). The years of Don Natividad’s life, at 101 going on 102, span the century of transition of parting words from “God be with you” to  “Stay Safe.”  I asked him, “How’d you get to be such a respectable age of 101?”   He said, “Tuve que”… “I had to.”   I think I was looking for something a little more highbrow. But, Don Natividad is a man of few words and didn’t explain. Then, upon reflection, I think he hit the nail on the head.

Don Natividad

           We leave home to “eat your bread by the sweat of your brow, until you return to the earth from which you were taken” (Gen. 3:1) because we have to.  Along the way we will face hard things in a dangerous world because we have to.  And the Brave will face them head on, chin up, shoulders squared because we have to.

           Jesus’s parting words to His disciples, His parting words to His Church, were not “stay safe.”  They were, “In the world you will have tribulation. But take heart; I have overcome the world” (John 16:33).

           Let me be clear. I am not condemning the use of specific, well-meaning parting words between people who actually care for each other. I certainly say words to that effect to my friends and loved ones on occasion.  And, I am not condemning the lost world for meaning well or for thinking they can stay safe by hiding.  I am talking about worldview, and I am talking to The Church, the Blood-Bought Children of the Living God. We, who are supposed to be in this world but not of this world, We who walk in the hope of the resurrection, We are supposed to walk in courage, For God gave us a spirit not of fear but of power and love and self-control (II Timothy 1:7). He sent us out to be His witnesses … to the end of the earth (Acts1:8).

           At Loma de Luz we try to share that Hope, that Courage, that Safe Tower, that Name.  For He sent us all out “unto all the world.”

           So, Be Brave! … because we have to.

           And, Take Heart! …. for He has overcome the world.

In Christ Jesus,

Jefferson McKenney, M.D.


News and Needs:

Mike and Peggy Yost:  Please pray for Mike and Peggy as they deal with very significant health concerns for Mike. Many of you who have visited or served at Loma de Luz know what a backbone to the mission Mike and Peggy have been for many, many years. Now you have an opportunity to give strength and help to them through faithful, intentional prayer.

Covid Cases:  We know many of you are probably wondering whether we’ve had Covid-19 cases at Loma de Luz. At the time of writing this newsletter, in one way or another, we’ve cared for about 50 test-positive Covid-19 cases (depending upon definitions). Most are screened and released to complete treatment and quarantine at home.  We only admit to the hospital (the separate Covid Unit) those who would elsewhere be categorized as Severe or Critical (by WHO criteria). Seventeen have been admitted to the Covid Unit (current Sept. 4), and all have been elderly and with multiple co-morbidities. All but two of these “Severe/Critical” patients have recovered (often after protracted hospitalizations) and gone home. Both of these two patients were statistically in the last year of their life (due to age + obesity + renal failure + cardiopulmonary disease + diabetes) prior to contracting the SARS CoV-2 virus. We actually dealt with significantly more disease and death last year from Hemorrhagic Dengue than we have so far from Covid-19 this year.

El Camino School Update:  Regarding schooling this year, the Honduran government and Teachers’ Union seem to be committed to not allowing schools to open before the end of the Honduran school year in November. According to the newspapers, they appear to be considering legislation to just pass all the students on to the next grade regardless of any metrics of actual learning.  Our El Camino School (which usually runs with the main terms August- May) has requested that the government let us begin face to face classes in September with the many modifications we’ve made to the facilities, the spacing within the facility, methods of instruction, etc., all designed to meet optimal and workable safety standards. We have submitted voluminous documentation of the changes we’ve made and the reasoning for opening school, and are waiting to hear their response.  Please pray for the Ministry of Health to allow the school to reopen (the local and regional authorities are in favor of it) and for God’s blessing on all related communications and our relationship with governmental officials and agencies.

Hand washing has always been stressed at El Camino.

Laptops: We continually need laptops.  The best laptop donation is when a business is able to donate a larger number of the same types of laptops, but we are grateful when people are able to donate just one or two as well.  Laptops should be in good working condition with a Windows operating system (Windows 7 or newer) and should have a minimum of 4GB of RAM and a minimum of a 150 GB hard drive.  We need a minimum of 15 for the school and would gladly receive a donation of up to 50, as we are continually cycling out older laptops in the hospital as well as using laptops to help our children at the Sanctuary House Children’s Center to study. If you have any laptops to donate, please contact Lindy at the Cornerstone office.

As we move gradually into Autumn, and the world continues to feel shaken, may you remember our Strong Tower. And may the view from the windows of that Tower give you eternal perspective and needed vision.

–Sally Mahoney for Cornerstone Foundation