Dad spent a day seeing what I do, first handFirst, on behalf of my mother and our family, thank you all so much for coming today. The love and support that you’ve shown us over these last 3 years and especially these last few weeks has meant so much to us. There are some who couldn’t be here today, and so we’re videotaping this message, so that they might hear - provided I don’t become a blubbering idiot - I do reserve the right to edit or delete that tape! Thank you, all so much. 

I don’t think many of you realize the real reason you are here today. In fact, I feel lucky that I happened on it myself. Just the other day, I stumbled across an unusual Twitter feed. It was from God - I bet you didn’t know God had a twitter account! It seems that God had tweeted that heaven was having a bit of a problem -that nearly all of the projects in heaven were nearing completion. So the following message was sent down: Needed, an ambitious worker to start projects that seemingly have no end, hashtag heaven help us. Now, the angel Gabriel responded quickly saying he had the ideal candidate and his name was Donald Joseph Forwith. But God, probed saying how do you know this is the right man for the job? Gabriel responded that he had visited in a dream the person who knows him best, who’d been his high school sweetheart, who’d been his best friend, lover, and life long companion. Someone who’d he’d laughed with, teased, yelled at, and worried over. In fact, he’d dedicated his whole life to her - 52 years of marriage! So, who would know him better than Carol Baker Forwith? So, Gabriel asked her in a dream, could Don be our man? She responded with confidence, “Lord, he’ll start so many projects it will take an eternity to finish them all.” And the Lord said, then it’s time to call him home. 

My name is Keith, and I’m Don and Carol’s oldest son. I live in Louisville KY where i practice medicine and with my wife of 24 years have raised four daughters. A few weeks ago, I discussed with my Dad the content of this eulogy. It may seem an odd thing to do, but it turns out that Dad had a few things he wanted you to know. So, what you are about to hear is a little bit of me, and a whole lot of Dad. Some of you may not like what you’ll hear, but Dad always told it like it was, whether you wanted to hear it or not. I will talk about some matters that involved me, in fact, in a little while,  I’m going to read you a short letter that he wrote to me just a few years ago, before he even knew he had cancer. I want you to focus on what kind of man would write these things and what it says about him. 

My father was not a highly educated man, he pretty much went to work after high school and set about the business of providing for a family. Because he didn’t pursue higher education, he often would comment that he wasn’t an intelligent man. But make no mistake, Don was very smart - especially when it came to that not so common characteristic of common sense. Dad could fix anything or at least start to. I was inspired and pushed by my Dad to do a bit better in the education department. For those that don’t know, I have a Bachelor’s in chemistry, a PhD in biochemistry and a medical degree. But, after all that - if I thought myself a wiser man than my Dad, well - I would be a fool! So, I’d ask - or warn - each each of you. Don’t dismiss what this wise man thought to be important.

Dad realized that his time was near four days before he passed. He knew his time was limited and his doctors had warned him he’d finish life in a coma. So, what does a man say when he realizes his remaining words are few? Dad talked about love and family. He said the most important thing in this life was to love one another and not to let anything stand in the way of that. Dad had faithfully read his bible, especially over the last three years. In the gospel of John,  Jesus states “My command is this: Love each other as I have loved you. Greater love has no one than this, that he lay down his life for his friends.” Laying down one’s life for those he loved is something Dad did on a daily basis. I remember a good portion of his life, he’d head off to General Electric where he knew his work didn’t provide the kind of challenge and fulfillment he’d dreamed of, but that job and his dedication to it provided for his family. His work ethic was unquestioned, something that I learned a bit of and it’s served me well. 

Many of you recall that Dad nearly lost his life in a horrific chainsaw accident. What he suffered in that event, has shaped my life perhaps more than any other moment. Dad’s pain, his recovery, my mom’s courage through it all and her dedication to him shaped my life in so many ways - we wouldn’t really have time to scratch the surface on this one. But, while Dad took pride in what he did, he was a humble man. He allowed a seeming tragedy in his life to change and shape him. And I noticed as a young man that his change was for the better. Life was more cherished after that, and Dad’s love for us was more evident. In his suffering, we all benefited. 

I would like to read an excerpt from a letter he wrote me about five years ago. I attended a retreat at my church and Dad, in an unusual moment of openness, wrote me the following letter. Let me warn you, I couldn’t get through this letter when he was alive and healthy, so I may struggle now but here’s my best effort:

Don wrote: “While pondering on what I could talk about it came to me to tell you how my life as a young man became part of your life. 

I was around 18 to 19 years old when I got my first job. My job centered around a lot of other people, both men and women. I started studying everyone’s personality and picking out their good and bad points. I thought if I could develop their good and avoid the bad I could grow into a good man. While this sounds easy, it certainly isn’t. It seems as good comes some bad tags along. I learned each of us has to struggle with their own life and pray to God for help. In my studies of people, one particular man stood out from the rest. He was an engineer that seemed to overlook everything at the factory when he walked through the door. A happiness was about him. He would speak to everyone no matter what their job was or where they came from. He wore regular clothes and never showed off his above average intelligence. I noticed how everyone liked him and enjoyed being around him. His name was Keith. 

I prayed to God asking him that if he ever blessed me with a son that he would be very intelligent and yet be modest, respect others and being respected himself. He would have high morals, love life and respect it. I prayed he would be blessed with a family and love them with all his heart, to always love his wife and respect her, to be true to her, to have God at the center of his life and others would see this godliness in him and thank God for him and that everyone would enjoy his company and his intelligence and he would never degrade them. This was my prayer to God. 

Well, as I was developing from a boy into manhood, my thoughts were what I’d like to be. An engineer or a doctor would be my dream. As time passed I knew that I didn’t have the intelligence or finances for this to ever happen, so once again I prayed to God. I asked that if I couldn’t be a servant to his people that he would let my son do his work through him. I asked if I wasn’t chosen to be his servant that my son would be. I asked God to bless this son and teach him to heal the sick. Before you were even conceived your destiny was prayed for. When you were born a prayer was answered and now I know I can look back and remember that God listens to our prayers and answers us with his blessings. 

Before you draw a drop of blood from God’s people stop for a moment and ask God to be with you, to fill your mind with knowledge and to guide your hands. God will give many rewards and blessings for being a servant to his people. 

Even if you are far away, you are in our hearts and our love. I’m very proud of you, Keith and the life you lead.

Love, Dad

That, in a nutshell, is Donald Joseph Forwith. A man who laid his dreams aside to provide a path for his son to reach his dreams. A man who suffered in quiet dignity and taught his son and family lessons even to his very last day. I thought it fitting that at the moment he died, I was seeing patients in the clinic - carrying out his dream and mine.  

My family at our last holiday with Dad, Thanksgiving 2012Today is a joyous day. Dad is in heaven with Jesus and no longer in pain. He has already heard the words “well done, my good and faithful servant.” He is happy. But, he wanted me to tell you something. Don’t think of him as in a better place - he’s in the best place! The only sad part of today, is that some of you may never see him again. To see him, you’ll have to go to heaven because that’s where he is. I say that with certainty because I can. You see, we’ve slipped into this false idea that good people go to heaven. Especially at funerals, we like to think of the good in people. Today, that should be easy as my Dad was a very good man. But, that is not why he’s in heaven. He wanted you to know, he wasn’t good enough for heaven. I joked with him that I could make a long list of why he shouldn’t go to heaven - but of course, today is not about Dad’s weaknesses or sins. Dad is in heaven because he was forgiven. Good people don’t go to heaven, forgiven people do. 

Dad was forgiven because he accepted the sacrifice of Jesus Christ.  His trust was in the Son of God who gave himself up so that our sins may be forgiven. Jesus suffered so that we all would benefit. It is by God’s grace that Dad was welcomed home. Dad wanted you to know, each and every one, that he wants to see you again. He wants to welcome you home. He told me at Thanksgiving that the only fear he had of dying was that he didn’t feel he’d talked to the people he loved enough about the saving grace of Jesus. So, I would like to close by asking you - are you one of Dad’s unfinished projects? Would you rather believe that this man of wisdom was a fool? Would you set aside the very foundation on which he based his life? I promised Dad I would continue to work on this project - to tell you in no uncertain terms, that heaven is real, that God loves you, and that Jesus has paid the price for your admission ticket. Don is waiting there to rejoice if and when you come. Don tried to not die so that you would know this message - that Jesus willingly died to give you eternal life if you would only accept it.  I thank God for giving me an earthly father who showed me a glimpse of my heavenly Father’s endless love.  I pray that each of you will know that same love. God Bless you all. 

I find it fitting that I was seeing patients in the office while he passed. I saw him last night and he wouldn't have wanted me to not be there for my patients on his account. Guaranteed, he'd see it that way - that's how he saw the world. I know he was proud of me for becoming the man I am, and the doctor that I strive to be. He would have been happy that I was trying to help others as he departed. He told us all -  "no tears for me, I'll be in a better place and relief will finally come." He said he knew he'd see me again - so long, Dad! Enjoy your journey - see you in God's time! 

He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away. Rev 21:4

For all the negatives we hear about modern communications, I must say that Facebook and the responses to this blog have been so helpful to me. It has been so comforting to know that people are praying for my father and family. I can't thank everyone enough for their kindness.  On Tuesday as he was drifting off, I read from the Bible - starting with some selected Psalms. I ended up consulting my FB page as so many had suggested great verses that were comforting. So, thanks for your prayers and I hope everyone has a blessed Christmas. I know my family will, as all this is part of God's plan. The joy of Christ's coming into the world is celebrated at Christmas - we will celebrate because His coming has granted my father salvation and eternal peace. That we know, and we can be sure of! Merry Christmas!

Dad, 71, with his wife, Carol, of 52 years!

Another victory came just last night. Dad's parish priest came to administer last rites. We crowded around his bed and prayed as the priest gave Dad his final blessing. We prayed and thanked the priest for his kindness. Then, my wife - who still suprises me with the depth of her goodness, began to sing. She started Silent Night with a few reluctant family members joining in at first. But then came the deep, weak, slightly out of tune, voice of my Dad. The rest of us joined in and soon had gone through every carol we could think of. When we ran out of meaningful ones, we resorted to Rudolph, Frosty and the like. We were searching for song suggestions and lyrics on our smartphones and ipads. The music proved to be therapeutic for all of us. My Dad loved it!- he'd join in on random lines here and there. The music ended with my wife and daughters singing Breath of Heaven as Dad drifted off to a temporary sleep.  We soon said our goodbyes, perhaps for the last time. 

As hard as it may be, I try to follow his counsel not to be sad.  Afterall, he's suffering - his pain is constant and his quality of life is poor. I know that I will see him again as he knows Jesus and trusts in His saving grace. He knows where's he's headed and now says he's ready to go. So, now we're waiting to see not if, but when the Lord will take him. I pray it is soon, as Dad wants to go. He has run with perserverence the race marked out for him. He is in the Lord's hands - in that we can trust and be thankful.

But you, man of God, flee from all this, and pursue righteousness, godliness, faith, love, endurance and gentleness. Fight the good fight of the faith. Take Hold of eternal life to which you were called when you made your good confession in the presence of many witnesses. 1Timothy 6:11-12 NIV

Radiologist and friend, John Hutchinson MD in the conference room

So, I have prayed the last several nights for just one victory. One patient who we can save. Just one, please! Well, today God gave me what I prayed for, but not exactly as I thought it would come. The man came to us with difficulty swallowing for over a month. I was working with a family practice resident, Dr. Castro Mugala, whom I admire very much. Unfortunately, I had been able to show him several types of head and neck cancer - all unresectable (too far advanced for surgical removal). This patient was actually no different. His tumor started at the back of his tongue and came all the way forward to just behind his teeth. He couldn't lift or move his tongue on the right side because of the cancer growing just under it. His neck was full of metastatic nodes and the tumor had invaded his mandible (jaw bone). He was having pain which radiated to his right ear. Cerainly, he was not a surgical candidate and even radiation would not work on this advanced disease, even if he could afford it. So, how was my prayer answered by this man? Dr. Mugala and I planned for hospice, discussed tracheostomy and a feeding tube for him. But, we also discussed the need to talk to him about Jesus Christ. I believe that the sacrifice of Jesus on the cross atoned for all of my sins and this man's sins. It is a free gift of grace that we need only accept. This patient, whose days are few in number on this earth, accepted Christ right there in the clinic. He got on his knees and prayed with Dr. Mugala in swahili - oh, how I wish I could speak swahili! Later, a chaplain came to follow up with him and he left just after getting a bible - in his own language! 

So, my prayer for victory was answered. Not through surgery, but through the saving grace of my Lord and Savior Jesus Christ. Yes, he will die - as we all will. But this man came to Christ today! I smiled all morning because what he recieved today is more precious than any surgery or cure. His life will now be eternal! God, indeed does have His ways.

I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future! Jeremiah 29:11

Earlier this year as I was preparing for a mission trip to Nicaragua, our team leader recommended the book Foreign to Familiar: A Guide to Understanding Hot -and Cold -Climate Cultures. Turns out the book was exactly correct in its descriptions of cultural differences. The invitation states the wedding begins at 10:00 am. So, being the cold climate creature that I am, I showed up exactly at 9:00 to catch a ride with the White family to Kericho - one hour drive away. The Whites are long term missionaries here and they knew better. Beth White was still feeding children breakfast and hadn't started getting ready yet. She informed me that the bride's mother was still in Nairobi and that it would be at least a couple of hours! I returned to my room to do some reading and remembered the book's description of this very situation. We left three hours later and arrived just on time to the wedding. A full four hours past the stated start time. According to the book, this was typical because hot climate cultures regard the start of the wedding as when preparations begin - the arrival at the church comes later - well after the start of the event! I spoke with a few residents who confirmed that it's always a guessing game as to when the bride will show for the wedding. Four hours late was not out of line! TIA!

Mike and Liz are both first year surgical residents who have centered their life around serving the Lord and His people. Their day and their ceremony were likewise God centered. The wedding was outdoors and began with the typical bride processional. The biggest difference was the women who did this high pitched trill that is unlike anything we do in America! The groom awaited at the front of a small tent which was lined with about 50 chairs that formed a small aisle. The tent provided an intimate setting for the ceremony. The bride's mother then gave her away with a short speech that was heartfelt and moving. She described Liz as her only jewel and asked for God's blessing on her new home with Mike.  A worship team offered two Swahili songs which found everyone in strong voice - except the English only speakers like me. One thing that's been abundantly clear is that culturally, Americans have a hang up about singing and dancing. These Kenyans sing with an abandon which I envy. Most have good voices, but the quality of the voice doesn't determine a person's volume as it does back home. Singing is for celebrations and enjoyment is for everyone. Wish we were like that! 

The ceremony had the typical elements of sermon, vows, ring exchange and candle lighting. The newlyweds were announced by the pastor and the emcee took over right there in the church tent. He had them dance, not walk, down the aisle followed by the wedding party and family. It sounds like a stereotype, but there is no doubt that Africans are blessed with rhythm. I could have watched them process all day! Age is no barrier, kids and elderly all dance with ease and grace. The only awkwardness I saw were the white folks whose attempts were, to be kind... lame! I was safely behind my camera which was probably best for everyone! 

A buffett was served while the wedding party disappeared for pictures. One of the coolest parts was when the couple returned to the festivities. The women went out to escort them in. A Swahili song was sung by the crowd as they danced their way in a parade that encircled the grounds for the next half hour or so. Two or three songs were sung, with never the need for any instruments other than the voices. Harmonies, rhythms, and melodies blended together as the party danced it's way around in no particular hurry. The bridal party nestled under a tent with the head table. Their meal would be followed by gifts, toasts and more dancing. Unfortunately for me, we had to hit the road back to Tenwek. Missionaries are not permitted to drive after dark (for safety reasons) and the late started meant we'd miss some of the festivities. We arrived back just before dark at Tenwek.

I feel so honored to have been invited. The love of family and friends was so abundantly clear to me, even though I understood none of the Swahili that made up most of the conversations. Africans are really good at relationships and family. They celebrate without reservation and take joy in the simple act of spending time together. Time is not their master. Life is often hard in Africa, but days like today are for celebrating the love of friends, family and God. Their remaining surgical training will be difficult and once finished, their lives will be taxed by the overwhelming need of their community. I pray for God's blessings and protection of their marriage. I know that they will be a blessing to so many in their lives and surgical careers. 

Kenya is not the place for me! I nearly went into convulsions today over efficiency withdrawal! I spent too much time thinking of all that needs to be done while realizing all the obstacles that are standing in the way. I did three operations today that consumed most of the day! Three 45 minute cases in an entire day! I felt like crawling out of my skin! In one case, I walked into the room to see the nurse sitting on a chair, seemingly content. The instruments I needed weren't in the room and opened. The injection wasn't drawn up. No gloves were pulled for the case. The Mayo stand wasn't prepared. In fact, she had done absolutely nothing - nothing to prepare the room, nothing to help the surgeon or anesthetist, and nothing to help the patient. I then recalled that I remember her pretty much doing the same thing last year; so why was I surprised? In fact, I've spent enough time here that I should have expected all this! 

But that is the intellectual side of my brain reasoning over the situation. My heart and my ambition were screaming "let's get to work! let's help some people! I didn't come half way around the world to relax! I only have two weeks here and my time is valuable!" Funny, I had a similar feeling three weeks into my stay last year - when I only had a week or so left. I remember telling myself that "this is a waste, I'm never coming back, these people don't appreciate me, these people aren't helping themselves!" But, this is Kenya. Kenyans don't see things my way. They are in no hurry; they don't understand why I would rush by and not visit. They don't seem to compile checklists each day. Their culture is not mine and I'm called to honor theirs - and that is not always easy! So, I returned to my room late afternoon and succumbed to the jet lag and took a nap! Those of you that know me well, know that I don't nap! Fortunately, the ER had an emergency and I was paged out of my nap. Yes, I'm still tired, but now there's a need - a chance to get something done! A chance to feed my addiction! Turns out, it was just a simple nosebleed that was well managed before I got there. No excitement, but I think I'm ok now. 

Just had to get that off my chest. I'll pick up tomorrow trying to work within the system and help where I can. I just have to take it a Kenyan pace. I have to shred the mental checklist; I have to stop the mental comparisions (if my OR team at home...) I have to trust that God put me here to serve, not to dictate. So, when frustration comes, I'll just shrug my shoulders and say "TIA!" (This is Africa!) and I'm glad to be here. 

One patient had a vocal cord paralysis from a botched thyroid operation. She had several extra scars from where the previous surgeons had carelessly cut through the skin as they were raising the subplatysmal flaps. Ironically, this is one of the easier parts of the operation! Not surprising that the most delicate part of the procedure was not performed well. 

I want to emphasize that these were not Tenwek surgeons. The surgical residents I've worked with here are outstanding. It mainly motivated me to keep coming back to help train these young physicians so that disasters like this aren't inflicted on these poor people. The worst part of this is that her thyroid cancer has spread into the lateral neck. God willing, we will be doing a much bigger operation to save her next week. 

This 26 year old gentleman was told that they completely removed this tumor - just over a month ago! Obviously, that was not the case. He had two different nerves paralyzed by the poor surgery. The ending on this one may not be so happy. We need a CT scan - which he says he can't afford - to determine if there is a chance of a life-saving operation - which he can't afford. 

Each year I come, I bring extra money to help patients get the care they need. Each year I get here and realize that I haven't brought nearly enough! This year the exchange rate changed dramatically so I have 37% less than I anticipated. Even so, it is always challenging to know when to offer and when to hold back. The culture here is much more communal and most patients have to rely on their relatives or village for surgical funds. And this is not neccessarily a bad thing. So, when to offer help is a tough decision. I especially worry that a more heartbreaking story or situation may present tomorrow. Triage with your funds is a painful process! Wisdom in this area is something I will pray for tonight.

In the USA or in Africa, surgical residency is a demanding 5 year process that truly matters. Residency is the process where doctors become surgeons. It is not overdramatic to say that lives are on the line. Poor training leads to unneccessary suffering and poor outcomes. Life here is tough and both these patients deserved better. The surgical training that PAACS offers these African surgeons rivals the quality of American programs. As more PAACS surgeons graduate and begin working in their communities there will be fewer of these tragic cases. That is a reason for hope and the reason I continue to return. 

 What good is it my brothers, if a man claims to have faith but has no deeds? Can such faith save him? In the same way, faith by itself, if it is not accompanied by action is dead. James 2:14, 17