Resources

Today's blog post is a contribution from a long-time GMHC alum, Suzanne R. Snyder, MD. Her story is one of faith, passion, and relentless pursuit of God and his glory. We think you will be blown away by her story and truly encouraged wherever you are in your own journey. Enjoy this blog post, which was originally a session that Dr. Snyder gave at our 2019 conference. Have you have ever wondered, “How is this ever going to work?” How am I going to be a health professional and have a family… AND be a missionary?? Is it even possible to combine all these roles? I know this is a relevant topic. When I talk to medical students and residents about missions, they often have these questions. Even 30 years into my medical career, I find that balancing medicine, family and missions is a challenge. I have been invited to share my story and through it, some of the lessons I have learned from 30 years in medicine, 30 years as a mother and 16 years on the mission field… not that I have all the answers; I don’t… and not that I did everything right, because I didn’t … but hopefully I can give you some encouragement… by telling you some of the things that worked for my family…. and some of the things that did NOT work… you might learn from my experience, and even from my mistakes! Hopefully by sharing my experiences and some of the lessons learned in the journey to combine Medicine, Missions & Motherhood, you can see how God can work out a seemingly impossible situation and that whatever you give to Him; your life, your career and your family - He will bless it far more than you could imagine. I’m Dr. Suzanne Snyder. Currently, I am an Emergency Room physician in Columbus Ohio, and married to a delightful, Christian husband, Jason Estep. I have two married daughters: Lauren who is 26 and Rebekah who is 29 and has 3 little boys of her own. And in a previous season of life, I served as a medical missionary with Christian Missionary Fellowship, in Kenya, East Africa. I lived and worked for 15 years among the Maasai people. My family at that time was on a team of families involved in evangelism, church planting, and Christian leadership development. I was the only physician on the team so our family was primarily responsible for the medical ministry of our team, which involved overseeing nine bush clinics in remote locations of Southwest Kenya. My first husband, Dave Snyder, was an ordained minister. We met in college, and as we dated and considered marriage and our future together, one of our primary goals was to combine our careers in ministry and medicine. While in college, we went to Haiti on a Christmas break mission trip and worked at an orphanage which had a church and medical clinic side-by-side. It was a very tangible example of how medicine and ministry really can go hand in hand. I have since gone on numerous short-term medical mission trips where a clinic is hosted inside a church, as a means for the church to reach out to the community. Medicine is a very powerful way to demonstrate God’s love to people, and therefore “preach the gospel.” Medicine opens doors to communities and to people’s hearts. Providing excellent medical care gives credibility and gains a platform to speak on others matters: heart matters, spiritual matters. While the American medical culture tends to compartmentalize medicine and ministry separately, on the mission field medicine and ministry flow more easily together. As we explored our calling to missions, we debated going independently or with a mission organization. I had grown up in a church that supported independent missionaries and with my dad as a forwarding agent for one family in Brazil, I had seen time and time again how different financial crises came up and it was very difficult because they didn’t have a supporting organization to fall back upon. With that experience, my husband and I decided we wanted to go with an organization…. So then, which one? Christian Missionary Fellowship (CMF) was a mission agency supported by our home church, so already familiar with this agency, and it was the same church group and theological background, we decided to approach them first, with the question, “Could you use a doctor and a minister?... and where?” They said, “Yes, and Kenya” was the immediate reply. During medical school, we took a 2-month internship to Kenya to check it out. The ministry, the people group, and the team and came back feeling confirmed that Kenya and service to the Maasai people was where God was leading us. So, five years later, after completing the graduate degrees which included medical school at the University of Texas Medical School and the Med-Peds residency at Vanderbilt University Medical Center, we left for the mission field. When we arrived in Kenya, our first job was to learn the language, and we spent the first year in language and culture study. We did not attend a language school, but lived in a Maasai village and immersed ourselves in their culture, learning the language, Maa, through a language helper and daily routes of walking through villages and talking to the people. After the first year in Kenya, we moved to our bush ministry site. We thought we had arrived! After all the training, preparation and language study, we were finally true missionaries. And we were ready to begin full-time ministry. Our team had some assumptions: Dave was to lead the church, preach on Sundays and teach Bible studies to different villages every day. I was to work in the clinics and continue their oversight and maintenance. Two missionaries for the price of one! It sounded like a great plan. Unfortunately, it didn’t work! And a deluge of lessons to be learned rained upon our heads. Who was supposed to do the homeschooling of our children? Who was supposed to do the laundry and cooking? Who was supposed to keep the household together? What we hadn’t factored into the equation was what I have come to refer to as “the supportive spouse role.” The take home message is that “the supportive spouse” role is a worthwhile job. It is a valid role and it is an essential one. It’s not just important, it’s crucial. It’s vital and somebody’s got to do it! And the person who does it, whether husband or wife, is not a second-rate citizen, because it is a valid role within any marriage. The first step is to recognize the validity of the “supportive spouse” role. Furthermore, “the supportive spouse” role is a full-time job. It requires 100%. It can’t be done on the fly. It can’t be done half way. It needs to be expected, validated and factored in. It deserves the best, just as much as any role God gives us. As Dave and I came to realize the necessity and validity of the “supportive spouse role,” we realigned our expectations, redefined our job descriptions and rescheduled our daily activities. While our family lived in the bush, I was the primary homeschool teacher. Yes, I was a homeschool teacher for our girls for 5 years! But when I went on clinic rounds, Dave took over as the substitute homeschool teacher. When he needed to go to the capital city for medical supplies or groceries, or if he went to the training center to teach a course, I remained home with the girls. We became an experienced “tag team,” trading roles as needed. When we were on the field, I was the “chief cook and bottle washer”. I did the cooking and housekeeping. But when our family was on furlough and I worked in a hospital and studied for recertification exams, the roles reversed and my husband became “Mr. Mom.” He picked up the girls from school, supervised the homework, did the grocery shopping, and cooking. Communication, cooperation, organization, advanced planning, and flexibility with back-up plans were all essential to make it work. The percentage of your time and energy that is divided between medicine and parenthood may vary from year to year, season to season, week to week, or even day to day. The point is that however you and your spouse divide the homemaking role, whether 50/50, 40/60, or 90/10, the percentages have to add up to 100%.Because the supportive spouse role is valid, it’s a full-time job, and it deserves your best, whether you are on the mission field or not. Can you combine Medicine, Missions, and Parenthood? Yes! But you can’t give all of yourself to all of your roles all of the time. Which leads me to another lesson: Life comes in seasons Remember the story when we first moved to the bush and we thought we could do it all? Preaching, village teaching, homeschool, medical clinics? We had two small children! What were we thinking??! Rebekah was 3 years old; Lauren was born in Kenya. What an experience! During the early years on the mission field it was the season of small children. Believe me, the season of small children does not correlate with the season of reading medical journals!! Here I was fresh out of residency, getting a dozen free medical journals every month, which were stacking up on my desk. And so was the guilt, because I couldn’t find the time to read them. We hauled them around in growing bundles for several years. And as I lost track of reading medical journals, I also lost hope of ever being able to keep up in medicine. I could feel myself slipping as more and more information was forgotten and more new information about research and drugs, etc. was not getting incorporated into my knowledge base. I lost hope of ever being able to go back to medical practice in the US. But as I released my selfish grip on medical knowledge and self-sufficiency, I learned that God is faithful and life comes in seasons. The season of small children is NOT, in my humble opinion, the season for full-time medical work. When you are in your early seasons, you can’t see those that lie ahead. But now that I’ve been through several seasons, let me share some advice. The season of small children is shorter that you think it will be. They grow up fast. Don’t let your children grow up without you. Our marriages and our children are our first ministry and top priority. They are a higher calling than medicine or even mission service. The season of medical journals did come. During furlough as I studied for board recertification exams, and will come again some day. But for now, I can’t do everything I plan or want to do all the time. Remember, you can’t give all of yourself to all of your roles all the time. Which brings me to my next point: Part-time is NOT a crime. When I was in medical school, there was definitely an overriding attitude that a medical career was supposed to absorb all of your time and energy. From my professors’ perspective, “Part-time was not an option.” If I didn’t commit my full self to medicine then I was a ‘nobody’, I wasn’t truly committed, and my goals weren’t worthwhile. Maybe you can relate. I have heard from some of you that it’s still a pervasive issue. That’s a warped perspective. The American medical culture is a driven culture. There are a million different options for how your medical career can play out. They all have validity as long as your career is in God’s hands. Part-time is not a crime. Part-time, or even “zero time” for a season are valid options. And just as life comes in seasons, and part-time is not a crime, it’s also true that you can go back. You can go back from mission service and you can go back from part-time to full-time. You may have a season of small children ....a season of homeschool …a season of service on a foreign mission field …a season of full-time medical work here in the USA ....a season of caring for aging parents …a season of professional enrichment… it’s called “going back to school” and each season you focus on a different role. But going to the mission field, or taking some time out of medical practice for family is not career suicide. What you give to God he will not return void. Let me explain: When I first went to the mission field, I assumed that I would never be able to return and practice medicine in the USA. A fellow OB/Gyn missionary friend coined it “Career Suicide” that by giving our careers to God for missionary service, we were cutting ourselves off from any future work in the USA. But what you give to God, He will not return empty to you. After four years in Kenya, we spent our first furlough in San Antonio, Texas where our major supporting church was located. I got a job as a civilian pediatrician in an Air Force base working about two days per week. I was one of a group of 12 part-time pediatricians staffing this acute care clinic. I was certainly uncomfortable at first, being so out of touch with American medicine, but within 3-4 months of working and reading, I was back in the swing of things. I was one of the group, and I learned that I can come back. I studied that year and passed the Pediatric recertification exam. I learned a valuable lesson: God helped me to get through medical school. He had helped me get through residency and to pass the Internal Medicine and Pediatric certification exams in the first place. God had made a significant investment in my education. What He helped me to attain, He would help me to maintain. God helped me study and pass the Pediatric recertification exam. The following furlough, He helped me pass the Internal Medicine recertification exam, and the Peds recertification exam the furlough after that. And I trust that he will help me pass the recertification exams again as needed in the future. For our second furlough, I was invited to return to Vanderbilt University Medical Center, where I had done residency, and I was given a faculty position in the Department of Internal Medicine and Pediatrics. During furlough, I worked as an attending physician for medical ward teams and resident continuity clinics. Talk about a miracle! I came from eight years in the bush to being an Assistant Professor at the #16 medical school in the country?! That is a testimony of God’s sense of humor! Vanderbilt allowed me to keep my faculty status when I went back to the field. I offered an International Elective where 4th year med students and residents came to work with me in the CMF Maasai clinics for a month for school credit. On our third furlough, I was back in the Vanderbilt system, working at an indigent clinic and the Veterans hospital ER, precepting medical students and residents. God allowed me to keep this relationship with Vanderbilt for 11 years. After spending eight years in the bush, overseeing Maasai clinics in village locations, God moved us into the capital city, where our girls attended a Christian international school. I commuted out to the bush, to provide medical services and oversee the Maasai clinics. God also spread my wings and sent me on several trips to other mission efforts, such as community health seminars in Tanzania and Ethiopia, several medical mission trips to Afghanistan, and a world-wide health conference in Thailand. Being a Vanderbilt professor allowed me the chance to teach in China and Afghanistan. So I want to encourage you: Get the best education you can, and then keep your credentials and certificates valid. Get your CME. Keep your licenses renewed. You never know how God is going to use your credentials to open doors. The season of Nairobi city living was far different from bush living, but afforded the chance to provide a better education for the girls, host more medical visitors and in God’s amazing timing, living outside of Maasailand actually encouraged the disengagement of the Maasai churches and clinics. Being physically absent on a daily basis became a vital step in the long term process of turning the work over to the local Christians. The Maasai clinics we worked with are still open, functioning, and growing all under the leadership of national Maasai partners! It is a testimony to God’s faithfulness. The Maasai clinic system functions independently, has their own Kenyan registration and is self-governed; they let me stay on the clinic board as an honorary member and Jason and I visit them as often as we can. So what happened to the Snyder family? Where are they now? You may have noticed I refer to my first husband, Dave Snyder, but my current husband is Jason Estep, which brings me to my next lesson: Real missionaries have real problems. My first husband, Dave, suffered from migraine headaches. Before we left for Kenya, he was treated with what was then considered standard of care: Imitrex, Phenergan, and Percodan (a prescription opiate pain medication). He managed with his usual once monthly doses. He’d take a day or two to recover and life went on. He functioned very well. However, when we moved into Nairobi, whether from smog, diesel fumes, and burning yard trash, or from job stress, or from reasons we’ll never know, the migraines gradually escalated. They went from two a month, to one a week, to two a week. Dave had taken Percodan once a month for 20 years without a problem, or so we thought. When he took it twice a week, physiological tolerance developed and before we realized it, he was addicted to the prescription narcotic pain medication. Being a medical missionary bestows a lot of honor and prestige, at least in Christian circles. Narcotics Addiction, wow, that’s a diagnosis that carries a lot of stigma. It’s also a disease that affects the whole family. It brings a change in behavior and personality, betrayal and deception. It was all there. In April 2006, I realized that I couldn’t account for all the Percodan tablets that Dave should have for a 2-year supply and I found receipts from a local pharmacy where Dave had gone to get vials of injectable narcotic which he had acquired by writing his own prescriptions with my signature. That’s forgery, and it’s illegal, and if done in the USA, it could have cost me my medical license. Yes, the situation was bad. When confronted by our team leader, Dave agreed that he had a problem and consented to an inpatient drug treatment program in Nairobi. After the 6-week program in Kenya, we were brought back to the USA so he could continue drug rehabilitation and medical care. We had to leave Kenya urgently and unexpectedly. We moved across the globe to a town we had never lived in before and in which we had no family. Our girls had to change schools, leave friends, say goodbye to pets. We left our work and ministries in the hands of others who weren’t prepared for those responsibilities. We left suddenly and the leaving was messy and incomplete. In a short span of six weeks, we lost our home, school, jobs, and identity. The losses were immeasurable. We were in crisis and remained in crisis for years. After a two-year medical leave, I took a job with CMF in the Indianapolis home office as the Director of Member Care. I worked one day a week as an ER physician to make ends meet and keep up my medical skills. Despite six years of Narcotics Anonymous meetings, drug addiction therapy, marriage counseling, Behavioral Couples therapy, and family counseling, our marriage did not survive. I certainly made more than my fair share of mistakes along the way, being co-dependent and broken. Opiate addiction destroyed our marriage and imploded our family. Addiction hit home. Real missionaries have real problems. Missionaries are real, ordinary people. But the deeper we are in service, the more of a target we are to Satan. Mission service comes with a cost, and we truly are engaged in spiritual warfare. There are no guarantees in life; no guarantees for missionaries that everything will turn out ok. The day the divorce was finalized I was informed my job with CMF was ended. I was divorced and unemployed. That was a tough day. But despite life’s challenges, God promises to be present. He continues to work, to grow us, to mold us. And He promises to redeem and protect. In that season of ashes after divorce, God graciously provided me with a full-time Emergency Room job; the income of which allowed me to support myself, to pay off the mortgage, to help my daughter through college at Johns Hopkins and to care for my father in my home his last three years. And I was debt free in three years… a miracle and a testimony of God’s provision! So where am I now? Columbus, Ohio. And what on earth am I doing there? God continues His story of redemption in my life. God has given me a new husband, a new marriage and a new beginning. Jason and I both love God and missions. And yet we are both in very secular jobs and we’re firmly anchored in the USA for now. While Jason’s career as an aircraft mechanic for the State of Ohio and mine as an ER doctor in suburbia don’t obviously mesh as a partnership for missions, we still have missions as a goal, both overseas and at home. What does missions look like at this season of life? First of all, we have to recognize what season we’re in. We are in a season of caring for aging parents. Jason and I are both only children. Neither of us has siblings to help care for our sets of parents. First with my dad and now with my mother, we find that our parents have limited resources and need more help. When my step-dad died last year, we invited my mom to move in with us to stretch her funds and so we could help her more. She gets along in the house pretty well but is no longer driving, cooking, cleaning or doing laundry. She lives with us, and I am her primary caregiver, and Jason is an angel for letting his mother-in-law live with us! We realize we can’t take care of her in our home forever, at some point she will need more help than we can provide, but she is living with us as long as she can. We’re the sandwich generation, where roles are reversed and the parent becomes the child, and the child, the parent. Jason and I realize that caring for mom is our primary ministry right now. So how do we make mission service a reality in this season of life? The lesson we are learning is: We serve within our capacity. Jason and I cannot live overseas right now. Instead of long-term mission service, we focus on what we can do, which is (tithing to financially support missions through our church) and short-term mission service. By utilizing a facility for respite care or bringing in home caregivers for Mom, we are able to do short-term mission trips 2-3 times a year. For the last several years, we have served with Samaritan’s Purse in their program for wounded veterans, Operation Heal Our Patriots, in Alaska. We go for two weeks each summer and I serve as the on-call doctor and Jason helps the maintenance crew. We have also made short-term medical mission trips back to Kenya and with our home church. Our church in Ohio is a Great Commission church and partners with Great Commission churches in Latin America, some of which have medical clinics as part of their ongoing ministries or host short-term medical teams to open doors into the community. In this capacity, Jason and I made trips to Honduras last year and El Salvador this year. We’ve seen how short-term medical teams can validate and encourage the national workers and provide opportunities to enter the local community to evangelize, to introduce people to the church and to start relationships. When connected to the long-term ministry and used to augment the local church, short-term medical mission teams can have a huge positive impact for God’s Kingdom. We are also learning that God is constantly preparing us for what He will bring next. I often wonder why God has me working in an ER here in the USA. I look back and remember how I got the job at the hospital in Columbus and am convinced God opened the door and provided the job, so I believe I am called to be there. But that doesn’t mean it has been easy. The physician group that hired me lost their contract before I started, so 75% of the doctors left, leaving those of us remaining very short-staffed. Hospital metrics and the push for productivity and efficiency to see more patients, in less time and bill for more services and make more money, while keeping patient satisfaction scores high… is suffocating. Physician burnout is real, and I unfortunately experienced burnout first hand last year. And all the while, I questioned God why I was there. I don’t have all the answers but I have relearned that part-time is not a crime, and I am cutting back my hours to survive and regain my physical and emotional health. Jason and I also realize that this is a season, and it’s temporary. May 2021, Jason will complete his required 31 years of service for the State of Ohio and be eligible for retirement and his full pension. On one hand, his commitment to secure his pension keeps us anchored in the USA for now… but it also allows us the time and financial resources to retire at a relatively young age. We’re looking forward to ways we can increase our mission service after we retire. And in the meantime, we have made some important financial decisions: For starters, we have not allowed our standard of living to accelerate to meet our level of income. We’re trying to live frugally and save enormously. Like Joseph’s 7 years of plenty preparing for the 7 years of drought. We are putting over half of our income in retirement accounts, 401Ks, IRAs and savings. So that when Jason retires and we have time for mission service, we will also have the financial freedom to go when and where God leads us. We’re not allowing ourselves to be strapped to the typical American lifestyle that would necessitate a 6-figure income. We realize that all the money we have actually belongs to God. It’s really His, we are just stewards of it. All our income and retirement accounts are ultimately meant to do good works for God’s glory and benefit, and bring as many people as possible into heaven with us. That perspective helps guide how we’re going to spend it. God is preparing us financially and perhaps even professionally. I can’t help but wonder if my ER work is honing skills God will use in the future. Perhaps God will call us to serve in Samaritan’s Purse disaster relief team or the SP Emergency Field Hospital. Maybe God will want us to spend 2-3 months at a time in Kenya or other World Medical Mission assignments. It’s rather exciting to think about! Retirement is not a time to quit or just live for ourselves; it will be a new season for mission service. Medicine and Missions… can it be done? YES! …with God’s help and grace. Should you consider it? Absolutely! If you give your career, family and life to God, He will use it, fulfill it, and enrich it more than you ever imagined. Cast your bread upon the waters, for after many days you will find it again. Eccl 11:1 (NIV)