Dr. Bob's Blog

…HOPE DOES NOT DISAPPOINT…ROMANS 5:5a

2007-03-18T11:10:00.001-07:00

I hate to start out with an apology, but anyway, here goes. I am sorry for not posting on the blog for a couple of months. I will do my best to make a new entry weekly from now on. Dr. Bob.

I was reflecting recently about the power of hope. One of the biggest enemies we face daily in West Hill is the atmosphere of hopelessness and despair. G. K. Chesterton wrote, “Hope is the power of being cheerful in circumstances we know to be desperate.” We know we are in the midst of a desperate situation here in West Hill; however, we continue to work very hard, enduring trials, troubles, and tribulations, because we carry the hope of transformation in our hearts. I believe that this is a gift from God, not anything that we can boast about. We remain cheerful, even in the midst of trouble, because we can see our young people rising up out of the bondage of poverty and despair, our middle-agers prospering and living fulfilled lives, and our elders living their later years in peace, comfort, and safety. This is our great hope! Many times when we are faced with the daunting obstacles that we encounter on a daily basis, we tend to lose hope and give up. I am encouraged, however, when I reflect upon history and see example after example of how a small group of committed people rose up and did extraordinary things which changed the course of history. They were little, insignificant people changing their world because they held onto a belief in something good that was far greater than themselves. I would like to share with you just one example:

In 1860, this country went to war over issues of slavery and states rights. It was brother against brother in a conflict that threatened to tear this nation asunder. It was the bloodiest conflict in our history with over 900,000 casualties, about 3% of the population at that time. The question was whether this nation conceived in liberty and dedicated to the proposition that all men are created equal could withstand this conflict and remain one nation. You see, if this nation were divided, it is doubtful that it would have had the strength to withstand and defeat that great evil which was to arise over Europe less than 80 years later. I am sure even the most prophetic seers of that time could not imagine a future with a divided America. I am sure that the men who participated in that dire conflict had very little insight into how historic and important their actions were. To them it must have seemed just a progression of suffering. Fatigue, pain, and discouragement must have felt like the daily lot for many of these men. I wonder how many in the midst of their suffering were able to see the “bigger picture” and see themselves as history-makers and history-changers. How many were just hanging on, hoping to make it through alive, and like many people today, were just surviving and not really living? How many were tossed about by the vagaries of circumstances and hardships, more the victims than the victors?

The critical battle of the Civil War was to be fought in a small, relatively insignificant farming town in Southern Pennsylvania. It was to be fought by mostly insignificant people, in an insignificant place, with the history of this nation at stake. The brilliant General Robert E. Lee, never having known defeat, was leading the army of Northern Virginia. The Union Army of the Potomac, not only recently at Fredericksburg but often defeated, was demoralized due to these defeats and ineffectual, constantly changing, leadership.

Lee’s plan was to defeat the beleaguered Union forces in Pennsylvania, turn right, and capture Washington, and the country as we knew it would have ceased to exist. The two combatants collided at Gettysburg July 1-3, 1863. The first day of the battle went badly for the Union forces, but they managed to re-gather their lines south of the town of Gettysburg at a place known as Cemetery Ridge. This set the stage for the historic events on the second, or critical, day of the Battle of Gettysburg. On that second fateful day, it was noted that the hill called “Little Round Top” which was on the very left of the Union lines and commanded the high ground over the whole of the Union defenses, by some incredible oversight, was left undefended. Colonel Strong Vincent, realizing that this placed the whole army at extreme risk, commanded Col. J. Lawrence Chamberlain and the 20th Maine to climb Little Round Top and “hold the ground at all hazards.” They arrived on the summit of Little Round Top just 10 minutes prior to the enemy’s attack, and Chamberlain’s regiment, along with the 16th Michigan and 44th New York, dug in on Little Round Top.

Wave after wave of enemy attacks came against these brave and gallant men that fateful afternoon. These same men who had been previously defeated and had suffered great discouragement, stood and fought valiantly. Half of Chamberlain’s troops consisted of deserters who were given a second chance to fight and defend their honor. Many of his men were wounded, and many had already died. They did not realize the historic significance of what they were doing that hot July day. They only knew the pain, the fatigue, the discouragement, and the bravery of their leaders. The men of the 20th Maine looked up upon Col. Chamberlain standing in the middle of his troops, seemingly indomitable, through the smoke and the hail of many volleys. “Stand firm, steady.” Chamberlain strengthened his troops, as if by force of will, he could steel his men against the furious onslaught.

As the battle for Little Round Top raged, the Union generals back at headquarters began to realize how critical this small mound of rocks had become. They hurriedly dispatched couriers to bring back reports to see if this little rocky hill could be held. If not, they must withdraw in complete retreat. The fate of a nation hung in the balance. Time after time, the generals asked the scouts to go see, “How goes it on Little Round Top?” Every time, there came back the same report, “Chamberlain is holding!” The cheer, “Chamberlain is holding,” began to ring out through the whole Union line. At first greeted with tacit skepticism, report after report began to infuse these men with a tonic little before tasted, the hope of victory. Men who were exhausted received new energy, men who had quit picked up their muskets, wounded men forgot their pain and got back into the fight, fearful men became courageous, and slowly, almost imperceptibly, the tide of the battle began to turn.

During the last respite between waves of enemy attacks, Chamberlain’s officers gathered around him. “Colonel, many men are down to their last bullet, some are completely out of ammunition, and we can’t withstand another wave of attack. Should we surrender?” Chamberlain, stopping just for a second, replied, “Fix bayonets and prepare to attack.” With that, he led a sweeping attack down Little Round Top defeating an enemy with far superior numbers, saving the day, and ultimately the Battle of Gettysburg.

A few weary, desperate men, whose leaders refused to quit despite great loss to themselves, had started a tidal wave of hope which ultimately flooded and preserved a nation. You may be thinking now, “Why is he sharing this particular story with us?” If you haven’t quite figured it out yet, I believe we all have our individual Little Round Tops. Maybe these tests of character, fortitude, courage, and self-sacrifice are counting for more in history than we can ever imagine. Someday it will seem your enemies will have you outnumbered, and you will be down to your last bullet. On West Hill, we have been there many times already, and I am certain we will be there many times again. At these times, temptation comes. Although veiled differently, it almost always comes down to the same thing: “Just quit. Give up. No one cares anyway! Are we really making any difference? Does anyone care?” The temptation comes when you are hurting, tired, wounded, and just seem to be holding on by your last thread. The deceiver whispers in your ear, “Just give up.” When you are in that place, and everyone destined for greatness always stands in that place, I want you to think about a short, chubby, jolly guy in West Hill, Albany, NY. He never had much and most thought he would never amount to anything. He was not handsome, or rich, and was not nobly-born. He almost flunked out of eleventh grade in high school. But, one day he decided that he was not going to surrender his old neighborhood to the enemy, no matter what the cost! He was going to stand and fight, down to his last bullet and beyond.

He decided to fight, not for himself, but so someone can hear the story. So that some weary, discouraged soul on the verge of capitulation, who is standing in a place of great trial, can hear a positive report: “Dr. Bob is holding! Dr. Bob is holding on West Hill. He is down to his last bullet, but he is holding. He is not giving up. He will never give up.” And when this weary soul hears this report, hope will begin to flood back into his innermost being. He will endure in the place of trial and overcome into the place of greatness, and history will be changed.

History is hanging in the balance, and that is why this report must go out. The message of hope must be known to those who make history, and hope does not disappoint.

"O Holy Night"

2006-12-21T15:10:00.000-08:00

Placide Cappeau

3rd verse:
Truly He taught us to love one another.
His law is love and His gospel is peace.
Chains shall He break for the slave is our brother.
And in His name all oppression shall cease.
Sweet hymns of joy in grateful chorus praise we.
Let all within us praise His holy name.

Recently Leane and I were invited by a friend to come and hear the Wototo Children's Choir sing in his Community. Milton had been my PA (Physician’s Assistant) for 6 months on loan from the Bruderhof Community, and he had recently accompanied me on a medical mission to Uganda.

God had touched his heart there. He met a young girl who had been severely burned in a fire that resulted in scarring her jaw, cheek, neck and shoulder together and seriously disfiguring her face. Although her problems were far beyond our ability, Milton resolved to do what he could to help her.

His efforts led him to a contact at Wotot, an orphanage for Ugandan children, and the knowledge that their touring choir would be in the U.S. during the holiday season. Milton couldn’t wait to make arrangements for the choir to come and sing. He wanted to share some of his experience in Africa with those at home.

I think Milton felt a little nervous about such an endeavor and he invited Leane and I to come not only for our enjoyment, but I suspect he wanted our support. You see, the Wototo Orphanage is run by the Pentecostal Church of Kampala, a denomination far different from his Anabaptist Bruderhof Community ; throw in the fact that he had never heard the choir sing before, that many people from outside the Bruderhof community would be coming to the concert, and I think you can understand his anxiety. We committed ourselves to go that evening and support our friend.

On the day of the concert we had closed the office a little early to make the two hour trip to Milton's community in Orange County. I remember thinking how I would rather be spending a quiet night home on a Tuesday, going to bed early and getting some rest. The clinic had been pretty crazy lately, throw in People Magazine, Good Morning America, local TV, radio, etc. not to mention the needs of our patients, and the rest of our ministry, I was feeling pretty exhausted! As we were approaching the Thruway entrance, Leane asked, "Do you have any money?" I replied, "No, I thought you had some. We better get to an ATM.”

She reminded me that we didn’t have any money in our account. Stymied for just a moment I said: "Call Kristen at the office and see if there is anything in petty cash." The answer was no again. I couldn't help noting the irony, here I was close to becoming a nationally known "celebrity" and we couldn’t afford Thruway tolls. Fortunately, our son Bob was at the clinic when Leane called and soon we were on our way with his $37 tucked away in our pocket. Leane was relieved, and I was hoping we had enough gas!

All the way to Orange County I had to fight off the temptation to start feeling sorry for myself. When you're a little down, it’s easy; you just start entertaining negative thoughts and the next thing you know the world really looks bleak. Even the exciting thoughts and feelings seem fleeting under the weight of the harsh realities of being broke, frustrated, and discouraged. You begin to wonder, "Who cares anyway?" or "Maybe I should just turn around and go home!"

I was close to having my own little pity party when I began to remember what was really important. I remembered the vow I had made to myself. " I will never bow and worship at the altar of despair and cynicism. " The battle raged as I tried to have a conversation with Leane. I would think of our situation and I would start to feel down, and then I would remember Leane's love and support and I would begin to feel better. I started to think about the generosity of all those who had helped recently, and who shared our burden for the less fortunate.

By the time we arrived at the Bruderhof community I was a little better. It was great seeing Milton and his wife Catherine and feeling the love of this community of brothers! They fed us a quick supper and it was off to the concert hall. What I was about to see next would change my attitude forever! About 30 African orphans took the stage with their leaders. They were between 6-13 years old. These were not the scrawny, sickly, children that I had seen so many times, on so many missions. The ones I had shed so many tears over, and who visit me from time to time in my nightmares. These children were happy, vibrant, healthy, and full of life and joy.

I remember many of them introducing their songs, "Hello I’m Rose, or Paul, or Isaac. I was orphaned, alone and afraid, and I thought God had forgotten me. But now I have a new home, with my own bed. I have good food to eat. I have brothers and sisters, and a house Mother and Dad who love me. I can go to school! But most importantly I have the love of God in my heart!” They also shared their hopes and dreams with the audience. They wanted to be an airline pilot, engineer, teacher or a nurse!

They began to sing with an enthusiasm and joy that touched me to the core of my being. I began to fill with tears as I realized God was giving me a special gift through these children. He was allowing me to see the hope of my calling. Beautiful, incredible children who had suffered so much, and yet were so alive and grateful for their new beginning! Hope was being renewed inside me as I began to see children all over the world filled with light, vitality, and hope. All of a sudden I realized that every hardship, every struggle, every sleepless night was worth it!

To have some small part in helping someone overcome hopelessness and despair was worth millions! My small investment in the lives of the children of Africa, Asia, North and South America was paying incredible dividends and I was an incredibly rich man! It wasn’t anything I could take to the bank but it was something that no man could ever take away. No one can ever rob me of the feelings of hope that flooded my heart on that wonderful, magical night. I continue to give thanks for the incredible blessings that God has given me!!!

May you all have a wonderful and blessed holiday.

Dr. Bob

Congratulations, Trish!

2006-12-07T03:18:00.000-08:00

Trish's baby was born on Monday 11/27/06.

A beautiful healthy 7 pound baby girl. Trish had a C-section performed by Dr. Christopher Bloss. Dr. Bloss and Dr. Jeff Altman have a local Obstetrics and Gynecology practice. They graciously donated their services to care for Trish and perform her delivery.

We have experienced an amazing turnout of community support to help this wonderful young lady! Parkview House, a ministry of the Bruderhof Community here in Albany, has taken Trish in and is providing all kinds of support for her and the baby. Many people have donated material support, best wishes, and prayers after reading this blog and we are overwhelmed with their generosity.

It really does "take a village to raise a child" and we are so blessed to be doing our small part to make life better for Mom and baby. To all those that have participated, we send our heartiest thank yous and best wishes for a wonderful Holiday season.

Dr. Bob

The Faces of the Uninsured

2006-11-26T13:16:00.000-08:00

Over the next few weeks, I want to introduce you to a few of my patients. All of their names have been changed to protect their privacy, but as you get to know them, I believe you will see the faces of the uninsured in America in a new way.

The stories are all about real people whom we have seen recently in our clinic, and there are dozens more of them. I can assure you that each of them are just like you: they hurt, they bleed, and they feel. They are our friends, our neighbors, and ourselves.

"...No man is an island, entire of itself. Every man is a piece of the continent, a part of the main. If a clod be washed away to the sea, Europe is the less, as well as if a promontory were, as well as if a manner of thy friends or of thine own were: any man’s death diminishes me, because I am involved in mankind...."
John Dunne, Meditation 17

Trish

Trish looked scared and lost as she walked into our clinic a few weeks ago. When we first met her she was eight-months pregnant at the tender age of nineteen and fleeing a domestic violence situation. We didn’t know it yet, but Trish had escaped her violent partner by moving into a burned-out, boarded-up, abandoned building in the West Hill neighborhood of Albany, New York with her father. Because she won’t leave her father alone, she cannot move into a shelter. As I write this, it is November, which can be very cold here in the Northeast. The boarded-up building she is living in has no heat or electricity.

In spite of her circumstances, she was still so full of wonderment about her pregnancy that I couldn’t help wanting to get in her corner and care for her. I just wanted to see life start to break right for this woman who had suffered such trouble.

All of our staff began to reach out to her as the details of her story came to light. During her exam that first day, we discovered that her baby was in a breech position putting both Trish and her newborn at risk for life-threatening complications if the baby did not change position before Trish went into labor. If the baby didn’t turn, Trish would need an expensive C-section, but she has no health insurance.

After addressing her medical needs, our staff at Compassion in Action/Koinonia Primary Care began to gather much-needed and practical baby gear to help her prepare for her coming newborn. Car seats, baby clothes, furniture, and best wishes began to flow in as they began to advocate for Trish’s needs. We even took the clock off of our break room wall to send home with her so that she could time her contractions, just in case she started to go into labor.

As of this writing, Trish’s breech baby hasn’t turned. She needs to have the C-section, which is a procedure that I am not qualified to perform. During the past few weeks, we had to find an obstetrician willing to donate his or her time for Trish. We are very fortunate that a local obstetrician has volunteered his services. Trish is scheduled for the C-section tomorrow.

Thank God that the community is reaching out to Trish. My hope is that all of her needs will be met. She still needs to find housing for herself, her father, and her newborn. I believe that everything will turn out right for Trish.
I just don’t know how many more situations like Trish’s we can handle.

33 Cents

2006-11-15T02:27:00.000-08:00

One of the turning points of my life occurred when I was a "geriatric" 39-year-old 4th-year medical student. I was introduced to a man in Albany who was trying to raise a small amount of money to buy supplies and equipment for a Cholera "hospital" in central Mozambique.

Neto and I met almost by accident. I was leaving home to study for an exam at the library, but I had returned to retrieve a forgotten book. When I re-entered my home the phone was ringing. "Bob you've got to meet this guy sitting in my office" my friend Peter blurted out excitedly. “He's been sharing stories with me about Mozambique, and I'm getting really excited about what's going on there. You've got to meet him!” A meeting was hurriedly arranged.

A short while later I found myself in the presence of one of the most interesting—and extraordinary—people I have ever met. Neto has a smile that can light up a dark room. His warmth immediately burned through my awkwardness in meeting a stranger. His vitality and infectious laugh could make anyone feel that they had known him all their life. I would later learn that he could play the guitar such that it would make you weep, and also climb a coconut palm tree to pick out the choicest young coconuts with the sweetest "water." Within one hour, we were close friends.

Neto told me how he had given up a lucrative career and lots of money in his native Brazil to follow his heart to Mozambique. His fiancée gave him an ultimatum, "It's either me, or Africa!" They were to be married in four months. "I love you, but I must follow my calling to Africa. Please come with me!" An engagement ring thrown at his feet was the only reply. Neto later sold it to pay for a one-way plane ticket. By the end of the evening, I knew we would be working together.

Four months later, Peter, an LPN, and I arrived at Albany County Airport ready to embark on the adventure of our lives, our first medical "mission of mercy to Mozambique." I was as green as a ripened lime, counting a trip to Iowa, as my furthest journey to date. I never expected the look on the ticket agent’s face when I responded, "12" to his question, "How many bags do you wish to check in?"

The agent responded, "No way, these bags are not going!"

Peter, a more experienced traveler, came to the rescue. "These are emergency medical supplies for Mozambique; there are lives depending on them. They must go!"

"No way!" was the agent’s response.

Never being daunted by a hopeless situation, Peter replied in his firm, but gentle manner. "Alright, we will leave these supplies here if you call the President of the airline, and he tells us they can't go. Otherwise, we are not moving!"

The ticket agent was flabbergasted, but then amazingly picked up the telephone and began dialing corporate headquarters. Peter whispered to me "start praying!" I didn't need the reminder. The agent was getting frustrated as he was being transferred from department to department. We continued silently praying our hearts out. The check-in line was getting longer and longer. Finally we got a break! The executive vice president of the airlines answered the phone.

The agent explained the situation to him in very unflattering terms. I couldn't help thinking we were dead. "What do you want me to do with these guys? They have the whole ticket area in a mess and the flights are going to be late." the agent said. I was still praying, all the while having visions of police officers coming to take us away. Finally the response came, "Help them load it on the plane!" God had saved our butts, again!

This was the first of many miracles we experienced on this truly incredible adventure, but all this paled in the light of what we would soon experience! Arriving in Mozambique we quickly found ourselves in the middle of what had to be a chapter from Dante's Inferno.

We worked in seven refugee camps with 50,000 refugees in various stages of filth, disease, and starvation. The nearest real doctor was 500 miles of African road away. In our makeshift clinic we encountered every conceivable horror. There were cases of malaria, infection, and starvation all served with an ample portion of hopelessness and despair and topped with lice and scabies—just in case you weren't already feeling you had landed somewhere in the vicinity of hell.

Peter and I would return from a long day in the clinic seeing hundreds of people. We would flop on our mattresses on the floor and cry until our pillows were soaked with tears. This was no gentle crying; our sobs would have rattled the window panes, if there had been windows. I remember praying "Lord, please kill me! I'd rather be dead than see one more starving baby! I can't do this anymore!" God didn't answer my prayer.

As if all this wasn't enough, after our last day of clinic and just when I was drinking in the relief of being delivered from the pit, a horrific traffic accident occurred a few hundred yards from our base. The causalities included 9 severely injured people. Soon our base was an ICU.

Somehow the honor of being the first 4th-year medical student ever to establish and run an ICU was lost in the blood, the fractures, and the fatigue as I operated all night using only local anesthesia, but even the anesthesia ran out half way through. So I cut and sewed with none while many patients were too much in shock to even feel my knife. It was only by God's grace, and miracles, that every victim survived.

For our departure, Neto had organized a special church service to thank and honor us. He had prepared the people to bring something to give as a thanksgiving. We didn't know what was happening as he called us to take the place of honor in the front of this thatched-roof, mud-walled church. He said "Now it’s our turn to give to those who have given so much to us. Come forward and bring your offering of thanks to God for them!" I was overwhelmed with emotion as I saw the people come forward with joy in their hearts. Through my tears I saw an old woman; she looked ancient, all bent over with bare feet and leather skin. Her gift was a single egg that she placed on the mud altar. I saw a man using a makeshift crutch—necessary because a land mine had blown off his leg—bring a small coin. I saw a child bring the aluminum pop-top from a precious crushed soda can. They came by the hundreds bringing a banana here, a half a sweet potato there, a small coin all mixed with our tears. The money that was received during this offering amounted to 33 cents. It was too holy to ever spend and remains in our office to this day—a gift from the poorest of the poor.

Since then I have been on over 20 medical missions of mercy. I have seen over 100,000 people all over the world in the poorest and most desperate of circumstances, and now I work back in my old neighborhood, the poorest in my city, to do what I can to help. I have been exhausted and down to my last dollar too many times to count. I have been broken in so many ways and have cried more than a million tears. A reporter asked me recently "Dr Bob, surely you could have a great career as a physician, probably a big house, a nice car, and you wouldn't have to work half the hours you do. You're getting older, why do you do the things you do?"

My reply: "for 33 cents."

.........................

In the Summer of 1997, Sebastiao “Neto” Veloso made the ultimate sacrifice and gave his life for the people of Mozambique. He died shortly after our working together,at the age of 32, of unknown causes. He is buried in a shallow grave in Dondo, central Mozambique. I had the privilege of finding and visiting his grave in 2004, ten years after we first worked together in Mozambique. I anointed the ground with my tears. He is survived by his beautiful wife of almost 3 years, Charlene, and their son Joshua who was 14 months old at the time of Neto’s death.

Neto, my friend, I don't know whether I'll ever meet a better man. Thank you for introducing me to the world of caring for the least, the last, and the lost! Rest in God's arms until we meet again.

Bob

Health Insurance in America--The Status Quo Must Go!

2006-11-07T06:14:00.000-08:00

Recently, I was reflecting about the fact that 46 million Americans are currently without health insurance. Just who are these people?

In my office we see many people without health insurance, and often these are not the poorest of the poor. Many of our patients who are poor qualify for Medicaid, and have at least some access to health care services. (This is far from perfect, which we will discuss at some later time.) It seems the "working poor"--those that make just enough to not qualify for medicaid, but whose employers do not offer much in the way of benefits--are the most at risk. I recently heard a talk that by the year 2024 no employer will offer health care benefits to their employees, that's at the present rate of employers dropping their health plans due to cost. We are in crisis, but no one seems to be talking or doing much about it!

Another group are those who don't understand how to work through the system or for whatever reason, don't cooperate with the system. Have you ever tried to keep track of the ever changing face of requirements? Just when you think you've got it figured out you realize things have changed again. In our neighborhood we spend an incredible amount of time keeping track of people. Their addresses change, their phones are disconnected, and on and on. They often think they have benefits but find out they've been canceled when they arrive at the office; then what do you do. Their cancellation notice went to some address that is now ancient history. What happens when they need medicine? Can you say go your way brother, be warm and well fed, we'll pray for you? That's not good enough! In most places these people never get beyond the receptionist! They usually end up in some ER further complicating the clogged system!

Then there are those who just "slip through the cracks", such as the 8-month-pregnant woman who came to Albany from New Jersey to avoid a domestic violence situation and has no health plan. We also have a number of patients who are in the country illegally. Some might think these people shouldn't get care because of their immigration status, but I took an oath to care for all people. Even those in prison receive some form of health care.

These are all people! They laugh, they cry, they hurt, they bleed, they have families, at least the more fortunate ones, they are like you and me! The uninsured are not only in the inner city, we just see a lot more of them here. We cannot just drive to the suburbs and pretend it isn't there just because you can't see it from there. If we really love humanity, then we better do something about it! The clock is ticking on our society, and God is watching. What are you going to tell Him when He asks " what have you done for the least of these my brothers?"

The status quo must go!!! Write me and tell me your ideas.

Dr. Bob