ONE – BIENVENUE AU BURUNDI

The first thing Dr. Seth Queller saw out his window as the plane rattled down the runway was the rusting, worn-out shell of an airplane. It sat by itself, between the lone runway and the single hanger which itself, did not appear to be usable. Why leave a broken-down plane for passengers to see? Random windows missing, both engines stripped off, stacks of wooden pallets and a few metal stands bearing the load as the landing gear no longer could. But also, where were the other planes, the non-broken ones, the ones capable of flight?

He could just make out ‘Air Burundi’ on the side of the abandoned plane’s fuselage, a throw-back to an era when the country had an airline. Back when the west was pumping hundreds-of-millions of dollars a year into a post-conflict nation, which turned out to be merely intra-conflict. The donors intending to help it accelerate toward a better future and away from its bloody, ethnically fueled, 12-year long civil war. Now, many of those bridges were burnt, and much of the money dried up.

The heavy-set Kenyan in seat 1A saw Seth staring at the plane and informed him that ‘Air Burundi’ did still exist, at least in one form. Someone close to those in power was appointed Directeur Nationale de Transport Aerienne. What he did to earn his minister-level salary since there were no planes, no employees and no flights, was unclear. It was hard to make out any details on that lone plane as the Kenya Airways 737 bounced across the uneven tarmac. It wasn’t the worst landing he’d ever experienced, but the peculiar thing was the lack of response from everyone else on board. They must know this is how planes landed in Burundi since many didn’t even look up.

‘Aeroport International de Bujumbura’ the sign proclaimed but he would argue any place referring to itself as an ‘international airport’ should have more than one plane on the ground. At least it should have the capacity for more than one aircraft at a time. There were no jet-ways at all, no bridges allowing the basic act of walking into an airport without going outside. There was only a single set of worn metal steps now being pushed up to the front cabin door that spilled passengers down onto the airport apron itself. Dr. Seth Queller had stepped down the air-stairs leading from a plane’s cabin, but those had been the ten steps that led from a Gulfstream-IV to a waiting car. This was something different.

The first thing he felt, was the visceral blast of hot, sticky, humid tropical air. It was mixed with a stinging level of jet fumes, and what he was grappling to accept must be the body odor of the passengers exiting in front of him. That pungent, boiling, air hit him, a blast of equatorial heat, rainy-season moisture and all those smells. It shoved him in his chest, and he stumbled back on his heels at the top of the stairs leading to the ground. Three passengers stood to deplane before as he got up from seat 2A. Two men and a woman jumped up, grabbed their bags, and stood in the front galley before the aircraft had even come close to a complete stop. He didn’t want to imagine what it would smell like if any more of them were upwind of him as the depressurized cabin filled with this caustic air.

The airport terminal itself was something to behold. A cluster of five half-dome structures of various sizes, slightly overlapping with each other, painted white time ago. The whole thing screamed early 1960s utopian optimism. It was like glancing back to what everyone in that era hoped the world would look like a half-century in the future when ‘The Year 2000’ would finally arrive. The rest of us seemed to have moved on to rectangular office buildings, and airports that can only be described as airport-shaped. Meanwhile, this one-runway aérogare in the middle of east Africa looked more like a rejected Disney proposal for a secondary pavilion at Epcot Center.

As passengers descended the stairs and scurried across the airfield towards this retro-futuristic marvel, he noticed two long, covered sidewalks leading into the largest of the half-domes. One which almost everyone headed under; and a separate one with “V.I.P.” in just-off-centred, blue lettering. He darted to the left with visions of expedited customs and getting out the other side as quickly as possible keeping him going.

A man in uniform held out his hand, obstructing Seth from moving any further. By reflex, Seth flashed his first-class ticket.

“Non, non,” he laughed “passport.”

Seth handed over his passport, and without even opening it the man mumbled, “Non, c’est le VIP only.”

“Surely you jest?” he said, fortunately only to himself. Still fuming about the pathetic level of service on the last leg where all he got was a slightly wider seat at the front of the plane. If a full-price first-class ticket for someone with million-mile status wasn’t enough for “VIP” then what the heck was?

A man approached Seth from behind, topped with thinning hair, his face framed with thick-rimmed glasses of clear-plastic with purple spots. The kind Seth identified as those only middle-aged German men wear.

“It’s only for diplomats,” he said with a certain French accent Seth immediately recognized as the man handed over his burgundy passport.

Belgian.

He was close.

Seth swiped his passport back from the policeman. Only then did he notice the AK-47 hanging from a worn leather strap over the man’s shoulder. It had what appeared to be four extra magazines of bullets strapped onto the one mounted in the gun with a section of a spent bicycle inner tube. He lost his insolence and headed back to the line where everyone from the economy seats now queued up, forcing him to shuffle to the back. The wheels of the Belgian diplomat’s aluminum carry-on rhythmically calling out as he made his way down the sidewalk, mocking Dr. Seth Queller. He now stood behind a large African woman with an over-stuffed reusable grocery bag wrapped with twine as a substitute for carry-on luggage. She shouted some incomprehensible language into a Chinese-brand phone she held out in front of her mouth like a megaphone. Through it all, a child wrapped onto her back slept soundly, sweat pouring off its head. Due to the recent Ebola scare, a woman in uniform at the front of the line scanned foreheads making the painfully slow process even more prolonged.

He had been on the ground for two minutes of a five-day trip, but he already knew he would not like it here.

TWO – I DON’T LIKE THIS

For a significant portion of his 32-hour trip he considered one simple question to which he still had no satisfactory answer: “What in the world am I doing here?” It was hard to believe it took so many flights and so many hours to get anywhere. Yet it was almost unimaginable that a mere 32 hours ago he left his house in the neaveau-riche community close to several of his favorite ski resorts. He didn’t spend much time there, never as much as he wanted. That’s partially why he was so agitated. He grew up skiing dozens of days every season as his parents ran a language school in the French Alps. His current job planted him in North Carolina, some distance in any direction from a decent mountain. His schedule wrestled away almost any opportunity to ski he could find. What had been a 15-minute bus ride up to the ski station several times a week whenever he wanted during his childhood, was now a significant effort. It only occurred when he lined up all the moving parts of his life, but never more than twice a year. Even those few times he made it during the ski season, he often ended up bringing a work project or colleague. Sometimes a co-authoring for a publication that needed editing on the flight, sometimes an eligible young lady coming to spend the weekend, sometimes both. Sometimes the same person was both.

He loved his home in the mountains, its massive over-sized timber beams, generous use of slate, river-rock and copious amounts of glass. He directed the design and architecture team himself to ensure a mixture of his three most influential schools of thought. “French Alpine” was an obvious one, while the clean lines of “mid-20th century Finnish minimalism” appealed to his sense of order*.* The third he rarely mentioned by name as he toured guests around while sampling a bottle from his private reserve of Crozes-Hermitage. However, it was there all the same: “conspicuous consumption.”

Seth Queller held American/Canadian dual-citizenship, as his father, (from Detroit Lakes, Minnesota) and mother, (from a tiny northern town of Meadow Lake, Saskatchewan) met at university in Seattle. Their first conversation started over the peculiar similarity between the names of their home-towns. Seth lived in small-town France from birth until he left home, completed his university studies in both Canada and the US and worked in several cities since finishing his training. This movement gave him a sense he wasn’t sure what ‘home’ was. He considered this a unique advantage, a hand of cards dealt to him to play in his favor. Seth could move for work without feeling like ‘leaving home’, as he had no family ties restricting him. He didn’t have to worry about a wife’s career or school for kids. Instead of a tight group of friends he had a network of acquaintances scattered all over the globe. He didn’t mind international travel at all, and his language abilities came in handy. But this sense of “this is not where I’m from” was the strongest he had ever felt. Far beyond “this isn’t my home” and much closer to “I have no idea where I am.” Not just in a tangible, geographical sense, but in a way that approached what a college freshman who’s taken one class in philosophy would like to call an ‘existential crisis.’

His upbringing did partially explain what in the world he was doing here, at least one small piece, his fluent French. Having spent his entire twelve years of schooling in the French public system gave him a native-like grasp of the language. For his entire childhood, his parents ran a small cluster of 300-year-old, stone, farm buildings converted to a language school for missionaries preparing to serve in French-speaking countries. In doing so his parents also worked as missionaries, living via the support of various individuals and churches back in North America. But this upbringing also partially explained his distaste, no – his revulsion – for being where he was. Those twelve years also gave him a near-native grasp of the French disdain for religion, their almost militant ‘laïcité’. This distinctly French version of secularism emerged as a hyper-reaction to the iron-grip the Catholic church held on that country for centuries. Modern France was a place where 60% identified as ‘Christian,’ though, few differentiated ‘Christian’ from ‘Roman Catholic.’ Only half of those believe in God, and only half of those would have been to a church in the past year. Realistically about 3% of French hold beliefs that in any way line up with traditional Christianity. So despite various things, and in fact, because of other events, he emerged from that childhood firmly in that other 97%. Of that, there was no question in his mind, nor in the minds of those who knew him. It was almost cliché, but Dr. Seth Queller was a textbook example of “missionary kid gone bad.” A living example of what caused parents to reconsider taking their young families overseas to ‘serve in hard places.’ Ironically, many of the families who lived and studied at the language school probably dreaded that hypothetical idea. Yet they lived right alongside a flesh and blood, almost stereotypical example, and had no idea.

If he ever thought about it – God, or religion or whatever – which he rarely did, he had lots of people and things to recall if he ever needed to defend not following his parents superstitious ways. Mostly it was just plain anger. Too many times he and people he cared got hurt or watched others suffer. He always held a very strong sense of justice, and he could not swallow the story of a God who is both good and powerful that allows the pain he experienced and witnessed. For him – the matter started and ended right there.

Not that any of that mattered now. He sure was not the one whose idea it was to give up the last two days of treasured ski-break to fly to some tiny, dirty, African country to volunteer his time. Several other people had the idea, but certainly not him. His Dean suggested he needed to appease the promotion committee, six peers who now presented the last hurdle between him and a coveted endowed chair. The Dean recommended he try to counter the effects of all the stories and rumors the committee received from various sources. Dr. Seth Queller was on track to become the youngest person ever to be promoted to an endowed-chair, full-professorship. A well-deserved recognition, he considered, of his brilliant career thus far. In only seven years he had been poached two times to bigger and more prestigious universities. Each time earning himself more prominence, better resources and remuneration he believed in line with his market value. Now he was about to become the youngest holder of a research chair at the Duke University School of Medicine and the most respected member in his department. Well, at least they respected his skill. In terms of being a person, and who he was as an individual, most would use ‘despise’, ‘loath’, or ‘fear’ rather than ‘respect.’ He told himself it was jealousy, which was partially true. Many were in awe of his raw technical skill in the operating theater. His ability to not only pick up new concepts but also explain them in a way that made sense to others at the same time as they were impressed at his ability to do so. Which was exactly what he intended.

But there was one other aspect that affected all his interactions with his peers. Simply ‘the software’ is how many referred to it. It hung over his relationship with the university as his employer. There was always ‘the software.’ Seth’s assigned roommate in his first year of undergrad, with whom he formed a bond, and ended up living with for four years. They got along as good as he had with anyone. They were both driven, off-the-chart intelligent, and had not the easiest time forming friendships. Seth because he had not yet learned to temper his natural arrogance, and Cody Anderson because he was a classic introverted genius. He had finished high school a full year early, so Cody had only turned 17 the week before they met. Cody was brilliant, yet awkward. Seth was smart, and good at reading people. Seth following his pre-med studies, Cody blazing through computer science.

After four years when Seth advanced to med school, Cody went straight into a fully funded PhD in artificial intelligence. It was during this time that Seth found an application for some technology that Cody developed as a hobby. On the first day of Seth’s first rotation on a surgical service he watched a shoulder surgery. Given his personality he was shocked at how sloppy the approach was to such a precise procedure. He watched as the orthopedist first tried one kit for a shoulder replacement, realized it would not be ideal, then took another complete kit of device, tools and materials. All because measurements of the shoulder weren’t accurate enough before starting the procedure. Right there Seth realized that he could use Cody’s rudimentary Artificial Intelligence system for something. The program they used to scan and slice white bread in their dorm room because Cody wanted something to test it on. They could use this technology to plan a surgical intervention with incredible accuracy before making the first incision. Using scans as input, Cody’s software could map out the surgery, choose the device, and provide laser guidance for the angle of every cut, and every anchor point. It would save doctors and hospitals massive amounts of time, reduce the number of devices, tools, and equipment needed for every surgery, and reduce post-operative complications. That would almost ensure better patient outcomes and diminish malpractice lawsuits. He realized he’d just found a way to save time and money for one of the most lucrative markets in the world – American orthopedics.

When they sold the technology for 8-figures to a French-based orthopedic firm, Cody tried to keep the financial payout as hidden as possible. He didn’t want to be treated differently by his peers in the Comp Sci department. Everyone expected Seth to buy a red Ferrari, which is partially why he didn’t. But he also didn’t because he saw how to leverage his newfound wealth as an influence on those with impact on his future trajectory. He still wanted to be a surgeon. It had never been because of some petty altruistic feelings, and now it wasn’t the money. Now it was almost in spite of it. Seth wanted to show others he could do it simply to prove that he could. He bought himself a condo in a neighborhood amongst professors, attending surgeons, and the dean of the medical school himself. Seth was careful not to have the biggest home, but by the time he finished his residency it was the most expensive property ever sold in the tree-lined community. He learned that the most powerful thing about his wealth was more than its ability to acquire essentially anything he wanted. The real power was that others knew he didn’t have to play by the normal rules. He couldn’t be convinced to take a position that wasn’t exactly what he wanted because of a dangling offer of a raise. Seth would even list his home with a realtor, around the time of his contract renewal, knowing the threat of another offer would give him a bargaining chip. This would allow him to stay where he wanted and leverage his way to a better contract, just for the sake of winning. The threat of dismissal did not affect him. He would be no one’s dancing monkey. Which is what made his present predicament so difficult for him. It wasn’t the details of what he was doing. It was that he was actually doing something he didn’t want to. He didn’t do that. Other people may be agitated at what they had to stoop to in order to keep their jobs, or get a promotion. They may not like having to teach an extra course, or cover more time in the ER or whatever. But for Seth, this was a principle. He didn’t feel he should ever have to do anything he didn’t want to.

This promotion was not about the money. It was merely a way for him to know he won. What was vital is that he do what he wanted. He thought he should be a full-professor, he felt he deserved to hold a research chair position, and he was determined to see exactly that happen. But now some old profs, protected by their tenure at the university, threatened to keep him out. They didn’t even pretend to base it on his skill, or expertise or knowledge, but because they thought he wasn’t nice enough. They pointed to the clause in the contract for full-professorship that everyone always skipped overstating “… work and character worthy of the appointment.” No one ever imagined using the word “character” in that document for anything other than to feel good about themselves when they were promoted. But now two aged surgeons on the committee felt like proving this phrase meant something. This would be their last stand before retirement and being sent out to play with their grandchildren and bulldogs. So here he was, doing something he loathed doing. It wasn’t even specifically being there or work that bothered him, but being forced to appease others because he had no leverage over them. That’s what he truly detested. Having his hand forced, that there was no way to use his contacts, his influence, his brilliance, his resources to get what he wanted. This was uncomfortable, it was tedious, and it drove him even harder to make sure he would soon be that prof. Protected by his own tenure and full-professor status to make sure this could never happen again.

THREE – THIS IS NOT WHAT I SIGNED UP FOR

Dr. Seth Queller was there to perform cleft-pallet surgeries at the clinic attached to the university. His dean claimed Seth’s French-language skills and his medical specialty would make it fairly easy for him to work there. He was already realizing this was not worth it that there must be another way. If there were any lingering doubt this was not worth it – it was about to be eliminated.

The president of the university sent his personal driver to get Seth from the airport, and it was this meek, young man who now waited for him. Standing there in an immaculately pressed yet noticeably over-sized dress shirt, way-too-pleated pants, and shiny, pointed shoes. Dr. Seth Queller didn’t know who he was looking for, but the driver easily identified Seth as his man. He was one of only 15 who got off the flight, and one of three white people. Seth was also the only person who didn’t have a colleague/driver/family member greet him as he passed the policeman slouching next to the clearly out-of-order ATM. The driver took Seth’s bag and led him past a metal detector from a previous era, now sitting only as a testament to the incapacity to repair such equipment in-country. They walked out of the domed structure, past the police and the soldiers with AK-47’s, large guns dangling tripods, and what he would soon learn were Rocket-Propelled-Grenade launchers. What struck him most was how scratched up and poorly taken care of the RPG looked, all scuffed and marked. He couldn’t help but think if he carried an armament like that he’d be more careful with it.They walked beyond the Toyota trucks with wooden benches lengthwise through the box to carry the soldiers. Beyond the cluster of white Land Cruisers, each with a huge antenna mounted on the front bumper, right next to the winch. Several had the flag of the Red Cross hanging limply, half-way up the antenna, the Red Cross logo also on the doors, and a massive logo covering one of the two spare tires on the back. Apparently, wherever they were going, they wanted people to know what side they were on. Onesphore the driver led him to a 10-year-old SUV that looked like it had previously belonged to someone who listened to a fair bit of late-90’s gangster rap. Burundi imported cheap, used vehicles from all over the world. This one had come from Dubai, and it showed. The gold-trim, ground-skirts, and custom grill looked out-of-place on a vehicle used to chauffeur around a short, svelte man in charge of a struggling Christian university. But then again, the university president’s penchant for shiny suits made that dissonance somewhat disappear. But the president of the university was not there, a slight not unnoticed. He would be repeatedly shoved to the side over the next few days. Kicked down a social pecking-order that neither recognized nor appreciated his talents, his publication record, his title, his reputation or the software. Not once introduced with his usual title he’d heard from podiums and by colleagues introducing him at parties, ‘Dr M. Seth Queller, Chief of the Bombardier Center for Facial Reconstruction, and associate professor of pediatric craniofacial plastic surgery.’ None of that seemed to matter to anyone here as he was routinely introduced as “a visiting doctor”.

A ‘doctor.’

Not even surgeonprofessor or anything with a shred of respect to it, but merely, ‘doctor.’ As if he peaked as some kind of nondescript med school grad that spent his days in a small clinic seeing runny noses and hemorrhoids.

But now this visiting doctor had bigger problems. The clinic where he was supposed to work was completely and utterly unprepared for his arrival in every conceivable way. The Bloc Opératoire (if one could even consider it an Operating Room) was a small, single room with a bed, a light with florescent bulbs, and a few carts clearly donated several years ago. There was no running water in the OR, or anywhere else in the hospital except for a few sinks upstairs. The power would shut down and a minute or more would pass until the generator kicked in. Anything resembling surgery would not be possible.

But there was a bigger reason why he could do no surgery. There were no patients. None. Somehow the Dean had been too busy running the medical school to notice that one of his Burundian colleagues who was supposed to be screening patients handed the task over to a group of three interns. One of those three fled to his native Rwanda just a day later as tensions continue to mount between the two countries. The remaining two found everyone they talked to were put-off by the cost, so they gave up.

To say Dr. Seth Queller was furious would be a disservice to his ability to generate impressive levels of anger. He volunteered his time, to come to this god-forsaken place to do surgeries for free, and the stupid students somehow didn’t get the memo that the procedures would be offered to them at no cost. So now here he was, completely and utterly wasting his time.

“Get me on the next flight out of here,” he demanded. “I don’t care about the cost, or even if it’s on my preferred carrier – just get me out of here.”

“My dear brother” the president replied

“Seriously,” Seth thought to himself “if that guy calls me brother or dear one more time…”

“Actually,” the president continued, “there are only so few flights from our capital because of the current problems.”

In less than ten minutes of conversation with this man his penchant for using ‘actually’ as his default translation for the French word actuellement instead of the English world connoting the same meaning – ‘currently’ – was almost enough to make him snap.

“There are now only the flight that you just came on – which is actually leaving now. It comes every Friday and Sunday.”

Trapped. Completely trapped for the full five days.

The university sat in the middle of one of several areas that people referred to, almost kindly, as an ‘opposition neighborhood.’ The capital city had only a decade earlier been divided along ethnic lines, and much of that division still showed in the political allegiance of those in various quartiers of the city. He had seen nothing like this neighborhood in his life. Not even close. Seth traveled to Africa one time before, about 5 years prior, to Cape Town to receive an award one of his papers garnered from the International Academy of Pediatric Surgery. He flew in, was picked up by a driver, spent two nights at a resort on the coast, received his award, enjoyed a few grand meals, and left. He knew this had not been an exposure to ‘typical Africa,’ but he assumed several neighborhoods he drove past on his way to the airport gave him a sense how ‘the rest’ lived. This, however, was an entirely other universe. The only narrative he could connect this to were images on CNN with the words ‘military coup,’ ‘famine declared’ or ‘genocide’ superimposed on the bottom of the screen. There was one fundamental thing wrong, something that didn’t sit well with his white-privileged sense of those kinds of places. Crossing the street from the university to the clinic for the third time as they tried to figure out what happened to his cleft-pallet cases, he realized what it was. The people were not menacing, or threatening, but rather they looked rather normal, and many of them even happy.

“What do these people possibly have to smile about?” he wondered as he tried to keep up with the Dean Whickham as he darted across the dusty road, weaving between three-wheeled moto-rickshaws.

Seth had nothing to smile about here. Oppressively hot, sweaty, dusty, nine hours jet-lagged, only a bottle of room-temperature (that is, hot) local bottled water since he got off the plane a few hours ago.

“I’m sorry Dr Whickham, but this appears as though it’s just not going to work out – I’m afraid this has all just been a waste of time.” he said to the mid—50-year-old physician wearing cargo pants, sporting a safari hat, and sandals. A walking stereotype of a middle-aged lawyer from Minneapolis taking a once-in-a-lifetime trip to Kenya to see animals. “I’ll let Dr. Builllon know we tried, and maybe we can send one of my colleagues out if you can find a way to arrange the program…”

“You know Jacque and I go way back,” he interrupted.

It was shocking not only that this random doctor would know his Dean but that he would call him by his first name. It was unbelievable that someone who clearly couldn’t get a job and came over here on a religious crusade would even know of one of the leading experts in his field.

“Did you go to medical school together?” he asked, thinking of the only place they may have crossed paths.

“No no, he went to John’s Hopkins, I certainly couldn’t have gotten into there,” he said with a laugh.

Well, at least he knew his place.

“We published a few papers together…”

“Really,” he thought “this guy does research?”

“When we were on the certification board together…”

This guy sat on a board? This seemed unbelievable. As in, he did not believe him. So he pressed him, “What board?”

“Plastics,” the man replied. “From ’98-04.”

“You’re a board-certified plastic surgeon?” he asked, sounding more surprised than he intended to.

“Yeah – well I do a lot more general surgery here, but that’s what I started my career in. Jacque and I published several papers on post-operative recovery for maxillofacial interventions.”

Now he was more than surprised, he was shocked and confused. How did someone with board certifications, who published work that Seth was familiar with…

Suddenly, It was all coming together. This was “the” Whickham of the paper he knew almost by heart as ‘Whickham & Builllon, 1990, New England Journal of Medicine.’ Assuming this man could be that Whickham was so inconceivable Seth had not even considered it.

“I actually talked to Jacque last night – he told me you’d be coming, and that if anything went sideways, you’d probably say that. So I’ve set up something else for you.”

“We’ve got another hospital upcountry,” he continued as if the phrase ‘upcountry’ was supposed to mean something to him. “It’s not as big as this one, but we’ve got a great old doc up there who could use some help in the OR.”

Well if this guy who published in top-tier journals 25 years ago called someone else ‘old’ – he couldn’t imagine. “The hospital is not much to look at – but some good work is being done up there”

“Like this ‘hospital’ is something to look at?” he thought, barely capable of keeping the judgement to himself.

He remembered the decent looking resort hotels that sat on the lake, mere minutes from the airport. He’d get a driver to take him there, spend five days getting caught up on email, review data for his next paper, and call it done. However, if the committee that forced him to be here in the first place, found out he spent his time with his laptop pool-side at the only decent hotel in the country, this whole ordeal would be wasted. In fact, things would probably be worse, and he would have taken this horrific trip for less than nothing.

Besides, “How much worse could it be?”

He was about to find out.

FOUR – DR. TOM

Dr. Seth Queller was there to perform cleft-pallet surgeries at the clinic attached to the university. His dean claimed Seth’s French-language skills and his medical specialty would make it fairly easy for him to work there. He was already realizing this was not worth it that there must be another way. If there were any lingering doubt this was not worth it – it was about to be eliminated.

The president of the university sent his personal driver to get Seth from the airport, and it was this meek, young man who now waited for him. Standing there in an immaculately pressed yet noticeably over-sized dress shirt, way-too-pleated pants, and shiny, pointed shoes. Dr. Seth Queller didn’t know who he was looking for, but the driver easily identified Seth as his man. He was one of only 15 who got off the flight, and one of three white people. Seth was also the only person who didn’t have a colleague/driver/family member greet him as he passed the policeman slouching next to the clearly out-of-order ATM. The driver took Seth’s bag and led him past a metal detector from a previous era, now sitting only as a testament to the incapacity to repair such equipment in-country. They walked out of the domed structure, past the police and the soldiers with AK-47’s, large guns dangling tripods, and what he would soon learn were Rocket-Propelled-Grenade launchers. What struck him most was how scratched up and poorly taken care of the RPG looked, all scuffed and marked. He couldn’t help but think if he carried an armament like that he’d be more careful with it.They walked beyond the Toyota trucks with wooden benches lengthwise through the box to carry the soldiers. Beyond the cluster of white Land Cruisers, each with a huge antenna mounted on the front bumper, right next to the winch. Several had the flag of the Red Cross hanging limply, half-way up the antenna, the Red Cross logo also on the doors, and a massive logo covering one of the two spare tires on the back. Apparently, wherever they were going, they wanted people to know what side they were on. Onesphore the driver led him to a 10-year-old SUV that looked like it had previously belonged to someone who listened to a fair bit of late-90’s gangster rap. Burundi imported cheap, used vehicles from all over the world. This one had come from Dubai, and it showed. The gold-trim, ground-skirts, and custom grill looked out-of-place on a vehicle used to chauffeur around a short, svelte man in charge of a struggling Christian university. But then again, the university president’s penchant for shiny suits made that dissonance somewhat disappear. But the president of the university was not there, a slight not unnoticed. He would be repeatedly shoved to the side over the next few days. Kicked down a social pecking-order that neither recognized nor appreciated his talents, his publication record, his title, his reputation or the software. Not once introduced with his usual title he’d heard from podiums and by colleagues introducing him at parties, ‘Dr M. Seth Queller, Chief of the Bombardier Center for Facial Reconstruction, and associate professor of pediatric craniofacial plastic surgery.’ None of that seemed to matter to anyone here as he was routinely introduced as “a visiting doctor”.

A ‘doctor.’

Not even surgeonprofessor or anything with a shred of respect to it, but merely, ‘doctor.’ As if he peaked as some kind of nondescript med school grad that spent his days in a small clinic seeing runny noses and hemorrhoids.

But now this visiting doctor had bigger problems. The clinic where he was supposed to work was completely and utterly unprepared for his arrival in every conceivable way. The Bloc Opératoire (if one could even consider it an Operating Room) was a small, single room with a bed, a light with florescent bulbs, and a few carts clearly donated several years ago. There was no running water in the OR, or anywhere else in the hospital except for a few sinks upstairs. The power would shut down and a minute or more would pass until the generator kicked in. Anything resembling surgery would not be possible.

But there was a bigger reason why he could do no surgery. There were no patients. None. Somehow the Dean had been too busy running the medical school to notice that one of his Burundian colleagues who was supposed to be screening patients handed the task over to a group of three interns. One of those three fled to his native Rwanda just a day later as tensions continue to mount between the two countries. The remaining two found everyone they talked to were put-off by the cost, so they gave up.

To say Dr. Seth Queller was furious would be a disservice to his ability to generate impressive levels of anger. He volunteered his time, to come to this god-forsaken place to do surgeries for free, and the stupid students somehow didn’t get the memo that the procedures would be offered to them at no cost. So now here he was, completely and utterly wasting his time.

“Get me on the next flight out of here,” he demanded. “I don’t care about the cost, or even if it’s on my preferred carrier – just get me out of here.”

“My dear brother” the president replied

“Seriously,” Seth thought to himself “if that guy calls me brother or dear one more time…”

“Actually,” the president continued, “there are only so few flights from our capital because of the current problems.”

In less than ten minutes of conversation with this man his penchant for using ‘actually’ as his default translation for the French word actuellement instead of the English world connoting the same meaning – ‘currently’ – was almost enough to make him snap.

“There are now only the flight that you just came on – which is actually leaving now. It comes every Friday and Sunday.”

Trapped. Completely trapped for the full five days.

The university sat in the middle of one of several areas that people referred to, almost kindly, as an ‘opposition neighborhood.’ The capital city had only a decade earlier been divided along ethnic lines, and much of that division still showed in the political allegiance of those in various quartiers of the city. He had seen nothing like this neighborhood in his life. Not even close. Seth traveled to Africa one time before, about 5 years prior, to Cape Town to receive an award one of his papers garnered from the International Academy of Pediatric Surgery. He flew in, was picked up by a driver, spent two nights at a resort on the coast, received his award, enjoyed a few grand meals, and left. He knew this had not been an exposure to ‘typical Africa,’ but he assumed several neighborhoods he drove past on his way to the airport gave him a sense how ‘the rest’ lived. This, however, was an entirely other universe. The only narrative he could connect this to were images on CNN with the words ‘military coup,’ ‘famine declared’ or ‘genocide’ superimposed on the bottom of the screen. There was one fundamental thing wrong, something that didn’t sit well with his white-privileged sense of those kinds of places. Crossing the street from the university to the clinic for the third time as they tried to figure out what happened to his cleft-pallet cases, he realized what it was. The people were not menacing, or threatening, but rather they looked rather normal, and many of them even happy.

“What do these people possibly have to smile about?” he wondered as he tried to keep up with the Dean Whickham as he darted across the dusty road, weaving between three-wheeled moto-rickshaws.

Seth had nothing to smile about here. Oppressively hot, sweaty, dusty, nine hours jet-lagged, only a bottle of room-temperature (that is, hot) local bottled water since he got off the plane a few hours ago.

“I’m sorry Dr Whickham, but this appears as though it’s just not going to work out – I’m afraid this has all just been a waste of time.” he said to the mid—50-year-old physician wearing cargo pants, sporting a safari hat, and sandals. A walking stereotype of a middle-aged lawyer from Minneapolis taking a once-in-a-lifetime trip to Kenya to see animals. “I’ll let Dr. Builllon know we tried, and maybe we can send one of my colleagues out if you can find a way to arrange the program…”

“You know Jacque and I go way back,” he interrupted.

It was shocking not only that this random doctor would know his Dean but that he would call him by his first name. It was unbelievable that someone who clearly couldn’t get a job and came over here on a religious crusade would even know of one of the leading experts in his field.

“Did you go to medical school together?” he asked, thinking of the only place they may have crossed paths.

“No no, he went to John’s Hopkins, I certainly couldn’t have gotten into there,” he said with a laugh.

Well, at least he knew his place.

“We published a few papers together…”

“Really,” he thought “this guy does research?”

“When we were on the certification board together…”

This guy sat on a board? This seemed unbelievable. As in, he did not believe him. So he pressed him, “What board?”

“Plastics,” the man replied. “From ’98-04.”

“You’re a board-certified plastic surgeon?” he asked, sounding more surprised than he intended to.

“Yeah – well I do a lot more general surgery here, but that’s what I started my career in. Jacque and I published several papers on post-operative recovery for maxillofacial interventions.”

Now he was more than surprised, he was shocked and confused. How did someone with board certifications, who published work that Seth was familiar with…

Suddenly, It was all coming together. This was “the” Whickham of the paper he knew almost by heart as ‘Whickham & Builllon, 1990, New England Journal of Medicine.’ Assuming this man could be that Whickham was so inconceivable Seth had not even considered it.

“I actually talked to Jacque last night – he told me you’d be coming, and that if anything went sideways, you’d probably say that. So I’ve set up something else for you.”

“We’ve got another hospital upcountry,” he continued as if the phrase ‘upcountry’ was supposed to mean something to him. “It’s not as big as this one, but we’ve got a great old doc up there who could use some help in the OR.”

Well if this guy who published in top-tier journals 25 years ago called someone else ‘old’ – he couldn’t imagine. “The hospital is not much to look at – but some good work is being done up there”

“Like this ‘hospital’ is something to look at?” he thought, barely capable of keeping the judgement to himself.

He remembered the decent looking resort hotels that sat on the lake, mere minutes from the airport. He’d get a driver to take him there, spend five days getting caught up on email, review data for his next paper, and call it done. However, if the committee that forced him to be here in the first place, found out he spent his time with his laptop pool-side at the only decent hotel in the country, this whole ordeal would be wasted. In fact, things would probably be worse, and he would have taken this horrific trip for less than nothing.

Besides, “How much worse could it be?”

He was about to find out.

FIVE – THERE’S BEEN AN ACCIDENT

As a kid, Seth loved watching MASH off a well-worn boxed set of VHS tapes. As soon as he got home from school, he’d head straight to that built-in shelf to the right of their understated tv in the corner of their living room. Since his parents both tended to be occupied right before supper time, he always was the first one home. He could catch an episode or two of MASH before his parents walked across the little compound of the language school to their small stone and timber home. Young Seth was not allowed to do this, but he soon realized that he was clever enough to get all his homework done in a much shorter amount of time than almost anyone else. He could do this because he was, well, clever. Not just smart (which he was) but also – unusually clever. Yes he was intelligent and got more work done in a shorter amount of time than most kids in his class, yet his cunningness, his ability to understand people, and play people really got him ahead. He figured out which insecure kids wanted to be liked and were willing to ‘help’ him complete his homework. Seth was adept enough to sort out who were the over-achieving, type-A students and somehow convince them they wanted him for group projects. He was crafty enough to determine which teachers could be pushed, to what extent, and how. That skill set, which would serve him well the rest of his life, allowed him to have more leisure time than a student in French public school should have, and allowed him to slide those tapes into the VCR with no one noticing. Those images of the Korean War surgeons originally inspired him to go into medicine. He often tried to convince others, and perhaps himself, that he wanted to help others and give them a better quality of life by helping children recover from deformities and trauma from injury and accident. But deep inside, it was the smarmy, womanizing, heavy-drinking, yet always correct and immeasurably talented character of Hawkeye Pierce that drew him in.

Those images of MASH were burnt deep in his memory and he often thought of them and would occasionally bring them up. Once he subconsciously referenced it while yelling at one of his surgical residents at Stanford University Hospital for dropping an instrument. “What is this – Korean War meatball surgery? Does this look like a canvas tent to you?”

Those who had never seen this side of Seth were shocked, and most in the room, including this young resident, had no idea what he was talking about. His physique, well-dressed demeanor and general attitude towards life gave him confidence that often betrayed the fact that he was in fact – over 40. No matter how you look at it, 43 is more than 40. No one ever wanted to remind him of this, and no soul would dare question such an obviously outdated pop-culture reference that would bring this fact to light.

Yet now, here he stood in this pathetic excuse for an operating theater that felt like it was about as close to the working conditions of those shows as he could imagine. And after ten hours, looking deeper into himself than perhaps he ever had before.

The ten hours had not been scheduled of course, they were supposed to just treat the young man with the facial trauma. While they were in the middle of that case, a series of people darted into the room, merely holding masks on their faces, speaking rapidly with Dr. Tom in Kirundi. After someone barged in a fourth time Seth finally demanded what was so important that justified interrupting his concentration and desecrating anything resembling a sterile work environment.

“There’s been an accident,” Dr Tom said in the tone doctors seem to reserve for that phrase.

“An entire church choir was riding in the back of a truck, the brakes failed and it rolled off the road down a pretty big hill. There were probably 40 in the truck, plus a few in the house it crushed over. Muguru says they are starting to triage them right now.”

Seth had seen something similar on his drive up the hill. A truck, not much bigger than a pickup with a cage that looked like it was intended to transport two cows, but instead was packed with people. They looked as if someone poured them in from the top, filling every available space, spilling out through the sides as arms, hands, and even faces protruded through, trying to get some fresh air. For a moment, he imagined what it would be like to be in that mass of humanity when it rolled off a hill – and then he yanked himself back.

Seth glanced at the windows though one section of glass with no white paint on it, to see wounded being carried in. They were simply being set on the ground under the tin roof that had just a moment ago had been a waiting area.

“It looks like at least 15 will need surgical treatment of some kind. Get ready – this will be a long night.”

“We aren’t seriously going to prep all those people for transport to a real hospital ourselves?” he asked.

“No son,” Dr. Tom looked at Seth with a shockingly calm demeanor, “we are the only real hospital for three hours in any direction. We’re going to operate on all those people.”

SIX – MAYBE I NEED TO WHAT?!

“Maybe what you need to do is try to care a bit less about yourself, and a bit more about others.”

Really?

That was his advice?

Just over 24 hours in the country had already completely overwhelmed him. If his phone had any reception, he would have been contacting someone, anyone, to come get him out of this rat-infested hell-hole. Literally rat-infested.

Seth arrived in Kibuye the day around 6.00. The sun was setting as it does every single day of the year 2º from the equator. Since then he had spent ten hours working with Dr. Tom, not just ten hours working, ten hours in surgery. Ten excruciatingly long hours inside a poorly lit, damp room that shouldn’t even be called an operating theater. That concrete room with holes in the ceiling, handmade wooden furniture, old donated surgical equipment and DIY tools.

After a single hour of sleep Dr. Tom sent someone to pound on the metal door of the small guest house. Seth jumped to see what the emergency was, only to find Muguru.

Without even an apology for waking him so early, he said “Good morning Doc-tah. It is the time to do rounds.” Then he stood there, waiting.

Seth realized he was still dressed from the night before, so he snatched his white coat. He stared at Muguru as he tore it from the chair, hoping that his displeasure in this whole situation would be evident. In his haste, he neglected to notice he grabbed the bottom of the coat off the wooden chair.The contents of his pockets sprayed around the room, sliding across the concrete floor. His stethoscope, the Montblanc pen and Moleskine notebook he kept in his left chest pocket, and his phone.

“Sorry, sorry,” was all Muguru said as he scurried to help Seth pick up everything. He was closer to the phone which stopped only when it hit the brick wall next to the door.

“Oh oh – Sorry, sorry,” he said again as he saw the shattered screen and handed it back to Seth. A phone whose brown leather case with lovely patina cost more than what Muguru made in a month.

“Take. Me. To Dr. Tom.” was all Seth could say without screaming at the man, or throwing something else across the room.

When they reached Dr. Tom he had already finished rounding on several of the patients they operated on less than 12 hours earlier.

“I need to talk to you” Seth allowed the words to seethe out from his clenched mouth, dispensing with anything resembling pleasantries.

“Go ahead,” he said, inserting these two English words in between his Kirundi questions to the patient and his French instructions to his nurses.

Realizing that Dr. Tom had no intention of pausing his work to speak to him somewhere else Seth added: “.. in private?”

“If you’re concerned about privacy, there is no one in this room who understands more than a few words of English… so go ahead.”

When presented with the opportunity to list his grievances, he was not even sure where to start. The lack of respect, the working conditions, the assumptions about, well, everything. But he tried.

“Look. I am not supposed to be here. I am a pediatric craniofacial plastic surgeon, and I was supposed to be doing cleft-pallet cases in the capital. Someone dropped the ball, and I got stuck with no patients. Then I got sent up here, and I’ve helped you with patching up all these trauma patients last night. But listen, I’m not an ER surgeon, I’m not going to round on these patients, in fact, there is nothing for me to do here. I was about to call to get out of this place as soon as I got up, but my phone shattered when you sent your nurse to wake me up for rounds! Now what do you suggest I do?”

That’s when he said it. That’s when Dr. Tom turned the orientation of everything around, in a Copernican way he shifted Seth’s religiously held belief that he was, in fact, the center of the universe.

“Listen. If you don’t want to be here, please leave. I can arrange a driver to take you back down as soon as we find a car and ensure there are no bandits on the road. But before you do, perhaps you should realize what is going on here.”

Here he paused, asked the patient one more question in the local dialect, and shook her hand for the third time since they had been standing there. They moved away from the bed, and out the open door.

“That older woman that we removed the bamboo pole from her belly last night, she’s alive. In the next bed is a man who surely would have died had he not been brought here. He lost his wife last month in childbirth… their seventh. So there are seven kids who are not orphans because he didn’t die last night. The 14-year-old girl whose leg we amputated will never walk, but she will live. What our surgical team did last night was not insignificant. The 55-year-old grandmother who we removed the end of the fence-post from her leg, she died overnight. So did the 5-year-old whose eye you saved… turns out he already had an undiagnosed very advanced bone infection in his leg and was too weak to recover. 18 others died last night in that accident. But, we were part of saving many others. There are hundreds on this hill full of grief and mourning, and amid all that, they all have to find some way to work their fields or their families won’t eat tonight. Not to mention the family whose house was crushed, and now have to dig up mud to make bricks, to start the process of rebuilding even though they probably don’t have one dollar.”

Here he paused, shook hands with someone who passed by. An ancient looking man, walking with a stick taller than him, that he used as an aid for an obviously lame leg.

Dr. Tom continued in his calm manner, his words cut, yet his tone was still compassionate. “Yet you came in here, and you didn’t ask about any of them. You didn’t ask about those who died, you didn’t ask about who made it. Never once did you ask about their families. You assumed what you had to say was more important than what we were talking about. You’ve talked about your skills and certifications, about ways you were inconvenienced, about how things didn’t work out how you had hoped. About how a phone you can replace without the slightest impact on your financial well-being has been damaged. You view the entire world through a lens that can see no one other than you. If you would pull back even just for a moment, you would realize what we were a part of last night was the worst tragedy for some on this hill, and the greatest gift to hundreds of others.”

He paused, and he placed his right hand on Seth’s shoulder, an action that if it had come in any other circumstance, he would have swatted it away. Yet now he somehow felt paralyzed by what Tom said. Not because the words were mean, or the tone was harsh.

But, because they were true.

“Maybe what you need to do is try to care a bit less about yourself, and a bit more about others.”

Just then, Muguru approached Dr. Tom, saying something Seth would not have heard even in a language he understood, and the two disappeared into the OR.

Seth was left standing there, under the corrugated asbestos roof that covered the sidewalk linking the buildings. Only then did he notice a group of women who had gathered to stare at him and Dr. Tom, as white-skinned people were so rare in the country, and unheard of outside the capital. The women started to withdraw as the rain began. While only a sprinkle, it sounded like an oncoming truck on a gravel road. Seth looked up to see a line dragging across the dirt field, the front line of an advancing army. They left him there alone, with the thoughts inside his head pounding like the drops hitting the covered walkway. No one had ever talked to him like that – at least not that he could remember – and perhaps that’s why he felt something he never had before.

SEVEN – NO HITLER

“What are you going to do next?”

These words echoed in his mind as he sat on the shockingly heavy eucalyptus-wood chair in his room.

He wrestled with this question well into the night.

He had not been in a real bed for 42 hours — the thin foam mattress in his guest room didn’t count – and hadn’t showered since the business lounge in Heathrow on his layover. There was a shower in the guest room, but he was frozen in place, unable to do anything. Besides, it had been cloudy most of the afternoon, so the water coming from the homemade solar hot water tank on the roof was only barley warm. He couldn’t get the faces out of his head, replaying them over and over in his mind.

The woman who walked past him with a massive cluster of green bananas on her head, a basket on top of that. When she passed, he noticed a sleeping baby strapped to her back with a wide band of fabric that matched her skirt. He saw her as he left the hospital compound, heading back to his one-room guest house.

The boy in the tattered shirt that could be considered nothing other than ‘dirt-colored’, the same rusty hue as the soil. He had been sitting on a bench outside the surgical ward – apparently not a patient himself but seemed to be caring for a younger sibling. Anywhere else in the world, they would admit the older boy to a severe malnourishment program, yet here he was the healthy one.

The mother of the child who they could not save. She came into the OR to see her son when Dr. Tom went to tell her they had done all they could, but the damage to his internal organs was too severe. She wore a t-shirt from a fundraising run in Texas, worn almost through, and a piece of previously colorful fabric wrapped around her waist. The mother didn’t cry, did not even touch the boy. She approached his now lifeless body. She stood next to her son for a moment, turned, and left.

“They have no idea,” he kept thinking to himself. “No idea what the real world is like. They don’t even know how crappy their lives are. All of them speak only their local language, and most of them can’t even read that. No one has internet, no television, no radio – they don’t even have electricity. Not only do they not know who just won the World Series, they don’t even know who won World War II.”

Seth only knew this because of an interaction that involved one of the sterilization nurses. He was an older man wearing light blue scrubs with the stamp “Property of St Joseph’s” just visible on the pocket. The man had sewn his name with capital letters of red thread onto a white patch of cloth that made it appear as though he could barely write his own name. Printed there for all to see: Adolf. The first time that Adolf approached the OR table and Seth noticed him, he looked across the open belly he and Dr. Tom had their hands in and caught his eye.

“Really?” was all Seth said.

“What?” was Dr. Tom’s characteristically simple response, without looking up.

“The man’s name. Surely he is not old enough … that he was born before 1940” he said, careful not to say “Adolf” or even “World War Two.” In case anyone – especially Adolf – recognized any English words and realized the two white surgeons were talking about him while they operated.

“This place was a colony but not of any strategic importance to the war… or to the world. So it never really affected them. Many people have little education, and even if they do, world history is not given much attention. There’s a good chance that his parents had never heard of Hitler, and there’s a decent chance he hasn’t either.”

Then, without explanation, Dr. Tom turned to the man and spoke. “Adolf…” he started, followed by the peculiar rhythm of their local dialect. To Seth, it sounded like a cryptic sequence of consonant-vowel-consonant-vowel – that he felt he could make up himself. The man responded in a way that seemed so characteristic here, low, quiet voice, no eye contact. After some back and forth, Dr. Tom switched back to English so abruptly that Seth almost missed that Tom now spoke to him.

“He had three years of school before he dropped out to support his family after his father was killed in the civil war,” he said so matter-of-factly that you would think he spoke of who his dentist was. “He said he heard there was a big war between the Europeans before he was born, and it had to do with a genocide, but that’s all he’s ever learned about it.”

That’s when it hit Seth how isolated these people, and now he, really were. One day ago his first thought would have been ‘what is this uneducated man doing in the OR?’ Now he was overcome with not just being in another country, or a culture far beyond the ones he was comfortable in, but a part of the world that was something he never imagined still existed. He was struck with the image of the village in the Asterix comic books he -and every other child who grew up in France – loved so much. One small village at the far corner of the Roman empire the last location not part of the reality of everyone else. This place was like some kind of lost tribe deep in the heart of Africa, essentially untouched by the rest of the world – for all its evil and its good.

They finally walked away from the hospital after a day like Seth had never known. It wasn’t the sheer length of the work, Seth had of course done his time as a surgical resident. As part of his training he knew what it was like to put in unimaginably long days, be on call during the night, and everything else that went with it. That phase of becoming a surgeon which often seemed little more than proving you could keep going. But no surgeon in any developed country would ever have cases so completely unrelated to each other, or so far outside their expertise. Dr. Tom would at one point be repairing a broken femur on a 12-year-old with a stainless-steel rod. Dr. Tom made the rods in his workshop, as he found that he could buy the metal directly from the manufacturer and save a lot of money by cutting and shaping them himself. The next case was a c-section, followed by more trauma from the night before, patients who didn’t come right away as they lacked funds. Then he did an endoscopy on a 50-year-old man, followed by a skin graft on a child whose epilepsy caused him to fall into his family’s cooking fire. The diversity was so shocking that Seth couldn’t help but think back home it would be malpractice for one person to do them all.

EIGHT – COUNT YOUR LOSSES

There was one massive question he couldn’t stop from rolling over and over in his head.

“What might I lose?”

Besides the obvious.

The reality that he had lived a life completely and utterly with himself and his own happiness as the measuring stick of every decision he made finally hit him. His parents would be shocked that this was the first time in decades he had recognized the self-absorbed approach he overlaid onto everything he saw, said, thought, and did. They would also be overcome with joy he finally had reached this point of awareness.

He began to take stock of all the consequential decisions he made over the years. Decisions he made to get where he was, and to point him on this trajectory he was so pleased with. They came streaming through his mind, not sequenced by time, but by significance. He thought of his decisions to take that job, to bend the truth for that promotion, to not emotionally engage with that woman. To walk away from the faith of his parents.

It was all so fast, his own thoughts passed by too quickly for his emotions to keep up. But there was one overarching thought. He had built his life around a single guiding principle that itself now risked crashing down. While he had done exceedingly well at reaching his goal, it was the goal itself that seemed off. He had been so successful at achieving what he set out to do that he never stopped to assess whether it was the right thing. Individual success in every format – respect, money, positional power, influence – at the expense of everything else, was something he had never questioned

He faced the reality that not only was he chasing the wrong goal, but a thought he himself could not even imagine was coming into his head. Perhaps there was something he could do to right some of these misdirections:

‘Give it all up and move here.’

He took a piece of paper from the junk-drawer in the mid-century hutch that clearly a previous generation of missionary doctor brought over in a shipping container some decades prior.

He scratched out on the only paper he could find, a tear-off grocery list decorated with Christmas-teddy-bears. 24 lines with little check-boxes to the left of each one. As he filled them – he realized he needed to go back over his list and mark the things he was willing to lose, to give up, to throw away, or not.

He returned to items, adding things, removing others, checking some off, and realizing that he could not check off others. He didn’t notice how long he had been working on the list when there was a knock on the door. It was Dr. Tom, who Seth noticed for the first time looked rather tired, and worn down.

Seth felt like he finally was at a point where he could admit something he couldn’t believe he was ready to say out loud. Dr. Seth Queller felt so wrecked inside about where his life had arrived, that he felt he might be ready for a fundamental shift. He could actually see the negative aspects of the worldview he defended subconsciously for as long as he could remember.

“Dr. Tom,” he began, the most respectful words he had spoken to him since they met, “I feel I have learned something significant being here. I now see you aren’t here because you couldn’t find work back home, but you chose to be here.”

“Well, you must understand my real motivations…” he started to reply when Seth interrupted, but more politely than every time before.

“Let me finish… please.

I…

…I think I’m ready to think about giving up everything to move here and help with this work.”

NINE – BUT WHY?

There was one massive question he couldn’t stop from rolling over and over in his head.

“What might I lose?”

Besides the obvious.

The reality that he had lived a life completely and utterly with himself and his own happiness as the measuring stick of every decision he made finally hit him. His parents would be shocked that this was the first time in decades he had recognized the self-absorbed approach he overlaid onto everything he saw, said, thought, and did. They would also be overcome with joy he finally had reached this point of awareness.

He began to take stock of all the consequential decisions he made over the years. Decisions he made to get where he was, and to point him on this trajectory he was so pleased with. They came streaming through his mind, not sequenced by time, but by significance. He thought of his decisions to take that job, to bend the truth for that promotion, to not emotionally engage with that woman. To walk away from the faith of his parents.

It was all so fast, his own thoughts passed by too quickly for his emotions to keep up. But there was one overarching thought. He had built his life around a single guiding principle that itself now risked crashing down. While he had done exceedingly well at reaching his goal, it was the goal itself that seemed off. He had been so successful at achieving what he set out to do that he never stopped to assess whether it was the right thing. Individual success in every format – respect, money, positional power, influence – at the expense of everything else, was something he had never questioned

He faced the reality that not only was he chasing the wrong goal, but a thought he himself could not even imagine was coming into his head. Perhaps there was something he could do to right some of these misdirections:

‘Give it all up and move here.’

He took a piece of paper from the junk-drawer in the mid-century hutch that clearly a previous generation of missionary doctor brought over in a shipping container some decades prior.

He scratched out on the only paper he could find, a tear-off grocery list decorated with Christmas-teddy-bears. 24 lines with little check-boxes to the left of each one. As he filled them – he realized he needed to go back over his list and mark the things he was willing to lose, to give up, to throw away, or not.

He returned to items, adding things, removing others, checking some off, and realizing that he could not check off others. He didn’t notice how long he had been working on the list when there was a knock on the door. It was Dr. Tom, who Seth noticed for the first time looked rather tired, and worn down.

Seth felt like he finally was at a point where he could admit something he couldn’t believe he was ready to say out loud. Dr. Seth Queller felt so wrecked inside about where his life had arrived, that he felt he might be ready for a fundamental shift. He could actually see the negative aspects of the worldview he defended subconsciously for as long as he could remember.

“Dr. Tom,” he began, the most respectful words he had spoken to him since they met, “I feel I have learned something significant being here. I now see you aren’t here because you couldn’t find work back home, but you chose to be here.”

“Well, you must understand my real motivations…” he started to reply when Seth interrupted, but more politely than every time before.

“Let me finish… please.

I…

…I think I’m ready to think about giving up everything to move here and help with this work.”

TEN – TUZOSUBIRA

Finally, he headed back to the half-domed structures of the airport. While it seemed like he had just arrived, in ways much deeper and more personal, it felt like he had experienced years of living.

Dr. Tom sent him back down to the capital with a hired driver. A ‘taxi’ is what he called it, but when it arrived, it was just a seemingly random guy who owned, or at least had access to, a car. A white, right-hand drive Toyota model clearly only ever sold in the Japanese market. He didn’t notice as he got into the left seat of the car as he was so tired. But, since cars drove on the right side of the road, he felt like he was literally in the driver seat, as he sat next to the centerline would have been if one existed. The smiley, thin man kept asking him if he could see past the trucks ahead of them on the windy mountain roads for them to ‘safely’ pass. He could only communicate this request by an “OK?” and a thumbs-up and awaited Seth’s reply.

Even a few days ago he would have seen this as yet another insult, but after spending just days with Dr. Tom, he could see that he was a simple and practical man. Seth needed to get to the airport, so the most efficient thing was to find someone with a car. Not send for the university president’s driver, not have the hospital driver take him, certainly not take Dr. Tom away from his bloc opératoire for the better part of a day. Merely find some way to make it happen, preferably the least expensive. So, no formal send off. Nobody of standing or importance to take him down. Just this hired driver with a steering wheel on the wrong side of a 1995 Toyota Bluebird, with Dr. Tom standing on the rough-rock driveway as he pulled out. Dr. Tom heading up, yet again, to the hospital for who-knows-what procedures for who-knows-how-many hours.

Just before he got into the car, Dr. Tom reached into the back pocket of his scrub pants.

“I want you to take this – and read it. I don’t know if you’ve ever read it before, but I’d recommend starting with…”

“I have,” he said “I have read the Bible before” not knowing what to say next. At the same time the words made him feel connected to Dr. Tom and his life of simple but powerful faith, yet also revealing a sense that he had little excuse for what his own life had become.

“I know you can get the Bible on your phone, and whatnot, but I figured since yours didn’t look like it was in much shape to be reading on…. that you might appreciate this.

“I do,” Seth replied, “I do appreciate it. All of it. Everything.”

“Sorry that it’s in French, but it’s what…”

“No” Seth interrupted, “it’s perfect”

“Tuzosubira,” he said, “It’s: ‘until the next time we are together,’” he explained. The door closed, and that was it.

He sat in a near-daze as the car skipped over the holes in the dirt road that led back out to the highway. Nowhere else would this be considered a highway, but now Seth was too overcome to even have his natural reactive judgement. He barely noticed anything until a policeman tapped on the back window with the muzzle of his weapon. Startled, he realized they had stopped where the police dragged a rusty coil of barbed-wire across the road. “Uh… smile” the driver told him. He did, and the policeman’s face changed, and flashed him a thumbs-up. Seth returned the gesture, and they continued down the mountain.

As he approached the domes, the logistics of departing from this airport re-emphasized to him how utterly alone he was. Even if anyone wanted to see him off, it wasn’t possible. Two national police stood at the door to the second largest dome marked ‘departures.’ Only after showing them his passport and flight information (which they seemed more surprised that it was possible to be on his phone than the fact that it was almost illegible on his shattered screen) could he enter. There were a few people by the door, waiting to get in. A few days ago he would have noticed nothing other than their dated sense of fashion. After just a few days up at the rural hospital, his attention shifted. Now he noticed the women were wearing actual clothes instead of a Goodwill rejected T-shirt and a faded piece of cloth, that they all had shoes and weren’t standing there with calloused, dirty bare feet.

He realized when he picked up the grey plastic bin from the conveyor belt on the other side of the x-ray he forgot to take his watch off. It wasn’t a huge watch, but it was solid, looked expensive without looking like it was trying to look expensive. Definitely it should have triggered the metal detector. He looked back and noticed that neither the green lights nor the red lights were flashing. The machine was not even turned on.

As he stood in line, he noticed several people paying for the extra service of having their luggage shrink-wrapped. While some bags weren’t made for actual travel, he wondered if the people in line with decent looking bags knew something he didn’t.

The woman behind the desk in an ill-fitting Kenya Airways blazer informed him there was a problem with ‘the machine’ as she pointed to the aged IBM laptop in front of her. She handed back his passport with a boarding pass on which she had handwritten his seat number. He was about to point out she failed to indicate a gate when he remembered that it would be extraneous information in this situation.

“What a perfectly typical way to leave this country,” he thought.

There was no business lounge to allow him to be even somewhat alone with his thoughts. His normal routine would be to grab a quick tumbler of whatever drinkable scotch they stocked, grab a bottle of sparkling water, and head for a shower. But here he sat, in a terminal with only one waiting area for all passengers. He didn’t realize it but the group of people he sat with (those capable of paying for air travel) was a more exclusive subset of the 1% in this country than the lounges he normally frequented.

The plane taxied away from the cluster of half-domes, and onto the single runway. It rumbled up to the end by a canvas army tent where it swung a U-turn. With no taxiway, the aircraft had to drive one direction, then take-off the other on the same surface. Since the next flight at the airport wasn’t scheduled until tomorrow, this was not a problem for air traffic control. The plane lifted off the uneven runway and ascended over the massive lake that stretched to the south as far as the horizon. Now, with the mountains of Congo out the window to one side, and the Burundian capital to the other, he felt a strange fusion of relief and sadness, of accomplishment and regret.

He looked down at the worn brown leather Bible in his hand. Old but sturdy, well used but still solid, only grown more beautiful with age. In his other hand was his phone. The screen shattered, the brown leather case only a facade, machine-shaped and treated with chemicals to look aged and solid. One wrong move and the phone had become useless. Yet the book in his other hand had been through years of hard life and was more beautiful than when it was new. He pulled off the elastic band which had been holding it closed, and read a passage at the same time so completely new and foreign, and yet unimaginably familiar. He ran his finger over words so simple and clear and yet complex and profound. The same words he had been forced to commit to memory decades earlier now held meaning he never imagined.

The plane spiraled up into the clouds holding that day’s quota of rain. He looked down at the lush green hills, the networks of footpaths linking houses and small villages creating a spiderweb of red where the soil stood out from the surrounding green blanket of plants producing bananas, coffee, and rice.

Thinking back to his arrival here just several days before and the question he kept angrily asking. He smiled to himself as he realized perhaps he had an answer to the question. ‘What in the world he was doing here,’ turned out to be something he never imagined. As the clouds streaking past the window got closer to each other until they blocked all view of the ground below, he sank back into his seat. He rested in a sensation that while he had no idea what had been going on, there was something, someone who had, all along. Comfort wrapped him in a way he had never known was possible.

Seth did not know what would come next. Yet for the first time in his life that didn’t bother him. For once he didn’t have a plan for how everything would play out in his favor. He wasn’t scheming how to play everything and everyone to benefit himself. Seth sat with an awareness he was definitely at the end of something, but more importantly at the beginning of something else. He had only a vague sense of what it may be, and that was enough. For the first time, he had a sense of peace about the future. Right then he realized that for the very first time, he was starting to understand what faith may be. He wasn’t sure what he’d tell them, but he would call his parents from his layover in Brussels, convinced by the time he got there he’d have a better idea what to say. Now he saw a glimpse of what they had been praying for him for decades. The future, his parents, faith. These things that had caused turmoil and anxiety for as long as he could remember, now covered him in comfort. He shook his head to himself as he departed, thinking about what he had in mind when he arrived. He did not have any idea what he was doing here, and that was just fine.