Life is changing on the ship.  Over the past few weeks I've said good-bye to several friends.  The numbers keep thinning every week.  Of course there are new people coming in, but it will take time to build the same depth in friendship that I had with those that have left.  This is the hard part of Mercy Ships life.  You meet such amazing people and make great memories together, but we all come for different lengths of time so over and over again we say good-bye.  I'd love to believe that we'll all be able to reunite again soon, but most of us are from different countries and the probability of meeting again is low.  The moments of joy and excitement I've experienced with friends here outweighs the pain of saying good-bye though.
  Tim left the hospital.  It's amazing how quickly he has recovered.  About two weeks ago he got his trach out and he was able to speak for the first time in a while.  He didn't say much at first.  We had to prompt him a lot.  I think he was so used to not speaking.  One evening when I worked I heard my name called from behind me.  I was puzzled for a moment because it was a distinct African voice, but I didn't recognize it.  Then I looked around and there was Tim smiling and waving at me.  It was amazing.  Later that evening he was talking non-stop with his mom.  Him speaking is just one representation of how he has become a renewed person.  While we left the feeding tube in until he was discharged he started eating completely on his own.  One question I had asked him the night before his surgery was "Do you miss the taste of food?", and he said he did very much.  To have healed so quickly in 2 weeks that he can enjoy the taste of food again is so great.  He just wanted to eat constantly, he was always asking for another can of Ensure.  We only carry Vanilla flavored Ensure in the hospital, he drank that everyday about 8 times a day, and never seemed to get sick of it.  I'm sure he's getting some more variety in his diet now.  He left the hospital this past Wednesday.  He was discharged to the HOPE center so it's not an official good-bye.  I can still go and visit  him and his mother.  It'll be sad the day he officially goes home.  He's been with Mercy Ships since September.  I'm so excited for him though.  He will be able to enter his village a new man.  He will finally be able to participate in everyday life.  I can't even imagine what he will look like in a year when he has gained weight and his face has healed up.
  We celebrated Thanksgiving on the ship this past Thursday.  Really it was like any other day, except we had turkey, mashed potatoes, stuffing, green bean casserole, and pumpkin pie for dinner.  It was delicious.  Since the crew is so international, not everybody celebrates.  I did get to tour a French naval ship on Thursday.  That was fun.  The ship was docked behind us for about 4 days.  It was a frigate that was about one third the size of our ship and carried a crew of about 100 men.  They offered tours through the ship.  They actually showed us around most of the space.  We got to see the engine room, the bridge, the galley, all their guns on deck and more.  I've never toured a working naval ship before.  Because of my father's affinity for ships, particularly naval ships, I think I have toured a decommissioned navy ship almost every summer of my life.  Those were always fun because I loved pressing all the buttons and pulling all the levers.  It was safe to do it on inactive ships, but on a working ship I had to resist the temptation.  Who knows what kind of damage I could have done.
  Here are some picture to leave you with.

 This is one of the funniest patients I've ever taken care of.  Her name is Bintou.  She is so full of life and sass.  Notice in the picture that she has a trachoestomy and feeding tube.  Her feedings were running while she posed for this picture.  Not much can slow her down.  I've never seen a patient so active with a trach before.  She has good reason to be active though.  Before her surgery she has a mass in her neck that was almost completely blocking her airway.  She had difficulty breathing especially when she slept.  Once the mass was removed and the trach was temporarily placed she could breath normal again.  Now the trach and feeding tube are out and she will probably be going home soon.  She has a husband, a 5 month daughter, and a 3 year old son to go home to.  I'm so glad we could save her life.

This is a picture of Tim about a day before he went home.  He's showing the muscles that he's finally gaining back.  We didn't have much to offer in terms of exercise equipment in the ward so I gave him 1 liter saline bottles to lift.  He loved using them to work on his biceps and triceps.

Friday morning brunch with friends.

Delicious food.

This week was a good week.  Tim’s surgery went better than we all expected, absolutely no complications.  While he did require several units of blood and ended up with some sore legs from the position he was laying in for 10 hours, he came out alive and on the road to recovery.  His face only needed minimal reconstruction, so he has a good chance of getting close to what he looked like before his tumor.  Currently he has a lot of excess skin sagging from his face, but over time the skin will pull back into its original shape without any surgery.  I wish I could see what he looks like a year down the road.  As for now I’m just excited to see that he can hold his head so much better.  He can smile now.  And soon he will have his tracheostomy and feeding tube removed because he will be able to eat and breathe on his own.  By his hand signals and frequent hand-shakes I can tell he is very grateful for how we have helped him.  Hopefully before I leave I’ll be able to hear his voice.

  Other than that great news, things are going well on the ship.  I am loving all of the friends I’ve made here.  There are so many amazing people from amazing places.  I often get side-tracked here.  Many times I’ve made plans for my day doing some mediocre activity alone, like reading a book, but then I run into a few people and before I know 3 hours have past while I’ve been talking to them.  Meal times often take 2-3 hours because I spend so much of the time talking with friends.  I’m going to miss that when I go home.

 My name badge.  This thing goes with me everywhere.

 Picture of the ship from the water.  I was returning back to the ship after a weekend away at one of the islands.  It was hard to get a good shot of the ship in one photo.

The patient I mentioned in a previous post is going to surgery tomorrow, November 7. We’ll call him Tim. There has been so much done for in him preparation for his surgery.  He has a facial tumor called an ameloblastoma.  The tumor originates in teeth and can grow quite large.  From what I understand his tumor has been growing for 5 years and it takes up the entire right side of his face below his eye and it extends into his entire mouth.  It protrudes from his face a few inches.  Because of the massive size of the tumor he has not been able to eat a nourishing diet and therefore is extremely emaciated. The tumor has consumed so much of his mouth that he was very close to having his airway blocked off.  To counteract both his starvation and his breathing difficulties he has received a tracheostomy and feeding tube.  For the past 3 weeks he has been in our ward trying to “beef up” for surgery.  We’ve been watching his blood lab work closely to see what can be done to correct his electrolyte imbalances and his malnourishment.  All in all he’s done well over that time.  He’s adjusted well to breathing through his trach, he’s gained weight, and he’s been exercising. 

  This date of November 7 seemed so far away that it almost felt like I would never see it coming, but now it lies just a few hours ahead.  I feel very nervous for what awaits him.  This surgery will be very risky.  The tumor is pushing into his skull so extensively that he runs the risk of stroke, and massive bleeding.  The surgeon has talked to Tim and his mother at length about the risks involved.  He was told that the surgery itself could kill him, but if he does not receive surgery he will also die.  Either way he might lose.  Of course we hope and pray that he will survive and not sustain any permanent injuries.  He has so much potential to move on and live a normal life.  He really is a healthy man.

  Over the past few days that I’ve cared for him my aim has been to give him as much quality as possible.  If these are his last few days of life, or normal physical function I want him to make the most of it.  I’m limited on what I can help him do.  He’s not allowed off the ship, and he’s only allowed to walk around certain areas.  I usually go on walks with him through the hospital ward.  I give him heavy objects, like 1 liter saline bottles, to use as weights.  The past two evenings I have taken up to our seventh deck in the evening to watch the sunset.  I brought my water polo ball from home and we use it to kick around.  Tim used to be a semi-professional soccer player, so I think he really enjoys kicking the ball.

   Amidst all my doubt and worry about the outcome of his surgery some hope gets through and I picture him as a renewed man.  I imagine how he will do a simple task, like sitting, without having to carry the weight of is tumor.  He will literally be cut free from his burden.  I hope it is God’s will that he makes it safely through surgery and we can be there to witness his recovery.

I have some pictures to post from the past week. So enjoy (if you like looking at pictures as much as I do).

My roommate Faye at the ship control panel while we were on our tour through Deck 1 of the ship.

Getting a tour through the engine room.

It is a very large engine room.

Me in front of our incinerator, where all our medical waste goes.

The D-ward family.

Hanging out with the kiddos.

My decorated cabin door on my birthday.

My first Mercy Ships birthday.

Eating birthday dinner by sunset with my wonderful friends.

Playing spoons.

Hanging out with some awesome girls at the HOPE Center.

They are so much fun.