Emmanuel

Behold, a virgin shall be with child, and shall bring forth a son, and they shall call his name Emmanuel, which being interpreted is, God with us.  Matthew 1:23 (King James Version)

It is difficult to appreciate the first century reality of this birth story.   It starts early when as children we learn this story.  A “YouTube” video wonderfully documents the Christmas story as reported by children.

A Kids View of the Christmas Story - YouTube

Diane Sawyer on 20/20, December 16, 2011, “Giving Life: A Risky Proposition” documents birth stories that more realistically and commonly occur in the world.   It is a “Mary Story”  of women giving birth alone with the real chance of mortality.   It is a longer and complicated story that fortunately is only rarely told in “developed” countries.

So here is the good news that shall be to all people, that even when we are most alone and vulnerable, God is with us.  Thanks be to God for his wonderful gift of Life.

Wishing you a Blessed Christmas,

Marvin

Healing on Trial

Walking down the street, Jesus saw a man blind from birth. His disciples asked, "Rabbi, who sinned: this man or his parents, causing him to be born blind?" Jesus said, "You're asking the wrong question. You're looking for someone to blame. There is no such cause-effect here. Look instead for what God can do.

  John 9:1-5 (The Message)

Recently, I saw a patient who reported that her last child was found to be blind when he was 3 months old; blind from birth.  I had seen this patient with that pregnancy and was unaware of this outcome.  It is still unclear in my mind how this happened!

I have also recently seen two movies that address how our contemporary culture understands healing.   These movies,  “Sympathy for Delicious” and ‘Lourdes” are similar in that our cultures are skeptical about the reality of healing; not unlike the report in John’s gospel (John 9:1-41).  We are no different than the disciples in the story and many times like the Pharisees who set out to investigate the cause and discredit the restoration of sight to this blind man.  We don’t “get it”! 

Much of my professional life has been looking for causes, effects  and prevention of birth abnormalities.   Sometimes, we know the cause and prevention responses but most of the time we do not see what God is doing!   We usually see only the “short stories”  and miss seeing the “bigger picture”.   In a paradoxical way the only way we see that larger vision of God’s healing work is to be a part of the story of suffering.  We recognize this big story in the witness and the work of people we call saints who have the “unconditional commitment to a place and a purpose”.  We do not believe that following Jesus is an easy path to avoid suffering and sometimes we finally come to believe that healing happens even when we don’t understand the underlying causes.

A witness of this Truth of God’s healing is Ken Medema.   He is a talented musician and a healing agent whose “blindness since birth” has given us all a new vision of God’s work in the world.   Check out his web site and if you have the opportunity, attend his performance of celebration and healing.

Marvin

The film “Lourdes” with English subtitles can be found on http://www.youtube.com

    search for “Lourdes film Full Movie Part (1 of 10)”

http://sympathyfordelicious.com/

http://www.kenmedema.com

Healing Agent Education

Dr. Paul Gray washing the feet of the Surgical Residents at Soddo Christian Hospital, Ethiopia (10/13/2011)

“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.” Modern Hippocratic Oath and Medical Education
"The term mentor doesn't do justice to what a great one does. ... A mentor does so much more than share his or her wisdom with the mentored. The mentor allows the protege to share in his or her achievement, an extraordinary gift. Moreover, the mentor puts his or her reputation on the line with every good word dropped about the mentored to people in power, every recommendation made. In that sense, mentoring is an act of faith." from “Still Surprised” by Warren Bennis
So he got up from the supper table, set aside his robe, and put on an apron. Then he poured water into a basin and began to wash the feet of the disciples, drying them with his apron. When he got to Simon Peter, Peter said, "Master, you wash my feet?" John 13:4-6 (The Message)

There is a challenge to how we see education with its inequalities in distribution and its conduct.  This is particularly true in how we see the spiritual challenges to healthcare education.  There is suspicion that medical education is still a guild or a exclusive union.

What was particularly impressive to me as what I would call a Christian version of a “White Coat” ceremony.  The report and the picture comes from Soddo Ethiopia as reported by a missionary wife.  I have come to the conclusion that to be a Healing Agent educator is more than the Hippocratic description, more than a mentor and more like the Biblical description of our model of the “servant educator”.  It does not preclude respect and mentoring but promotes the model of “servant leadership”.

If this can be true in a mission hospital in Ethiopia, can it be translated to developed countries?   Can it work for those who come from other traditions?  Can it change the perception of healthcare education by the public in this country?  This maybe a lesson where the “poor” help us rediscover the spirit of healthcare education.

Marvin

http://en.wikipedia.org/wiki/Hippocratic_Oath

http://www.amazon.com/Still-Surprised-Memoir-Leadership-Warren/dp/0470432381

http://en.wikipedia.org/wiki/White_coat_ceremony

Gift Reflections

Chicago Skyline as seen in the Cloud Gate -  Millennium Park

So Christ himself gave the apostles, the prophets, the evangelists, the pastors and teachers, to equip his people for works of service, so that the body of Christ may be built up  until we all reach unity in the faith and in the knowledge of the Son of God and become mature, attaining to the whole measure of the fullness of Christ.

Ephesians 4: 11-13(NIV)

There are real concerns about the ethics of gift-giving in healthcare, particularly when it has financial implications that are hidden and impact the patient without their knowledge or consent.  I would propose that there are other gifts that although frequently unseen are critically important to our vocation.  

We have been raised in an educational culture and have grown to believe that this is what sustains us.  Tactical educational responses of self-reflection, a mentor/coach or a new organization are proposed. *    What has surprised me are those unexpected gifts that have been critical to the direction of my life.  

One of those gifts is in "seeing again" that is more than self-reflection.  What became “common” leads to a kind of “blindness”.  We need to see again what we are doing.  Seeing again for me, has happened with “healing agent” children giving me the opportunity to revisit my vocation.  "Seeing again" is being a mentor or responding to a need in a new organization.

In another report, Atul Gawande, reports the importance of the gift of “other eyes”.**  The “other eyes” sees things that are difficult for the author/surgeon to see when he is focused in the performance of surgery.  A trusted senior colleague was the basis for finding a professional coach.  He reports that this new set of eyes was the way he is now seeing and responding to the hazards and challenges in the operating room. 

  

There is another gift that goes unstated and that is the gift of being invited into a trusting relationship with another suffering individual.   I have been blessed to be able to practice medicine for the last 44 years and involved in the education of healing agents and the recipient of the trust of patients.   That gift of “trust” is sometimes “earned”, but mostly one that is a freely given.  Like Atul Gawande, I have been blessed by relationships that have been gifts.  

Marvin

References:

*O'Connor M.  Walker JK. The dynamics of curriculum design, evaluation, and revision. Quality improvement in leadership development. Nursing Administration Quarterly.  27(4):290-6, 2003 Oct-Dec.

*Gaiser RR. The teaching of professionalism during residency: why it is failing and a suggestion to improve its success. Anesthesia & Analgesia.  108(3):948-54, 2009 Mar.

**Gawande A. Personal Best, October 3, 2011,  The New Yorker

A Right Mind

Those tending the pigs ran off and reported this in the town and countryside, and the people went out to see what had happened. When they came to Jesus, they saw the man who had been possessed by the legion of demons, sitting there, dressed and in his right mind; and they were afraid. Those who had seen it told the people what had happened to the demon-possessed man—and told about the pigs as well.  Then the people began to plead with Jesus to leave their region.

Mark 5:14-17(NIV)

Grace, mercy and peace from God the Father and from Jesus Christ, the Father’s Son, will be with us in truth and love.

2 John 1:3 (NIV)

“Dr. Gregory House” has become an iconic mythical figure in our culture.  He is not just a physician; he is a teacher.   He is looking for the “right diagnosis” but there is something “deeply wrong” with Dr House!   What should we call it?  What is your diagnosis?

What is fearful for all of us is the origin or etiology of the pain we see either in others or what we feel.   We look for words and names but more importantly we look for relief and if that doesn’t work we try to escape!   So like the incident in Mark, we are fascinated and yet fearful of what we see in “Dr. House”....it keeps us coming back but we wouldn’t want Dr. House to be either our physician or teacher.   The reality is that “IT” is more than pain, it is suffering!  “Suffering”, like birth, death and taxes, is what we all face.   Sometimes we give “IT” other names, but it is what we all confront!  

Dr. House, the residents and the patients are all suffering and looking for healing!  Dr. House’s strategy is a Socratic search for the truth with technology with clinical results that at best could be described as complicated.  The Mark account takes another approach and describes that healing looks like that is summarized by the phrase, “a right mind”.   This person who had no name, was physically and emotionally suffering now has a new life.  The problem is that even this good result makes the community nervous.  The community doesn’t want the healer to be around despite the “good outcome”.   

The “right mind” outcome is a gift of a peaceful and “purpose driven” life.  It has direction and seeks a shared truth and peace that is based in a extravagant Love that we call Grace.  Like the Mark account we still would rather pretend that we don’t need healing despite the suffering that we feel and see in this world.   It is a gift that we too often reject and or don’t share.  The good news is there are those in the world who are equipping healing agents and calling us to action.  Sometimes that looks like a Camp Geneva or a web site called the “The Peace Plan”.  

Marvin

Notes:

“A Right Mind” Dr. Laura Smit’s sermon title at Camp Geneva Worship Service August 28,  2011, Holland, Michigan

House and Philosophy: Everybody Lies  Edited by Henry Jacoby  John Wiley & Sons (2009)

Healing - Other Views

Photo by Vik Muniz - Waste Land* 

Then God came and stood before him exactly as before, calling out, "Samuel! Samuel!" 

Samuel answered, "Speak. I'm your servant, ready to listen."

1 Samuel 3:10 (The Message)

I have been impressed with the healing messages of some recent movies...“Waste Land” and “My Own Love Song”.  Both bring attention to Other Views of healing of some disadvantaged and unusual people.  The common theme for both these movies is the importance of being open to the healing power found within marginalized people and to some nontraditional methods of response to suffering.

Although one is a documentary and the other fiction, both share the method of using art as the catalyst for the healing story.  In many ways, the power of art, giving voice and form to relationships, is good news for lonely and marginalized people.  What is also the case is that it takes trusting and honest relationships to have the art materialize.  

In a recent analysis of responses to the needs in Africa, David Brooks outlines the virtues associated with altruism...courage, deference, thankfulness and “a noncontingent commitment to a specific place and purpose.”**   This kind of commitment is the basis of the relationships that are at the heart of healing.  For people of faith, we describe that noncontingent commitment as “calling” or as Leland Albright states in the David Brooks review “This is where God wants us to be.”


Marvin

* http://www.wastelandmovie.com/gallery.html

**http://www.nytimes.com/2011/08/23/opinion/brooks-the-rugged-altruists.html

Power, Politics and Healing

They sent some Pharisees and followers of Herod to bait him, hoping to catch him saying something incriminating. They came up and said, "Teacher, we know you have integrity, that you are indifferent to public opinion, don't pander to your students, and teach the way of God accurately. Tell us: Is it lawful to pay taxes to Caesar or not?"

He knew it was a trick question, and said, "Why are you playing these games with me? Bring me a coin and let me look at it." They handed him one.

   "This engraving—who does it look like? And whose name is on it?"

   "Caesar," they said.

 Jesus said, "Give Caesar what is his, and give God what is his."

   Their mouths hung open, speechless.

                                                                           Mark 12: 13-17 (The Message)

God's various gifts are handed out everywhere; but they all originate in God's Spirit. God's various ministries are carried out everywhere; but they all originate in God's Spirit. God's various expressions of power are in action everywhere; but God himself is behind it all. Each person is given something to do that shows who God is: Everyone gets in on it, everyone benefits. All kinds of things are handed out by the Spirit, and to all kinds of people! The variety is wonderful: wise counsel, clear understanding, simple trust, healing the sick, miraculous acts, proclamation, distinguishing between spirits, tongues, interpretation of tongues.  

All these gifts have a common origin, but are handed out one by one by the one Spirit of God. He decides who gets what, and when.

                                       1 Corinthians 12: 4-11 (The Message)

In a recent reports from Bahrain, physicians and nurses are being jailed for treating protesters in that country who have been participants in the “Arab Spring” protests - CNN Report and AMA request.  

The responses are arguments for “medical neutrality” of physicians and nurses in responding to any injured persons in times of violence.   Others have made the case for a social contract between medicine and society.*  It would appear that both of these arguments  have failed in Bahrain.

I have previously argued that the “telos” of healing agents does not include sponsoring state agendas even when the goals are laudable (December 24, 2010).   It seems even more obvious that the “telos” of Christian healing agents does not include torture and the denial of  care to the injured even if they have opposed the state’s agenda.  What should we do?

This brings me to modern Christian voices that opposed the state. The most instructive for me is  the writing of Alan Paton in his novel, Cry, the Beloved Country, and the challenge to the church in responding to apartheid in South Africa.  The book addresses the issue of racial violence in the struggle for justice.   The good news, despite the acquiescence of the church, is that God was at work to change an underlying evil.  I particularly love the last scene in the movie version of that book when in the face of death, Fundisi (James Earl Jones) goes to the beautiful mountains of South Africa to pray.  

As healing agents we need to look to the example of Jesus for models of response to the demands of the state.  Like Fundisi, we need to pray to the God of Abraham for relief to those who suffer for their practice of acts of healing and believe that God will be at work. 

Marvin

*Moreno, JD (2003) In the Wake of Terror: Medicine and Morality, MIT Press.

 Cruess SR. Professionalism and medicine's social contract with society.  Clinical Orthopaedics & Related Research.  449:170-6, 2006 Aug.

Minds, Bodies, Machines and Souls

And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.  

                                                                                     Genesis 2:7 KJV

da Vinci’s Last Supper

In the course of their meal, having taken and blessed the bread, he broke it and gave it to them. Then he said, Take, this is my body.  Mark 14:22 The Message

Western thought has struggled to integrate our minds and bodies.  Leonardo da Vinci became the personification of this integration as inventor and artist.  Now, we have come to a new depth of integration of machines, bodies and our minds.  The recent PBS Newshour looked at bionic research and we are confronted with some amazing responses to disability and limb loss - Bionic Bodies

How can we understand the implications of what we make and how it alters who we are?  Two recent and different responses give some important answers.

Ann Patchett in her recent novel, State of Wonder,  explores unintended consequences of fertility research in the Amazon.  It is a complicated story that tells a cautious tale of acting on our abilities to make new compounds.  

Allen Verhey in his recent book, Nature and Altering It, addresses the underlying assumptions about who we are in relationship to the the science and technology that have changed our worlds.   He uncovers the mythos that surround the ethos of our scientific endeavors.

The question then is not so much whether we make new tools and use them, it is more about the unintended results and how we become the “machines” that we make.  There are many examples and some with names like “da Vinci".

My summary is that our science and technology are not what is at stake, but our souls.  What we make and our bodies are not who we are.  So now, the task is too find ways of asking more hard questions about a world that we are creating and the bodies that we are altering.  

Marvin

Our Healing

How beautiful on the mountains 

   are the feet of the messenger bringing good news,

Breaking the news that all's well, 

   proclaiming good times, announcing salvation, 

   telling Zion, "Your God reigns!"    

Isaiah 52:7 The Message

He came to Nazareth where he had been reared. As he always did on the Sabbath, he went to the meeting place. When he stood up to read, he was handed the scroll of the prophet Isaiah. 

Unrolling the scroll, he found the place where it was written, 

   God's Spirit is on me; 

      he's chosen me to preach the Message of good news to the poor, 

   Sent me to announce pardon to prisoners and recovery of sight to the blind, 

   To set the burdened and battered free, to announce, "This is God's year to act!"

He rolled up the scroll, handed it back to the assistant, and sat down. 

Every eye in the place was on him, intent. 

Then he started in, 

"You've just heard Scripture make history. It came true just now in this place."

 All who were there, watching and listening, were surprised at how well he spoke. But they also said, "Isn't this Joseph's son, the one we've known since he was a youngster?"

He answered, "I suppose you're going to quote the proverb, 'Doctor, go heal yourself. Do here in your hometown what we heard you did in Capernaum.

                                                                   Luke 4:16-27 The Message

Most of the time our worlds get categorized into dichotomies...doctor/patient, teacher/student, nurse/patient, clergy/laity, us/them, etc.  These categories often carry with them a delusion of immunity and power.  The biblical story is that we are not immune and do not have the power.   Our healing is not distinct from those we serve.

We are vulnerable and sometimes we need to be at two different places at once...”providing care” and being “cared for”.   We know that sometimes we don’t have places to be “cared for” or we don’t  make use of the ones that are available.

One place to be “equipped” - to be a part of the suffering world - is the church.  It is a place where we can hear the “larger” stories of faith.  For Christians, the church has not only been a refuge but a community that believes that it has other responses to a suffering world.  The components can be prayer, meditation, singing, study and maybe even potluck suppers.   That is the wisdom for us as we read the visions of Isaiah and Jesus reading Isaiah in the “meeting place”.

There are many styles of response by churches*.  For some churches, “our healing” is part of its missional goal.   They focus on “equipping”  healing agents and sending them into a world of suffering.  This reality is named  “salvation” and for others “redeemed”, but what ever the word it is the basis of “Our Healing”. 


Marvin

*Dunlap, S. J. (2009). Caring Cultures: How Congregations Respond to the Sick. Waco, Texas: Baylor University Press.

Healing, HeLa and Heaven

"And that's not all. You will have complete and free access to God's kingdom, keys to open any and every door: no more barriers between heaven and earth, earth and heaven. A yes on earth is yes in heaven. A no on earth is no in heaven.”  Matthew 16:19 (The Message)

Rebecca Skloot, the author of The Immortal Life of Henrietta Lacks provides us with a long and wonderful story of healing that confronts the technology of cellular biology and the immortal  “HeLa” cell line.   This story identifies some surprising heros....an invisible patient, her family, a daughter who becomes a mother to the author and a researcher.

What I learned is that relationships and art are key ingredients to healing.  Chistoph Lengauer’s beautiful photo of the HeLa cells that previously have only been sources of pain; becomes a wonderful focus of communication and respect.   For scientists the art of the science maybe the best way to communicate when words and jargon only confuse and frustrate.  But art at its best must find meaning in the relationships with the communicants.  

By the art of storytelling, Rebecca Skloot, digs deep into the fractured relationships with a pilgrim’s persistence.   What is critical is that she is part of the healing story without diminishing the integrity of the others.   She becomes loved and through that love is able to hear and learn some remarkable truths.  

We are left with many unanswered questions at the end of this book.  I think the complicated questions of property and product will best be addressed by using the lessons previously learned.   We will need guidance and wisdom that may come from the patients and the community we serve; not just the voices of those who are the experts.

So what about the “heaven” part?...maybe that reality is when “the good” persists or as the title suggests is “immortal”.   We certainly know that when “the bad” persists it is “hell”.   So we can rejoice in the title, “The Immortal Life of Henrietta Lacks” as a “the good” that persists, a little bit of heaven here on earth.   Thanks for the life of Henrietta Lacks and the good that persists in her ongoing contribution to healing.

Marvin


For more information:   http://www.RebeccaSkloot.com

Good Courage and Healing

Be of good courage, and he shall strengthen your heart, all ye that hope in the LORD.

(King James Version)

Be brave. Be strong. Don't give up.
Expect God to get here soon.

Psalm 31:24(The Message)

In a recent book,  The Heart and the Fist: The education of a Humanitarian, the making of a Navy SEAL,  Eric Greitens connects two virtues, courage and compassion.  He states, “Without courage compassion falters, and that without compassion, courage has no direction”.  The most impressive part of the book is how he lives his beliefs through the work of his organization, “The Mission Continues”.  He writes about his time in Rwanda and reflects on a machete wound scar of a young girl states, "the world requires of us-of every one of us-that we be both good and strong in order to love and protect.”

Another recent book Love Wins:  A Book About Heaven, Hell and the Fate of Every Person Who Ever Lived, Rob Bell argues that there is another understanding of evil and that God’s love and specifically Christ’s love wins when confronting evil and suffering.   He also describes being in Rwanda (p. 70) with its visual artifacts of evil and is able to state, “God has been looking for partners ...(who) centered their hopes in God...the God who gives new spirits and new hearts and new futures.“

What I think both views come to is the reality of healing!   Both would agree that “good does overcome evil” but the source and process to the healing is seemingly different.  Eric sees it in discipline and dedication of the men and women he has met and studied.  Rob Bell sees it as gift from God that once accepted allows us a new vision of the world.

I give thanks for the healing agents, Rob Bell and Eric Greitens, who remind us of the importance of courage and love both as virtues and verbs!  God is at work in the lives and leadership of these men.  Thanks be to God!

Marvin

Faithful Minds

Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.

          Romans 12:2(NIV)

He answered, “‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind’; and, ‘Love your neighbor as yourself.

          Luke 10:27(NIV) 

About a year ago, I read the book, Fingerprints of God: The Search for the Science of Spirituality, by Barbara Bradley Hagerty.  What seems undeniable is that there are important neurologic markers of religious experience whatever your faith perspective.  What seems to be difficult is how this biology relates to the larger realities of our lives of faith.  More specifically, the studies look at individuals and not what happens between individuals.

Recently, I have had some challenging medical experiences.  What seems real to me is that the care and illness seems resonant with the larger stories of our Christian faith.   An “Easter Baby” is not resurrection, but it is a wonderful celebration of life in a world of death and suffering. 

This idea of spiritual resonance is not a new idea*.  It means that we see a new meaning in the facts of the care.  This is the narrative reality that we seek...how the facts fit together not just for the healing agent but how it can be understood by those who suffer.   It means that we need to be able to connect to those larger stories.   It means that we need to renew our minds and see that new reality.   It means that loving our neighbor is connecting with their stories as well as the larger redemptive story of faith, hope and love.

*A wonderful essay from Azusa Pacific University, “Love as Resonant Communication”, expands this theme of resonance.  Check it out. 

http://www.christianleadershipalliance.org/?resonantcom

Marvin

The Mystery of Healing

But he was pierced for our transgressions,
he was crushed for our iniquities;
the punishment that brought us peace was on him,
and by his wounds we are healed.

Isaiah 53:5 (NIV)

Bernini's The Ecstasy St. Teresa^*

In this season of Lent, we are confronted with the reality of death and the promise of healing.  How do we understand those realities?   Sometimes the answers are found in some unusual locations. 

In his epic novel, Cutting for Stone,  Abraham Verghese uses the vision of St. Teresa of Avila as a metaphor for the life and death of the Sister Mary Joseph Praise.  The story of maternal deaths is one that has occupied a large part of my professional life.   There are few harder questions than the causes and prevention of maternal death.  For me, the answer is summarized in the Latin phrase, “Mortui vivos docent” – “Let the dead teach the living”.   My focus has been on prevention and causes; but as Dr. Verghese implies there are important spiritual dimensions.  

St. Teresa of Avila’s impact is primarily related to her mystical visions and spiritual ecstasy.  We see this in the statue of Bernini that combines the apparent opposites of “piercing” with healing.  This is certainly a metaphor for the art of surgical healing; but what about death and healing?   Can we somehow see healing and death in the same story and statue?  Dr. Verghese makes that case in his novel!

I have previously seen this tragedy primarily from the perspective of the death of a mother and not as the reality of the orphans.   When in Africa, orphanages are a reality of lost generations of parents that have occupied the attention of religious organizations and NGOs.   The good news of  Dr. Verghese’s novel is the witness of foster parents.    So maybe the ecstasy that we can experience is found in that difficult but profound act of being a “parent”.   I think that is a lesson for the living!

“True religion is care for the widows and orphans”

“With God everything is possible”

*http://www.actlab.utexas.edu/~chelsea/pages/stTeresaVision.htm

Practitioner, Professor or Other?

The last and final word is this:
Fear God. Do what he tells you.
And that's it. Eventually God will bring everything that we do out into the open and judge it according to its hidden intent, whether it's good or evil.
                                                                   The Message Ecclesiastes 12: 13-14

But you are the ones chosen by God, chosen for the high calling of priestly work, chosen to be a holy people, God's instruments to do his work and speak out for him, to tell others of the night-and-day difference he made for you—from nothing to something, from rejected to accepted.
                                                                     The Message 1 Peter 2:9-10



I have read two recently published memoirs, Hannah’s Child and The Pastor. What is instructive for me is the movement between practicing and understanding the Christian faith. Both Stanley Hauerwas and Eugene Peterson have been prolific writers and Christian teachers. Their life journeys are mirrors of each other. Eugene Peterson moved from academy to pastor and most of his story is about being a pastor to a new congregation in Maryland. Stanley Hauerwas describes his life in the academies but finds fulfillment in the pastoral role. These stories should not be seen as vocational tension, but how practice and belief complement each other; how Christian living requires both and as a part of a larger story.

My medical vocation has been a strange dance of practitioner and professor. Just when I think, I have arrived at an identity; things change. It is as Peterson describes haphazard and at the same time intentional! What resonates with me and these two memoirs is the desire to be a witness to a larger story of God at work in the world.

For me the “patient congregation” is best appreciated when I have moved to new communities or countries. It means you wipe the slate clean. You bring what you have learned and taught into new and sometimes unusual locations. It means learning and teaching a new curriculum. When I have been with students you see the newness of the practice of medicine. The challenge is paying attention and realizing the limits of your professional preparation. Being with God’s people in these new places has been a blessing.

So for me these two memoirs challenge me to see that the vocation that we are called to is bigger than either practitioner or professor. That larger calling of the Christian journey is addressed by the “teacher” in Ecclesiastes. That final call is a clear challenge that is as much about outcomes as intent. It means that whatever our vocational titles all are subject to the duty to love God and keep his commandments and the bigger story of that royal priesthood in God’s Kingdom project.*

Marvin

*N.T. Wright, After you Believe: Why Christian Character Matters. HarperCollins, 2010

Mega-disasters

"Do you have any idea how powerful God is?

Have you ever heard of a teacher like him?

Has anyone ever had to tell him what to do,

or correct him, saying, 'You did that all wrong!'?

Remember, then, to praise his workmanship,

which is so often celebrated in song.

Everybody sees it;

nobody is too far away to see it.

"Take a long, hard look. See how great he is—infinite,

greater than anything you could ever imagine or figure out!

Job 36: 22-26 The Message

It has been overwhelming even for us who aren’t even directly affected by human or natural disasters ---people dying for causes and no specific reason. There are a lot of dead ends in our questions and responses to these human tragedies. We see the excitement of people searching for freedom as well as the brutal crushing military responses. We see our technical searches for energy sources become hazards to our global and personal health. We see the great forces of earthquakes and the limits of our preparations and response. Are these mega-disasters or is it just our ability to capture and share the reality with our new information technologies? At one level the individual loss of hope, life and future is a tragedy and a catastrophe. What also seems undeniable is the sheer volume of these tragedies... the definition of a mega-disaster where hope, life and the future is lost for whole countries in this world.

In 1952, J.B. Phillips published the book, “Your God is Too Small”. Despite that book, it appears our God, the God of Abraham and the Son of God, has continued to get smaller! The other observation has been that our counterfeit gods have gotten bigger. One response at this time of Lent is to re-examine, repent and redirect our understanding of who/what we commit our lives too. Maybe our denial of the reality of death means that we have not realized the sacredness of our lives. Maybe our hope has been misplaced on our technology. Maybe our faith has been focused on our idea of freedom when we need to rededicate our lives to service to those who suffer. Maybe we need to find humility and pray for forgiveness when we have come to believe that we are in control.

Like Job, I need to discover again how awesome is our God. That happens for me in the simple experiences of life where we see a God that continues to be present in lives of people of faith. They are a witness to a salvation that brings hope to whole nations of people who have been without hope. This is the mega-God response to mega-disasters. Praise be to God that is bigger than our mega-disasters.

Pilgrimage and Healing

 ¹ Some time later, Jesus went up to Jerusalem for one of the Jewish festivals. ² Now there is in Jerusalem near the Sheep Gate a pool, which in Aramaic is called Bethesda^[a] and which is surrounded by five covered colonnades. ³ Here a great number of disabled people used to lie—the blind, the lame, the paralyzed. ^{[4] [b] 5} One who was there had been an invalid for thirty-eight years. ⁶ When Jesus saw him lying there and learned that he had been in this condition for a long time, he asked him, “Do you want to get well?”  
John 5: 1-6

There is great confusion between the concepts of healing and cure. Cure is analogous to the extraction of the trapped Chilean miners. We like cures, but what we know is that the Chilean miners continue to suffer even though they are alive. How will the trauma they have sustained be redeemed? Will it come from more attention? Will it come from a pilgrimage?

The turmoil in the Middle East is overshadowing the story of the Chilean miners, “Pilgrimage of Thanks”. Here are the reports in the media:
http://www.jpost.com/VideoArticles/Video/Article.aspx?id=209466
http://www.nytimes.com/2011/02/25/world/middleeast/25miners.html

What have we learned? We love cures but healing is a larger idea. Pilgrimage is a good description of the journey that at its core is a metaphor for healing. Healing takes time and we are impatient and look to a quick technical response.

But is pilgrimage more than a metaphor? Maybe artifacts of the historic faith that was a gift to the miners will give them new strength. Maybe a Jewish prayer shawl will bring healing. Maybe it will happen quietly in the broken spirits of these men. What we should pray for is that the faith that we saw in the lives of the miners will continue to be a witness of their continued pilgrimage of healing to a world in chaos.

p.s. See the prior post “An International Healing Parable” – October 31, 2I010

"Watson" vs. Dr. House

It started out as a typical encounter...reporting the results of the ultrasound to the patient and her husband. On finishing, the patient’s husband states, “You should have been on House!” Before I could respond, the patient said, “Ya, but he is nicer”. I was uncertain how to respond to what might have been a criticism or a complement.

That evening the CBS news reported on the utility of “Watson”, the intelligent computer that successfully defeated prior champions on the game show “Jeopardy”. As a part of that report we heard about the success of “Watson” as a diagnostician in clinical trials. We were reassured not to worry that physicians would not be replaced by intelligent computers.

The obvious conclusion is that we should expect a “House MD” show that will play out the defeat of “House” by “Watson”, the technology he loves. This looks like Greek mythology with larger than life characters and principles in a cosmic struggle. I must admit that I hope we will see “Watson” soon on “House MD”! It would be an interesting story.

The reassurance by physicians on the CBS news seems less reliable to me since although technology has provided wonderful improvements in care, it has been at a high price! Complaints about the impersonal nature of healthcare seem to be played out in the character of Dr. House with little mention of the costs even though it is a primary concern of health care resource allocation. Maybe most importantly, it seems to me that healthcare technology is one of those counterfeit gods that seduce all of us into believing we can control our lives.

http://www.cbsnews.com/video/watch/?id=7357134n

http://www.fox.com/house/

http://www.amazon.com/Counterfeit-Gods-Empty-Promises-Matters/dp/0525951369#_

http://www.businessweek.com/magazine/content/09_44/b4153056904077.htm

Pupils/Patients – Teacher/Doctor

In 1995, I attended the AAMC (American Association of Medical Colleges) meeting where George Will was asked to comment on the public’s understanding of medical education. His response was simply “They don’t have an understanding!” That could be changing given two recent events!

There are two healing conversations that have recently occupied my attention. The first is the movie “The King’s Speech” and the second the play “Let Me Down Easy” by Anna Deveare Smith. Both are opportunities to examine the character of healing. In the movie we see a history of a royal British healing and the other we see the complex current state of healthcare in the United States. Both stories have been acclaimed at a time when serious conversations about healing are not popular.

It is hard to understand the popularity without a sense that in both these stories there is a concern about the roles we play in the interactions of two people in a modern world of anonymity. We usually talk about the patient/doctor relationship and less about the pupil/teacher one. What I think is the reality is that the best aspects of healing are found when we see the educational dynamic as the basis of healing in the patient/physician interaction.

The play is an educational conversation that started at the Yale School of Medicine to provide a view of medicine that is opaque to many physicians. “The King’s Speech” provides a view of healing that has more to do with teacher/pupil relationships. We see the pain in both the teacher and pupil as they live out a relationship that “healed a nation”. Both stories have a basis within a Christian history of the impact of the church as both a stimulus for educational and healthcare institutions. We still see that dynamic at work in Christian missions of education and healthcare in the developing world.

My hope is that both stories generate more serious healing conversations by virtue of their availability and visibility.

“Let Me Down Easy”

http://www.pbs.org/newshour/bb/entertainment/jan-june11/deaveresmith_02-07.html

http://video.pbs.org/video/1330271871/

“The King’s Speech”

http://www.kingsspeech.com/

http://www.christiancentury.org/article/2011-01/voice-lessons

Peace from Above

Yesterday (1/22/2011), I had the opportunity to visit two very special organizations. The first Kazuri (www.kazuri.com) and the other Amani ya juu (http://www.amaniafrica.org/) are both organizations that promote the status of women in some unique ways. Kazuri provides employment for women by making beads and Amani provides employment for women by sewing wonderful quilts that tell the story of reconciliation.

Here is what seems to be the basis of their success. First, they have big ideas but have pursued them in small ways. Thinking about helping marginalized women is a big idea but their responses have been small steps that have resulted in growing effective organizations. Second, they both have found art as a medium to communicate their mission to other women. There is truth in beauty and what they create is truly beautiful.

What was exciting to see at Amani was a new focus on the importance of children as “vehicles” of learning and passing this peace. These women have a joy, vision and approach to healing that we all should support!