The Center for Medical Mission's
October 2014

Welcome to this issue of the e-Pistle. It’s been busy around here, just like it has been for you, I’m guessing. Since the first of June I’ve been hoping things would ease up a little. I’m happy to report, they finally have. Don’t misunderstand, as I still have plenty to do but much of the pressure is behind me. I pray that you too have some times in your life when the pressure is a little less. I know that is not often the case though when you are working in life and death situations. Please know I am praying for you – by name when you share specific needs.

Several of this year’s pre-field training attendees have already made their way to the field. Won’t you join me in praying for them? If you have new team members, please consider going out of your way to help them over the rough places as they attempt to adjust to “all things new.”

I hope you will pray for the 2014 Global Missions Health Conference. That is the place where I have the most access to those who can become your future teammates. I will appreciate your prayers as Dr. Daniel Tolan and I talk to all the young people who pass by our booth to discuss how they can serve in healthcare missions. While Daniel is no longer helping out at the office, he is a huge help at GMHC.

Ladies, if you have not yet checked out the Velvet Ashes blog, I encourage you again to do so and to sign up. While not every entry will be “just what you need,” there will often be something “just for you.” Two recent entries that I recommend are October 7 (Fear and Doubt) and October 12 (What Men Wish We Knew). There are plenty of additional entries that will bless you as well. I believe you will be encouraged if you check out this community blog.

This is the final e-Pistle of 2014. I can hardly believe it, but the next issue will be in January 2015. I will be thinking of and praying for you as the holidays approach. I know this is frequently a hard time of year for many. I pray it will instead be a time when the Lord’s presence is especially close, reminding you of all the ways He loves and cares for you and your family.


Included in this newsletter are:
Cura Animarum by Rev. Stan Key
Vision Casting is a Team Sport by David Stevens, MD, MA (Ethics)
Volunteers Needed
Fed Up by Judy Palpant
Perfectionism by Dr. Ron Koteskey

Cura Animarum
Note to Self - Praise the Lord
By Rev. Stan Key

Psalm 103 – A Personal Paraphrase

So I preached myself a sermon:

“Self, you just need to praise the Lord. Stop whining and give Him thanks for all He has done during all of your life. And do it all the time. Yes, praise Him with your entire being: from the tip of your head to the soles of your feet. What’s your problem anyway? Are you suffering from amnesia? Have you forgotten the many ways He has lavished love on you? He forgave all your sins. He healed you all those times you were sick. He rescued you time after time from ‘impossible’ situations. He treated you like royalty, ‘crowning’ you with His love and mercy. He satisfied the deepest longings of your soul...again and again and again. He gave you a second chance...and a third...and a fourth. Each new start made you feel like a teenager again. You stretched your wings and soared like an eagle. So, what’s wrong with you, Self? Have you forgotten God? Wake up and remember!”

Guess what? I listened to my own sermon! I began to think clearly again and see things in their proper perspective.

What God revealed about Himself many years ago to Moses and the Israelites when they left Egypt for the Promised Land is true. God is great, God is good. Everything He does, even when it doesn’t seem like it at first, is just and loving. He is infinitely merciful and full of grace. He has a long fuse. When He does get angry, it’s only for a short while. He doesn’t give us what we deserve or pay us back for all those times we’ve ignored Him or disobeyed His commandments. His love is bigger than the ocean and taller than the heavens. And when He forgives our sins, He buries them so deep in the earth that no one is able to dig them up again... ever! He’s like a daddy who loves His children with all His heart; He is quick to forgive and always ready to welcome them into His arms. You see, He created us. He knows that we’re made of dirt! Therefore, you can be sure He is understanding and tender when it comes to dealing with our sins.

We’re like wild flowers in a field; here today, gone tomorrow. But though we may wither and vanish, God’s love for us never does! He loved us before we arrived on this earth and He will love us after we’re gone. In fact, He promises to love our children too...and even our grandchildren! But remember, these marvelous promises are not for just anybody. They are only for those who have been reborn into His covenant family and who live lives that are pleasing to Him.

Yes, God rules! His kingdom is we realize it or not!

Vision Casting is a Team Sport
by David Stevens, MD, MA (Ethics)

Andy Stanley got me thinking about vision casting in a whole new way recently. (Check out his monthly leadership podcast for a wealth of great leadership ideas!)

I always thought vision casting was something that essentially the leader did. Conceptually, it was like me heading down to the river, getting in my one-man pontoon boat and casting a fly into the swirling, trout-filled waters of the South Holston River. If I pick the right fly, cast it upstream so it floated with the current naturally, without any drag from the line, I will make an irresistible presentation and catch a trout. If I consistently did that, I might get 25 trout in a day. In the same way, I cast my vision to individuals as a leader and, if I do it well, they will follow me and that vision.

But what if I did to others what Justin Shroyer, my trout guide, did to me? I went fishing with him and he turned me into a raving fan of trout fishing, so now I’m a “trout fishing evangelist” of sorts. I ask people I’ve just met whether they like to fish and, whether they do or not, then invite them to come to Bristol and go trout fishing with me. (I’m so busy I need someone coming as an excuse to go myself!) Often I turn them into raving trout fishing fans and they hook other people to go who become raving fans and they catch others to become raving fans, and together we catch hundreds of trout but throw them all back so other people can catch them again and become raving fans!

Get the picture?

I lead CMDA, but if I want to create of movement of “Transformed Doctors, Transforming the World” the quickest way to do it is to create healthcare professionals so excited about transforming the world that they are contagious and infect other healthcare professionals with the same passion they have. CMDA then goes “viral!”

So how does that apply to healthcare missions? It starts with letting people know you genuinely care about them and their needs. On Andy’s podcast, one of his staff shared how he a recent experience at a Ritz Carlton Hotel turned him into a raving fan. When he arrived for a special weekend away with his daughter, the doorman introduced himself, asked his name and then inquired about what brought him to the Ritz. By the time they arrived at the hotel’s registration desk, the doorman had radioed his answers to the person at the desk who greeted them by name and let them know how thrilled they were that they were going to make special memories with them that weekend. That and other personal touches turned him into a raving fan of Ritz Carlton before the weekend was over. He told all his friends about their experience.

So ask yourself, how can you create raving fans among your healthcare colleagues, as well as your financial and prayer supporters, so that they go out and recruit more people to share your vision?

Often just one or two incidents can create a raving fan for a lifetime. A nurse that I have no recollection of recently contacted me. She visited Tenwek in the mid-1980s and wanted to reconnect. She remembered every detail and sent me a picture of her with our family on the front steps of our house in Kenya. She remembered what Jody had fixed for dinner when she ate at our table. She related stories of our interactions together and taking her to the game preserve. She was still a “raving fan” almost 30 years later.

You can probably add things you have learned to the few I listed above. The key is to take these principles, apply them and make them systematic parts of your life. Remember, raving fans will join you and help both short- and long-term. Raving fans mobilize others to pray and support you. Raving fans increase your influence and opportunities to touch many more lives as they grasp your vision and create other raving fans. It’s worth the effort. It’s worth the time.


CMDE Conference – Chiang Mai, Thailand, February 23 – March 5, 2015

The CMDE Commission asked that I let you know that both the Thailand and the Greece CMDE conferences are open to all regardless of where you serve. If one site fits your schedule better than the other, please feel free to register. If you have not yet registered for the 2015 conference, you need to do that as soon as possible. The contact is Dr. Collin Sanford, whom you can reach at I will be going and staying for the entire conference so I hope to meet many of you there.

Global Missions Health Conference

It’s that time of year again—time for the Global Missions Health Conference. The dates are November 6-8. I hope you are planning to attend if you are in the states. If so, please stop by the Center for Medical Missions booth in the middle aisle of the main floor exhibit hall. I seldom leave the booth so you should find me there. You can register at

Volunteers Needed for New Medical Missionary Training

Due to the number of participants at our 2014 Orientation to Medical Missions conferences, we have added an extra training on the days of March 19-22, 2015. This is in addition to the regularly scheduled conference in July. I would once again like to have two or three healthcare missionary volunteers who can serve as resource people for our next class of new healthcare missionaries. Of greatest priority is a healthcare missionary couple back for their first home ministry assignment. I would also like to have a healthcare missionary serving in a closed country and, if possible, a single healthcare missionary who can speak to those issues. I will also need volunteers for the July 16-19 and July 23-26 conferences. If you are interested in volunteering, please contact me at

Fed Up
by Judy Palpant

He ate and drank the precious words,
His spirit grew robust... --Emily Dickinson

Early in his presidency, the infamous Ugandan dictator Idi Amin was invited to England by Queen Elizabeth. After a state dinner at Buckingham Palace, he reportedly said, “Thank you, Mr. Queen. I have eaten and I'm fed up. If you come to Uganda, I will revenge.” Noting the small portion of meat on his plate, Amin went on to promise to feed the queen a whole cow on her next visit to his country.

We heard this joke often around dinner tables in East Africa. It was a favorite of our Ugandan refugee friends living in Kenya in the early 1980s.

Travel demands that we eat the food our hosts set before us.

In 1983, halfway through our five-month furlough and a road trip starting in New York with stops at churches and family reunions, we landed in a home provided for us in Pasadena close to "Dizzyland," as our daughter called it. For the first time, we had four walls to ourselves, besides those of the car. We could do our own cooking and thinking and even choose our own cereal. Accustomed to only two choices in Kenya--Wheatabix or Cornflakes--our kids, ages 8, 5 and 4, stared down the long aisle of American cereal choices. Which one? How about Wheaties, the classic Breakfast of Champions? No? Ah, the one with the funny rabbit and colored balls.

They had never heard the well-known ad: Silly rabbit, Trix are for kids, but they found the cereal box image enticing.

However, one spoonful and my children rejected it. They had no palate for fake fruit flavors dressed in bright colors. Ironically, the foreign country was turning out to be our own.

* * * * *

When we arrived in Kenya in 1980, Nathan, five months old, ate mashed arrowroot like a champ. And he used his five teeth to clean an ear of tough Kenyan corn. He drank sour milk without wincing. Sunday mornings he swallowed a teaspoon of bitter liquid medicine to keep malaria at bay.

After living in Kenya for a year, Andrea, aged three, chose thick corn meal mush called ugali and kidney beans for her birthday celebration meal. Simple. Local. I plunged three pink candles into the mountain of ugali piled on a plate. They glowed and melted as we sang "Happy Birthday."

Ben, our oldest at age five, watched the banana trees behind our house as a single blossom matured into a fountain of finger bananas. His dad ultimately cut the stalk and carried it to the kitchen to ripen. The green finger bananas turned yellow a few at a time--ready to be plucked, peeled and savored.

For sweets? Fresh pineapples and mangos--all that juice dripping down little chins. Another favorite--a stick of sugar cane. With the tough exterior cut away, they sucked the sweet juice and spit out the fiber.

* * * * *

So, on that wildly exciting morning back in the U.S. anticipating the first bite of Trix, their disappointed taste buds pined for the African flavors they'd grown accustomed to after almost four years in Kenya. Silly rabbit? Yes. Plus three disillusioned kids, enticed by flashy packaging to eat high sugar junk food.

To be sure, our children ate their share of burgers and fries on the road. At church potlucks, they consumed fried chicken and brownies. But America served up more than fat and sugar to my children. It exposed them to wonderful and terrible new things that set their mental and emotional teeth on edge.

Materialism. Movies. Marvelous toys. Distractions. We gradually felt fed up with the predictable discontentments brought our way by the daily fare of American cultural immersion. Distressed parents--we were caught with our kids between cultures, languages, foods and perspectives. We all needed manna to feed our hearts and minds.

In our wanderings, we found our daily portion though routines and words. We talked. We read. We sang. Stuffed in a borrowed old Plymouth station wagon, a real family on a real road trip, we sometimes squabbled or sulked. We laughed. Sam whistled. The day we hit St. Louis and crossed Mark Twain's Mississippi River, we read a psalm and wondered at the wide waters. The letters “M-I-S-S-I-S-S-I-P-P-I” rolled off our tongues while Tom Sawyer and Huck Finn danced in our heads. We sang a favorite hymn:

Like a river glorious, is God's perfect peace, Over all victorious, in its bright increase...

By afternoon, I-70 took us through Kansas cornfields. With our windows rolled down for air conditioning, and the promise of a motel with a pool, we kept going. By nightfall, cooled and comforted, we talked through the day, prayed together and sang them their lullabies.

Five months on furlough in a dizzying land--our own. But better than our kids' beloved peanut butter and jelly sandwiches, and more delectable than an American Jonagold apple, the rituals brought joy and peace to our souls.

We ate and drank the precious words,
and our spirits grew robust...

“When your words showed up, I ate them--swallowed them whole. What a feast!”
(Jeremiah 15:16a, MSG).

Dr. Ron Koteskey

During her first term of service, Betsy had a maid and housekeeper, but she never put the hiring of help in prayer letters for fear that supporters would think she was pampered. Later she and her husband bought a house back “home” so their children always return to the same place—what would those who gave money think? Then someone loaned them an SUV to drive for deputation—a Lexus. Surely their supporters would stop giving.

When introducing himself to a group of nationals, Paul thought he had told them he was embarrassed about his language ability, but he had told them he was pregnant! Even though they laughed, he believed he was stupid and could hardly face the other missionaries. He just could not get that incident out of his mind because he wanted to do everything right. He had agreed to write an article for the monthly agency newsletter, and he had written the article; however, he had missed three deadlines to submit it because he kept going over it to make sure it was perfect.

What is perfectionism?

Perfectionism is a trait some missionaries have, a trait that involves setting goals or standards so high they are virtually impossible. Such perfectionists measure their self-worth by their performance in reaching these goals; however, they are usually disappointed when they fail and are very critical of themselves for this failure. They believe anything short of perfection is terrible and people will lose respect for them if they make any mistakes. They get caught in a vicious cycle as follows.

Perfectionists are usually rather unhappy and depressed, feel guilty, have no sense of personal satisfaction and perform more poorly than people who set more realistic goals.

What is not perfectionism?

Although similar to striving for excellence, perfectionism is not the same. Setting realistic goals and standards and then working to reach them is very good. Healthy strivers set goals that are attainable, just a little more than they have already done, and they feel satisfied when they reach their goals.

Also, mistakes or failures are interpreted quite differently. Such failures are seen as a learning opportunity and an incentive to work harder by those striving for excellence. Perfectionists see failures or mistakes as personal defects. They may have difficulty understanding that baseball players who fail to get hits 70 percent of the time are considered to be excellent players.

Doesn’t the Bible say to be perfect?

The Bible has many passages about being perfect, and it refers to one group of people who at least border on perfectionism.

The Old Testament has very few places where it commands people to be perfect. Moses said, “Thou shalt be perfect with the LORD thy God” (Deuteronomy 18:13, KJV). The Hebrew word “tamim” used in that passage means “whole” or “complete.” Most recent versions translate it differently than the King James Version.

The New Testament has more places which tell Christians to be perfect. Here are some passages spoken by Jesus and written by an early missionary.

These passages and many others in the New Testament use the Greek word “telios” which basically means mature or complete. Although perfectionists may believe they must become flawless in everything they do and say, telios (perfect) does not mean that.

What does the Bible say about perfectionism?

One group that at least bordered on perfectionism was the Pharisees who tried to keep every rule in the Old Testament as well as all of the traditions that had developed during past centuries. They often criticized those who did not share their ideas, and they did not have anything to do with such “sinners.”

The Pharisees condemned Jesus because His disciples picked some grain along the way and ate it on the Sabbath. Eating was not against the rules, but harvesting was (Matthew 12:1-14). Jesus warned His followers to avoid being like the Pharisees (Matthew 23:1-36).

Paul, an early missionary, said he was a Pharisee and the son of a Pharisee, part of the strictest sect of Judaism. He tried to do everything perfectly right for years even if it meant putting Christians in prison and killing them (Acts 23:6; Acts 26:5; Acts 22:3-5). However, after meeting Jesus, Paul said that he considered all of this “perfect” performance as worthless loss and as rubbish (NIV), garbage (NLT) or even dung (KJV) (Philippians 3:7-9).

What causes perfectionism?

Several things can lead to perfectionism, but probably the most common are developmental and cognitive factors.

Early in life, as children, some missionaries may have found that people in their lives valued them because of their performance, how much they succeeded. Rather than valuing themselves as children of God, these missionaries began trying to win the approval of others. As adult missionaries they then try to please everyone by being absolutely perfect and never making a mistake or failing at anything.

Other missionaries may have developed some flaws in their thinking, often in thinking about God. They may see God as being pleased with them only if they have a certain minimum number of converts, only if they spend so much time in devotions and prayer, etc. They have long lists of “shoulds” or “oughts” that are impossible to keep. They fall short of their goals and become critical of others who do not live up to their own goals. Even though other missionaries may see them as very successful, they feel like failures themselves.

What can missionaries do about perfectionism?

Perfectionists often find it very difficult to change. They have often been that way for many years and do not want to quit or find it difficult to quit even though they are unhappy, depressed and not functioning well. Remember that God had to blind Paul for three days before he was ready to begin changing (Acts 9). We do not know how long it took for Paul to change, but we do know that he went immediately into Arabia to allow God to work in him before he talked with anyone else. After his time “alone” with God in Arabia, Paul returned to Damascus for three years before going to Jerusalem to get acquainted with Peter and talk with James (Galatians 1:11-24).

Because some missionaries find it so difficult to change, and the process of changing takes far more space than is available here, I am not even attempting to summarize what needs to be done. For those readers who want to try changing, here is a link to excellent information about perfectionism online. Perfectionism in Perspective is provided by the Centre for Clinical Interventions, Government of Western Australia, Department of Health at

This information package is organized into modules one can work through. The modules are as follows.

  1. What is perfectionism?
  2. Understanding perfectionism
  3. What keeps perfectionism going?
  4. Changing perfectionism
  5. Reducing my perfectionist behavior
  6. Challenging my perfectionist thinking
  7. Adjusting unhelpful rules and assumptions
  8. Re-evaluating the importance of achieving
  9. Putting it all together

These modules are each 10 pages long, but the pages have many illustrations and lots of white space. The modules are written to be done in the order they are presented, so even though Module 1 has the same title as the first section of this document, please note that it has much more information than presented here. It is essential to do Module 1 before trying to do any of the others. Then do Module 2, etc.

In addition, as perfectionistic missionaries do the modules, they need to remember to bring in thoughts and behaviors unique to them and their Christian perspective. For example, when listing unrealistic goals they should think of things such as the following.

In addition, asking trusted people to help one become aware of unrealistic goals can be very valuable. These people do not need to be counselors or pastors, but they must be trusted people who know the missionaries well. Many missionaries have a select group of supporters who they can ask to pray for “healing” or “growth” as they struggle with things like perfectionism.

For other topics please visit Also please let your non-medical colleagues know about these free resources.

Center for Medical Missions
P.O. Box 7500
Bristol, TN 37621

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