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

Do You Want to Be a Doctor?

“I want to be a doctor. How do I do it?”

As a teenager, I was very shy and very awkward. Talking to strangers was a painful and anxiety-laden task, and I didn’t like to talk to strangers any longer than necessary. So when a pediatrician asked me, at a routine office visit, if I had any questions, I surprised myself by blurting out, “I want to be a doctor. How do I do it?” I had never seen the same pediatrician twice, mainly because most of them were residents-in-training. This one was caught off-guard by the question, so she rambled a bit. She talked about medical school and residency and fellowship, about job security and the logistics of working in a practice, about other things she must have been preoccupied with in the scope and span of her professional life, things that I couldn’t know. She finished talking and exited the room, leaving my mother and I to wait.

The two of us had recently been talking about my future career. She was a nurse, and though there were many positive experiences she would share at the dinner table with me, the impact of many negative experiences caused her to humbly and gently discourage me from going into the medical field myself. She would tell me how hard and how stressful it could be, how many of its demands were dirty, unforgiving, and intense. She was a similarly introverted person who chose the work for a very adult-like reason: it was good work that provided a good opportunity for migrating to America. She would tell me stories about her first day of nursing school in her home country, how the new students were led down to the large formaldehyde “pool” in the basement where an instructor immediately plucked out a dripping arm and began teaching. She told me that people promptly vomited and a third of the class dropped out that day, and that she strongly considered doing the same thing herself.

Medicine has changed in many ways. Though the hours and training have become more forgiving and humane over the years, other elements have actually become more noxious to the process: the ballooning price of education, uncertainty over major shifts in the landscape of health policy and insurance, the ever-increasing length of medical training, and the associated opportunity cost of lost alternative careers. This does not even begin to mention the fear of malpractice (not to be confused with the distinctly different fear of malpractice lawsuits), the burden of responsibility, the ever-mounting piles of paperwork, the erosion of patient-provider trust, the advent of the self-information (and dis-information), the loss of respect and autonomy in practice (and in relation to insurance companies). Any physician can (and perhaps is likely to) list an unending tally of reasons not to become a doctor in today’s healthcare environment.

It is therefore not surprising that it has become more and more difficult for aspiring students to describe why they want to become involved in healthcare, or even for current healthcare workers to describe why they continue to practice from day to day. At the end of the day, so much of it comes down to stories: abstract but intensely personal illustrations that capture the essence of an idea and what makes it so compelling even in the face of many practically demoralizing factors. It is why it is easier to describe and quantify the negative and yet so difficult to advocate for something positive and meaningful.

However, this is why there is something more to becoming a “Christian physician” than simply being a Christian and being a physician. We are created as both body and soul, as both the concrete and the metaphysical. Early church doctrine struggled to battle the heresy of Gnosticism because, as the Gnostics knew, there is something very appealing about the supremacy of asceticism and the idealized, intangible spiritual realms above that of the dirty, imperfect, and broken physical world we find ourselves in. And yet the message of the gospel is this: that God himself became flesh and took on physical form in the world, with all its impurities and imperfections, that we might have access to life:

So if there is any encouragement in Christ, any comfort from love, any participation in the Spirit, any affection and sympathy, complete my joy by being of the same mind, having the same love, being in full accord and of one mind. 3 Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others. Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. - Philippians 2

As that awkward teenager sitting silently in that sterile, clinical office, I must have looked pensive and puzzled. My mother watched me mull over the very grown-up words of a grown-up pediatrician. She looked at me directly, interrupted the silence and said, “David, she did not say the most important thing: you get to help people. And you help them when they need it the most.”

People often ask me what medical school and medicine are like, and I often find myself falling into adult lingo and babble. I babble about the cost of school, about the monetization of medicine, about the burden of responsibility and the terror of error. On my more cynical and jaded days, I will babble for quite a long time. But what I eventually aim to tell people is that the highest aspiration of the practice of medicine is to invoke and evoke the gospel: that through the physical engagement of Christ in our suffering, we have resurrection. In that, I find unending satisfaction.

Indeed, I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord. For his sake I have suffered the loss of all things and count them as rubbish, in order that I may gain Christ and be found in him, not having a righteousness of my own that comes from the law, but that which comes through faith in Christ, the righteousness from God that depends on faith— that I may know him and the power of his resurrection, and may share his sufferings, becoming like him in his death, that by any means possible I may attain the resurrection from the dead. — Philippians 3

[This is an introduction to a series on becoming a Christian physician.]

No medical students were harmed in the taking of this photo.
This is an actual picture of me at 6AM sleeping during my surgery rotation as a medical student.
Do You Want to Be a Doctor?

Match Day: On Calling

Still have that letter (and even the envelope).
Still have that letter (and even the envelope).

Friday will be Match Day. On that day, thousands of medical students across the USA will be given a sealed envelope containing a description of where they will be going for residency. At noon, in every medical school, they will gather to simultaneously open those envelopes. These students have spent months applying and interviewing for various programs. Many will have spent hundreds of dollars and hours on applications, interview suits, travel expenses, and retail therapy in the pursuit of a place to give them the training necessary to become a board-certified physician. (For my own interviews, I drove up to Boston, flew out to Texas, and trekked from Detroit across half of Michigan in the span of a month, and my journey was considered less involved than most.) Nearly a month ago, these students submitted a final list of their programs in order of preference, and the same programs submitted a similarly ranked list of applicants. Over the past month, both sides have simply been waiting for a single, centralized computer system to work its way through an algorithm and literally assign applicants to programs.

It is radically different from applications to undergraduate, graduate, or even most professional schools, where the applicant (in the best scenario) is able to select from a variety of accepting programs and weigh offers and counter-offers. The Match is a singular, contractually binding decision, a mandate of sorts. There is no negotiation, no secondary option. As a student, when you open that envelope you learn your future and are committed to it whether it is your first, fourth, eighth, or last choice. Up until this moment, you have not been able to plan anything following it — housing, spouse requests for a job transfer, loan repayment programs — because you did not know where you would be assigned to. The only thing you knew was that, in three months, you would have to start a new job somewhere, doing something.

It is terrifying.

It has been two years since my own Match, but I still have pictures of that day pinned to my wall, photographs of a detached composure that belied the intense nervousness and anxiety I felt. There have been few instances in my life where so much of my immediate future was distilled into a single moment of revelation, and even now I shiver at the thought of future times when I will encounter similarly radical change.

A pregnancy test, a biopsy result, a phone call, a voice in the waiting room… I have often been on the side delivering the news, occupying that gut-wrenching position where I am about to speak news that will forever change a person’s life: you are pregnant, she has Huntington’s, it is cancer, she is gone, he is dead. These are dramatic moments, and often I find that I have only a few more moments than the patient or family during which to compose myself. I need those moments because, in virtually every instance, I have far less power to change the outcome than patients or family members would like to believe.

The third time he said to him, “Simon son of John, do you love me?”

Peter was hurt because Jesus asked him the third time, “Do you love me?” He said, “Lord, you know all things; you know that I love you.”

Jesus said, “Feed my sheep. Very truly I tell you, when you were younger you dressed yourself and went where you wanted; but when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.” Jesus said this to indicate the kind of death by which Peter would glorify God. Then he said to him, “Follow me!” — John 21

Match Day is typically a joyful experience. Most of my colleagues, including myself, were assigned to their top three choices. I was ecstatic and ebullient. But I also knew of other students, friends of mine, who quietly slipped into another room to weep in frustration, intensely disappointed that their years of hard labor did not earn them the opportunities they longed for so desperately. Many of them have come to enjoy and love the positions that they are in now, but there are few things in life as bitter as disappointment and the confirmation of fear and insecurity.

When we talk about calling, in the vocational sense, in the day-to-day realities of life, we often assume that it is a situation over which we will have some degree of election and control. But in many cases, perhaps the most meaningful ones, it will be a condition in which we will be led where we do not want to go. And yet we are still urged, still called to hear the voice of Jesus who says, “Follow me!”

In this Lenten season, let us reflect on the Jesus Christ who was led where He did not want to go, who was obedient to a calling to suffering, humiliation, and death. Let us imitate that obedience, not because of what we can gain and not despite what we fear, but because we love and because He first loved us.

What, then, shall we say in response to these things? If God is for us, who can be against us? He who did not spare his own Son, but gave him up for us all—how will he not also, along with him, graciously give us all things? Who will bring any charge against those whom God has chosen? It is God who justifies. Who then is the one who condemns? No one. Christ Jesus who died—more than that, who was raised to life—is at the right hand of God and is also interceding for us. Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword? As it is written:

“For your sake we face death all day long;
we are considered as sheep to be slaughtered.”

No, in all these things we are more than conquerors through him who loved us. For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord. — Romans 8

To all my colleagues matching then, to all those awaiting decisions that may lead them some place new: Godspeed.

Match Day: On Calling

Selection Bias: Statistical Integrity in Christian Community

Originally a guest post for the Emerging Scholars Network (a ministry of Intervarsity Christian Fellowship):

One day a num­ber of con­cerned moth­ers met with the min­is­ter to express their frus­tra­tion and anger over the unseemly con­duct of a par­tic­u­lar boy in Sun­day School. They did not want their chil­dren exposed to this child and feared what he rep­re­sented. For it seemed that this boy was mod­el­ing “bad behav­ior” – ver­bal out­bursts that some­times involved pro­fan­ity, a lack of sen­si­tiv­ity to other children’s per­sonal space (occa­sion­ally bit­ing them when irri­tated or pro­voked) and an unpre­dictably vio­lent imag­i­na­tion when play­ing with toys. No Sun­day school is equipped to han­dle prob­lems of this mag­ni­tude. So upon express­ing their indig­na­tion, the moth­ers requested that the min­is­ter call the child’s par­ents and ask that he not return to Sun­day school. Obvi­ously, there were fam­ily issues that needed seri­ous and imme­di­ate attention.

The “prob­lem child” was ours. My wife received the call early one morn­ing. The min­is­ter was deeply apolo­getic and pas­toral in his approach. But the dam­age had been done. What were we to do? Where could we go? Over the years, we had been through behav­ioral pro­grams, fam­ily coun­sel­ing, and psy­chi­atric care. At this point, we were just begin­ning to come to terms with our son’s recent diag­no­sis: Tourette’s syn­drome. Later, he would also be diag­nosed with Asperger’s syn­drome, bipo­lar dis­or­der, and obsessive-compulsive dis­or­der. But at this point he was about seven years old, and we knew only of the Tourette’s. We stopped attend­ing this church. In fact, we stopped attend­ing church alto­gether. — Thomas E. Reynolds, Vul­ner­a­ble Com­mu­nity: A The­ol­ogy of Dis­abil­ity and Hospitality

Engineering does not often apply directly to faith, but one method that has transformed the way I view community is a commitment to statistical honesty. In reading papers and critiques of clinical trials, one thing that comes up repeatedly is the question, “Is the community they engaged in this trial one that is diverse? Does it represent society in general? Can it translate into meaningful implications for the people I treat? Or were these participants selected in a biased way to favor a certain outcome? Is there a skew that limits how we may interpret and understand the world?”

One day it struck me to think about my own community with a similar critique. If I took a random sample of my friends from work, my neighborhood, and my church, would it look like it was truly random? Would there be an overrepresentation of certain types of people or a paucity in others? Would that statistical bias be a reflection of intentionality or a revelation in exclusivity?

I did a brief mental estimation and was not happy with the results. It is my natural human tendency to surround myself with others who think like me, talk like me, and act like me. What I have been grateful for in the work of medicine is being forced into contact with those who are very different from me, those whom, I am ashamed to say, I would not ordinarily choose as neighbors, associates, or friends. Through this means of grace, in the past year alone I have encountered former drug dealers and drug addicts, millionaires and mansion owners, wheelchair riders and deaf academics, judges and janitors, Holocaust survivors and pedophiles, saints and sinners. Though my coworkers (and myself) have often varied in expressions of compassion, we were obligated by both law and ethic to work with them in seeking their greatest benefit.

And so I found myself wondering, “Who is my neighbor? And have I shaped the courses of my encounters, friendships, and associations to suit their needs or my own?” I found that I did not like the answer: that my friends were mainly from certain ethnic groups, certain socioeconomic demographics, certain intellectual capacities and predispositions, certain persuasions of personality and even certain sects of faith. I had groomed and self-selected myself into becoming a statistical outlier in ways incompatible with the gospel, and it grieved me to think of those I had hurt in my exclusivity.

In this season of Lent, it is both sobering and encouraging to consider Christ’s disabled state, the divinity of he whose statistical cross-section of acquaintances included fishermen and Pharisees, tax collectors and political zealots, Samaritans and the blind, lepers and the governor’s wife, Centurions and servants:

Who, being in very nature God,
did not con­sider equal­ity with God some­thing to be grasped,
but made him­self nothing,
tak­ing the very nature of a servant,
being made in human likeness.
And being found in appear­ance as a man,
he hum­bled himself
and became obe­di­ent to death—
even death on a cross!
Philip­pi­ans 2:6–8

Selection Bias: Statistical Integrity in Christian Community

Never Normal

Shootings/homicide in the past year.
Shootings/homicide in the past year.

I got up before the alarm yesterday even though my sleep was fitful and restless. Though it was hard for me to know for sure, I was fairly certain that a series of gunshots had woken me up in the middle of the night, and that what had followed was a series of nightmares about more violence, break-ins, muggings, and deaths, including my own. I won’t lie; despite the victorious tone of the last entry here, I’ve been pretty anxious this past week. Every time I open my door or hear a creak in the floorboards or listen to the mice (or something else) scuttling around, I say another prayer, sing another verse of “God of Angel Armies,” and try to move on.

One of my bookmarked webpages is a running description of violent crime in the city. Of course, today I read about this incident:

Feb. 4, 2013, around 12:52 p.m.: Police responding to reports of a shooting found a 29-year-old man with a gunshot wound to his chest.

Two men wearing all black and masks entered the victim’s home and attempted to steal items. When the victim confronted the suspects, one of them shot him and fled southbound on ______.

This is perhaps 5 blocks away from where I live, and happened to someone the same age as me. Perhaps it could have been me. Perhaps that is why I was so disturbed in my spirit the night before; I have found, more out of necessity than out of a sense of piety, that I have become much more prayerful. I am grateful for that.

As I drove home last night, I was on the phone with my parents trying to describe last week’s incident in a little more detail. I drove down the street and was tempted to park around back, far removed from the scene I was verbally describing. But I am glad to say that I parked in the same spot, got out of the car, and was blessed to see a friendly neighbor. We sat in my kitchen and had a great chat over some popcorn and fresh asian pears I had managed to get over the weekend. I told him how glad I was to have him as a neighbor, and how happy I was to have moved in. And I meant every word.

Every day, I find more and more people who will teach me what it is like to live in the city. Yesterday it was a medical assistant in the office, whom I also ran into at a local convenience store. We talked about the development of the city over the past decade, about the police officer who was shot in the face the day before, about her life growing up with a brother who was shot and paralyzed from the waist down, then later shot again and finally murdered by the same people who didn’t think paralysis was punishment enough. Last week the conversation topic was a 16 year old boy who was shot in the head, murdered in a drive-by shooting for supposedly “snitching.”

I have only been here for half a year, but I can feel my soul beginning to ache from the gravity of perpetual violence. Contrary to popular opinion, it is never something one “just gets used to.” I didn’t understand what this all meant at first, but a good friend of mine, who also lives in the city and works with the children here on a daily basis, wrote this in her blog:

“On half of your paper, use the watercolors to paint something that you are afraid of or makes you angry.

On the other half paint something that gives you hope.”

If given these instructions in a suburban after-school program, I wonder what the response would be. Maybe it would be the same. I don’t know for sure.

But I can tell you the theme for my kids as they shared in front of each other.

Guns and the men that hold the guns.

“Because the people feel like they have so much power when they hold them.”

Guns.

“Because I don’t want to die before it’s my time.” Answers a third grader.

And what gives you hope?

Family.

God.

Jesus.

“Why?” Kiera asks.

“Because he made us and he died for us.”

And I don’t know whether they actually believe it or not. That’s not for me to judge. But I can tell you one thing. I don’t see much use in hoping in anything else. People, the government, religion…it all amounts to nothing in the wake of real tragedy. If Jesus isn’t real. If hope isn’t alive in His resurrection, forgiveness of sin, reconciliation between us and our Father.…then, I sure don’t see much hope in anything.

I can’t imagine what it would’ve been like to grow up in a place where I feared gunshots. Each day a couple of kids ask me to walk them home. “we’re scared.” “it’s too dark.”

Oh God, I can’t give them anything but You. And I wouldn’t want to. College, education, all of the money in the world, living in the suburbs…it’d all be false security. So, Jesus, above all, I pray that they’ll know You. And yes, Jesus, please protect these little ones. May they find peace in You.

There’s power in Your Name, Lord Jesus. And it’s in that power that I trust my friends. Let me serve where I can serve, wait when I need to wait, trust when I need to trust, be still when I need to be still, suffer when I need to suffer, and help me in my unbelief.

Our next series on violence, specifically gun violence, will feature more stories from her blog (which I really encourage you to read and support! She was the one who introduced me to the inner city and the people I now live with.) In the heated national debate on constitutionality, guns, and violence, there is much talk about liberty, defense, and rights. But there is little talk about the laying down of our entitlements, of redemption through suffering, of the knowledge and exaltation of Jesus Christ. And yet, what else can we hope for in this world of terrors? From where else will we derive our joy?

But whatever was to my profit I now consider loss for the sake of Christ. What is more, I consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord, for whose sake I have lost all things. I consider them rubbish, that I may gain Christ and be found in him, not having a righteousness of my own that comes from the law, but that which is through faith in Christ—the righteousness that comes from God and is by faith. I want to know Christ and the power of his resurrection and the fellowship of sharing in his sufferings, becoming like him in his death, and so, somehow, to attain to the resurrection from the dead. — Philippians 3

Never Normal

Entitlement

One of the most difficult things I’ve struggled with since moving here has been a sense of entitlement. That word is not one I ever hear from those living here, mainly because it’s never used in a positive context. It is typically in reference to “handouts to the poor” and finds its anchoring in food stamps and other poverty-related imagery, even though the largest entitlement programs in the US are Medicare and Social Security (which merit the name simply because they are guaranteed payouts/benefits from the government, even if they are drawn from money you put in previously through your paycheck). I hear it mainly from politicians these days, people who want you to believe that such handouts are not only unmerited but expected. It is meant to inspire you with a sense of injustice: that there are deserving victims and undeserving freeloaders, there are hardworking benefactors that just need a hand and lazy ingrates who not only feed off the system but feel that the benefit is owed to them. I don’t mean to be politically one-sided, but it is impossible to ignore a statement like Mitt Romney’s, who put it starkly and bluntly:

There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it. That that’s an entitlement. And the government should give it to them. And they will vote for this president no matter what … he starts off with a huge number. These are people who pay no income tax. Forty-seven percent of Americans pay no income tax.… I mean that’s what they sell every four years. And so my job is not to worry about those people. I’ll never convince them they should take personal responsibility and care for their lives.

In watching the video, you can hear the disgust that permeates that single word, “entitlement.” It is not a pretty word, mainly because it is not meant to be. For some reason (perhaps many reasons), it is important to distinguish between those who are deserving and who are undeserving, those who have earned a right or entitlement and those who have not.

But this is not what I mean in struggling with entitlement. It is not a problem with “them”; it is a problem with me.

It was difficult to describe at first, these twinges of irritation, cramps in the soul. It would be a missed compliment I had been expecting to receive, perhaps triggered by a generous and sacrificial action on my part that went underrecognized and underappreciated. Or it would be a moment of temptation to slip a reference to my educational pedigree into the conversation, how unusual and awkward I felt in a community “so different from the one I grew up in.” I still can’t describe exactly what it was I felt entitled to, but it was probably a number of things: a pat on the back, gratitude, respect, change. I guess I wanted to fit in enough to be accepted, but stick out enough to be exalted. And phrasing all this so bluntly sounds terribly egotistical and obnoxious, but it is what I struggle with, and I describe it because perhaps you struggle with it too. There is a neediness deep inside me for what I subconsciously believe is the rightful recompense for my efforts. Some days it is just the right to be thanked, to a quiet home at night, or to working heat in the house. Other days, it is the right to have my desires fulfilled, to be praised, to see positive results in my work.

But in reality, I deserve none of these things. My sentiments of entitlement run deep, but they run foul.

You say, ‘I am rich; I have acquired wealth and do not need a thing.’ But you do not realize that you are wretched, pitiful, poor, blind and naked. I counsel you to buy from me gold refined in the fire, so you can become rich; and white clothes to wear, so you can cover your shameful nakedness; and salve to put on your eyes, so you can see.

Those whom I love I rebuke and discipline. So be earnest, and repent. Here I am! I stand at the door and knock. If anyone hears my voice and opens the door, I will come in and eat with him, and he with me. — Revelation 3

The true reality of our human condition is that we are all impoverished, that there is nothing that we deserve or have earned by personal right or vigilance. We are fools to think otherwise. Politics gets it all wrong; it is not that 47% feel entitled, or that 99% are disenfranchised or that 1% hoard the wealth. We are 100% impoverished in demographic, in spirit, and in human condition.

Who will liberate me? How am I freed from this body of death? In Jesus Christ, we find the secret to contentment, the effacement of entitlement. Through the willing and intentional identification with Christ and his suffering, I choose to allow the revelation of the selfish and human-centered desires of my heart and through that twinge of self-righteousness and entitlement, understand the audacity and magnitude of the self-emptying suffering of Jesus Christ.

But whatever was to my profit I now consider loss for the sake of Christ. What is more, I consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord, for whose sake I have lost all things. I consider them rubbish, that I may gain Christ and be found in him, not having a righteousness of my own that comes from the law, but that which is through faith in Christ—the righteousness that comes from God and is by faith. I want to know Christ and the power of his resurrection and the fellowship of sharing in his sufferings, becoming like him in his death, and so, somehow, to attain to the resurrection from the dead. — Philippians 3

Entitlement

Humbler Yet

We were sitting around the peeled and cracking table, chatting late into the night. It has become a common occurrence in our small dining room to see an eclectic mix of people perched on different pieces of our patchwork furniture, trading stories and snippets about what it means to believe in God and live out our faith. One of my roommates is an introspective, easy-going South Londoner from the UK. I am an Asian-American suburbanite from Jersey. We are like twins.

K, who joined us that evening, is a vibrant, athletic young man whose most consistent quality is his fervent preaching. “Praise God,” and “Amen” are the most common words to come out of his mouth, and he always says them with an accent of soul and joy. I envy his fluent spirituality, the way his words and life seem to drip with the grace of God. Perhaps some of that jealousy comes from how I struggle to believe, how I tend to brood and obsess over areas of ambiguity and doubt. I have always had trouble believing that people who talked like K, who used praise as punctuation, could really have an honest and meticulous faith. Do such people fully understand the accolades and aphorisms that slip out so freely? Do they know how much hesitation and insecurity they inspire in those of us who struggle with unbelief? But it was hard not to believe him and in his warmness and openness, to hope his friendship could inspire me in the same kind of ways.

So I shared about my day. I had just come back from a personal finance lecture of sorts, intended for young physicians in training. My mind was spinning with numbers and phrases about disability insurance, return of investments, retirement planning, and the thematic concept that I could, that I would one day make money and a career as a doctor. And so I told them what I was thinking, that I didn’t really want to make money, that it was hard for my peers and colleagues to understand why I would live in this neighborhood, that I was happy to give up wealth and prestige and security in exchange for conversations like these, for the friends and gospel-centered community here, and that I wouldn’t want to go back. And deep down inside, I knew that I wanted to impress them, mainly because I was already impressed with myself.

K was quiet for a moment. “Yeah,” he said. “I would never want to go back to my old life.” And then he told me his story. He told me how he used to be “one of those guys” out there. He told me how he used run around with them, how he got high and was gravitating more and more towards the underworld of drugs and violence, how he was hurt by people he thought were friends but just used him for one thing or another. He spoke in uncharacteristically muted tones, as if moving through a dream.

My roommate, who has lived on this block for years, calls them “the walking dead.” He tells me how this stretch of the city earned the nickname, “The Bucket” because no one ever escapes the cycle of violence and hopelessness. He tells me how it was more recently named “Iraq” because of the rapid rise in shootings. He tells me that the kids can’t make it out to the after school programs cause they’re afraid of the violence, of the teenagers who make daily choices between working seven dollars an hour at McDonald’s or working a single drug run for hundreds of dollars and more.

K looked at us and said, “I would rather die than go back to that life.” He paused, and said it again. “If they came to my house, and dragged me and put a gun to my head making me do it, I would rather die.” He spoke more forcefully. “But you know what? You don’t have to be afraid of them. What have you got to fear? They should be afraid of you. Why? Cause you got LIFE. What compares to that?

And it started making sense to me. There was some meaning in the places that we came from, either as a self-satisfied child of privilege or as a hardened survivor of the street. But there was more meaning in what we were saying and where we were going. That meaning was the source of our courage, however small, and the force of our joy, now intensified. Through Jesus Christ, who became humbler yet, we have access to a new world in which the sacrifice of old ways and fears and insecurities is really our liberation into that which is irresistibly divine, that wellspring in which we find our commonality, affection, and life.

So if there is any encouragement in Christ, any comfort from love, any participation in the Spirit, any affection and sympathy, complete my joy by being of the same mind, having the same love, being in full accord and of one mind. Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others. Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. Therefore God has highly exalted him and bestowed on him the name that is above every name, so that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father. — Philippians 2:1–11

Humbler Yet