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

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

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.”


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

And what gives you hope?




“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

Part 2: On Hope

After a brutal series of Christmas shifts in the ER, I had finally come home for the holidays. My mother and I were in the kitchen, talking like we used to. We had seen and loved the new Les Miserables film, and so I brought up an interesting question from an interview with Samantha Barks, who played Eponine:

Interviewer: I think aside from “I Dreamed a Dream”, “On My Own” is probably one of the most loved songs of the musical, and I think it’s fascinating that the two most recognized and loved are just the two most heartbreaking songs, so what does it say about us as an audience that the songs that we connect with are the most heartbreaking songs?

My mother was quiet as she thought about it. “I think,” she said, “that it is something we all share in common. We all suffer, and know what it means to lose a dream or to be disappointed. We all know how it feels.”

In those moments, I was reminded of how much of her life and our family history was filled with a tragedy not too different from that of Les Miserables. Half of our family tree was missing or unknown, scattered and wiped out during the Communist revolution in China. My grandparents’ histories were characterized by their flight from the war: watching massacres of schoolmates while hiding in the bushes, stepping on dead bodies to avoid landmines, being trafficked via hay carts and ships in order to seek refuge in Taiwan. My parents grew up in the grinding poverty of the rural villages there, their childhood overshadowed by the threat of imminent war, their education grimly driven by the hope of an opportunity to emigrate to the US so that they could form a family here… so that their future children — meaning I — could have a better life.

Without knowing my thoughts, my mother spoke again. “I really like that song from the carriage… where he has the little girl sleeping in his lap and realizes that everything is different now he has a child.” She paused. “You know, everything is different when there is a child. Your whole world changes.” Suddenly, I remembered a day from medical school that struck me the same way:

She wouldn’t stop crying, so I picked her up before realizing that the diaper was wet. The sun was setting and the room was dim and quiet, disturbed only by the peripheral noises of the hospital hallway and the sound of her distress. I gingerly held her up, setting her flat on the bed, and watched her arms wave from side to side as I puzzled over how to change my first diaper.

“Hey,” I whispered. “Stop crying.” She didn’t listen and I spent a few moments fumbling with the pacifier before sitting down in the rocking chair, swinging back and forth easily with the infant cradled in my arms. A plastic music box hanging on the edge of the crib’s stainless-steel safety bars began playing a lullaby. We rocked and swayed, rustling quietly in the dusky shadows of twilight. It was as if the hospital, that crazy world of light and noise and pain and angst, had rumbled off into the distance and lazily forgot to bother us for now.

… I couldn’t recall the details, save the small fact that we were now responsible for her. We, meaning the hospital and the State of New Jersey, who were granted temporary custody as the parents were “currently indisposed of for the time being.” I thought about all the other rooms on the pediatric floor, each of which held two beds: one for the patient and one for the caretaker. Each room had its own guardian: an anxious mother or grandparent or cousin or other relative. Each room except this one.

I remembered the words of a nurse who stood by the bed at rounds, updating us on the baby’s condition. “She’s doing well,” the nurse reported, thoroughly distracted by the baby. The team continued talking about the details of custody and social work while the nurse remained preoccupied. She cooed at the baby. “Hey,” she said quietly, gently caressing the swaddling clothes: “It’s going to be a tough world out there.”

… And so we rocked, back and forth, and I thought and thought. Did she know how alone she was? What kind of person would she become? Who would rise up to defend her weakness, her frailty and vulnerability? If she met me in ten, twenty, thirty years from now, would she still let me hold her in my arms? Why couldn’t I adopt her? How different will it be on the day I hold my own child? Unfamiliar feelings of affection, of unknown protection and helplessness swilled around inside of me, centered but unfocused on this loose bundle of warmed clothing and weak, spastic movements. I didn’t know how to feel or how to respond. I still don’t.

I couldn’t wait to write this stuff down, mainly because I didn’t know what to do with all these ambiguous thoughts. I only held her for a few minutes and yet it’s taken me two days to articulate what I’ve been feeling. Who will love her? Who will dream good dreams for her at night? Who will give her the first cherry ice pop, the first kiss on her scraped knee? Who will keep her safe in this world of terrors?


“I have had this all my life, and I am going to get wid of it!”

“Rid of it,” her therapist corrected.

“W-right.” She turned her head to grin at us, and I couldn’t stop smiling. We were all lying on exercise mats in the therapy rooms because, as the therapist taught us, we could use “gwavity” to help roll those “r’s” better. I was sure she was one of the therapist’s favorite patients: diligent, focused, and with a personality composed entirely of laughter and light. In less than fifteen minutes, through listening to her “chawming pwonun-sheation,” I had already named her as a favorite. Few of my little patients were as mature, knowledgeable, and thrillingly articulate at the dignified age of seven.

And in that moment, I thought about the Newtown massacre and the fact that there must have been precious little difference between any of those children and this young girl who was now sprinkling glitter on a craft snowman, that even the best and brightest of us still live in that same world of terrors.


My mother spoke again. “My favorite song is that one Jean Valjean prays, about bringing him home… it is such a beautiful prayer. He says, ‘You can take, you can give… If I die, let me die; let him live… bring him home.’”

We talked some more, then she said this: “Life is filled with such suffering, you know. There is so much sorrow… but there are moments when God saves.”

That night, I went to my old bedroom and pulled a stack of journals off the bookcase. They were etched on eight, nine, ten years ago with an illegible scrawl that reflected the tired and stress-filled times they were written in. I leafed through the many yellowed pages of thought-scratch, reliving those moments of anxiety and worry. So many of them were desperate calls to God about things I no longer remember now, reflecting crisis after crisis that seem trivial and inconsequential now. I wanted to laugh at the little boy, his deep insecurities and obsession with doubt and suffering, and say, “You haven’t seen anything yet.”

But I didn’t because I realized that even I, the same boy a decade later, am still immersed in my own world of sorrows, conflicts, despair, and cynicism. In the New Year, like every year, we are hopeful that the old wounds of our past will heal, that we can assume a new and a fresh start, that the world will be a better and brighter place… if not for us, then at least for our children, the icons of innocence and hope. But this belies the experiences of our own sordid history as humanity and as individual humans. Is our redemption progressive? Does anything ever change? Are our cries for salvation heard?

Henri Nouwen writes about this in his last book, Can You Drink the Cup?, scripted during his final years as minister at l’Arche Daybreak, a community of those with intellectual disabilities:

There is Tracy, completely paralyzed, but with a bright mind, always struggling to find ways to express her feelings and thoughts. There is Susanne, not only mentally disabled but also regularly battered by inner voices that she cannot control. There is Loretta, whose disability causes her to feel unwanted by family and friends and whose search for affection and affirmation throws her into moments of deep despair and depression. There are David, Francis, Patrick, Janice, Carol, Gordie, George, Patsy… each of them with a cup full of sorrow…

And for me things are not very different. After ten years of living with people with mental disabilities and their assistants, I have become deeply aware of my own sorrow-filled heart. There was a time when I said: “Next year I will finally have it together,” or “When I grow more mature these moments of inner darkness will go,” or “Age will diminish my emotional needs.” But now I know that my sorrows are mine and will not leave me. In fact I know they are very old and very deep sorrows, and that no amount of positive thinking or optimism will make them less. The adolescent struggle to find someone to love me is still there; unfulfilled needs for affirmation as a young adult remain alive in me. The deaths of my mother and many family members and friends during my later years cause me continual grief. Beyond all that, I experience deep sorrow that I have not become who I wanted to be, and that the God to whom I have prayed so much has not given me what I have most desired…

Whose cup is this? It is our cup, the cup of human suffering. For each of us our sorrows are deeply personal. For all of us our sorrows, too, are universal… Jesus, the man of sorrows, and we, the people of sorrow, hang there between heaven and earth, crying out, “God, our God, why have you forsaken us?”…

In his immense loneliness, he fell on his face and cried out: “My Father, if it is possible, let this cup pass me by” (Matthew 26:39). Jesus couldn’t face it. Too much pain to hold, too much suffering to embrace, too much agony to live through. He didn’t feel he could drink that cup filled to the brim with sorrows.

Why then could he still say yes? I can’t fully answer that question, except to say that beyond all the abandonment experienced in body and mind Jesus still had a spiritual bond with the one he called Abba. He possessed a trust beyond betrayal, a surrender beyond despair, a love beyond all fears. This intimacy beyond all human intimacies made it possible for Jesus to allow the request to let the cup pass him by become a prayer directed to the one who had called him “My Beloved.” Notwithstanding his anguish, that bond of love had not been broken. It couldn’t be felt in the body, nor thought through in the mind. But it was there, beyond all feelings and thoughts, and it maintained the communion underneath all disruptions. It was that spiritual sinew, that intimate communion with his Father, that made him hold on to the cup and pray: “My Father, let it be as you, not I, would have it” (Matthew 26:39).

Jesus didn’t throw the cup away in despair. No, he kept it in his hands, willing to drink it to the dregs. This was not a show of willpower, staunch determination, or great heroism. This was a deep spiritual yes to Abba, the lover of his wounded heart…

Our culture tends towards an inflexible sense of optimism and humanism. We are convinced that true joy and human actualization must come through the eradication of pain, suffering, and sorrow. It comes as little surprise then that we hide away the sick and suffering in hospitals and mental institutions and ghettoes, or that conversations about suffering are branded as cynical and faux pas (unless they revolve around the trivial). It is only logical that our perspective on hope is sentimental and, when brutally challenged by events like Newtown or other corruptions of innocence, easily susceptible to cynicism and despair.

In the person of Jesus Christ, whose entrance into the world was humble and threatened by scandal and violence, we are reminded that hope must be divine. It must derive itself from the external, the invisible, and the eternal if it is to pose any help to our intractable, superficial, and fickle humanity. It cannot be the mere absence or abolition of suffering; it must engage it, overcome it, transform it. It does not begin from a position of strength or intimidation; it starts with weakness so that it might express itself in desire and, through satisfaction, bring joy. It has no grounding in idealism, theory, or abstraction; it instead comes from the closeness, the sweetness, and the affection of Jesus Christ, the incarnation of all we hope for and desire.

It is this recognition of Christ’s presence in the hardness of life that brings us liberty and enables us to hope freely and challenge the darkness of cynicism, unburdened by the restrictions of sentimentality and its incongruity with reality. We can live and thrive in the darkest corners of the hospitals, nursing homes, mental institutions, funeral homes, labor camps, and ghettoes simply because Jesus says he lives and thrives there as well.

“Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.

“Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you?  When did we see you sick or in prison and go to visit you?’

“The King will reply, ‘I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’” — Jesus (Matthew 25)

For you did not receive a spirit that makes you a slave again to fear, but you received the Spirit of sonship. And by him we cry, “Abba, Father.”  The Spirit himself testifies with our spirit that we are God’s children.  Now if we are children, then we are heirs—heirs of God and co-heirs with Christ, if indeed we share in his sufferings in order that we may also share in his glory. — Romans 8

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

Genocide, massacre, poverty, disappointment, crucifixion, famine, nakedness, death, or sword; together with Christ, with the fellowship of suffering and the drinking of its cup to its dregs, we shall have our overcoming. Somehow, we shall attain.

Happy New Year.

Part 2: On Hope

Reasons [Reprise]

Note: Originally written several years ago.

My mom looks for Reasons the way some people look for spare change on the ground. She always has an eye out for them, an ear cocked to hear the faintest whisper of a consequence or a lesson. Most were simple illustrations of basic character: an irritating person was placed in my life to teach me patience; a flat tire the day after a stingy financial decision was a reminder to be more generous; an unexpected piece of good news was an example of God’s consistent goodness. Some links were easy to see and understand. Others were not.

I grew up listening to these narratives, and the concept of Reasons has left a permanent impression on my thinking. I suppose it is the way in which everyone learns to make sense of an otherwise haphazard world, how we maintain the hope to cope through difficult situations. But as I grew older, reason began to challenge the Reasons.

It started with the big questions. Were people really poor because they were lazy? Was HIV really God’s punishment to homosexuals? Was evolution really at odds with Christianity? And of course, the biggest of them all: is there a Reason for suffering?

For nearly each of these questions, I found the answer to be, “Perhaps, perhaps not.” We would go through endless cycles of arguments, some of which were very heated during which bitter words were exchanged. Sometimes I held on to prove a point, but I often found myself fighting out of sheer stubbornness and pride. I was challenging the Reasons because I began to doubt that there were any.

Madness and chaos. That was what disease seemed to me, the struggle between life and death in the hospital wards. Kind and generous patients suffered from horrific fates while those who were malingering and malicious fed off of the system’s generosity without punishment. The hospital was a new and disorienting place in which the old rules, the old Reasons no longer seemed to apply. Who lived and who died was less a function of morality as it was of biological processes, state variables, and an element of luck. In a world where so much was at stake, only the new reasons, the Evidence of hard data and tight correlations mattered. Even basic assumptions about standards of care were challenged and occasionally overthrown by the latest and greatest studies, and many reasonable, long-standing associations between health and disease disintegrated under closer scrutiny.

My own shift in perspective was subtle at first, and I wasn’t able to articulate my discomfort with it until one of my friends began using “evidence based arguments” for everything. He would launch into a political discussion with others and pepper them with the question, “Where’s your reference? Show me the study.” It was an irritating thing for him to do in the context of otherwise casual conversation, but the inflammatory nature came from the realization that most of what we say on a daily basis is complete bullshit. We speculate and make conclusions based on very little evidence because that is how we must deal with the complexities of daily life, but if we truly realized how uneducated and sporadic those decisions were, we would lose the confidence to make it from one moment to the next.

Something in me hardened. My faith in God, the Ultimate Reason, which had once been so strong began to settle for lesser things. God may count the hairs on your head, but I can tell you now that it will be exactly zero once your chemotherapy is started. You can pray for a miracle, but if we don’t amputate that leg tomorrow you might lose your life. Praying is good, but praying 20 hours outside in the snow is not; please restart your bipolar medications or we won’t let you out of here.

And so prayer, something I once loved to do, became more an act of desperation and a superstition than one of faith. I didn’t know what to pray for, mainly because I was tired of being disappointed. I began knocking on wood and crossing my fingers because they seemed to be just as effective: barely, if at all. I was tired of bullshitting and really just wanted to admit: I don’t know I don’t know I don’t know.

Finally, at the end of a long year, this illness knocked me out long enough to mull it over in my mind. True to form, my mother insisted that there was a Reason behind my lung collapse; the timing, the method, the stresses I was going through were all too coincidental to be due to anything else. And we talked, perhaps for the first time, about what it meant to use reasons and to look for Reasons. It reminded me of the Tower of Siloam:

There were some present at that very time who told him about the Galileans whose blood Pilate had mingled with their sacrifices. And he answered them, “Do you think that these Galileans were worse sinners than all the other Galileans, because they suffered in this way? No, I tell you; but unless you repent, you will all likewise perish. Or those eighteen on whom the tower in Siloam fell and killed them: do you think that they were worse offenders than all the others who lived in Jerusalem? No, I tell you; but unless you repent, you will all likewise perish.” — Luke 13

Whenever I talk at length about the nature of suffering, I mention an example a mentor once used. Suffering is just the push that tips a cup over; it has no bearing on what comes out. This is what I have come to believe about suffering, illness, death, and all Events with consequences for which we seek a Reason: they reveal what is inside me, deep down inside that refuses to come out otherwise. I may have no control over my environment or the insanity of this small earth we inhabit, but there is always something in me that I can ask to have transformed:

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect. — Romans 12

Perhaps, in this way, I may attain to the resurrection of the dead.

Reasons [Reprise]

I didn’t think about that

People wonder why I have such an

unhealthy obsession with

human suffering and frailty,

as if there were some other mystery,

some other unfathomable principle in the universe

more puzzling, infuriating, and crucial

to the human experience.

“Tell me,” I ask,

with some trace of smugness,

“What drives the human spirit more,

reaches out to the heart of the divine

and the depths of hell,

what creates a more genuine sentiment

than the paradox of pain?”

And how can one word be more disarming,

more flabbergasting to all the carefully

worded philosophical rhetoric of my life

than this:



Somehow, I never imagined that the pursuit

of one could lead to the other in such

a profound,






“Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.” — James 1

I didn’t think about that

Roasting Pan

In the middle of Target is not the sort of place

I would expect to receive bad news.

The extra twenty dollars I saved by finding

my coveted piece of cookware there instead of

at Macy’s thirty minutes ago seemed somewhat

trite by comparison, and I did what I could to

smile and talk about the weekend weather instead.

It wasn’t as if I hadn’t lost patients before,

hadn’t watched a soul depart or told a family,

“I’m sorry,” in that hesitant, sonorous tone.

So I wasn’t sure why hearing about this one

felt so different and filled me with such disbelief,

as if someone had used my new roasting pan

to beat me in the face and then catch the

dripping blood from my nose while telling me it

wasn’t actually anodized aluminum,

wasn’t even worth the forty-two dollars

and eighty-nine cents I paid for it

with the money I earned while thinking I saved

a certain patient’s life.

Roasting Pan

Rituals of Annotation

I am not exactly sure of what prompted me to do it, but I began keeping a tally of all the pronouncements I have done. I never really knew this before, but pronouncements are done in a remarkably simple and impersonal way. Most patients who die in the hospital do not go with a bang but with a whimper. While some situations involve spectacular theatrics involving beeping monitors, charged paddles, and the cracking of cartilage from chest compressions, most patients die with a quiet, gasping sigh. I am still not sure which is more unnerving, but the former is what we typically imagine or see on TV during a pronouncement: a sweaty and distraught doctor ripping off latex gloves in frustration and listlessly intoning, “Time of death…”

What usually happens, however, is that the person will expectedly but spontaneously expire. Death is typically spotted from a fair distance and in most cases the family is cognizant of this. Sometimes hospice arrangements are made and the patient goes home to die surrounded by family and friends. Sometimes a volunteer in the hospital will keep a death vigil of sorts, sitting in a chair while reading a book or watching TV to pass the time as they wait to fulfill a promise “not to let anyone die alone.” Sometimes a nurse will make the rounds and discover that the patient is simply dead. It happens at all hours and in most floors of the hospital. Regardless, whenever the death is discovered a page is put out to whichever resident is on call to come by and make the official pronouncement, even though everyone already knows the truth.

This means that I usually know nothing about the patient or the family. I have to make an effort to commit the name and overall disposition of the patient to heart long enough to speak with the family and request their permission to grant or deny an autopsy. It typically takes thirty seconds to do the examination and less than thirty minutes to speak to everyone and document everything I need to before moving on to other things.

My little tally is nothing fancy, nothing more than a series of hatch marks in a small booklet of mundane medical information tucked into my white coat. So far, there have been five marks in two weeks. I can hardly remember the patients at all, much less their names or even what they died from.

But I remember the families. I remember the different reactions of different people, some joking and laughing about the whole affair, some quietly sniffling in a brother or a sister’s shoulder. I remember their words, which are often filled with appreciation and deep respect for everything that has been done for this house of memories. And I feel unworthy and deeply unsettled because I had no part in it… in fact, I never knew the patient, because the only reason I came into contact with him or her at all was because there was only an it left.

If the family was particularly effusive, I will write a little note of it in the chart: “No pulse, no audible heart beat; no corneal, pupillary, or gag reflexes. Family expresses deep appreciation for all staff.” And every single time, I am tempted to then write, “Kyrie eleison,” as has become my habit to say whenever I am otherwise speechless with sorrow. But not all the patient’s family members might appreciate that sort of addendum, so I say it to myself, place a little tick in my booklet, and move on.

To “pronounce” means to state, often with a degree of finality and certainty. But to me, it has also meant to describe and therein impart an element of meaning. Pronouncements have become a ritual of annotation, one that is suffused with meaning precisely because it is routine without being mundane. Small wonder that the closest I have come to intimacy with God in this heavily secularized profession have been in moments like these, where that which is ephemeral proceeds into the eternal.

Making a note of it is the least that I can do.

But someone may ask, “How are the dead raised? With what kind of body will they come?” How foolish! What you sow does not come to life unless it dies. When you sow, you do not plant the body that will be, but just a seed, perhaps of wheat or of something else. But God gives it a body as he has determined, and to each kind of seed he gives its own body…

So will it be with the resurrection of the dead. The body that is sown is perishable, it is raised imperishable; it is sown in dishonor, it is raised in glory; it is sown in weakness, it is raised in power; it is sown a natural body, it is raised a spiritual body.

I declare to you, brothers, that flesh and blood cannot inherit the kingdom of God, nor does the perishable inherit the imperishable. Listen, I tell you a mystery: We will not all sleep, but we will all be changed— in a flash, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, the dead will be raised imperishable, and we will be changed. For the perishable must clothe itself with the imperishable, and the mortal with immortality.

- 1 Corinthians 15 

Rituals of Annotation