Tag: faith

The Lord Thy Surgeon

Hamilton and Perfection

It has been a long time since the last blog post.  Thank you to one encouraging reader who said, “Are you still posting on your blog? I keep checking the website to see if a new one is up.” I’ve been so busy recently moving up into a leadership job at the hospital that I work at. Secondly, I feel an overwhelming sense of the need for perfection when writing.  At times, I feel paralyzed at writing the wrong thing or typing something that I won’t want on the internet FOREVER…

But I truly believe that we cannot be afraid of failure.  Failure is the beginning of new growth.  Failure is an opportunity for improvement. As Michael Jordan said, “”I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life.” Is he not considered one of the best of all-time at basketball? Failure allows us to see our needs in Christ.

Recently, I was in Chicago and had the opportunity to watch the Broadway show “Hamilton.” I think I had been spending more time thinking about how special our country is prior to going to the show but the forethought that the founding fathers had to keep the Union together is overwhelming and inspiring.  Can you imagine 13 “united” states trying to decide on a “Constitution” or agreement of how they would govern themselves together?  As Hamilton states in the first Federalist Paper, “The subject speaks its own importance; comprehending in its consequences nothing less than the existence of the UNION, the safety and welfare of the parts of which it is composed, the fate of an empire in many respects the most interesting in the world. It has been frequently remarked that it seems to have been reserved to the people of this country, by their conduct and example, to decide the important question, whether societies of men are really capable or not of establishing good government from reflection and choice, or whether they are forever destined to depend for their political constitutions on accident and force.”

Can men govern themselves? Can they reflect on the important questions and choose how their government would look rather than being pushed around by the forces around them?  After Jacob wrestled with God, God gave him the name Israel (Genesis 32:28). Israel means “God governed.” The people were under God’s government until they demanded their own government and chose King Saul.  It was downhill with Saul as the “people’s choice.” I’d argue that we’re in the same situation now.  If it were not for God holding this Union together, we’d have destroyed it already.

What amazes me so much about the founders is how they knew how bad men were.  Or at least they knew even good men could go bad.  Hamilton, in the first federalist paper, also says this, “So numerous indeed and so powerful are the causes which serve to give a false bias to the judgment, that we, upon many occasions, see wise and good men on the wrong as well as on the right side of questions of the first magnitude to society.” I truly believe that there are good men on both sides of the spectrum that are truly misguided.  And in the age of Twitter, the information just whizzes by us in such rapid fashion.  How could we possibly fact-check all the information that might “give a false bias to judgement”?  Perhaps some cooler heads might prevail in polarized political debates if we first see that we both want the best for our nation but have different ways of solving the problem.  I believe we frequently assume bad intentions of our neighbors rather than poor plans.  Are their motives really hateful or just misguided?

Finally, in closing his first Federalist paper, Hamilton writes, “I propose, in a series of papers, to discuss the following interesting particulars: THE UTILITY OF THE UNION TO YOUR POLITICAL PROSPERITY, THE INSUFFICIENCY OF THE PRESENT CONFEDERATION TO PRESERVE THAT UNION, THE NECESSITY OF A GOVERNMENT AT LEAST EQUALLY ENERGETIC WITH THE ONE PROPOSED, TO THE ATTAINMENT OF THIS OBJECT THE CONFORMITY OF THE PROPOSED CONSTITUTION TO THE TRUE PRINCIPLES OF REPUBLICAN GOVERNMENT, ITS ANALOGY TO YOUR OWN STATE CONSTITUTION and lastly, THE ADDITIONAL SECURITY WHICH ITS ADOPTION WILL AFFORD TO THE PRESERVATION OF THAT SPECIES OF GOVERNMENT, TO LIBERTY, AND TO PROPERTY.”

The pace of Hamilton and the Federalist papers was furious with 51 essays in not even a year. For me, perhaps the paralysis of trying to attain perfection will pass and the passion for posting will return. Perhaps, we’ll call it writing by faith about faith.  One other interesting observation from the Broadway play, Hamilton, was the reflection of Aaron Burr and his legacy.  (He did so much and basically, he is remembered only for shooting Hamilton.)  May God help us press on by faith to have a legacy of faith.

Therefore, I propose that I continue writing to show you the utility of union with Christ to your eternal prosperity, the insufficiency of the present confederation with the world to preserve yourself, the necessity of a relationship with Christ to the attainment of Life proposed in the Bible to true principles of God, its contrast to your own state of confusion, and lastly, the eternal security which your adoption as son will be to your preservation of liberty and prosperity under God. (Eph 2:8-9, Rom 3:23-28, Rom 8:31-39, Heb 7:25, Rom 5:10-11)

Grander RoundsThe Lord Thy Surgeon

Death: A Gateway to…

An aneurysm ruptures as an 85 y/o woman talks on the phone with her only relative, a niece, 150 miles away. She dies hours later in my Emergency Room. A 40 y/o woman and her 6 y/o child have their passenger side destroyed by a driver running a stoplight. They never make it from the scene.

At times, it seems as though I am (we are) surrounded by death. I joke with my staff and residents to ease the tension, “All of us are dying. Some of us just get moved to the front of the line.” Death is experienced by all of us. Sometimes we look in. Sometimes we endure the loss. Sometimes, we are up. All of us deal with it differently. We all fear the unknown.

My wife worries about something happening to me. Finishing my will seems morbid and is difficult to complete. Though important, I know that when the will is “executed” I will be dead. It is a plan for what I hope won’t happen, at least not any time soon. My parents are essentially my oldest relatives. One by one, my grandparents departed.

“I’m ready to meet my Jesus.” A few nights ago, I prayed with a patient for the first time in a long time. The words proceeded from my mouth jumbled and awkward. It was short and not so eloquent. “Watch over this child of God. Comfort her in her pain. Bring Mrs. H to be with you,” was the gist of it. I had just diagnosed Mrs. H with pancreatic cancer at age 89. She had been trying to get a CT scan for the past several weeks with insurance not approving it because certain tests had not been ordered yet. She showed up in the ED with worsening pain and looking for answers with her daughter. She seemed otherwise content but desiring to know why she continued to have persistent abdominal pain. A CT scan a few hours after her arrival delivered to me the answer, “Pancreatic mass concerning for pancreatic adenocarcinoma with severe dilation of the pancreatic duct.” This diagnosis hits me like a train. As we have been told in medical school and on our surgical rotations, “Don’t mess with the pancreas!” (Using slightly more colorful language typically.) I knew that this was likely a terminal diagnosis. For a 30 or 40 year old, it might be a diagnosis of struggle and a year or two of intense pain before the inevitable death. Or if extra lucky, a longer course with the constant fear of return of the cancer of the “Whipple procedure” (which again is one of the most intense surgeries one can have.) In the face of death, this 89 year old didn’t ask about surgery or how long she had to live or what chemo she could have. She didn’t even ask for more pain medication. After I had explained to her daughters about the mass, she succinctly said, “I’m ready to meet my Jesus.”

I’ve met death many times in my emergency room. Some people fear it fiercely and others, like the 89 y/o woman above, seem relieved. For the Christian, death is a departure. Physical death is the body releasing the soul to be with God. The early church fathers viewed death not as the endpoint but as the beginning. Paul states, “For I am already being poured out as an offering, and the time for me to depart is at hand. I have competed well; I have finished the race; I have kept the faith! Finally the crown of righteousness is reserved for me. The Lord, the righteous Judge, will award it to me in that day – and not to me only, but also to all who have set their affection on his appearing.” 2 Tim 4:6-8

Nearly 50 executed in a nightclub. Dozens shot in a theater. Schools seem unsafe. This year freshmen in high school will learn about 9/11 as history. I feel old(er).

For the atheist, death is “the end.” It is nothingness. What does the atheist have to say at your suffering and dying? Is death (and this life) not absurdity and meaningless? “I’m glad it’s you and not me.”

As Christians, do we not have a different outlook? What have we “to fear”? Christ conquered death. For the Christian, spiritual death is put to death by Christ. Spiritual death comes from the fall.   Christ, who knew no sin, took on the likeness of sinful flesh and was sinless. Hosea and Paul exclaim, “Where, O death, is your victory? Where, O death, is your sting?” 1 Cor 15:55

Our favorite comedians die of overdoses. 5000 abortions happen every day in America. Every day. A prominent and influential Christian writer is diagnosed with advanced stomach cancer. A 28 y/o is on hospice, dying of ovarian cancer. A toddler dies of methamphetamine overdose after he puts a filter paper in his mouth in a rat infested basement while his mother gets a pop with her boyfriend at the local gas station. At times, it seems like death is on every corner and takes the most innocent.

In my emergency room, there is no shortage of those suffering and dying. In some senses, we only prolong the inevitable. I think it would be a grim profession if this was all we did. There is hope. The only place I know of this hope is in Jesus. We fell away from God when we transgressed His Law. Only one command existed at the beginning, “Do not eat of the tree of the knowledge of good and evil or you will surely die.” We did. It has been separation ever since.   Spiritual death reigns over us. The consequence is physical death. HOWEVER, God gave His only Son. Christ died that we should LIVE. Death is not the end. Christ resurrected from the dead. Death is a gateway to eternity with God for all who believe in Jesus. Jesus is the Way, the Truth, and the Life. John 14:6

For the Christian, death is not to be feared. Death is a reunion with God. We will shed off this body of death and live with Him in eternity. This life is only the beginning. As Paul states, “For to me, living is Christ and dying is gain. Now if I am to go on living in the body, this will mean productive work for me, yet I don’t know which I prefer: I feel torn between the two, because I have a desire to depart and be with Christ, which is better by far, but it is more vital for your sake that I remain in the body.” Phil 1:22-24

The word “depart” is just like a ship leaving harbor. The journey is just beginning. May we have confidence that Christ paid the price that we may be united with Him. Christ is our forerunner. He has conquered death. We have nothing to fear about death. As my 89 y/o sister said, “I’m ready to meet my Jesus.”

Grander RoundsThe Lord Thy Surgeon

Where has the doctor-patient relationship gone?

“We used to treat patients. Now, we treat computers.”  Such is some of the frustration facing the 21st century doctor today.  In 2014, implementation of Electronic Health Records was mandated across the board in healthcare facilities in the United States.  This was done with the goodwilled hope that quality and efficiency would improve. Legible and easily transferable records would ultimately help the patient and decrease costs. Unfortunately, these systems have increased costs everywhere. Doctors are now less efficient because of tedious interfaces and the necessity of documenting unnecessary information.

One thing that has improved: monitoring… Now CMS can monitor doctors’ performance, and on the basis of what they’re [not] doing or documenting [in]correctly, decide their compensation.  It takes coders on both sides to determine the right codes to describe what the doctor did in order to bill correctly.  Entire degrees have been created just to become a medical coder.  What happened to the good ol’ days of seeing your doctor and just paying him what you could afford for your visit? Perhaps you could have bartered a goat or a chicken with your doctor.  Honestly, I can’t even tell you exactly what it costs to come see the doctor.  At our hospital, we have a 24 hour nurse (probably more than one) that is there just to determine whether your admission is “observation” status or “full admission” status.  Their daily job is to review the status of a patient’s admission because the hospital may be partially paid or forfeit payment if it is listed incorrectly. Have we really come so far that our job as healthcare workers is to make sure that we collect enough costs and document thoroughly so that we can keep our jobs?  I’m not against collecting money for services but it seems like we’ve lost the heart of what medicine is: The doctor-patient relationship.

Obstacles, barriers, curtains, walls.  These are what we have set between our doctors and the patient.  We have so many middlemen in the temple of healing now.  What occurred to me this week is that men are great at setting up barriers.  Our new emergency department (about 5 years old now) went to completely private rooms. There are 2 doors to enter the ED waiting area, 1 door to get to the back area of the ED, 1 door to get into the patient room, 1 door to get into the inner core of the ED pod, and 1 door still that can separate the doctor “fishbowl” from the inner core.  6 doors separate the doctor from the patient outside the hospital.  The suffering patient can be physically separated from the healer.  It is easy to see how, to the doctor, the patient could become just a name on a list in the computer, sitting in a room down the hall.  Even while in the room, the computer’s information may dominate the words coming out of the patient’s mouth or sound of their lungs in the stethoscope.  Is not being a doctor more than processing the data in a computer?  Why are politicians, bureaucrats, administrators, coders, and everybody else telling the doctor and the patient what their relationship should be? Yes, clinical decision aids are helpful in computers. Yes, legible data that is easily transmittable is good.  But have we forgotten what was basic to the healer-healed relationship?

I think the same is true in our spiritual lives.  We have forgotten the Doctor-patient relationship.  We have set up barriers to our worship and praise.  We have set up barriers in our relationship with God.  We do not want to be naked before our Creator.  We put doors between God and our transgressions.  We put gowns over our iniquities.  We put traditions and religiousness in place of intimacy.  But isn’t orthodoxy a good thing? The priests, pastors and congregation can then monitor our holiness!?… Is this the kind of relationship our Creator wants?

At first, it was from a distance. It was for our own good. The temple of Israel had regulations. God’s holiness was separated from us because He could not identify with our sinfulness.  Sin was utterly sinful and God completely Holy. To approach Him, certain steps had to be taken.  The entire book of Leviticus is filled with the regulations for worship in the temple.  Wash here, purify there, separate here, slay there, pour blood here, sanctify there.  Most importantly, separate the holy from that which is stained.  Keep them apart! In fact, “holy” means “set apart” or “to be sanctified.” How could He Who was Holiness identify with a fallen creation?  How could He possibly have a relationship with us?…It is because HE TORE DOWN THE BARRIER!

In Christ, God tore the curtain between man and Himself! (Mark 15:38, Luke 23:45, Matthew 27:51) God came in the flesh and suffered with us! He had compassion on us. Compassion is made of two words. “com-” or “con-” or “co-” prefixes meaning “together/with” and “pathos” meaning suffering.  “Path-ology” is the department we send diseased tissue.  It is “the study of suffering.”  It is He Who identified with our suffering. He suffered WITH us. He knew what the pain felt like. He was tempted in the same ways.  As Hebrews states, “For we do not have a high priest incapable of sympathizing with our weaknesses, but one who has been tempted in every way just as we are, yet without sin. Therefore let us confidently approach the throne of grace to receive mercy and find grace whenever we need help.” (Heb 4:15-16) Jesus was offered as the perfect offering to God so that we could have relationship with Him!  (Heb 9:11-25) This is the meaning of the communion.  It is the Thanksgiving offering. It is the Passover.  It is togetherness with Him.

Why do we set up these barriers? Why do we make excuses? Why do we not just turn to Him in our time of need? Why do we make everything a complicated procedure? Faith and trust is what He is looking for.  As Habakkuk says, “My righteous one will live by faith.” (Hab 2:4) And to David He said, “if My people who are called by My name will humble themselves, and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.” (2 Chr 7:14) In Hebrews it says, “But without faith it is impossible to please Him, for he who comes to God must believe that He is, and that He is a rewarder of those who diligently seek Him.” (Heb 10:6) And to Micah He says, “He has showed you, O man, what is good. And what does the LORD require of you? To act justly and to love mercy and to walk humbly with your God.” (Mic 6:8) Should we not walk closer with Him?

John explains our relationship with Him well. “Now this is the gospel message we have heard from Him and announce to you: God is light, and in Him there is no darkness at all. If we say we have fellowship with Him and yet keep on walking in the darkness, we are lying and not practicing the truth. But if we walk in the light as He Himself is in the light, we have fellowship with one another and the blood of Jesus His Son cleanses us from all sin. If we say we do not bear the guilt of sin, we are deceiving ourselves and the truth is not in us. But if we confess our sins, He is faithful and righteous, forgiving us our sins and cleansing us from all unrighteousness. If we say we have not sinned, we make Him a liar and His word is not in us. (My little children, I am writing these things to you so that you may not sin.) But if anyone does sin, we have an Advocate with the Father, Jesus Christ the righteous One, and He Himself is the atoning sacrifice for our sins, and not only for our sins but also for the whole world.” (1 John 1:5-2:2)

Why do we continually set up barriers between the doctor and the patient? Why do we set up barriers between the Lord thy Surgeon and ourselves? A doctor must take a history and do a physical examination.  It requires talking with and touching the patient.  As doctors, we use light to see where the problem is.  It is hard to see exactly what the disease is without being in the room.  I cannot tell you if you need stitches if you don’t show me your laceration. So why is it we do not want to come into His light to show Him where our problem is? Our sin is painful. We are ashamed of it. It is the part of us that is ugly and deformed.  But the Surgeon has the healing we need if this sin is exposed to Him. He provides the sin covering in the blood of Christ  He provides the healing in the body of Christ.

Computers and technology are not bad. Orthodoxy is not bad.  The temple was not bad.  The temple was complicated.  So, let us (as doctors) get back to listening to the patient and examining them and identifying the problem. Let us stop treating computers and and go back treating to the patient. As patients, let us seek a doctor that listens to our problem and examines our iniquities. As patients, let us seek the Surgeon in prayer and seek His Word.  Let us seek the intimacy that He wants.  Let us go by boldly to the throne of grace. (Heb 4:16) Let us restore the Doctor-patient relationship by communion with Him.  It was God Himself Who established Doctor-patient relationship when He tore the veil on Calvary. (Mat 27:51)  It is God who is our Healer. He is the Lord thy Surgeon.

 

The Lord Thy Surgeon

The Lord Thy Surgeon

 

“If ye will hearken unto the voice of the Lord your God, and will do that which is right in his sight and will give an ear unto his commandments, and keep all his ordinances: then I will put none of this diseases upon thee which I brought upon the Egyptians: for I am the Lord thy surgeon.” Exodus 15:26, Tyndale Old Testament 1530.

Have we forgotten “His story”? Has the medical technology of today blinded us to our real purpose as doctors? Has medicine found the root of man’s continued self-destruction and self-rot? Does life have intrinsic value? What is the purpose of medicine if the life’s end is inevitable?

This site is dedicated to seeking understanding with faith as the starting point. Its purpose is to glorify and praise Our Creator who is truly Our Surgeon. Pain and suffering tells us that there is a problem. Pain is a symptom of a deeper cause; a malfunction within. Tyndale, the first translator of the Bible into modern English, put down the words, “the Lord thy surgeon” for Exodus 15:26. In today’s texts, we frequently find “healer” or “the Lord who heals you.” A surgeon works inside of the body to cut out tumors, to open vessels, to stop hemorrhage, and to replace missing/defective parts. It is a sinful heart problem that man faces. Man tries to put salves and lotions on the problem; or worse he buries it under opiates, alcohol, and sedatives.

We are constantly searching for the next 12-step program, cure-all medication, or revolutionary procedure. Perhaps, instead of searching for our own cure, we need to lie down by faith on the surgical table and let the Surgeon go to the hidden places to excise our sin and graft in His faith. (Romans 3:20-24) The disease, chaos, and pain that exist in our lives are only the symptoms of our sinful nature. As Malcolm Muggeridge states, “The depravity of man is at once the most empirically verifiable reality but at the same time the most intellectually resisted fact.” It is only through the healing found in the resurrection of Christ that we are able to have a relationship with God. God’s only begotten Son came and identified Himself with our humanity. Jesus is our Healer and our Surgeon.

Through the posts on this website, I hope to explore the foundations of modern medicine from a biblical perspective. I hope to explore answers and show that faith and science are not opposed. What does it means to be human? How much more can we impact our care of the patient if faith is at the forefront?