I remember those early, heady days when we founded the Preemptive Love Coalition and we envisioned—for the first time—an Iraq free of the burdensome backlog of children waiting in line for heart surgery. I remember calling families to alert them that we could finally send their child to heart surgery, only to hear on the other end of the line a polite-but-devastated, “It’s too late. My child died yesterday.”



I’ve sat in different waiting rooms across the country where children were waiting to be seen by the doctor, and I’ve seen children die before my eyes—literally while waiting in line.

We’ve said from the beginning that our mission is to “eradicate the backlog.” But our vision, stated more positively, is that every Iraqi child would have access to the surgical intervention they require to thrive.

Since 2003 and the start of the war, an estimated 50,000 children have been born into The Backlog. There is no way of knowing how many were already alive and waiting in line before that time; nor do we know how many we have lost during that period nationwide.

In that time, while seeking to serve these children, we have faced bombings, death threats, the imprisonment of our staff, armed conflict in the cities where we’ve worked, political roils, funding crises, and partnerships that have turned predatory.

The minefields you will have to endure while pursuing your vision are complex. All the easy stuff has been accomplished already! The things that remain are usually fraught with risk and even danger. Depending on your context, it will become impossible at times to move forward with your vision at all.

So what do you do when you are placed in a holding pattern? Like these Iraqi children I’ve sat with and held, the “waiting room” is where many a vision has died. Visions need activity. They need momentum. They need progress.

Below are three things I’ve consistently done to nurture vision while stuck, for reasons beyond my control, in the waiting room.

1) Plan. Whether the vision you are nurturing is one for your marriage, your children, your business, or some social issue across the world, nothing gets done well without planning. When you start to become dissatisfied with the world (marriage, business, etc) as it is; when you start to envision a better way to live or a solution to one of the world’s intractable problems, you must begin to plan.



Planning means different things relative to the vision in question. It might mean quiet research on the problem itself. It might require a lot of info gathering about proposed and enacted solutions currently in the marketplace. If the problem is really so bad, why has no one else tackled it yet? What are the obstacles to success? Is the space crowded with solutions already? What would you need to do in order to bring something new to the field? What will it cost if it all goes well? What will it cost if it all goes terribly? 



Woe to the visionary who jumps in without planning. The waiting room is one of the most important places for a vision to begin, as it gives us time to make our missteps on paper before ever spending a dime or wasting the time of others in the real world.

2) Position. I’ve met many people along this journey who want to eradicate poverty, provide clean water, transform social problems across Iraq and the Middle East, etc. Among the worst things I’ve seen passionate visionaries do is a chronic failure to become well-positioned in the field of choice so that expertise and solutions might flow more naturally.



A well-intentioned twenty-something starts a new non-profit organization out of Idaho to help Darfur. A well-to-do family from the suburbs launches a ministry to the homeless downtown. A businessman seeks to change industries and launch a new venture at the invitation of a friend.

Sometimes these things work well enough. But if you are pursuing a vision for the future as it should be, and not merely as it is, you must position yourself for the desired change.

Whenever possible, I advocate networking and proximity. Trying to engineer a vision for another part of the world from the comfort of your living room in America is usually a bad idea. A reliance on internet material instead of diverse, first-hand accounts from your customers or constituents just won’t cut it. Whether you are in business or in international development—indeed even as a parent or a spouse—vision is about meeting the needs of others. We must be in a position to accurately understand the needs of those for whom we are pursuing our vision.

When the waiting room keeps you from fully acting upon your desired vision, sometimes the best thing you can do is move your body; get closer to the action; and hold more meetings with all relevant parties to ensure that you deeply understand the issues affecting them.

3) Pray. I won’t spend my time on a vision that I can accomplish on my own. Anything small enough to be accomplished by me, without the intervention of God, is a task that I am happy to forgo and leave for someone else.

When I pursue vision, I choose to work on things that overwhelm me and cause me to go to God in prayerful dependence. In fact, one of the greatest things for me about pursuing vision is the act of worship that it can become; not worship of the vision itself, but worship of the God who alone can sovereignly work through human freedom to bring about a better future.

I realize not all readers and visionaries will agree with me on this point. But when I am sitting in the waiting room of vision (or riding the wave of visionary success, for that matter), I commit myself again and again to God who hears, who cares, and who proactively works in this world to set all wrongs to right.

The snares that lay in wait for you on your journey to fulfill your vision are beyond number. The delays and unexpected detours have caused the death of countless visions and visionaries. Planning, positioning and prayer are neither exhaustive nor fool-proof, but without these disciplines, my vision that every Iraqi child would have access to the cardiac surgical intervention they require to thrive in childhood and become fully-contributing members of society would have long-since died in the many waiting rooms that have beset us along the way.

Are you in a holding pattern? Are you waiting on details to be clarified? Is your how still taking shape now that you’ve defined the what of your vision?

Keep planning, get positioned, and by all means I commend to you the God Who Cares.

These things are not passing. They are still a part of the active pursuit of your vision. Do you see it differently? Do you have other disciplines you use when stuck in one of life’s waiting rooms? I would love to hear about it. Send me an email by clicking this link.

Iraq’s first-ever TEDx event happened in Baghdad and, as the only westerner to attend TEDxBaghdad’s inaugural conference, it was an honor for us to have Jeremy attend as a speaker.

Jeremy spoke on the concept of ‘preemptive love’ and its ability to heal, reconcile and restore people to right relationship with one another. If you’re having trouble loading the video above, just click here.

I was sitting in an Iraqi hotel lobby in 2007 when one of the hotel staff who was serving me tea approached me and asked: “Can you help my cousin? His daughter was born with a hole in her heart, and no one in all of Iraq can help her. Please, can you help?”

I had just moved to Iraq with my family to work with a different NGO. I didn’t know anything about heart surgery for children or anything about taking children to other countries for treatment.

From the beginning, helping this little girl seemed impossible. And she wasn’t the first child I’d met in Iraq with a life-threatening heart defect. In fact, it seemed like almost everyone knew someone with a child who was born with a messed up heart.

My work with the organization I was with was not capturing my heart. It seemed to lack both vision and impact. And, in any case, it was not set up with an exit strategy—there was no developmental finish line.

Around the same time, Cody Fisher began telling me of his NGO work with many of these children in need whose files were piling up on his friend’s desk as she sought to find them heart surgeries outside the country. The more I inquired, the more intrigued I became.

I learned that there were seven hundred children within a two hour drive of our city who were waiting in line for lifesaving heart surgery. You would never find a backlog that large anywhere in America!

Over the course of this journey, my wife, Cody Fisher, Michelle (then Bailey) Fisher and I chaffed under the tyranny of life as we knew it in Iraq.

After all, it seemed that many of these heart defects were not simply occurring naturally but were probably directly attributable to acts of war—both martial and economic. This was an issue of justice. As Americans, we felt directly responsible for some of this. But it was primarily as Christians that we decided to jump into the unknown and commit ourselves indefinitely to the cause.

Defining the cause itself could have taken us a number of different directions. I am grateful to God that we got this one right amidst all the unknowns: we defined the what before the how.

Would we create an organization primarily because Jeremy had met a little girl in a hotel lobby? No. Would we create an organization primarily because Cody had a few connections to get us off the ground quickly? No.

From the very beginning we established a vision that was far more grand than anything else in cardiac care nationwide.

“… to eradicate the backlog of Iraqi children waiting in line for lifesaving heart surgeries.”

Looking back, it was ludicrous. It was naive. But it was never a mere “dream.” It was a vision. (See my last post on my differentiation between a dream and a vision). There was a moral conviction behind it. It would never be enough for us to simply help the children who crossed our path. It would never be enough to clear the files or the “backlog” on our desk. We had to exist for all the children of Iraq who were waiting in line for lifesaving heart surgery.

Months after articulating our vision for a Backlog-free Iraq, I learned that the leading expert in the region had actually dumbed down the number of children waiting for surgery because he did not want to scare us off. The number was actually 5X greater—closer to four thousand children. We were still waiting on estimates from the rest of the country.

We started to suspect ten thousand children or more were waiting for surgery. And we were not smart enough at that time to really question how many new children were born into the country each year in need of heart surgery.

We were almost immediately faced with a crisis. Our 20-child per year pace was never going to “eradicate the backlog.” Our methodology—the how—could never see our vision realized.

Do we change our vision to meet our methods, or must we change our methods to meet our vision?

Nothing had changed in our desire to see Iraq free of a burdensome backlog. We had established our vision—our what—before we had a clear idea how we were going to bring it about. So we stuck with our vision and forced our methods to catch up.

We redoubled our commitment to eradicate the backlog. We personified “The Backlog”—for he was a devilish foe who needed to be vanquished by all the heroes like you who would partner with us in the coming years. The Backlog only existed because of injustice—both local and internationally imposed. To defeat The Backlog would be more than a triumph of our organization; it would be a victory for every family across Iraq, because every family across Iraq is susceptible to congenital heart disease, the number one birth defect in Iraq and in the world.

Our vision was still maturing, to be sure, but we got this one thing right: we established the what before the how.

There are other organizations that work into Iraq in an effort to help children with heart disease. But sometimes I wonder if the how has taken precedence over the what. Candid conversations often reveal a complete absence of vision; a settling for the methodology of today for lack of a compelling picture of the future.

Since our inception in 2007, we have made four major programatic (methodological) changes in an effort to stay the course and eradicate The Backlog. Every one of them was scary. Every one of them could have been a colossal failure. But vision demands innovation and risk.

Do you have a hard time accepting the world as it is? Do you feel morally compelled to work for a different future? Do you have a vision that you are currently nurturing or pursuing? If so, do yourself a favor: define the what before the how. Methods change with technology, culture and economics. Don’t focus on the how. Get your sweeping vision right by defining the destination point at which you want to arrive. Let the how work itself out one step at a time and don’t sacrifice your “what” for a method that leads you astray.

Can I be a helpful ear as as you try to work out your vision? Don’t hesitate to send me an email by clicking this link!

In any case, I operate daily according to a vision of the future that is not yet reality.

I prefer the word “vision” to the word “dream” because dreams are so often associated with “dreaming”, “dreamy” and “dreamers.” “Dream” has connotations of other-worldliness. Apart from Martin Luther King’s wonderful speech, most “I have a dream” talk that I’ve encountered reeks of non-action, an assumption that dreaming alone is enough to spark the desired change.

Think of the spate of status updates and tweets on New Year’s Eve in which people dreamed (and invoked Dreaming’s close cousins, “Hope” and “Wish”) for world peace, an eradication of poverty, and global sing-alongs. At the risk of sounding cynical, much of our dreaming is just socially conscious enough to sound engaged and just vague enough to require zero effort of our own.

Therefore, I prefer to have vision over dreams. In the way I use the word, vision requires much of me. I work on vision. I plan for vision. I submit my vision to the critique of others so that it will be refined and strengthened. I seek partnerships to bring the vision into reality. And I pray while waiting for the correct timing to pursue vision.

This post marks the launch of a series on vision – how to define it, nurture it, pursue it and succeed in it. Ultimately I want to encourage others out there who have a hard time accepting things as they are. I want to ignite more passion in the hearts of those of you who insist on returning things to how they should be.

In the process, you will get a clearer picture of what it has required for us to get to this point as an organization. I will be honest about our failures and I will paint a picture of a future Iraq—and a future world—that I hope you will find compelling and inspiring.

We are not just out here in Iraq cranking out heart surgeries. There is a much more sweeping vision, and I feel I’ve failed to bring that to the fore regularly enough.

As you read, if there is anything you feel you’d like to ask or any way in which I might spur you on in your vision, don’t hesitate to send me an email by clicking this link.

A Yazidi man in traditional garb. Photo by Kamaran Najim.

This mission’s last child was a little baby boy named Younis.

Younis came 400 miles to get to Remedy, but the drive took it’s toll and Younis—just 2 months old—came down with a fever. Every day we put him on the schedule for surgery, but every day we had to cancel because his fever wouldn’t break. Some days it would break in the middle of the night, but by the time we could rush to the hospital to operate the fever had returned. This continued until the very last day of the mission. This time his fever broke for good, giving us just enough time to give Younis the lifesaving surgery for which he had traveled so far.

These are the stories of Remedy.

I also had the privilege of telling Ali’s story this mission, but it wasn’t just Ali who you helped us save this mission. You saved Amjed, Zainab, Alawi, Zain, and so many more.

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This past week I’ve been reflecting more on the lives of these children and the life and vision of Martin Luther King Jr. In between surgical days I re-listened to some of his sermons, trying to once again stir my heart for the things that stirred his.

I was humbled by the devotion and the vision that he carried throughout his life, right up until his assassination. He maintained an astounding vision of God and his fellow man, one that led to his unparalleled passion for justice and peace.

King reminded me once again that there comes a point when silence is betrayal.

And so he shouted out for justice, equality and love. He spoke up for the broken, the poor, the ones affected by unjust war and the ones who had no voice of their own.

And people listened. We’re still listening.

This week I’m profoundly grateful for the life of Martin Luther King Jr. And I’m also profoundly grateful for you.

You see, these Remedy Missions can’t happen without you. In our writings we use the word “I” and “we” a lot but truth-be-told, I can’t think of one thing “I’ or “we” have done apart from you.

Because of that, together we’re breaking the silence. You’re bringing Remedy Missions to cities all over Iraq and because of that you’re saying to the people of Iraq “You are not alone. We are in this together.”

And they’re listening.

Thank you for not reducing the vision and legacy of Martin Luther King Jr. to a yearly quote, but for committing to live it out by saving the lives of children like Ali and Younis. Thank you for Remedy Mission VIII!

We’re just two weeks away from our next Remedy Mission….stick with us!

If you’ve been following Ali’s story, you’ll be happy to know he is doing extremely well! Remedy Mission VIII is almost at an end, but Ali’s last words for the camera were expressions of gratitude—thank you for saving him!

In case you missed them, go check out more photos/videos of Ali and his friends on our Twitter stream.

I got a phone call from Ali early this morning telling me not to bother looking for him in the ICU anymore. I walked into the hospital to find him walking around in the ward!

Not only that, but he was already asking me when he can go home. Ali still really wants to be a doctor, so maybe one day he’ll understand how important this time is in the hospital.

But I love that he’s still a 12 year-old boy who can’t wait to go home and play soccer with his friends. At this rate, who knows, he could even be home by tomorrow!

The next 24 hours will be absolutely crucial for Ali, though. The operation was a complete success, but now we have to wait to see how his heart and the rest of his body will respond.

I ran into the ICU so I could take the above photo of Ali and show it to his mother. She was ecstatic to see her little boy!

Who knows what will happen next—Ali could be up walking around as soon as tomorrow!

I went to see how Ali’s mother was doing and she was surrounded by a group of women—all with enormous smiles on their faces. I asked why they were all smiling and they said it’s because Ali is getting his heart fixed!

12 years of waiting for a lifesaving heart surgery…I’d be all smiles too!

Ali should be coming out of the operating room within the next few hours. We’ll let you know how it goes!