Scum of the World

I could hear the cussing from inside the room and noted the awkward glances of nearby nurses and staff who turned to look and gawk. Even though I only sat a few feet outside the door, I ignored the increasingly loud litany of expletives and deliberately focused on the screen in front of me. He was my patient and I was doing my best to concentrate on his rapidly evolving list of medical problems, the electronic progress note already ballooning in front of me as I tried to prioritize multiple terminal conditions competing for attention. I scrolled through pages of old notes that were littered with repeating instances of phrases such as “lost to follow up,” “did not comply with therapy,” “uncooperative,” and the ever favored, “signed out against medical advice.” I paused and watched as a freshly berated specialist walked out of the room, sat down at a nearby computer, and dictated into his own note the word “belligerent.” The diction snob inside me was pleasantly surprised to hear a new and applicable word and so I inserted it into my note as well.

Last week my pastor asked me, “How do you keep from becoming cynical?” The question caught me off guard; it occurred in the context of a series of conversations on the struggles of caring for people in both spiritual as well as physical matters. My reply was somewhat flippant as I didn’t have a good response. The question was unintentionally pointed; Pastor Tom is a quick-witted man and one of the many reasons why I respect him so much is that even though he appreciates a dry and sardonic sense of humor, he intentionally suppresses it. By contrast, I relish in lengthy conversations about all things dark and cynical. In college I would rant about the evils of systems of poverty, child slave labor, sex trafficking. Nowadays I rant about urban violence, health disparities, child abuse, racism, Donald Trump. I am not shy about these views and justify vocalizing them as a mechanism for challenging injustice, but the genuine and curious nature of Pastor Tom’s question left me unexpectedly exposed to scrutiny. After all, what is justice and how does that apply in medicine? What is the root of cynicism and why are criticism and sarcasm so satisfying?

Continue reading “Scum of the World”

Scum of the World

Failing Faithfully: Created, Fallen, and Waiting

[This is an advance post in a series from the ESN blog. You can find the first part here or here.]

In the first post of this series, I was ruminating about a patient who had a rapid decline in health and social circumstances, culminating in a recent scan that showed the possibility of cancer even while he was struggling with homelessness. It was a bleak situation that caught me off guard because I was not expecting it and was grieved to think of what it would be like for him to die alone.

He has since died.

Continue reading “Failing Faithfully: Created, Fallen, and Waiting”

Failing Faithfully: Created, Fallen, and Waiting

Pediatrician to Parent to the Passion

I stopped and put my fork down on the plate. There was still food on it, but an emotional force had interrupted my appetite. My wife and I had been sitting at the dining table, chatting idly about preparations for our child, now nearly 34 weeks old and still in the womb.

34 weeks. In the mere act of thinking those numbers, my mind suddenly brought out memories of many other children I had seen with those same numbers attached. 34 weeks but still with an unexpected high-grade intraventricular hemorrhage. 34 weeks but with panhypopituitarism. 34 weeks but with neurologic devastation. 34 weeks but…

Continue reading “Pediatrician to Parent to the Passion”

Pediatrician to Parent to the Passion

Suffering on Mission

I Peter 4:12–19 Beloved, do not be surprised at the fiery trial when it comes upon you to test you, as though something strange were happening to you. But rejoice insofar as you share Christ’s sufferings, that you may also rejoice and be glad when his glory is revealed.

Back in March I traveled overseas to do disaster relief work for nine days. Short-term medical missions work and being part of an inner city church plant are two things God has called me to at this time in my life. Our team went to an area that was recently hit by a large typhoon. People have asked me before, but especially with this high risk trip, “Why do you go to far away countries to do missions work?,” and, “Why do you choose to go to a church in Camden?” Sometimes I ask myself the same question. Before I left for this trip, I concluded that it’s because I’m not afraid to die. But I didn’t ask myself the question of what to do when God asks me to continue living for Him in the midst of difficulties.

When I returned home, I had a mild case of various gastrointestinal symptoms, pretty typical when working in a disaster area overseas. Over the course of two weeks, mild discomfort slowly turned into severe symptoms, forcing me to take about 10 days off of work. My skin was in a constant state of hives due to different medications. At the same time, I was in the middle of trying to plan an upcoming move, visiting my ailing grandmother, and preparing for a friend’s wedding. I spent some days barely able to get off the couch, and many other days only able to tolerate fruit juices and liquids. For someone who is rarely sick, just having to stay at home was torture. I spent a couple weeks trekking back and forth to the doctor’s office.

One night, after being sick for a month, I found myself reaching a point of utter exhaustion and frustration. It was very late in the night and I was lying there in bed, flat on my back, my arms stretched out. I had just put a medicated cream on my arms and hands and they were stinging very badly. I was miserable. I was tempted to- maybe I even did- ask God, “Why?”

There in the dark a tear trickled down the side of my face.
I thought of my Lord Jesus Christ.
Who for the joy that was set before him endured the cross, despising the shame.
And stretched out His arms for me.

Jesus Christ is the ultimate picture of suffering. The recent movie Son of God clearly depicts this. The Roman method of crucifixion is one of the most painful, humiliating, and prolonging ways to die. And yet, he took the pain joyfully upon himself for my sake. My stinging hands and upset stomach were nothing compared to the weight of taking on the world’s sin.

I realized in that moment that my short and momentary affliction was from God. He allowed this in my life for His glory. I was trying to obey God when I went overseas; it was very clear to me that I had to go. I wanted to blame the sickness on Satan and spiritual forces, but a look at Job in the Bible told me otherwise. God has more power than Satan. Job was a very righteous man, probably one of the most righteous men ever to live other than Jesus, but God gave permission to Satan to allow him to suffer. God allowed Satan to afflict Job with the death of his family, financial ruin, and physical illness. Through it all, Job remained faithful to God. His response was: “Naked I came from my mother’s womb, and naked I will depart. The Lord gave and the Lord has taken away; may the name of the Lord be praised.” Job’s decision was to continue praising God and give Him glory for who He is.

Now, I don’t claim to be righteous like Job. But that night lying in bed I was faced with a decision: will I continue serving God when it causes me to suffer? I had the option of becoming bitter over the fact that I had become sick while trying to be obedient or I could choose to praise God and find comfort in Him. I decided to start a thankfulness journal and wrote down things that I was thankful for each day. Slowly my tummy began to return back to its normal self, but God taught me a lot in five weeks and brought several important questions to mind.

Serving God comes with a price tag. When missions is no longer “fun,” what drives us to obey God? When the price tag of life on mission starts to hit closer and closer to home, will we continue to serve? Suffering might mean not being able to buy that computer you really need because you’ve used up all your savings to pay for airfare. Perhaps it is foregoing a family vacation because you’ve already used up all your time off for the year or coming down with a strange illness no doctor in the states knows how to treat. If you choose to serve God by living in the inner city, it might mean having your car broken into or breaking up fights at 1 in the morning or finding that the sewer system has overflowed into the street.

Instead of focusing on our temporary losses, let us consider the price Christ paid for us to become His. He gave up everything so that we could have eternal life. May that be our motivation as we strive to glorify Christ in our lives and may we strive to give up our lives so that others could know Him.

Suffering on Mission

Should We Pray With Patients?

The patient was abruptly, unexpectedly, and neurologically devastated, leaving his family stunned and grief stricken. There was little else for the ICU team to offer, even as we worked to do everything physiologically possible to sustain life. It was late at night and as we stood in the room listening to beeping monitors and the running motors of IV pumps, the family mentioned in passing that many people were praying for him. So I asked them two simple questions: Are you Christian? Would you like me to pray for you? They answered yes to both. I led them in a short prayer, expressing no more in terms of medical prognosis or aspirations for therapy than had already been offered, but also asking for strength, wisdom, and a clearer understanding and experience with God himself. The family was marginally but visibly relieved and calmed by it, and we continued on with the grueling task of caring for the patient.

As anticipated, the patient passed away several days later. After the family left, their nurse told me, “They could not stop talking about that prayer. They said that of the dozens of physicians they have interacted with over many years, not a single one ever offered to pray with them. It meant a lot.”

Modern healthcare is conflicted about how to approach faith and illness. On the one hand, rising pressure to improve patient satisfaction must recognize the importance of faith in the lives of patients; in one small family practice study, 48% percent of patients wanted a physician to pray with them (even though 68% never had a physician discuss religious beliefs with them). On the other hand, the secularization and humanism-ization of medicine can use the ethical mandate to respect patient autonomy as an excuse not to engage in matters that could be controversial (such as faith). Fear of “abuse of paternalistic power” in the physician-patient relationship or fear of invoking religious ritual and methodologies that are virtually impossible to hypothesis-test can create a “chilling effect” on the inquiry and expression of religious belief by healthcare workers even when no hostility or indifference is there. It is as if medical practitioners find it hard to believe that faith not only exists, but that it could possibly matter more to patients than the field of medical therapeutics itself.

The earliest practitioners of medicine were clergy members. In virtually every culture, ministers of medicine began as… well, ministers. After all, what can be a more compelling reason to drive us to our knees than helplessness in the face of suffering? Though modern medicine can explain the physiology of how we decay and die in excruciating detail, it is certainly not equipped to answer the question of why we do. This observation alone should explain why questions of faith contend to occupy the center of a patient’s attention and not simply the periphery.

The next time you are in a small group or a prayer gathering, try to count how many times health-related concerns come up for prayer.  Illness afflicts our minds, hearts, and souls as readily as our bodies. Healthcare workers are compelled to take hours of training in cultural sensitivity, mindfulness, and meditation; shouldn’t we be similarly compelled to attain and encourage proficiency in spiritual need assessment, willing to offer prayer when requested instead of retreating in indifference? Shouldn’t this be true in all the “helping professions”?

[Originally published at the Gospel Worldview Blog, written by very thoughtful college alumni. Read and contribute there!]

Should We Pray With Patients?

Death and Resurrection

He was a young man, and I could see fear in his eyes as he gripped the railings of the bed and struggled to breathe, sucking in heavily through the plastic mask feeding him oxygen. His body was wasting away from cancer, and the infections that had crept into his lungs were now forcing every compensatory mechanism into extremis. He wanted to fight and live, but there was little left for the ICU to offer. I had been pleading with him for days to consider hospice and a more peaceable passing at home where he could be surrounded by family and friends, but to him that meant giving up.

He was a young man …

So we had continued to do everything, and as predicted we eventually came to that point where every biomarker and technological parameter heralded physiologic disaster. “Your breathing cannot hold on its own. We will need to intubate you soon, but your body is so sick that we will probably never be able to take the breathing tube out.” I paused. We had had this conversation before. “Do you still want us to do it? I need to tell you the truth; you will almost certainly die either way. If we transition you to hospice, you can go home and pass away with your family and friends, and we will make sure that you are comfortable. But if you still want us to do everything — intubation, CPR, shocks — you will still die, but it will be here in this hospital, and it will be brutal. Do you want us to intubate you? Do you want CPR?” He nodded vigorously, still afraid, still adamant.

He was intubated. Continue reading “Death and Resurrection”

Death and Resurrection

What Does It Take?

[Guest poem]

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What does it take
to change a life
from within?

Young and fearless
those 3 words,
inscribed on your chest

Invincible you were
til one day,
gun shots fired

your body running
suddenly ablaze
the sirens wailed

your family prayed
your homies await
your enemies irate

everything hurt
a miracle, you survived
and lived to tell

did you understand
you put your
family at risk?

did it matter
you committed a crime
done did your time

did you realize
a bullet would injure
more than a disk

now, though young
you’re bound to a chair
cannot run, cannot hide

a lifelong disability
you must take in stride
swallow all that gangsta pride

you leave the hospital
vowing to change
yet a few months later

it’s back to the same.

what does it take
to change a life
from within?

[Submission from Soapie, a nurse from the New England area who works in the urban setting. Soapie has been a fellow Christian blogger with David C for years (!), long before this site existed.]

What Does It Take?