I love this sunburnt country

I love this sunburnt country.
I know there’s been some pains,
when colonists advanced and pillaged
and subdued our coasts and plains.

But white, black, red or yellow,
or whatever your skin may be,
Together we are Australians,
and together, we live free.

Our unity is our strength,
many cultures give us beauty.
Our past may be dark and painful,
but our future’s as bright as can be.

So let’s love this sunburnt country,
Together, let’s take a stand,
To treat everyone as equals,
To extend a welcome hand.

Let’s celebrate this country
And all that makes us tick
Today, and every Australia Day,
Each January twenty-six.

A Dissertation on the Uterus

When one thinks of Mothers Day, one tends to think of flowers, chocolates, perfume, presents in pink paper, and breakfast in bed … you know, “sugar and spice and all things nice.”

But the unsung hero of Mothers Day is the uterus.  It’s concealed inside every woman, yet never given the accolades that it deserves.  After all, without the uterus, none of us would be here today.  So I would like to share some observations on the humble uterus, and I hope, add a new dimension to the celebration of Mothers Day.

The uterus resides in the female pelvis, nestled between the bladder in the front and the rectum at the back.  It is a pear-shaped, hollow, and very muscular, and measures three inches long, two inches wide and about one inch thick.  All up, it weighs about 60 grams.  It has two tubes leading to the ovaries, and the lower part opens into the upper vagina.

Two ligaments are responsible for holding the uterus in place and carrying the vital blood vessels and innervation.  The round ligaments attach to the top of the uterus and curve around the wall of the pelvis like two arms extended to give a hug.  The broad ligaments hang from the fallopian tubes and round ligaments like a curtain, and attach the uterus to the floor and sides of the pelvis.

While the uterus is very small in a woman before she becomes pregnant, it has an amazing capacity to stretch.  A uterus in late pregnancy actually takes up most of the abdominal cavity (thus measuring over a foot in length) and can weigh a couple of kilograms.  The uterus just keeps growing to whatever size it needs to be to accommodate the baby inside of it.  The uterus is also very strong – uterine contractions during labour can produce between 30 and 60 pounds per square inch of pressure.

Before pregnancy, the uterus gets itself ready every month to receive a new life.  The womb lining is thick and nurturing, and is ready and waiting when ovulation takes place each month, just in case it’s needed.  If it’s not, then it renews itself, ready for the next time it might be called upon.

From the moment of conception, the uterus is providing for the baby.  In fact, the baby literally takes over, modulating the responses of the uterus.  It secretes hormones to bring more blood flow to the uterus to support its own growth and make the uterus stronger, while at the same time making the ligaments around it to relax so that it can grow.  The uterus completely envelops the growing baby, protecting it with the thick layer of muscle.  So protective is the uterus that babies in the womb can survive trauma from high speed car crashes or heavy blows to the mothers abdomen, with no noticeable trauma.

Finally, after 40 weeks of stretching and growth, of protecting and nurturing, the baby must leave the uterus.  If the baby stays any longer than two weeks over, both the baby and the mother are at risk of dying.  It goes without saying that the process of separation is painful – labour is synonymous with pain and travail.

There are two causes of labour pains, stretching and pushing.  I don’t think I can really do justice to the pain from childbirth, but I will do my best for those who will never, or have not yet, experienced labour.  The birth canal in ordinary life has a maximal diameter of about four centimetres.  During parturition, the birth canal has to accommodate a baby’s head which is usually between ten and eleven centimetres in diameter.  So imagine taking your lower lip and trying to pull it up over your eyebrows.  This would be the rough equivalent to the stretching that occurs during delivery.  The muscular contractions are different again.  Think of the pain of a muscle cramp in your calf, then imagine that across your whole lower abdomen and lasting for two minutes.  You may have a now have an idea why childbirth is painful.

While it may seem that the process is pretty easy for the baby, it also goes through some pretty intense stress.  The intensive squeezing through the already overstretched birth canal actually wrings the excess fluid out of the babies lungs, which were previously filled with amniotic fluid.  It is because of this squeezing, and the very rude shock of the cold air of the outside world on it’s face, that the baby takes it’s first breath.  The average time that it takes to get the baby through the four inches of the birth canal is about 30 minutes. It may not be physically far, but the journey of separation is very strenuous.

When God made man and woman, he had already been creating for five and a half days, so he was in the groove (see Genesis 1:24-31).  He made man, and the things that define man he placed on the outside, like his “defining organs”, and his physical strength.  But man wasn’t complete.  So God made woman, the pinnacle of his creation.  She complements and completes the man.  God made her so that which defines her was internal – the uterus, her defining organ, and the emotional strength and nurturing which the uterus represents.

Even before they are mothers themselves, most women will cultivate relationships and help the people in their life to flourish.  Women, like the uterus, have a remarkable capacity to stretch and nowhere it is better demonstrated than motherhood.  Like a foetus to the womb, so a child literally takes over the life of it’s mother, constantly demanding in every aspect of life.  But the selfless care results in growth and stretching – the baby fostering a type of inner strength that is rarely found in women who have not raised a baby of their own.

The protective instinct of a mother is amazing, sometimes going beyond rational explanation to the level of absolute self-sacrifice.  Like the uterus, enclosing the baby with an almost impenetrable layer of thick, strong muscle, a mothers love cocoons her child and so often takes the physical and psychological blows that were meant for her child.  And mothers are very strong, with an inner force that can push through physical obstacles, social barriers and psychological pain in order to find what is best for their children.

The transition from dependence to independence, like the process of labour, is painful.  Pushing a child away requires emotional strength as much as caring and protecting does, but children eventually need to move on and start living on their own, “breathing for themselves” so to speak.  They may not move very far physically, but in terms of emotional separation, it is often a long and stressful journey.  The cold air of the real world and the stress of the transition can make them gasp and scream for a while, but it makes them stronger, and able to live on their own.

Finally the uterus is, anatomically speaking, like an angel, with the round ligaments extending out in front like arms reaching out to hug, and the broad ligaments flowing down from them like wings.  It goes without saying that mothers are angels.  Constantly reaching out to give love and protecting by enveloping in their wings, mothers personify the spiritual ministry of angels.  They also reflect God’s likeness, as it says in Psalm 91:4, “He will cover you with his feathers, and under his wings you will find refuge; his faithfulness will be your shield and rampart.”

So we owe a lot to the uterus.  An amazing yet understated organ, it reflects the amazing traits that God placed inside women everywhere, which are brought to the fore by the journey of motherhood.  Without the uterus, there would be no mothers, or Mothers Day.  On Mothers Day, when you give your mum a hug and a kiss on the cheek, don’t forget to thank God for his amazing creation of the humble uterus and the special traits it shares with the pinnacle of Gods creation.

Scars

I’ve spent a lot of time in trees.

When I grew up, there was no such thing as video games. In those days, we were lucky to have a colour TV and four channels, but watching it was a privilege. Instead, I would usually be outside, bare foot and naive, exploring the creek behind my house and the thin ribbon of bushland that guarded it, or climbing the tree in my backyard, or picking up sticks from the ground and using them as weapons so I could fight off pretend villains like the superheroes I aspired to.

Eventually I discovered cricket and learnt to ride my bike, which changed my outdoor pass times. If I wasn’t practising my cricket skills, I would ride for hours on the footpaths and bikeways that criss-crossed my neighbourhood. There were no bike helmets in those days, and still no shoes. It was an innocent time.

My adventurous spirit and lack of protective equipment invariably resulted in injuries. Once when playing with a stick in the front yard, I somehow managed to dig the sharp end into my right leg, gouging a chunk out of my lower thigh. A few years later when riding my bike, the handlebars of my BMX came loose and trapped my legs so I was unable to peddle. It also stopped me from using the footbrake and steering properly, and there was nowhere else for me to go except into a pole next to a low concrete bridge over the creek, and then over the handlebars and onto a causeway which was covered in large rocks and debris. Amongst the injuries sustained was a large graze to my elbow, which my teenage sister helped tend and dress for me. Unfortunately no one had taught her that the dressing needed to go cotton side up, not onto the wound. A few days later, the scab had to be torn off to remove the dressing.

Several decades later, I would also find myself being thrown off a bike, but this time after a man driving a 4-Wheel Drive didn’t notice that I was riding on the footpath and kept coming out of the driveway he was in. Thankfully this time I was wearing shoes and a helmet, though it still didn’t help much when face smacked into the bitumen after bouncing of his windscreen and sprawling five metres through the air. I wasn’t that beautiful to start with, so my bitumen face didn’t matter too much and the scars eventually healed. But three weeks later when I couldn’t move my arm properly, I suspected that there was something wrong and the MRI showed a fracture of the head of my left radius (bone near my elbow).

The common link in each of my war stories was the eventual outcome – scars. I’ve now got a collection of scars ranging from small to obvious, internal and external. Scars are an interesting though rarely considered part of our normal function. Our body faces assault in various forms all the time. Usually we’re able to stop infections before they take hold. Sometimes, an infection or injury will still get the better of us, but our body will be able to heal our tissues completely, fully restoring our function and appearance as if nothing ever happened. Sometimes, there’s just too much damage, and our body has to do the best it can. It has to fill in the gap left by the irreparable tissue to maximise the structure and function of that tissue. To do that, it uses a scar.

Microscopically, scar tissue is made up of collagen, a dense fibrous tissue that’s also found in tendons. When a breach in the tissue occurs, there are three distinct phases that are followed to create a scar: the inflammatory phase, the fibroplastic phase, and the remodelling phase. The boring, intricate scientific details don’t matter for this essay, but essentially the phases are needed for cleaning up the debris, laying the scaffolding, and reinforcing the scar.

What’s more interesting are some other characteristics of scars that we don’t often appreciate. Firstly, scars hurt. Ok, so that sounds obvious … it always hurts when the injury first happens. The inflammatory phase is the time that a wound hurts the most, but in physiological terms, this phase only lasts about 48 hours. As time goes on, the scar hurts less and less, and in most scars, the pain eventually goes away completely. However, there are a few scars that are still sensitive when touched, sometimes for years.

Some people have a tendency to form bigger scars than others. This is called keloid scarring, and is a process of excessive inflammation of the forming scar tissue which causes too much collagen to be laid down. Keloid scars can be large, itchy and painful. Keloid scarring is thought to have a genetic component to it.

Even if you’re lucky to avoid keloid scarring, scars are usually considered ugly and unwanted. Maybe it’s because they’re associated with pain, or they ruin our otherwise perfect skin. Either way, many people don’t like their scars.

Scars are also weaker than normal tissue, though not by much. By the time a wound has completely healed, the scar strength is about 98% of that of the normal tissue.

Sometimes we’re afraid of getting scars, probably for the same reasons I’ve described. Doing things that are risky might lead to getting hurt, and those scars are a permanent reminder of how we not only failed but also how we hurt ourselves in the process.

Although, I think we have the wrong ideas about scarring. Sure, sometimes scars can be ugly, or painful, or weak. But scars can also tell us a lot about ourselves if we’re willing to look past the superficial and see what they really represent.

Scars can show our bravery to others, remind us of our courage, help us learn from our mistakes, and remember our successes. They can enable empathy, and remind us of our vulnerability and our humanity. They prove that we’ve overcome adversity. Altogether, they tell us our history.

When I see my scars, I remember how I should be careful with sharp objects, or to dress wounds carefully, or to watch out for 4-Wheel Drives. The caesarean scar on my wife’s abdomen reminds me of the mix of fear and joy at the birth of my two children. My scars help me to remember what others are going through in their journey. They remind me that I’m not invincible. When I ask my patients about their scars, they often tell me of how they overcame desperate illness and survived.

At Easter time, we often focus on the power of the resurrection, and so we should. Through the resurrection, we have the opportunity to embrace eternal life with a loving God, who sacrificed his own son to give us that chance.

But one thing that always intrigued me about the Easter story was that after Jesus was resurrected, in his glorious new body, he still bore the scars of the crucifixion. John gives a clear account in the gospel of John 20:24-27, “Now Thomas (also known as Didymus), one of the Twelve, was not with the disciples when Jesus came. So the other disciples told him, ‘We have seen the Lord!’ But he said to them, ‘Unless I see the nail marks in his hands and put my finger where the nails were, and put my hand into his side, I will not believe.’ A week later his disciples were in the house again, and Thomas was with them. Though the doors were locked, Jesus came and stood among them and said, ‘Peace be with you!’ Then he said to Thomas, ‘Put your finger here; see my hands. Reach out your hand and put it into my side. Stop doubting and believe.’”

Before I fully understood the significance of this verse, I had assumed that Jesus’s resurrected body was supernaturally perfect. He had just experienced the power of the resurrection after all. It sort of threw me when I realised that Jesus’s supernatural body was still scarred. And if scars are considered ugly, painful and weak, then it doesn’t seem to make sense.

I’ve come to realise that God knew exactly what he was doing. Those scars on Jesus’s hands, feet and side demonstrate that he gave up his deity to embrace humanity. They show his amazing sacrifice by taking our place on the cross. They prove that that he overcame the power of sin and death. They will remind us of his amazing love for us for the rest of eternity.

Yes, our scars seem ugly, painful and weak on the outside, but they are signs of our struggles, our strength, our victories – things that we have learnt from, and things that we can be proud of.

Scars aren’t a sign of weakness, but of our humanity. Scars are evidence that we’ve overcome adversity, that we are strong. Scars are a permanent reminder of the gift of God to man. Scars are nothing to be ashamed of.

Don’t look at your scars as a sign of weakness and shame, but instead, see your strengths through the story of your scars.

Bibliography

Gauglitz, G. G., Korting, H. C., Pavicic, T., Ruzicka, T., & Jeschke, M. G. (2011). Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med, 17(1-2), 113-125. doi: 10.2119/molmed.2009.00153

Hardy, M. A. (1989). The biology of scar formation. Phys Ther, 69(12), 1014-1024.