Richard Brueton reflects on his journey to faith and subsequent overseas work in Malawi.

I drove northwards out of Blantyre in the bright early morning sun, passing the stream of human traffic, barefoot in the dust, flowing towards me. Sitting beside me in the front of the Land Rover, the orthopaedic clinical officer had nodded off following our early morning start to a district clinic in Dedza, Central Malawi. I reflected that two years ago, to this very day, I was sitting in a fracture clinic at St Thomas' Hospital and I could never have thought how my world would have changed.

My problem was that I had never understood what life was all about. Interested in human behaviour, I left school to begin a psychology degree but rapidly changed to medicine, in an effort to find a more scientific base from which to begin. I soon dismissed psychiatry as too vague and neurology as a therapeutic desert. Perhaps it was emerging from a car smash while a medical student, having left the M1 at speed, still alive, with just a compound fracture of the tibia and fibula, that concentrated the mind. Ten weeks in hospital certainly gave me time to think.

Eventually I decided that, if I could not fathom out the meaning of life myself, patching up other people would at least enable them to continue along life's rich pathway, giving them a chance to work it all out for themselves, where I had spectacularly failed. It was this flawed philosophy that gave me the motivation to get up in the morning for the next 25 years as an orthopaedic surgeon.

Many years later, for some reason, a crunch came and I felt the need to think again and re-assess. I had been brought up in a good Christian home and had spent many hours of utter boredom in church. I then went to a local grammar school, Bristol Cathedral School, and spent many more hours immersed in the incomprehensible, though soothing, liturgy. My overwhelming recollection of the cathedral and the liturgy was one of peace and tranquillity.

Perhaps it was this memory that led me into St James, Muswell Hill some 40 years later. I slipped in and sat anonymously at the back, or so I thought. I needed somewhere to sit and think and be alone. The only problem was that on my solitary visits, the vicar, Alex Ross, seemed to want to talk to me, though he was very discrete. I avoided him for weeks, but began to read the Gospels in my own time, with commentaries. Eventually, I relented and he lent me one book, then another that led to another.

As I was leaving the church one evening, I said to the associate vicar, Philip Sudell that I knew I was just not good enough to be a Christian. 'That is the whole point', he said. 'None of us are and it doesn't matter.' The penny very slowly began to drop but it took a terribly long time and a lot of spadework by the vicar. For months, I used to stop off at the vicarage at 6.30am on a Tuesday morning for half an hour on the way to work, while Alex painstakingly led me through the Gospels. One day I knew that I could no longer walk away from this and took communion.

I now felt that I ought to work abroad and went to the offices of Interserve, just along the road from St Thomas'. They advised me to spend a year at a Bible college first. So I left the NHS and went to Oak Hill College in North London. It had taken me so long to become a Christian that I wanted catch up and learn as much as I could.

An opportunity then appeared to work in Malawi at a newly built orthopaedic children's hospital in Blantyre. During the previous year I had also become married, so Valerie and I packed up home in Muswell Hill and headed off for sub-Saharan Africa where we were to work for the next two and a quarter years.

The children in Malawi presented predominantly with club feet, angular limb deformities, osteomyelitis, burns contractures, untreated trauma and a variety of conditions the like of which I had not previously encountered. Many were anaemic from malnourishment and sub-clinical malaria that we treated to make them fit for surgery. I learned a variety of new skills, including patience.

We became used to the lack of infrastructure and the frequent cuts in power, water and telephone. I became used to an environment where there was a lack of accountability and responsibility; where daily living was a matter of risk reduction. I soon appreciated the two elements that we take for granted in England, but without which you will not be able to go to work. Your home must be secure, or you will not leave your family to go to the hospital, and you must have transport or you will not be able to get there. Simple but essential.

It was hard, but I knew that this was the place where we were meant to be. We stumbled but never fell. We learned to trust in God's provision and put our faith in him totally.

If the Lord delights in a man's way, he makes his steps firm; though he stumble, he will not fall, for the Lord upholds him with his hand.
Psalm 37:23

While in Malawi, we knew that a wise friend back at St James was praying for us every day. He said that we would be truly blessed when we returned and he was right. I am afraid to admit that I could never have imagined the extent of the blessing that we would receive.

Driving home to Muswell Hill from the Royal Free Hospital in North London, under a grey and overcast sky, after a busy trauma list and clinic, it was now five years since we had come back from sub-Saharan Africa. I never thought that I would be back in the NHS as an orthopaedic consultant, particularly not in the hospital where I had trained, many years ago.

So I had moved from a world with a life expectancy of 45 years back to one of fragility fractures in the elderly; from anaemic children walking on the outside of their club feet to in-toeing and worried mothers; from malunions after falls from mango trees to acute fractures in the playground. All equally deserving.

We had intended to go from Malawi to Ethiopia to a similar orthopaedic children's hospital which was to be built in Addis Ababa. We returned to London, en route from Blantyre, for a two month break at home. However, the Addis job just did not happen. Finding ourselves back in London, with a mortgage to pay, I needed a job and the Royal Free Hospital took me on. Colleagues told me that you cannot just leave one London teaching hospital job, go to Africa, come back and expect to get a job in another one, particularly at the age of 59, but my friend at St James was right.

I have just 'retired' again and have left the NHS once more. I now teach anatomy to medical students at UCL and to those preparing for the MRCS at the Royal College of Surgeons. Last summer, I spent three weeks in Kenya at the Africa Inland Church hospital in Kijabe, helping with orthopaedic trauma. A friend suggested that I should do 'Kingdom Work' in my retirement, and I am still searching for a role.

From St Thomas' to Oak Hill, to Malawi, back to the Royal Free and now teaching Anatomy at the Royal College of Surgeons. I have been on a journey the like of which I could never have imagined when I walked into St James Church one day to sit, think and be alone.

Trust in the Lord with all your heart and lean not on your own understanding; in all your ways acknowledge him, and he will make your paths straight.
Proverbs 3:5

Richard Brueton is an honorary consultant orthopaedic surgeon at the Royal Free Hospital, London.