Wednesday, September 9, 2015

My Grandma

Working as a family doc I come across hospice, dying, death… quite often. Sad to say, signing death certificates is as routine as signing an authorization for a medication refill. But every now and then… I allow my emotions to overcome me and I am right there crying at the bedside with the loved one’s family members. 

This past weekend, I managed to squeeze a trip in to visit my almost 99 year old grandmother, leaving my four kids in the very capable and willing hands of their daddy. This grandmother, my “ah ma”, helped raise me so she has a special place in my heart. So in just one year time, I found my ah-ma to be a little more frail, a little more fragile, and unable to speak anymore. However, she is in better shape than I was expecting given some of the frantic phone calls I received late Spring. Her eyes are very alert and she seems to recognize me. She would nod her head a couple of times and before I left, she was squeezing my arm. I even got her utter a few numbers in Japanese with me while I counted. Every time I visit her, I wonder if this is the last time we’ll get to interact… 


My ah-ma was a formidable woman… raised 6 kids almost literally by herself since grandpa (ah-gong) was off working in the city. Not only did she deal with the day to day stuff that moms deal with when they have a handful of kids to manage, but she ran a ping-pong table business to support the family while grandpa was away. This is how my dad and many of his siblings became so good at playing ping-pong. If customers were few, they would step in to play. If they lost, the game is free, if they won, the customers would pay. 

Although circumstance did not allow grandma to get much formal education, I remember her as a very sharp woman. She was also a fantastic cook. 

It is hard for me to see her this way… so different… 

This weekend had me thinking a lot about life… the purpose of life… how our bodies are made to fail us eventually… and then what? As Christians, we believe there is more to this life than just what is here… we have hope and faith in God’s promises. That there is more to come and what is to come is going to be more marvelous and glorious than anything we can ever imagine. 

This Sunday, I was googling churches to attend and was hoping to go to one that had expository preaching. Initially, I was disappointed when I looked at the sermon notes and realized that the preacher was going to do a topical approach. However, I soon realized that God brought me there to specifically answer some of the questions that I was pondering all weekend. The entire sermon was about heaven! The preacher quoted from the Bible, passage after passage… these are some of the verses… 
 “Do not let your hearts be troubled. You believe in God; believe also in me. My Father’s house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you? And if I go and prepare a place for you, I will come back and take you to be with me that you also may be where I am. (John 14:1-3) 

Brothers and sisters, we do not want you to be uninformed about those who sleep in death, so that you do not grieve like the rest of mankind, who have no hope. For we believe that Jesus died and rose again, and so we believe that God will bring with Jesus those who have fallen asleep in him. According to the Lord’s word, we tell you that we who are still alive, who are left until the coming of the Lord, will certainly not precede those who have fallen asleep. For the Lord himself will come down from heaven, with a loud command, with the voice of the archangel and with the trumpet call of God, and the dead in Christ will rise first. After that, we who are still alive and are left will be caught up together with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. (1 Thessalonians 4:13-17)

But our citizenship is in heaven. And we eagerly await a Savior from there, the Lord Jesus Christ, who, by the power that enables him to bring everything under his control, will transform our lowly bodies so that they will be like his glorious body. (Philippians 3:20-21)

Then I saw “a new heaven and a new earth,” for the first heaven and the first earth had passed away, and there was no longer any sea. I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband. And I heard a loud voice from the throne saying, “Look! God’s dwelling place is now among the people, and he will dwell with them. They will be his people, and God himself will be with them and be their God. ‘He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.” He who was seated on the throne said, “I am making everything new!” Then he said, “Write this down, for these words are trustworthy and true.” (Revelations 21:1-5)

Therefore, “they are before the throne of God and serve him day and night in his temple; and he who sits on the throne will shelter them with his presence. ‘Never again will they hunger; never again will they thirst. The sun will not beat down on them,’ nor any scorching heat. For the Lamb at the center of the throne will be their shepherd; ‘he will lead them to springs of living water.’ ‘And God will wipe away every tear from their eyes.’” (Revelations 7:15-17)

Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things. Whatever you have learned or received or heard from me, or seen in me—put it into practice. And the God of peace will be with you. (Philippians 4:6-9)
There are probably so many more. 

Leaving my ah-ma was especially hard this weekend. Again, I am not sure whether I would be able to visit her again and if I do…. how much would she change? As I held her hand sobbing, she looked at me and seemed to be saying to me “aiya, don’t cry” Although nonverbal with words, she has been very communicative with some squeezing of her hand and with the movement of her eyes and head.

I love you, ah-ma. I don’t know at the end of the day whether you chose to believe in God and heaven… but I pray that God in His mercy can still speak to your heart… despite the outside shell of a weakened and frail body and a forgetful mind… that inside maybe you still hear and understand everything we are saying… that He would speak to your soul and you’d respond… and that I would see you in glorious form one day.

Sunday, September 6, 2015

Yosemite National Park and The Plague

Hello world!  It has been way too long…
So many things to catch up on… where to start…
As I knew it would, the summer just flew by. This has been the third year in a row that we packed a tremendous amount of luggage and flew six hours cross country to California. Herding our little ones through airport security and all that that entails is like… well… I can’t think of a good analogy. But the one huge difference this summer is that this is the first summer in EIGHT years that I am not either pregnant or nursing! Whoo-hoo! The physical freedom… I cannot even put into words…
Why all this trouble, you may wonder...  I am a very sentimental person and I value certain intangibles. Seeing my cousins and extended family and watching my kids form relationships with their extended cousins makes it all more than worth it.
Now we can’t fly six hours and put our kids through a three hour time zone change just to fly back after a long weekend, so we decided to make a vacation out of it and headed to Yosemite National Park.
Yes, this is the same Yosemite that CNN was reporting cases of plague.  And yes… we arrived there right when the first case was reported and left there right when they reported a second case.
So I had to do some research on bubonic plague since this is not something we see often these days and I definitely did not come across any cases as a medical student or resident.  Here is the basic 101:
WHAT IS IT?
It is a severe potentially deadly bacterial infection
HOW DO YOU GET IT?
It is caused by a bacteria called Yersinia pestis.  Usually transmitted by a bite from fleas or wild rodents such as rats, squirrels, chipmunks, and prairie dogs.  If the bacteria reaches the lungs, then it can be transmitted from human to human by respiratory droplets from coughing.
ISN'T IT ANCIENT HISTORY?
So this bacteria is the cause of the famous Black Death which killed 70 million to 200 million people in Europe during the Middle Ages.  However, it is still around today.  In the US, it is mostly found in the west (California, Colorado, Arizona, New Mexico) in more remote areas.  Since April 2015 there has been 11 human cases.
WHAT ARE THE SYMPTOMS?
Bubonic plague...
  • fever and chills
  • malaise
  • headaches
  • muscle pains
  • seizures
  • painful lymph node gland swellings (groin, armpit, or neck)
If Pneumonic plague...
  • fever
  • cough
  • difficulty breathing
  • bloody sputum
  • chest pain
If Septicemic plague...
  • fever
  • abdominal pain
  • diarrhea
  • nausea
  • vomiting
  • bleeding 
HOW DO YOU TREAT IT?
Requires antibiotics within first 24 hours or can result in death.  Need to be hospitilized for oxygen, respiratory support, fluids, and monitoring.
HOW DO YOU PREVENT GETTING IT?
  • Do not handle sick or dead animal bodies
  • Avoid rodents (mice, rats) and rodent droppings
  • Avoid insect bites by using an insect repellent containing DEET
  • Eliminate fleas from your home
Here's more info from CDC website:
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Well, we are all fine. 
Yosemite is beautiful by the way… unfortunately, it was dry due to California’s drought… but beautiful just the same.



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