Tradition: I’m on the plane from Seoul to San Francisco, with Kirk beside me, returning from our seventh surgical trip to Mongolia since 2005, and writing this update. I felt like the Lord gave me a word picture this week. I was feeling euphoric in the midst of a hard week and I was wondering how I could feel like I was on a mountaintop in the middle of a valley. I remembered our time in Tibet, where we were in a valley at 11,000 feet, and I realized you can be in a valley while at the same time on top of a mountain.

Kirk went to Mongolia a week ahead of me with a team of 21 Americans and 11 Mongolians for the annual Searching for the Broken Hearts week. They went to four locations in the central part of the country and set a record for screening the most kids ever in one week: 3650. In fact, they set a record for the most kids seen in one day: 956. There were a number of people on this team that stayed for the surgical, or Mending the Broken Hearts week. The rest of the 34 of us on that team, including me, started arriving on Friday.

Before I even left the U.S., I got word that our faithful pediatric heart surgeon, John Kupferschmid, who has been the one and only surgeon on all these trips, had a very sick baby to take care of and could not leave the country as planned and didn’t know when or if he would leave at all. When I heard this, I thought “and so it begins….” Seven surgical trips to the same country and you start to feel you have things well in hand. But the Lord ALWAYS brings us to a point of prayerful dependence on Him. He ALWAYS changes something that we think we have control of so that He can remind us that He is in control. He started early this year. I met our faithful perfusionist Bart Hensler (he runs the cardiac bypass pump that acts as the child’s heart and lungs so that the heart can be stopped and operated on and has also been the one and only perfusionist on all these trips) in the airport in San Antonio. He knew John’s status. Without John there to operate, there’s not a lot of reason for him to be there! I loved hearing that his sweet wife Denise had encouraged him to go ahead and get on the plane, saying “you never know what the Lord has planned for you.” We spent a lot of time praying on our trip from San Antonio to San Francisco to Seoul that all would work out and we’d hear that Kup, as we affectionately call him, was on his way.

When we arrived in Seoul, we got word from Kirk that Kup was still not on his way nor had any plan to be on his way soon…and that the container of supplies that we had sent from the U.S. in May and that had been in Mongolia for a month had not been released from customs yet. I love that Bart didn’t even flinch. He just said “we’ll see what happens.” I love the phrase “you don’t see a miracle unless you need a miracle.” We needed some miracles! We also found out when we arrived in Mongolia that one of the essential pieces of equipment that we needed was stuck in customs in Beijing, China. Hmmm, three strikes, we should have been out! One of the hardest parts about being team leader, if you’re Kirk, or being married to the team leader, if you’re me, is worrying about how the team will react to all of this. You have 34 dedicated people who used their time off and paid their way to Mongolia to do….what?!?!? I am so blessed to say this team did not flinch or falter! We had an incredibly sweet and encouraging time of prayer together on Saturday morning, we collectively said “we trust you, Lord,” and we set to work. The container got released from customs on Friday night, so we were able to unload it and unpack it as planned on Saturday. One of our faithful biomedical engineers, Jim Moore from Samaritan’s Purse, flew back to Beijing, got the equipment out of customs, and arrived back on Monday. After church on Sunday, we had our traditional lunch with the patients for the week and their families, told them our surgeon was delayed, and told them how we were going to change the schedule accordingly.

I’ve learned there’s often a hindsight understanding of what the Lord was up to if you just trust Him and go along. One of my hindsight understandings is that we were able to reap a lot of the fruit that we’ve sown over five years of working with the Mongolian medical staff. Our goal is to work ourselves out of a job. So each of us on the team has been working in teaching and training those we work alongside. We were planning to do seven diagnostic heart catheterizations in the cardiac cath lab as time permitted around the operating room (OR) schedule throughout the week. We have two interventional cardiologists that usually travel with us, Mary Porisch and Allison Cabalka. Neither were able to come this week. In fact, Mary had planned to come up until a month prior to the trip and then was unable to. I guess the Lord started really early! Kirk and fellow cardiologist Dave Bush are capable of doing diagnostic caths, so they planned to take the lead on this. When Kup’s schedule changed, Dave (another faithful servant—are you getting the theme here?), who had already participated in the Searching week, changed his flight schedule to stay an extra day so that he and Kirk could get the caths done in the first two days. Neither Dave nor Kirk ever scrubbed into any of these caths. The Mongolian physicians did them entirely themselves with only Dave and/or Kirk supervising, an absolute victory from five years of training! There was good news for six out of the seven children, in that they were still operable. They will have surgery in the future, either in Mongolia or in the United States. One child is not currently operable, but he is young, so we took him to the OR to put a band on his pulmonary artery in the hopes of limiting blood flow to his lungs and hopefully preventing or even reversing damage to the vessels in his lungs and, we’re praying, making him operable in the future. We had planned to do two surgeries during the week that did not require cardiac bypass, with a possible third being the child that did, in fact, have a surgery. We were able to do these three surgeries on Monday and Tuesday with one of the Mongolian surgeons, more fruit of five years’ experience working together.

We got word on Monday afternoon that Kup was on his way and would arrive Wednesday. On Wednesday, we literally sent someone to the airport to watch the video cameras to see him come off the plane. Once he was spotted, we took a child to the OR to get him ready for his surgery requiring cardiac bypass. Kup arrived at the hospital, changed his clothes, and went straight to the OR. To give him a chance to rest, we did only that one surgery that day and planned to come back and do three surgeries on Thursday and Friday. Our original plan was to do nine surgeries requiring cardiac bypass during the week. For seven children, time was of the essence…and we were able to do these surgeries. Two children have time and will be done in future years, either in the U.S. or, more likely, in Mongolia. These were the only children’s operations that we planned to do that did not get done. To pull off three operations requiring cardiac bypass in one day is ambitious even in the U.S. To do so in Mongolia, not once but two days in a row, was amazing and absolutely historic for our team. It required all of us, both Americans and Mongolians, working incredibly well together. It was more fruit of five years of working together because I was able to finish one procedure in one OR, wake the child up, and take him or her to the ICU, while the Mongolian anesthesiologists (Drs. Dorjoo, Amra, and Enebish) were able to start the procedure in another OR. We had a long day on Thursday because the last case went long and, when this happens, children tend to bleed more. The blood supply was limited and the team quickly realized they could give their own blood. We had many more volunteers than we needed, but two team members did donate their own blood (another first for our team!) and the child ultimately did well. I think Thursday night was the night I got the image of being on a mountaintop while still being in a valley. On Friday, everyone (except those dedicated team members who stayed overnight in the ICU that night—one of whom was our pediatiric intensivist Minnette Son, who has been on every trip and always stays all night EVERY night!) was able to meet for a team dinner out at 8 p.m., even after three surgeries. Truly miraculous!

Prior to our trip, Kirk sent an e-mail to the team with this verse: “ And let our people also learn to maintain good works, to meet urgent needs, that they may not be unfruitful (Titus 3:14).” The needs are urgent. For many of these children, time is of the essence. If they are not operated on in a timely manner, their lesions become inoperable and their lives are shortened. That’s why Kup was willing to fly halfway around the world, walk straight into the OR, and operate for 2 ½ days on 7 children. The needs are urgent. That’s why our team of 34 was willing to do whatever it took and stay there as long as it took to operate on those 7 children. The needs are urgent. That’s why Minnette willingly stays in the hospital all night every night and misses out on a lot of the team bonding and fun out of the hospital. The needs are urgent. The Lord asked us at the beginning of the week if we were going to trust Him when it looked bleak. We did…and He showed up. We never lacked a single supply we needed. All the kids did well. He redeemed it all victoriously! We thought we were in a valley and it turned out we were standing on one beautiful mountaintop. As always, to Him be the glory! What an honor to see Him work.